USE OF VISCOELASTIC COAGULATION TESTING IN MEGACHIROPTERA (PTEROPUS HYPOMELANUS AND PTEROPUS VAMPYRUS) REVEALS HIGH VARIABILITY IN CLOT KINETICS.

Megachiroptera is a mammalian suborder that includes old world fruit bats. Common clinical problems among captive Megachiroptera, such as liver disease (e.g., iron storage disease), kidney disease (e.g., protein-losing nephropathy), and heart disease (e.g., dilated cardiomyopathy), carry elevated risk for hemostatic derangements. The assessment of viscoelastic coagulation assays, however, has not yet been reported in bats. The main objective of the study was to describe viscoelastography data using the Viscoelastic Coagulation Monitor (VCM) Vet in captive large flying foxes (Pteropus vampyrus) (n = 20) and variable flying foxes (Pteropus hypomelanus) (n = 10). Additional objectives were to compare viscoelastic and clotting parameters (1) between healthy P. vampyrus and P. hypomelanus bats and (2) between untreated bats and those treated with meloxicam or aspirin, and (3) to examine relationships between activated partial thromboplastin time (aPTT) and potentially homologous viscoelastic parameters clotting time (CT) and clot formation time (CFT). The results showed marked variability among clinically normal bats. The intrinsic pathway, as measured by aPTT, had prolonged times compared with most terrestrial mammals, but similar times to birds, marine mammals, and sea turtles. A search of P. vampyrus genome found stop codons present in two exons of the factor XI gene; alterations in factor XI expression would be expected to alter intrinsic coagulation. Because of the high variability, no statistically significant findings were noted in the secondary objectives. Correlation between aPTT and CT or CFT was not strong (rs = 0.406 or 0.192, respectively). The results from this study suggest that clot kinetics vary widely among Megachiroptera when using the VCM Vet with untreated blood. A prolonged intrinsic coagulation pathway, as has been found in other megachiropteran species, and activation of the extrinsic coagulation pathway during venipuncture may be responsible for the inconsistent results.

Pharmacokinetics and pharmacodynamics of intramuscular alfaxalone in central bearded dragons (Pogona vitticeps): effect of injection site.

OBJECTIVE: To evaluate the pharmacodynamic effects and pharmacokinetics of a single intramuscular (IM) injection of alfaxalone in central bearded dragons (Pogona vitticeps) when injected at a cranial versus a caudal site. STUDY DESIGN: Prospective, masked, randomized crossover study. ANIMALS: A total of 13 healthy bearded dragons weighing 0.48 ± 0.1 kg. METHODS: Alfaxalone (10 mg kg-1) was administered IM to 13 bearded dragons in the triceps muscle (cranial treatment) or the quadriceps muscle (caudal treatment) separated by 4 weeks. Pharmacodynamic variables included movement score, muscle tone score and righting reflex. Blood was obtained from the caudal tail vein using a sparse sampling methodology. Plasma alfaxalone concentrations were determined using liquid chromatography-mass spectrometry, and pharmacokinetic analysis was performed using nonlinear mixed-effects modeling. Differences in variables between injection sites were analyzed using a nonparametric Wilcoxon signed-rank test for paired data with significance set at p ≤ 0.05. RESULTS: Time to loss of righting reflex score was not different, median (interquartile range), between cranial and caudal treatments [8 (5-11) and 8 (4-12) minutes, respectively, p = 0.72]. Time to recovery of righting reflex was also not different between cranial and caudal treatments [80 (44-112) and 64 (56-104) minutes, respectively, p = 0.75]. Plasma alfaxalone concentrations were not significantly different between treatments. The population estimate (95% confidence intervals) for volume of distribution per fraction absorbed was 1.0 (0.79-1.20) L kg-1, clearance per fraction absorbed was 9.6 (7.6-11.6) mL minute-1 kg-1, absorption rate constant was 2.3 (1.9-2.8) minute-1 and elimination half-life was 71.9 (52.7-91.1) minutes. CONCLUSIONS AND CLINICAL RELEVANCE: Regardless of the injection site, IM alfaxalone (10 mg kg-1) produced reliable chemical restraint in central bearded dragons, appropriate for nonpainful diagnostic procedures or anesthetic premedication.

DETERMINATION OF ECHOCARDIOGRAPHIC TECHNIQUES FOR CLINICAL ASSESSMENT OF GALAPAGOS (CHELONOIDIS NIGRA COMPLEX) AND ALDABRA (ALDABRACHELYS GIGANTEA) TORTOISES.

The first objective of this study was to establish clinically relevant techniques for cardiac echocardiography in nonanesthetized Galapagos (Chelonoidis nigra complex) and Aldabra (Aldabrachelys gigantea) tortoises. A second objective was to establish guidelines for determining normal echocardiographic anatomy and function in both species. Select echocardiographic reference values were defined for 17 healthy Galapagos tortoises and 27 healthy Aldabra tortoises. Tortoises were either placed in ventral recumbency on an elevated surface or allowed to stand in a natural position by using food distraction. An ultrasound probe was applied in the left or right cervicobrachial window and was positioned in two long axis views to evaluate the three chambers of the heart and the associated great vessels, the presence of pericardial effusion, the atrioventricular inflow velocities, and pulmonic and aortic outflow velocities. The heart rate was 28 ± 12 (median ± SD) bpm, and the ejection fraction was 60.5 ± 10%. Thirty-four of 44 tortoises had identifiable physiologic pericardial effusion. All tortoises were successfully imaged using the techniques described, with consistent identification of cardiac structure and assessment of function. This study provides echocardiographic reference intervals for the clinical evaluation of suspected cardiac disease in captive-managed Galapagos and Aldabra tortoises.

Intralipid Emulsion Therapy for the Treatment of Suspected Toxicity in 2 Avian Species.

Intravenous lipid emulsion (ILE) therapy has shown promise as a treatment option for a variety of lipophilic toxins. Two birds presented for suspected ingestion of a toxic substance. A blue-and-gold macaw (Ara ararauna) presented after chewing a block of bromethalin rodenticide without overt clinical signs at the time of presentation. Additionally, a free-ranging bald eagle (Haliaeetus leucocephalus) was found weak and depressed near a municipal landfill after presumptive ingestion of pentobarbital. Both birds were treated with ILE therapy for potential intoxication without any adverse events. The macaw was clinically normal after 3 days of hospitalization and at a 1-week reevaluation. The eagle was transferred to a rehabilitation center after markedly improved mentation and strength and was released 7 days later. Clinicians should consider ILE therapy for the treatment of lipophilic toxicities; however, monitoring is recommended for persistent lipemia and other adverse effects that have been reported in the veterinary literature.

PULMONARY AND COELOMIC MYCOSES DUE TO METARHIZIUM AND BEAUVERIA SPECIES IN REPTILES.

This report documents cases of fatal pulmonary mycosis caused by entomopathogenic fungi in the genera Metarhizium and Beauveria (Order Hypocreales) in a loggerhead sea turtle (Caretta caretta), a Chinese alligator (Alligator sinensis), two gopher tortoises (Gopherus polyphemus), a Cuvier's dwarf caiman (Paleosuchus palpebrosus), a false gharial (Tomistoma schlegelii), a green sea turtle (Chelonia mydas), and a Kemp's ridley sea turtle (Lepidochelys kempii), and a case of granulomatous coelomitis in a hawksbill sea turtle (Eretmochelys imbricata). Fungi identified in these cases included Beauveria bassiana, Beauveria brongniartii, Metarhizium anisopliae, Metarhizium robertsii, and one case of infection by a novel Metarhizium species. The animals were either housed at zoos or brought into rehabilitation from the wild. Although the majority of animals had comorbidities, the fungal infections were believed to be the primary cause of death. Fungal susceptibility testing was performed on two Beauveria spp. isolates, and revealed lower minimum inhibitory concentrations for itraconazole and voriconazole when compared to terbinafine and fluconazole. This case series demonstrates that a variety of reptile species from different orders are vulnerable to infection with Metarhizium, and multiple species of sea turtle are susceptible to infection with Beauveria.

Retrospective analysis of ocular disease in a population of captive pteropodid bats, 2003-2020.

OBJECTIVE: To perform retrospective analysis of captive pteropodid bats presented to the University of Florida for ocular or adnexal disease from 2003-2020. ANIMALS STUDIED: Twenty-four individuals from seven species were included. PROCEDURES: Records were analyzed for disease process, methods of treatment, and surgical techniques and complications. RESULTS: The most frequently reported abnormality was corneal disease (79%), followed by cataracts (54%), and uveitis (42%). Corneal disease was primarily attributed to either trauma or exposure keratitis secondary to buphthalmia. The majority of uveitis appeared to be lens-induced. Five cases (21%) of glaucoma were reported, all of which accompanied lens luxation. Of the seven enucleations performed, six had post-operative complications (85.7%), including swelling at the surgical site, seroma formation, and bacterial infection. There was no significant relationship between age and trauma, age and cataract formation, sex and trauma, or species and cataract formation. CONCLUSIONS: The most common underlying cause of ocular pathology in these cases was trauma. While the bats tolerated topical and systemic treatment well, individual temperament must be taken into account when developing treatment plans, and prevention of injury is the most effective management strategy.

THE USE OF INTRADERMAL ALLERGY TESTING FOR ALLERGIC DERMATITIS IN PTEROPID BATS AND TREATMENT WITH ALLERGEN SPECIFIC IMMUNOTHERAPY: A CASE SERIES.

This case series describes the diagnosis of allergic dermatitis and management with allergen-specific immunotherapy (ASIT) based on intradermal allergy testing (IDAT) and adjunctive medical therapy in six pteropid bats; five large flying foxes (Pteropus vampyrus); and one variable flying fox (Pteropus hypomelanus). The cases ranged from 2 to 15 yr of age at the time of presentation. Clinical signs varied between individuals and included moist ulcerative cutaneous lesions in nonhaired skin, blepharoconjunctivitis, alopecia, and pruritus. All bats underwent IDAT under general anesthesia, and reactive allergens included a mixture of grasses, trees, weeds, and biting insects. Three of the six cases (50%) had reformulation of the ASIT before control of clinical signs was seen, and two bats were treated with the addition of oclacitinib (Apoquel). Severe adverse effects were not identified; however, one bat had self-limiting swelling at the immunotherapy injection site. All six cases showed improvement of clinical signs and perceived comfort level, including in subsequent allergy seasons.

RENAL NEOPLASIA FROM A SINGLE POPULATION OF PTEROPODID BATS.

Neoplastic diseases have rarely been reported in the family Pteropodidae, and primary malignant renal neoplasms are generally uncommon across animal species. This case series describes four cases of primary renal neoplasia: three renal cell carcinomas and one nephroblastoma in three species of pteropodid bats, specifically large flying foxes (Pteropus vampyrus, n = 2), straw-colored fruit bat (Eidolon helvum, n = 1), and a little golden-mantled flying fox (Pteropus pumilus, n = 1). Two of the cases were diagnosed antemortem using ultrasonography, computed tomography, and cytology; and one of these bats with a renal cell carcinoma was treated successfully with a unilateral nephrectomy. The remaining two cases were diagnosed at necropsy.

Variability in hematology of white-spotted bamboo sharks (Chiloscyllium plagiosum) in different living environments.

Elasmobranch hematology continues to reveal new peculiarities within this specialized field. This report compares total hematologic values from the same white-spotted bamboo sharks (Chiloscyllium plagiosum) housed in different environments. We compared the hemograms one year apart, using a standardized Natt-Herrick's technique. The total white blood cell (WBC) counts of the sharks were statistically different between the two time points (initial median total WBC count = 18,920 leukocytes/µl, SD = 8,108; 1 year later total WBC count = 1,815 leukocytes/µl, SD = 1,309). The packed cell volumes were additionally found to be statistically different (19%, SD = 2.9 vs. 22%, SD = 2.0). Analysis revealed the only differences between the time points were the temperature and stocking densities at which these sharks were housed. This report emphasizes the need for a thorough understanding of the husbandry of an elasmobranch prior to interpretation of a hemogram and suggests that reference intervals should be created for each environment.

Radiation Therapy of Periorbital Lymphoma in a Blue-and-Gold Macaw (Ara ararauna).

An adult male blue and gold macaw (Ara ararauna) was presented for evaluation of a right periorbital mass. Results of diagnostic tests, including periorbital ultrasound, fine-needle aspirate, and cytologic examination, confirmed a diagnosis of periocular lymphoma. Radiographs were suggestive of disseminated disease but because of concerns about the patient's quality of life, localized radiation therapy to address the periorbital disease was pursued. Coarse-fractionated radiation therapy was initiated, and the mass regressed rapidly during the 3-week course of treatment. The macaw tolerated the treatments well, maintained vision in the affected eye, and activity level and appetite improved. Three months after treatment was completed, the bird died. Necropsy revealed T-cell-rich B-cell-infiltrative lymphoma of the spleen, liver, and kidneys, with some residual neoplastic cells found in the right periorbital region. This case demonstrates a radiation therapy protocol that reduced a tumor mass in a localized treatment of periorbital lymphoma in a macaw.

The hemic response of white-spotted bamboo sharks (Chiloscyllium plagiosum) with inflammatory disease.

As elasmobranch medicine becomes more commonplace, there continues to be confusion with techniques and evaluation of the shark hemogram and it remains unknown if they are able to mount an inflammatory hemic response. The aims of this study were to compare two total white blood cell (WBC) count techniques, establish a reference interval for captive white-spotted bamboo sharks (Chiloscyllium plagiosum), and determine if elasmobranchs are capable of mounting an inflammatory hemic response. Correlation statistics were performed on hematologic results for healthy female bamboo sharks to assess the use of Natt-Herrick's and phloxine methods. Total WBC counts and differentials were obtained from males with severe traumatic clasper wounds and compared to the healthy females. We elected clasper amputation as the preferred treatment intervention and post-operative hematology was performed one month later. There was poor correlation of leukocyte counts between the two WBC count methods. Hematologic values were established for the females and males pre- and post-operatively. Males with wounds had a marked leukocytosis and heterophilia. Post-operative blood work showed a resolution of total WBC count and a trend toward resolution of the heterophilia. This study provides hematologic values for white-spotted bamboo sharks and confirms that the Natt-Herrick's method is preferred for lymphocytic species. Hematologic differences present in males with clasper wounds suggests that elasmobranchs do mount an inflammatory hemic response. Treatment via clasper amputation proved to be a safe and efficient means for clinical treatment that led to a trend toward resolution of the inflammatory leukogram. Zoo Biol. 35:251-259, 2016. © 2016 Wiley Periodicals, Inc.

GASTROINTESTINAL PARASITES OF CAPTIVE AND FREE-LIVING LEMURS AND DOMESTIC CARNIVORES IN EASTERN MADAGASCAR.

Fecal samples from captive and free-living lemurs at Ivoloina Zoological Park (IZP) and domestic carnivores from six villages surrounding IZP were evaluated between July and August 2012. Free-living lemurs from Betampona Natural Reserve (BNR), a relatively pristine rainforest fragment 40 km away, were also evaluated in November 2013. All 33 dogs sampled (100%) and 16 of 22 cats sampled (72.7%) were parasitized, predominantly with nematodes (strongyles, ascarids, and spirurids) as well as cestodes and protozoans. Similar types of parasites were identified in the lemur populations. Identification of spirurid nematodes and protozoans in the lemur fecal samples were of concern due to previously documented morbidity and mortality in lemurs from these parasitic agents. Twelve of 13 free-living (93%) and 31 of 49 captive (63%) lemurs sampled at IZP had a higher parasite prevalence than lemurs at BNR, with 13 of 24 (54%) being parasitized. The lemurs in BNR are likely at risk of increased exposure to these parasites and, therefore, increased morbidity and mortality, as humans and their domestic animals are encroaching on this natural area.

MANAGEMENT OF TOXIC MASTITIS IN A BABIRUSA (BABYROUSA CELEBENSIS).

A 1 yr 8 mo-old, previously healthy, primiparous female babirusa (Babyrousa celebensis) presented acutely recumbent and minimally responsive approximately 36 hr after giving birth to a single piglet. Toxic mastitis was diagnosed based on physical examination and laboratory results. The mammary tissue was firm, discolored, and produced negligible amounts of milk. All of the teats were eventually affected, resulting in the inability to provide adequate nutrition to the piglet. Although toxic mastitis has a poor prognosis in domestic sows, this babirusa recovered completely with aggressive management, including antibiotics and supportive care.

MANAGEMENT OF ACUTE RENAL FAILURE WITH DELAYED HYPERCALCEMIA SECONDARY TO SARCOCYSTIS NEURONA-INDUCED MYOSITIS AND RHABDOMYOLYSIS IN A CALIFORNIA SEA LION (ZALOPHUS CALIFORNIANUS).

A 3-yr-old captive-born California sea lion (Zalophus californianus) developed Sarcocystis neurona-induced myositis and rhabdomyolysis that led to acute renal failure. The sea lion was successfully managed with fluid therapy, antiprotozoals, antibiotics, anti-inflammatories, antiemetics, gastroprotectants, and diuretics, but developed severe delayed hypercalcemia, a syndrome identified in humans after traumatic or exertion-induced rhabdomyolysis. Treatment with calcitonin was added to the management, and the individual recovered fully. The case emphasizes that animals with rhabdomyolysis-induced renal failure risk developing delayed hypercalcemia, which may be life threatening, and calcium levels should be closely monitored past the resolution of renal failure.

Cardiovascular disease in central bearded dragons (Pogona vitticeps): 54 cases (2007-2022).

OBJECTIVE: To describe the clinical features, histopathologic lesions, and outcome of cardiovascular disease in central bearded dragons. ANIMALS: 54 bearded dragons. METHODS: Retrospective evaluation of captive bearded dragons with antemortem imaging or postmortem diagnosis of cardiovascular disease from 2007 to 2022 from 6 hospitals. RESULTS: The total prevalence of cardiovascular disease was 3.3% (54/1,655). Physical examination findings were available in 46 cases with change in mentation being the most common finding (n = 28/46 [60.9%]), followed by dehydration (17/46 [37%]), palpable coelomic mass (13/46 [28.3%]), dyspnea (10/46 [21.7%]), and sunken eyes (10/46 [21.7%)]. Doppler auscultation revealed an arrhythmia in 5/34 (14.7%) animals. Diagnostic imaging was only performed on 21 animals, and 10 (47.6%) had cardiovascular abnormalities described. In total, 84 cardiovascular diagnoses were found in 54 animals. The most common diagnosis was myocarditis (n = 14) followed by aneurysms (11), pericardial effusion (9), atherosclerosis (7), epicarditis (7), and myocardial degeneration/necrosis (7). Overall, 62 causes of death were identified in 52 cases, with cardiovascular disease being the most common (n = 18/52 [34.5%]). Only 3/54 animals were diagnosed with congestive heart failure. Animals with aneurysms were more likely to die to due cardiovascular disease compared to other types of cardiovascular diagnoses (OR, 43.75; 95% CI, 4.88 to 392.65; P < .001). CLINICAL RELEVANCE: Diagnosis of cardiovascular disease in bearded dragons is challenging given the inconsistent clinical presentation; however, it should remain a differential in animals with nonspecific signs of illness. Antemortem diagnostics are recommended in suspected cases, including diagnostic imaging. Of the cardiovascular diseases described, aneurysms most often contributed to clinical demise.

Regional Anesthesia of the Dentition in Bennett's Wallaby (Macropus rufogriseus): Anatomical Landmarks and Approaches Assessed with Computed Tomography and Gross Dissection.

Dental disease is common in captive-managed macropods, including Bennett's wallabies, and is a significant cause of morbidity and mortality. Dental extractions and debridement of diseased tissue is often necessary for those undergoing treatment for severe dental disease. Regional anesthesia of the dentition is considered standard of care for domestic animals undergoing orofacial surgery, however, it is not routinely performed in macropods due to limited information on dental anatomy and block approaches. Regional block descriptions for the infraorbital, maxillary, inferior alveolar, and mental blocks in domestic dogs and cats were evaluated and adapted for use in Bennett's wallabies based on descriptions of their anatomy and examination of 2 skulls. These approaches were then performed on cadaver heads with iohexol and methylene blue dye, and block placement was assessed on computed tomography scans and by gross dissection. All block approaches described in this study resulted in appropriate placement of regional anesthesia of the dentition in Bennett's wallabies. They can thus be used by clinicians to improve the intra and postoperative pain control of patients and provide a high level of veterinary care.

Retrospective evaluation of wobbly hedgehog syndrome in 49 African pygmy hedgehogs (Atelerix albiventris): 2000-2020.

OBJECTIVE: To retrospectively evaluate the prevalence and clinical progression of wobbly hedgehog syndrome (WHS) and concurrent incidence of neoplasia in a cohort of African pygmy hedgehogs (Atelerix albiventris). ANIMALS: 49 hedgehogs. CLINICAL PRESENTATION AND PROCEDURES: Medical records of hedgehogs from 7 institutions across the US over a 20-year period (2000 to 2020) were retrospectively reviewed. Inclusion criteria were hedgehogs of any sex or age with postmortem CNS histopathology consistent with WHS. Collected data included sex, age at onset and euthanasia, major histopathologic findings, reported neurologic clinical signs, and treatments administered. RESULTS: 24 males and 25 females were included. Fifteen of 49 (31%) individuals had subclinical WHS with no reported antemortem neurologic clinical signs. In neurologically affected (clinical) hedgehogs (n = 34), the mean ± SD age at onset was 3.3 ± 1.5 years with a median (range) time from onset to euthanasia of 51 days (1 to 319 days). In neurologically affected hedgehogs, the most commonly reported clinical signs were ataxia (n = 21) and pelvic limb paresis (16) and the most commonly administered treatment was meloxicam (13). Overall, 31 of 49 (63%) hedgehogs had a concurrent histopathologic diagnosis of neoplasia outside of the CNS. CLINICAL RELEVANCE: The prognosis for hedgehogs with WHS is poor. No treatment had a significant effect on survival time, and neoplasia was a common comorbidity in the current cohort. A small but clinically relevant subset of neurologically normal hedgehogs had a histopathologic diagnosis of WHS.

Correction: Turner et al. Steatitis in Cold-Stunned Kemp's Ridley Sea Turtles (Lepidochelys kempii). Animals 2021, 11, 898.

In the original publication [...].

AUSTWICKIA CHELONAE IN A WILD GOPHER TORTOISE (GOPHERUS POLYPHEMUS) AND EVIDENCE OF POSITIVE SELECTION ON THE DIPHTHERIA-LIKE TOXIN GENE.

Austwickia (Dermatophilus) chelonae is a filamentous, Gram-positive Actinobacteria in the Dermatophilaceae family. It has caused fatal granulomatous disease in diverse captive reptile species on three continents, but its presence in wild or free-ranging populations was unknown. An adult female gopher tortoise (Gopherus polyphemus) was presented euhydrated, but cachectic and infested with ticks, with two firm, encapsulated masses over the cranioventral neck and right stifle. The tortoise had moderate nonregenerative anemia and evidence of inflammation; plasma biochemistry data was within normal limits. Fine needle aspirate of the neck lesion revealed abundant necrosis and aggregates of cocci. Computed tomography delineated the masses and revealed an additional mass adjacent to the left zygomatic bone. After surgical excision, histology identified chronic granulomas with intralesional filamentous bacteria. Pan-bacterial 16S rRNA PCR and sequencing of the masses identified A. chelonae. Despite treatment with oxytetracycline and ceftazidime, the tortoise deteriorated and was euthanatized. An esophageal lesion consistent with A. chelonae was seen on postmortem examination, although it was determined that the tortoise ultimately succumbed to fungal pneumonia caused by Metarhizium robertsii, an entomopathogenic biotoxin sprayed as insect control. This case reveals A. chelonae is present in free-ranging chelonians in North America. This organism produces a toxin gene similar to diphtheria toxin, one of the most potent known biotoxins, which has not been previously identified outside the genus Corynebacterium. Novel PCR primers were designed for the toxin and rpoB genes, which were amplified and sequenced from two cases and compared with two available genomes. Selection analysis revealed that the toxin gene is under positive selection, which implies it interacts significantly with the immune system, making it a good candidate for immunodiagnostic test development.

Sedation and Anesthesia of Galapagos (Chelonoidis nigra), Aldabra (Aldabrachelys gigantea), and African Spurred Tortoises (Centrochelys sulcata): A Retrospective Review (2009-2019).

Tortoises belong to the taxonomic family Testudinidae, which is considered one of the most imperiled families of the order Testudines. Anesthesia is often required for the medical and surgical management of large tortoises. The objectives of this retrospective study were to review drug regimens used to successfully anesthetize Galapagos (Chelonoidis nigra), Aldabra (Aldabrachelys gigantea) and African spurred (Centrochelys sulcata) tortoises, and to compare the times to effect and to extubation in tortoises administered different premedication protocols. Anesthetic records of giant tortoises admitted to the University of Florida College of Veterinary Medicine between January 2009 and December 2019 were reviewed. A total of 34 tortoises (six Aldabra, 23 Galapagos, and five African spurred) were included, resulting in 64 anesthetic events. Frequently used premedication protocols included an α2-adrenergic agonist and ketamine combined with either midazolam (group α2-adrenergic agonist, midazolam, ketamine, AMK; n = 34), a µ-opioid receptor agonist (group α2-adrenergic agonist, µ-opioid receptor agonist, ketamine, AOK; n = 13), or a µ-opioid receptor agonist and midazolam (group α2-adrenergic agonist, midazolam, µ-opioid receptor agonist, ketamine, AMOK; n = 10). Inhalant anesthetics (isoflurane, n = 21; sevoflurane, n = 23) were frequently used for maintenance of anesthesia following premedication. Out of the 34 total tortoises, 22 had only one anesthetic event, five had two anesthetic events, three had three anesthetic events, and four had four or more anesthetic events. Few adverse effects were observed and there was no mortality reported during the peri-anesthetic period. Sedation and general anesthesia of giant tortoises can be successfully performed with a combination of an α2-adrenergic agonist and ketamine in combination with midazolam and/or a µ-opioid receptor agonist.