Editorial Type:
Article Category: Brief Report
 | 
Online Publication Date: 14 Sept 2022

Successful Treatment of Severe Ulcerative Dermatitis in an Aubry's Flapshell Turtle (Cycloderma aubryi)

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Page Range: 262 – 270
DOI: 10.5818/JHMS-D-22-00002
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Abstract

An adult, wild-caught, intact female Aubry's flapshell turtle (Cycloderma aubryi), that had been in the collection for 21 months, presented with rapid onset of multifocal, tan-white, 1.5 cm and smaller, crateriform, ulcerated lesions on the carapace and plastron. Empirical antibiotic therapy, initiated on the suspicion of an infectious etiology, yielded no clinical improvement and the disease progressed. Multifocal osteomyelitis was visible deep to the dermatological lesions on the carapace and plastron on computed tomography (CT) imaging, and culture results included Stenotrophomonas maltophilia and Achromobacter (Alcaligenes) xylosoxidans. Two months after surgical debridement and ostectomy, healing of lesions was incomplete and slow to progress. Photobiomodulation (PBM) was initiated on some of the lesions, and the treated lesions showed grossly visible indications of progressive healing after 17 days; there were no indications of healing in the untreated lesions. All lesions were subsequently treated with PBM, and the patient made a full recovery. This case report describes successful treatment of severe ulcerative dermatitis in a softshell turtle using advanced imaging (CT), surgical debridement and ostectomy, supportive care, husbandry modifications, and PBM. This report highlights that PBM can be a valuable therapeutic tool that should be considered for treatment of ulcerative dermatitis in softshell turtles, especially in patients with delayed wound healing or chronic dermatologic lesions.

Keywords: Cycloderma aubryi ; laser therapy; photobiomodulation (PBM); shell rot; softshell turtle; ulcerative dermatitis
Figure 1.
Figure 1.

Sagittal and transverse computed tomography (CT) images of penetrating lesions and bone lysis in an Aubry's flapshell turtle (Cycloderma aubryi) 11 weeks after initial presentation.

Figure 2.
Figure 2.

Carapace lesions in an Aubry's flapshell turtle (Cycloderma aubryi) immediately following surgical debridement. (A) The large cranial lesion on the left and (B) the large cranial lesion on the right were used to compare the effects of photobiomodulation (PBM) treatment over the following 2 months.

Figure 3.
Figure 3.

Carapace lesions in an Aubry's flapshell turtle (Cycloderma aubryi) documenting changes over time in two lesions. (A) Lesion treated with photobiomodulation (PBM) therapy beginning on 26 February 2019, (B) lesion originally not treated with PBM. This lesion was treated with PBM beginning on 13 March 2019 (1) 4 January 2019, 1 wk postsurgery; (2) 21 January 2019, 24 days postsurgery; (3) 26 February 2019, 60 days postsurgery, and immediately before initiating treatment of lesion A with PBM; (4) 13 March 2019, 75 days postsurgery, at which point lesion A had received four PBM treatments and lesion B had not been treated with PBM; (5) 25 March 2019, 87 days postsurgery, lesion A had received nine PBM treatments and lesion B five PBM treatments.

Figure 4.
Figure 4.

Carapace lesions in an Aubry's flapshell turtle (Cycloderma aubryi) on 1 July 2022, more than 2 yr after ending treatment. Image on right shows a close-up of the same lesions.

Figure 5.
Figure 5.

Sagittal and transverse CT images of the same penetrating lesions in an Aubry's flapshell turtle (Cycloderma aubryi) shown in Figure 1, from followup CT on 4 August 2021, 29 months after ending treatment, showing healed shell lesions with bone regrowth.

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