Exotic Vol 11

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EXOTIC
A P R A C T I C A L R E S O U R C E F O R
DVM
VOLUME 11
ISSUE 1
C L I N I C I A N S
contents Cover photo of Jörg Mayer, DVM, MSc by

Andrew Cunningham, Director of Media Services
Cummings School of Veterinary Medicine, Tufts University
Observations from the Field

3 Beak Osteosynthesis in a Magpie - Giuseppe Visigalli, DVM;
Alessandra Cappelletti, DVM and Sara Nuvoli, DVM
7 Ivermectin Treatment of Red Bug Disease in Acropora Coral -
Kevin Wright, DVM
Matthew Wheelock
9 Surgical Removal of Foleyella furcata from Wild-caught Panther

Chameleons - Matthew Wheelock, DVM
9
Observations from the Forum
11 Ferrets As I See Them -
Cathy Johnson-Delaney, DVM, Dipl ABVP-Avian
Case Reports Peer Reviewed
13 Abdominal Abscess in a Rabbit - David Perpiñán, LV, MSc
17 Fecal Bacteriotherapy for Treatment of Clostridial Enterotoxemia

in Rabbits - Julie Hébert, DVM
11 21 Ultrasound Imaging of the Reproductive Tract

of Reticulated Gila Monsters - Kerri Cooper, MS; Stephen A. Smith,
DVM, PhD and Martha M. Larson, DVM, Dipl ACVR
25 Thyroid Scintigraphy in a Guinea Pig

with Suspected Hyperthyroidism - Jörg Mayer, DVM, MSc;
Kathleen Hunt, BS; David Eshar, DVM; Mauricio Solano, MV, Dipl ACVR
Special Feature
Quick Reference Guide to Selected Exotic Species
32 Ornamental geese (Anser sp., Chen sp., Branta sp.) -
Michelle L. Campbell-Ward, BSc, BVSc (Hons I), DZooMed
25 (Mammalian), MRCVS
35 Blood python (Python curtus) - Giuseppe Visigalli, DVM
37 Corn snake (Pantherophis guttata) -

Nathalie Wissink-Argilaga, Lic Vet, GPCert (ExAP), MRCVS
39 Mud turtle (Kinosternon sp.) - Jennifer Mosier, DVM
Departments
41 Time Off
42 For Your Bookshelf
47 em Exotic Marketplace
37 48 Tools
11-1 masthead.qxd 3/12/2009 12:55 PM Page 2
EXOTIC
A PRACTICAL RESOURCE FOR CLINICIANS
DVM
Supported in part by a grant from Harrisons’ Pet Products

Volume 11, Issue 1, March 2009
MEDICAL EDITOR Ariana Finkelstein, DVM Neus Morera, DVM

Melissa Kling, DVM Peter Fisher, DVM Holly S. Mullen, DVM, Dipl ACVS
Rose Ann Fiskett, VMD, Dipl ABVP-Avian Michael Murray, DVM
REVIEWERS Richard S. Funk, MS, DVM Curt Nakamura, DVM
Experienced exotic animal practitioners who Jennifer Graham, DVM, Dipl ABVP-Avian, Dipl ACZM Connie Orcutt, DVM, Dipl ABVP-Avian
have reviewed articles written by their peers for Cheryl Greenacre, DVM, Dipl ABVP-Avian Lauren Powers, DVM, Dipl ABVP-Avian
Exotic DVM include: Craig A. Harms, DVM, PhD, Dipl ACZM Katrina Ramsell, PhD, DVM
Greg Harrison, DVM, Dipl Emeritus ABVP-Avian; Drury Reavill, DVM, Dipl ABVP-Avian, Dipl ACVP
Kay Backues, DVM Dipl ECAMS (retired) Victor T. Rendano Jr, VMD, MS, Dipl ACVR (RO)
Frances M. Baines, MA, VetMB, MRCVS Heidi Hoefer, DVM, Dipl ABVP-Avian Helen Roberts, DVM
Kornelis Biron, Dr med vet Susan Horton, DVM Kristin Sinclair, DVM
Heather Bowles, DVM, Dipl ABVP-Avian Stormy Hudelson, DVM, Dipl ABVP-Avian Dale Smith, DVM, DVSc
Shane Boylan, DVM Cathy Johnson-Delaney, DVM, Dipl ABVP-Avian Scott Stahl, DVM, Dipl ABVP-Avian
Michael Cannon, BVSc, MACVSc, Grad Dip Ed Dan Johnson, DVM Michael Stanford, BVSc, FRCVS
Vittorio Capello, DVM Jay Johnson, DVM W. Michael Taylor, DVM
Brendan Carmel, BVSc, MVS, David Jones Frank J.M. Verstraete, Dr med vet, BVSc (Hons),
GDipComp, MCP, MRCVS Carla Kasaback, DVM MMedVet, Dipl AVDC, Dipl ECVS, Dipl EVDC
Leigh Clayton, DVM, Dipl ABVP-Avian Susan Kelleher, DVM Laura Wade, DVM, Dipl ABVP-Avian
Rob Coke, DVM, Dipl ACZM Amy Kizer, DVM W.H. Wildgoose, BVMS, CertFHP, MRCVS
Bobby R. Collins, DVM, MS, Dipl ACLAM Melissa Kling, DVM Kevin Wright, DVM
Graham Crawshaw, BVetMed, MRCVS, Dipl ACZM David Knapp, DVM, Dipl ACVS Donald Zantop, DVM, Dipl ABVP-Avian
Lorenzo Crosta, DVM Jack Kottwitz, DVM Flavia Zorgniotti, DVM
Morgan Dawkins, DVM Marc Kramer, DVM
Byron de la Navarre, DVM Daniel Lejnieks, DVM
Bob Doneley, BVSc, MACVSc (Avian Health) Angela Lennox, DVM, Dipl ABVP-Avian Zoological Education Network is committed to
Thomas M. Donnelly, DVM, Dipl ACLAM Bruce Levine, DVM, Dipl ABVP-Avian, increasing the competence and confidence of
Michael Dutton, DVM, Dipl ABVP-Avian Canine & Feline veterinary clinicians in working with exotic
Kevin Eatwell, BVSc (Hons), DZooMed, MRCVS, Gregory Lewbart, VMD, Dipl ACZM companion animals and raising the standards of
RCVS Certified in Zoological Medicine Michael Lierz, Dr med vet care for these species. www.exoticdvm.com
Christine Eckermann-Ross, DVM Brad Lock, DVM, Dipl ACZM
Patty Ewing, DVM, MS, Dipl ACVP Fabiano Montiani-Ferreira, MV, MCV, PhD
EXOTIC DVM STAFF

READERS’ FORUM Linda R. Harrison
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observations
F R O M T H E F I E L D
Because EXOTIC DVM Veterinary Magazine is a publication for international veterinary professionals, some of the information published may relate
to drugs, products and procedures that may not be available or considered ethical/legal in some countries. EXOTIC DVM is a disseminator of infor-
mation and has no opinion on the efficacy or legality of the drugs, products or procedures mentioned. It is the responsibility of the reader to con-
sult regional and national veterinary and animal legislation in evaluating the use of this information.
Contributors
Beak Osteosynthesis in a Magpie
Giuseppe Visigalli, DVM; Alessandra Cappelletti, DVM and
Sara Nuvoli, DVM
An adult magpie (Pica pica) was presented with a traumatic beak
lesion as a result of an attack by a flock of aggressive carrion
crows (Corvus coronae). The injured bird escaped to a nearby
building where it was captured and administered first aid. The
wound was cleaned with an iodine solution and an antibiotic
ointment was applied. Noticing that the magpie was anorectic
after a few days, the rescuer sought veterinary attention.
The animal had sustained several wounds on its back and
severe damage to the gnathotheca (mandibular rhamphotheca),
which was partially avulsed. Close to the rictus (oral commis-
sure) on the right side, the keratin and supporting soft tissues
and mandibular bone were completely separated. The soft
tissues on the ventral midline of the inferior beak were
involved in the injury as well. The poor condition of the bird
required supportive care: warm fluids (25 ml/kg SC 50%
Matthew Wheelock, DVM glucose 5% and 50% sodium chloride); analgesia (meloxicam,
Dilworth Animal Hospital 0.3 mg/kg IM); and infection control (enrofloxacin, 10 mg/kg
Charlotte, North Carolina IM). The magpie was housed in a thermostat-controlled heated
mwheelock@carolina.rr.com vivarium. Because the owner wanted to continue treatment at
home, he was taught how to syringe-feed the bird with a
Kevin Wright, DVM
formula that could easily be found in a pet store (NutriBird
Research Associate,
A21) as well as administer oral therapies of enrofloxacin and
National Aquarium
meloxicam. The magpie was housed in darkness for a few
in Baltimore
Arizona Exotic Animal days in order to keep it quiet between feeding and therapy
Giuseppe Visigalli, DVM Hospital administration.
Alessandra Cappelletti, Mesa, Arizona In a first attempt to repair the beak, the bird was anesthetized
DVM kwright@azeah.com with isoflurane via facemask, then intubated and maintained
Sara Nuvoli, DVM on isoflurane. A 20-ga needle was introduced as a pin into the
Clinica Veterinaria Liana Blu fractured half mandible, and polymethylmethacrylate (PMMA)
Medicina e Chirurgia degli was applied to the surface.
Animali Esotici One month later the needle was removed, and a necrotic
Varedo MI ITALY piece of the beak broke off, exposing the soft tissues of the
herpbepp@tiscali.it
midline of the gnathotheca. The remainder of the wound was
completely healed and the magpie was self feeding.
Osteosynthesis was proposed to avoid further trauma to the
beak subsequent to its use. Two months following the initial
injury, during which time further PMMA was applied to
reinforce the beak, the owners agreed to surgery.
www.exoticdvm.com EXOTIC DVM V O LU M E 1 1 I S S U E 1

3
O B S E R V A T I O N S F R O M T H E F I E L D
a b
Fig 1. a) Shown is the magpie beak defect as seen through a magnifier. A small amount of Fig 2. An intraoral exam was performed to
PMMA was still present on the apex of the gnathotheca. b) The rhinotheca was overgrown assess for further damage.
due to malocclusion from lack of normal wear.
Fig 3. Shown is the beak following removal Fig 4. In preparation for surgery, the magpie Fig 5. After the surgical field was covered
of the old polymethylmethacrylate (PMMA). was intubated with a 2.5 Murphy endotra- with a transparent surgical drape, the apex
cheal tube and connected to a capnograph. of the gnathotheca was drilled with a mini-
drill in order to introduce one end of a
cerclage wire.
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Fig 6. The cerclage wire was placed. Two of Fig 7. A second tunnel was drilled aborally. Fig 8. An end of the cerclage was withdrawn
the 4 electrodes connected to the ECG through the second hole.
monitor can be seen beneath the drape.
Fig 9. One end of the cerclage was bent Fig 10. The second end of the cerclage was Fig 11. The handle of a forceps positioned
forward. bent backward. on the internal face of the mandibular branch
prevented an accidental injury of the tongue
during the placement of a 0.35 inch (0.88
mm) Miniature Interface™ Half positive pin.
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Fig 12. The pin was drawn to the front, Fig 13. The front part of the pin and the
parallel to the back end of the cerclage. cerclage were introduced into a piece of
0.39 inch (1 mm) nasolacrimal horse
catheter.
a b
Fig 14. a) Another small cerclage wire secured the first cerclage and the pin together and
b) was tightened.
Fig 15. The PMMA was mixed and applied to Fig 16. The surface was filed with an Fig 17. A few hours following anesthetic
the external fixator bridge. abrasive bur. recovery, the magpie was observed jumping
on its perches.
Ivermectin Treatment of Red Bug Disease in Acropora Coral

Kevin Wright, DVM
A pernicious parasite of the Acropora
stone corals is a miniscule arthropod
barely visible to the naked eye that is
commonly called red bug, red bug
syndrome, red spot disease or red
mite disease. This is actually a cope-
pod, Tegastes acroporanus, which was
first noted in the coral trade in 2001.1,2
Very little is known about the life
cycle of this parasite.
A client brought in an Acropora Fig 1. Red bugs on Acropora coral frag Fig 2. Tegastes acroporanus paralyzed by
coral frag for examination. The observed via light microscopy. The single red ivermectin, which causes it to curl. This was
Acropora was in a home aquarium eye (arrow) is clearly seen on the center left free-floating in aquarium water on a wet
red bug. 40x magnification. mount slide. The red-tinged spot in upper left
that included fish (clown fish, Pseudo-
is the eye (arrow). The larger red-tinged spot
chromis), other species of stone corals,
on bottom of picture is the abdomen. 100x
various crustaceans (crabs, shrimp,
magnification.
copepods), gastropods (snails), and
bivalves (tridacnid clams). Although
the aquarium was a larger enclosure, not be removed, so the client picked a A 5-mm piece of coral was broken
the client calculated that it held only representative piece of a different off the tip of the frag and placed in a
45 gallons (170.3 L) of water. The red group and broke off a small frag (an clear syringe cap with aquarium
bugs were noted to be injurious to aquarist term for a small piece of water added to a depth of approxi-
the coral, causing it to become dis- coral broken off a larger colony), mately 3 mm so the piece was
colored and unthrifty. The main coral placed it in a 250-ml plastic bag filled immersed. The condenser was
group that was originally infested with aquarium water, and brought brought as close to the microscope
was positioned in a way that it could the patient to the hospital. stage as possible with the light at
■ Academic based diagnostic service with

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7
maximum intensity and the iris fully 7 days for 3 treatments.1 A successful 2 weeks. The client was instructed to
opened. Low power magnification treatment with ivermectin was based treat the tank at least one additional
revealed multiple yellow crustaceans on the assumption that a marine time after he had last observed any
with red spots on either ends. On tank’s water volume is basically a red bugs. The client was warned that
higher magnification, a single red giant living organism so a dose of any crustaceans or other arthropods
eyespot was visible on one end and a 200 mcg/kg (i.e., 200 mcg/L water) that may be present may be killed by
larger red spot was visible on the tail. would be appropriate to eliminate this treatment and to remove any
Some clearly had eggs held on the arthropods (pers comm, S.J. other specimens that were valuable
ventral side. The yellow and red crus- Hernandez-Divers 2009). as there was no guarantee ivermectin
taceans were consistent with “red Ivermectin was chosen for this would be safe for mollusks or other
bug” descriptions (i.e., Tegastes acro- case. Several of the red bugs were invertebrates. It should be safe for
poranus) and after several minutes observed to have eggs, so repeated fish other than angelfish.
of observation one was observed dosing with ivermectin at 2-week The client reported that the red
actively pulling out a coral tentacle intervals was prescribed to treat any bugs were no longer visible after the
and eating it. A drop of ivermectin larvae that may hatch from the eggs. first treatment and the coral remains
was placed into the water and the The actual dosing for 45 gallons was free of infestation to date.
red bugs became paralyzed within 34 mg of ivermectin (3.4 ml Ivomec
Acknowledgments
2 hours at which time they could be 1%™, Merial) dissolved in 10 ml of
The author thanks Dr. Steve Hernandez-Divers,
removed by pipette and placed onto propylene glycol and then slowly
University of Georgia, for his thoughts on red
a wet mount slide. poured into a strong current within bug treatment, and also Dr. Leigh Ann Clayton,
The formal literature on treating the aquarium. The protein skimmer, National Aquarium in Baltimore, for sharing the
this parasite is scant while online UV sterilizer and canister filter were Powerpoint,™ “Milbemycin Treatment of Parasitic
forums have various discussions disconnected from the system during Copepods on Acropora Corals.”
about the use of ivermectin and treatment. After 12 hours, the client
References and Further Reading
milbemycin. Milbemycin had been was told to run a canister filter filled 1. Hadfield CA, Clayton LA, O’Neil HL: Milbemycin treat-
used by dissolving Interceptor® with fresh activated carbon for at ment of parasitic copepods on Acropora corals. Proc
33rd Eastern Fish Health Workshop, 2008, p 76.
(Novartis) in water to achieve a least 12 hours. This same water 2. Lewbart GA: What you should know about red bug
syndrome of corals. Proc No Am Vet Conf, 2009,
milbemycin concentration of 16 management was to be repeated p 1653.
mcg/L for 8 hours repeated every with each ivermectin treatment every
N O W AVA I L A B L E
©2008
494 pages
Emirates Printing
Press LLC
Dubai
ISBN 978-9948-03-562-6
Diseases and Medical Management of

Houbara Bustards and Other Otididae
EDITED BY TOM BAILEY
Contact: tom.bailey@dfh.ae
Surgical Removal of Foleyella furcata from

Wild-caught Panther Chameleons
Matthew Wheelock, DVM
Captive-bred chameleons are becom- intermediate host. Adult filarial
ing more prevalent in the reptile pet worms may invade the body cavity
market, but wild-caught chameleons and intramuscular connective tissues,
are still being imported to establish but usually appear as subcutaneous
new bloodlines and create colorful nodules or linear bodies and are often
morphs. Chameleons that survive the seen moving under the skin (Fig 1).
importation process are usually Although they generally do not
dehydrated and immunologically/ present much danger to native
psychologically stressed and may chameleons, they can result in irrita-
have high parasitic burdens. tion and discomfort. Immunosup- Fig 1. Filarial worms can be seen as linear
Breeders and advanced keepers of pression or concurrent disease in bodies under the skin of this chameleon.
these chameleons have varying newly acquired imports may exacer-

bate clinical signs and lesions (e.g., the species-specific Preferred Optimal
degrees of success in rehabilitation
thrombosis, edema and necrosis) from Temperature Zone (POTZ). The
and elimination of the parasitic load.
these worms. For this reason, some patient is placed in a modified
Many keepers have access to metron-
wild-caught chameleons may present facemask and induced with 7%
idazole and fenbendazole, and some sevoflurane. When the animal is
for removal of the offending parasites.
treat empirically without diagnostic sufficiently relaxed, a surgical plane
confirmation or identification of the EVALUATION AND PREPARATION of anesthesia can be maintained at 4-
parasite. However, one parasite that A complete physical exam, assess- 5% sevoflurane. Surgical preparation
is commonly found in chameleons of ment of diet and husbandry and a of all sites is performed with warmed
Madagascar, which is immune to fecal exam should be performed prior Nolvasan® solution. A 10% dilution of
basic deworming procedures, is the to anesthesia. Presurgical analgesia 2% lidocaine (0.05 ml) is injected into
filarial worm, Foleyella furcata. (butorphanol, 1 mg/kg SC) should each surgical location. The chameleon
The filarial worms are transmitted be administered,5 and the chameleon is placed in lateral recumbency with
as microfilaria by the mosquito should be warmed to the high end of supplemental thermal support.
ASSOCIATION OF
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Or contact ARAVETS@aol.com

9
SURGICAL REMOVAL
Fig 2. An area approximately in the center of Fig 3 The worm is then gently grasped with Fig 4. The skin incision is closed with tissue
a worm is identified. The skin is tented, and forceps and exteriorized. Worms will some- adhesive. Suturing is another viable option for
a stab incision is made, taking care not to times congregate together, so visualization closure, but scarring of pigmented areas may
cut into the worm, which is recognized by its into the keyhole incision following removal result.
pale orange color. After the worm is identi- may reveal other smaller specimens.
fied, the incision may be lengthened several
millimeters to aid in extraction. The worm will
move but usually not far or fast enough to
make extraction difficult.
Fig 5. The procedure is repeated in all areas Fig 6. Although not visualized externally, 2 Fig 7. Shown is the appearance and size of
that have visible worms. In the author’s worms were identified and removed from 3 of the 7 worms removed from this wild-
experience, keyhole incisions should be behind the left shoulder and 3 from behind caught red-barred Ambanja panther
made just caudal and ventral to both the right shoulder in this chameleon. Closure chameleon.
shoulders for inspection even if no worms was performed as described. Prior to recovery,
have been visualized in these locations. warmed fluids were administered (5 ml IC).
POSTOPERATIVE CARE analgesia may be outweighed by smear from a wild-caught panther chameleon
(Furcifer pardalis). Vet Clin Pathol 31(3):129-132,
Recovery is generally uneventful, and stress from administration. 2002.
4. Lane TJ, Mader DR: Parasitology. In Mader DR (ed):
the chameleon will often return to Reptile Medicine and Surgery. WB Saunders, 1996,
Acknowledgments pp 185-203.
normal activity a day or two after 5. Sladky KK, Kinney ME, Johnson SM: Analgesic
The author appreciates the support of Todd
surgery. Wild-caught chameleons can Stinson, photographer, and Chris Carson of
efficacy of butorphanol and morphine in bearded
dragons and corn snakes. J Am Vet Med Assoc
be temperamental and stress easily, so Clean Line Chameleons. 233(2):267-273, 2008.
6. Stahl S: Parasites. In de Vosjoli P, Furguson G (ed):
limited contact should be encouraged Care and Breeding of Chameleons. Advanced
for the next few days. Visual inspec- References and Further Reading Vivarium Systems, 1995, pp 97-99.
1. Bartlett RD, Bartlett P: Chameleons - Everything 7. Szell Z, Sreter T, Varga I: Ivermectin toxicosis in a
tion from outside the cage will help to About Purchase, Care, Nutrition, and Breeding. chameleon (Chamaeleo senegalensis) infected with
Barron Educational Series, 2005, pp 40-41. Foleyella furcata. J Zoo Wild Med 32(1): 115-117,
ensure no secondary infections occur. 2. Carpenter JW, Mashima TY, Rupiper DJ: Exotic 2001.
Analgesic administration is made on Animal Formulary. WB Saunders Co, 2001, 8. www.ChameleonNews.com
pp 51-69. 9. www.ChameleonForums.com
a case by case basis, as benefits of 3. Irizarry-Rovira AR, Wolf A, Bolek M, et al: Blood
11-1 Observations Forum.qxd 3/12/2009 1:57 PM Page 11
O B S E R V A T I O N S F R O M T H E F O R U M
Ferrets As I See Them

Cathy Johnson-Delaney, DVM, Dipl ABVP-Avian Practice
OVERVIEW OF ONGOING SCHEDULING

FERRET ADRENAL RESEARCH LUPRON INJECTIONS
At this time, the use of an annual injection The most important time to suppress the first
of 30-day depo Lupron may or may not truly “turn on” of the adrenal receptors is likely at
prevent the onset of adrenal disease. At least puberty—the first reproductive season after
theoretically it may delay the onset and early birth. Kits should be given at least 1 injection
clinical trial results seem to show this to be and possibly 1-2 additional months or a 3-
true, but this has not been proven and trials month, longer acting Lupron that first season.
are on-going. Educating owners for that initial injection and
Cathy A. Johnson-Delaney, Nico Schoemaker (from the University of then annually in young ferrets will likely be the
DVM, Dipl ABVP-Avian Utrecht, The Netherlands) and I are investigat- most effective. Until we have in-house ability
Eastside Avian & Exotic Animal ing different parts of the disease, but we both to get estradiol, progesterone and androstene-
Medical Center have seen that there is a correlation between dione results instantaneously in the office, we
Kirkland, Washington the time of neuter/spay and the onset of are using the hormone schedule for Seattle-
cajddvm@hotmail.com adrenal disease. We’ve also seen that the area ferrets as the basis for recommended
hormones spike annually in neutered animals scheduling.
Dr. Johnson-Delaney, a 1980 graduate corresponding with the normal onset of If a ferret is born in 2009, males likely
of Washington State University, breeding season (similar to spiking and build- should have 200 mcg Lupron 30-day in
practices avian and exotic animal up of hormones by intact ferrets). December and January. If there is an early
medicine in Kirkland, Washington.
My studies were done in the Seattle area spring, another injection should be adminis-
She is the current President of the
with Seattle light and climate conditions. tered in February. Females should receive 100
Association of Exotic Mammal
The timing for our ferrets is known based on mcg Lupron 30-day formulation in January,
Veterinarians and works closely with
5 years of year-round monthly hormone panels February and probably March. Ferrets should
the Washington Ferret Rescue and
run on intact, neutered and adrenal disease be given 1-2 injections annually, males in
Shelter. She has been committed to
ferret health her entire career and has ferrets (not yet published data). It may differ December/January and females in February/
conducted research into ferret adrenal elsewhere in the country and it may differ March or starting in very late January. This
disease for many years. slightly even from year to year. protocol is for northern latitudes, with marked

11
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O B S E R V A T I O N S F R O M T H E F O R U M
changes in the light cycle. In the southern The “depot” part of the Lupron is due to at enough ferret hearts (particularly in young
US, ferrets can have multiple breeding the microsphere the GnRH agonist synthetic healthy ones), you will develop a good sense
cycles. The ideal suppression times might molecule is encased in, not the suspension about a more geriatric heart and one that is
actually be all year so this theoretical solution. The microsphere of the 30-day diseased, e.g., not contracting fully, stenosis,
breeding season stop-it-before-it-starts Lupron takes about 30 days for ferret muscle irregular filling.
suppression might not work. The work we tissue esterase to break down. I found that I find ultrasound extremely useful in
did needs to be repeated in different the 3-month Lupron lasts only 60-75 days, evaluating the heart. If there is a problem,
locations with different light cycles. and folks who have used the 4-month I check the blood pressure, too, and look
If the ferret is already a year old, the product find it lasts less than 3 months (data closely at blood vessels in the liver and the
window for that initial stimulation has already not yet published). So use the 30-day size of the caudal vena cava, abdominal
closed so an annual dose of Lupron may/ Lupron. The individual doses made by aorta and portal vein. With heart disease
may not be as effective. I think it is still worth compounders cannot be recommended. and/or heart “failure,” there will be abnormal-
doing, but we don’t know statistically how If you can’t go through 75 100-mcg doses ities in abdominal vasculature, also. Putting
effective it will eventually be. in 1-2 months, buy a 3.75-mg kit (30-day all the parameters together gives you a
In reality, we should probably suppress sex formulation), which makes 37.5 100-mcg detailed picture of the cardiovascular system.
steroid production in neutered ferrets for doses. Mix it yourself and freeze in 100- or I have seen dilated and pulsing renal arteries
their entire life, starting injections of Lupron 200-mcg aliquots (use insulin syringes with in cases of cardiomyopathy with hyperten-
as close to full-grown as possible. This would swaged-on needles). However, there is some sion, for example. I don’t just do an echo-
help push the development of adrenal degradation in the freezer. cardiogram—I must look at the abdomen
disease to the aged ferret. So far, with over and the whole ferret!
50 ferrets we are following, this seems to be QUALITY OF LIFE The key is to pick it up early. I always take
the case. Some are now 6 years of age, with The sooner the disease is diagnosed and a quick look at the heart when doing any
far fewer adrenal-related problems than we characterized, the sooner the veterinarian abdominal ultrasound just to check walls,
find in the control (non-treated) animals. can work out an optimal management plan. contractibility and valve function. Without
It’s promising but still in its infancy. This may include medical management using doing measurements, you can get a good
either/or/and injectable or oral hormone- sense of function and whether you need to
Determining scientifically if the use of
production or -suppressing medications, pursue more diagnostics. I perform the
Lupron prolongs the onset of the disease
medical and surgical management, including ultrasound with the ferret on its back and
takes a long time to complete (up to 8 years,
removal of some/most of the adrenal tissue usually awake, while being bribed with
or the lifespan of a large number of ferrets).
(although full removal is almost impossible in Nutri-Cal® or FerreTone™ on a tongue
Adrenal disease has been slowed from
most ferrets). Work has shown that surgery depressor for distraction. They tolerate the
progressing in ferrets that have been on
alone in the short term may seem the most procedure very well. You do not have to do
Lupron 30-day for more than 3 years. even-
successful, but the hormone production the ferret sternally, as is done with dogs and
tually Lupron may not be able to control it,
continues and over the life of the ferret, and cats, to get the right positioning for standard-
but it gets the ferret to old age symptom free.
the disease returns. Our studies have shown ized measurements. You can obtain these
SOURCE OF LUPRON that medical suppression plus debulking in results with the ferret in dorsal recumbency
older ferrets was equally as effective as due to the position of the heart and the
There is no “generic” Lupron. It is still only
medical intervention alone. In younger flexibility of the ribs. I’ve picked up fat
manufactured by TAP Pharmaceuticals in
ferrets, suppression plus debulking buys deposits in the thorax as well as enlarged
Japan, marketed either through TAP
more asymptomatic time (unpublished at this lymph nodes, neoplastic tissue and other
(www.tap.com) or Abbott (Canada,
time). In other words, based on current disorders. It helps to have access to a lot of
www.abbott.com). Lupron comes in a number
research, we can say that adrenal disease ferrets to practice on.
of microsphere compositions. The “cheap”
one is a daily Lupron, sometimes used in can be managed so the ferret has a full,
Further Reading in Exotic DVM
children. This one will not do what we need it happy life, but it cannot be truly “cured.” 1. Johnson-Delaney CA: Ferret adrenal disease:
Alternative to surgery. Exotic DVM 1(4):19-22,
to do in ferrets. I have seen a number of 1999.
ferrets over the years treated with this— EVALUATING THE FERRET HEART 2. Johnson-Delaney CA: Update on use of leuprolide
acetate. Exotic DVM 3(5):13, 2001.
compounders do it “cheaply” and mix it with If you are accustomed to performing 3. Johnson-Delaney CA: Update on ferret adrenal
the depo they get from depo provera or other echocardiograms on dogs and cats, you research. Exotic DVM 4(3):61-64, 2002.
4. Johnson-Delaney CA: Ferret adrenal disease: 2006
depo formulations. This is not what should be probably will think most ferrets are OK. I have perspective. Exotic DVM 8(3):31-34, 2006.
used. In fact, it quickly accelerates tumor found that the changes are subtle when 5. Schoemaker N, Fisher P: Hyperadrenocorticism in
ferrets: An interpretive summary. Exotic DVM
growth and problems. compared to dogs and cats, but if you look 6(1):44-45, 2004.
11-1 Case Report Abdominal Abscess.qxd 3/12/2009 1:52 PM Page 13
CASE
R E P O R T
Peer Reviewed
Abdominal Abscess in a Rabbit

David Perpiñán, LV, MSc
A 4-year-old male domestic rabbit (Oryctolagus cuniculus)

weighing 2.7 kg was presented with a 3-day history of
reduction of the size of the fecal pellets. In addition, the
owners noticed 4 weeks previously that the rabbit was
putting on weight and the abdominal wall was hard on
palpation. The diet consisted of pellets, mixture of seeds,
alfalfa hay and romaine lettuce. The owners did not
notice any reduction in the amounts consumed. The
rabbit was the only pet in the household, had no access
to outdoors and was allowed to roam unsupervised for
1 hour every evening. No past medical problems were
David Perpiñán, LV, MSc reported.
Zoological Medicine Resident
On physical examination, the rabbit was bright, alert
Department of Small Animal
and responsive. The heart rate was 240 beats per minute,
Medicine & Surgery
respiratory rate was 52 breaths per minute and rectal
College of Veterinary Medicine
temperature was 39.3ºC (102.7ºF). Palpation revealed a
University of Georgia
hard and rounded abdomen, and no discernible internal
Athens, Georgia
organs upon palpation. Gut sounds were reduced. Dental
david1@uga.edu
examination with an otoscope while the animal was
awake showed no abnormalities. Fecal pellets were
present in the cage and were considered reduced in
David Perpiñán graduated in 2000 from the
College of Veterinary Science at University of size (Fig 1).
Barcelona, Spain. He obtained a master’s
degree working with wildlife and then moved
to private practice to work with exotics and
small animals in Spain and England. He
completed an internship at the Henry Doorly
Zoo in Omaha in 2008 and is currently the
Zoological Medicine Resident at the
University of Georgia, College of Veterinary
Medicine.
Fig 1. Fecal pellets at the initial examination were

small and dry.

13
CASE
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Peer Reviewed
A radiograph taken under physical restraint showed elected exploratory laparotomy.

an image compatible with a large fluid-filled mass con- Butorphanol (0.3 mg/kg) was administered 10 minutes
taining a central gas bubble, which was displacing the prior to induction. The rabbit was anesthetized with
intestines dorsally. In addition, small, linear radiodense isoflurane via face mask and prepared for surgery. A
particles were seen in stomach and cecum (Fig 2). routine ventral midline incision was made with the
A presumptive diagnosis of a large mass displacing animal in dorsal recumbency. The mass was identified as
and compressing the intestines was made. No organ was a large abscess (19 × 20 cm) (Fig 3) with multiple attach-
believed to be seriously compromised as the rabbit was ments to several portions of intestinal wall and mesen-
bright, alert and responsive. Upon further questioning, terium. The rabbit was euthanized intra-operatively at
the owners admitted seeing their rabbit chewing on the owner's request. Necropsy did not show any other
cables, which could explain the radiodense particles seen abnormality. Further opening of the abscess obtained
radiographically. Bloodwork, ultrasonography and 1.5 L of pus (Fig 4). No histopathology or cultures were
biopsy were offered but declined by the owners. They allowed.
Intestines
displaced
Stomach with
radiodense
particles Mass outline
Fig 2. Lateral radiograph shows a mass displacing the intestines
dorsally.
Fig 3. Shown is an intraoperative image of the abdominal abscess. Fig 4. A large amount of pus was recovered from the abdominal
abscess.
Abdominal Abscess in a Rabbit

D. Perpiñán
Discussion
Slow growing, well encapsulated and seemingly painless It should be remembered that oral penicillins are con-
abscesses develop readily in rabbits.1 Abdominal traindicated in rabbits due to the risk of intestinal dysbio-
abscesses are not uncommon in rabbits, and theoretically sis.4 A combination of aggressive surgical removal and
they can be primary or secondary to hematogenous long-term antibiotic treatment (based on culture and
spread. Although the small pieces of cable ingested by sensitivity results) seem the best therapeutic approach
this rabbit may have perforated the intestine and origi- for abdominal abscesses in rabbits.
nated the abscess, all cases seen by the author have had As demonstrated in this case and other similar cases,
an uncertain origin and were not related to abscesses in such as the one depicted in Figs 5 and 6 (Case 2), abdom-
other parts of the body. However, initiating causes, such inal abscesses can develop to a considerable size before
as foreign body penetration from the intestine, hematoge- production of obvious clinical signs. However, such large
nous spread or underlying tumors, should be considered. abscesses are usually associated with inexperienced
Abdominal abscesses are difficult to remove due to owners who are unable to recognize early findings,
adhesion formation with surrounding structures,1 and such as a hard abdominal wall or gastrointestinal
incomplete removal usually results in relapse of the disturbances.
abscess. Antibiotic therapy is challenging in rabbits due Case 2 had a similar account and outcome as Case 1:
to the fact that abscesses contain thick pus and are well This 3-year-old male rabbit was not handled much by the
encapsulated. Pasteurella multocida, a gram-negative owners, who noticed a hard abdomen without any other
bacterium and Staphylococcus aureus, a gram-positive clinical sign. They decided euthanasia after the radio-
bacterium, are commonly isolated.1,2 Depending on the graph, and gross necropsy revealed the abscess was
location, anaerobes may also be present; therefore, extensively attached to mesentery and intestine. No
aerobic and anaerobic cultures and sensitivities are other gross lesions were found, and no histopathology
necessary to establish an appropriate antibiotic therapy. or cultures were allowed. These cases demonstrate that
If culture and sensitivity are not available, administration early recognition of abdominal abscesses is vital to
of injectable penicillins (e.g., penicillin procaine at 40,000 improving the chances of a successful outcome following
units/kg SC) is a good empiric initial option.3 treatment.
Abscess outline
Fig 5. The rabbit in Case 2 also had a large abdominal abscess. Fig 6. Lateral radiograph of the rabbit in Case 2 revealed severe
displacement of all abdominal organs.

1. Harcourt-Brown F: Textbook of Rabbit Medicine. Edinburgh, UK, Butterworth 3. Gaertner DJ: Comparison of penicillin and gentamicin for treatment of
Heinemann, 2002. pasteurellosis in rabbits. Lab Anim Sci 41:78-80, 1991.
2. Segura P, Martínez J, Peris B, et al: Staphylococcal infections in rabbits does 4. Jenkins JR: Gastrointestinal diseases. In Quesenberry KE, Carpenter JE (eds):
on two industrial farms. Vet Rec 160:869-873, 2007. Ferrets, Rabbits, and Rodents: Clinical Medicine and Surgery. Saunders, 2003,
pp 161-171.

15
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11-1 Case Report Clostridial REV.qxd 3/12/2009 2:51 PM Page 17
CASE
R E P O R T
Peer Reviewed
Fecal Bacteriotherapy for

Treatment of Clostridial
Enterotoxemia in Rabbits
Julie Hébert, DVM
Clostridial enterotoxemia of rabbits is caused by Clostridium

spiroforme and its enterotoxin. Clostridium difficile and C.
perfringens have been implicated in enterotoxemia in rabbits
but are not considered to be a significant cause of the
disease.1 Clostridium spiroforme is a helically coiled, anaero-
bic gram-positive spore-forming rod.2 This bacterium can be
found in the cecum of asymptomatic rabbits.2 Under certain
conditions, it undergoes rapid multiplication resulting in
fulminant enteritis.1 Young rabbits having undeveloped
gastrointestinal flora are particularly susceptible to primary
infection with the bacterium.3 Clostridium spiroforme and its
Julie Hébert, DVM toxin have been isolated from colon contents of rabbits that
Hôpital pour Oiseaux et developed acute diarrhea a week after weaning.4 The
Animaux Exotiques bacterium has been implicated in juvenile enteritis-complex
Montréal, Québec, Canada and is a significant pathogen of commercial rabbits.5 In
hebertju56@hotmail.com adult rabbits, predisposing conditions include a low fiber,
high protein and high carbohydrate diet, oral administra-
Dr. Hébert is a 2000 graduate tion of certain antibiotics, other pathogens, and stress.3
of the University of Montréal.
Clinical signs include acute anorexia, diarrhea that may
be mucoid and/or hemorrhagic, abdominal distension,
dehydration, hypothermia and death.1 Clostridial entero-
toxemia usually has an acute progression but is occasionally
preceded by a short period of anorexia.1 Peracute disease
may manifest with death and the absence of prior symp-
toms.1 Chronic cases can occur and are characterized by
intermittent diarrhea, weight loss and anorexia.1 Post-
mortem findings in rabbits that succumb to clostridial
enterotoxemia suggest most of the colonization occurs in
the cecum, although lesions can be found in the small
intestine or proximal colon.1
Diagnosis is usually based on history and clinical signs.
Confirmation of a diagnosis of clostridial enterotoxemia is
difficult in the living rabbit, as it requires detection of the
bacterium and its enterotoxin from cecal contents.6 In
rabbitries, necropsy with visualization of characteristic
bacteria in cecal contents and subsequent isolation in
selective culture medium may contribute to a diagnosis of
Clostridium spiroforme enterotoxemia.7 Smears and anaerobic

17
CASE
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Peer Reviewed
cultures of cecal contents provide identification of the tions by displacing pathogenic microorganisms with
bacterium in approximately 50% of cases.2 Detection of harmless bacteria. In human fecal bacteriotherapy, whole
the toxin from cecal contents confirms a diagnosis of human fecal flora from a healthy donor is introduced, via
Clostridium spiroforme.7 A recently developed PCR protocol retention enema, into a patient’s dysbiotic colonic micro-
is a rapid diagnostic tool for the detection of Clostridium environment to antagonize pathogenic bacteria of the
spiroforme from cecal contents. These tests are useful for
7
gut. The treatment protocol for fecal bacteriotherapy in
diagnosing the disease in commercial rabbitries where humans has not been standardized. Doses ranging from
necropsy is an option, but are not practical for its diagno- 5-300 g of donor stool suspended in 10-300 ml of saline
sis in companion rabbits. Clostridium spiroforme can be have been used.10 The fecal suspensions have been given
identified based on its morphological characteristics from as single retention enemas in some patients, and repeated
a gram stain of a fecal sample in some cases.8 every 12 hours for 14 days in others.10 Fecal suspensions
Treatment involves aggressive supportive therapy, have also been administered via enteric tube to the
stimulation of cecal and colonic motility, inhibition of jejunum, duodenum and via nasogastric tube. Colon-
growth of pathogenic bacteria and production of their oscopy has been used to ensure an even distribution of
toxin, and promotion of growth of normal flora. Place- 3 the fecal suspension throughout the colon.10
ment of an intravenous catheter for administration of Inhibition of pathogenic bacteria occurs through
crystalloids is indicated but can be impeded by the competition at epithelial adhesion sites, competition for
collapse of veins in a severely dehydrated animal. Place- access to nutrients, and through production of metabo-
ment of an intraosseous catheter offers an alternative lites from healthy bacteria having inhibitory effects on
technique for access to the vascular compartment in a the growth or adhesion of the pathogen.11 Fecal bacterio-
moribund patient. This technique may necessitate therapy may also act indirectly by altering local immune
general anesthesia or sedation, and local anesthesia at a mechanisms.12 Fecal bacteriotherapy has been used to
minimum. Although metronidazole (20 mg/kg PO q12h treat fulminant Clostridium difficile infection and other
x 5-7 days) is effective against Clostridium spiroforme, Clostridium difficile-associated syndromes including
antimicrobials have limited value in the treatment of recurrent diarrhea, pseudomembranous colitis, chronic
enterotoxemia and are used as supportive therapy.3 ulcerative colitis, inflammatory bowel disease, irritable
Probiotics are indicated to colonize the gut with healthy bowel syndrome and chronic constipation in humans.10,12,13
enteric flora but are of limited use during concurrent Clinical responses have been promising in the treatment
administration of oral antibiotics. Metoclopramide (0.5 of Clostridium difficile-associated syndromes and other
mg/kg SC, PO q12h) and cisapride (0.5 mg/kg PO q12h) gastrointestinal diseases in humans.10 However, there are
are indicated to stimulate gastrointestinal motility until few published reports on fecal bacteriotherapy in
production of stool returns to normal. The ion exchange
1 humans, and no reports were found on the use of this
resin cholestyramine (2 g in 20 ml PO q24h) is an effec- treatment in animals. This case describes the use of fecal
tive toxin adsorbent and is used until signs of enterotox- bacteriotherapy as a treatment for clostridial enterotox-
emia subside. The latter can also bind oral antimicro-
1 emia in rabbits.
bials, such as metronidazole; therefore, they should not
be given simultaneously.9 Nutritional supplementation is Case Report
indicated to stimulate gastrointestinal function. Patients
A 5-year-old spayed female rabbit of 2.2 kg was pre-
are often too depressed to accept oral medication or food.
sented to our hospital with a history of a sudden onset of
A nasoesophageal tube can be used to administer oral
anorexia and diarrhea. The rabbit had been living in
medication and short-term nutritional supplementation.
optimal husbandry conditions with a low carbohydrate,
The advantages of this technique need to be weighed
low protein and high fiber diet. The rabbit’s diet con-
against the stress it causes, which reduces gastrointestinal
sisted of unlimited timothy hay, leafy greens and limited
mobility and impairs digestive function.
timothy-based pellets. It lived free in a rabbit-proofed
Therapeutics may not act fast enough to reverse the room. There was no history of recent antibiotic adminis-
effects of Clostridium spiroforme and its toxin. Treatment is tration. The physical exam showed a marked depression,
often unsuccessful given the rapid progression of the 10-14% dehydration, cyanotic oral mucosa, distended
disease, the critical state of the animal at time of presen- abdomen, soiling of perineum with malodorous and
tation, and the difficulty in administering treatments.1 mucoid diarrhea, and a rectal temperature of 35°C (95°F).
Most cases are presented dead or moribund. The rabbit was tentatively diagnosed with clostridial
In humans, bacteriotherapy is used to combat infec- enterotoxemia based on clinical signs. Given the condi-
11-1 Case Report Clostridial REV.qxd 3/16/2009 9:11 AM Page 19
Fecal Bacteriotherapy for Treatment of

Clostridial Enterotoxemia in Rabbits
J. Hébert
tion of the rabbit, supportive therapy was deemed a period, and the general appearance of the rabbit
priority and was initiated before diagnostic procedures improved. Three hours after the initiation of the fecal
were considered. bacteriotherapy, the rabbit was alert and started showing
Based on a lack of success in the treatment of previous an interest in food. Another 50 ml/kg of Normosol was
cases of enterotoxemia, a novel therapeutic technique administered subcutaneously within the first 12 hours of
was attempted. A fecal suspension was prepared contain- hospitalization. Within 24 hours the rabbit was eating
ing 4 g (approximately 50 fecal pellets) of fresh (still and passing stool, maintaining a stable rectal tempera-
slightly moist and warm) ground feces from a healthy ture, and no longer had abdominal distension.
adult rabbit mixed in 30 ml of warmed Normosol (38°C, Early attempts at administration of oral medications
100°F). Although cecotrophs may be a more appropriate failed, as the rabbit was too weak to swallow them.
donor material with their rich cecal bacterial content, Placement of a nasogastric tube was considered. How-
their collection is difficult in a healthy rabbit. Given the ever, as the rabbit responded dramatically to the initial
fibrous nature of the healthy donor feces, the fecal fecal bacteriotherapy, it became apparent that placement
suspension was prepared with the fluids necessary to of a nasogastric tube would be superfluous as medica-
allow the passage of the suspension through the tube tions and nutritional supplementation could be given
(Fig 1). The suspension was poured into a 30 ml syringe orally. Cholestyramine, metronidazol, and probiotics
to which was attached a 12 Fr red rubber feeding tube. were administered orally but separately at 2-hour
The tube was cut to a length of approximately 10 cm and intervals. Cholestyramine was administered at 20 ml PO
the tip was singed to make it blunt. The tube was q24h for the first 24 hours, and metronidazole was given
lubricated then inserted in full into the rectum, and the at 20 mg/kg PO q12h for 5 days. Probiotics were contin-
suspension was injected at a volume of 10 ml/kg body ued for 10 days, allowing for their effectiveness to be
weight (Fig 2). There was no loss of fluids from the anus maximized in the absence of antibiotics. The rabbit was
following administration of the suspension. The rabbit syringe-fed a commercial nutritional supplement in
was placed in a heated cubicle (25°C, 77°F). Boluses (10 frequent and small doses until its appetite returned to
ml/kg) of warm fecal suspension were administered by normal (within 6 hours). Treatment with metoclopramide
enema repeatedly at 20-30 minute intervals, for a com- (0.5 mg/kg SC q12h) was initiated when the rabbit was
bined volume of approximately 50 ml/kg. Given the hospitalized but was discontinued the following day as
paucity of information on protocol for this procedure, the the rabbit maintained a healthy appetite and passed
volume of the fecal suspension was determined accord- normal fecal pellets. Husbandry and diet were reviewed
ing to a conservative estimate of the capacity of the with the client and found to be within our hospital’s
patient’s colon. Following the positive response to the recommendations. The underlying cause of the entero-
first enema, subsequent enemas were administered at the toxemia could not be determined.
same dose, allowing for the rabbit to have a rest period Fecal bacteriotherapy has since been used in our
between each treatment. hospital as an adjunct for treatment of similar cases of
The rectal temperature was taken just prior to each clostridial enterotoxemia in rabbits. Five out of seven of
treatment. The rectal temperature increased from 35°C these cases survived. Both of the deceased rabbits had
(95°F) to 38°C (100°F) in less than 2 hours. The oral arrived moribund, severely dehydrated and cyanotic
mucosa turned from cyanotic to pink within the same with a rectal temperature of 33°C (91°F) and 34°C (93°F).
Fig 1. A suspension with ground fecal pellets mixed with Normosol. Fig 2. Administration of fecal suspension enema.

19
CASE
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Peer Reviewed
Discussion sion, volume and frequency of administration and depth

of insertion of the tube. Given the complex composition
This case report describes the use of fecal bacteriotherapy
of the endogenous digestive microflora, a quantitative
for the treatment of clostridial enterotoxemia in a rabbit.
and qualitative standardization of the bacterial species to
The presumptive diagnosis was based on clinical signs
be used in fecal bacteriotherapy is not likely.
only. Given the poor condition of the animal, supportive
Individual variations in digestive microflora and the
therapy was initiated as a priority at the expense of
transfer of such populations from donor to patient raises
diagnostic work up. Under more favorable conditions,
questions about the safety of the procedure. Risks of
anaerobic fecal cultures, fecal gram stain, radiography
transmission of disease can be minimized by screening of
and blood work would have been completed prior to
donors. Donors should be fed a high fiber, low carbohy-
therapy.
drate and low protein diet and have no history of recent
The positive response to the treatment may derive antibiotic therapy. Donors should be screened for endo-
from different therapeutic components of the procedure. parasites and coccidia. Transmission of other enteric
First, the thermal effect of the administration of warmed pathogens can be minimized by using adult donors that
fluids directly into the animal may have contributed to have no history of digestive disorders. Other risks of this
controlling and treating the hypothermia. Delivery of procedure include perforation of the rectal or colonic
fluids rectally makes use of the absorptive properties of walls with subsequent peritonitis. Care must be taken to
the distal colonic walls and was likely a key factor in the ensure the tip of the tube is well blunted and lubricated,
positive response seen in this rabbit. The assumption that that the rabbit is comfortably restrained during the
the fluids were well absorbed by the mucosa is supported procedure, and that the tube is inserted slowly without
by the absence of any leakage of the fecal suspension. forcing through any resistance that may be encountered.
The mechanical action of the fecal suspension flush Further exploration is warranted in the use of fecal
against the digestive wall may have dislodged Clostri- bacteriotherapy for other gastrointestinal diseases in
dium spiroforme and its toxin from their epithelial attach- rabbits and rodents. Treatment of chronic clostridial
ments. Furthermore, the administration of an abundant diarrhea, coliform enteritis and mucoid enteritis in
normal intestinal flora may have played a role by com- rabbits, antibiotic-associated dysbiosis, Tyzzer’s disease
peting with Clostridium spiroforme for epithelial attach- and proliferative enteritis in rabbits and rodents and
ment sites or for nutrients or by producing inhibitory salmonella enteritis and Clostridium difficile enterotoxemia
metabolites. Both these mechanisms can only have value in rodents could benefit from fecal bacteriotherapy.
if the suspension reaches areas of high density Clostri-
dium spiroforme, in the cecum and proximal colon. References and Further Reading
1. Harcourt-Brown F: Digestive disorders. In Harcourt-Brown F: Textbook of
Administration of 50 ml/kg of fecal suspension rectally Rabbit Medicine. Elsevier, 2001, pp 249-291.
most likely reaches the distal colon, but whether it 2. Boriello SP, Carman RJ: Association of iota-like toxin and Clostridium
spiroforme with both spontaneous and antibiotic-associated diarrhea and
reaches the proximal colon and especially the cecum colitis in rabbits. J Clin Microbiol 17(3):414-418, 1983.
3. Jenkins JR: Gastrointestinal diseases. In Quesenberry KE, Carpenter JW (eds):
where it can have most of its anticlostridial effects is Ferrets, Rabbits and Rodents Clinical Medicine and Surgery, 2nd ed.
arguable. Addition of a contrast medium to the suspen- Saunders Elsevier, 2004, pp 155-160.
4. Yonushonis WP, Roy MJ, Carman RJ, et al: Diagnosis of spontaneous
sion followed by radiographs could assist in determining Clostridium iota enterotoxemia in a barrier rabbit breeding colony. Lab Anim
Sci 37(1):69-71, 1987.
its presence in the colon and cecum. 5. Peeters JE, Geeroms R, Carman RJ, et al: Significance of Clostridium
spiroforme in the enteritis-complex of commercial rabbits. Vet Microbiol
Given the positive outcomes in our, albeit, limited
12:25-31, 1986.
number of cases, this treatment warrants further atten- 6. Butt MT, Papendick RE, Carbone LG, et al: A cytotoxicity assay for Clostridium
spiroforme enterotoxin in cecal fluid of rabbits. Lab Anim Sci 44(1):52-54,
tion. Accurate identification of Clostridium spiroforme is 1994.
difficult in the living rabbit, requiring collection of cecal 7. Drigo I, et al: Development of PCR protocols for specific identification of
Clostridium spiroforme and detection of sas and sbs genes. Vet Microbiol
content samples for anaerobic culture and identification 131:414-418, 2008.
8. Julie-Hélène Fairbrother, Faculty of Veterinary Medicine, University of
or biomolecular analysis of its toxin. However, identifica- Montreal. Personal communication. 2008.
tion of the spiral-shaped bacterium in gram-stained 9. Senok AC, Rotimi VO: The management of Clostridium difficile infection:
Antibiotics, probiotics and other strategies. J Chemotherapy 20(1):5-13,
diarrhea smears may support a diagnosis of clostridial 2008.
10. Borody TJ, Warren EF, Leis S, et al: Bacteriotherapy using fecal flora: Toying
enterotoxemia, and subsequent fecal gram stains could with human motions. J Clin Gastroenterol 38(6):475-483, 2004.
help monitor therapeutic efficacy with a return to normal 11. Blomberg L, Henrikson A, Conway PL: Inhibition of Escherichia coli K88 to
piglet ileal mucus by Lactobacillus spp. Appl Environ Microbiol 59:34-39,
flora after the treatment. 1993.
12. Borody TJ, Warren EF, Leis S, et al: Treatment of ulcerative colitis using fecal
A protocol for fecal bacteriotherapy in rabbits should bacteriotherapy. J Clin Gastroenterol 37(1):42-47, 2003.
13. You DM, Franzos MA, Holman RP: Successful treatment of fulminant
be developed. More particularly, the following elements
Clostridium difficile infection with fecal bacteriotherapy. Ann Intern Med
need to be standardized: the concentration of the suspen- 148(8):632-633, 2008.
11-1 Case Report Gila Monsters.qxd 3/12/2009 1:49 PM Page 21
CASE
R E P O R T
Peer Reviewed
Ultrasound Imaging
of the Reproductive Tract
of Reticulated Gila Monsters
Kerri Cooper, MS; Stephen A. Smith, DVM, PhD and
Martha M. Larson, DVM, Dipl ACVR
The Helodermatidae family consists of one genus and

two species of venomous lizards, which are indigenous
to the southwestern United States and Mexico.1 Sub-
species consist of the reticulated Gila, Heloderma suspec-
tum suspectum (Fig 1), the banded Gila, Heloderma suspec-
tum cinctum, and four subspecies of the Mexican beaded
lizard.2 Their low maintenance requirements, carnivorous
nature and attractive coloration have made them appeal-
ing in the reptile trade.
Although these are protected species in their native
states of Arizona, Nevada, Utah, California and New
Kerri Cooper, MS Mexico and acquisition is illegal there, they are available
Stephen A. Smith, DVM, PhD as captive-bred pets in many other states.
Martha M. Larson, DVM, Dipl ACVR Because Gila monsters do not exhibit obvious dimor-
Virginia-Maryland Regional College of phism, such as the presence of the hemipene bulges and
Veterinary Medicine, Virginia Tech femoral glands of the adult bearded dragon (Pogona
Blacksburg, Virginia vitticeps), there are challenges in differentiating the
genders based on physical characteristics and/or behav-
Kerri Cooper will be a 2009 graduate of ior. Experienced breeders suggest that males have a
Virginia-Maryland Regional College of larger, more robust and less angular head shape, whereas
Veterinary Medicine (VMRCVM). She
earned her Master’s degree in Veterinary
Sciences in 2004, focusing on veterinary
viruses and emerging infectious diseases.
Kerri is currently one of the few licensed
female falconers in the nation and a
licensed wildlife rehabilitator. Her passions
include reptile and raptor medicine, and
she plans to pursue a career in exotic
animal or zoological medicine.
Fig 1. Gila monsters are approximately 9-14 inches (23-35 cm) in

length and have large stout bodies, large heads and short limbs.
There are loose folds of skin on the neck including a gular fold.3
Their body form is adapted for burrowing, even though they have
been known to climb.

21
CASE
R E P O R T
Peer Reviewed
females have sharper, more triangular heads; they believe Limits of Radiography
females have a smaller and more pear-shaped body and
One feature that may limit the usefulness of radiographic
their tails tend to end in more of a point whereas males
imaging of Gila monsters is the presence of calcified
have a more rounded tip. These are subjective criteria
scales called osteoderms (Fig 2), which may produce
and often require the presence of one individual of each
superimposed cobblestone-like opacities (Figs 3, 4). As a
gender to differentiate.
result, interpretation of lung fields, the gastrointestinal
Behavior is also not a reliable indication of sex. Free- tract and the appendicular or axial skeleton may be
ranging Gila monsters are reclusive, spending the rather subjective. Also, determining if a female is gravid
majority of their time underground with only a 3-4 week may not be possible with this technique during late stage
active period annually in the late spring.4,5 At this time of gestation before calcification of shells.
mating, males become aggressive, but females may also
be hostile to any newcomers. A positive identification can Ultrasonography
be confirmed when the female lays eggs 3-4 months later.
Ultrasound imaging of reproductive anatomy in Gila
Successful captive propagation depends on accurate monsters was documented by Morris and Henderson,7
sexing techniques. Imaging techniques, such as digital who were interested in determining the presence or
radiography and ultrasonography, are more reliable tools absence of hemipenes with this method. Multiple
for differentiation between the genders. techniques to achieve increased contrast have been
Fig 2. Shown is the “studded” dermis with the cobblestone osteoderms and their attractive
coloration.
Fig 3. Horizontal digital radiography of a male Gila monster. This image demonstrates the Fig 4. Dorsoventral digital radiography of a
radiolucent lung fields and the gastrointestinal tract. This animal was fed one week previously female Gila monster. The cobblestone
but the remains of its mouse meal are still evident. appearance is attributed to the mineralized
osteoderms of the skin. This image allows
some interpretation of the lung fields, heart
shape and size and portions of the gastro-
intestinal tract.
Ultrasound Imaging of the Reproductive

Tract of Reticulated Gila Monsters
K. Cooper, S.A. Smith and M.M. Larson
suggested, such as using the Gila’s natural ability of are venomous (Fig 7). The Gila’s venom is secreted from
retaining water by soaking them in water prior to the ducts located between the teeth. Gilas must bite and
procedure.8 But adult gonads are easy to visualize, then gnaw or chew on their victim to envenomate,
especially during the fall to spring season when their which takes time and a good firm grip by the lizard.
reproductive organs are in optimum condition and size.
Envenomations are not fatal to humans unless the result
of anaphylactic shock but can be extremely painful, with
Restraint
clinical signs of vomiting, nausea, swelling, faintness,
Because Gila monsters are relatively slow movers, some
thirst and weakness.*
images may be obtained without the use of sedatives,
tranquilizers or general anesthesia. However, small For ultrasound evaluation of the reproductive system
physical restraints or confinement boxes to limit move- of Heloderma s. suspectum at VMRCVM, a high frequency
ment are suggested (Figs 5, 6). (14 MHz) transducer was used. The probe was placed
A well-trained staff is necessary because these lizards ventrally and off center to one side or the other (Fig 8).
*An emergency response plan, including notification of a local or experienced poison control hotline, e.g., the Arizona Poison Control
and Drug Information Center (800-362-0101 or 800-222-1222), should be in place in case of an accidental envenomation.9
Fig 5. An avian/raptor restraint device may hold a Gila’s head without Fig 6. Slight pressure by a snake hook can easily restrain a Gila on
injury to the animal. the dorsum of the neck and allow manual restraint of the animal’s
head. Cardboard boxes can temporarily limit movement.
Fig 7. For manual restraint, a firm grip must wrap around the back of Fig 8. Restraint and positioning are important factors in Gila ultra-
the head with fingers behind the angle of the mandible. The most im- sound. Staff skilled in appropriate handling techniques can yield
portant restraint must be directed at keeping the head and neck straight productive images without the need for chemical immobilization.
and immobilizing the head. The other hand can support the body and
tail. Gilas roll, twist and move with surprising strength. Support of the
body is important because vertebral fractures can result from a fall.

23
CASE
R E P O R T
Peer Reviewed
Fig 9. This ultrasound image demonstrates a 1.31-cm bilobed, Fig 10. Early gestational eggs were noted in one female as 2.5 cm
spherical organ in the male Gila’s abdominal cavity. This organ was circular objects within the abdomen with hyperechoic linings and
interpreted as male gonads on transverse section. hypoechoic, fluid-filled centers.
Fig 11. At mid-gestation before calcification of the shells, the eggs

grew to a size of 3.77 cm and some extended as far cranial as the
liver and gall bladder, pressing against these organs on the right side.
The eggs lost their hypoechoic centers and changed from a more
circular shape to oval.
Ultrasonic Features of the Male evaluation of reproductive anatomy in adult Heloder-

matids is recommended because of its noninvasive
The adult Gila male has a bilobed testis, which is internal nature and its availability in the veterinary community.
and not easy to distinguish anatomically without imag-
ing techniques (Fig 9). The testes are positioned along the Acknowledgements
ventral midline approximately 6 cm cranial to the vent in The authors acknowledge the contributions of Philip Bailey and
mature males. VMRCVM staff members, Susie Ayers, Gerald Baber and Terry
Lawrence.
Ultrasonic Features of the Female
Ovaries often are found 6-8 cm cranially from the vent 1. Beck DD: Biology of Gila Monsters and Beaded Lizards. Berkeley, University of
California Press, 2005.
on either side. The gravid female in this study had eggs 2. Beaman KR, Beck DD, McGurty BM: The Beaded Lizard (Heloderma
positioned as far as 10 cm from the vent and pressed horridum) and Gila Monster (Heloderma suspectum): A Bibliography of the
Family Helodermatidae. Smithsonian Herpetological Information Service No.
against the left lobes of the liver. With the extension of 136, 2006.
3. Alden P, et al: National Audubon Society Field Guide to the Southwestern
ribs past the thoracic vertebrae, lateral placement of the States: Arizona, New Mexico, Nevada, Utah. Knopf Publishing Group, 1999.
probe is not advised. The image is most often of poor 4. Degenhardt W, Painter C, Price A: Amphibians and Reptiles of New Mexico.
University of New Mexico Press, 1996.
quality due to the extensive shadowing from the bony 5. Beck D: Ecology and behavior of the gila monster in southwestern Utah. J
Herpetol 24:54-68, 1990.
protuberances. As demonstrated (Figs 10, 11), it is easy to 6. Goldberg SR, Lowe CH: Reproductive cycle of the gila monster, Heloderma
identify female gonads via ultrasound and determine if suspectum, in southern Arizona. J Herpetol 31(1):161-166, 1997.
7. Morris PJ, Henderson C: Gender determination in mature gila monsters, Helo-
they are gravid. derma suspectum, and Mexican beaded lizards, Heloderma horridum by ultra-
sound imaging of the ventral tail. Bull Assoc Reptil Amphib Vet 8(4):4-5, 1998.
8. Seward M: Dr. Mark Seward’s Gila Monster Propagation 2nd ed. Natural
Summary Selections Publishing, 2002.
9. Arizona Poison Control and Drug Information Center. First Aid and Medical
The animals evaluated here were adults (2+ years) so it Information for Victims of Gila Monster Attacks.
http://www.dotcomtucson.com/tucson_arizona_animals/gila_monster
is unclear if this technique for distinguishing gender is 10. AZA. Zoos, Aquariums and Poison Centers Debut New Web-Based Antivenom
Index to Speed Antidote Delivery. News Release. August 10, 2006.
valid in juveniles. However, the use of ultrasound for the
11-1 Case Report Joerg.qxd 3/12/2009 1:45 PM Page 25
CASE
R E P O R T
Peer Reviewed
Thyroid Scintigraphy
in a Guinea Pig with
Suspected Hyperthyroidism
Jörg Mayer, DVM, MSc; Kathleen Hunt, BS; David Eshar, DVM
and Mauricio Solano, MV, Dipl ACVR
Jörg Mayer, DVM, MSc

Kathleen Hunt, BS While functional hyperthyroidism in guinea pigs
David Eshar, DVM (Cavia porcellus) has not been scientifically documented,
Mauricio Solano, MV, Dipl ACVR it appears that thyroid neoplasia in guinea pigs is a
Tufts University common but poorly documented condition in these
Cummings School of Veterinary Medicine animals.4 The relative prevalence is 4.6% at one pathol-
North Grafton, Massachusetts ogy facility, making thyroid pathology the second most
commonly reported malignancy after lymphoma (Garner,
After Jörg Mayer received his veterinary degree from pers comm, 2006). Contrary to this observation, German
the University of Budapest, Hungary, he participated in literature states that hyperthyroidism is a relatively
an internship in zoological medicine and surgery at the
common clinical pathology in guinea pigs.3 This is the
Roger Williams Park Zoo in Providence, Rhode Island.
first report of a clinical case with the strong suspicion of
He later received his Masters of Science degree in
hyperthyroidism in a guinea pig based on the history,
wild animal health from the Royal Veterinary College in
clinical findings, diagnostic workup and the result of
London. In between these positions he had experience
nuclear scintigraphy as a choice of diagnostic imaging.
with veterinary care of captive and free-ranging
animals in South Africa, Namibia and Papua New
Guinea. His Masters project, which focused on lead
toxicity in the common loon, brought him to the Tufts
Wildlife Clinic. He currently serves as a clinical
associate professor and as the head of the clinical
service for exotic animals. He lectures regularly at
national and international conferences on all aspects
of exotic animal medicine.

25
CASE
R E P O R T
Peer Reviewed
Case Report
A 4-year-old spayed female guinea pig was presented to venous catheter in the cephalic vein. A 1.2 mCi dose of
the Exotic Animal Service at the Tufts Cummings School Technetium (pertechnetate) (Tc-99m) was administered as
of Veterinary Medicine for a 2-month history of weight an intravenous bolus via the cephalic vein. In order to
loss despite a ravenous appetite. The animal had been evaluate the nuclear scan more effectively, these images
healthy otherwise. The animal was spayed 2 years were compared to images obtained from a clinical
previously due to ovarian cyst formation. At the time of healthy animal. The animal was recovered immediately
presentation the animal weighed 710 g and had lost 265 g after the nucleotide was administered and the catheter
in 4 months. The weight loss was considered significant was flushed with 2 ml of heparinized saline. The animal
but the animal remained clinically in good condition. was placed on a gamma camera (IS2 Research Corp.
During the clinical workup for the weight loss, blood Ottowa, Canada) using a HRGP (High Resolution
was obtained for a complete blood count and a chemistry General Purpose) collimator for the initial reading
profile, which did not reveal significant abnormalities. approximately 15 minutes post injection.
A full dental exam was performed under 6% sevoflorane The interpretation of the initial scan revealed the
gas delivered via facemask and no abnormalities were expected uptake of the imaging agent in the salivary
seen. An abdominal ultrasound exam revealed no gland and the thyroid. All images were acquired for
significant changes of the visceral organs. No cardiac or 100,000 counts. The images were analyzed using specific
respiratory abnormalities were noted during the clinical software (Segami Corp). The initial images obtained
examination. The animal did produce a normal amount between 15-25 minutes post injection did show a mild
of urine and no episodes of diarrhea were noted by the difference in the pattern of the nucleotide uptake of the
owner. Fecal examination was negative for parasites. thyroids between the healthy and the diseased animal
The owner reported that the animal appeared to (Figs 1, 2). In order to get a better image of the thyroid as
be eating ravenously and preferred to be syringe fed to avoid the superimposition of the salivary gland with
with a feeding formula (Herbivore Critical Care, the thyroid, a second series of images were obtained 60-
www.oxbowhay.com), which it would eat in amounts 80 minutes post injection and clearly showed a signifi-
up to 200 ml within a 24-hour period. The guinea pig cant difference of the uptake of radioactive material by
would appear extremely hungry at approximately 4-hour the thyroid between the two animals (Figs 1-4).
intervals and accept a syringe feeding while nibbling on Due to the significant difference in uptake of the
hay in between. radioactive material in one thyroid of the diseased
The guinea pig was presented again 7 days later. Some animal, and the significant overall uptake of radioactive
mild respiratory sounds were evident at that time, and a substance in comparison to the image obtained from the
small nodule the size of a cherry pit was palpated in the clinically normal animal, the working diagnosis of
ventral neck area. Due to the absence of obvious abnor- hyperthyroidism was made.
mality in the imaging studies or other diagnostic tests,
The animal was hospitalized for 24 hours in order to
hyperthyroidism was considered a differential diagnosis.
avoid any environmental contamination with the
Blood was collected for a T4 test in order to rule out a
radioactive material, which the animal secretes in bodily
hyperthyroid state. While the total T4 was within normal
waste products. As soon as the animal was measured to
limits compared to published values for guinea pigs,2 the
emit less than 2.0 mR/hr of radioactivity at the skin
free T4 value was above reported normal values (Table 1).
surface it was cleared to be released. The cage was also
checked after it has been cleaned to be sure the radioac-
Table 1. Total T4 and Free T4 Values of the Patient*
tivity was below 0.5 mR/hr. The reading was performed
Patient Low normal High normal
using a Geiger counter at the surface and 3 feet away the
Total T4 2.9 µg/dL 2.5 +/- 0.3 µg/dL 3.2 +/- 0.8 µg/dL
day after the scan for both the patients and their cages.
Free T4 3.1 ng/dL 1.26 ng/dL 2.03 ng/dL
*Free T4 was evaluated by equilibrium dialysis and total T4 by chemiluminescence; The owner was offered the options of surgical removal
normal values from Castro, et al2 of the nodule, treatment with radioactive iodine and
Due to the inconclusive test results and the progressive treatment with antithyroid medication. The owner
nature of the clinical problem, it was decided to perform elected to treat the animal with antithyroid medication.
a nuclear scan of the thyroid. Anesthesia was induced The animal was started on oral methimazole (Tapazole,®
with sevoflurane at 8% and oxygen via facemask and Lilly) at 1 mg/animal q12h.
maintained at 4% to facilitate placement of an intra- The guinea pig responded very well to the medication
Thyroid Scintigraphy in a Guinea Pig

with Suspected Hyperthyroidism
J. Mayer, K. Hunt, D. Eshar and M. Solano
Fig 1. Lateral and ventral scintigrams of abnormal guinea Fig 2. Lateral and ventral scintigrams of a normal guinea pig
pig. There is an intense radiopharmaceutical uptake taken 60 minutes after injection of the radiopharmaceutical.
associated with the right thyroid gland (arrow) that persists Salivary glands (large arrowhead) and gastric (curved arrow)
throughout the entire examination. In addition, there is radiopharmaceutical uptake indicates the normal route of
contralateral abnormal radiopharmaceutical uptake of less excretion of the radiopharmaceutical. Activity remaining in the
intensity associated with the contralateral left thyroid gland. catheter at the injection is also seen (waved arrow). A small
Radiopharmaceutical accumulation in the salivary glands amount of saliva in the oral cavity (small arrowhead) is noted.
and saliva (arrowhead) and stomach (curved arrow) The normal thyroid glands cannot be discerned, likely due to
indicates the normal route of excretion of the radiopharma- their small size and nearby activity in the salivary glands.
ceutical. Activity remaining in the catheter at the injection
site is also seen (waved arrow).
Fig 3. A ventral color scintigram of the abnormal Fig 4. A ventral color scintigram of the healthy guinea
guinea pig taken 60 minutes after administration of pig taken 60 minutes after administration of the
the radiopharmaceutical illustrates a subjectively radiopharmaceutical shows a more even distribution of
increased pattern of uptake of the right thyroid. the radioactive agent in both thyroids.
and gained about 60 g (8% of body weight) in the first animal still displayed an increased interest in food, and
week after medication was started. The animal appeared the owner continued to syringe feed the liquid nutri-
to show some minor side effects to the medication in tional support mixture on a daily basis.
form of mild GI bloats. The owner medicated with an Thirty days post-treatment the medication was stopped
over-the-counter simethicone product with successful for 4 days as the owner elected to have thyroid treatment
resolution. performed using radioactive iodine. Unfortunately, the
After 1 month of medication the animal was rechecked animal died on the 4th day without medication and was
and had gained 180 g (25% of initial body weight). The not presented for a necropsy.

27
CASE
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Peer Reviewed
Discussion
While the diagnosis of hyperthyroidism in domestic the thyroid by the iodide pump of the follicular thyroid
species is usually a combination of historical information, cells. The radioactive technetium ion is taken up by the
physical findings and laboratory test evaluations, it is a thyroid, because the size and the charge of the particle is
different situation for exotic species due to several factors. very similar compared to that of the iodine.1 The other
In exotic species it might be difficult to obtain enough main sites of concentration of technetium in the body are
blood or blood at all to run a multitude of tests. Even if the salivary glands and the gastric mucosa (see Fig 1).
the resource blood is readily available, interpreting T4 As the gamma camera is set to capture a certain count
values in species for which the specific assay has not of impulses, the stomach is usually blocked from the
been validated poses significant problems to the clinician gamma camera by a lead shield.
regarding the validity of the results and the conclusion In order to differentiate between normal thyroid
drawn from the results. Interpretation of the values can activity the uptake of radioactive material by the thyroid
be even considered to be difficult in species for which the is compared to the uptake of the radioactive material by
test has been validated. In cats with early or mild forms the salivary gland around 15-20 minutes post injection.
of hyperthyroidism the levels might fall well within Ideally the ratio of uptake between the two organs
described normal references values. In addition, the should be around 1:1.1 The change in the thyroid:salivary
presence of a concurrent secondary problem might lower (T:S) ratios of pertechnetate changes over time and the
the T4 value back into the reference value in a true procedure to obtain and evaluate diagnostic images is
hyperthyroid patient.7 Due to these common problems it limited. However, a recent study showed that the base-
has been suggested to perform a “free” T4 test as this line T:S ratios in cats were not significantly different from
assay is considered more sensitive for the diagnosis of 20 minutes to 2 hours.6 Another study with cats con-
early stages of hyperthyroidism.8 Table 2 provides some cluded that the optimal time for visualization of the
reference ranges for T4 and T3 values in guinea pigs and thyroid by pertechnetate scanning was 60 minutes after
other selected small mammals. IV injection of the radionuclide.5 As to what degree this
applies to other species needs to be investigated.
Table 2. Reference Ranges for T4 and T3 In our case a significant uptake of the radioactive
in Selected Small Mammalsa,b
material was noted, which made the evaluation of the
T4 T3
function of the thyroid somewhat difficult on the initial
Rabbit 1.7-2.4 µg/dL 130-430 ng/dL
body scan obtained 15-20 minutes post-injection. It might
Rat 3-7 µg/dL 25-100 ng/dL
be possible to speculate that herbivores, such as guinea
Mice 4-7 µg/dL 65-140 ng/dL
pigs, have a relatively high saliva production based on
Hamster 3-7 µg/dL 30-80 ng/dL
their diet and that early imaging of pertechnetate is
Ferret Male 3.24 ± 1.65 µg/dL 58 ± 9 ng/dL
contraindicated when the thyroid is the organ of interest.
Female 1.87 ± 0.79 µg/dL 53 ± 13 ng/dL
Ideally in smaller animals where the area of interest is
Guinea pig Male 2.9 ± 0.6 µg/dL 39 ± 17 ng/dL
very minute, a pinhole collimator would be recom-
Female 3.2 ± 0.7 µg/dL 44 ± 10 ng/dL
mended for a more optimal study, as it allows for better
Free T4 Free T3
imaging quality by eliminating background activity and
Male 1.26 ± 0.41 ng/dL 257 ± 35 pg/dL
increasing resolution.
Female 1.33 ± 0.25 ng/dL 260 ± 59 pg/dL
a. Fox JG: Biology and Diseases of the Ferret. Wiley-Blackwell, 1998. The images obtained 1 hour post injection (Figs 3, 4)
b. Loeb WF, Quimby FW: Clinical Chemistry of Laboratory Animals. Elsevier, 1989. were considered of diagnostic quality as they clearly
showed an asymmetry in the uptake of radioactive
Another more reliable method to diagnose functional material in the normally symmetrically paired thyroid
pathologies of the thyroid is nuclear medicine. While this glands. The significance of this asymmetry pattern as a
diagnostic method appears to be rarely used in exotic functional pathological feature was obvious when the
veterinary medicine, it provides superior diagnostic images of the diseased animal were compared to the
abilities over hormone panels. The basis of this imaging images of the clinically healthy animal.
procedure is the physiology of thyroid gland in particu- Although the owner did not consent to a necropsy or a
lar regard to the iodine metabolism, which appears biopsy procedure in order to accurately diagnose the
similar across different species. Dietary iodine is con- condition, the authors believe the amount of clinical data
verted into iodide and then absorbed from the GI tract. is highly suggestive for the primary pathology of the
A percentage of the iodide is then actively taken up by thyroid.
11-1 Case Report Joerg.qxd 3/16/2009 9:09 AM Page 29
Thyroid Scintigraphy in a Guinea Pig

with Suspected Hyperthyroidism
J. Mayer, K. Hunt, D. Eshar and M. Solano
In lieu of a postmortem exam we also have no con-

firmed cause of death of the animal but considering the
history and the owners report we feel that the animal
most likely aspirated some food during a syringe feeding
session. This is a highly likely event considering the large
amount of food given via syringe and the ravenous
appetite of the unmedicated animal.
In conclusion, thyroid scintigraphy appears to provide
the clinician with a noninvasive screening tool for the
detection of hyperthyroidism in guinea pigs. Histological
evaluation of the thyroid tissue still remains the gold
standard to diagnose functional pathology of the thyroid
but scintigraphy can play an important role in this
relatively common disease in guinea pigs. The authors
suggest obtaining diagnostic images with the gamma
camera of guinea pigs 60 minutes post injection of the
pertechnetate when the thyroid is the area of interest.

1. Broome MR: Thyroid scintigraphy in hyperthyroidism. Clin Tech Small Anim
Pract 21(1):10-16, 2006.
2. Castro MI, Alex S, et al: Total and free serum thyroid hormone concentrations
in fetal and adult pregnant and nonpregnant guinea pigs. Endocrin 118(2):
533-537, 1986.
3. Ewringmann A, Glöckner B: Leitsymptome bei Meerschweinchen, Chinchilla
und Degu. Diagnostischer Leitfaden und Therapie. Enke Publishing,
Stuttgart/Germany, 2005.
4. Garner M: A pictorial of selected diseases in guinea pigs. Exotic DVM 8(3):48-
50, 2006.
5. Nap AM, Pollak YW, et al: Quantitative aspects of thyroid scintigraphy with
pertechnetate (99mTcO4-) in cats. J Vet Intern Med 8(4):302-303, 1994.
6. Nieckarz JA, Daniel GB: The effect of methimazole on thyroid uptake of
pertechnetate and radioiodine in normal cats. Vet Radiol Ultrasound
42(5):448-457, 2001. Fig 5. The anesthetized guinea pig rests on top of the gamma
7. Peterson ME, Gamble DA: Effect of nonthyroidal illness on serum thyroxine
concentrations in cats: 494 cases. J Am Vet Med Assoc 197(9):1203-1208,
camera for the scintigraphy procedure. Even minimal motion will
1990. result in an inaccurate capture of the image details obtained by the
8. Peterson ME, Melian C, et al: Measurement of serum concentrations of free
thyroxine, total thyroxine, and total triiodothyronine in cats with hyperthyroidism gamma camera.
and cats with nonthyroidal disease. J Am Vet Med Assoc 218(4): 529-36,
2001.
AEMVASSOCIATION OF EXOTIC
MAMMAL VETERINARIANS
AEMV membership* provides many benefits,

including:
• Discount registration to AEMV
continuing education opportunities
• Members-only web database
of client education materials
• Subscription to the
Journal of Exotic Pet Medicine
*Membership is restricted to veterinarians, veterinary students, and veterinary staff only.
info@aemv.org fax 478-757-1315

www.AEMV.org

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• Accelerated healing of severe injuries or wounds is • May improve the effectiveness of nonsteroidal anti-
achieved with the addition of HEALx Booster inflammatory drugs
• Is a vegetarian alternative to fish oil that is more stable
Soother ®
than flax oil
TOPICAL SPRAY • Easy to administer; animals like the taste
A patented quaternary ammonium suspended
in aloe vera distillate for irritation relief Booster ®
DIETARY SUPPLEMENT
BENEFITS
• May reduce superficial itching and provide Certified organic red palm fruit oil with
soothing topical relief for skin inflammation the addition of a patented monoglyceride
and irritation for nontoxic antimicrobial activity
• May promote healing of sensitive skin and BENEFITS
superficial lesions often noted in early self- In addition to all the benefits of Sunshine Factor:
mutilation cases • May help eliminate infections without the use of anti-
• Transdermal technology for efficacy of topical application biotics; works well in conjunction with antibiotic protocols
• Soother Spray is most beneficial when used in conjunction • May support healing of conditions affecting the skin and
with HEALx Booster plumage, such as dermatitis or feather-picking
• May contribute to decreased risk of chronic diseases
Rain ®
• Inhibits non-autochthonous life forms while allowing
TOPICAL SPRAY native GI flora to repopulate
A nontoxic suspension of naturally

soothing aloe vera distillate in water Booster Concentrate ®
DIETARY SUPPLEMENT
BENEFITS
• Promotes skin health A patented highly purified distilled
• Brings out the natural luster of coat or feathers monoglyceride (glyceryl monolaurate)
• Restores moisture to skin, coat or feathers that BENEFITS
have lost moisture due to dry environments • May biochemically balance the body for optimal health
• Acceptable for daily use as a natural bath and self-healing by supporting the immune system
• Reduces dander and dust in the home • Shown in laboratories worldwide to inactivate some
• Uses the natural qualities of aloe to soothe dry and bacteria, viruses and fungi/yeast without destroying the
irritated skin body’s friendly bacteria or form resistant organisms
Individual results may vary. These products are not intended to diagnose, treat, cure, or prevent any disease.
11-1 SPECIES.qxd 3/12/2009 2:32 PM Page 32
SPECIAL FEATURE
QUICK REFERENCE GUIDE TO SELECTED
Exotic Species
Contributors
Michelle Campbell-Ward, Jennifer Mosier, DVM Giuseppe Visigalli, DVM Nathalie Wissink-Argilaga,
BSc, BVSc (Hons I), DZooMed Veterinary Referral Center Clinica Veterinaria Liana Blu Lic Vet GPCert (ExAP),
(Mammalian), MRCVS Greenbelt, Maryland Medicina e Chirurgia degli MRCVS
Taronga Western Plains Zoo Animali Esotici The Scott Veterinary Clinic
Dubbo NSW Australia Varedo-MI, Italy Bedford, United Kingdom
Ornamental geese (Anser sp., Chen sp., Branta sp.)

Michelle L. Campbell-Ward, BSc, BVSc (Hons I),
DZooMed (Mammalian), MRCVS
COMMON SPECIES
Most common types kept can be divided broadly into three groups:
• Grey geese (Anser sp.) include greylag (A. anser), bean
(A. fabalis), pink-footed (A. brachyrhynchus), greater white-fronted
(A. albifrons) and bar-headed (A. indicus),
• White geese (Chen sp.) include snow (C. caerulescens),
Ross (C. rossii) and emperor (C. canagicus)
• Black geese (Branta sp.) include Canada (B. canadensis),
Brent (B. bernicla), barnacle (B. leucopsis), red-breasted
(B. ruficollis) and nene or Hawaiian (B. sandvicensis)
SUITABILITY AS PETS
Some species/individuals may be aggressive
Lifespan is 10-26 years in captivity.
ADULT SIZE
Variable depending on species/subspecies: 1.1-6.5 kg (2.4-14.0 lb)
Canada geese: 3.2-6.5 kg (7-14 lb)
BEHAVIOR
Generally monomorphic, except for size and vocalization
Monogamous
Piotr Kuczynski
Most species are sexually mature at 2 years of age.
CAPTIVE HOUSING
Large predator-proof enclosure with a pond (minimum 300 m2 [360 Greylag goose (Anser anser)
square yards] for one pair; up to 10 pairs per hectare)
32 EXOTIC DVM VOLUME 11 IS SUE 1

Ornamental geese
Geese should be housed in pairs or groups to meet their social needs.
Access to open water is necessary.
Pond size: minimum 20% water to land
Pond water must be fresh and preferably flowing.
Pond should have slope or ramp (<30°) for entry and exit.
Plants are necessary for shelter, protection and shade.
An artificial shelter should be erected if plant cover is minimal and/or
the climate is harsh.
Materials for nest-building (e.g., leaf litter, peat, fresh straw, piles of
rocks/logs, old car tires) should be provided.
Access to a large area of short grass for grazing, ideally on free-
draining soil, is recommended.
Clean, dry bedding should be provided.
Geese can be kept with ornamental ducks.
Overhead netting to limit wild bird access is desirable.
Geese are tolerant of a range of temperature and humidity, provided
that enclosure permits shelter from extremes.
DIET Bar-headed goose (Anser indicus)

Grazers; strictly herbivorous
Short herbs, grasses and clovers; may dig for roots/tubers
Generally large areas of short grass sward are needed.
If the grass area is not sufficient, e.g., high stocking densities and/or
in winter, supplementation may be provided with dark leafy greens,
pellets (waterfowl or poultry layer) and wheat.
One feeder per pair is necessary to ensure all in group can feed freely.
A number of feeding stations and/or scattered food will promote
normal foraging behavior.
Grit should be available.
Feeding excess food should be avoided; uneaten food promotes wild
rodents, food spoilage (e.g., fungal growth) and eutrophication of
water sources.
Because gizzard worms and gapeworms overwinter on grass swards
it is recommended to use a fresh sward (not used by adults or
juveniles the previous year) for goslings.
RESTRAINT
Geese can be aggressive and will bite. Canada goose (Branta canadensis)
Limit access to water; drive into a corner.
Geese may be restrained by placing one hand
loosely around the neck while using the other hand
to hold the wings in over the back and then sliding
one hand under the body to restrain the feet.
Alternatively, the goose may be lifted onto a forearm,
tucking the neck under the arm so the head is
pointing behind the handler (as demonstrated on a swan above).
ANESTHESIA
Pre-anesthetic fasting is not required.
Options for pre-medication (not always required): butorphanol
0.5-1.0 mg/kg IM/IV or midazolam 0.1-1 mg/kg IM/IV
Inhalational (via mask and/or endotracheal tube): isoflurane
(5% induction; 2-3% maintenance) or sevoflurane (8% induction;
4-5% maintenance)
Injectable option 1: medetomidine 0.15 mg/kg IV + ketamine
3 mg/kg (reversed with atipamezole 0.75 mg/kg IM)
Injectable option 2: alfaxalone 5-10 mg/kg IV or IM
Injectable option 3: alfaxalone/alfadalone 7 mg/kg IV
Injectable option 4: propofol 10-15 mg/kg IV followed by intubation
and maintenance on isoflurane or sevoflurane Red-breasted goose (Branta ruficollis)
Assisted ventilation may be required (manual or mechanical)
www.exoticdvm.com EXOTIC DVM VOLUME 11 IS SUE 1

33
EXOTIC ANIMAL CARE
Ornamental geese
MOST COMMON DISORDERS
Pododermatitis (bumblefoot)
Alimentary tract impactions (if feeding on lush, long grass)
Amyloidosis
Botulism
Algal and mycotoxicosis
Yolk coelomitis
Dystocia (egg binding)
Cloacal organ prolapse
Viral diseases, e.g., goose viral hepatitis, hemorrhagic nephritis and
enteritis of geese
Bacterial diseases, e.g., Mycobacterium avium, pseudotuberculosis,
mycoplasmosis, salmonellosis, colibacillosis, chlamydiosis,
Pasteurella multocida (avian cholera)
Fungal diseases, e.g., aspergillosis, candidiasis
Parasitic diseases, e.g., gizzard worm, schistosomiasis, coccidiosis,
gapeworms, air sac mites
Neonatal disorders, e.g., yolk sac infection/retention, enteritis,
Canada geese mating ritual leg/wing deformities
VACCINES
None essential, but vaccination for the following may be considered
if significant risk factors for a particular disease/individual are relevant:
• Goose viral hepatitis 1
• Hemorrhagic nephritis and enteritis of geese
• Newcastle disease
• Avian influenza
• West Nile virus
ZOONOTIC POTENTIAL
Avian influenza
Avian tuberculosis
Tim Bowman, USFWS
Campylobacteriosis
Chlamydiosis
Erysipelas
Escherichia coli infection
Newcastle disease
Salmonellosis
Emperor goose (Chen canagicus) on its nest
SPECIAL CONSIDERATIONS
Regular (once or twice yearly) endoparasite prophylaxis is recom-
mended, e.g., with ivermectin, levamisole or a benzimidazole.
New stock should be isolated for up to 1 month before introduction
to existing group.
To aid restraint and to permanently limit flying ability where open
enclosures are used, pinioning (amputation of the terminal phalanx
of one wing) can be carried out on conscious goslings at 1-7 days
of age. In older birds, anesthesia is required.
REFERENCES AND FURTHER READING

1. Kear J, Hulme M: Ducks, Geese and Swans. Oxford University Press, 2005.
2. Morishita T: Waterfowl husbandry for the avian health professional. Sem Avian
Exot Pet 13(4):184-190, 2004.
3. Roberts V: Waterfowl: Health and husbandry. In Roberts V, Scott-Park F (eds):
BSAVA Manual of Farm Pets. BSAVA, 2008, pp 237-249.
Donna Dewhurst
4. Smith S, Rodriguez Barbon A: Waterfowl: Medicine and surgery. In Roberts V,

Scott-Park F (eds): BSAVA Manual of Farm Pets. British Small Animal Veterinary
Association, 2008, pp 250-273.
5. Wildlife Information Network. Wildpro Multimedia CD: Waterfowl. The Royal
Veterinary College, 2000.
6. www.waterfowl.org.uk
7. Flinchum GB: Management of waterfowl. In Harrison GJ, Lightfoot T (eds): Clinical
Canada goose and goslings Avian Medicine. Palm Beach, Spix Publishing, 2006, pp 830-848.
8. Olsen JH: Anseriformes. 1999, In Ritchie BW, Harrison GJ, Harrison LR (eds): Avian
Medicine: Principles & Application. Brentwood, TN, HBD Intl, 2001, pp 1236-1275.

Blood python (Python curtus)

Giuseppe Visigalli, DVM
SUBSPECIES
Blood python or Sumatran blood python (P. c. curtis)
Malaysan blood python or red blood python (P. c. brongersmai)
Borneo blood python or short-tailed blood python (P. c. breitensteini)
ORIGIN
Malaysia, Sumatra, Borneo, coastal Thailand and Cambodia
FREE-RANGING HABITAT
Palm plantations, tropical forests and marshes
SUITABILITY AS PETS
Wild-caught pythons tend to be nervous, irritable and even aggressive
Captive-bred specimens often mature into docile, placid animals
Blood pythons are suitable for intermediate keepers. Male Python curtus curtus
They are non-venomous.
Lifespan is 25 years or more in captivity.
ADULT SIZE
Females: 4-6 feet (1.2-1.8 m) avg; males: 3-5 feet (0.9-1.5 m) avg
PHYSICAL CHARACTERISTICS
Blood pythons are squat, heavy-bodied serpents with varied markings.
Coloration may vary from yellow, tan and brown to a bright red,
cherry red or oxblood with lighter tan, gold, orange and black
blotched markings.
The head is typically gray, although specimens may exhibit black,
light gray or even red heads.
Blood pythons are well known for their changing head colors
(e.g., black-headed snake in the evening and very pale head in
the morning).
Some blood pythons exhibit broken dorsal striping.
Color mutations include striped, T+ albino, T- albino, ivory (white
body with gray and black dorsal speckling ) and hypomelanistic
SEXING AND REPRODUCTION

Sexual determination by probe depth is 9 subcaudal scales for males
and 3-4 for females.
Sexual maturity is 18 months to 4 years. Python curtus brongersmai
Breeding size occurs at lengths of 3-5 feet (0.9-1.5 m).
Wild-caught females may not breed at all in captivity.
Breeding season in captivity typically ranges from November to March.
All feeding should be stopped at this time. Animals should be well
established and in excellent condition before breeding is attempted.
Breeding may be induced by reducing daytime photoperiod to 8-10
hours and dropping nighttime temperatures to around 75°F (24°C).
The female should be introduced into the male’s cage. Misting the
animals with water may also induce breeding activity.
Females shed 14-20+ days after ovulation; eggs are typically laid
within 30 days of post-ovulation shed.
Clutch size varies from 8-20 eggs.
At an optimal incubation temperature of 88-90°F (31-32 C°), these
Dawson
eggs take an average of 60 days to hatch.
BEHAVIOR Python curtus breitensteini

Nocturnal; timid; may be temperamental, especially young snakes

35
EXOTIC ANIMAL CARE
Blood python
CAPTIVE HOUSING
Minimum cage size (enclosure perimeter) for one adult python is the
length of snake x 2.5.
Enclosure may be simple or elaborate plastic sweater boxes (e.g.,
Rubbermaid®), melamine racks, Freedom Breeder® cages, or any of
the commercially available plastic-type reptile cages. Glass aquariums
and tanks are adequate; however, screen tops on such enclosures
can make it difficult to maintain humidity levels.
Feces/urates/uneaten prey items must be removed from the
enclosure as soon as possible.
Depending on cage conditions, all substrate and cage furniture should
be removed and the enclosure completely disinfected using a 5%
bleach solution approximately every 30 days. The enclosure must be
rinsed thoroughly and allowed to dry before cage furniture and snake
are replaced.
Newspaper is the easiest and least expensive substrate material for ENVIRONMENTAL ENRICHMENT
cleaning and disinfecting. Cypress mulch holds humidity but excess Blood pythons are sensitive snakes that appreciate and utilize a hide
humidity should be avoided. Do not use substrate containing cedar. spot, so at least two should be provided. Clay flowerpots, plastic
flowerpot trays and commercially available hide boxes all work well.
ENVIRONMENTAL TEMPERATURE/HUMIDITY
Basking spot should be 88-89°F (31°C); ambient (background) DIET
temperature range is 78-82°F (25-27°C); minimum ambient Primary diet is live rodents (young gerbils, mice) and birds (chickens).
temperature is 75°F (24°C). A live rodent should not be left unattended with any snake.
If the ambient temperature is strictly maintained around 80-84°F Blood pythons are generally easy to convert to frozen/thawed or
(26-28°C), a juvenile blood python can live in a simple Rubbermaid®/ pre-killed rodents.
melamine rack setup without a basking spot or supplemental heat; Blood pythons should be fed with an appropriately-sized rodent
it needs a basic hide box, water bowl and substrate. weekly (prey = 2.5 x snake head size or 10-15% snake weight).
Under-cage heating pads, ceramic heat emitters, basking bulbs Very young prey or defrosted prey need vitamin-calcium integration
(both regular daytime and red “night” bulbs) are possible heating every 2-3 meals.
accessories. Blood pythons can eat rats starting off with rat “crawlers” for younger
Thermostats, rheostats and/or timers must be used to control the snakes (every 5 days) and moving up in size as the animal grows.
heat source. Sub-adult and adult pythons are prone to obesity due to a strong
Hot rocks should not be used in order to avoid serious burn. feeding response coupled with a slow metabolism, so a 10-14 day
Heat emitters and bulbs, especially if combined with a screen top, will feeding schedule is strongly recommended.
dry the air in the enclosure quickly, so additional humidity is needed. In order to avoid regurgitation, it is recommended for the owner to
To provide a snake with a humidity level of 50-60%: not handle the snake for at least a day after feeding.
• Use cypress mulch or a similar mold-resistant substrate that can
be misted. It is advantageous if the substrate changes color when MOST COMMON DISORDERS
it is wet, thereby providing visual cue for the next dampening. Intestinal parasites
Using cypress mulch requires disciplined maintenance, as a dirty Loss of appetite
and humid enclosure will quickly lead to unhealthy conditions. Respiratory disease
• A “humidity box” may be constructed for the snake by packing a Mouth rot
plastic container with damp sphagnum moss (think well-wrung-out External parasites (mites and ticks)
wash cloth to gauge moisture) with a hole cut in the top or side. Dysecdysis (retained skin shed, retained eye spectacles)
Screen top on the enclosure needs keeping moisture from Obstipation/constipation
escaping. It is important to maintain a proper, reliable ambient Bite wounds from prey
temperature, as warm air holds more moisture than cool air. Inclusion body disease
Because blood pythons are nocturnal, supplemental lighting is not Spinal fractures/trauma/thermal burns
necessary. However, if it is used it should run on a 12/12 cycle.
Continuous bright, overhead lighting is stressful. ZOONOTIC POTENTIAL
Salmonella, as with all reptiles
WATER
Fresh, clean water must always be available, as blood pythons have SPECIAL CONSIDERATIONS
a tendency to drink copiously. Clinical visits should be scheduled every 4-6 months and include a
A water dish should be large enough for the python to crawl into and fecal exam for parasites.
soak. Ensure that the bowl is not too deep for juvenile animals— Microchip application for identification is advised.
approximately 1 inch (2.54 cm) of water will suffice.
Because snakes often defecate in their water bowls, regular cleaning, REFERENCE AND FURTHER READING
disinfection and water changes must be scheduled at least weekly. 1. Mader DL (ed): Reptile Medicine and Surgery 2nd ed. Elsevier, 2006.
2. Kramer M: Sexual determination by probe depth. Exotic DVM 7(6):7, 2006.

Corn snake (Pantherophis guttata)*

*formerly Elaphe guttata
Nathalie Wissink-Argilaga, Lic Vet, GPCert (ExAP), MRCVS
COMMON SUBSPECIES
Common corn snake or red rat snake (P. g. guttata)
Great Plains rat snake or Southwestern rat snake (P. g. emoryi,
formerly P. g. meahllmorum)
ORIGIN
Eastern United States
P. g. guttata is found in the southeastern United States
P. g. emoryi is found in the United States from Nebraska to Texas
and into northern Mexico
Primarily ground-dwellers but some are semi-arboreal
Pine forests, rocky outcrops/hills and around farms and grain stores Common corn snake (Pantherophis guttata guttata)
SUITABILITY AS PETS
Corn snakes are a good beginner snake because they are easy to
handle and care for and are non-venomous.
The average lifespan is 10 years, but records show up to 22 years.
ADULT SIZE
4-6 feet (120-190 cm) in length
The common corn snake is distinguished by having brownish orange
skin with orange/red saddles, the saddles having black borders and
usually a black and white underbelly.
After many generations of selective breeding, domesticated corn
snakes are found in a wide variety of different colors and patterns:
Erik McCormick
color morphs, such as Miami Phase, Okeetee Corns, Candycane;
pattern morphs like Aztec, Zigzag, Milksnake Phase, Motley; and
compound morphs like Snow, Blizzard, Ghost, Phantom.
There is also a wide variety of hybrids.
Great Plains rat snake (Pantherophis guttata emoryi)
BEHAVIOR
Corn snakes are most active at night and at dawn and dusk.
They are generally calm, docile, placid snakes that thrive in captivity.
They are solitary animals so they are best housed alone in captivity.
CAPTIVE HOUSING
A corn snake can be housed in at least a 20-gallon tank with a
secure top as they are known to be escape artists.
Aspen or cypress shavings are often used as substrate to allow the
snake to burrow. Other suitable substrates are newspaper, reptile
carpet or paper towel.
Fresh water to drink must be provided in a reasonably-sized bowl.
ENVIRONMENTAL TEMPERATURE/HUMIDITY
A temperature gradient from 70-85°F (21-29°C) should be
maintained. The temperature can fall to the lower range at night.
WATER
Slowinski’s corn snake (Elaphe slowinskii) was originally considered an
Corn snakes need a bowl of fresh water that is large enough for them intergrade subspecies of the corn snake and Great Plains rat snake, but
to submerge their whole body in. Ensure that the bowl is not too deep it has been elevated to species status.
for juvenile animals—approximately 1 inch (2.54 cm) of water.

37
EXOTIC ANIMAL CARE
Corn snake
Because snakes often defecate in their water bowls, regular cleaning,
disinfection and water changes must be scheduled at least weekly.
ENVIRONMENTAL ENRICHMENT
Hiding places should be available as corn snakes become stressed if
they cannot hide.
An interesting branch should be available for climbing and resting.
DIET
Carole Saucier, www.reptilecare.com
In the wild, hatchlings feed largely on small lizards and tree frogs,
while adults feed on small rodents and birds, killing their prey by
constriction.
In captivity, hatchlings can easily be started on pinkie mice (1-2 days
old), quickly moving up the prey scale to fuzzies, crews and small
adult mice. A live rodent should not be left unattended with any
snake.
Juveniles should be fed every 5-7 days; adults every 7-10 days.
Corn snakes need water every day but most people probably will not
Corn snakes spend much of their time coiled up in containers. see the snake drink.
RESTRAINT
Minimal restraint is recommended as corn snakes are normally very
docile. The body must be fully supported.
Corn snakes will not wrap snugly around the handler’s arm, but
they tend to pick a direction and go, so the head can be gently
guided in another direction as necessary.
ANESTHESIA
The use of premedication eases induction and may provide some
analgesia: butorphanol (1-2 mg/kg IM), low dose ketamine (5-20
mg/kg IM), tiletamine/zolazepam (3 mg/kg IM).
Intravenous induction (with/without premedication) using propofol
(5-10 mg/kg IV).
Gaseous induction with isoflurane (5%) via mask, induction chamber
or by intubating the sedated patient and performing intermittent
positive pressure ventilation (IPPV).
• Maintenance is achieved with isoflurane and oxygen via an
Corn snakes may soak frequently in water.
uncuffed endotracheal tube connected to a non-rebreathing
circuit, IPPV at 4-8 breaths/min and pressure of 16-10 cm H2O.
• It is very important to maintain body temperature.
• During recovery, IPPV may be provided with room air rather than
100% oxygen to encourage spontaneous respiration. Decreasing
the frequency of IPPV will also hasten recovery.

Dysecdysis
Respiratory infections
Stomatitis
Cloacal prolapse
Constipation
ZOONOTIC POTENTIAL
Salmonella, as with all reptiles
E. coli and other enteric pathogens
Pentastomiasis

1. Mader DL (ed): Reptile Medicine and Surgery 2nd ed. Elsevier, 2006.
2. Longley LA: Anaesthesia of Exotic Pets. Elsevier, 2008.
A female snow color morph corn snake 3. www.anapsid.org
4. www.cornsnake.co.uk

Mud turtle (Kinosternon sp.)

Jennifer Mosier, DVM
COMMON SUBSPECIES
Eastern mud turtle or common mud turtle (K. subrubrum)
Striped mud turtle (K. baurii)
Chris Leone, www.gardenstatetortoise.com

Yellow mud turtle (K. flavescens)
Sonoran mud turtle (K. sonoriense)
Pelusios sp. (side-necked African mud turtles), found in sub-Saharan
regions of Africa, have similar husbandry requirements.
Mud turtles are found from southern Canada to central South
America in areas of slow-moving or still, shallow bodies of warm
water with moderate to heavy vegetation and soft bottoms.
SUITABILITY AS PETS
Their small size facilitates easy indoor housing and handling. Eastern mud turtle (Kinosternon subrubrum)
Average lifespan for captive mud turtles is 10-15 years; some turtles
can live 30+ years.
ADULT SIZE
Mud turtles are commonly 8-12 cm (3-5 inches) in length; maximum
size is 22 cm (9 inches).
Mud turtles are generally dark in color and have a relatively flattened
carapace. Different subspecies have subtle differences in shading as
well as various shades of yellow or orange on the sides of the neck.
All subspecies have two plastral hinges.
Turtles in the Kinosterninae family have 10-11 scutes on their
plastron compared to the 7-8 in Staurotypinae.
Males tend to be larger than females of the same age and have
thicker tails and larger heads.
BEHAVIOR
Mud turtles are nocturnal and generally shy. Striped mud turtle (Kinosternon baurii)
They prefer to walk on the bottom of ponds and streams.
They can be very aggressive toward other individuals and need to be
housed only with similar-sized members of the same species.
Mud turtles can release foul-smelling secretions when threatened.
CAPTIVE HOUSING
Outdoor housing with shade and haul-out areas is preferred.
Aquariums may be used for indoor housing; a 20 gallon is fine for a
hatchling, but adults need a larger enclosure.
The aquarium should have shallow water with a depth as deep as
the widest part of the turtle (2-4 inches [5-10 cm] for hatchlings and
8-12 inches [20-30 cm] for adults).
A dry area, such as a pile of rocks, at one end of the enclosure
should be provided for a basking spot.
A heat lamp may be beneficial; it can be positioned over the dry area
to provide a basking spot of 90°F (32°C).
Water temperature should be 75-78°F (24-25°C). Abrupt changes in
temperature may be harmful.
Optimal water quality is essential for health. Both mechanical and
biologic filtration are needed, with canister filters preferred.
Frequent water changes are required.
UVB full-spectrum lighting is believed to be important if there is no The aquarium should have shallow water to allow mud turtles to breathe
access to sunlight. while they walk on the bottom of the enclosure.

39
EXOTIC ANIMAL CARE
Mud turtle
ENVIRONMENTAL ENRICHMENT
A hiding place (e.g., half of clay flowerpot) under the surface of the
water is essential.
Aquatic plants will help mud turtles feel more secure.
DIET
Mud turtles are opportunistic carnivores or omnivores.
The young are generally carnivores, with larger amounts of vegetation
added to the diet with age.

Adults should be fed 2-3 times per week; hatchlings are fed daily.
Variety of diet is essential to maintaining good nutrition, and a mixture
of insects, worms, snails, fish and vegetation should be offered.
Commercial turtle diets are also widely available.
Calcium supplementation is essential. Powdered calcium can be
sprinkled on all foods. If the turtle is kept indoors the calcium
supplement should include vitamin D3.
RESTRAINT
Individuals should be held by their shell in the middle of their body.
Free-ranging mud turtles spend much of their time walking on the
The head and front limbs can often be exteriorized by pressing the
bottom of ponds and streams.
hind limbs into the shell; the hind limbs can be exteriorized by
pressing the front legs inside.
If the mud turtle is uncooperative, chemical restraint may be
necessary for a thorough examination and diagnostics.
ANESTHESIA
Premedication with butorphanol IM is suggested.
Analgesia may be achieved with butorphanol, buprenorphine and/or
ketoprofen, but more information is needed.

Induction with propofol is preferred when IV access is available.
A combination of ketamine, medetomIdine and butorphanol IM may
also be used.
Chamber or mask induction with inhalants is not recommended due
to their prolonged breath holding.
Maintenance via inhalants may be provided after endotracheal
intubation with an uncuffed tube. Note the short trachea and take
care to intubate the bronchus.

Diarrhea (secondary to improper diet)
Shells can provide a hiding place for hatchlings.
Aural abscess
Internal parasites
Chronic eye infections (hypovitaminosis A)
Shell rot
Trauma
ZOONOTIC POTENTIAL
Salmonella, as with other reptiles.
SPECIAL CONSIDERATIONS
A fecal analysis is recommended for all new acquisitions and every
6-12 months thereafter.
Many subspecies are endangered or threatened in the wild.

1. Mader DR (ed): Reptile Medicine and Surgery 2nd ed. WB Saunders Co, 2006.
2. McArthur S, Wilkinson R, Meyer J: Medicine and Surgery of Tortoises and Turtles.
Blackwell Publishing, 2004.
3. Wappel SM, Schulte MS: Turtle care and husbandry. Vet Clin No Am Exot Anim
Pract 7(2):447-472, 2004.
4. World Chelonian Trust - www.chelonia.org/articles/kinosternidaecare.htm
Aquatic plants will help mud turtles feel more secure. 5. www.dec.ny.gov/animals/7152.html

11-1 Time Off.qxd 3/12/2009 1:21 PM Page 41
Time Off with

EXOTIC DVMs
Jörg Mayer and

Janet Martin on Safari in Tanzania
The husband and wife team of Drs. Jörg Mayer and Janet Martin recently
returned from Tanzania where they served as faculty hosts for a “Spectacle
of the Serengeti” trip organized by Tufts University for its alumni. In their role
as links between the university and the travelers, Jörg and Janet presented
lectures to the group in the evening and commented on the African wildlife
while on safari. Some incredible images from their trip can be viewed at
http://gallery.me.com/jmayer#gallery.

41
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For Your Bookshelf

PRACTICAL REVIEWS
Clinical Radiology
of Exotic Companion Mammals
By Vittorio Capello, DVM and Angela M. Lennox, DVM, Dipl ABVP (Avian) with
William R. Widmer, DVM, MS, Dipl ACVR
Radiography is an important diagnostic tool for + On the Plus Side
the exotic animal practitioner, and few texts The number of species included in this book is
are available detailing what is normal and excellent. It is often difficult to find “normal”
what isn’t normal in the “exotic companion radiographs of some less common species,
mammal.” Radiography can be especially such as prairie dogs and African pygmy
useful in those small mammals that don’t hedgehogs. The inclusion of pictures of
have enough blood volume or easy venous animals with lesions is very helpful to see
ISBN: 978-0-8138-1049-2
access to perform complete blood work. This how “abnormal” radiographs correspond to
2008
book is essentially divided into two parts. The physical exam findings. The initial overview
528 pages, hardcover
first part (Chapter 1) details the basics of of positioning should be useful to the novice
$149.99
radiology, radiographic equipment, patient exotic animal practitioner.
Wiley-Blackwell
positioning, special radiographic studies (e.g.,
www.wiley.com
contrast, myelograms) and computed tomo- - On the Minus Side
graphy. This chapter is an excellent review of Abnormalities in some of the radiographs are
stated as “consistent with neoplasia” without
radiology principles as well as a guide to
having a histological diagnosis. I realize that
proper positioning of exotic mammals.
histopathology is not always available, but I
The second part of the book consists of
have had instances when radiographs were
14 chapters, each of which focuses on one
not consistent with what was found on
species of exotic mammal, specifically rabbits,
necropsy. I would also like to see a CT image
guinea pigs, chinchillas, degus, rats, mice,
of a prairie dog with a pseudo-odontoma
hamsters, prairie dogs, ferrets, skunks, sugar
included (but that could just be my personal
gliders, Virginia opossums, potbellied pigs and
love of dental CT imaging of rabbits and
African pygmy hedgehogs. Radiographs of
rodents!). Perhaps it will make the 2nd
both normal and abnormal animals are
edition!
included in each chapter. Chapters focus on
the more common diseases of each species, Add to Bookshelf?
although some more unusual cases are also Absolutely! I always hate the hunt for
included. Dental disease is a common “normals” of some of the species included in
presentation for rabbits and rodents, and this text. The number of species, as well as
numerous radiographs of affected animals, the number of radiographs that demonstrate
including dental films, are included. Addition- normal and diseased conditions, make this
ally, computed tomographic (CT) images of book an essential for any exotic animal
rabbit, guinea pig, and chinchilla heads, both practitioner. This book would be very useful
normal and abnormal, are included. The use for both the novice and experienced exotic
of CT imaging, when available, can greatly animal practitioner.
improve the ability to determine the type and
extent of lesions in animals with dental Reviewed by Marcy J. Souza, DVM,
disease. The text also includes numerous MPH, Dipl ABVP (Avian)
pictures (next to corresponding radiographic University of Tennessee
images) that show the affected animal or the College of Veterinary Medicine
specific lesion or mass. Knoxville, Tennessee
For Your Bookshelf

PRACTICAL REVIEWS
Rapid Review of Exotic Animal Medicine

and Husbandry
Pet Mammals, Birds, Reptiles, Amphibians and Fish
Edited by Karen L. Rosenthal, Neil A. Forbes, Fredric L. Frye
and Gregory A. Lewbart
The contents of this interesting book were pictures of parasites (both of the species we
assembled to give the practitioner a resource treat and even of their food—a cricket worm
that includes mammals, birds, reptiles and was shown). Some of the pictures in this book
fish in one place. It is set up in the fashion of are like someone went around and got free ISBN: 978-1-84076-055-2
a self-assessment book, except that the case access to everyone’s strangest cases and put 256 pages, paperback
presentation, differentials, diagnosis and them into one place. What does duck plague 2008
treatment recommendations are all on the present like? What can be done for a corneal $99.99
same page. It is broken down into sections laceration in a frog? What does a torsed swim Wiley
per animal group, which include an introduc- bladder look like on a radiograph? What if my www.wiley.com
tion, the English and Latin names, case technician brings her fish in for a contrast
presentations by species or type, a question study? It’s in the book! A big plus is the
and answer section and bibliography. Some appendix that gives adult and birth weights,
of the case presentations are common lifespan, origin, heart and respiratory rates,
syndromes and some are rare. Some cases litter numbers, gestation, breeding onset and
are how-to techniques (for example, rabbit weaning age. For the birds, it also gives
and guinea pig intubation, repair of a rectal gavage volumes and frequency, blood collec-
prolapse in a turtle). A list of common abbre- tion volumes and IV fluid bolus volumes.
viations used in the book is provided in the
- On the Minus Side
front. The appendix lists a conversion chart
This book is case based, so looking for a
of SI units to old units and some normal
particular syndrome could be difficult unless
physiologic values for the groups. An index is
it is listed in the index and/or you already
provided in the back.
know its name.
+ On the Plus Side Add to Bookshelf?

The pictures are high quality and provide Yes. It is a well done book that has most of
enough detail to see what the case is pre- the pet exotics seen in practice under one
senting, whether it is a Hexamita parasite or cover. It provides good, basic information on
a swim bladder in a koi. The cases include common and some rare species. At $100
conditions that are both common to help a (US), the price is a little steep, especially for
novice and rare to help anyone with that those on a budget. Price aside, buy it just for
“weird” case no one knows about. Some of the pictures! For those of you on the Exotic
the pictures/cases are so cool it would be DVM Forum whose posts meet deafening
worth the price of the book just to see them. silence, this book is for you! This book is not
The authors have presented uncommon a substitute for other references, but would
species doing odd things that are normal for make a valuable addition to any exotics library.
that species but abnormal in our more
common exotic species (for example, the Reviewed by Carla M. Kasaback, DVM
upside-down catfish). The book provides York, Pennsylvania

43
For Your Bookshelf

PRACTICAL REVIEWS
Essentials of Avian Medicine & Surgery

3rd edition
Edited by Brian H. Coles with contributions from
Maria Krautwald-Junghanns, Susan E. Orosz and Thomas N. Tully
This is a very concise reference that packs a always a huge topic and receives a thorough
large amount of information into a small book. overview of varying options and the authors’
experiences with each.
+ On the Plus Side
One useful thing is the set of helpful clinic tips
- On the Minus Side
and facts in an easily referenced style focus- By design, the book has limited pictures and
ing on functional information. For example, refers the reader to other books for full
ISBN: 978-1-4051-5755-1 diagrams. This can be frustrating to pull out
the blood work section includes common
2007 several books and impossible if you are just
interpretations, relative usefulness and even
392 pages, paperback starting your collection. For this reason, the
conversion formulas to compare different
$79.99 radiography, CBC, endoscopy, and CT/MRI
machine values. The anatomy section is
Wiley sections are a nice update to current
limited in number of diagrams, but the ones
www.wiley.com technology levels but are not useful in a
included are very useful. It focuses on the
www.avianpublications.com clinical setting. All of these modalities are
kinetics of the skull and wing, necessary for
based on images and there just are not
planning beak repair or wing surgery. The
enough pictures that can be included in such
approach also focuses on the “whys” of
a concise reference. None of the sections
differences from mammals: like the tongue
goes into much depth, so those readers
shape, use of uric acid and varying wing
looking for detailed descriptions will need to
shapes. This helps with extrapolating to new
reference weightier textbooks (this book does
species when they come in presenting their
include titles of best references for more
unique variations.
information).
Nearly one-third of the book consists of
easily accessed tables of average species’ Add to Bookshelf?
weights, infectious diseases and drug dosages. This book will make a nice addition to shelves,
The infectious disease section covers bacte- both for those who see birds infrequently and
rial, fungal and viral diseases with the sus- on a daily basis. It will be used often for drug
ceptible species, general signs, relevant test- dosages and disease rule-outs that you don’t
ing and any differential diagnosis. For many want to flip through larger textbooks to obtain.
presenting signs (e.g., dermatologic, polyuria/ Many good facts are in a single location and
polydipsia, renal), there are sections detailing can be easily accessed between appointments.
the best tests to start with for the patient.
Even though I have been practicing for several Reviewed by Kirsten Love, DVM
years, I found tips on diagnostics that I could Lantana-Atlantis Animal Hospital
immediately use at my practice. Anesthesia is Atlantis, Florida
For Your Bookshelf

PRACTICAL REVIEWS
Avian Medicine 2nd edition

Edited by Jaime Samour, MVZ (Hons), PhD, Dipl ECAMS
Avian Medicine provides a range of useful While there are few typographic errors
information, from basic husbandry, restraint throughout most of the text, the section on
and handling of different sizes and types of general anesthesia (Chapter 4, Martin P.C.
birds, to diagnosis, treatment and prevention Lawton) has several errors, including mis-
of specific diseases and common injuries. spellings, redundancies and incorrectly
A formulary is also included. labeled figures.
+ On the Plus Side Add to Bookshelf?

This text is full of beautiful pictures that This is a good summary book for a general
provide examples of restraint and treatment practitioner who wants to include birds in ISBN: 9780723434016
techniques as well as normal and abnormal his/her practice, but one text cannot include a 2007
conditions. Appendices contain normal full description of every species and variation; 470 pages, hardcover
chemistry and hematology values for a someone aiming to specialize in avian practice $190
variety of species. For the most part, the would need more specific and in-depth texts. Mosby-Elsevier
text is well organized and concise, although www.elsevierhealth.com
there are some repeated sections between Reviewed by Jessica Adams, DVM
“management-related diseases” and Chewelah Veterinary Clinic
“infectious diseases.” Chewelah, Washington
A photographic “walk-through” of a
necropsy supplies images of normal
anatomy and organ appearance,
which is a valuable contrast to the
images of abnormal findings in the
rest of the text. Color slides of normal
and abnormal blood smears, aspirates
and impression slide cytology are
clear and detailed, and important
differences between normal avian
blood cells and mammalian cells are
demonstrated. There is also an
appendix containing contact informa-
tion for many organizations that can
provide more species- or region-
specific information or assistance.
- On the Minus Side

There is an abundance of radio-
graphic pictures, which are clearly
labeled and captioned, but many
have been reduced to such a small
size (up to 6 pictures on each page)
that it is difficult to see the indicated
features. Photos that show restraint
for radiology without gloves and
surgical procedures in which the
surgeon and assistant wear neither
mask nor cap seem inappropriate
choices for a professional text.

45
11-1 NWZoo n Oxbow ads.qxd 3/12/2009 1:14 PM Page 46
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10-3 Harrisons ad.qxd 9/10/2008 12:43 PM Page 1
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Zoological Education Network - A Division of Harrisons’ Pet Products

contents Cover photo of Jörg Mayer, DVM, MSc by

Observations from the Field

9 Surgical Removal of Foleyella furcata from Wild-caught Panther

Case Reports Peer Reviewed

13 Abdominal Abscess in a Rabbit - David Perpiñán, LV, MSc

17 Fecal Bacteriotherapy for Treatment of Clostridial Enterotoxemia

11 21 Ultrasound Imaging of the Reproductive Tract

25 Thyroid Scintigraphy in a Guinea Pig

35 Blood python (Python curtus) - Giuseppe Visigalli, DVM

37 Corn snake (Pantherophis guttata) -

39 Mud turtle (Kinosternon sp.) - Jennifer Mosier, DVM

Supported in part by a grant from Harrisons’ Pet Products

MEDICAL EDITOR Ariana Finkelstein, DVM Neus Morera, DVM

EXOTIC DVM STAFF

© 2009 Zoological Education Network

www.exoticdvm.com EXOTIC DVM V O LU M E 1 1 I S S U E 1

JOIN THE DISTINCTIVE

INTENSIVE CARE UNITS

Ideal products for veterinary professionals

www.exoticdvm.com EXOTIC DVM V O LU M E 1 1 I S S U E 1

Ivermectin Treatment of Red Bug Disease in Acropora Coral

■ Academic based diagnostic service with

■ Infectious disease testing for rodents

■ Special handling of low volume samples

■ Active research program

Phone: (800) 596-7390

www.exoticdvm.com EXOTIC DVM V O LU M E 1 1 I S S U E 1

Diseases and Medical Management of

Surgical Removal of Foleyella furcata from

these chameleons have varying newly acquired imports may exacer-

Enjoy the benefits of an ARAV member:

Join now on-line at http://arav.allenmm.com

www.exoticdvm.com EXOTIC DVM V O LU M E 1 1 I S S U E 1

Ferrets As I See Them

OVERVIEW OF ONGOING SCHEDULING

www.exoticdvm.com EXOTIC DVM V O LU M E 1 1 I S S U E 1

Abdominal Abscess in a Rabbit

A 4-year-old male domestic rabbit (Oryctolagus cuniculus)

Fig 1. Fecal pellets at the initial examination were

www.exoticdvm.com EXOTIC DVM V O LU M E 1 1 I S S U E 1

A radiograph taken under physical restraint showed elected exploratory laparotomy.

Abdominal Abscess in a Rabbit

References and Further Reading

www.exoticdvm.com EXOTIC DVM V O LU M E 1 1 I S S U E 1

Fecal Bacteriotherapy for

Clostridial enterotoxemia of rabbits is caused by Clostridium

www.exoticdvm.com EXOTIC DVM V O LU M E 1 1 I S S U E 1

Fecal Bacteriotherapy for Treatment of

www.exoticdvm.com EXOTIC DVM V O LU M E 1 1 I S S U E 1

Discussion sion, volume and frequency of administration and depth

The Helodermatidae family consists of one genus and

Fig 1. Gila monsters are approximately 9-14 inches (23-35 cm) in

www.exoticdvm.com EXOTIC DVM V O LU M E 1 1 I S S U E 1

Ultrasound Imaging of the Reproductive

www.exoticdvm.com EXOTIC DVM V O LU M E 1 1 I S S U E 1

Fig 11. At mid-gestation before calcification of the shells, the eggs

Ultrasonic Features of the Male evaluation of reproductive anatomy in adult Heloder-

Jörg Mayer, DVM, MSc

www.exoticdvm.com EXOTIC DVM V O LU M E 1 1 I S S U E 1