Diarrhea associated with enterotoxigenic Clostridium perfringens in a red-footed tortoise (Geochelone carbonaria).

Enterotoxigenic Clostridium perfringens was associated with diarrhea in a 4-yr-old female captive-bred red-footed tortoise (Geochelone carbonaria). Diagnosis was based on bacterial culture, detection of C. perfringens enterotoxin in feces, and exclusion of commonly recognized pathogens. After treatment with metronidazole, normal feces were passed and C. perfringens enterotoxin was no longer detected in the feces. Although the role of C. perfringens cannot be determined definitively from this case, this pathogen should be considered in cases of diarrhea in tortoises and, perhaps, other reptiles.     

Undifferentiated sarcoma resolved by forelimb amputation and prosthesis in a radiated tortoise (Geochelone radiata).

An adult female, radiated tortoise (Geochelone radiata) presented with a grossly swollen left forelimb that restricted mobility and prevented limb withdrawal. Clinical pathology revealed leukopenia (1.9 x 10(9)/L) and hyperproteinemia (69 g/L) that on protein electrophoresis was attributed to increased acute-phase proteins in the alpha fraction (26.4 g/L). Biopsy revealed a poorly differentiated soft tissue sarcoma. Surgical amputation at the proximal humerus was curative. To encourage postoperative mobility, a novel methylmethacrylate prosthesis, molded from a lubricated transected tennis ball, was adhered to the plastron using three cortical bone screws. This is the first recorded case of a sarcoma in the genus Geochelone.     

Acute ibuprofen toxicosis in a ferret

A 20-month-old 1.44-kg (3.2-lb) castrated male ferret was examined because of vomiting, defecating in an abnormal location, dyspnea, and signs of depression. Within 5 minutes of initial evaluation, the ferret became nonresponsive to all stimuli except deep pain. Despite intensive supportive treatment, the ferret died. Toxicologic analyses for ibuprofen were performed on serum, urine, and liver, using gas chromatography and mass spectrophotometry. Serum ibuprofen concentrations were 245 micrograms/g before and 269 micrograms/g after death. Acute ibuprofen toxicosis may cause severe lethargy progressing to coma, apnea, and death in ferrets. Ibuprofen toxicosis should be considered in differential diagnoses for ferrets with signs of depression, with or without clinical signs of gastrointestinal tract dysfunction.     

Intranuclear coccidiosis in tortoises: nine cases

Chelonian intranuclear coccidiosis has been reported once, in two radiated tortoises (Geochelone radiata), and is apparently rare. We describe intranuclear coccidiosis diagnosed histologically in two radiated tortoises, three Travancore tortoises (Indotestudo forstenii), two leopard tortoises (Geochelone pardalis), one bowsprit tortoise (Chersina angulata), and one impressed tortoise (Manouria impressa). Infection was systemic and involved alimentary, urogenital, respiratory, lymphoid, endocrine, and integumentary systems. Trophozoites, meronts, merozoites, macrogametocytes, microgametocytes, and nonsporulated oocysts were seen histologically or by electron microscopy. Intracytoplasmic and extracellular stages of parasite development also were identified histologically. Sequencing of a coccidial 18S rRNA consensus polymerase chain reaction (PCR) product revealed a novel sequence that provided phylogenetic information and may be useful for further diagnostic test design. Intranuclear coccidiosis was associated with variable degrees of inflammation in all cases, was considered the cause of death in six tortoises, and was a substantial contributing factor to the cause of death in two tortoises.     

Nonsteroidal anti-inflammatory drug toxicosis in dogs and cats: 240 cases (1989-1990)

A search of medical records at the Georgia Animal Poison Information Center over a 19-month period revealed 240 cases of dog and cat exposure to nonsteroidal anti-inflammatory drugs (NSAID). The most common NSAID consumed were ibuprofen, acetaminophen, aspirin, and indomethacin. The most common clinical signs of toxicosis were vomiting and diarrhea, CNS depression, and circulatory manifestations. Pets are at risk from NSAID toxicosis through administration by the owners or accidental consumption of improperly stored drugs.     

Rebound hyperkalemia in a dog with albuterol toxicosis after cessation of potassium supplementation

Objective

To describe the presentation of rebound hyperkalemia as a delayed side effect of albuterol toxicity in a dog.

Case Summary

A 3-year-old female neutered mixed-breed dog was presented for albuterol toxicosis that led to a severe hypokalemia, hyperlactatemia, and hyperglycemia. The dog also experienced sinus tachycardia and generalized weakness. Treatment was instituted with intravenous fluid therapy and potassium supplementation, and the dog was monitored with a continuous electrocardiogram. Resolution of hypokalemia was documented 12 hours after initial presentation, at which time fluid therapy and potassium supplementation were discontinued. There were no further periods of sinus tachycardia, but instead the dog developed ventricular ectopy with rapid couplets (instantaneous rates of 300/min). An echocardiogram revealed normal cardiac size and function. Twenty-four hours after presentation, the patient developed severe hyperkalemia, despite discontinuation of fluids and potassium supplementation for 12 hours. Serial venous and urinary electrolytes were performed for determination of the fractional excretion of electrolytes. These data confirmed rebound hyperkalemia (7.0 mmol/L), consistent with a markedly increased fractional excretion of potassium, and secondary to the release of potassium from inside the cells. Fluid therapy with dextrose supplementation was provided until 36 hours postpresentation. The hyperkalemia resolved, and the dog was discharged after 44 hours of hospitalization.

New or Unique Information Provided

This case documents rebound hyperkalemia following treatment of albuterol toxicosis in a dog. This case highlights the importance of understanding the distribution of total body potassium when treating serum hypokalemia. Transcellular shifts of potassium, as in the case of albuterol toxicosis, can lead to rebound hyperkalemia even after discontinuation of potassium supplementation. This case further explores the utility of fractional excretion of electrolytes in elucidating the etiology and management of electrolyte disturbances.     

Diagnosis of skeletal injuries in Chelonians using computed tomography.

Computed tomography (CT) was used to diagnose the cause of lameness in a radiated tortoise (Geochelone radiata) and to determine the extent of shell and skeletal trauma in two snapping turtles (Chelydra serpentina). The radiated tortoise's lameness was ultimately attributed to luxation of the right-shoulder joint that was not detected during plain film radiography. Axial and appendicular fractures were identified in one of the snapping turtles that were not detected during plain film radiography. In each patient, the information obtained during CT provided important diagnostic, therapeutic, or prognostic information.     

Survival and prognostic indicators for cycad intoxication in dogs

Background: Cycad palms are commonly used in landscaping and ingestion by dogs can cause disease or death. Objectives: Determine the morbidity and case fatality of cycad palm toxicosis in dogs from Louisiana, and examine putative prognostic factors. Animals: Thirty‐four client‐owned dogs with confirmed cycad palm toxicosis between 2003 and 2010. Methods: Retrospective cohort study. Search of all medical records for animals with cycad palm toxicosis. Results: Seventeen of 34 (50%) dogs died or were euthanized as a direct consequence of cycad intoxication. There were no differences in presenting signs and physical examination findings between survivors and nonsurvivors. Nonsurvivors had higher serum alanine transaminase activity (median 196 U/L; range 16–4,123 versus 113.5; 48–1,530) and total bilirubin concentration (0.5 mg/dL; 0.1–6.2 versus 0.25; 0–1.7) upon presentation, and their initial serum concentrations of albumin (2.9 g/dL; 1.4–4.1 versus 3.3; 2.2–3.9) were lower than those of survivors. Nadir serum albumin concentration was also lower in nonsurvivors (1.9; 1.4–3.7 versus 3.2; 1.8–3.5). A higher proportion of nonsurvivors had prolonged coagulation times, prothrombin time. and partial thromboplastin time. In a multivariate model, administration of charcoal at initial presentation was associated with longer survival (heart rate [HR] 0.019, 95% CI 0.001–0.644), while high serum aspartate aminotransferase activity was a negative prognostic factor (HR 118.2, 95% CI 2.89–4,826). Conclusions and Clinical Importance: Cycad intoxication is associated with a higher case fatality than previously published. Several laboratory parameters might help differentiating potential nonsurvivors from survivors. Administration of charcoal as part of the emergency treatment appears to have a protective effect.     

Evaluation of safety and efficacy of acaricides for control of the African tortoise tick (Amblyomma marmoreum) on leopard tortoises (Geochelone pardalis).

Nine acaricides (amitraz, carbaryl, chlorpyrifos, cyfluthrin, fipronil, lindane, permethrin, phenothrin, and pyrethrins) were studied for their efficacy in killing the African tortoise tick (Amblyomma marmoreum). Only four of the acaricides (chlorpyrifos, cyfluthrin, lindane, and permethrin) produced 100% mortality within 24 hr of application, and only two (cyfluthrin and permethrin) continued to cause 100% mortality when diluted to as low as 1:10,000. Five of the acaricides (amitraz, carbaryl, chlorpyrifos, cyfluthrin, and permethrin) were studied for toxicity to the leopard tortoise (Geochelone pardalis), the most common host of A. marmoreum. The results indicate that cyfluthrin and permethrin, which were herein found to be the two most effective acaricides for control of A. marmoreum, are also the safest acaricides for use on leopard tortoises.     

Presumptive hepatotoxicity and rhabdomyolysis secondary to phenazopyridine toxicity in a dog

Objective – To describe a rare, but potential clinical manifestation of phenazopyridine (PAP) toxicity in a dog. Case Summary – A 6‐year‐old spayed female Chihuahua was evaluated for ataxia and dysphagia after ingestion of 200 mg (66 mg/kg) of PAP hydrochloride. The dog was presented to the hospital with shifting leg lameness involving all 4 limbs, which progressed to reluctance to walk and severe diffuse muscle hyperesthesia. Clinical laboratory abnormalities included marked increases in serum alanine aminotransferase, aspartate aminotransferase, creatine kinase, mild increases in alkaline phosphatase, and increased c‐Tnl‐troponin concentration. Treatment included administration of intravenous fluids, muscle relaxants, pain medications, and hepatoprotectants for 5 days in the hospital, and medical management at home for an additional 5 days. Follow‐up examinations performed 1 and 6 months after initial presentation revealed the dog to be clinically healthy with serum biochemical profiles within reference intervals. New or Unique Information Provided – The purpose of this report is to describe an unusual manifestation of PAP toxicosis in a dog, which has not been previously reported in the literature. A review of the ASPCA Animal Poison Control Center database revealed 347 cases of PAP exposure in dogs during 2000–2009 underscoring the importance of being aware of this toxicity in the dog.     

Use of intralipid emulsion therapy to treat suspected oleander toxicosis in a domestic goose (Anser anser domesticus)

Ingestion of toxic substances is a common event in companion animals and livestock, especially in waterfowl. Oleander (Nerium oleander) toxicosis is rarely reported in avian species, with symptoms including cardiac, neurological and gastrointestinal manifestations. A 6-month-old domestic goose (Anser anser domesticus) was presented for depression, anorexia, permanent sternal recumbency, weakness and incoordination, and the owners witnessed the ingestion of oleander leaves. Despite the absence of evident cardiac symptoms, biochemical hematological findings showed significant increase of CPK, AST, LDH, and troponin I. Therapy was set with intravenous (IV) fluid administration, antibiotic and anti-inflammatory, oral activated charcoal, and IV lipid emulsion at 15 mL/kg/h. Clinical improvement was achieved after 2 hours. The patient was discharged 3 days after admission, with complete recovery and return to normal biochemical values 10 days after initial presentation. The present work describes a suspected case of spontaneous oleander poisoning in a domestic goose, with the first use of troponin I to diagnose cardiac injury in this species, and the first report of IV lipid emulsion to successfully treat this kind of toxicosis in veterinary practice.     

Ibuprofen Ingestion in Ferrets: 43 Cases January 1995–March 2000)

Objective: To summarize typical clinical signs, characterize the anticipated course of action, and give treatment recommendations for ibuprofen ingestion in ferrets.
Design: Retrospective study
Patients: Records of 43 cases of ibuprofen ingestion in ferrets that were reported between January 1996-March 2000, to the ASPCA Animal Poison Control Center (APCC).
Measurements and Main Results: Twenty-seven (93.1%) ferrets that had ingested ibuprofen developed neurologic signs, such as depression, coma, ataxia, recumbency, tremors, and weakness. In addition, 16 cases (55.2%) had one or more GI effects including anorexia, vomiting, retching or gagging, diarrhea, and melena. Polydipsia, polyuria, dysuria, renal failure, weight loss, shallow breathing, metabolic acidosis, dehydration, and hypothermia were also reported. Death was reported in 4 cases. The lowest dose associated with death was 220 mg/kg.
Conclusion: Data in this study indicate that clinical signs of ibuprofen toxicosis in ferrets are more severe than those expected at similar dosages in dogs. The reason for this difference is poorly understood since the pathophysiology of ibuprofen is relatively unknown in ferrets. The onset of clinical signs appeared to occurr soon after ingestion and the toxic effects in ferrets typically involve the CNS, GI and renal systems. Treatment for ibuprofen toxicosis in the ferret includes stabilization, gastrointestinal decontamination, fluid diuresis, GI protection, and supportive care.(J Vet Emerg Crit Care 2001; 11(1):53–59)     

Synovial fluid from an African spur-thighed tortoise (Geochelone sulcata)

A 4.5-year old, male African spur-thighed tortoise (Geochelone sulcata) was presented to the University of Florida Veterinary Teaching Hospital with a 2-week history of lethargy, anorexia, constipation, dyspnea, and coughing up fluid or vomiting. Laboratory results included an inflammatory leukogram and a marked increase in plasma uric acid concentration. Synovial fluid from multiple joints was thick, chalky white, and opaque, with a grainy consistency. Microscopically, the fluid contained numerous brown, needle-like crystals consistent with urates (gout). Gross necropsy findings and histopathology confirmed a diagnosis of systemic gout, with urate deposition, gout tophi, and underlying necrosis in multiple organs, including kidneys, lung, and liver. Dehydration with concurrent renal insufficiency may have impaired urate excretion and led to a build-up of urates in the blood and tissues of this tortoise. A high protein diet also may have contributed to the development of gout. Cytologic evaluation of synovial fluid can be used as a quick and definitive tool to diagnose gout in tortoises.     

Hematochezia in an African spurred tortoise (Centrochelys sulcata)

An African spurred tortoise (Centrochelys sulcata) that had been housed with a conspecific was presented for tenesmus, diarrhea, and hematochezia of 48 hr duration. Husbandry was considered substandard. Hematology and plasma biochemical analysis revealed dehydration. Urinalysis was considered normal and fecal examination was negative for parasitic ova and protozoa. Radiography demonstrated moderate constipation. Initial treatment consisted of fluid therapy, enrofloxacin, metoclopramide, and improvement of husbandry practices. Recurrence of hematochezia developed 2 wk after initial presentation. Cloacoscopy followed by manual exteriorization of the penis revealed a puncture wound on the dorsal surface of the corpus cavernosum proximal to the glans penis. The wound was sutured using an absorbable monofilament material. The tortoise recovered uneventfully and was asymptomatic for the following 6 mo.     

Influence of environmental humidity and dietary protein on pyramidal growth of carapaces in African spurred tortoises (Geochelone sulcata)

The carapaces of captive-raised tortoises (terrestrial chelonians of the zoological family Testudinidae, often develop pyramidal-shaped osseous growth centrally within the horny plates. With very few exceptions (e.g. Geochelone elegans, Psammobates sp.), this conical growth pattern is considered to be pathologic. This very common defect is believed to be an important indicator of the quality of captive tortoise management. This study was designed to examine the effect of dietary protein level and environmental humidity on the degree of pyramidal growth in the carapaces. Fifty recently hatched African spurred tortoises (G. sulcata) were raised for 5 months under artificial conditions of varying environmental humidity and dietary protein content (14% vs. 19% vs. 30% crude protein in dry matter). Humps of the carapaces that developed and blood values of calcium, phosphorus and haematocrit were measured and compared among groups. Dry environmental conditions (24.3-57.8% and 30.6-74.8% relative humidity) produced taller humps than humid conditions (45-99% relative humidity). Hump formation differed significantly (p < or = 0.001) between these three groups kept under different humidity conditions. Variable dietary protein had a minor, positive impact on this pathological formation of humps (pyramidal growth syndrome, PGS). Analysis of blood (calcium, phosphorus and haematocrit) offered no further explanation as to the development of the humps.     

Effects of blood processing techniques on sodium and potassium values: a comparison between Aldabra tortoises (Geochelone gigantea) and Burmese mountain tortoises (Manouria emys)

Background: Hematologic and plasma biochemical evaluations are routinely used in evaluating the chelonian patient, but appropriate processing techniques have been minimally defined.
Objectives: This study was designed to compare the effects of temperature, time, anticoagulant, and species on sodium and potassium values in the Aldabra tortoise ( Geochelone gigantea ) and the Burmese mountain tortoise ( Manouria emys ).
Methods: Blood samples from 7 Aldabra tortoises and 8 Burmese mountain tortoises were collected into tubes without anticoagulant and tubes containing lithium heparin. Sodium and potassium concentrations were measured by flame photometry in serum and plasma harvested immediately after collection and from aliquots of whole blood stored at 4°C and 25°C for 5 to 120 minutes.
Results: In Aldabra tortoises, storage time and temperature had no significant effect on potassium concentrations in heparinized blood and in blood without anticoagulant. However, sodium concentrations in serum and plasma decreased significantly in samples without anticoagulant stored at 4°C and 25°C and in heparinized samples stored at 4°C. In Burmese mountain tortoises, potassium concentrations in serum and plasma increased significantly with time in samples without anticoagulant and in heparinized samples stored at 4°C and 25°C, but the increases were less at 4°C. Sodium concentrations in serum and plasma decreased significantly in blood without anticoagulant and heparinized blood stored at 4°C and 25°C.
Conclusions: Storage of blood samples with and without anticoagulant at 4°C significantly improved the stability of potassium and sodium concentrations in both species of tortoises. Early separation of red cells from serum or plasma after blood collection is especially important to ensure the reliability of potassium measurements.     

The developmental success of Amblyomma hebraeum and Amblyomma marmoreum on the leopard tortoise, Geochelone pardalis

The success of natural infestations of various life history stages of Amblyomma hebraeum and Amblyomma marmoreum on the leopard tortoise, Geochelone pardalis, was compared. Success was measured by the time taken for ticks to detach, as well as the percentage of ticks engorging and subsequently either moulting to the next life history stage or laying viable eggs. Larvae of A. hebraeum were the only developmental stage not recovered. Nymphae and female A. hebraeum were less successful in moulting or laying eggs than the corresponding stages of A. marmoreum. Nevertheless, 48,7% of A. hebraeum nymphae moulted, while 1 of 6 females laid viable eggs.     

Sedative Effects of Intranasal Midazolam and Dexmedetomidine in 2 Species of Tortoises (Chelonoidis carbonaria and Geochelone platynota)

The sedative effects of intranasal midazolam and dexmedetomidine were evaluated in 2 tortoise species as a means to facilitate handling and performing diagnostic procedures. Six red-footed tortoises (Chelonoidis carbonaria) and 6 Indian star tortoises (Geochelone platynota) received the following treatments in a randomized order with 2-week washout periods between the treatments: midazolam (0.5 and 1.5 mg/kg), dexmedetomidine (0.05 and 0.15 mg/kg), and saline control. Tortoises were evaluated and scored for sedation (using a previously published subjective method) by blinded observers, and results were averaged for each species and treatment group. Low-dose dexmedetomidine (0.05 mg/kg) in red-footed tortoises resulted in a significantly higher median sedation score at 5 minutes compared with other treatments. Control saline resulted in a higher median sedation score 5 minutes after administration in Indian star tortoises compared with red-footed tortoises. No other significant differences were observed between treatments or between species. The results suggest that intranasal administration of midazolam or dexmedetomidine, at the dosages used in this study, do not provide effective sedation in red-footed tortoises or Indian star tortoises, based on a subjective scoring system.     

Intraocular pressure determination in clinically normal red-footed tortoise (Geochelone carbonaria).

Intraocular pressure (IOP) reflects a balance between aqueous humor production and outflow and is often an essential ophthalmic diagnostic procedure in animals. The objective of this study was to estimate IOP in clinically normal red-footed tortoises (Geochelone carbonaria) of various sizes by using applanation tonometry. Intraocular pressures were estimated for 25 captive red-footed tortoises (10 males, 10 females, and 5 animals of unknown sex) by using an applanation tonometer after topical anesthesia. Body length ranged from 5.1 to 54.9 cm, measured from nuchal to anal scutes. Five measurements from each eye were obtained by a single observer in an ambient temperature of approximately 30 degrees C. Observer's reliability was good (intraclass r = 0.75), and IOP did not change over the ordered sequence of five replicate measurements. For individual tortoises the correlation for IOP between the left and right eyes was low (r = 0.20). The paired t-test did not show any statistical effect (P = 0.426) for the difference in IOP between the left and right eyes. Mean IOP determined for 10 confirmed males and 10 confirmed females did not differ between sexes (P = 0.244). The mean IOP of five small tortoises (< 10 cm long) was not significantly different (P = 0.244) from that of 20 large tortoises (> 10 cm long). In red-footed tortoises there does not appear to be any relation between carapace length and IOP.     

Survey of tortoises with urolithiasis in Japan

Urolithiasis is a disease often seen in tortoises at veterinary hospitals, however there have been no comprehensive research reports of tortoises with urolithiasis in Japan. In this study, we analyzed tortoises diagnosed with urolithiasis at three domestic veterinary hospitals. Based on medical records, we assessed the diagnostic method, species, sex, body weight, dietary history, husbandry, clinical signs, clinical examination, treatment for urolithiasis, and clinical outcome. The total number of cases in the 3 facilities was 101. As for species of tortoises, the most common was the African spurred tortoise (Centrochelys sulcata) with 42 cases (41.6%), followed by the Indian star tortoise (Geochelone elegans) with 30 cases (29.7%). Six other species were confirmed to have calculi. Almost all cases (99 cases, 98%) had a single calculus, and only 2 had multiple calculi. The prevalence of urolithiasis for the total number of tortoises having visited to one institution during the same period was 5.1%. Of the 86 cases that underwent calculi removal, 64 (74.4%) were successfully removed via the vent, and the efficacy of this method was confirmed. Nineteen cases (22%) were approached via plastronotomy, among which only 2 died postoperatively. In this study, we could not clarify the relationship between calculi formation and diets or other husbandry factors.