Urinary Tract Diseases of Reptiles

In-nest mortality and pathology of hawksbill sea turtle (Eretmochelys imbricata) embryos and hatchlings in St. Kitts and Nevis

Strategies to improve the hatch success and survival of critically endangered hawksbill turtles (Eretmochelys imbricata) require knowledge of threats to them including pathological conditions. The objective of this study was to describe the mortality and pathology of embryos and dead-in-nest hatchlings on St. Kitts and Nevis. Over the 2019/20 and 2020/21 nesting seasons, the combined mean (SD) hatch success for the two islands was 81.9% (13.2%) and deceased individuals within excavated nests were early-stage embryos (70.7%), late-stage embryos (17.7%), pipped-hatchlings (8.2%) or dead-in-nest hatchlings (3.4%). From 2017 to 2021, a post-mortem examination was performed on 183 turtles, including histology for 116. Anatomical malformations affected 77 (42.1%) examined turtles and included abnormal scute shape or number (22.4%), dysmelia (8.7%), schistosomus reflexus (7.7%) and compressed carapace (7.7%). Microscopic lesions were found in 49.1% of turtles and included tissue mineralization (26.7%, including renal, fetal membrane, liver, heart or muscle), chorioallantoitis (16.2%) and skeletal muscle degeneration and necrosis (10%). Inflammatory lesions associated with fungal or bacterial infections were in the skin (n = 3), chorioallantois (n = 4), lung (n = 3) or yolk sac (n = 1). These lesions may reflect non-specific terminal conditions but their presence in-nest helps explain some of the mortality and pathology documented in hatchlings that die during rehabilitative care. All of the gonads adequately represented for histological determination of sex were female (n = 62), supporting concern for feminization of Caribbean hawksbill turtle nests. The study identifies lesions that could affect hatch and emergence success. The high frequency of skeletal malformations indicates the need for investigations addressing regional impact and pathogenesis, especially genetic and environmental aetiologies including nest temperature. Immediate examination of live hatchlings on nest emergence is warranted to better determine the prevalence of non-fatal malformations that could impact fitness and population genetics.

UVB-emitting LEDs for reptile lighting: Identifying the risks of nonsolar UV spectra

UVB lamps are used to provide reptiles housed indoors with the UV radiation necessary to synthesize vitamin D3 in their skin. Since 2019, UVB-LED lamps have been on sale for use in reptile husbandry. We performed spectral analysis and mapped the UV irradiance for 18 of these lamps. The positive benefits of UVB-LED lamps over traditional products include greater energy efficiency, freedom from mercury and easy installation without external ballasts. However, the spectra of all the UVB-LED lamps tested had little similarity to the solar UV spectrum. Some lamps emitted short-wavelength, non-terrestrial, radiation known to cause acute photo-kerato-conjunctivitis; we report one case. All lamps were lacking significant output in the range 315-335 nm, essential for natural self-regulation of cutaneous vitamin D3 synthesis, preventing overproduction. We describe a possible risk of serious hypervitaminosis D based on our spectral analysis. We call for long-term animal studies to assess this risk, in which the reptiles under these lamps are exposed to species-appropriate UV index levels according to their Ferguson Zone allocation and serum levels of vitamin D3 and 25(OH)D3 monitored. Spectral modifications of the lamps to make the spectrum more like sunlight may be an essential way of mitigating this risk.

An Improved Model for Biogenic Ammonium Urate

The pathological crystallization of ammonium urate inside the urinary tract is a well-documented medical condition; however, structural studies of the biogenic material have proven challenging owing to its propensity to precipitate as a powder and to exhibit diffraction patterns with widely varying intensities. Using block Rietveld refinement methods of powder diffraction data, here we identify ammonium urate hydrate (AUH) as a likely component in natural uroliths. AUH has a planar 2-D hydrogen-bonded organic framework of urate ions separated by ammonium ions with water molecules residing in bisecting channels. AUH is stable up to 150 °C for short time periods but begins to decompose with prolonged heating times and/or at higher temperatures. Changes in the solid-state structure and composition of synthetic material over a temperature range from 25 to 300 °C are elucidated through thermogravimetric and spectroscopic data, combustion analysis, and time-resolved synchrotron powder X-ray diffraction studies. We contend that biogenic ammonium urate is more accurately modeled as a mixture of AUH and anhydrous ammonium urate, in ratios that can vary depending on the growth environment. The similar but not identical diffraction patterns of these two forms likely account for much of the variability seen in natural ammonium urate samples.

Urine Output Monitoring and Acute Kidney Injury in Non-mammalian Exotic Animal Critical Care

Acute kidney injury (AKI) is a sudden, severe decrease in kidney function which can occur in any species. There are various causes of AKI, some of which are seen in domestic species and some that are unique to birds, reptiles, and amphibians. These species present unique challenges with AKI management, such as differences in anatomy and physiology, intravenous and urinary catheterization, repeated blood sampling, and their tendency to present in advanced states of illness. This article will discuss AKI, diagnosis, treatment, and prognosis for non-mammalian exotic species.

Point of Care Ultrasound in Exotic Animal Emergency and Critical Care

Exotic pets are presented to veterinary clinics with increasing frequency for routine, urgent, and emergency needs. With these increased visits, owners' expectations for high-quality veterinary care are also increasing. Many presenting complaints of reptiles, birds, and small mammals can benefit from the use of point of care ultrasound (POCUS) to establish a minimum database, aid in triage, and help guide further diagnostics, treatment, and prognostic discussions with the owner. Hospitalized exotic patients can also have their progress tracked and better assessed with the aid of POCUS.

Urothelial carcinoma in a Russian tortoise (Testudohorsfieldii)

An adult female Russian tortoise (Testudo horsfieldii) was admitted to a veterinary clinic with a 1-week history of anorexia and lethargy. Physical examination revealed significant dehydration and generalized dysecdysis. Blood parameters were all within species-reported limits. Radiography revealed an increased amount of soft tissue opacity within the coelomic cavity and a distinct loss of serosal detail. A large cavitated mass was detected ultrasonographically in the right coelom and a tentative diagnosis of kidney pathology was made. Using computed tomography and magnetic resonance imaging, a partly mineralized heterogeneous mass was seen in the right coelom. After stabilization, a transplastron coeliotomy was performed. A 7 × 5 cm mass, including associated cysts, was removed. The tortoise died 8 h postoperatively and post-mortem examination revealed a urothelial carcinoma arising from the renal pelvis. To the authors' knowledge, this is the first report in a tortoise of urothelial carcinoma, which has rarely been reported in reptiles.

Identification of Uric Acid Crystals Accumulation in Human and Animal Tissues Using Combined Morphological and Raman Spectroscopy Analysis

Gout is a metabolic condition, common to animals and humans, issuing from the excessive accumulation of end products of proteins degradation. In this study, histopathological and cytological examinations, combined with Raman spectroscopy, have been performed to investigate tissue samples from reptiles, chickens, and humans, presenting lesions produced by uric acid accumulation. As a result of classic processing and staining techniques commonly used in the anatomopathological diagnosis, uric acid crystals lose their structural characteristics, thus making difficult a precise diagnostic. Therefore, complementary diagnostic methods, such as Raman spectroscopy, are needed. This study compares from several perspectives the above mentioned diagnostic methods, concluding that Raman spectroscopy provides highlights in the diagnosis of gout in humans and animals, also adding useful information to differential diagnosis of lesions.

A REVIEW OF MORTALITY IN TENTACLED SNAKES (ERPETON TENTACULATUM) IN A MULTI-INSTITUTION ZOOLOGICAL COLLECTION BETWEEN 1966 AND 2017

The tentacled snake (Erpeton tentaculatum) is a viviparous aquatic snake that is a desirable species to exhibit in zoological collections because of its unique appearance and feeding strategies. Despite its presence in zoo collections over the past 50 yr, a comprehensive review of mortality and morbidity in the species has not been published. This study retrospectively reviewed 125 pathology reports from tentacled snakes in a multi-institution zoological collection in New York (The Wildlife Conservation Society's Bronx and Central Park zoos) between 1966 and 2017. Just over half of the deaths were due to infectious disease (n = 67; 53.6%), and of these, over half (n = 40; 59.7%) were due to fungal dermatitis. Fungal histomorphology was consistent with Paranannizziopsis spp. in most cases. Death due to bacterial infection was also relatively common (n = 21; 16.8%), and one-third had intralesional bacilli consistent with Mycobacterium spp. (n = 7; 5.6%). The most common comorbidities included gastrointestinal parasitism (n = 44; 35.2%), renal pathology (n = 31; 24.8%), and lipid accumulation of hepatocytes (n = 13; 10.4%). This retrospective review suggests that managing infectious diseases plays a role in the long-term care and survival of captive tentacled snakes.

RETROSPECTIVE REVIEW OF HISTOLOGIC FINDINGS IN CAPTIVE GILA MONSTERS (HELODERMA SUSPECTUM) AND BEADED LIZARDS (HELODERMA HORRIDUM)

A retrospective study was performed by reviewing all Heloderma spp. submissions to Northwest ZooPath from 1996 to 2019. Necropsy and biopsy specimens from 106 captive Gila monsters (Heloderma suspectum) and 49 captive beaded lizards (Heloderma horridum) were reviewed. Inflammatory diseases were the most frequently diagnosed condition in Heloderma spp., and were diagnosed in 72% of all animals examined, including 76% of Gila monsters and 63% of beaded lizards. The most common cause of inflammation was bacterial infection, which was present in 52% of all Heloderma spp. with inflammation. Enterocolitis was common in Gila monsters (20%) and beaded lizards (14%), but the underlying causes were different for each species. Cryptosporidium spp. was the most common cause of enterocolitis in Gila monsters (36%) but was not identified in beaded lizards. Amoebiasis was a common cause of enterocolitis in Gila monsters (27%) and was the most common cause of enterocolitis in beaded lizards (57%). Deposition diseases were diagnosed in 34% of all Heloderma spp. The most frequently diagnosed deposition disease in beaded lizards was urolithiasis-nephrolithiasis (12%). This disease was not diagnosed in Gila monsters. Deposition diseases that were common in Gila monsters and beaded lizards included hepatic lipidosis and renal gout. Neoplasia was diagnosed in 17% of all Heloderma spp., including 17% of Gila monsters and 18% of beaded lizards. The most common neoplasm of Heloderma spp. was renal adenocarcinoma, which was equally common in Gila monsters and beaded lizards. Less common diagnoses included degenerative diseases, trauma, nutritional disease, nonneoplastic proliferative disease, nondegenerative cardiovascular disease, and congenital malformation.

Diseases Caused by Amoebae in Fish: An Overview

Parasitic and amphizoic amoebae are ubiquitous and can affect a huge variety of hosts, from invertebrates to humans, and fish are not an exception. Most of the relationships between amoebae and fish are based on four different types: ectocommensals, ectoparasites, endocommensals and endoparasites, although the lines between them are not always clear. As ectocommensals, they are located specially on the gills and particularly the amphizoic Neoparamoeba perurans is the most relevant species, being a real pathogenic parasite in farmed salmon. It causes amoebic gill disease, which causes a progressive hyperplasia of epithelial cells in the gill filaments and lamellae. Nodular gill disease is its analogue in freshwater fish but the causative agent is still not clear, although several amoebae have been identified associated to the lesions. Other species have been described in different fish species, affecting not only gills but also other organs, even internal ones. In some cases, species of the genera Naegleria or Acanthamoeba, which also contain pathogenic species affecting humans, are usually described affecting freshwater fish species. As endocommensals, Entamoebae species have been described in the digestive tract of freshwater and marine fish species, but Endolimax nana can reach other organs and cause systemic infections in farmed Solea senegalensis. Other systemic infections caused by amoebae are usually described in wild fish, although in most cases these are isolated cases without clinical signs or significance.

Diseases of the Reptile Renal System

Renal disease accounts for a considerable amount of morbidity and mortality in reptiles, in part owing to inadequate husbandry practices, such as inappropriate temperature, humidity, and access to water. Inappropriate husbandry practices may lead to subclinical dehydration that can specifically impact the renal system, which relies on vascular perfusion to function. This article aims to highlight urinary pathophysiology and summarize infectious and noninfectious causes of renal disease in reptiles as a guide for differential diagnoses to consider during clinical evaluation.

Clinical Management of Reptile Renal Disease

Renal disease is one of the most common medical conditions encountered in captive reptiles. In most cases, signs of disease are nonspecific and often not present until the condition is advanced. Many factors contribute to the development of renal disease, and the etiology often is multifactorial. Diagnosis of renal disease by traditional methods used in small animals is not as straightforward as in reptiles; often many tests may be needed to reach a firm diagnosis. Prevention is preferred to treatment. Understanding the pathophysiology, potential causes, diagnostic tests available, and treatment options is essential for the reptile veterinarian to manage this condition.

Diagnostic Imaging of the Reptile Urinary System

Reptiles can develop various diseases of the urinary tract, including, but not exclusively, urolithiasis, gout, acute and chronic kidney injury, and secondary renal hyperparathyroidism. Diagnostic imaging is instrumental in differentiating and diagnosing these ailments. This article describes the current diagnostic imaging approaches used in reptile medicine for evaluation of urinary tract disease. The use of radiographs, ultrasonography, computed tomography, MRI, and endoscopy is discussed and compared for the evaluation of urinary tract disease in reptiles.

A renal adenocarcinoma in a corn snake (Pantherophis guttatus) resembling human collecting duct carcinoma

A 5-year-old male captive corn snake ( Pantherophis guttatus) with caudal coelomic swelling was admitted for surgical treatment. Laparotomy revealed a 5 × 4 × 2.5 cm, firm, expansile, irregularly shaped mass arising from the middle portion of the right kidney with a mild lobulated pattern and mottled white-to-tan. Microscopically, the mass was composed of numerous bizarre angulated tubules of polygonal neoplastic cells separated by a scirrhous stroma with remarkable heterophilic infiltrates. The neoplastic cells were nonciliated and mucin secreting, with abundant brightly eosinophilic cytoplasm. There were marked cellular and nuclear atypia, frequent cell individualization, and stromal invasion, indicative of malignant behavior, which was confirmed by metastasis to the left kidney 1.5 months postoperatively. Both neoplastic epithelial cells and mesenchymal cells contributing to the scirrhous stroma had variable immunopositivity for pan-cytokeratin. The neoplasm was considered a renal adenocarcinoma resembling human collecting duct carcinoma.