Gastrointestinal system

image of Gastrointestinal system
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Diagnosis and treatment of gastrointestinal disease in reptiles can be challenging due to the huge anatomical and physiological diversity between species. A thorough and systematic approach to cases is essential. This chapter describes the clinical approach to gastrointestinal problems, and considers a range of diseases by region.

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17.1 Oxyurid ovum (top) and cyst (bottom) on a wet preparation from a Mediterranean spur-thighed tortoise; X400.
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17.2 Radiological contrast study in a black marsh turtle. (a) Plain dorsoventral radiograph; (b) following administration of 10 ml/kg barium sulphate (70% w/v) at 0–1 hour; (c) at 24 hours; (d) at 48 hours; and (e) at 72 hours. (a) A small volume of gas within the stomach is a normal finding in most chelonians. (b) Administration via gastric lavage provides clear delineation of the stomach (some contrast is also apparent within the distal oesophagus and small intestine). (e) After 72 hours the contrast agent is seen entirely within the colon. The contrast agent was voided after a further 72 hours. (Courtesy of Bristol Zoo Gardens)
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17.4 Overgrowth of the rhinotheca in a Mediterranean spur-thighed tortoise. (Courtesy of Norfolk Tortoise Club)
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17.5 Overgrowth of the gnathotheca in a Horsfield’s tortoise. (Courtesy of Norfolk Tortoise Club)
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17.6 Lateral and rostral views of (a–b) a spur-thighed tortoise and (c–d) a red-eared terrapin, showing normal beak anatomy. Note that marked differences in normal beak anatomy occur between chelonian species, so literature review before corrective trimming is advised. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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17.7 A bearded dragon displaying discoloration of the mandibular teeth, calculus build-up and gingival recession.
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17.8 An Asian water dragon displaying advanced periodontal disease; marked gingival recession, loss of teeth, and missing sections of the maxillary and mandibular bone are noted.
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17.9 Mild rostral abrasions in an Asian water dragon affecting the rostral maxilla and mandible. At this stage, management changes alone may be sufficient in preventing further progression.
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17.10 Left-sided facial swelling in a reticulated python. Inflammation and secondary infection resulted from repeated trauma on the vivarium glass wall.
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17.11 (a) Visceral gout in a corn snake, confirmed by microscopy of fine-needle aspirates; (b) numerous rectangular monosodium urate crystals (arrowed) are evident.
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17.12 Tongue paresis in a panther chameleon due to nutritional secondary hyperparathyroidism.
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17.13 (a) A wild common snapping turtle presented with fishing tackle protruding from the mouth. (b) Dorsoventral radiography confirms the presence of two fishing hooks; one in the cranial and one in the caudal oesophagus. Both were removed using oral endoscopy under anaesthesia. (Courtesy of Wildlife Center of Virginia)
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17.14 Oesophageal endoscopy of a common snapping turtle performed under sedation; a plastic syringe case is used as an oral gag to prevent damage to the scope. (Courtesy of Wildlife Center of Virginia)
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17.15 A Mediterranean spur-thighed tortoise with severe external and internal trauma, having been hit by a car. Gastric rupture was identified and partial gastrectomy (30%) was required prior to repair of the carapace. An oesophagostomy tube was placed to facilitate fluid and nutritional support. The tortoise went on to make a full recovery.
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17.17 Cloacal prolapse in an Oustalet’s chameleon secondary to hepatomegaly; the prolapsed structure is shiny, pink and has a lumen containing faecal material, consistent with prolapse of the colon. (Courtesy of A. Barratclough, Lowry Park Zoo)
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17.18 Prolapse of the colon secondary to heavy oxyurid burden in a bearded dragon; prolapsed tissues were replaced through the cloaca without coeliotomy.
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17.19 (a) Dorsoventral and (b) lateral radiographs of a Mediterranean spur-thighed tortoise with extensive cloacal prolapse. A single oversized egg causing obstructive dystocia is evident and required coeliotomy for removal. Prolapsed tissues were replaced during the same procedure.
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17.20 A bearded dragon with colon prolapse; tissues appear discoloured, oedematous and contaminated with substrate material. Owing to concerns regarding tissue viability, coeliotomy for partial enterectomy with end-to-end anastomosis was performed.
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17.22 Dorsoventral radiograph of a kingsnake showing constipation secondary to gravidity.
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17.23 Dorsoventral radiograph of a leopard gecko showing radiodense (mineral opacity) material within the mid to caudal coelom, consistent with a sand substrate impaction.
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17.24 (a) A wild black ratsnake presented with a mid-body focal swelling. Radiography confirmed a spherical mineral opacity within the intestinal tract. (b) Coeliotomy for enterotomy was performed, and (c) a golf ball removed. While foreign body ingestion is uncommon in captive snakes this case is not isolated in wild snakes, which presumably perceive these objects to be eggs, which form part of their natural diet. (Courtesy of Wildlife Center of Virginia)
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17.25 Intussusception in a bearded dragon secondary to obstruction caused by a gastrointestinal foreign body.
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17.27 Transillumination to visualize the hepatic silhouette in a leopard gecko.
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17.28 The liver of a female bearded dragon with preovulatory follicular stasis, showing the typical appearance of hepatic lipidosis.
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17.30 Cheilitis caused by infection in a Saharan spiny-tailed lizard.
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17.32 sp. on a wet preparation from a green tree python; X400.
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17.33 Sporulated coccidian ( sp.) on a direct wet preparation from a veiled chameleon; X400.
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17.34 A leopard gecko with cachexia due to cryptosporidiosis; note loss of epaxial musculature and tail fat stores.
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17.35 Hand-feeding anorexic tortoises may encourage appetite.
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17.36 An African spurred tortoise with an oesophagostomy tube; the tube is taped along the ventral rim of the cranial carapace and then over the dorsum so as to prevent removal with the forelimbs.
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