GROSS AND ULTRASONOGRAPHIC ANATOMY OF THE COELOMIC ORGANS OF HEALTHY AXOLOTLS (AMBYSTOMA MEXICANUM).

The objectives of this study were to describe the gross anatomy and ultrasonographic appearance of coelomic organs in subadult and adult axolotls (Ambystoma mexicanum), to describe an ultrasound technique, and to test correlations of ultrasonographic measurement with body length, width, and weight. Necropsies of coelomic organs were conducted on 10 axolotls (females = 5; males = 5) and ultrasound on 11 (males = 5; females = 6). Animals were kept in water and maintained conscious during ultrasound. The heart, caudal vena cava, liver, gallbladder, spleen, esophagus, stomach, colon, kidneys, ovaries, and fat bodies were identified in all study subjects, although testicles were identified in only 6/7 subjects. The pancreas and adrenal glands could not be identified in any animals, either during necropsy or ultrasonography. Coelomic and pericardial effusion was present in all animals. Ultrasonographic measurements of the liver, spleen, myocardial thickness, and right and left kidney length were highly repeatable (correlation value [CV] < 5%) and the esophagus, spleen, caudal vena cava, fat bodies, gallbladder, colon thickness, right kidney height and width, and right testicle diameter were statistically repeatable (CV < 10%).

COMPLETE UNILATERAL MAXILLECTOMY IN A COHORT OF FIVE COLOMBIAN BOAS (BOA IMPERATOR).

Five unrelated adult Colombian boas (Boa imperator) presented with a 1- to 3-mon history of unilateral rostral swelling of the maxilla associated with a chronic rubbing against the enclosure's walls. Moderate to severe gingival inflammation and ulceration of the labial mucosa were present at the level of the swelling with tenderness to the touch. Radiography revealed osteolytic or proliferative lesions of the maxillary bone. Chronic maxillary osteomyelitis was diagnosed. Unilateral maxillectomy was performed on each animal under general anesthesia. Local anesthesia was also achieved by infiltrating lidocaine along the medial and lateral aspect of the maxillary gingiva and at the level of the maxillo-ectopterygoid joint. Using a lateral gingival approach, the maxillo-prefrontal, maxillary-palatine, and maxillo-ectopterygoid attachments were transected, and the maxillary bone removed. Histologic examination revealed pyogranulomatous stomatitis and osteomyelitis in all snakes, and presence of intralesional bacteria (n = 3 snakes). Gram-negative bacteria (Chryseobacterium indologenes and Proteus mirabilis) were cultured from the resected tissue of two snakes. One snake suffered from wound dehiscence 5 d postoperatively. All snakes were fed 15 d postoperatively and ingested dead mice without apparent difficulties. One snake was examined 2 mon and 1 yr after surgery, with no evidence of soft tissue or osseous infection and only minor facial scaring; all other snakes were lost to follow-up 15 d after surgery. Unilateral maxillectomy was performed in a cohort of five Colombian boas suffering from maxillary osteomyelitis. This surgical technique should be considered as an alternative to medical treatment in boid snakes.

IRIDIUM 192 (192-Ir) HIGH DOSE RATE BRACHYTHERAPY IN A CENTRAL BEARDED DRAGON (POGONA VITTICEPS) WITH ROSTRAL SQUAMOUS CELL CARCINOMA.

A 0.5-kg, 9-yr-old, male central bearded dragon (Pogona vitticeps) presented with a proliferative mass (0.4 × 0.2 inches) on the left rostral aspect of the lower lip. Physical examination, blood work, and whole-body radiography did not reveal any other abnormalities. Histopathology confirmed squamous cell carcinoma. Considering the small size of the tumor, absence of deep tissue infiltration, and its radioresponsive characteristics, iridium 192 high dose rate brachytherapy was attempted. The dragon initially received three doses of 4 Gy/site at days 0, 7, and 17. Recurrence developed 3 mo later. Three more fractions of 6 Gy/site at days 0, 7, and 14 were delivered according to the same procedure. A second recurrence appeared after 2 mo. Surgical excision was then performed, followed by four fractions of 6 Gy/site on the surgical site at 2-wk intervals. Sixteen months posttreatment, no recurrence of the mass was observed.

TWO-DIMENSIONAL ECHOCARDIOGRAPHIC MEASUREMENTS IN THE BALL PYTHON (PYTHON REGIUS).

Reptiles can suffer from infectious and noninfectious cardiac pathologies, requiring the need for standardized diagnostic approaches and reference intervals. Despite the popularity of ball pythons (Python regius) as pets, echocardiographic measurements are unknown in this species. Twenty healthy adult ball pythons were evaluated to identify imaging planes, establish reference intervals for cardiac assessment by two-dimensional echocardiography, and study the effects of sex, body length, and body mass on heart rate, fractional shortening, and vascular, atrial, and ventricular dimensions. Echocardiography was performed under manual restraint. Most cardiac measurements were positively correlated with body length and mass, with the strongest correlation between ventricular end-systolic measurements and body length. The only significant difference found between sexes was for right and left atrial lengths. This study provides guidelines and reference intervals for two-dimensional echocardiographic measurements in adult healthy ball pythons.

HYPERTENSIVE HEART DISEASE AND ENCEPHALOPATHY IN A CENTRAL BEARDED DRAGON (POGONA VITTICEPS) WITH SEVERE ATHEROSCLEROSIS AND FIRST-DEGREE ATRIOVENTRICULAR BLOCK.

A 0.5 kg, 5-yr-old male bearded dragon (Pogona vitticeps) presented with a 2-mo history of lethargy, anorexia, and impaired locomotion. Upon physical examination, bradyarrhythmia (heart rate: 20 beats/min) and balance disorders were noted. Electrocardiography revealed a first-degree atrioventricular block (P-R interval: 360 ms). On echocardiography, all cardiac chambers were slightly above normal ranges. Complete blood count, blood biochemistry, and T4 were unremarkable except for mildly elevated aspartate aminotransferase. Adenovirus testing was negative by polymerase chain reaction. Following euthanasia, necropsy revealed marked thickening of the arterial trunks and histopathology confirmed multifocal atherosclerosis of efferent heart vessels, arteriosclerosis of cerebral arterioles, and multifocal spongiosis of brain tissue, more pronounced in the optic chiasma. Owing to its severity, atherosclerosis may have contributed to chronic arterial hypertension with damages to the heart, brain vessels, and brain tissue-optic chiasma.

RESTRICTIVE CARDIOMYOPATHY AND SECONDARY CONGESTIVE HEART FAILURE IN A MCDOWELL'S CARPET PYTHON (MORELIA SPILOTA MCDOWELLI).

Echocardiography is an established and noninvasive diagnostic tool used in herpetologic cardiology. Various cardiac lesions have been previously described in reptiles with the exception of restrictive cardiomyopathy. In this case report, restrictive cardiomyopathy and congestive heart failure associated with left atrial and sinus venosus dilation were diagnosed in a 2-yr-old captive lethargic McDowell's carpet python ( Morelia spilota mcdowelli), based on echocardiographic, Doppler, and histopathologic examinations. This cardiomyopathy was also associated with thrombosis within the sinus venosus.

Computed tomography-guided bone biopsies for evaluation of proliferative vertebral lesions in two boa constrictors (Boa constrictor imperator).

Two boa constrictors (Boa constrictor imperator) presented with paresis of the trunk originating cranial to the cloaca. Radiographs were consistent with proliferative bone lesions involving several vertebrae. Computed tomography (CT) demonstrated the presence of lytic/expansile lesions. Computed tomography-guided biopsies of the lesions were performed without complications. Histology was consistent with bacterial osteomyelitis and osteoarthritis. Gram-negative bacteria (Salmonella sp. and Pseudomonas sp.) were isolated from cultures of the biopsies. Medical treatment with specific antibiotics was attempted for several weeks in both cases without clinical or radiographic improvements. The animals were euthanized, and necropsy confirmed the findings observed upon CT. To the authors' knowledge, this is the first report of the use of CT-guided biopsies to evaluate proliferative vertebral lesions in snakes. In the present report, CT-guided biopsies were easily performed, and both histologic and microbiologic results were consistent with the final diagnosis.

Cheyletus eruditus (taurrus): an effective candidate for the biological control of the snake mite (Ophionyssus natricis).

The most commonly encountered ectoparasite in captive snakes is the hematophagous snake mite (Ophionyssus natricis). Infected snakes often exhibit lethargy, dysecdysis, pruritus, crusting dermatitis (sometimes progressing to abscesses), and behavioral changes (increased bathing time, rubbing against objects). Anemia and septicemia are occasional complications. Eliminating snake mites from a collection is frustrating. Insecticidal and acaricidal compounds used in mammals can be used against O. natricis infestation in reptiles, but they all are potentially neurotoxic to reptiles. The use of a biological agent to control the snake mite was first developed by using the predatory mites Hypoaspis miles and Hypoaspis aculeifer. However, no data are available regarding the potential of these mites to control O. natricis. Furthermore, the survival and predatory behavior of H. aculeifer and H. miles decreases above 28 degrees C, which is the lower value of the optimal temperature zone range required for rearing snakes. The aim of this study is to identify the ability of the predatory mite Cheyletus eruditus to control O. natricis. In the first experiment, 125 O. natricis mites where placed in separate plastic tubes together with the same number of C. eruditus mites. After 48 hr, the survival rate of snake mites was 6% compared with 92% in the control group (n = 125, P < 0,001). In the second experiment, 11 infested (average of 13 O. natricis per snake) ball pythons, with an average of 13 O. natricis per individual, were placed in separate cages with 1,000 C. eruditus mites + vermiculite After 15 days, only an average of two mites per snake remained, compared with 48 per snake in the control group (t-test, P < 0,01).

Major Emerging Fungal Diseases of Reptiles and Amphibians.

Emerging infectious diseases (EIDs) are caused by pathogens that have undergone recent changes in terms of geographic spread, increasing incidence, or expanding host range. In this narrative review, we describe three important fungal EIDs with keratin trophism that are relevant to reptile and amphibian conservation and veterinary practice. Nannizziopsis spp. have been mainly described in saurians; infection results in thickened, discolored skin crusting, with eventual progression to deep tissues. Previously only reported in captive populations, it was first described in wild animals in Australia in 2020. Ophidiomyces ophidiicola (formely O. ophiodiicola) is only known to infect snakes; clinical signs include ulcerating lesions in the cranial, ventral, and pericloacal regions. It has been associated with mortality events in wild populations in North America. Batrachochytrium spp. cause ulceration, hyperkeratosis, and erythema in amphibians. They are a major cause of catastrophic amphibian declines worldwide. In general, infection and clinical course are determined by host-related characteristics (e.g., nutritional, metabolic, and immune status), pathogens (e.g., virulence and environmental survival), and environment (e.g., temperature, hygrometry, and water quality). The animal trade is thought to be an important cause of worldwide spread, with global modifications in temperature, hygrometry, and water quality further affecting fungal pathogenicity and host immune response.

Case report: Intracoelomic neoplastic mass of undetermined origin in an Asia minor spur-thighed tortoise (Testudo graeca ibera).

This article describes the diagnostic, treatment and attempted characterization of a neoplasia of undetermined origin in a Asia minor spur-thighed tortoise. A 21-year-old male Asia minor spur-thighed tortoise (Testudo graeca ibera) was admitted for a 4-month history of diarrhea, and a 2-month history of anorexia and lethargy. Physical examination revealed a firm midcoelomic mass in the right prefemoral fossa. Blood biochemistry indicated hypocalcemia and mild elevation of aspartate aminotransferase. Supportive care was administered in the form of heating, baths, and calcium injections. Ultrasound examination of the coelomic cavity revealed a 6-cm diameter, highly vascularized mass with liver-like echogenicity. Neoplasia was suspected, and endoscopy was performed, revealing a brown circumscribed mass with smooth edges. Surgical removal of the mass was evaluated by CT scan and achieved via a plastrotomy; however, the patient died 1 day post-surgery. The mass was located on the dorsal right side of the coelomic cavity in the anatomic location of the right testicle. Histopathology revealed neoplastic cells organized in packets supported by fibrous septa. Neoplastic cells showed moderate and inconsistent positive immunohistochemical labeling for S100 and NSE, and negative immunohistochemical labeling for pan-cytokeratin, vimentin, CD3, CD79a, chromogranin A, and synaptophysin. The prominent histological and anatomical characteristics of the mass indicated a possible testicular or neuroendocrine (e.g., adrenal gland) origin. Due to inconclusive immunohistochemical profiles and poorly differentiated neoplastic cells, only a final diagnosis of intracoelomic malignant tumor of undetermined origin could be established. This case underscores the difficulties encountered in achieving definitive diagnoses of neoplastic diseases in reptile medicine.

Pancuronium Bromide for Chemical Immobilization of Adult Nile Crocodiles (Crocodylus niloticus): A Field Study.

(1) Background: Pancuronium bromide is a neuromuscular blocker used for immobilizing crocodiles that can be reversed with neostigmine. A recommended drug dose has only been established for saltwater crocodiles (Crocodylus porosus), mostly based on trials in juveniles and subadults. After trialing a dose recommendation in a small cohort of nine Nile crocodiles (Crocodylus niloticus), we developed and applied a new dose recommendation for large adult Nile crocodiles. (2) Methods: we trialed and adapted a pancuronium bromide (Pavulon 4 mg/2 mL) dose in Nile crocodiles originally established for saltwater crocodiles and applied the new dose for the immobilization of 32 Nile crocodiles destined for transport. Reversal was achieved with neostigmine (Stigmine 0.5 mg/mL). (3) Results: Nine crocodiles were included in the trial phase; the induction time was highly variable (average: 70 min; range: 20-143 min), and the recovery time was prolonged (average: 22 h; range: 50 min-5 days), especially in large animals after reversal with neostigmine. Based on these results, we established a dose-independent recommendation (3 mg pancuronium bromide and 2.5 mg neostigmine) for animals weighing ≥ 270 kg (TL ≥ ~3.8 m). When applied to 32 adult male crocodiles (BW range: 270-460 kg; TL range: 3.76-4.48 m), the shortest induction time was ~20 min and the longest ~45 min. (4) Conclusions: Pancuronium bromide and its antidote, neostigmine, are effective for the immobilization and reversal of adult male Nile crocodiles (TL ≥ 3.8 m or BW ≥ 270 kg) when given in a weight-independent fashion.

Heart Diseases in Reptiles: Diagnosis and Therapy.

The notion that poikilotherms do not suffer from cardiovascular conditions is being increasingly challenged as diagnostic tools used in companion animal practice are applied to reptiles. However, the cause, diagnosis, and treatment of cardiac conditions in reptiles is difficult because of the scarcity of published literature. Auscultation, electrocardiography, radiography, and ultrasonography are helpful diagnostic techniques in herpetologic practice. Although the pharmacokinetics and pharmacodynamics of cardiovascular drugs are poorly understood in these animals, basic principles remain applicable; these include pharmacologic and nonpharmacologic interventions. Further research is needed to establish species-specific cardiac reference ranges and evidence-based treatment options.

Clinical Reptile Behavior.

Reptile behavior varies widely among the approximately 11,000 species of this class. The authors' objective is to allow practitioners to discriminate between normal and abnormal behaviors in reptiles. Some of the most common reasons for presentation of behavioral issues are discussed, including hyperactivity, self-mutilation, biting, repetitive behaviors, and postural abnormalities. Medical problems and suboptimal husbandry causing abnormal behaviors should be ruled out by attending veterinarians. Addressing behavior issues involves determining a differential diagnosis through a systematic approach, which then allows implementation of necessary environmental changes including enrichment, developing plans for behavior modification and biomedical training, and medication when appropriate.

Atherosclerosis associated with pericardial effusion in a central bearded dragon (Pogona vitticeps).

Atherosclerosis is a common disease in pet birds, particularly in psittacines, and is frequently found when performing postmortem examinations on adult and old dogs, in which it is mainly associated with endocrine diseases, such as hypothyroidism and diabetes mellitus. However, atherosclerosis is poorly documented in reptiles and consequently poorly understood. In the current case report, atherosclerosis and pericardial effusion were diagnosed in a 2-year-old male central bearded dragon (Pogona vitticeps) based on ultrasound visualization, necropsy, and histologic examination.

Double valvular insufficiency in a Burmese python (Python molurus bivittatus, Linnaeus, 1758) suffering from concomitant bacterial pneumonia.

Ultrasonography, and, to a lesser extent, echocardiography are now well-established, noninvasive, and painless diagnostic tools in herpetologic medicine. Various cardiac lesions have been previously described in reptiles, but valvulopathy is rarely documented in these animals and, consequently, is poorly understood. In this report, sinoatrial and atrioventricular insufficiencies were diagnosed in a 5-yr-old captive dyspneic Burmese python (Python molurus bivittatus) on the basis of echocardiographic and Doppler examination. This case report is the first to document Doppler assessment of valvular regurgitations in a reptile.

Triple infection with agamid adenovirus 1, Encephaliton cuniculi-like microsporidium and enteric coccidia in a bearded dragon (Pogona vitticeps). / Dreifachinfektion mit Agamid-Adenovirus 1, einem Encephalitozoon-cuniculi-ähnlichen Mikrosporidium und Darmkokzidien bei einer Bartagame (Pogona vitticeps).

A 2-month-old juvenile central bearded dragon was presented for anorexia and cachexia. Another specimen from the same cage had died suddenly 2 weeks prior. Fecal analysis revealed a high quantity of Isospora amphiboluri and a few pinworm eggs. Other examinations were not performed and the animal died a few days later despite supportive care. A third individual from the same cage presented with anorexia and a distended cœlom and was euthanized. In this third dragon, histological examination revealed intestinal coccidiosis, basophilic intranuclear inclusions compatible with adenovirus infection, acute hepatic necrosis with intrahepatocytic and intraenteritic organisms typical of microsporidia and renal gout. A PCR confirmed the diagnosis of adenovirosis. Sequencing showed that the PCR product was 100% identical to the corresponding portion of the agamid adenovirus 1 genome. A PCR for the detection of Encephalitozoon (E.) cuniculi was positive. Partial sequencing revealed 100% identity to an E. cuniculi-like organism previously found in bearded dragons. In cases where environmental factors such as poor hygiene or stress can be excluded, the presence of opportunistic pathogens in high numbers can be due to a systemic (viral) infection with temporary immunosuppression.

Lymphoblastic lymphoma and leukemic blood profile in a red-tail boa (Boa constrictor constrictor) with concurrent inclusion body disease.

An adult male wild-caught true red-tail boa (Boa constrictor constrictor), imported from Surinam, was presented for anorexia, extreme lethargy, and coelomic swelling in the cranial third of the body, in the anatomic location of the thymus. The snake died a few minutes after blood sampling via cardiocentesis. Hematology revealed anemia and extreme leukocytosis (820 × 10(3)/ml) characterized by a predominance (95%) of lymphocytes. Necropsy revealed enlargement of most of the visceral organs. Histology confirmed lymphoblastic lymphoma with a leukemic blood profile and diffuse infiltration of some of the heart, thymus, bone marrow, kidney, spleen, lung, and liver. Several large intracytoplasmic eosinophilic inclusion bodies surrounded by narrow clear "halos" were identified within gastric mucosal cells, proximal and distal convoluted tubule epithelial cells, and splenic cells. The final diagnosis was lymphoblast lymphoma with a leukemic blood profile and concurrent inclusion body disease.

Granulomatous myocarditis and coelomic effusion due to Salmonella enterica arizonae in a Madagascar Dumerili's boa (Acrantophis dumerili, Jan. 1860).

A granulomatous myocarditis due to Salmonella enterica arizonae was diagnosed in an 8-year-old Madagascar Dumerili's boa (Acrantophis dumerili) based on positive coelomic effusion culture, ultrasound visualization of abnormal ventricular myocardium, necropsy and cardiac histological examination.