More reptile objectives Flashcards
1
Q
T/F: Venipuncture is a blind technique in reptiles
A
TRUE
2
Q
Is aseptic preparation required for venipuncture?
A
YES
3
Q
How much blood can be sampled at one time?
A
0.5ml/100g body weight
(Size and condition dictate; decrease volume in debilitated patients)
4
Q
What are the anticoagulants of choice?
A
Lithium and sodium heparin
**EDTA causes RBC lysis in chelonians**
5
Q
What possible contaminant should you be aware of during venipuncture?
A
Lymph contamination
6
Q
What are the venipuncture sites for turtles, tortoises, and terrapins?
A
- Jugular
- Coccygeal
- Brachial
- Subcarapacial
- Interdigital vein (leatherbacks)
- Dorsal cervical sinus
7
Q
What are the snake venipuncture sites?
A
- Caudal (ventral tail) vein
- Caudal to cloaca, 25-50% down tail, 40-60o angle on ventral midline
- Heart
- Located 22-33% from snout to vent (sedated)
8
Q
How do you sample blood from the heart in a snake?
A
- Sedation, restraint in dorsal recumbency
- Palpate and immobilize
- Advance needle at 45o in craniodorsal direction into apex of beating ventricle
- Maintain digital pressure 30-60sec after this
9
Q
Where are the venipuncture sites in lizards?
A
- Caudal tail vein
- Ventral midline 20-80% down tail, 45-90o
- Ventral abdominal vein
- Jugular vein
- Gives large sample
- Located behind tympanic membrane near level of the point of shoulder
10
Q
Where is the crocodilian venipuncture site?
A
- Caudal ventral tail vein
- Small to medium
- Supravertebral
- Medium to large
11
Q
What are the routine views for chelonian radiographs?
A
- Dorsoventral
- Lateral
- Craniocaudal
12
Q
What are the various types of fluids used in reptilians?
A
- “Reptile ringers solution”
- One part LRS + two parts 2.5% dextrose and 0.45% NaCl
- Normasol-R
- LRS
13
Q
What other colloid fluids can be used?
A
- Hetastarch
- Diluted 1:2 or 1:3 with 0.9% saline
- Given at a rate of 0.1ml/kg every 10-15min
- May be used in chelonians with severe shock from massive blood loss
- Oxyglobin
- Limited clinical use in sea turtles and desert tortoises without adverse affects
14
Q
What fluid therapy routes are used for severely compromised chelonians?
A
- IV or IO routes of fluid administration
- Allow for rapid rehydration and emergency therapy
- IV or IO routes necessary for whole and artificial blood, colloid fluids, and fluids containing greater than 5% dextrose
15
Q
Can the jugular vein be used for fluid administration?
A
Yes
16
Q
In what species is the cervical sinus used for fluid therapy?
What are the advantages?
A
- Sea turtles
- Used for bolus IV fluid therapy
- Advantages
- Easy vessel accessibility
- Minimal stress to patient
- Repeated vascular access
17
Q
What species/situations is the intracoelomic fluid therapy route used in?
A
- Maintenance therapy
- Injected through
- Chelonians–inguinal fossa
- Lizards–right side of lower abdomen
- Snakes–lower 1/3 of body
18
Q
What are the advantages of the IC route for fluid therapy?
A
Technically easy
Allows administration of crystalloid fluids with up to 5% dextrose
19
Q
What are the disadvantages of the IC route for fluid therapy?
A
- Fluids might not be absorbed rapidly
- Potential of compromising lung space or perforating the lungs, urinary bladder, or an ovarian follicle in mature females
- Hypoproteinemic patients may have fluid in the coelomic cavity (ascites/anasarca), which will further complicate absorption
20
Q
What are the advantages of subcutaneous fluid administration?
A
- Technically easy
- Any available skin fold
- Chelonians: inguinal fossa, medially in the front limb fossa and the ventral neck fold
- Squamates: usually lateral body wall
- Also between and over scapula in lizards
21
Q
What are the disadvantages of subcutaneous fluid administration?
A
- Poor absorption in severely debilitated chelonians
- Only 2.5% dextrose or less
22
Q
When can oral fluids be administered? Which ones are administered first?
A
- Mild to moderate dehydration, maintenance
- Oral fluids consisting of electrolytes and dextrose administered first
23
Q
How are oral fluids administered?
A
- Stomach tube using appropriately sized, well-lubricated red rubber or metal feeding tube
- Stomach volume in most chelonian patients is about 2% BW or 20ml/kg
- Anatomically, stomach is located in anterior 1/3 to mid-carapace in chelonians
24
Q
When is soaking used as fluid administration? For how long?
A
- Rehydration
- Reduction of epibiota
- 24hrs
25
Can fluids be administered intra-cloacally?
Yes
26
What are the limits for volumes of fluid administration?
* Do NOT exceed 2-3% BW per day
* Maintenance = 15ml/kg/day
* Can go up to 30ml/kg/day
27
What are the indications for a blood transfusion?
* Life-threatening anemia, PCV \<5%
* Acute hemorrhage
28
What should be used to collect blood for transfusions?
Acid-citrate-dextrose (ACD) solutions
29
If performing a blood transfusion in a chelonian with a PCV \>5%, what else should be done?
Fluid therapy, iron supplementation, and other supportive measures
30
What are the general guidelines for antimicrobial therapy?
* Broad spectrum
* Diagnostic samples for culture/sensitivity should be acquired prior to initiation of antimicrobial therapy
* **Front half of body used for injections**
31
What 3 antimicrobials are generally used for aerobes?
Amikacin
Ceftazidime
Baytril
32
What 3 antimicrobials are generally used for anaerobes?
Metronidazole
Clindamycin
Penicillins
33
What antimicrobial covers both the aerobic and anaerobic spectrum?
Chloramphenicol
34
Name 2 specific antifungal medications
* Itraconazole
* Oral
* SID Q 72hrs
* Fluconazole
* Oral and injectable
* Q 5days
* **Expensive**
35
Name 3 antiparasitic medications
Praziquantel, Pyrantelpamoate, Fenbendazole
36
When should you use ivermectin in chelonians?
**NEVER**
37
How should you proceed with anesthesia in a debilitated turtle?
**CAREFULLY**
* If PCV \<10% or plasma TP \< 2.0g/dl, respiratory compromise, or sepsis, a thorough diagnostic workup should be performed
* **STABILIZE FIRST**
38
What are the advantages of medetomidine and ketamine?
* IV or IM
* Medetomidine reversible with atipamezole--faster recovery
* Low dose of ketamine may be given b/c of synergism with medetomidine
39
What are the disadvantages of medetomidine and ketamine?
* Bradycardia, hypotension, hypercapnia, and hypoxemia
* May be contraindicated in debilitated animals with impaired renal or liver function
* Use lower end of dose range until stabilized
40
What is the procedure for using propofol?
* Dilute drug with 2 parts saline to 1 part propofol and administer IV over 2 minutes
* Rapid induction
* Use caution when administering--the faster administered, more marked respiratory depression
41
What are 5 common nutritional disorders in reptiles?
* Secondary nutritional hyperparathyroidism
* Hypovitaminosis A
* Gout
* Pyramiding
* Thiamine deficiency
42
In which species is hyperparathyroidism most common?
Lizards and aquatic turtles
43
What is the signalment/history of hyperparathyroidism?
* Juveniles, reproductively active females
* Long-term rehabilitation animals
* Inappropriate diet and environment
44
What is the etiology of nutritional hyperparathyroidism?
* Multifactorial
* Prolonged deficiency in Ca or vit D
* Imbalance of Ca:P ration in diet (typically excess P)
* Inadequate exposure to UV light
45
What will you find during the PE of a patient with nutritional hyperparathyroidism?
* Muscle tremors, fasiculations, tetany
* Skeletal
* Fibrous osteodystrophy (thickening and swelling of long bones and mandibles)
* Pathological fractures
* Tooth loss
46
What are the diagnostics of nutritional hyperparathyroidism?
* Blood work
* Usually low normal
* Radiographs
* Loss of cortical density
* Fractures
47
What is the (general) treatment for nutritional hyperparathyroidism?
Correct diet environment
Fluids (10-30ml/kg/day)
48
What is the specific therapy for nutritional hyperparathyroidism
* Ca glubionate
* Vitamin D therapy
* Calcitonin
* 50IU/kg every 7 days for 2 treatments
* Monitor blood Ca closely
49
What is gout?
Deposition of uric acid and urate salts w/in visceral tissues and on articular surfaces
50
What history is typically associated with gout?
Adult reptiles
Water deprived
High protein diets
51
What is found on the PE of a patient with gout?
* Variable
* Similar to renal disease
* Reduced mobility
52
What are the different types of gout? Forms?
Primary (overproduction) and secondary (chronic disease or drug)
Visceral, articular, periarticular
53
How do you diagnose gout?
* Clinical pathology
* Plasma chemistry
* Hyperuricemia
* Rads
* Lytic lesions around or near joints, gouti tophi
* Biopsy: affected site
* **Definitive diagnosis: demonstration of monosodium urate crystals w/in joints of affected patients or w/in tophi**
54
What is the therapy for gout?
* Correct husbandry
* Low purine diet
* High moisture foods
* Mist and regular access to water
* Fluid therapy--secondary renal disease?
* Probenecid--increase secretion
* Allopurinol--reduce hepatic production
* Manage inflammation (corticosteroids)
* Sx?
55
What is the signalment of hypovitaminosis A?
Young, fast-growing chelonians
Long-term rehabilitation chelonians
56
What is the typical history of a patient with hypovitaminosis A?
* Lacking adequate levels of vitamin A
* Green plants
* Caratenoids
57
What are the clinical signs of hypovitaminosis A?
* Bilateral blepharoedema
* Squamous metaplasia
* Nasal and ocular discharge
* Lethargy
* Anorexia
* Wt. loss
* Pneumonia
* Diarrhea
* Abscesses
58
How do you diagnose hypovitaminosis A?
* Vit A assay of liver
* Levels vary according to species
* Vit A blood testing
* Retinol (varies)
* History and PE
* Culture and sensitivity--infection
* Rads--pneumonia
59
T/F: When treating hypovitaminosis A, you must correct the diet and environment
TRUE
60
Which type of supplementation is preferred when treating hypovitaminosis A?
Oral (Vit A products, liver)
61
Can SQ injections be given for treatment of hypovitaminosis A?
Yes
* 1500-2000 IU/kg
* 1-2 treatments at 14d intervals
* Symptoms resolve over 2-4wks
* Use oil based product
62
Is it possible to overdose when treating hypovitaminosis A?
Yes!
--\>epidermal sloughing
63
What supportive care is needed for hypovitaminosis A?
Fluids and energy
64
What is the signalment of thiamine deficiency?
Adult, piscivorous reptiles
65
What is the typical history of thiaminase deficiency patients?
Frozen fish diet
## Footnote
**Freezing fish decreases the amount of available thiamine and increases thiaminase activity**
66
What is seen on the PE of a thiamine deficiency patient?
Neurological signs
67
How do you diagnose thiamine deficiency?
**Response to therapy:**
Vitamin B1 (thiamine) 25mg/kg/day IM
68
What are the parameters/correction guidelines for blood glucose?
* Portable units
* Normal = 70-100g/dl
* 40-50g/dl
* 5% dextrose in LRS IC
* 20-40g/dl
* 10% bolus IV
* \< 20g/dl
* 50% 0.5-1.0ml/kg
