Causes And Treatments for Leopard Gecko Impaction

Bowel impaction is a potentially fatal health condition in leopard gecko and other reptiles. Find out how to prevent it and treat it.

Leopard gecko impaction care

Leopard gecko is considered an ideal beginner pet reptile. One of the reasons is that leos are hardy and it is relatively simple to keep them top health.

However, did you know that there is one preventable, but potentially deadly leopard gecko health issue that remains commonly seen in the leopard gecko community?

Bowel impaction is a condition that occurs when a fecal mass, or indigestible material, blocks the lizard’s tiny bowels. If the impaction is not treated, the entire digestive system collapses, leading to organ failure and, eventually, death.

The best way to cure impaction is to make sure it doesn’t happen. If it still does occur, it is crucial to know how to recognize it and subsequently treat it, efficiently and safely. The good news is you can avoid impaction by providing proper leo husbandry.

What Causes Impaction?

Causes of impaction can be many:

  • Too large and/or hard feeder insects
  • Overfeeding with hard-to-digest feeders
  • Loose substrate
  • Low temperatures
  • Dehydration
  • Parasites

> Learn more about the proper Leopard Gecko diet here

Can Sand Substrate Cause Impaction in Leopard Geckos?

One of the most common causes of impaction is the use of sand as a substrate in a leo tank. Guided by the misconception that leopard geckos are desert creatures, pet shop personnel and uneducated breeders have recommended sand as a natural substrate for years. That resulted in a significant number of unnecessary vet interventions leo deaths.

The use of calcium sand is particularly tricky. Leopard geckos, and especially those who are calcium deficient, will be tempted to consume the larger-than-usual amounts of the substrate if they sense it contains calcium. Although calcium sand is labeled as digestible, it often clumps together when wet – and that’s precisely what can happen inside your pet’s bowels.

I acknowledge that some people keep leos on sand and that their pets remain healthy. However, the risk is still too high, especially since there are many suitable alternatives. Leos originate from predominantly rocky and not sandy areas anyway.

Substrates And Impaction – A Deeper Perspective

Why do some geckos get impacted by sand while others do not? The answer may lie in a hidden health condition. For example, leopard geckos with vitamin and mineral deficiencies may try to make up for the missing nutrients by consuming the substrate.

Also, low tank temperatures can lead to impaired digestion, causing the amount of substrate that would otherwise be passed normally to create a blockage.

While you may think, “My gecko is in perfect health, so why not keep him on sand?”, the truth is that we can never know if our pet’s health is going to be jeopardized for any reason. That makes sand – or other hard, loose substrate – an accident waiting to happen.

If your leo survived through substrate impaction, examine what could be the underlying cause of his need to consume large amounts of the substrate (but ditch the substrate anyway).

Leopard Gecko impaction

Is My Leopard Gecko Safe If I Use Paper Towels Instead of a Substrate?

The truth is your leo will be much safer if you use paper towels, but still not 100% safe.

Freakish cases of impaction – from paper towel pieces, eco earth, or peat moss are rare, but have occurred! We have to be mindful and not exclude the possibility of impaction simply because we have the right substrate.

The substrate that is the least prone to causing bowel impaction is slate or ceramic tile. It looks and feels quite natural too.

Can Mealworms Cause Impaction?

The opinions on mealworms and impaction continue to be divided. While some people in the hobby still strongly advise against mealworms due to their hard exoskeletons, enthusiasts like the legendary Ron Temper have been using mealworms as a staple diet for his leos for decades.

I never had issues with feeding mealworms. If your leo has no underlying health issues, and you have proper temperatures in the tank, he should be able to eat them safely. Size is the key – never give your leo mealworms that are too large from him. A mealworm that takes more than three bites to swallow is probably too large for your leo.

On the other hand, you should never give your leo mealworm beetles or any other beetle species. Their hard shells undoubtedly increase the risk of impaction.

Symptoms: How Do I Know If My Leopard Gecko Has Impaction?

There are several common signs of leopard gecko impaction. I have listed them according to their severity – from those occurring in light impaction to those occurring in late or severe stages.

  1. Constipation
  2. Cloaca licking
  3. Appetite loss
  4. Lethargy
  5. An unusual dark spot on the underside of the belly
  6. Weight loss
  7. Bloating

The first and most apparent sign of impaction is constipation. It is essential to clean your leo’s potty corner daily, so you can track if he is passing his stools.

Lack of appetite usually goes hand in hand with constipation. Since his bowels are not functioning, leo will be reluctant to take in any new food.

As impaction continues, emaciation and bloating take place. The dark spot on the underside of the belly is another sign of persistent impaction. However, a dark patch on the abdomen can appear for other reasons too – enlarged liver, for example, so this single symptom doesn’t automatically mean impaction.

Impaction Treatments

There are a couple of first-line home treatments for impaction. If they fail, head for the reptile vet’s office ASAP.

Warm Bath

Giving your leo a warm bath is the first line of treatment when you suspect impaction. Baths are comfortable, pretty stress-free, and surprisingly efficient in solving uncomplicated cases of impaction.

Here is how to do it:

  • Take a plastic tub or dish that has a well-fitting lid.
  • Create ventilation holes
  • Fill it with water. The temperature should match your terrarium’s warm area, or be in the upper range of official recommendation for leos (86 degrees F/30 degrees C).
  • The water level should be high enough for it to cover your leo’s belly, but the water level must not pass the height of your leo’s shoulders.
  • I recommended giving your lizard two baths a day, each lasting about 30 minutes, 3-4 days in a row. During the bathing, massage his belly gently, moving your finger from throat to the tail base every five minutes or so.
  • Monitor your leo at all times to avoid water asphyxiation.
  • If he passes poop, inspect it for traces of substrate or other hard particles to determine the cause of impaction.

Leopard gecko taking warm bath

Olive Oil

Another home remedy for impaction is giving your leo a drop of olive oil, or mineral oil. Oil won’t harm your leo as long as you administer it carefully and take care it doesn’t get into his nostrils. Put an oily drop in front of his mouth, lightly touching them. He will most likely lick off the droplet. You can use this remedy together with baths.

I advise using oil only coupled with the baths, and not after the bating method has failed. There is anything particularly risky about the oil itself. Still, if the bathing has failed, it is highly likely that impaction is severe and that your pet needs urgent veterinary care. In a situation like that, you don’t want to waste precious time to see if another light technique will work. Time can make a difference between life and death.

> Further reading: Dying signs in leopard geckos

Veterinary Intervention And Surgery

If the home remedies fail, you have to take your leo to an experienced reptile vet.

At the vet’s, the impacted leo will probably get an X-ray so the doctor can see what’s going on in his belly. After that, the vet will prescribe a laxative (usually the one used for cats, or medical paraffine), try to flush out the impaction using the procedure called enema, or proceed to do a surgery.

Take care!

I hope this article has helped you gain an in-depth perspective on bowel impaction in leopard geckos. I wholeheartedly hope that you won’t ever need to use my advice on the topic. However, considering that impaction is still common and deadly, every leopard gecko owner should know how to prevent it and treat it.

Has your leo had a case of bowel impaction? How did you treat it? Help other reptile enthusiasts by sharing your experience in the comments.

Katarina Samurovic

Katarina Samurovic

Katarina is an environmental analyst and she has been involved with herpetology researches. She's been keeping reptiles for 20 years, mostly different species of turtles and leopard geckos. Her 2 lovely leos, Sonya and Mia are 20 and 19 years old.

18 thoughts on “Causes And Treatments for Leopard Gecko Impaction”

  1. Christine Clemens

    I’ve had my granddaughters Leo about 3 weeks now he stopped eating about 2 weeks ago I took him to the vet his stomach is extended she’s having me give him a supplement four times a day with mineral oil
    I cannot get her mouth open I’ve done everything it’s taken me an hour each time just to feed her I’m sure it’s stressing her out I literally cannot get her mouth open I just don’t know what to do now.
    I have another, different vet appt Friday, a week away, I hope she can survive

    1. Hey, Christine. So sorry you’re dealing with this problem – especially since it’s your granddaughter’s pet!

      Definitely follow your vet’s advice, and it’s never a bad idea to get a second opinion. As for prying open the lizard’s mouth, that can be tricky: You must be gentle, but it can also take a bit of pressure to convince the lizard to open up.

      One trick I’ve used over the years is to use a very soft spatula (not a pancake turner, but an actual spatula). They’re usually the perfect combination of firm, yet flexible, and they often get the job done. If that doesn’t work, you can try a credit card or business card – just be as gentle as possible.

      Best of luck! Our fingers are crossed for you!

    2. ChelsiJo E Mildenberger

      Would this work for babies? I just got a leopard gecko that has an obvious impaction, tummy has large dark area and very hard. How often with olive oil? Skin is very thin and I don’t think they could survive surgery.

      1. sam

        Hi Chelsi,

        Yes you can try a warm bath and tiny drop of olive oil for baby geckos. If this does not work get your gecko to a vet, there are steps that can be taken by your vet, for example laxatives or an enema, before resorting to surgery.

    1. sam

      Hi Elizabeth,

      It is possible that your gecko is lethargic because she just ate a lot and needs time to digest. Are there any dark spots on her underside or any signs of impaction?

  2. My leopard gecko is impacted and my mom says she’s not and that “we don’t know yet” she hasn’t pooped out her last meal of big mealworms. Should we stop getting the big mealworms?

    1. sam

      Hi Sophia,

      Giant mealworms should be given in moderation as they are difficult to digest and have been known to cause gut impaction. You don’t have to completely stop feeding them to your gecko but definitely restrict the number and opt for other insects over these.

  3. I am the owner of a 7-8 week old leopard gecko, and recently he hasn’t been eating as much as he should. I just moved him to a bigger cage on Tuesday which might have caused him some initial stress, but now he has gone three days eating 8 then 6 then 3 insects (today). I placed him in a glass container and looked at his stomach, and there is a small black or blue-ish dot that is not where his stomach is and more in the higher stomach region of his body. I’m thinking he may have some impaction possibly from food? I have him on paper towels so substrate shouldn’t be an issue. I gave him a warm bath and some olive oil tonight to see if that helps. What do you recommend I should do? Should I schedule an appointment as soon as possible, or be patient? He has been pooping every night pretty well as well.

    1. sam

      Hi Maya,

      This could be a small impaction or potentially a slight internal bleed. The move may have caused some additional stress, make sure he has plenty of places to hide and check that your temperatures are all good. Try to restrict handling as this may stress him more, if things are not better within another day then I would suggest taking him to the vet. Hopefully he’ll go for a poop soon.

  4. Um, my leopard gecko is really pale and hasn’t shed yet. She has no dark spot under her belly, an interest in food and is eating, a full water dish, she’s not licking her cloaca (as far as I’ve seen yet). She doesn’t move a lot in general in the 3 years I’ve owned her however, when needed to pick her up to examine her belly she sprinted and (she just ate a cricket and moved really fast to get it too.) The only think that concerns me is that she hasn’t shed starting from 9:00 Pm last night to 4:53 Am. (she’s usually faster than this with shedding) Should I be concerned?

    1. sam

      Hi Madeleine,

      I wouldn’t worry too much this early on, just keep an eye on her. Check your temperatures are good and that her moist hide is clean but damp.

  5. Hi! I think my 20 year old Leo is in trouble 🙁 I noticed yesterday and today what looks like feces still attached to his underside. He isn’t eating even though he has a few crickets running around his tank. He is extremely skidding, to the point I’ve never even held him. I’d like tongue the warm bath but across that with stress him even more. Help!!

    1. dr.-mohsin-iqbal-dvm

      Hey Jenn,

      I am sorry to hear that your Leo is not doing well. It sounds like he may be constipated, which can be caused by a few different things.

      • Cold weather can affect digestion and cause constipation, so if it is too cold in his tank he may be having trouble.

      • Dehydration can also cause constipation, so make sure he is drinking enough water.

      • Another possibility is that substrate (bedding) may be stuck around his vent, which can make it difficult for him to defecate.

      If his vent is clean and he is well-hydrated, he should be able to pass the feces on his own.

      If he is still having trouble, you can try giving him a warm bath, which may help him to relax and pass the feces.

      Be sure not to stress him out even more, though, so monitor him closely during the bath. If he is still struggling, please take him to a reptile vet for further assistance.

  6. I feel like my leo is constipated, he is very active and does NOT show any signs of
    Cloaca licking
    Appetite loss
    An unusual dark spot on the underside of the belly
    Weight loss
    He just looks bigger then normal and only poops every 4 days. I use eco earth (Conut Shavings) but almost always tong feed him on a pice of tile. He has a great apitite so mabe he is just fat?

    1. dr.-mohsin-iqbal-dvm

      Hello Ashley,

      If your leopard gecko is active and doesn’t show any other signs of being constipated, then it’s likely that he’s just fine. Adult Leopard geckos typically poop every two to three times a week, but some may go a bit longer in between bowel movements. If your Leo is eating well and doesn’t appear to be in any discomfort, then there’s no need to worry.

      As for being overweight, leopard geckos can certainly become obese if they’re not fed a balanced diet and don’t get enough exercise. If you think your Leo may be overweight, you can try offering him smaller meals more often throughout the day instead of one large meal. You can also try placing his food on the other side of the tank so he has to walk to get it. These simple changes can help encourage your leopard gecko to be more active and help him shed any excess weight.


    1. dr.-mohsin-iqbal-dvm

      Hey Tom,

      In short, no. Just because your gecko has pooped once, does not mean he or she is automatically in the clear. However, if your gecko is pooping regularly and has no other symptoms, then he or she is likely doing just fine.


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Katarina Samurovic
Katarina Samurovic
Katarina is an environmental analyst and she has been involved with herpetology researches. She's been keeping reptiles for 20 years, mostly different species of turtles and leopard geckos. Her 2 lovely leos, Sonya and Mia are 20 and 19 years old.