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Endoscopic Hepatic Biopsy in Coahuilan Box Tdrtles, Terrapene Coahuila Gary West, DVM San Antonio Zoo and Aquarium 3903 N

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Endoscopic Hepatic Biopsy in Coahuilan Box Tdrtles, Terrapene Coahuila Gary West, DVM San Antonio Zoo and Aquarium 3903 N C linical T echniques Endoscopic Hepatic Biopsy in Coahuilan Box Tdrtles, Terrapene coahuila Gary West, DVM San Antonio Zoo and Aquarium 3903 N. St. Mary’s Street San Antonio, TX 78212 USA Abstract: Endoscopic procedures are becoming standard diagnostic tools for reptile practitioners. However, Downloaded from http://meridian.allenpress.com/jhms/article-pdf/11/2/28/2207106/1529-9651_11_2_28.pdf by guest on 26 September 2021 endoscopic examinations in chelonia have been only briefly reported in the literature. Turtles and tortoises are ideal candidates for endoscopic examination of the coelomic cavity. A Coahuilan box turtle, Terrapene coahuila, from a breeding group at the San Antonio Zoo was found dead. Post-mortem examination of this tur­ tle revealed mycobacterial hepatitis. Coelomic cavity endoscopic exams were then performed on the rest of the breeding group. Hepatic biopsies from all turtles were performed. Key W ords: Coahuilan box turtle, Terrapene coahuila, hepatic biopsy, endoscopic examination, hepatic lipi­ dosis. INTRODUCTION After anesthetic induction an assistant held each turtle in left lateral recumbency. An endoscopic approach to the The Coahuilan box turtle, Terrapene coahuila, is an endan­ coelomic cavity is similar to a surgical approach previously gered reptile endemic to a drainage area basin of Cuatro described (Brannian, 1984). This inguinal or preformal loca­ Cienegas in the state of Coahuila, Mexico. Due to the arid tion was more recently described for endoscopy of the environment of this region this species became tertiairily coelomic cavity in turtles (Taylor, 1999). aquatic and is often called the aquatic box turtle (Pritchard, A right inguinal approach was made to the coelomic cavity. 1979). This area between the carapace and plastron has been called The San Antonio Zoo houses a breeding group of seven the preformal area or inguinal fossa (Mangone, 1998, Divers, Coahuilan box turtles. A female turtle was found dead in its 1999, Stahl, 1999, Taylor, 1999). This approach allows access exhibit with no previous signs of illness. Histopathology of to the coelomic cavity without plastronotomy. The skin was tissues revealed a severe, multifocal granulomatous hepatitis surgically prepared with povidone-iodine and alcohol. A ster­ and moderate hepatic lipidosis. Acid-fast staining of hepatic ile, self-adhering, fenestrated drape was placed over the tissue was diagnostic for mycobacterial hepatitis. After the patient (U-drape, 3M health care, St. Paul, MN). A vertical diagnosis of mycobacterial disease in one turtle, endoscopic skin incision was made with a 15-scalpel blade. The subcuta­ hepatic biopsies were planned for the six remaining turtles. neous tissue was bluntly dissected and the underlying The use of rigid endoscopy in Chelonia has been briefly transverse abdominis muscle was incised. The pleuro-peri- reported in the literature (Jenkins, 1996, Divers, 1999, toneal membrane of the coelomic cavity was bluntly Schildger, et al, 1999, Taylor, 1999). Surgical approach to penetrated with a hemostat. the coelomic cavity of chelonia without entering the plastron After entry into the coelomic cavity, a 2.7 mm Wolf rigid has also been described (Brannian, 1984, Mangone, 1998, endoscope (Richard Wolf Medical Instruments Corporation, Stahl, 1999). A soft tissue laparatomy in turtles without enter­ Rosemont, II) was introduced. No insufflation was needed to ing the plastron was effective in identifying coelomic organs view abdominal organs and the liver was easily visualized and allowed for surgical procedures on the reproductive tract and examined. Diffuse hepatomegaly with rounded margins and gastrointestinal tract (Brannian, 1984, Mangone, 1998, and a homogeneous pale brown color was seen in all livers Stahl, 1999). examined. Diffuse, infiltrative disease of the liver was sus­ pected in all six turtles. A biopsy of each turtle’s liver was PROCEDURE done with an Eppendorfer uterine biopsy forceps (Miltex Instrument Corporation, Inc., Lake Success, NY) inserted in All six turtles were fasted for 24 hr prior to endoscopic parallel with the endoscope. The biopsies were taken from the examination. Each turtle was given 40 - 60 mg/kg ketamine right lobe margin. The uterine biopsy forceps took a single hydrochloride (Ketaset, USP, 100 mg/ml, Fort Dodge Animal clean bite through the serosa and parenchyma with little sub­ Health, Fort Dodge, IA) IM in the triceps musculature. sequent hemorrhage. Biopsies obtained were approximately 2 Anesthetic relaxation was determined by loss of limb motion, mm by 1 mm in size. Other organs in the coelomic cavity righting reflexes, and absence of a pain response. All six tur­ were examined and no abnormalities were seen. Cardiac tles were intubated and manually ventilated with oxygen motion could be visualized and allowed for further anesthetic throughout the procedure. monitoring (Schildberg, 1999). 28 Journal of Herpetological Medicine and Surgery Volume 11, No. 2,2001 The pleruro-peritoneal membrane and overlying muscle REFERENCES were closed with 2-0 polydioxanone suture (PDS, Ethicon, Inc. Sommerville, NJ) in a simple continuous pattern. Skin Brannian RE. 1984 A soft tissue laparatomy technique in tur­ was closed with 2-0 polydioxanone suture in a single cruciate tles, JAVMA, 185:1416-7. pattern. Formulated cyanoacrylate (Nexaband, Veterinary Divers S. 1999. Endoscopic examination of reptiles. Exotic Products Laboratories, Phoenix, Arizona) was applied over DVM, 1.3:21-27. sutures and the incision. Jenkins J. 1996. Diagnostic and clinical techniques. In Mader All turtles were recovered at 28°C (82°F) without access to D (ed): Reptile Medicine and Surgery. WB Saunders Co, water. All turtles were active and fully recovered from anes­ Philadelphia PA:275-6. thesia within two hours of the procedure. The next day the Mangone B, Johnson J. 1998. Surgical removal of cystic cal­ turtles were allowed access to water and were all seen eating. culi via the inguinal fossa and other techniques applicable to the All turtles were completely healed within 30 days and have approach in the desert tortoise, Gopherus agassizii. Proc. ARAV, remained clinically normal for over two years since the endo­ 87-88. scopic procedure. Pritchard P. 1979. Encyclopedia of turtles, TFH Pub, Neptune, Biopsies from all turtles revealed hepatic lipidosis with no NJ: 168-170. Downloaded from http://meridian.allenpress.com/jhms/article-pdf/11/2/28/2207106/1529-9651_11_2_28.pdf by guest on 26 September 2021 evidence of mycobacterial infection. Hepatic lipidosis appears Shildger B, et al. 1999. Endoscopic examination of the pleuro- to be a common finding in captive chelonia at the San periotoneal cavity in reptiles. Seminars in Avian and Exotic Pet Antonio Zoo. Medicine, 8:131-9. Rigid endoscopic procedures in captive turtles and tortoises Stahl S. 1999. Prefemoral approach to celiotomy in cheloni- can be safe and useful diagnostic aids to help investigate dis­ ans, Exotic DVM. 1.3:15-21. ease conditions in these species. Taylor M. 1999. Endoscopy in birds and reptiles. In Tams T (ed): Small Animal Endoscopy. Mosby, Inc., St. Louis, MS:439- 40. Volume 11, No. 2,2001 Journal of Herpetological Medicine and Surgery 29.
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