Copy
Having trouble viewing this email? Click here to View in Browser
ARAV News
header-image
ExoticsCon 2015 is DAYS Away, Don’t Miss Out!

The ARAV Program committee is very excited for August 29, the opening day of ExoticsCon in 2015! San Antonio is an exciting and fun destination, and you won’t want to miss a minute. There's still time to register at ExoticsCon.org. Join us and reconnect with your ARAV family. We’ll see y’all in Texas!
 
SATURDAY, AUGUST 29
Preconference Sessions for ARAV, AEMV, and AAV — registration for this focused CE event is still open at ExoticsCon.org
 
SUNDAY, AUGUST 30
ARAV Workshops: some lab places still available. If you're planning to become boarded in reptile medicine through ABVP, you need to take this course. It's only offered every 3-5 years, so register now:: Venomous Snake Handling.
 
Special Session:
ARAV Special Session: The Palawan Forest Turtle Crisis, A Veterinary Perspective 
7:30-9:00 PM Salon M
Interested in conservation or critically endangered species? Want to know how you can help? Come attend our special session of the Palawan turtle crisis that YOU helped with.

MONDAY, AUGUST 31
Opening Reception 5:15 PM – 7:00 PM Exhibit Hall
 
Committee Meetings:
Interested in volunteering with ARAV? Join one or more of the following committee meetings, open to all members and free to attend.
 
7:00 - 8:00 PM:
  • Education Committee - Room 9
  • Legislative & Animal Welfare Committee - Room 10
  • International Committee - Room 8 
7:30 - 9:00 PM
  • Development Committee - Exhibit Hall
8:00 - 9:00 PM:      
  • Membership/PR Committee - Room 8
  • Editorial Board - Room 9
 
TUESDAY, SEPTEMBER 1
Support the ARAV Conservation and Research Fund at our ARAV Silent Auction
8:00 AM - 3:45 PM – Exhibit Hall
 
Infectious Diseases Committee In the ARAV lecture room, Salon AB, 12:00 - 1:00 PM

Zoo Day  and Live Auction at the San Antonio Zoo 3:30 PM - 9:00 PM

WEDNESDAY, SEPTEMBER 2
ARAV Annual Business Meeting 12:30 PM - 1:00 PM
Left Col Image Right Col image
Votes Are In!

Congratulations to the winners of the 2015-2016 ARAV Officers election!

President Elect
Susan Horton, DVM

Vice President
Nicole Johnson, DVM

Secretary
Tim Tristan, DVM DABVP (Reptile/Amphibian)

Members-at-Large
Heather A. Bjornebo, DVM  
Stacey Leonatti Wilkinson, DVM, DABVP (Reptile & Amphibian)

Thank you to all who participated in the election process!
Don’t Miss Out:

ExoticCon 2015 Wet Labs
are Filling Fast

Secure your spot at the Wet Labs at ExoticCon 2015 before they're gone! The Venomous Handling lab, especially, is a rare opportunity only occurring every 3-5 years and necessary for those wishing to sit for the ABVP reptile medicine boards. 

ALL labs are open to veterinarians, veterinary students and technicians. We also have openings in all labs except for Chelonian Shell Repair. 

They are filling up fast, so make sure you register!
 
Silent Auction Needs Your Items and Bids 

One of my favorite breaks in the ExoticsCon conference is the exciting auction. Every year we raise thousands of dollars, which directly fund research to help the species we work with.

We need auction items! Please show your generosity and support this year, not just by bidding high, but sharing something your peers will fight over.

Please contact Nelson Bricker (nbricker@gmail.com) or Kourtney Grimm (kourtneyjgrimm@gmail.com) with your items you plan to bring, or for information on how to ship them ahead of time. Thank you ahead of time for your support, and see you in Texas!
Feeling Bloated?: Hydrops and Hydrocoelom in a Green Frog

Signalment
Green Frog (Rana clamitans), male, approximately 2 years old
 
History
An approximately 2-year-old male, wild-caught Green Frog was presented for a 1-week history of generalized swelling and a 1-day history of anorexia. He was housed alone in a 20-gallon tank with 50% of the tank containing water, a stone substrate, a hide box and fake branches. The temperature was maintained at 75 degrees F, with a room humidifier and heater. A canister was used to filter the water, and the water was changed monthly with tap water. The daily diet consisted of crickets and a multivitamin.
 
Physical exam
On physical exam, the frog was quiet, alert and responsive. The coelom and hind limbs were swollen and edematous, and transillumination of the coelom revealed no abnormalities. The eyes were clear, though there were erythematous abrasions on the skin, just ventral to both eyes, and a bloody discharge from the left naris. Oral examination revealed swelling of the dorsal aspect of the mouth, located just ventral to the eyes. The frog was able to ambulate on all four limbs, though there were noticeable musculoskeletal deformities of the long bones, which were softened and mildly rubbery on palpation. A 1 cm diameter, dark red swelling was present around the dorsal aspect of the cloaca. 

Differential Diagnoses
Initial differential diagnoses for hydrocoelom and hydrops included renal failure, lymph heart failure and hepatic disease. The underlying etiologies of these organ failures vary and may include bacterial (Mycobacterium) or fungal infections (Batrachochytrium dendrobatidis) that are often secondary due to poor husbandry, malnutrition leading to immunosuppression or hypoproteinemia, osmotic imbalances and hypocalcemia, which can lead to decreased function of the lymph hearts. Differential diagnoses for the musculoskeletal abnormalities and the mass in the region of the cloaca included metabolic bone disease and cloacal prolapse, respectively.
 
Diagnostics
It was decided that we would drain the subcutaneous and intracoelomic fluid and analyze it via cytology and refractometry. On presentation, the frog was 145 g. Celiocentesis was performed with a 25-gauge butterfly needle attached to a 6 cc syringe. Prior to puncturing the skin, the coelom was transilluminated in order to identify and avoid any organs or blood vessels, and 29 mL were aspirated. The same procedure was repeated for the right and left hind limbs, which yielded a total of 27 mL. A total of 56 mL of a serosanguinous fluid were removed from the frog to yield a new body weight of 89 g. The total protein of the fluid was 0.2 g/dL. Direct microscopic examination and a diff-quick stain of the coelomic fluid revealed 3+ erythrocytes. A Gram stain did not reveal any bacteria, though there was a moderate amount of proteinaceous debris.   
 
A ventrodorsal whole body radiograph was taken after the 56 mL were aspirated from the frog. The results of the radiograph revealed an increased soft tissue/fluid opacity of the thorax and hind limbs. The lung fields appeared to be clear, though, perhaps, mildly decreased in size. There was generalized decreased bone density of the long bones, and both humeri were bowed. There was no foreign body or mass observed during evaluation of the coelom.


Treatment
The frog was hospitalized and provided with earthworms overnight after receiving one subcutaneous injection of 8.9 mg calcium gluconate. Treatments during hospitalization included 8.9 mg calcium glubionate PO once daily, 1-2 drops of tobramycin ophthalmic solution applied topically to the skin once daily, and a 10-minute soak in amphibian ringer’s solution once daily (1 part LRS to 2 parts 0.45% saline + 2.5% dextrose). The frog was sent home the next day with instructions to continue applying 1-2 drops of tobramycin ophthalmic solution once daily topically to the skin for 21 days, 0.09 mL calcium glubionate (2.07 mg elemental calcium) PO once daily for 21 days, 8 mg piperacillin IM once daily for 14 days, and to return for a recheck in 21 days. Recommendations for husbandry were also made and included:
  • 10 minutes of supervised exposure to sunlight when temperature permits using dechlorinated tap water for 25% water changes;
  • removal of pebbles from the tank to decrease bacterial load and the possibility of ingestion;
  • wearing gloves during handling;
  • adding a 10.0 UVB light bulb; and
  • improving his diet by adding earthworms dusted three times weekly with calcium powder and once weekly with a multivitamin.
Follow up
One week after initial presentation, the frog returned for a recheck appointment. Over the previous week, the generalized edema improved, although the hind limbs continued to remain more swollen than normal. Several days after the frog was sent home, aquarium salt was added to his water, but when a color change of the ventral surface of the frog was noticed, the water was switched to distilled water. In addition, the owners were syringe feeding the frog because he still had a decreased appetite. On examination, the 61 g frog was much improved with regards to the cloacal swelling, the abrasion ventral to his left eye was healing, his left naris was no longer bleeding, and there was only moderate edema of the hind limbs. However, there were multiple areas of the skin that had a gray discoloration with petechiation (ventral abdomen, ventral femoral region, lateral carpi) suggestive of chemical burns that were likely due to being soaked in salt water and distilled water. The owners were warned that while the skin may heal, it could also potentially become necrotic and slough. The frog was sent home with instructions to soak 10-15 minutes once daily in amphibian ringer’s solution for the next two weeks, to syringe feed an insectivore supportive diet as needed, to continue administering the previously prescribed medications, and to return for a recheck in 14 days. 
 
References
Mader, DR. Reptile Medicine and Surgery. 2nd ed. St. Louis: Saunders Elsevier, 2006.
Wright, Kevin M. and Brent R. Whitaker. Amphibian Medicine and Captive Husbandry. Malabar: Krieger Publishing Company, 2001.
 
Amanda Igeta, Colorado State University, DVM Candidate 2016
Time for Herp Trivia

Every month the wonderful folks at AVTCP send us trivia questions to help technicians study for their Exotic Companion Animal specialization. If you, or a technician you work with, are interested in this specialization, take a moment to read through their website at www.avtcp.org. They have a wonderful mentor program to help technicians every step of the way.
 
Which of the following lizards does not possess a urinary bladder?
1.  Jackson’s Chameleon (Trioceros jacksonii)
2.  Water Monitor (Varanus salvator)
3.  Leopard Gecko (Eublephars macularius)
4.  Green Iguana (Iguana iguana)
 
Which of the following chelonian species should NOT hibernate during the winter months?
1.  Eastern Box Turtle (Terrapene Carolina)
2.  California Desert Tortoise (Gopherus agassizii)
3.  Red Foot Tortoise (Geochelone carbonaria)
4.  Red Eared Slider (Trachemys scripta elegans)

Answers: 2, 3
Committee Corner

This is a new feature where we'll have updates from our committees. If you'd like to volunteer for a committee, e-mail Erica Mede at e.medecvt@gmail.com and she'll put you in contact with the head of that committee.
 
Journal of Herpetological Medicine and Surgery
The latest addition of the journal is live online. Sign in to read about:
  • A tribute to Wilbur B. Amand
  • A review of recent infectious disease articles in scientific literature as compiled by our own Infectious Disease  Committee
  • Case reports on a Veiled chameleon, Peron’s Tree Frog, and soil mites as a biological control agent for acariasis in lizards
  • Original research on seroprevalence of Leptospira in Blanding’s turtles, detection of bacteria in oral swabs of Common Musk turtles, oral bacterial microflora in pythons, criticism over the intraosseous route for Testudines, and parasitic enteritis in wild invasive turtles
  • Meeting announcements and other ARAV breaking news
Membership and Public Relations Committee
We're proud to announce that the edited care sheets for clients, and our edited Exotic DVM teaching material on iguana surgery, will be out very soon! Thank you so much for those volunteering to help edit.
 
Conservation and Research Committee
The ARAV Research and Conservation Research Grant application deadline is approaching on September 1st. Get the details. 
 
Infectious Disease Committee
The ARAV Infectious Diseases Committee has put together a new list of peer-reviewed publications on infectious agents in amphibians and reptiles that were published between January and June, 2015. You can find the new lists with the exciting information on newly discovered pathogens and news on efficacy of treatments, diagnostics, disease prevalence, immunology and much more in the next issue of the Journal of Herpetological Medicine and Surgery and on the ARAV website.
ARAV Awesomeness

Running through the airport? Afraid you won’t remember which bag is yours? We all have that worry — but luckily ARAV has a custom duffel bag! You never have to worry about losing or confusing your carry on again. :-)

Shop Now
header-image
Case of the Month

This month’s case is from Emily McConnelly. A 12-year-old male northern diamond back terrapin presented to me yesterday for non-progressive, left stifle swelling of approximately 4 months duration (owners noted it on return from vacation in January). It does not interfere with his swimming, but he does move that leg with more effort when taken out of water. Appetite and activity remain excellent. He is a wild caught specimen, housed alone in a 75-gallon tank with basking area. Housing temperatures and diet are appropriate, but I recommended increasing the frequency of water changes (monthly now, with filtration present).

During the physical exam, the terrapin as bright, alert and active. The limb swelling was bi-lobed and fluctuant. Radiographic results showed soft tissue swelling associated with the left stifle. When I aspirated the swelling in two sites, only blood was collected. One aspirate site continued to hemorrhage for approximately one hour post-aspirate, despite the owner applying pressure at home. The bleeding stopped after application of tissue glue. The swelling associated with the left stifle had markedly increased in size since the aspirate, according to the owner.

Any thoughts on what this might be? Am I reasonable to assume I should have aspirated crystalline material if this was gout, or inflammatory cells if infectious? At this time the owner is continuing to monitor the swelling. I am not inclined to biopsy what appears to be a blood filled pocket or a very vascular mass, but I am open to ideas. This terrapin also had some interesting chronic shell changes that have been present for years. The owner reported a previous infection.
 
Ken Harkewicz observed that this could be a possible infection and/or articular gout. A blood panel was recommended and a water quality check, including a determining salinity due to the condition of the shell. Ken noted that a species such as this requires brackish water for optimal health. Nelson Bricker recommended a culture of aspirated fluids despite the blood being the only fluid withdrawn. Nelson theorized that there may be infectious material still within the aspirate and should be evaluated. Adolf Maas and Harkewicz both felt that a fine needle aspirate of the leg alone would not yield conclusive results and recommended instead a wedge biopsy with a local anesthetic. 
 
McConnelly updated the case stating that the water was indeed brackish and water quality was within normal limits. McConnelly voiced concerns regarding hemorrhage after a biopsy, since there was hemorrhage and increased swelling after a fine needle aspirate. Harkewicz and Maas noted that they had very little bleeding involved with biopsies and reminded McConnelly that reptiles have thromboplastin, not platelets, which causes reptiles to bleed more when clean, sharp incisions are made. Gentle crushing of peripheral tissue with a hemostat helps release thromboplastin and encourages hemostasis. 

The plasma biochemical panel came back essentially within normal limits, except for slight, but regenerative, anemia (18% PCV) with immature reticulocytes. 
 
A biopsy was scheduled, but was not performed, as the specialist to which the patient was referred did not feel comfortable with the patient having anemia. The terrapin was administered enrofloxacin and meloxicam orally and passed away at home. Neither McConnelly, nor the specialist, were able to perform a necropsy.
 
Summary: The Diamond back terrapin presented with a mass associated with the left stifle. Differential diagnoses included articular gout, vascular neoplasia, and an abscess. A plasma biochemical panel yielded only a low hematocrit of 18%. A normal range can be extrapolated from Carpenter’s 4th Edition Exotic Animal Formulary using the hematocrit values of Trachemys scripta and Chrysemys picta. With this in mind, it is suspected that the normal range may be 24-33%. A bacterial culture was not performed on the aspirate sample, which bled steadily for an hour despite application of pressure. A biopsy was scheduled, but not performed. The patient was administered oral enrofloxacin and meloxicam by a different veterinarian. Oral medications in chelonians take longer to reach appropriate therapeutic levels. Although no dosage was given in this report, the typical dosages are generally 0.50 mg/kg orally for meloxicam and 5-10 mg/kg orally for enrofloxacin according to Carpenter’s formulary. No necropsy or final diagnosis was determined.