I think my gecko has had a hemipenis prolapse, I’m not sure.

I am sincerely ***** ***** there was a delay in someone responding to your question. (Experts are independent contractors and as such are online based on their own schedules.) However, I am available and can assist you if you still need veterinary advice.

Hello and thanks for posting your question on JustAnswer.com. My name is***** and I have been a licensed and accredited veterinarian in the US for over 22 years, specializing in aquatics, reptiles, amphibians, avian and other exotic species. JustAnswer is a question and answer service, not a veterinary telemedicine or emergency service. On this platform veterinarians can provide insight and advice based on the information you provide, but as this is not considered a legal client-patient relationship and we cannot examine your pet, we are unable to provide definitive diagnoses, prescribe medications, provide medical records or sign documents for your specific pet. For any of those you would need to make an in person visit with a local veterinarian. If your pet has a serious illness or life-threatening emergency, I strongly recommend you obtain hands-on veterinary care with a local veterinarian or veterinary emergency service as soon as possible. I am happy to chat with you via the JustAnswer app via text. For US based clients, if you are interested in a phone call instead that is an option you can choose for an additional charge. In the meantime, I am putting together some questions and/or suggestions to help with your pet’s concern.

Thanks again for posting your question, I’m sorry that your leopard gecko Clyde is under the weather and may be experiencing recurrent hemipene prolapses. I have some questions that will help me get a better idea of your pet’s environment and what may be going on with them:

-Is the tissue still prolapsed? If so, what color is it?

-What is the current tank set-up, e.g.,

Temperature (cool side, warm/main area, hottest basking temp) and humidity?

-Do they receive any access to UV light? When was the UVB bulb last changed out?

-Have they been eating normally?

-What do you usually feed them? Do they receive any calcium or vitamin supplements?

-Have they been pooping regularly and has it looked normal?

Thanks very much for providing additional information, it is very helpful for me to try and figure out what is going on with your gecko and the history information will help me to do that.

If you can upload a photo or video that might be helpful so I can see the tissue that is prolapsed (if it is still that way). You can do so using the upload attachment (paperclip) icon below the text field. Note that uploads must be smaller than 5 Mb to upload properly.

With any ill gecko, it is always a good idea to start by checking that their environment and husbandry are proper for their species. Taking a physical measurement of the temperature gradient within the enclosure and measuring humidity with a hygrometer are a good idea. Making sure the UVB bulb is appropriate for the size of the space and has been changed regularly. Even if they are still producing visible light, UVB bulbs have a limited lifespan and need to be changed every 6-12 months, depending upon bulb type. Making sure diet is varied and the insects have been gut loaded with a nutritious gut-loading diet as well as dusted regularly with calcium and multivitamin powder. Therefore, I am attaching a leopard gecko care (husbandry) reference sheet that I put together. Please review it at your convenience and let me know if you have any questions.

For example, if the environmental temperatures are too low, since geckos are cold-blooded, this will negatively affect their metabolism, appetite, digestion and immune function. So start by checking the temperature gradient in the enclosure and, if it's too low, adjust your basking light or get a stronger watt bulb so you are achieving the proper environmental temperatures. Also proper humidity is very important for overall and skin health, with 30-40% humidity in the main enclosure and 70-80% in the moist hide.

In the meantime, I will give you some information about what may be causing these signs, a care sheet with recommendations about environment and diet as some common medical conditions are unintentionally caused by improper husbandry (such as too low temperatures, humidity, UVB lighting or calcium and vitamin supplementation) and some suggestions for home care and support of your ill gecko.

A prolapse of tissue from the vent of the gecko occurs when an internal tissue or organ (such as the cloaca, urinary bladder, hemipenes or uterus or part of the GI tract such as the small or large intestines) abnormally protrudes through the vent. Prolapsed tissue that does not or cannot go back inside on its own in a timely manner is a potentially serious medical problem that does require veterinary care. Prolapsed tissue may become traumatized by the environment, bitten by a tankmate, or so swollen that blood flow becomes cut off and the tissue begins to die.

While geckos can evert their hemipenes (the dual copulatory organs at the base of the tail) voluntarily, if they are unable to be retracted they can become abnormally swollen and damaged. In females that are pregnant if there is problem laying eggs due to unusual egg size or low blood calcium, the reproductive tract (such as the uterus) can prolapse. Other internal organs such as the cloaca, large or small intestines may prolapse if the lizard has internal parasites causing loose stool and/or straining to defecate. It is not normal for these organs (other than the penis) to evert through the vent and this does require medical treatment. I highly recommend that you call your local exotics/reptile veterinarian or veterinary ER to have Clyde locally evaluated and treated.

To help find a local veterinarian with reptile experience, here is a useful website you can use to search for a local reptile veterinarian. These veterinarians are active members of the Association of Reptile and Amphibian Veterinarians, which means they have interest and experience in treating reptile patients:

https://arav.site-ym.com/search/

(please note this site may not work on older browsers like Safari)

Please note that since you are outside the US, you will need to choose Advanced Search.

Advanced Search: Step 1 of 2, Member status

Select/toggle honorary member, life member, new grad, active veterinarian, and associate.

Press Continue.

Advanced Search: Step 2 of 2

Use the drop down menu in Country to select your country. Press Search.

While you are waiting to take your gecko to the vet, there are a few things you can do to try and keep the prolapsed tissue healthy. First you should physically separate Clyde from other tankmates to prevent the tissue from being bitten. You can gently rinse the exposed tissue with room temperature or slightly warm water to clean it off. If you have some non-spermicidal, water-based lubricant, you can put some on the exposed tissue and gently wrap the lizard’s hind end, including the prolapsed tissue, gently in clingfilm. This will help keep the tissue moist. If you don’t have any water-based, non-spermicidal lubricant, no worries, instead you can place some clean gauze or kitchen roll moistened with water over the prolapsed tissue and then wrap the lizard’s hind end with clingfilm. I don’t recommend using toilet paper (loo roll) as it breaks down too much in water.

Lastly, if the tissue appears very engorged, swollen and red, you can try to reduce the swelling by treating the tissue topically with either a paste made by mixing table sugar and water or by applying some honey gently onto the prolapsed tissue. After applying this, wrap Clyde’s hind end with moistened gauze or kitchen roll and then wrap with clingfilm. I would recommend only doing this for an hour or so at a time, then rinsing gently but thoroughly with room temperature or slightly warmed water. This can be repeated 2 or three times during the day, but make sure you rinse off the sugar well between treatments. While you are waiting to see the veterinarian, keeping your lizard on, clean, non-abrasive substrate would be advised, e.g., moist toweling or moss, rather than gravel, peat, dirt, etc.

It's also a good idea to double check underlying husbandry to make sure it is proper. Therefore I am attaching a leopard gecko care sheet I put together as reference. Please review this at your convenience and let me know if you have any questions.

Ah, sorry, I thought Clyde was a leopard gecko, my mistake, as he is an African fat tailed gecko. The information I have provided is still the same, but please disregard the leopard gecko care sheet as that is for leopard geckos, not African fat tailed geckos.

I am attaching the care sheet I put together for African fat tailed geckos. Please review it at your convenience and let me know if you have any questions, thanks.

The bottom line is that you can try the home care methods suggested but for a recurring vent prolapse or for one in which the tissue does not internalize quickly on its own, hands on veterinary care is required as soon as possible.

It’s especially important if your African fat tailed gecko is sick or injured to make sure that their tank is clean, food is fresh and prepared hygienically and that the temperature is appropriate and that your UV-B bulb is in proper working condition. Here are some additional recommendations of how you can support your ill African fat tailed gecko while they are awaiting a veterinary evaluation:

-Keep them warm. Temperature is very important for keeping your AFT gecko healthy with a gradient of temperature from cool to warm. Daytime temperature range with a cool side at 72-75F (22.5-24C), a warm zone at 78-85F (25.5-29.5C) and a very warm, focal basking area of 90F (32.5C). Nighttime temperature can and should be cooler, but no lower than 65F (18C).

But if they’re not moving around much on their own, place them in an area of the tank that is around 85F (30C), but not on top of a hot rock or under the hottest basking area as they can overheat or get burned.

-To prevent or treat dehydration, you can give your gecko a soak in a shallow dish of warm water (85F, 30C) for 15-30 minutes twice a day. Or if they are too weak to be in water, you can help with hydration by placing them in a small, plastic or glass container lined with moistened paper towels for 15 minutes two to four times per day. Cover the container with the snap on lid or with clean cling film and poke holes in the lid or cling film to allow for air flow. Place the container into the enclosure where the temperature is around 85F for the 15 minutes so they stay warm during the soak

Dry them off after the soak so they don't cool off too much.

-Make sure you wash your hands with warm water and soap after handling your gecko or their cage furniture.

-Make sure the enclosure is clean as built up waste, dust and other irritants can predispose your animal to infection. Spot cleaning daily but cleaning the enclosure more thoroughly at least once monthly with a reptile safe disinfectant is recommended. F10 Veterinary Disinfectant is a good option, safe with reptiles and comes pre-diluted and ready for use in a spray bottle. You can also consider lining the tank with disposable unbleached paper towels or newspaper while they are ill to make cleaning easier. The papers should be changed out daily or more frequently if they become soiled. Also, since they defecate into their water bowls often, cleaning the water bowl daily with soap and warm water before refilling it and weekly disinfection of the bowl is a good idea while they are ill (normally, it's okay just to do a daily rinse and refill of the water dish with 1-2x per week washing/disinfection).

-Offer food, even if not eating. If your African fat tailed gecko is having difficulty reaching or getting to their food, put the food dish next to them or you can also hand or tong feed them. Place an insect gently against their lips and if they are hungry, they will bite at it. If not, don’t force it.

If needed (if inappetence is prolonged), you can assist feed whole, calcium or multivitamin dusted insects (I recommend removing their heads first) or you can syringe feed them a replacement formula like Fluker’s ReptaBoost, EmerAid Intensive Care Carnivore, Oxbow Animal Health Critical Care Carnivore.

Outside the US if these options are not available you can try Vetark Critical Care Formula (not ideal as a long term replacer as it is grain based).

Another option is to assist or syringe feed Repashy Grub Pie for reptiles. It's a diet that is normally mixed with boiling water and then allowed to set up into a solid to make a gel food to feed to insectivorous reptiles. But if you mix it with room temperature (not boiling) water, more water than the package recommends, to make a slurry that is thin enough to go through a syringe, it can be used for syringe feeding. Or you can make it according to the package directions, using boiling water to make a gel that sets up, then cut the gel into pieces that you can then assist feed (like you would assist feed an insect). This formula is nice because it's based on insect and fish based protein and has a good variety of vitamins. Treat any gel you make like you would fresh fish, store leftovers in the refrigerator and discard after a day or two.

With any assist or syringe feeding, go slowly and don't feed too quickly to prevent choking. If you’ve never done this before there are some good online videos that you can watch first such as these (these videos are for leopard geckos but the procedure is the same for AFT geckos):

Assist feeding an insect by hobbyist Garrett Rose (I do recommend pinching the insects head off first so it is dead before assist feeding if your gecko is sick or lethargic so they are not injured by the insect):

https://youtu.be/cN5Uaoqmrg4

Syringe feeding by exotic pet veterinarian Dr. Kristin Britton:

https://youtu.be/Fq0fGmLNP-4

-Limit and be gentle with handling. If they are ill, limit handling and limit time out of the enclosure. If you must lift or remove them from their tank, go slowly and support their weight from underneath with your palm.

-Calcium and vitamin supplementation. It is important to still offer calcium and vitamin supplements if they are eating. More information about supplements is in the care sheet I shared with you. An excellent brand of multivitamins I highly recommend is ZooMed Reptivite with D3. There are a number of good reptile calcium brands on the market, if you need a recommendation on those, please let me know.

If they are prolapsing because they are experiencing a severe calcium deficiency related to Metabolic Bone Disease or dietary insufficiency or if they are not eating for another reason, you can buy a liquid calcium supplement at the pet store and give them a drop into their mouth once a day and this should help, but isn't a replacement for proper nutrition and a veterinary evaluation and treatment.

Fluker's Liquid Calcium Reptile Supplement

If they are experiencing signs of hypovitaminosis (A or D) or if they are not eating for another reason, then you can buy a liquid multivitamin supplement at the pet store and give them 2 drops for every 50 grams of body weight, twice a week. If they are not eating, then you can give this supplement every other day for a week before decreasing to twice weekly, while they are not eating. The supplement can be placed onto a food item before feeding or dropped directly into their mouth if they are not eating. Once they are back to eating or no longer have signs of a vitamin deficiency, this liquid supplement should be stopped in favor of multivitamin powder dusting of food and gut loading of insects, as described in the care sheet I shared with you.

Fluker’s Liquid Vitamin (Reptile Supplement)

It is also a good idea to re-evaluate your current husbandry practices as some common disorders, such as metabolic bone disease, are caused by deficiencies or imbalances in diet, UVB lighting, calcium/vitamin supplementation or improper environmental temperature or humidity. Therefore, I have already attached a general African fat tailed gecko care sheet for you to review. Thanks.

I should be notified if/when you respond with additional information so we can connect about your African fat tailed gecko Clyde but, in the meantime, I hope this information is helpful and I wish you both the best. Thanks again for posting your question to JustAnswer.com. Sincerely, ***** *****