The perspective is changed when fighting Karnath as a boss. He attacks in the Z-axis and tries to bite the player. When he is killed, he is decapitated, and can have his head kicked off screen.
In Battletoads in Battlemaniacs, there are two references to Karnath. Stage 2, inside the giant tree, involves huge green snakes made up of connected spheres, much like the Karnath pictured above, who's mouths snap at Pimple and Rash as they travel through the giant tree and can only be defeated by being hit in the head repeatedly. Stage 4 is set inside Karnath's lair (essentially the same as Stage 6 in the first Battletoads game on NES) and requires players to travel along, climb and jump between many different coloured snakes at varying speeds while avoiding spiked balls.
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Karnath is 93 feet tall and 2 feet wide which is said in the picture at the top of this page.