A free-ranging adult female American bullfrog (Rana catesbeiana) presented with a degloving injury to the right manus. Insufficient healthy cutaneous tissue remained on the manus for primary closure. A porcine small intestinal submucosa (SIS) graft was sutured over the wound to promote skin regeneration. Additional treatment included gentamicin solution immersion therapy followed by topical glycerin impregnated with insulin and SilvaSorb® Gel. The initial porcine SIS graft began to fail after 5 days and was replaced. The second porcine SIS graft began to break down 9 days after placement. The graft was allowed to disintegrate after a strong granulation bed had formed and served as a form of mechanical protection. Application of the porcine SIS graft in combination with gentamicin therapy and topical treatment resulted in complete healing of the manus 34 days after the initial placement of the porcine SIS graft, and the patient was released.Abstract
In December 2022, a juvenile female green sea turtle (Chelonia mydas) was stranded in North Carolina, USA. On admission to rehabilitation, physical exam and point-of-care diagnostics found severe emaciation, a healing wound to the left cranial neck, abnormal buoyancy, a heavy burden of epibiota on its carapace, anemia, and hypoproteinemia. Over time, the turtle exhibited progressive weight loss, dysphagia, and regurgitation characterized by forcefully ejecting water and masticated fish from its nares. When attempted tube feeding was unsuccessful, a cranial esophageal stricture was suspected. Computed tomography and ultrasonography revealed no evidence of an esophageal foreign body or intraluminal and extraluminal masses. Esophagoscopy confirmed a cranial esophageal stricture; however, neither bouginage nor surgical resection via an esophagostomy was successful, and the turtle was euthanized. Necropsy confirmed an esophageal stricture and occlusion, diffuse serous atrophy of fat, and widespread muscle atrophy. Histopathology revealed the esophageal stricture was comprised of focal marked fibrosis with edema and mild perivascular lymphoplasmacytic inflammation. Given the age class and size of the turtle, the authors suspect the esophageal stricture and occlusion were acquired secondary to unknown prior trauma. Esophageal stricture in sea turtles is a possible severe sequela of esophageal injury and likely carries a guarded prognosis for survival and release.Abstract
Ophidiomycosis (formerly snake fungal disease) is an emerging disease in snakes caused by the fungal pathogen Ophidiomyces ophidiicola (Oo). The disease is characterized by skin lesions that can range from mild to severe with associated fatalities documented. Subclinical infections have also been described presenting a wide variability of the impact Oo has on the host. In wild snakes, infections have most often been documented in North America, but increasing numbers of reports are becoming available from other parts of the world, including Europe. While monitoring dice snake (Natrix tessellata) populations in 2018 at Schleuse Hollerich/Lahn, a nature reserve in Germany, three dice snakes were observed with cutaneous granulomas. One year later, snakes with granulomas were also observed, and two dice snakes were captured and examined. Fungal hyphae were found in skin biopsies of the lesions, and Oo was detected by PCR in the shed skin from one of the snakes. After shedding, the snakes appeared clinically healthy and were released back to the location at which they had been found. This is the first report of histologically confirmed ophidiomycosis in dice snakes and the first confirmed report of ophidiomycosis in a wild snake in Germany.Abstract
Two injured wild Mohave desert tortoises (Gopherus agassizii) presented with hind leg lameness. A contaminated and infected bite wound exposed the coxofemoral joint in one individual. Dorsoventral, lateral, and craniocaudal radiographs produced reduced detail of the affected coxofemoral joint in each tortoise because of superimposition of soft tissue and the bones of the shell, pelvis, and femur. Radiotracking devices that had been epoxied to the shell also complicated diagnosis with traditional radiographic views. Based on a view described in birds, a craniodorsal–caudoventral 45° oblique image offered a superior view of the coxofemoral joint. This image was used to prescribe a femoral head ostectomy and verify successful completion following surgery.Abstract
Eastern collared lizards (Crotaphytus collaris) are growing in popularity as exotic pets in the United States and worldwide. However, clinical biochemistry reference data to support the interpretation of health and disease for this species are lacking. This study evaluated 87 apparently healthy eastern collared lizards (C. collaris). Blood samples were collected from the ventral coccygeal vein and assayed via an Abaxis VetScan VS2 analyzer and avian/reptile profile plus rotor. Although lizard weight and snout–vent length (SVL) were normally distributed, most biochemical analytes, except albumin and total protein, were not. Many analytes were affected, albeit slightly, by lizard age, SVL, body condition score, gravidity and/or recent oviposition, sex, health status, and color and locality. However, except for calcium, phosphorous, and albumin for gravid or immediately postoviposition females, biochemical values remained within the generated reference interval. Limitations of this study included that the VetScan VS2 avian/reptile profile plus rotor was unable to successfully provide values for bile acids for most of these apparently healthy lizards. When compared to biochemistry analyte values of lizards from the suborder Iguania from the western hemisphere, eastern collared lizard biochemistries were similar for some analytes, but a relatively increased plasma glucose and uric acid occurs in this species, which could affect the diagnosis of clinical disease or other health abnormalities.Abstract
Evaluating leukocytes provides insight in the overall health of animals by characterizing pathologies related to infection, inflammation, and stress. In reptile species, many leukocyte quantification methods are used to evaluate white blood cell (WBC) parameters; however, agreement and analytical variability (repeatability) between the various methods have yet to be reported and critically assessed in many species, including the prairie rattlesnake (Crotalus viridis). The objectives of this study were to 1) test agreement between hematology parameters determined by phloxine-based stain (Eosinophilic leukopet, EO), Natt–Herrick’s (NH), and estimate (EST) methods using fresh whole blood and lithium-heparinized blood; 2) determine the agreement between estimates from a veterinary student and from a board-certified clinical pathologist; and 3) determine the analytical variability of EO, NH, and EST methods. Venipuncture was performed in 27 adult snakes, and agreement was then assessed using Bland–Altman plots and Passing–Bablock regression between all methods. There was a variable degree of proportional and constant error between many of the quantification methods, but descriptive statistics for all methods fell within biologically relevant values. There was good agreement in the EST method between the clinical pathologist and the veterinary student, but the student had a significantly higher mean WBC count in fresh whole blood. The lowest analytical variability was observed with the NH method (15.4%), whereas the highest was observed with the EST method (58.6% for the clinical pathologist, 59.4% for the veterinary student). These results identify the intrinsic variability in reptile hematological methods currently used and emphasize the need to develop a singular diagnostic standard for leukocyte quantification in reptile species.Abstract
Hematology is a common diagnostic assay for evaluation of health in veterinary species. Several manual methods exist to evaluate the leukocyte component of reptile complete blood counts; however, no single method has been proven reliable for all reptiles. To investigate the analytical variability and agreement of commonly used leukocyte quantification methods, blood was collected from 10 clinically healthy bearded dragons (Pogona vitticeps) and analyzed in triplicate using Natt-Herricks (NH) solution, eosinophilic leukopet (LO), and estimated white blood cell counts on peripheral blood smears made from fresh whole blood or blood anticoagulated with lithium heparin (LH). To investigate interobserver variability, blood film white blood cell estimates were generated by both a novice veterinary student and a boarded clinical pathologist and analyzed for agreement. Analytical variability was highest using the LH blood film estimate by a boarded clinical pathologist (21.0%), followed by the student’s NH method (20.8%), fresh whole blood film estimate from the clinical pathologist (16.6%), eosinophilic LO (student; 8.7%), and blood film estimates using fresh whole blood (6.5%) and LH blood (4.5%), read by the student. Bland Altman plots revealed that agreement occurred between LO and NH methods and between the two blood film estimate methods; Passing-Bablok regression analysis revealed constant and proportional error between LO and both estimate methods and between NH and both estimate methods. Agreement occurred between the veterinary student and clinical pathologist for both blood smear leukocyte estimates. These results highlight the importance of considering which leukocyte quantification method is used when clinically assessing reptile patients.Abstract
Normal ophthalmic parameters of the blue-tongued skink (Tiliqua scincoides), one of the largest members of the skink family of lizards, have yet to be evaluated. The objective of this study was to establish baseline ophthalmic parameters for a captive population of 12 healthy, 1-yr-old blue-tongued skinks. Ophthalmic examination, corneal touch threshold, tear production including phenol red thread test (PRTT) and modified Schirmer tear test-2 (mSTT-2), horizontal palpebral fissure length (HPFL), rebound tonometry (TONOVET and TONOVET Plus), and bacterial and fungal cultures were performed. The blue-tongued skinks were all amenable to ocular diagnostic testing. Corneal touch threshold (mean ± SD) was 5.48 ± 0.81 cm. PRTT (mean ± SD) was 9.17 ± 6.62 mm/15 sec. mSTT-2 (mean ± SD) was 2.54 ± 2.72 mm/60 sec. HPFL (mean ± SD) was 6.96 ± 0.62 mm and was positively correlated with body weight. Intraocular pressure (IOP) assessed using TONOVET (mean ± SD) was 8.43± 1.51 mmHg, whereas IOP assessed using TONOVET Plus (mean ± SD) was 12.39± 1.54 mmHg. Differences in TONOVET and TONOVET Plus tonometry values were statistically significant (P < 0.0001), and TONOVET values were positively correlated with body weight. The most common bacterial species identified were Staphylococcus xylosus (10/12) and Staphylococcus sciuri (8/12). Fungal cultures were all negative. One animal had superficial corneal ulceration that resolved with treatment. Ophthalmic examination and testing is readily performed in blue-tongued skinks. These parameters may be useful for ocular assessment of this species in a clinical setting.Abstract
Fungal infections were histologically confirmed in 20 stranded sea turtles, including 18 Kemp’s ridley turtles (Lepidochelys kempii), 1 green turtle (Chelonia mydas), and 1 leatherback turtle (Dermochelys coriacea). Infection was detected antemortem in six cases. Gross external findings in live turtles included carapace lesions (n = 3) and dermatitis (n = 1). Radiographs revealed evidence of pneumonia in 18 animals. Bronchoscopy detected excessive fluid, mucus, clotted blood, or caseous material within the bronchi and lungs of three turtles. At necropsy, the most common gross lesions were pulmonary granulomas, consolidation, and/or hemorrhage (n = 18), and the most common histologic lesion was severe heterophilic-to-granulomatous pneumonia (n = 18). Nine animals had fungal infection at sites outside of the lung. The most commonly identified genera were Purpureocillium, Beauveria, and Fusarium. Other isolates included Metarhizium sp., Trichoderma sp., Clavispora lusitaniae (Candida lusitaniae), Leptospherulina sp., Penicillium chrysogenum, Mucor sp., and Aspergillus section Nigri. Antifungal susceptibility performed for 10 isolates indicated minimum inhibitory concentrations (milligrams per liter) for fluconazole ranging from 8 to >64, often >32; itraconazole from 0.06 to 16, often ≤1; voriconazole from 0.06 to 2, often ≤0.5; and terbinafine from 0.06 to >2, often ≤2. These data indicate that fluconazole resistance is common among the fungi that cause infection in sea turtles. Based on susceptibility data, itraconazole, voriconazole, or terbinafine may be appropriate for treatment of such infections, but additional clinical research is needed. Results of this study indicate that fungal infections can be difficult to diagnose antemortem in sea turtles, and more aggressive methods of diagnosis, such as lung biopsy, may be indicated for suspected cases.Abstract
Measurement of corticosterone in various tissues has been used to investigate the stress response in reptile and amphibian species for decades. The tissue source from which corticosterone is measured reflects different periods of time and chronicity of stress levels in the subject, and different tissue-collection methods differ in degree of invasiveness. Studies of corticosterone in keratinized tissues of reptiles, such as shed skin, are limited in number compared to hair and feather glucocorticoid studies in avian and mammalian species, but warrant continued research, as they may reflect more different periods of time and chronicity of corticosterone levels than plasma or other tissues, and can be obtained in a minimally invasive manner. In this study, we measured corticosterone concentrations in both plasma and shed skin of Louisiana pine snakes (Pituophis ruthveni) that were all previously diagnosed with subclinical Cryptosporidium serpentis infection. We also tracked stressors experienced by different individuals to identify potential relationships between periods of increased stress and corticosterone levels in plasma and shed skin. There were no significant correlations between individual plasma and shed-skin corticosterone levels, or between corticosterone levels in either tissue type and stressors experienced. This is the first study where corticosterone levels were measured in plasma and shed skin of Louisiana pine snakes, and is the first known evaluation of plasma and shed-skin corticosterone levels in a snake population previously testing positive for Cryptosporidium serpentis.Abstract
The Journal of Herpetological Medicine and Surgery (JHMS) is designed to be a source of information for veterinarians and others involved in the health of reptiles and amphibians. JHMS is interested in all aspects of care for these species, including natural history and maintenance in captivity as well as particular medical and surgical problems. All authors are welcome to submit manuscripts for consideration. Student authors (including undergraduate, veterinary, graduate, residents, interns, etc.) enrolled in a full-time education program will be granted a complimentary 1-year online student membership to the Association of Reptile and Amphibian Veterinarians once they have completedSCOPE
