Diagnosis and Successful Medical Management of a Colonic, Urate Enterolith in an Argentine Black and White Tegu (Salvator merianae)
A 5-yr-old female Argentine black and white tegu (Salvator merianae) was presented for a lack of fecal output, anorexia, and lethargy. Several weeks prior the tegu underwent a rapid diet change to whole rodents. Computed tomography revealed a mineral-dense calculus in the distal colon, causing gastrointestinal obstruction. Because of poor response to enteric fluid therapy alone, transcloacal enterolith removal was elected. Under sedation and neuraxial anesthesia, saline-infusion cloacoscopy was performed and the calculus visualized and destructed using a dental burr on a low-speed dental handpiece and grasping forceps. Recovery from the procedure was unremarkable. Fluid therapy and oral lactulose therapy were prescribed postoperatively. The tegu began to defecate several days later. Transcloacal calculus destruction with a low-speed drill under cloacoscopic guidance should be considered a noninvasive option for management of colonic and cloacal calculi in larger lizard species.Abstract
Dorsoventral radiograph showing marked caudal gastrointestinal distension with fecal material (white arrows) orad to a colonic, urate enterolith (black arrowheads) in an Argentine black and white tegu (Salvator merianae).
Computed tomography (CT) images using a soft-tissue viewing algorithm demonstrating a colonic, urate enterolith causing secondary gastrointestinal (GI) obstruction in an Argentine black and white tegu (Salvator merianae). Dorsal CT images of the tegu (A) at presentation and (B) 11 days after partial transcloacal removal using a low-speed dental drill and grasping forceps. The caudal GI tract (white arrows) was markedly distended with fecal material orad to the enterolith (black arrowheads). (C) Transverse CT images of the enterolith at presentation and (D) 11 days after partial removal. In the transverse CT images, the white arrow identifies the cranial-most portion of the pelvic brim.
Administration of preservative-free lidocaine and morphine for neuraxial anesthesia and analgesia, respectively, in a sedated Argentine black and white tegu (Salvator merianae). (A) The injection site was identified based on palpation of the pelvic girdle and dorsal processes of the coccygeal vertebrae. (B) A 1-inch, 25-gauge spinal needle was used to deliver both drugs in the same syringe. Saline-infusion cloacoscopy and transcloacal removal of an enteric calculus were successfully performed following the injection.
A sedated Argentine black and white tegu (Salvator merianae) in dorsal recumbency to allow for transcloacal removal of a colonic, urate enterolith. Saline-infusion cloacoscopy allowed for visualization of the calculus and irrigation of smaller calculus fragments; larger fragments were removed using long, grasping forceps. Portions of the removed enterolith are visible at the top of the image.
Endoscopic images of a colonic, urate enterolith in an Argentine black and white tegu (Salvator merianae) obtained during cloacoscopy and colonoscopy. (A) The calculus was visible just inside the colonic lumen when the cloaca was distended with sterile saline. (B) Both a diamond dental burr on a low-speed dental handpiece and (C) long-handled grasping forceps were used to remove small portions of the large calculus, creating (D) concave depressions that eventually destabilized, breaking into removable pieces.
