Paget-like bone remodeling disorder in a red-tailed boa (Boa constrictor constrictor): diagnosis and management

Paget-like bone remodeling disorder is a rare skeletal disease in reptiles, and clinical management strategies are poorly defined. Reporting clinically documented cases may improve recognition and welfare-centered care.

A 23-year-old male red-tailed boa (Boa constrictor constrictor) presented with anorexia, dysecdysis and spinal rigidity. Radiography and computed tomography showed diffuse vertebral deformities with irregular bone proliferation, and erosive lesions. Serum alkaline phosphatase activity was markedly increased. Blood cultures yielded Escherichia coli. Treatment with enrofloxacin and dexamethasone was followed by a transient decrease in alkaline phosphatase activity and partial improvement in appetite. Husbandry modifications, including transfer to a larger enclosure, improved mobility and short-term quality of life. The snake later developed recurrent anorexia and dysecdysis and was euthanized for welfare grounds. Necropsy and histopathology revealed extensive vertebral deformities, thickened trabeculae, mosaic lamellar bone and osteoclasts proliferation, consistent with Paget-like bone remodeling disorder.

This case supports the value of imaging, clinicopathologic assessment, and histopathology in diagnosis, and suggests that supportive husbandry modification may provide temporary welfare benefit in affected snakes.