VETcpd - Vol 2 - Issue 2 - Page 25 VET cpd - Exotics Common chelonian ailments seen in practice Introduction Following the first article on chelonian identification, nutrition and husbandry (Vet CPD Journal,Vol 2, Issue 1, 2015) the second article covers some of the com- mon conditions seen in general practice. The first section describes a few of the most commonly seen presentations in practice including upper respiratory tract disease, parasites and traumatic injuries. The second part covers conditions associated with husbandry and nutritional inadequacies, still a common finding in captive exotic species. Part 1 Common presentations: Upper respiratory tract disease Tortoises are frequently presented to the clinic with upper respiratory tract disease (URTD). This generally involves inflam- matory lesions of the nares, nasal cavity, mouth and pharynx. Multifactorial causes are implicated involving viruses such as herpes and picornavirus, mycoplasmosis due to Mycoplasma agassizii, bacterial infections usually as secondary opportun- istic infections and environmental factors. Keepers often call this ‘runny nose syndrome’ (RNS). It must be differenti- ated from unilateral discharge that has been seen by the authors due to a foreign body, such as a piece of hay or grass, in the nasal cavity. Clinical disease can occur as an outbreak within a collection. It is often seen when the animals are immunocompromised, such as in the post-hibernation period, at any time if temperatures are too low or when new animals have been introduced into a group without testing for pathogens or adequate quarantine given. It is common to see clinical signs in the autumn due to a drop in temperatures and the recrudescence of viruses. Subclinical infection can occur where the tortoise does not exhibit overt disease but serves as a source of infection for naïve animals Chelonia are often seen in practice with clinical signs associated with deficiencies of dietary calcium and/or vitamin D3, inadequate diet, inadequate exposure to ultraviolet radiation or from traumatic episodes or infectious diseases. Key words: chelonia, upper respiratory tract disease, shell injuries, parasites, nutritional disease Peer Reviewed Sarah Pellett BSc(Hons) MA VetMB CertAVP(ZooMed) MRCVS Sarah graduated from Cambridge in 2006. She spent three years working at a first opinion and referral exotic animal practice where she completed the RCVS Certificate in Advanced Veterinary Practice (Zoological Medicine). Sarah now works at Animates Veterinary Clinic in Thurlby, Lincolnshire, UK, where she has set up an exotics section seeing a wide range of first opinion and referral exotic animal cases. Nathalie Wissink-Argilaga Lic.Vet GPCert(ExAP) CertAVP(ZooMed) MRCVS Nathalie graduated from the Universitat Autonoma de Barcelona [Spain] in 2004. After seeing practice in several Exotic practices and Zoos around the world, she completed a 1 year Small Animal internship at Davies Veterinary Specialists. Nathalie started work at The Scott Veterinary Clinic in May 2006. She holds the GP Certificate in Exotic Animal Practice and the RCVS Certificate in Advanced Veterinary Practice (Zoological Medicine) and is currently studying towards her RCVS Diploma in Zoological Medicine. Donna Stocking Tortoise keeper and rehabilitator A tortoise enthusiast since childhood, Donna Stocking became a ‘serious’ keeper around 10 years ago. With a private collection consisting mainly of African species, including a large group of sulcata, her main interest lies in the rehabilitation of the inadequately kept British tortoise. Work with Norfolk Tortoise Club over the past 8 years has meant observations of a large number of sick tortoises and considerable success in rehabilitating many of them. Exotic referrals: vetindex.co.uk/exotics Exotic Animal Health Products: vetindex.co.uk/exotic-products 16th Edition 15 -, THE A-Z DIRECTORY OF VETERINARY PRODUCTS, SUPPLIES ANDSERVICES 2015 www.vetindex.co.uk 21st Edition Vet CPD Journal: Includes 5 hours of FREE CPD! See inside for further details!!! Vet CPD VETcpd Vet CPD VETcpd Vet CPD VETcpd Vet CPD VETcpd 5 hours FREE CPD!! within a collection (Wendland et al, 2006). Clinical signs can vary from a clear-yellow/green nasal discharge (Figure 1a) with the tortoise displaying normal appetite and demeanor through to an extremely sick tortoise with swelling of the head and neck, typically seen in tortoises infected with iridiovirus (McArthur, 2004). Figure 1a: Nasal discharge in a tortoise Figure 1b: Necrotising stomatitis Diagnostics are necessary to determine the cause. A thorough clinical examination and review of husbandry (including new additions to the group) and nutrition is essential. Blood work and imaging are necessary to determine the overall health of the chelonian. To determine whether an infectious element is the cause, a swab of the oral cavity and nasal secretion can be submitted for bacteriological and fungal culture and sensitivity. Molecular tests, for example herpesvirus and Mycoplasma PCR, can be performed. Farkas and colleagues (2015) have nearly completed sequencing the genomes of seven tortoise picornaviruses. Some laboratories are offering picornavi- rus PCR. The virus has also been isolated from healthy individuals and the correla- tion with any specific disease remains to be proven (Marschang and Ruemenapf, 2002; Pirbright Institute, 2015). Clinical signs seen from animals that have had this virus
Transcript
VETcpd - Vol 2 - Issue 2 - Page 25
VETcpd - Exotics
Common chelonian ailments seen in practice
IntroductionFollowing the first article on chelonian identification, nutrition and husbandry (Vet CPD Journal, Vol 2, Issue 1, 2015) the second article covers some of the com-mon conditions seen in general practice. The first section describes a few of the most commonly seen presentations in practice including upper respiratory tract disease, parasites and traumatic injuries. The second part covers conditions associated with husbandry and nutritional inadequacies, still a common finding in captive exotic species.
Part 1 Common presentations:Upper respiratory tract diseaseTortoises are frequently presented to the clinic with upper respiratory tract disease (URTD). This generally involves inflam-matory lesions of the nares, nasal cavity, mouth and pharynx. Multifactorial causes are implicated involving viruses such as herpes and picornavirus, mycoplasmosis due to Mycoplasma agassizii, bacterial infections usually as secondary opportun-istic infections and environmental factors. Keepers often call this ‘runny nose syndrome’ (RNS). It must be differenti-ated from unilateral discharge that has been seen by the authors due to a foreign body, such as a piece of hay or grass, in the nasal cavity.
Clinical disease can occur as an outbreak within a collection. It is often seen when the animals are immunocompromised, such as in the post-hibernation period, at any time if temperatures are too low or when new animals have been introduced into a group without testing for pathogens or adequate quarantine given. It is common to see clinical signs in the autumn due to a drop in temperatures and the recrudescence of viruses. Subclinical infection can occur where the tortoise does not exhibit overt disease but serves as a source of infection for naïve animals
Chelonia are often seen in practice with clinical signs associated with deficiencies of dietary calcium and/or vitamin D3, inadequate diet, inadequate exposure to ultraviolet radiation or from traumatic episodes or infectious diseases.
Sarah Pellett BSc(Hons) MA VetMB CertAVP(ZooMed) MRCVS
Sarah graduated from Cambridge in 2006. She spent three years working at a first opinion and referral exotic animal practice where she completed the
RCVS Certificate in Advanced Veterinary Practice (Zoological Medicine). Sarah now works at Animates Veterinary Clinic in Thurlby, Lincolnshire, UK, where she has set up an exotics section seeing a wide range of first opinion and referral exotic animal cases.
Nathalie graduated from the Universitat Autonoma de Barcelona [Spain] in 2004. After seeing practice in several Exotic practices and Zoos around the world, she completed
a 1 year Small Animal internship at Davies Veterinary Specialists. Nathalie started work at The Scott Veterinary Clinic in May 2006. She holds the GP Certificate in Exotic Animal Practice and the RCVS Certificate in Advanced Veterinary Practice (Zoological Medicine) and is currently studying towards her RCVS Diploma in Zoological Medicine.
Donna Stocking Tortoise keeper and rehabilitator
A tortoise enthusiast since childhood, Donna Stocking became a ‘serious’ keeper around 10 years ago. With a private collection consisting mainly
of African species, including a large group of sulcata, her main interest lies in the rehabilitation of the inadequately kept British tortoise. Work with Norfolk Tortoise Club over the past 8 years has meant observations of a large number of sick tortoises and considerable success in rehabilitating many of them.
Exotic referrals: vetindex.co.uk/exoticsExotic Animal Health Products: vetindex.co.uk/exotic-products
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within a collection (Wendland et al, 2006). Clinical signs can vary from a clear-yellow/green nasal discharge (Figure 1a) with the tortoise displaying normal appetite and demeanor through to an extremely sick tortoise with swelling of the head and neck, typically seen in tortoises infected with iridiovirus (McArthur, 2004).
Figure 1a: Nasal discharge in a tortoise
Figure 1b: Necrotising stomatitis
Diagnostics are necessary to determine the cause. A thorough clinical examination and review of husbandry (including new additions to the group) and nutrition is essential. Blood work and imaging are necessary to determine the overall health of the chelonian.
To determine whether an infectious element is the cause, a swab of the oral cavity and nasal secretion can be submitted for bacteriological and fungal culture and sensitivity. Molecular tests, for example herpesvirus and Mycoplasma PCR, can be performed. Farkas and colleagues (2015) have nearly completed sequencing the genomes of seven tortoise picornaviruses. Some laboratories are offering picornavi-rus PCR. The virus has also been isolated from healthy individuals and the correla-tion with any specific disease remains to be proven (Marschang and Ruemenapf, 2002; Pirbright Institute, 2015). Clinical signs seen from animals that have had this virus
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isolated include diphtheroid necrotising stomatitis (Figure 1b), pharyngitis, con-junctivitis, rhinitis, pneumonia, ascites and enteritis (Marschang et al, 2002).
Treatment is dependent on the causative agent but in all cases husbandry must be addressed to aid in enhancing the tortoise’s immune system and to eliminate any environmental stressors.
Herpesvirus cannot be eliminated from infected chelonians and in this case optimum environmental conditions are essential. If Mycoplasma agassizi is isolated then systemic drugs can be administered. These may include enrofloxacin, tylosin, doxycycline or clarithromycin. Most tortoises do not clear the infection and therefore are likely to display intermittent clinical signs. Mixed infections involving Mycoplasma and herpesvirus are a com-mon finding.
Other treatments include nasal flushes and/or nebulization with medications such as F10 Antiseptic (Health and Hygiene (Pty) Ltd) diluted to a concentration of 1:250.
Care for tortoises with upper respiratory tract diseaseEffective husbandry is essential, both during and after treatment, if the respiratory condition is to be managed successfully. This entails the following;
• Keeping the tortoise at the high end of the optimum temperature range for the particular species whilst it is undergoing treatment, and allowing warm daily baths to ensure good hydration.
• Ensuring that future temperatures and UVB light are appropriate for the species and are used in an effective manner (placed at correct height from the animal and the duration of lighting replicates the natural photoperiod for the individual species).
• Ensuring the diet is varied and made up of high quality plants and flowers that are high in fibre, high in calcium, low in sugar, and low in protein will aid in trying to establish long term immunity and health (Figure 2).
Supplementing the diet with a vitamin/mineral supplement is advised. Treat-ment for respiratory conditions can at times have a detrimental effect on the gastrointestinal tract, typically of a tortoise historically fed a salad and fruit diet. Use of probiotics alongside a high fibre diet, especially if antibiotics have been prescribed, will aid in minimising gastrointestinal upset. Support feeding may be required for many sick tortoises until their appetite returns. The author (DS) has had success with both gavage feeding of liquidised plants and hand feeding of rolled leaves. The leaf of choice is rolled into a cigarette shape and is placed as far back into the mouth as possible. In cases where repeated handling to administer medication and food would cause the individual stress, placement of an oesophagostomy tube would be advised. Once in place, in certain cases animals can be treated in their home environment. Oesophago-stomy tubes are generally well tolerated by most tortoises and are essential to the management and rehabilitation of sick patients (McArthur, 2004).
• Ensuring future hibernations are species appropriate in length, no longer than 12 weeks for Mediterranean species or 8-10 weeks for North African species. Stress is a contributing factor in reoccurrences of some respiratory conditions, therefore allowing some hibernation rather than none at all is thought beneficial for those individuals that are healthy enough to tolerate it.
• Ensuring isolation from any other tor-toises in the collection that test negative
Figure 3: Injuries from a dog bite
Figure 2: The ideal diet is a variety of garden plants and weeds (Courtesy of Helane Davidson)
for the disease is essential in an attempt to prevent transfer. Biosecure husband-ry and not introducing new tortoises into the environment are advisable.
• A stress free life! Achieved by separat-ing females from sexually active males; ensuring enclosure is size appropriate and furnished with the specific spe-cies in mind; not overcrowding an environment; providing access to a dry, damp free area for night and unsuitable weather; ensuring that the tortoises are not bothered by dogs or from over handling.
Shell injuriesDog-bite trauma (Figure 3) is a common presentation in terrestrial chelonians especially during the summer months when tortoises are often left unsupervised in the garden.
Primary closure is not usually an option and if the traumatic episode occurred more than six hours before presentation then most wounds would be considered contaminated and infected (Crum, 2013). Management in these cases includes lavage, analgesia, topical and systemic antimicrobial therapy and regular dressing changes. Initially, the tortoise must be assessed to determine whether the shell fractures extend in to the coelomic cavity. Radiography should be performed to assess the extent of the trauma and to observe if the underlying bony plates of the shell have been traumatised; not just the keratinised scutes above.
Once fluids and analgesia have been administered, wound care should proceed
