# Reptilian Cryptosporidiosis



## GlasgowGecko (Feb 23, 2008)

*Reptilian Cryptosporidiosis*

Cryptosporidium serpentis described from snakes (Levine, 1980) and C. varanii (syn. C. saurophilum) described from lizards (Pavlasek et al., 1995; Koudela and Modry, 1998 ) are the only valid species, although as many as five species of Cryptosporidium infecting reptiles have been suggested based on oocyst morphology (Upton, 1990) and molecular studies (Xiao et al., 2004). Cryptosporidium serpentis infections in snakes and C. varanii infections in lizards are acquired for a lifetime, and self-cure was not observed (Cranfield and Graczyk, 1995, 2000, 2006; Cranfield et al., 1999). Although C. serpentis has been described from snakes, this species is virulent for lizards, and C. varanii described from lizards is virulent for snakes (Koudela and Modry, 1998; Xiao et al., 2004).

Cryptosporidium serpentis preferentially infects the stomach, whereas C. varanii preferentially infects the intestine of snakes and lizards. Cryptosporidiumhas been reported in approximately 80 species of reptiles, including snakes, lizards, and tortoises (O’Donoghue, 1995; Fayer et al., 1997; Graczyk et al., 1998; Cranfield et al., 1999, 2000;
Xiao et al., 2004; Cranfield and Graczyk, 2006). Most reports described clinical and subclinical infections in captive reptiles, whereas only subclinical infections have been reported in wild reptiles (Upton et al.,1989; Graczyk et al., 1997). Cryptosporidiosis is a common and sometimes life-threatening disease of captive snakes, lizards, and tortoises (Cranfield et al., 1999; Cranfield and Graczyk, 2000, 2006; Brownstein
et al., 1977).

*A. Clinical Signs and Pathology
*
There are two manifestations of Cryptosporidiuminfections in reptiles: subclinical (i.e., carrier state), and clinical (i.e., gastritis, enteritis, and gastroenteritis) (Cranfield and Graczyk, 1995, 2000, 2006). Healthy reptiles are able to intermittently pass oocysts for years, oscillating between periods of excreting high numbers of oocysts to periods that are oocyst negative by acid-fast staining techniques. The prevalence of subclinically infected shedders can be high in a reptile collection (Carmel and Groves, 1993; Cranfield and Graczyk, 1995, 2000, 2006). Subclinical infections can be difficult to diagnosis
because of the low oocyst output, sometimes far below the detection threshold of 3.75
x 104 oocysts/g (Cranfield and Graczyk, 2006; Graczyk et al., 1995, 1996), and intermittent patterns of oocyst voiding. 

Clinical signs in snakes are associated with gastric hyperplasia of the mucus-secreting cells (Brownstein et al., 1977). Snakes often have foul-smelling diarrhea and midbody swelling with reduction in lumen diameter; they can live from a few days up to 2 years after the appearance of clinical signs
(Cranfield and Graczyk, 1995, 2000, 2006). Weight loss often occurs with persistent or periodical postprandial regurgitation 3 to 4 days after a meal. The gastric mucosa appears edematous with mucosal thickening and exaggerated longitudinal rugae that have copious amounts of mucus adhered to it. The surface may exhibit petechiae, enlarged rugae, excess mucous, and multiple foci of necrosis. Microscopy of gastric tissue reveals hyperplasia and hypertrophy of gastric glands, atrophy of granular cells, edema
of the submucosa and lamina propria, and inflammation of the gastric mucosa characterized by infiltration with lymphocytes and heterophils. Cryptosporidium
infections in lizards has been associated with acute enteritis and bacterial gastritis
(Dillehay et al., 1986; Frost et al., 1994; Terrel et al., 2003; Taylor et al., 1999). Clinical signs include weight loss, anorexia, lethargy, and diarrhea. Histological examination usually reveals hyperplasia and mononuclear inflammation of the small intestine.

*B. Diagnosis of Cryptosporidium Infection in Reptiles*

1. Barium
In snakes with postprandial regurgitation and midbody swelling, a barium study is useful to differentiate between gastric occlusion due to mucosal swelling and a nongastrointestinal mass (Cranfield and Graczyk, 1995, 2000, 2006).

2. Fecal Examination
Historically, oocysts have been identified in reptile fecal specimens by examination of direct fecal smears stained with acid-fast stain. Epitopes of C. serpentis oocyst wall antigens produce positive reactions with fluorescein-labeled monoclonal antibodies that are commercially available. The MERIFLUOR test is over 16 times more sensitive than acid-fast stain for detection of C. serpentis oocysts (Graczyk et al., 1995). However, even with the increased sensitivity of the immunofluorescent antibody (IFA), multiple negative fecal tests must be performed to raise the confidence level that a snake is truly negative
for Cryptosporidium. Oocysts of Cryptosporidium mouse genotype are frequently seen in captive reptiles, which can confound the diagnosis of cryptosporidiosis (Xiao et al., 2004).

3. Endoscopy
Endoscopy requires expensive equipment, and visual images of the gastric rugae and intestinal epithelium are difficult to interpret (Cranfield and Graczyk, 1995, 2000, 2006).

4. Gastric Lavage and Cloacal Swabs
Gastric lavage and cloacal swabbing can be performed on inappetant and nondefecating reptiles (Graczyk et al., 1996). Cloacal swab smears were demonstrated to be far less effective than gastric lavage smears. Because the pathogen resides in the stomach area, it is expected that in nondefecating reptiles higher concentrations of oocysts would be found in stomach aspirates than in cloacal swabs. Gastric lavage is performed by passing a tube into the stomach located at the midpoint between the head and the cloaca of a snake. Phosphate-buffered saline (equal to 2% of total body weight) is passed through the tube into the stomach and then aspirated with the snake held head down, retrieving approximately 50% of the administered fluid. The aspirate is centrifuged and a smear prepared from the pellet. Stomach aspirates contain little particulate matter and, therefore, acid-fast stain detection is nearly as sensitive as IFA staining (Graczyk et al., 1996). Additionally, it was noted that the gastric lavage test was more sensitive if performed within 3 days of eating (Graczyk et al., 1996). Because the metabolic rate of gastric mucosal tissue increases over 22 times after a meal, it is proposed that the
Cryptosporidium
reproductive cycle increases with the metabolic increase in the gastric mucosa. It may be beneficial to administer an appropriate baby food via a stomach tube meal to an inappetant reptile 3 days prior to the stomach lavage.

5. Regurgitated Material
Examination of smears of the parasite-rich mucus surrounding a regurgitated meal utilizing either the acid-fast or IFA stain can provide a definitive diagnosis (Cranfield and Graczyk, 1995, 2000, 2006).

6. Gastric Biopsies
This is a relatively safe procedure that can aid in the prognosis of a case when
Cryptosporidium developmental stages are found in the biopsy material. However, the nonuniform distribution of the pathogen on the gastric mucosa or intestinal epithelium makes a negative outcome difficult to interpret (Cranfield and Graczyk, 1995, 2000, 2006).

7. Serum Antibody Test
Serum antibody enzyme-linked immunosorbent assay (ELISA) utilizing C. serpentis
oocyst wall antigen has shown great sensitivity and specificity in surveys of reptile collections and in blind studies (Graczyk and Cranfield, 1997). The test diagnoses exposure to Cryptosporidium and can identify Cryptosporidium negative reptiles to establish pathogen-free colonies, and for selection for Cryptosporidium research.

8. Postmortem Examinations
Several stomach and intestinal (for C. varanii) tissue sections should be obtained for histological examination (Cranfield and Graczyk, 1995, 2000, 2006). On rare occasions,
Cryptosporidium positive reptiles diagnosed on fecal samples were found to be negative on postmortem examination when limited samples of gastric tissue were collected.

*C. Treatment*
Treatment regimes for reptiles have originated from the experiences of human and domestic animal treatment. The high morbidity and moderate mortality caused by
Cryptosporidium in ophidian collections is due to the lack of anticryptosporidial pharmaceuticals that can be safely and efficaciously used for prophylaxis or therapy (Cranfield and Graczyk, 1995, 2000, 2006). For reptiles, trimethoprim sulfa (30
mg/kg) once a day for 14 days and then 1 to 3 times weekly for several months, spiramycin 160 mg/kg for 10 days, and paromomycin at 100 mg/kg for 7 days and then twice a week for 3 months has been used (Graczyk et al., 1996). Halofuginone, paromomycin, and spiramycin reduced the number of voided oocysts, but did not eliminate infection as determined by histological sections. Furthermore, halofuginone
was severely hepatotoxic and nephrotoxic for snakes that were already physiologically debilitated by chronic Cryptosporidium infections. Trimethoprim-sulfamethoxazole and trimethoprim-sulfadiazine treatment resulted in oocyst-negative stools, but gastric biopsies of treated snakes revealed the pathogen in the mucosa (Cranfield and Graczyk, 1995; Graczyk et al., 1996). Therapy based on the protective passive immunity of hyperimmune bovine colostrum (raised against C. parvum in dairy cows immunized
during gestation) was efficacious in treating subclinical and clinical C. serpentis
infections in snakes and lizards (Graczyk et al., 1998, 1999, 2000). Six gastric colostrum treatments, delivered at 1% of the snake’s weight at weekly intervals histologically cleared C. serpentis in subclinical infections and regressed gastric histopathological changes. Supportive treatments, such as high temperatures, subcutaneous fluids, regular stomach tubing of highly digestible foods, and the elimination of any concurrent
disease problems, appear to act synergistically with treatment aimed at Cryptosporidium.

*D. Prevention and Control*
Cryptosporidium can be transmitted directly via the fecal-oral route or indirectly by contamination of food or water, e.g., utensils, feeding bottles, and cages (Cranfield and Graczyk, 1995, 2000, 2006). The oocysts, which are fully sporulated and infectious when excreted, are resistant to environmental stressors and to a wide range of commonly used disinfectants. Ammonia (5%) and formal saline (10%) were the most effective in altering oocysts’ infectivity after 18 h at > 4°C (Cranfield and Graczyk, 1995). Strict high-standard hygiene, good management, and isolation of infected animals are essential in prevention of spreading of Cryptosporidium within captive reptiles.


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## Julie&James (Sep 24, 2007)

Thanks for this, not been keeping reptiles as long as some and i was wondering what Crypto was.


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## GlasgowGecko (Feb 23, 2008)

I was hoping to give some information here that is less commonly available, but quite important. I really think this is something people should read and be aware of. I'm not an expert but i'm happy to discuss it with people, and for people to supplement what is here with other information.

Andy


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## zemanski (Jun 15, 2008)

it would be useful to have a list of papers like this on each of the common parasites and infections as a sticky

thanks for the information


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## Yavin (Sep 12, 2008)

Might be an idea to dumb it down for people. I found it a very interesting read. thanks.


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## GlasgowGecko (Feb 23, 2008)

I Know what you mean, but I'm not sure dumbing it down is the best idea. But, I'll do my best to answer any questions people have about it.

Andy


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## GlasgowGecko (Feb 23, 2008)

Oh, and If any one is interested I can give you the reference list for this paper.

Andy


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## jon harvey (Aug 29, 2007)

Good info. I am currently anxiously waiting for test results to come back hoping that my Dragons are not infected.


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## Nebbz (Jan 27, 2008)

woo nice job! its a nightmare when i was looking up illnesses on google trying to find one that makes sence, and this it does:notworthy::2thumb:


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## GlasgowGecko (Feb 23, 2008)

Nebbz said:


> woo nice job! its a nightmare when i was looking up illnesses on google trying to find one that makes sence, and this it does:notworthy::2thumb:


Cheers mate.

I guess some will find it hard going, but its worth a read. We could maybe do with a section for illness, with some break downs. Not that I'm suggesting self diagnosis, just that a lot of less reliable information gets passed around, and some times its useful to know a few facts.

Andy


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## Harrison (Feb 29, 2008)

GlasgowGecko said:


> Oh, and If any one is interested I can give you the reference list for this paper.
> 
> Andy


Ah, I thought it was your own writing. Could you reference the paper please? Thanks.

Cheers for pointing it out on the forums. : victory:


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## GlasgowGecko (Feb 23, 2008)

I just meant the references for the paper....

and do you want them pm'ing or posting?

Andy


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## sallyconyers (Mar 21, 2008)

Interesting read - I'm hoping to do some tests on the faeces of my own Leos and fat tails so very handy for me to use in the lab!


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## GlasgowGecko (Feb 23, 2008)

Fecal tests are pretty easy when you know what your looking for... but then this is the critical point. Determining the difference between the various eggs/oosyts is pretty tough. But with a good grip of microscopy you should be ok. 

On a related point though, if you discover oosyt like structures, I would not recommend self medicating... still best to check with a vet (unless you are truly sure...).

Andy


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## zemanski (Jun 15, 2008)

I just posted this 

http://www.reptileforums.co.uk/lizards/220394-understanding-reptile-parasites.html


a very good book:no1::no1::no1:


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## Shelly24 (Aug 28, 2008)

can you dumb it down for me please?! lol. I dont understand atall. 
What are the symptoms in a leo?


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## hollypops (Nov 3, 2008)

Found this on net-.......Crypto lives in the intestine of infected humans, birds, fish reptile and other animals. Millions of Crypto can be released in a single bowel movement from an infected specimen. Infections occur after oral consumption of the parasite. Crypto may be found in soil, food, water, or surfaces that have been contaminated with the feces from infected humans or animals. Crypto is not spread by contact with blood. 

It is a parasite.


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## GlasgowGecko (Feb 23, 2008)

Hey Shelly,

Unfortunately the symptoms for infection with cryptosporidium that the normal keeper can spot are very similar to those of any other parasite infection. That being said, things to look out for are rapid weight loss and diahrea. Not that these syptoms are unique to this condition, but are pretty indicative of parasites, and so a good clue to get a fecal done.

Hope this helps.
Andy


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## Shelly24 (Aug 28, 2008)

oh right, thanks for that, well mine has very bad weight loss however hasnt poo-d atal in 5 weeks so cant get any samples tested.


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## geckogirl85 (Oct 18, 2008)

Shelly24 said:


> oh right, thanks for that, well mine has very bad weight loss however hasnt poo-d atal in 5 weeks so cant get any samples tested.


my little one didnt poo when she had krypto cos she wasnt eating anything to poo it out. i saw her in my local rep shop and knew she was sick and the guys there let me take her home to fix her up cos i could give more time than them. unfortunately it was far too late, she was only 14g when i took her home. after a onth the only good thing i could do for her was to take her to vets to be sent to heaven. all her muscle had wasted away and she had nothing, no energy or anything. could barely open her eyes.


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## Girl (Feb 24, 2009)

Is there any ways of prevention?
Or is it unknown as to why some pick up this, and just carry out a good hygiene practice as usual and hope its not passed on?!


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## GlasgowGecko (Feb 23, 2008)

The best method of prevention of spread is a very rigourous cleaning regime. This means that all routes of transmission between tanks are prevented.
However, in a large majority of cases it is unclear how the initial infection was aquired, and so in terms of preventing infection, near impossible without a better understanding of all known (and unknown) threats...

A grim out look i'm afraid, thankfully however it isn't that common. Quarenteen practices MUST always be adhered to though.

Andy


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## gekox (Feb 8, 2008)

The prevention is to keep viv clean and if you have any new lizard, to keep her separate for quarantine. Some people say 1 month other 3 or even 6 months. But with crypto is quite difficult as healthy looking leo can have crypto and not be massively infected but one it can, all that time this lizard will spread crypto to all others. Crypto can survive even outside for as long as 6 month if temp is higher than 4 degrees. So when qurantine is very useful and let you know if you lizard is sick, have parasite (worms, mites etc) or is healthy. You really can't be sure it does not have crypto unless you do faeces test at vets - and this is not always 100% accurate.
Scary I know, but as old saying goes: hope for the best, propare for worst.

Thats why I would not buy any reptile from pet shops, as vey often they don't know where reptile came from and if this animal is healthy. Small breeder are alway better options.


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## GlasgowGecko (Feb 23, 2008)

Unfortunately everyones collection is susceptible, both shops and small breeders. Possible routes of transmission also include live food, viv decorations bought used and not cleaned properly... it can be a long list.

Andy


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## girlfunky (Mar 8, 2009)

yup it is wordy but read s-l-o-w-l-y it does make sense!

I have first hand experience of this disease. After 4 months of having my first 2 leopard geckos last year one started getting unexplainably sick, then the other one did too. The larger and (we thought) healthier of the 2 was really sick but the smaller one recovered as if it had had a cold. The larger one just wasted away, had loads of tests done as we had researched quite alot and knew it was cryptosporidium for the test was just a confirmation of what we knew, by that time the poor lep had become so sick that we decided it to be more humane to have him put to sleep as he was visably suffering a great deal. The hardest and most heartbreaking decision of my life and my kids were both upset because their pet had passed away through illness and happy because he wasnt suffering anymore :'(

Have to say it was very strange how one got sick then recovered naturally but the other one (a sibling) got very ill and ultimately never recovered???


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## burrow (Nov 5, 2007)

This is quite an interesting read =] i deal with the human strain and analyse drinking water treatment works to make sure they're cleaning the water and getting rid of crypto properly... so it's cool to see how it effects other organisms.

Just a note, crypto is waterborne so the water in your tanks should be replaced on regularly (which it should anyway) =]


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## eddy (Feb 24, 2009)

burrow said:


> i deal with the human strain and analyse drinking water treatment works to make sure they're cleaning the water and getting rid of crypto properly


oh hell burrow, dont say that, or all the water companies' call centres in the country will have their phone lines chocka tomorrow morning! =D


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## burrow (Nov 5, 2007)

eddy said:


> oh hell burrow, dont say that, or all the water companies' call centres in the country will have their phone lines chocka tomorrow morning! =D


Here you are.... Loser =P


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## Nic B-C (Dec 4, 2008)

I would have thought dumbing it down would be very beneficial it mentions several things that a casual reader would simply not understand.

Also Crypto is a lot more common than people think ive seen estimates that 50-60% of all reps actually have it and reporting of it is often hidden!


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## GlasgowGecko (Feb 23, 2008)

Nic B-C said:


> I would have thought dumbing it down would be very beneficial it mentions several things that a casual reader would simply not understand.
> 
> Also Crypto is a lot more common than people think ive seen estimates that 50-60% of all reps actually have it and reporting of it is often hidden!


Unfortunately dumbing it down was not really an option, the subject matter is complex and so the discription warrants a level of complexity. But the benefit of a forum environment is that things that are not clear can be discussed.

As for estimates of infection, its VERY difficult to say, and mostly pointless to speculate. Sub-clinical infections are probably present in a significant proportion of captive animals. This however doesn't mean that these animals are showing symptoms, mearly that they have a very low level infection.
I would be hesitant to listen to spurious estimates of infection size, especially if it comes from anyone other than people who have actual data. 

As the current testing methods are NOT fool proof, cases can go either undiagnosed or mis-diagnosed, so estimates can vary substantially.

The important thing, as always, is to maintain a good level of hygine practice to limit the spread of infectious diseases/ parasites as much as pssible.

Andy


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## Nic B-C (Dec 4, 2008)

Sorry this was from a reputable source i will try and find the paper some time


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## GlasgowGecko (Feb 23, 2008)

I would appreciate seeing the source of this info. Data collection methods for this type of study are notoriously poor. But'll i'll withhold judgment until I see it.

Andy


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## Nic B-C (Dec 4, 2008)

Will try and find it mate but up to my eyeballs at workshop at min didnt get in till nearly 11 tonight


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## SleepyD (Feb 13, 2008)

*bumpybump*


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## Mujician (Mar 7, 2007)

Just wondering, if this were to appear in somebodies animals, where will it have come from? I heard tap water is a posibiltiy. I thought there was an outbreak recently in water systems. Why havent all our animals gone downhill? Is there something we can do to get rid of it from the tap water? Thanks, Ben


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## GlasgowGecko (Feb 23, 2008)

Hey Ben, Whilst it is likely that there has been an outbreak recently in tap water, the strain/ species of cryptosporida responsible in human specific, and therefore poses no risk for your reptiles. You on the other hand....

As for where it comes from, well there are a number of possible routes, all of which involve coming into contact with infected feces.

Andy


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## Mujician (Mar 7, 2007)

GlasgowGecko said:


> Hey Ben, Whilst it is likely that there has been an outbreak recently in tap water, the strain/ species of cryptosporida responsible in human specific, and therefore poses no risk for your reptiles. You on the other hand....
> 
> As for where it comes from, well there are a number of possible routes, all of which involve coming into contact with infected feces.
> 
> Andy


? I thought I heard people mentioning it will affect reptiles ? Okay, touch wood none of them have or ever will get Crypto, but how would my animals get it? It would weither be from a newly bought, unquaranteened animal, or I would have to touch an infected animals poo? Is that it? Is there any way that they could get infected through drinking water? If so, how do i stop this? Thanks!


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## GlasgowGecko (Feb 23, 2008)

Basically anything which comes into contact with infected feces (you, the animal, crickets, viv furniture...) can pass on the oosyts. They need to be orally ingested. So with this in mind a very strick cleaning regime is a good way to prevent the spread. You should try to alcohol wash you hands after you touch a reptile. Try to keep the same bowls in each viv (don't swap bowls between vivs), and make sure you disinfect them regularly. Don't put feeder insects back into a communal tub if they have been in a viv.

Methods such as this are likely to prevent spread, but if an animal with cryptosporidiosis comes in, then further precautions need to be taken.

Andy


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## Mujician (Mar 7, 2007)

How doesn one initially notice crypto in an animal. Is it all to do with the digestion system? Not eating and watery poops etc? Will the animal feel poorly, i.e. will I notice it sitting looking miserable with is eyes half shut etc? Or will it look fine apart from the weight loss? Just trying to get a good clear picture in my mind!


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## GlasgowGecko (Feb 23, 2008)

Typically reptiles hide illness very well, so I would suggest that "looking miserable" if that is possible for a reptile is not too likely. Unfortunately (or fortunately depending on how you look at it) cryptosporidia can stay dormant in an animal for an indeterminant amount of time, so infection can go unnoticed. However when active, weight loss, and loose feces are common signs.

Andy


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