Journal of Herpetological Medicine and Surgery

A 13 year old male aquatic caecilian, Typhlonectes sp., presented with whole body swelling and a radiodense coelomic mass was identified radiographically. The mass was found to be free-floating during surgical exploration, was removed, and histologically determined to be mineralized fat necrosis. The animal did not recover from anesthesia and necropsy findings included excessive free coelomic fluid, a severely dilated venous structure, and a dermatopathy of unknown etiology. The animal's death was attributed to complications of anesthesia and circulatory compromise. Though no specific etiology was found, the whole body oedema was attributed to disruption of normal osmoregulation due to the dermatopathy. Mineralized fat necrosis should be considered in cases of radiodense coelomic masses in caecilians.

An adult female eastern box turtle, Terrapene carolina carolina, presented with a proliferative soft tissue mass adjacent to the tail. Initial blood work revealed a moderate leukocytosis. Over the next five months, the lesion progressed despite treatment with a combination of surgical debridement and antibiotic therapy. Ultimately, Mycobacterium terrae was isolated from the locally extensive cutaneous lesion. Euthanasia was elected, and necropsy revealed disseminated mycobacteriosis.

A retrospective review of sedation of lizards using dexmedetomidine-midazolam (DM) with or without ketamine administered intramuscularly or subcutaneously was performed. Forty-four sedation events, involving 25 individuals and 16 different species of lizards, were reviewed. Sedation was performed for physical examinations, imaging, biopsy collection, and wound treatments. Dexmedetomidine (median: 0.08 mg/kg, 25-75%: 0.05 - 0.1 mg/kg, range: 0.03 - 0.3 mg/kg) combined with midazolam (median: 1 mg/kg, 25-75%: 0.85 - 1 mg/kg, range: 0.5 - 2 mg/kg) was used in 11/44 (25%) sedation events. In 33/44 (75%) sedation events, ketamine (median: 2.9 mg/kg, 25-75%: 2.43 - 3 mg/kg, range: 0.9 - 5 mg/kg) was administered in addition to DM. Insufficient depth of sedation was reported for 2/44 (4.5%) events. Atipamezole (10-times the mg dose of dexmedetomidine) and flumazenil (median: 0.05 mg/kg, 25-75%: 0.05 - 0.05 mg/kg, range: 0.01 - 0.1 mg/kg) were administered for reversal of the sedative effects of DM in all sedation events. The most common complication noted was apnea, which occurred in 2/44 (4.5%) sedation events, and which resolved following administration of the reversal agents.

An eight-year old intact male woma python (Aspidites ramsayi) presented for a caudal coelomic mass effect of three weeks duration. Ultrasound and fine needle aspiration cytology failed to identify the source of the mass. Exploratory surgery found a 10-cm diameter, lobulated, cystic mass closely associated with the left kidney. Tumor resection with left adrenalectomy and left nephrectomy was performed. Histopathologic examination identified an adrenal interrenal cell (cortical) adenocarcinoma with adjacent renal fibrosis. The snake recovered from surgery uneventfully and was clinically healthy over an 18-month follow up period. At 11 months, a contrast-enhanced coelomic computed tomography scan was performed to evaluate for metastatic disease or local recurrence. No metastases were identified, but local recurrence was not definitively ruled out and continued monitoring of the surgery site was recommended. At 18 months, ultrasound examination revealed significant tumor regrowth and no further treatment was pursued.

An 8-yr-old intact male woma python (Aspidites ramsayi) presented for a caudal coelomic mass effect of 3 wk duration. Ultrasound and fine needle aspiration with cytology failed to identify the source of the mass. Exploratory surgery found a 10-cm diameter, lobulated, cystic mass closely associated with the left kidney. Tumor resection with left adrenalectomy and left nephrectomy was performed. Histopathologic examination identified an adrenal interrenal cell (cortical) adenocarcinoma with adjacent renal fibrosis. The snake recovered from surgery uneventfully and was clinically healthy over an 18 month follow-up period. Eleven months postsurgery a contrast-enhanced coelomic computed tomography scan was performed to evaluate the snake for metastatic disease or local recurrence. No metastases were identified, but local recurrence was not definitively ruled out and continued monitoring of the surgery site was recommended. Eighteen months postsurgery an ultrasound examination of the snake revealed significant tumor regrowth. Because of the recurrence of disease, no further treatment was pursued.

Medical records of 63 Fiji banded iguanas (Brachylophus bulabula) examined by veterinarians at the San Diego Zoo from January 2000 to May 2010 were reviewed to identify age, sex, presenting complaint, final diagnosis, and outcome. A total of 154 presentations were recorded, which included 63 individual animals. Females outnumbered the males, both in number of presentations and in mean presentations per individual. Trauma was the most frequent diagnosis (39%) and, of those cases, conspecific inflicted trauma was more common than trauma from environmental elements. In addition, the majority of conspecific trauma presentations were female (86%). Additional causes of morbidity included reproductive, idiopathic, infectious, congenital, inflammatory, and neoplastic conditions. All reproductive presentations were female. In hatchlings, congenital issues made up the majority of presentations. The majority of cases improved (84%), 8% were euthanized, 4% died, and 3% remained static but stable. The overall mortality rate during the 125 month study period was 20%.

The St. Kitts Sea Turtle Monitoring Network (SKSTMN) began implementation of a leatherback sea turtle (Dermochelys coriacea) monitoring program in 2003 on the main leatherback nesting beaches on St. Kitts, Keys Beach and North Friars Beach. From March 2003 to July 2016, a total of 2,419 adult female leatherback emergence events were recorded and evaluated. A notable decrease in adult leatherback emergence activity was observed over the course of the study period. The nesting season ranged from February to August. April and May were the months with the highest frequency of nesting. The number of females individually identified (flipper tagging and/or passive integrated transponder) from 2004-2016 was 259 with a mean curved carapace length (CCL) (n=720) of 153 cm and mean curved carapace width (CCW) (n=719) of 113 cm. Remigration intervals ranged from one to five years with a median of two years. Mean clutch frequency for nesting females in St. Kitts over the course of the study period was 3 (standard deviation (SD) 2.9) and during a reproductive season was 2.2 (SD 1.44). Mean total number of eggs laid per nest was 113 with mean number of yolked eggs being 83.5 and yolkless 29.3. The mean incubation period was 59.5 days overall (SD 3.5) with a hatch success overall of 16.75%. Relocated nests had significantly lower hatch success than in situ nests and poaching rates decreased over the course of this study. From 2006-2016 a total of 191 blood samples were collected from 118 individual animals.

Between 2008 and 2014, mechanical positive pressure ventilation (PPV) was used to manage 48 critically ill, cold-stunned sea turtles during their first week of treatment. Twenty-nine turtles had complete records for analysis and no ventilator complications, including 21 Kemp's ridley (Lepidochelys kempii), four loggerhead (Caretta caretta), and four green turtles (Chelonia mydas). Indications for PPV included poor responsiveness, bradypnea or apnea, bradycardia, and respiratory acidosis. Twenty turtles were successfully extubated, seven turtles died naturally during PPV, and two turtles were euthanized during PPV. Of the 20 turtles that were extubated, 11 survived over 24 hours after extubation and were considered successfully weaned from the ventilator, but only four turtles survived to eventual release. Throughout PPV, improvements in respiratory, cardiovascular, and clinicopathologic status were variable, likely related to the degree of illness at presentation. On average, however, ventilation resulted in expected physical and physiologic improvements between the beginning and end of ventilation, including significant increases in activity, heart rate, venous pH and pO2, and decreases in venous pCO2, potassium, and Mortality Prediction Index score. Results of this study indicate that mechanical PPV is effective in improving the respiratory status of some moribund cold-stunned sea turtles; however, further refinement of ventilation methods is recommended, and the prognosis remains poor to guarded for the most severely debilitated turtles.

Toads in the genus Bufo are commonly kept in pet, research, and zoological settings and may require anesthesia during veterinary care. Limited information is available comparing anesthetic protocols in most amphibian species. The purpose of this study was to evaluate the clinical and cardiopulmonary effects of tricaine methanesulfonate (MS-222) and propofol in Sonoran desert toads (Bufo alvarius). Nine juvenile Sonoran desert toads were anesthetized with an immersion bath of 1 g/L MS-222 and 35 mg/kg intracoelomic propofol with a minimum 2-wk wash-out period between trials. Heart rate, respiratory rate, and reflexes (righting, escape, corneal, superficial pain, and deep pain) were monitored every 5 min for the first 90 min and then every 10 min for the next 90 min during both anesthetic trials. Surgical anesthesia was defined as complete loss of all measured reflexes. MS-222 produced surgical anesthesia in 100% (9/9) of toads, whereas propofol produced surgical anesthesia in 11.1% (1/9). Mean ind...

Tricaine methanesulfonate (MS-222) is a bath anesthetic agent commonly used in amphibians, but few studies have demonstrated its efficacy in a wide variety of anuran species. In this study, White's tree frogs (Litoria caerulea; n = 9) were used in a blinded, randomized, complete cross-over study to assess the anesthetic effects of two MS-222 concentrations (0.5 g/L and 2 g/L). Frogs were placed in MS-222 to induce chemical restraint. Heart and gular rates and palpebral, corneal, withdrawal, and righting reflexes were measured every 5 min. Frogs were removed from the anesthetic solution when reflexes were lost or after 25 min. Only mild sedation was induced with 0.5 g/L MS-222 after 25 min in all frogs, and surgical anesthesia was induced in all frogs with 2 g/L MS-222 within 5–20 min. Time from rinsing with distilled water to regaining reflexes in the 2 g/L group ranged from 10 to 43 min. There was a time-dependent decrease in heart rate with no significant difference between treatments. There was a significant decrease in gular rate for the 2 g/L dose compared to the 0.5 g/L dose. These results suggest that 0.5 g/L MS-222 can be used for mild sedation to facilitate diagnostic techniques, and 2 g/L MS-222 can be used to induce surgical anesthesia in White's tree frogs.

Turtles often present to wildlife rehabilitation centers for trauma secondary to motor vehicle collisions. Injuries to the pelvic girdles in turtles are challenging to assess on standard radiographic views due to the superimposition of bones. Pelvic trauma may have long term consequences for ambulation and reproduction. The novel use of caudoventral-craniodorsal and cranioventral-caudodorsal 45° oblique radiographic views in western painted turtles (Chrysemys picta bellii) at the Wildlife Rehabilitation Center of Minnesota has improved differentiation of bones in the pelvic girdle. Using dorsoventral radiographs, 45% of western painted turtles with caudal carapace fractures had suspected injuries to the pelvis. After using oblique views, 98% of western painted turtles with caudal carapace fractures were found to have pelvic involvement. These radiographic views improve diagnostic ability, facilitate medical and surgical interventions, and aid in monitoring the healing process.

A 16-yr-old male midland painted turtle (Chrysemys picta marginata) presented for evaluation of a crusted cervical lesion and conjunctivitis. The patient initially underwent several treatments of both topical and systemic antimicrobial therapies for dermatitis. Despite treatment guided by results of cytology, crust histopathology, and bacterial culture and sensitivity, dermal lesions were progressive, and a deep excisional biopsy was performed of the two largest lesions. Results of histopathology revealed an incompletely excised squamous cell carcinoma with secondary bacterial and fungal infections. Strontium-90 plesiotherapy was applied to all visible skin lesions, in addition to cryotherapy of a right-eyelid mass 5 wk later. These therapies provided a disease-free interval of less than 45 days in this patient. Because of progressive disease, the turtle was euthanized 7 wk after strontium-90 plesiotherapy. Results of necropsy revealed multifocal squamous cell carcinoma of the head, neck, and left forelimb with local neoplastic invasion and associated cellulitis and dermatitis. Treatment of multifocal cutaneous squamous cell carcinoma with strontium-90 and cryotherapy did not prevent disease progression in this turtle.

An adult male elongate tortoise (Indotestudo elongata) was presented to the Animal Medical Center of Taipei Zoo with an abscess on the tip of its nose. After 43 days of daily debridement and systemic antibiotic administration, we sought an alternative treatment modality due to poor wound management. We developed a novel treatment using platelet-rich fibrin (PRF). There are few studies documenting the benefits of PRF for the management of wounds in reptiles. Most published protocols require the use of specific anticoagulants and methods to prepare PRF; however, we found that a modified Choukroun's PRF was relatively easy to prepare and use for wound treatment of an elongate tortoise. Here, we describe a successful outcome of a chronic, nonresolving facial wound after treatment with modified Choukroun's PRF. To our knowledge, this is the first report of a Choukroun's PRF preparation derived from reptilian blood. We recommend further studies and detailed trials to evaluate the efficacy of this protocol in reptiles.