Management of Polyarthritis Affecting Sea Turtles at Kélonia, the Reunion Island Sea Turtle Observatory (2013-17)

Synovial fluid analysis in healthy green turtles Chelonia mydas in Taiwan

Septic arthritis is a frustrating disease in sea turtle rehabilitation because of its unclear pathogenesis, delayed onset during rehabilitation, long-term treatment requirements, and potentially poor prognosis. Radiography, blood cultures, and arthrocentesis have been used as diagnostic tools for suspected cases. However, there is currently a lack of data on the characteristics of synovial fluid in healthy sea turtles. To establish reference data for synovial fluid in sea turtles, we enrolled 14 green turtles Chelonia mydas rescued between 2019 and 2022 from 3 facilities using the following inclusion criteria: normal attitude and appetite, normal motor functions of the 4 limbs, no joint swelling, and no ongoing use of antibiotics for at least 1 mo. Bacterial cultures of blood and synovial fluid from the shoulder joints of these turtles were obtained and a qualitative analysis of the synovial fluid was performed. The results revealed bacterial culture-negative blood and synovial fluids at 37°C. Most characteristics of normal synovial fluid in green turtles, such as being transparent, colorless, and able to create a strand of over 2.5 cm by being pulled with a needle in viscosity trials, as well as the cytology of the normal synovial fluids being dominated by histiocytes and synovial lining cells, lymphocytes, and occasionally a few heterophils or erythrocytes were similar to those in mammals. This study provides information on the normal synovial fluid characteristics of green turtles in Taiwan, which may be beneficial for the diagnosis of joint diseases in sea turtles.

RETROSPECTIVE ANALYSIS OF BLOOD CULTURES AND THEIR ASSOCIATION WITH CLINICAL FINDINGS AND OUTCOME IN GREEN SEA TURTLES (CHELONIA MYDAS) AT A FLORIDA SEA TURTLE REHABILITATION FACILITY, 2017-2020

Septicemia is commonly suspected of sea turtles entering rehabilitation. However, blood culture results of green sea turtles (Chelonia mydas) are infrequently reported in the literature. Aerobic blood cultures were performed for intake examinations of 167 green sea turtles undergoing rehabilitation at Brevard Zoo's Sea Turtle Healing Center, Melbourne, Florida, USA from 2017 to 2020. The incidence of positive cultures during intake examinations was 24% (40/167). The most common bacterial isolates identified were Vibrio alginolyticus, Shewanella algae, Achromobacter xylosoxidans, Photobacterium damselae, Sphingomonas paucimobilis, and Vibrio parahaemolyticus. There was a statistically significant association (P < 0.05) between culture status and evidence of external injury. There was no significant association between culture status and Caryospora-like coccidia infection, or fibropapillomatosis. Culture-positive turtles had significantly lower (P < 0.05) total white blood cell, lymphocyte, monocyte, total protein, albumin, and calculated globulin values compared to turtles with negative blood cultures. Significantly more culture-positive turtles died in rehabilitation compared to culture-negative (P = 0.042). Positive blood cultures suggestive of septicemia are commonly found during intake examinations at a Florida sea turtle rehabilitation facility.

Disseminated Candidiasis and Candidemia Caused by Candida palmioleophila in a Green Sea Turtle (Chelonia mydas)

Simple Summary

A sub-adult green sea turtle was rescued and treated for shell fractures on the carapace and plastron. During the first 2 months, the turtle was kept dry-docked with a placement of an intravenous catheter. Pain management, antibiotic and anthelmintic therapy, fluid therapy, human albumin, force feeding, and wound debridement were provided to manage the shell fractures and to control the infection. After 2 months of care, small budding yeasts were noted on the turtle’s blood smears. Blood cultures yielded yeast-like colonies that were later identified as Candida palmioleophila. The patient was then treated with an antifungal agent and the catheter was removed. Approximately 3.5 months later, the carapace and plastron wounds had healed. However, the turtle died at 7.5 months after rescue. The postmortem examination revealed disseminated yeast in joints, bones, brain, and lungs. This study aims to improve the veterinary medical care and, therefore, enhance the conservation of endangered sea turtles by describing a rare report of systemic C. palmioleophila infection.

Abstract

A sub-adult green sea turtle (Chelonia mydas) was rescued and treated for carapace and plastron shell fractures. The turtle was kept dry-docked for the first 2 months with a placement of a long-term jugular central venous catheter (CVC). Pain management, aggressive antibiotic and anthelmintic therapy, fluid therapy, force feeding, and wound debridement were provided to manage the shell fractures and control bacteremia. Human albumin was administered to treat severe hypoalbuminemia. On day 59, small budding yeasts were noted on the blood smears. Candidemia was confirmed by blood culture, as the yeasts were identified as Candida palmioleophila by the molecular multi-locus identification method. The CVC was removed, and the patient was treated with itraconazole. Although the carapace and plastron wounds had epithelized by 5.5 months after the rescue, the turtle died unexpectedly by 7.5 months. The postmortem examination revealed numerous necrogranulomas with intralesional yeasts, morphologically compatible with Candida spp., in joints, bones, brain, and lungs, suggestive of disseminated candidiasis. We describe a rare case of candidemia in the veterinary field. To our knowledge, this is the first report of candidiasis caused by C. palmioleophila in a reptile. The present results should improve veterinary medical care and, therefore, enhance the conservation of endangered sea turtle species.

Osteomyelitis in cold-stunned Kemp's ridley sea turtles (Lepidochelys kempii) hospitalized for rehabilitation: 25 cases (2008-2018)

OBJECTIVE

To characterize osteolytic lesions in cold-stunned Kemp's ridley sea turtles (Lepidochelys kempii) hospitalized for rehabilitation and describe methods used for the management of such lesions.

ANIMALS

25 stranded, cold-stunned Kemp's ridley sea turtles hospitalized between 2008 and 2018.

PROCEDURES

Medical records of sea turtles with a diagnosis of osteolytic lesions were reviewed retrospectively to obtain the date of diagnosis, clinical signs, radiographic findings, microbial culture results, hematologic and plasma biochemical data, cytologic and histologic findings, antimicrobial history, time to first negative culture result, treatment duration, and outcome.

RESULTS

Lesions were identified radiographically a median of 50 days after admission and were located within epiphyses or metaphyses of various appendicular joints. Lesions were associated with periarticular swelling (n = 24), lameness (16), lethargy (2), and hyporexia (2). Bacterial culture yielded growth of single organisms (n = 16), multiple organisms (2), or no growth (6). Significant differences in hematologic and biochemical data were detected between the times of diagnosis and convalescence. Cytologic and histologic findings characterized the lesions as osteomyelitis leading to septic arthritis. Sixteen sea turtles were managed medically, and 8 were managed medically and surgically. Surgery resulted in rapid improvement in joint mobility and overall clinical status. Most (22/25 [88%]) sea turtles survived and were released after long-term management.

CONCLUSIONS AND CLINICAL RELEVANCE

During rehabilitation, cold-stunned Kemp's ridley sea turtles may be affected by osteomyelitis. Medical management based on antimicrobial susceptibility testing was effective for most turtles. Long term management efforts in turtles are justified by high survival rate.