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Evaluation of transcutaneous pulmonoscopy for examination and biopsy of the lungs of ball pythons and determination of preferred biopsy specimen handling and fixation procedures

Scott J. Stahl DVM, DABVP1, Stephen J. Hernandez-Divers BVetMed, DZooMed, DACZM2, Tanya L. Cooper3, and Uriel Blas-Machado DVM, PhD, DACVP4
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  • 1 Stahl Exotic Animal Veterinary Services, 111A Center St S, Vienna, VA 22180.
  • | 2 Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602-7390.
  • | 3 Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602-7390.
  • | 4 Athens Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Georgia, Athens, GA 30602-7390.

Abstract

Objective—To establish a safe and effective technique for the endoscopic examination and biopsy of snake lungs by use of a 2.7-mm rigid endoscope system.

Design—Clinical trial.

Animals—17 adult ball pythons (Python regius).

Procedures—The right lung of each anesthetized snake was transcutaneously penetrated at a predetermined site. Endoscopic lung examination was objectively scored, and 3 lung biopsies were performed. Tissue samples were evaluated histologically for diagnostic quality. One year later, 11 of the 17 snakes again underwent pulmonoscopy and biopsy; specimens were placed in various fixatives to compare preservation quality. All 17 snakes were euthanatized and necropsied.

Results—No major anesthetic, surgical, or biopsy-associated complications were detected in any snake. In 16 of 17 pythons, ease of right lung entry was satisfactory to excellent, and views of the distal portion of the trachea; primary bronchus; intrapulmonary bronchus; cranial lung lobe; and faveolar, semisaccular, and saccular lung regions were considered excellent. In 1 snake, mild hemorrhage caused minor procedural difficulties. After 1 year, pulmonoscopy revealed healing of the previous transcutaneous lung entry and biopsy sites. Important procedure-induced abnormalities were not detected at necropsy. Diagnostic quality of specimens that were shaken from biopsy forceps into physiologic saline (0.9% NaCl) solution before fixation in 2% glutaraldehyde or neutral-buffered 10% formalin was considered good to excellent.

Conclusions and Clinical Relevance—By use of a 2.7-mm rigid endoscope, lung examination and biopsy can be performed safely, swiftly, and with ease in ball pythons. Biopsy specimens obtained during this procedure are suitable for histologic examination.

Abstract

Objective—To establish a safe and effective technique for the endoscopic examination and biopsy of snake lungs by use of a 2.7-mm rigid endoscope system.

Design—Clinical trial.

Animals—17 adult ball pythons (Python regius).

Procedures—The right lung of each anesthetized snake was transcutaneously penetrated at a predetermined site. Endoscopic lung examination was objectively scored, and 3 lung biopsies were performed. Tissue samples were evaluated histologically for diagnostic quality. One year later, 11 of the 17 snakes again underwent pulmonoscopy and biopsy; specimens were placed in various fixatives to compare preservation quality. All 17 snakes were euthanatized and necropsied.

Results—No major anesthetic, surgical, or biopsy-associated complications were detected in any snake. In 16 of 17 pythons, ease of right lung entry was satisfactory to excellent, and views of the distal portion of the trachea; primary bronchus; intrapulmonary bronchus; cranial lung lobe; and faveolar, semisaccular, and saccular lung regions were considered excellent. In 1 snake, mild hemorrhage caused minor procedural difficulties. After 1 year, pulmonoscopy revealed healing of the previous transcutaneous lung entry and biopsy sites. Important procedure-induced abnormalities were not detected at necropsy. Diagnostic quality of specimens that were shaken from biopsy forceps into physiologic saline (0.9% NaCl) solution before fixation in 2% glutaraldehyde or neutral-buffered 10% formalin was considered good to excellent.

Conclusions and Clinical Relevance—By use of a 2.7-mm rigid endoscope, lung examination and biopsy can be performed safely, swiftly, and with ease in ball pythons. Biopsy specimens obtained during this procedure are suitable for histologic examination.

Contributor Notes

The authors thank Lisa Holthaus and Jason Norman for technical assistance and Karl Storz Veterinary Endoscopy America Inc and BAS Vetronics-Bioanalytical Systems Inc for provision of equipment.

Address correspondence to Dr. Hernandez-Divers.