Radiographic identification of challenging gastrointestinal tract foreign bodies: a descriptive study of how appearance varies in air versus water to aid interpretation.

OBJECTIVE: To provide veterinarians with updated radiographic descriptions of select radiolucent foreign material in a simulated gastrointestinal environment. SAMPLE: 368 veterinarian respondents from the US. METHODS: An online survey was administered between June 18, 2023, and July 2, 2023, through a private veterinarian-based social media group. Representative commonly ingested foreign bodies were radiographed surrounded by air and water to simulate being within the gastrointestinal tract. Two examiners evaluated and qualified the opacity of the objects for each environment. RESULTS: The private social media group had a total of 3,900 members including veterinarians from all disciplines. A total of 362 small animal veterinarians (9.3% of the group) responded to the study reporting a total of 123 foreign objects that were not causing mechanical obstruction at the time of initial presentation. Sixty-eight foreign bodies were reported greater than or equal to 5 times and grouped as balls (n = 4), food (9), fabric (14), wood (3), soft plastic (14), hard plastic (18), or other (6). Most (98.5% [67/68]) objects were easily identifiable in air. In water, 23.5% (16/68) of the objects were obscured, and 39.7% (27/68) had inversion of the major opacity when compared to the opacity in air. CLINICAL RELEVANCE: The opacity of some ingested radiolucent material can invert relative to air or fluid, which may reflect substantial differences in detection following repositioning. When known dietary indiscretion occurs, radiographing a sample of the material in air and water will improve the accuracy of assessment.

Pinniped electroencephalography: Methodology and findings in California sea lions (Zalophus californianus).

This study was designed to identify abnormalities in the electroencephalograms (EEGs) recorded from stranded California sea lions (Zalophus californianus) with suspected domoic acid (DA) toxicosis. Recordings from animals presenting for non-neurological issues were also obtained to better understand the normal EEG (background activity and transient events) in this species, as, to date, studies have focused on examining natural sleep in pinnipeds. Most animals were sedated for electrode placement and EEG acquisition with some receiving antiepileptic medications or isoflurane during the procedure. A total of 103 recordings were read and scored from 0 (normal) to 3 (severely abnormal). Epileptiform discharges, consisting of spikes, sharp waves, slow waves, and/or spike waves, were present in all EEGs with scores of 1, 2, or 3. The distribution of these events over the scalp varied. While often generalized, others were lateralized over one hemisphere, bifrontal, bioccipital, and/or bitemporal, while some discharges were multifocal. Findings were different between sea lions and occasionally changed within the EEG on a given sea lion. No clinical seizures were observed during the recording but a few sea lions had findings consistent with electroencephalographic seizures. When available, supporting diagnostic results obtained from magnetic resonance imaging (MRI) and/or necropsy/histopathology were described, as well as the status of those sea lions that recovered and were released with satellite tags.

Description of normal pulmonary radiographic findings in 55 apparently healthy juvenile Kemp's ridley sea turtles (Lepidochelys kempii).

A total of 55 digital radiographic studies from 53 individual juvenile Kemp's ridley sea turtles (Lepidochelys kempii) were retrospectively used to determine the normal radiographic anatomy of the lower respiratory tract in sea turtles that had been stranded due to hook-and-line injury and were otherwise clinically healthy. There were three or four projections available for each study: dorsoventral (DV), rostrocaudal (RoCd), and left and/or right lateral. The DV and RoCd were most conducive for assessing global lung volume and symmetry of lung volume. The DV and lateral views were most helpful for evaluating the main bronchus and its branching channels and for assessing lung margination. The RoCd view was most useful for assessing the symmetry of the lung opacity. The lateral views were most helpful for assessing the ventral margin of each lung lobe. On the lateral view, the main bronchus lay ventrally and coursed horizontally through the lung from cranial to caudal. On the DV view, the bronchus lay medially and was observed to be curvilinear coursing caudomedially. On the RoCd view, the main bronchus was located ventromedially. The RoCd view demonstrated the channels and niches end-on resulting in a reticulated or honeycomb appearance. The channels were seen as uniform striations coursing perpendicular to the main bronchus on the lateral views (vertical striations coursing dorsal to ventral) and DV views (horizontal striations coursing medially to laterally).

BARIUM SULFATE GELATIN AS A NOVEL APPROACH TO FACILITATE GASTROINTESTINAL TRACT POSITIVE CONTRAST STUDIES IN A CAPTIVE HARBOR SEAL (PHOCA VITULINA) AND CALIFORNIA SEA LIONS (ZALOPHUS CALIFORNIANUS) WITHOUT RESTRAINT.

Gastrointestinal tract contrast medium studies are a valuable diagnostic modality to evaluate gastrointestinal anatomy, motility, and pathology. Four positive contrast medium studies were performed twice on a harbor seal (Phoca vitulina) and once each on two California sea lions (Zalophus californianus) to evaluate for gastrointestinal abnormalities by using barium-impregnated gelatin. Because marine mammals in human care routinely receive plain gelatin as a component of their diet and as secondary reinforcement, feeding a barium gelatin mitigates the need for tube feeding or restraint. Operant conditioning was used to position the pinnipeds for voluntary radiographs. The barium gelatin permitted adequate evaluation of gastric emptying and intestinal transit times and good evaluation of the structure of the intestinal tract. Full evaluation of gastric anatomy was limited due to the gelatin blocks not conforming to the stomach in their solid form and the barium quickly exiting the stomach as barium gelatin blocks disintegrated and because orthogonal views could not always be acquired. Even with these limitations, barium gelatin resulted in diagnostically valuable contrast imaging in a stress-free patient setting with reduced risk of aspiration and eliminated the effects that anesthesia can have on gastric motility as well as other anesthesia-associated risks.

Xenotransplantation of porcine progenitor cells in an epileptic California sea lion (Zalophus californianus): illustrative case.

BACKGROUND: Domoic acid (DA) is a naturally occurring neurotoxin harmful to marine animals and humans. California sea lions exposed to DA in prey during algal blooms along the Pacific coast exhibit significant neurological symptoms, including epilepsy with hippocampal atrophy. OBSERVATIONS: Here the authors describe a xenotransplantation procedure to deliver interneuron progenitor cells into the damaged hippocampus of an epileptic sea lion with suspected DA toxicosis. The sea lion has had no evidence of seizures after the procedure, and clinical measures of well-being, including weight and feeding habits, have stabilized. LESSONS: These preliminary results suggest xenotransplantation has improved the quality of life for this animal and holds tremendous therapeutic promise.

DEVELOPMENT OF A MOBILITY ASSESSMENT SCORE FOR EVALUATION OF THE EFFECTS OF ORAL HYALURONIC ACID ON CLINICAL LAMENESS IN ASIAN SMALL-CLAWED OTTERS (AONYX CINEREA) AND AFRICAN SPOT-NECKED OTTERS (HYDRICTIS MACULICOLIS) UNDER HUMAN CARE.

Oral hyaluronic acid has been shown to reduce inflammation and pain in humans with osteoarthritis. Eight Asian small-clawed otters (Aonyx cinerea) and two African spot-necked otters (Hydrictis maculicolis) with varying degrees of osteoarthritic changes identified on radiographs were selected for a randomized, double-blinded, placebo-controlled clinical trial. Animal husbandry staff completed otter mobility assessment (OMA) questionnaires for each animal prior to study commencement and following either oral hyaluronic acid at a loading dose of 4 mg/kg PO SID for 10 d followed by a maintenance dose of 2 mg/kg PO SID for 20 d, or placebo for 30 d. Four veterinarians with experience assessing otters watched randomized videos of otter gaits and assigned a clinical lameness score. Two additional evaluators watched the videos: an experienced veterinarian in small animal practice and a final-year veterinary student. All evaluators for OMA and clinical lameness score were blinded to treatment group. Radiographs performed prior to, and following, the study were assessed by a board-certified radiologist (Dennison). The OMA questionnaire had high reliability coefficients and correlated strongly with clinical gait scores and radiographic assessment. Although hyaluronic acid appears to be safe for use in otters at the dose described, there was no observed significant effect of hyaluronic acid on clinical lameness scores, OMA scores, or radiographic assessment of the limbs. The development of the OMA questionnaire is a promising tool for evaluating lameness in managed-care otters and may be further validated in future studies investigating therapeutics or incorporated as a component of animal welfare assessment.

The first occurrence of an avian-style respiratory infection in a non-avian dinosaur.

Other than repaired fractures, osteoarthritis, and periosteal reaction, the vertebrate fossil record has limited evidence of non-osseous diseases. This difficulty in paleontological diagnoses stems from (1) the inability to conduct medical testing, (2) soft-tissue pathologic structures are less likely to be preserved, and (3) many osseous lesions are not diagnostically specific. However, here reported for the first time is an avian-style respiratory disorder in a non-avian dinosaur. This sauropod presents irregular bony pathologic structures stemming from the pneumatic features in the cervical vertebrae. As sauropods show well-understood osteological correlates indicating that respiratory tissues were incorporated into the post-cranial skeleton, and thus likely had an 'avian-style' form of respiration, it is most parsimonious to identify these pathologic structures as stemming from a respiratory infection. Although several extant avian infections produce comparable symptoms, the most parsimonious is airsacculitis with associated osteomyelitis. From actinobacterial to fungal in origin, airsacculitis is an extremely prevalent respiratory disorder in birds today. While we cannot pinpoint the specific infectious agent that caused the airsacculitis, this diagnosis establishes the first fossil record of this disease. Additionally, it allows us increased insight into the medical disorders of dinosaurs from a phylogenetic perspective and understanding what maladies plagued the "fearfully great lizards".

An MRI protocol for anatomical and functional evaluation of the California sea lion brain.

BACKGROUND: Domoic acid (DOM) is a neurotoxin produced by some harmful algae blooms in coastal waters. California sea lions (Zalophus californianus) exposed to DOM often strand on beaches where they exhibit a variety of symptoms, including seizures. These animals typically show hippocampal atrophy on MRI scans. NEW METHOD: We describe an MRI protocol for comprehensive evaluation of DOM toxicosis in the sea lion brain. We intend to study brain development in pups exposed in utero. The protocol depicts the hippocampal formation as the primary region of interest. We include scans for quantitative morphometry, functional and structural connectivity, and a cerebral blood flow map. RESULTS: High-resolution 3D anatomical scans facilitate post hoc slicing in arbitrary planes and accurate morphometry. We demonstrate the first cerebral blood flow map using MRI, and the first structural tractography from a live sea lion brain. COMPARISON WITH EXISTING METHODS: Scans were compared to prior anatomical and functional studies in live sea lions, and structural connectivity in post mortem specimens. Hippocampal volumes were broadly in line with prior studies, with differences likely attributable to the 3D approach used here. Functional connectivity of the dorsal left hippocampus matched that found in a prior study conducted at a lower magnetic field, while structural connectivity in the live brain agreed with findings observed in post mortem studies. CONCLUSIONS: Our protocol provides a comprehensive, longitudinal view of the functional and anatomical changes expected to result from DOM toxicosis. It can also screen for other common neurological pathologies and is suitable for any pinniped that can fit inside an MRI scanner.

MYCOBACTERIAL DISEASE AND SUBSEQUENT DIAGNOSTIC INVESTIGATIONS IN A GROUP OF CAPTIVE PINNIPEDS IN NEW ZEALAND.

This case series includes a single case of disseminated tuberculous disease due to Mycobacterium pinnipedii in a New Zealand fur seal (Arctocephalus forsteri), which was being cared for by a zoo in New Zealand. The remaining five pinnipeds in the colony underwent extensive mycobacterial disease surveillance over the following 4 yr, involving a total of 26 anesthetic procedures and numerous diagnostic tests that included comparative intradermal tuberculin skin tests, mycobacterial antibody serology, respiratory and gastric lavages, and computed tomography (CT) scans. An additional case of chronic sinusitis due to Mycobacterium marinum and Pseudomonas aeruginosa was identified in a California sea lion (Zalophus californianus). Results from CT and the respiratory lavages were the most helpful antemortem diagnostic tests for active mycobacterial disease in this case series. Of the remaining four animals, two were euthanatized and two remain alive, and none of them had evidence of active mycobacterial disease. Further mycobacterial disease surveillance in staff and animals was performed, and no other case was identified. There are no validated mycobacterial surveillance tests available for pinnipeds and so it remains unknown whether the two surviving pinnipeds are truly negative or whether they have latent mycobacterial infection that could develop into active mycobacterial disease in the future. For this reason, increased levels of biosecurity and quarantine remain permanently in place for the pinniped colony.

Renal and vaginal calculi in a free-ranging long-beaked common dolphin Delphinus capensis.

Bilateral nephrolithiasis with a concurrent vaginal calculus was identified in a stranded free-ranging long-beaked common dolphin Delphinus capensis. Necropsy and radiologic examinations of the sexually mature D. capensis revealed multiple small irregularly round nephroliths and a 6.4 × 4.1 × 9.2 cm vaginal calculus weighing 182 g. Nephroliths numbered 68 and 71 in the left and right kidneys, respectively, and ranged from 1.7 to 6.9 mm in diameter. Nephroliths were composed of 100% ammonium urate, which has been found in captive dolphin populations. However, the vaginolith consisted of struvite and calcium carbonate suggesting an alternate etiology. The composition of the vaginolith suggests that bacterial vaginitis could have served as the predisposing condition. Renal lesions included chronic tubulointerstitial nephritis with tubular degeneration and loss, likely secondary to the nephroliths. The pathogenesis of ammonium urate nephrolithiasis in managed care is suspected to be linked to diet and age but in this case may be due to metabolic disruption. However, if environmental changes cause a shift in prey species, the risk of nephrolithiasis in free-ranging cetaceans could increase. Careful surveillance for nephroliths in free-ranging populations should be considered by researchers.

Clinical signs and mortality of non-released stranded California sea lions housed in display facilities: the suspected role of prior exposure to algal toxins.

Stranded California sea lions considered unable to survive in the wild are often placed in public display facilities. Exposure to the biotoxin domoic acid (DA) is a common cause of stranding, and chronic effects are observed long after initial exposure. Medical records for 171 sea lions placed in US institutions between 2000 and 2016 were reviewed, including results from clinical examinations, histopathology, behavioural testing and advanced imaging. There was a statistically significant increase in neurological disease detected in neonates (24%) compared with other age classes (11%). Sixty per cent of all neurological cases died during the study period. In the 11 neurological neonate cases, six died (55%) and five are still alive with three of five developing epilepsy during placement. Of the six neurological neonate cases that died, one was attributed to DA toxicosis, one to seizures and four to acute unexplained neurological disease. This survey suggests delayed neurological disease can develop in sea lions after stranding as neonates. These data coupled with stranding records and epidemiological data on DA-producing algal blooms suggest further research into effects of neonatal exposure to DA on risk of neurological disease in later life is warranted. California sea lions offer a natural model of DA exposure to study such effects.

URINARY BLADDER TRANSITIONAL CELL CARCINOMA AND CARCINOMATOSIS IN A LINNAEUS'S TWO-TOED SLOTH, CHOLOEPUS DIDACTYLUS.

A 19-yr-old female Linnaeus's two-toed sloth (Choloepus didactylus) with a history of urinary incontinence, ascites, and behavioral changes was euthanized after diagnostic imaging revealed a large bladder mass. On gross necropsy, the sloth had a severely thickened bladder mucosa, partial urinary obstruction, and nonseptic exudate in the peritoneal cavity. Histopathology showed a malignant and highly invasive transitional cell (urothelial) carcinoma with transmural and intra-abdominal invasion and diffuse carcinomatosis. Immunohistochemistry for expression of pancytokeratin (AE1/AE3), cytokeratin 7 (CK7), cytokeratin 20 (CK20), and uroplakin III was performed to confirm the diagnosis of transitional cell carcinoma. Neoplastic cells had a strong cytoplasmic immunoreactivity with the antipancytokeratin antibody clone AE1/AE3, which was consistent with a neoplasm of epithelial origin. Neoplastic cells were negative for expression of CK20. This is the first detailed report describing the antemortem diagnosis of urinary bladder transitional cell carcinoma with carcinomatosis in a two-toed sloth.

Ventilation and gas exchange before and after voluntary static surface breath-holds in clinically healthy bottlenose dolphins, Tursiops truncatus.

We measured respiratory flow (V̇), breathing frequency (fR), tidal volume (VT), breath duration and end-expired O2 content in bottlenose dolphins (Tursiops truncatus) before and after static surface breath-holds ranging from 34 to 292 s. There was considerable variation in the end-expired O2, VT and fR following a breath-hold. The analysis suggests that the dolphins attempt to minimize recovery following a dive by altering VT and fR to rapidly replenish the O2 stores. For the first breath following a surface breath-hold, the end-expired O2 decreased with dive duration, while VT and fR increased. Throughout the recovery period, end-expired O2 increased while the respiratory effort (VT, fR) decreased. We propose that the dolphins alter respiratory effort following a breath-hold according to the reduction in end-expired O2 levels, allowing almost complete recovery after 1.2 min.

Natural exposure to domoic acid causes behavioral perseveration in Wild Sea lions: Neural underpinnings and diagnostic application.

Domoic acid is a naturally occurring algal toxin that causes neurological symptoms and mortality in exposed marine life. California sea lions (Zalophus californianus) are the most visible victims, and suffer epilepsy and progressive hippocampal atrophy. Despite its reliable neurological effects, little is known about how exposure to domoic acid alters behavior, which is critical for understanding the impact of toxic exposure on long-term survival in sea lions and other exposed animals, including humans. Better understanding of the behavioral effects may also inform veterinary diagnosis and treatment. Anecdotally, exposed sea lions have been reported to show enhanced perseverative behavior. To assess the neurobehavioral effects of domoic acid, we compared veterinary diagnoses, measures of hippocampal volume from in vivo MRI, and behavioral measures of habituation and dishabituation in 27 wild sea lions undergoing rehabilitation. The sample was divided post-hoc between subjects with clear veterinary diagnoses of chronic domoic acid toxicosis and those with no evidence of the disease. In the behavioral task, subjects were exposed repeatedly to sounds from two source locations, and, following a short delay, exposed again. Veterinary diagnosis of domoic acid toxicosis was associated with extent of hippocampal damage, predicted delayed habituation in phase 1, and enhanced dishabituation in phase 2. Receiver operating characteristic analysis indicated that delayed habituation in phase 1 was diagnostically predictive. Enhanced dishabituation in phase 2 was correlated with reduced right ventral hippocampal volume. Together, delayed habituation and enhanced dishabituation following domoic acid exposure indicate a clinically relevant and potentially maladaptive behavioral pattern of perseveration.

Algal toxin impairs sea lion memory and hippocampal connectivity, with implications for strandings.

Domoic acid (DA) is a naturally occurring neurotoxin known to harm marine animals. DA-producing algal blooms are increasing in size and frequency. Although chronic exposure is known to produce brain lesions, the influence of DA toxicosis on behavior in wild animals is unknown. We showed, in a large sample of wild sea lions, that spatial memory deficits are predicted by the extent of right dorsal hippocampal lesions related to natural exposure to DA and that exposure also disrupts hippocampal-thalamic brain networks. Because sea lions are dynamic foragers that rely on flexible navigation, impaired spatial memory may affect survival in the wild.

LAPAROSCOPIC GASTROPEXY FOR CORRECTION OF A HIATAL HERNIA IN A NORTHERN ELEPHANT SEAL (MIROUNGA ANGUSTIROSTRIS).

A female northern elephant seal (Mirounga angustirostris) weaned pup presented with malnutrition. During rehabilitation, the seal developed regurgitation and reduced lung sounds on auscultation. Radiographs and endoscopy performed under sedation suggested a diaphragmatic hernia. A Type I (or sliding) hiatal hernia was confirmed with a positive contrast upper gastrointestinal study, revealing varying degrees of herniation of the gastric fundus through the diaphragm into the caudal thorax as well as esophageal reflux. The animal was treated preoperatively with an H2 antagonist and antinausea medication. A laparoscopic gastropexy was performed under general anesthesia. The animal recovered well postoperatively and resolution of clinical signs was achieved. The animal was released back into the wild 21 kg above admit weight. To our knowledge, we report here the first surgical correction of a hiatal hernia in a marine mammal.

Clostridium perfringens septicemia in a long-beaked common dolphin Delphinus capensis: an etiology of gas bubble accumulation in cetaceans.

An adult female long-beaked common dolphin Delphinus capensis live-stranded in La Jolla, California, USA, on July 30, 2012 and subsequently died on the beach. Computed tomography and magnetic resonance imaging revealed gas bubble accumulation in the vasculature, organ parenchyma, mandibular fat pads, and subdermal sheath as well as a gas-filled cavity within the liver, mild caudal abdominal effusion, and fluid in the uterus. Gross examination confirmed these findings and also identified mild ulcerations on the palate, ventral skin, and flukes, uterine necrosis, and multifocal parenchymal cavitations in the brain. Histological review demonstrated necrosis and round clear spaces interpreted as gas bubbles with associated bacterial rods within the brain, liver, spleen, and lymph nodes. Anaerobic cultures of the lung, spleen, liver, bone marrow, and abdominal fluid yielded Clostridium perfringens, which was further identified as type A via a multiplex PCR assay. The gas composition of sampled bubbles was typical of putrefaction gases, which is consistent with the by-products of C. perfringens, a gas-producing bacterium. Gas bubble formation in marine mammals due to barotrauma, and peri- or postmortem off-gassing of supersaturated tissues and blood has been previously described. This case study concluded that a systemic infection of C. perfringens likely resulted in production of gas and toxins, causing tissue necrosis.

An optimized computed tomography protocol for metallic gunshot head trauma in a seal model.

Computed tomography (CT) is commonly used to assess animals with head trauma. However, strongly attenuating objects such as metallic gunshot cause artifacts that may make accurate localization of shrapnel pieces difficult. The purpose of this study was to develop an optimized CT protocol for minimizing metal artifacts in an animal model of gunshot head trauma. A cadaver head of a stranded Gray seal (Halichoerus grypus) was shot post-mortem with a 0.223-inch caliber rifle. The head was frozen, thawed, and scanned using a multislice CT scanner and protocols with varying acquisition and reconstruction parameters. Scans were acquired with and without use of the scanner's proprietary Extended CT Scale (ECTS) mode and beam hardening reduction (Posterior Fossa Optimization [PFO]) filter. Window/level display settings were also varied. For each protocol and each of five selected metallic shrapnel pieces, a single observer measured combined metal halo artifact and shrapnel area using a hand-traced region of interest. The number of hypo- and hyper-attenuating streak artifacts was also recorded. Measurements were repeated for three different reading sessions. Metal CT artifacts were minimized with a high-frequency image reconstruction algorithm and a wide window setting. Further artifact reduction was achieved with a proprietary ECTS raw data reconstruction technique and a very wide window. This enabled a more confident evaluation of surrounding bone. On the other hand, these techniques are unfortunately not effective under conditions of soft tissue evaluation. Increasing tube voltage and use of a proprietary PFO filter did not yield a significant reduction in metal artifacts.

Retroperitoneal hemangiosarcoma in a common carp Cyprinus carpio: a case report.

A 7.5 kg common carp Cyprinus carpio presented with prominent localized swelling in the caudal right coelomic area, identified by ultrasound as a fluid filled mass. Fine needle aspirate (FNA) and culture results suggested a sterile seroma. Centesis removed 290 ml of serosanguinous fluid that returned within days. Recheck ultrasonography revealed a solid component within the cavity. Radiography demonstrated irregular lysis and misalignment of vertebrae adjacent to the mass, most suggestive of bacterial osteitis or neoplasia. Treatment with antibiotics followed for 2 mo but failed to resolve the lesion. Repeated radiography and ultrasonography showed progressive enlargement of the mass, with vertebral lysis and invasion characteristic of neoplasia. Ultrasound-guided FNA of the solid component of the mass was non-diagnostic. Euthanasia was elected due to the poor clinical response and primary differential of neoplasia. Post-mortem MRI and CT confirmed a retroperitoneal soft tissue mass, partially surrounded by a fluid-filled cavity, causing vertebral lysis and infiltration of the spinal canal. Expansion of the mass caused severe muscle loss and an associated elevation in creatine kinase (>120000 U l-1). Necropsy results corroborated the MRI and CT findings, revealing a retroperitoneal, multilobular, red and tan mass causing dorsal displacement of the vertebral column, with vertebral lysis, pathologic fracture and invasion of the spinal canal. Histopathologic examination revealed a locally aggressive neoplasm exhibiting multiple patterns of growth, including endothelial lined vascular channels and solid areas formed by more pleomorphic polygonal and spindle cells, consistent with hemangiosarcoma.

Diagnosis and management of intestinal partial obstruction in a loggerhead turtle (Caretta caretta).

A loggerhead sea turtle (Caretta caretta) was suspected of ingesting rubber suction cups during rehabilitation following a cold-stun event. Survey radiographs were inconclusive. Computed tomography (CT) was performed to determine whether the objects had been ingested after traditional radiographs failed to resolve the material. The items were identified, and a partial obstruction was diagnosed. The case was managed with medical therapy using white petrolatum and light mineral oil administered to the turtle in fish for 3 wk. The CT exam was repeated 2 wk into the therapy. A persistent partial obstruction was identified; however, progression of the foreign objects through the intestinal tract was evident and continued medical mangement was deemed appropriate. The foreign bodies were passed with feces 26 days after ingestion.