Reptiles - Nutritional Disorders

Question 1

What is the signalment for Nutritional Hyperparathyroidism in reptiles?

Answer 1

Most common: lizards and aquatic turtles (but seen in all species)

Juveniles,
Reproductively active females,
Long-term rehab animals

Question 2

What might we observe on physical exam in a reptilian patient with Nutritional Hyperparathyroidism?

Answer 2

Muscle tremors, fasciculations, tetany;
Skeletal: fibrous osteodystrophy (thickening/swelling of long bones and mandibles)

Question 3

How do we diagnose nutritional hyperparathyroidism?

Answer 3

Blood work (Ca2+ usually low normal),
Radiographs - loss of cortical density - fractures

Question 4

How should we treat nutritional hyperparathyroidism?

Answer 4

Correct diet and env’t,

Fluid therapy: 10-30mL/kg/day
Calcium glubionate (oral),
Vitamin D therapy

Question 5

An adult, water-deprived reptile presents with difficult mobility and your client informs you that the patient is fed a high protein diet. What are you suspicious of?

Answer 5

GOUT!
—> deposition of URIC ACID and urate salts within visceral tissues and on articulate surfaces (May see swollen joints)

Question 6

What is the most common type of gout?

Answer 6

Secondary (chronic dz or drug-induced, like furosemide)

Question 7

What might plasma chemistry and radiographs reveal in a reptilian patient with Gout?

Answer 7

Hyperuricemia;
lytic lesions around or near joints,
gouti tophi (Uric acid + Ca)

Question 8

How do we DEFINITIVELY diagnose Gout in our reptilian patient?

Answer 8

Demonstration of monosodium urate crystals within joints of affected patients (or within tophi)

Question 9

How might we correct husbandry in a patient with gout as a means to therapy?

Answer 9

Provide low purine diet,
High moisture foods,
Mist/regular access to water

Question 10

How would probenecid and allopurinol be therapeutic for a gout patient?

Answer 10

Probenecid: increases secretion of Uric acid
Allopurinol: reduces hepatic production of Uric acid
*use both*

Question 11

What is the signalment for the commonly encountered Hypovitaminosis A?

Answer 11

Young, fast growing chelonians;
Long-term rehab chelonians (Esp. Turtles, red-eared sliders)

Question 12

A young red-eared slider presents with bilateral blepharoedema, lethargy, nasal and ocular discharge, among other symptoms… what’s at the top of your differential list?

Answer 12

Hypovitaminosis A!
Bilateral blepharoedema is the hallmark sign of this!!
You’ll see squamous metaplasia under the eyelids
—>looks like an abscess/caseous debris

Question 13

What is the preferred treatment for Hypovitaminosis A?

Answer 13

Oral supplementation (vit A products),
Liver—>1/2”x1/2” cube
If you are using injectable, use oil based product over a water-based
(absorption takes longer)

Question 14

Although we don’t know much about the etiology behind Pyramiding, what is it mostly associated with?

Answer 14

Lack of humidity and incorrect diet

*low humidity (<25%) makes keratin stiff and resistant, putting pressure on bone beneath, leading to deformities*

Question 15

Signalment for Thiamine Deficiency?

Answer 15

Adult,
Piscivorous reptiles;
Insectivores fed multivitamin supplement that lacked thiamine

Question 16

How do we diagnose Thiamine Deficiency?

Answer 16

By response to therapy:
Vitamin B1 25 mg/kg/day IM