To evaluate the prognostic value of PCV and blood glucose concentration in chelonians presented for veterinary care and to develop risk categories on the basis of the interaction of these analytes.
954 client-owned chelonians (34 genera).
Medical records of 1,059 client-owned chelonians presented to 2 veterinary institutions between 2014 and 2018 were reviewed. Logistic regression models were developed to evaluate factors associated with death, including PCV and blood glucose concentrations.
There were 954 chelonians (34 genera) for which the data required to be included in the analysis were available. Both PCV and blood glucose concentration were significant prognostic indicators of death. Odds of death for chelonians with severe anemia (PCV, < 10%) and moderate anemia (PCV, 11% to 20%) were 6.8 times (adjusted odds ratio [aOR], 6.8; 95% CI, 3.8 to 12.3) and 1.6 times (aOR, 1.6; 95% CI, 1.01 to 2.7), respectively, the odds of death for chelonians with PCV within reference range. Odds of death for chelonians with severe hypoglycemia (< 30 mg/dL), moderate hyperglycemia (91 to 150 mg/dL), and severe hyperglycemia (> 181 mg/dL) were 5.3 times (aOR, 5.3; 95% CI; 2.4 to 11.4), 3 times (aOR, 3.0;95% CI, 1.4 to 6.3), and 4.3 times (aOR, 4.3; 95% CI, 2.4 to 7.6), respectively, the odds of death for chelonians with blood glucose concentration within reference range. Five risk categories were identified on the basis of PCV and blood glucose concentration.
CONCLUSIONS AND CLINICAL RELEVANCE
Derangements in PCV and blood glucose concentration in client-owned chelonians were associated with increased odds of death. On the basis of these results, more aggressive diagnostic testing and treatments may be indicated in chelonians with similar alterations.
A 75-g (2.65-oz) posthatchling Hermann's tortoise (Testudo hermanni) was examined 3 days after being found in a public park. The tortoise was unable to move and had not urinated or defecated during the last 3 days. The prefemoral fossae were swollen, and the hind limbs lacked voluntary movement. On physical examination, the tortoise had open-mouth breathing and a partially healed lesion on the fourth vertebral scute. Survey radiography revealed a coelomic homogeneous soft tissue opacity. To better define the location of the gastrointestinal tract, radiographs were obtained after oral administration of iopamidol (Figure 1).
Objective—To determine whether face mask fit during anesthesia affects the occurrence of fire episodes during laser surgery in nonintubated cadaveric rodents under volatile anesthesia.
Design—Adaptive single-center randomized controlled trial with an interim analysis.
Sample—100 dead rats intended for animal consumption.
Procedures—Rat carcasses were randomly allocated to undergo simulated anesthetic procedures with 2 face masks: open mask versus tight-fitting mask. Under volatile anesthesia, 4 cutaneous surgeries were performed (skin biopsies at 3 different sites and resection of a pinna) by means of a diode laser on each carcass. A single interim analysis of 50 rats was planned a priori to drop an arm of the study in the case of a highly significant difference in the incidence of fire events. Surgeries would have continued with the other face mask until completion of the study. Univariate and multivariate analyses were performed.
Results—Overall, 25 surgeries were performed with open face masks and 75 with tight-fitting masks. During 400 surgical procedures on 100 rat carcasses, 11 (11%; 95% confidence interval, 5.62% to 18.83%) fire events occurred. Ten fire events occurred with the open masks, and 1 fire event occurred with the tight-fitting masks (relative risk, 30.0; 95% confidence interval, 4.0 to 222.8). All of the fire events occurred on different carcasses when cheek skin biopsy was performed. Procedure time, body weight, and surgeon did not significantly concur in the prediction of fire events.
Conclusions and Clinical Relevance—Modification of open masks by the addition of a latex diaphragm significantly reduced the occurrence of fire ignition during laser surgery. Results suggested that open masks should not be used for laser surgery of nonintubated rodents during volatile anesthesia. Additionally, results indicated that surgical lasers should be avoided for facial surgery of nonintubated anesthetized rodents, even if tight-fitting masks are used. (J Am Vet Med Assoc 2015;246:639–644)
Objective—To determine the effect of various UVB radiation sources on plasma 25-hydroxyvitamin D3 concentrations in Hermann's tortoises (Testudo hermanni).
Animals—18 healthy Hermann's tortoises.
Procedures—Tortoises were exposed to sunlight in an outdoor enclosure located in the natural geographic range of Hermann's tortoises (n = 6 tortoises) or a self-ballasted mercury-vapor lamp (6) or fluorescent UVB-emitting lamp (6) in an indoor enclosure for 35 days. Plasma samples were obtained from each tortoise on the first (day 0) and last (day 35) days of the study, and concentrations of 25-hydroxyvitamin D3 were determined. Amount of UVB radiation in enclosures was measured.
Results—Mean ± SD plasma 25-hydroxyvitamin D3 concentrations for tortoises exposed to the mercury-vapor and fluorescent lamps were significantly lower on day 35 (155.69 ± 80.71 nmol/L and 134.42 ± 51.42 nmol/L, respectively) than they were on day 0 (368.02 ± 119.34 nmol/L and 313.69 ± 109.54 nmol/L, respectively). Mean ± SD plasma 25-hydroxyvitamin D3 concentration for tortoises exposed to sunlight did not differ significantly between days 0 (387.74 ± 114.56 nmol/L) and 35 (411.51 ± 189.75 nmol/L). Mean day 35 plasma 25-hydroxyvitamin D3 concentration was significantly higher for tortoises exposed to sunlight versus those exposed to mercury-vapor or fluorescent lamps. Sunlight provided significantly more UVB radiation than did the mercury-vapor or fluorescent lamps.
Conclusions and Clinical Relevance—Plasma 25-hydroxyvitamin D3 concentrations differed between tortoises exposed to sunlight and those exposed to artificial UVB sources. Exposure to sunlight at a latitude similar to that of the natural geographic range is recommended for healthy and calcium-deficient tortoises.
To determine (1) the relationship, (2) the difference, and (3) the diagnostic discordance between blood total calcium concentration (tCa) and ionized calcium concentration (iCa) in a population of client-owned chelonian patients.
Results for tCa, iCa, and other variables were extracted from records. Bound calcium concentration (tCa – iCa) was calculated. General linear models were developed to evaluate factors affecting tCa, iCa and bound calcium concentrations. Diagnostic discordance between tCa and iCa was assessed.
iCa decreased with increasing albumin concentration, it was not influenced by sex, and it was lower in chelonians with disorders of the reproductive tract than in those with disorders of the endocrine/hemopoietic and urinary systems. Total calcium and bound calcium concentrations increased with increasing albumin concentration; they were higher in females and in chelonians with disorders of the reproductive tract. Of the 161 chelonians, 93 (57.7%; 95% CI, 49.7% to 65.5%) would have had a different diagnosis of calcium status based on tCa and iCa results (ie, diagnostic discordance). A 2.2 mmol/L cutoff value for bound calcium could differentiate chelonians with and without disorders of the reproductive tract with a sensitivity (95% CI) of 81.8% (64.5% to 93.0%) and specificity of 76.4% (68.0% to 83.5%).
tCa and iCa were related and were associated with albumin concentrations in chelonians. Evaluation of tCa or iCa alone is likely to result in underdiagnosis of alterations of the calcium status. Calculation of bound calcium concentration could help identify chelonians with reproductive disorders.
Objective—To describe a noninvasive technique for sex identification of posthatchling chelonians and to assess its safety in Hermann's tortoises (Testudo hermanni).
Design—Validation study and clinical trial.
Animals—15 recently dead posthachling chelonians and 25 healthy posthatchling Hermann's tortoises.
Procedures—Cystoscopy was performed on both dead and anesthetized live chelonians. Dead chelonians ranged in body weight from 32.4 to 75.1 g (0.07 to 0.17 lb; median, 45.7 g [0.10 lb]). Dead chelonians were dissected immediately after cystoscopy, and gonads were collected for histologic examination. Urinary bladder was macroscopically evaluated in situ to assess its integrity after retrograde injection of saline (0.9% NaCl) solution. Hermann's tortoises ranged in body weight from 27.3 to 57.8 g (0.06 to 0.13 lb; median, 37.0 g [0.08 lb]). Cystoscopic examination of live tortoises was performed following induction of general anesthesia with a mixture of morphine, dexmedetomidine, and ketamine administered IM. The Pearson coefficient was used to assess the consistency between procedure time and body weight; κ statistic was used to evaluate agreement between sex identified by cystoscopy and histologic examination beyond that expected by mere chance.
Results—Visualization of gonads was feasible through the thin, transparent urinary bladder wall in all the animals evaluated in this study. Blinded histologic examination confirmed the results of cystoscopic gonad identification in all dead chelonians (κ = 1.0). The urinary bladder did not have evidence of macroscopic leakage or microscopic alterations of normal tissue architecture within the representative sections chosen for histologic examination. In live tortoises, median procedure time (range) was 90 (39 to 345) seconds. No significant correlations were found between procedure time and body weight.
Conclusions and Clinical Relevance—Cystoscopy performed by means of rigid endoscopy with fluid instillation was found to be an effective method for sex identification of immature chelonians. Furthermore, no complications were observed when this procedure was performed in vivo.
OBJECTIVE To determine whether rectal temperature at hospital admission, independently or in conjunction with other parameters, was associated with all-cause mortality in client-owned rabbits.
DESIGN Prospective cohort study.
ANIMALS 316 client-owned rabbits consecutively hospitalized in an exotics-only animal hospital.
PROCEDURES Rectal temperature of each hospitalized rabbit was measured at admission. Individual variables, including survival up to 1 week after hospital discharge, were recorded. Univariate, multivariate, and sensitivity analyses were performed.
RESULTS Rabbits with hypothermia at admission had a risk of death before or within 1 week after hospital discharge 3 times that of rabbits without hypothermia (relative risk, 3.09; 95% confidence interval, 2.17 to 4.39). For each 1°C (1.8°F) decrease in admission rectal temperature, the odds of death were doubled (OR, 2.11; 95% confidence interval, 1.69 to 2.64). Sensitivity analyses confirmed the robustness of the finding. Older age, suspected presence of a systemic disease, and presence of gastrointestinal stasis were also significantly associated with an increased risk of death.
CONCLUSIONS AND CLINICAL RELEVANCE Rectal temperature was easily measured in rabbits and was a major predictor of death in the present patient cohort. Because of its association with death in both healthy and diseased rabbits in this study, rectal temperature should always be measured during physical examination of rabbits. Treatment of hypothermia in client-owned rabbits requires further research.
OBJECTIVE To determine the prognostic relevance of BUN concentration in client-owned rabbits evaluated at a veterinary referral center.
ANIMALS 246 healthy or clinically ill client-owned rabbits with BUN concentrations measured at a veterinary referral center.
PROCEDURES In a retrospective cohort study design, medical records of rabbits were retrieved, and data were collected on BUN concentration (exposure variable of interest) and other variables, including outcome (survival status at 15 days after BUN concentration measurement). Univariate, multivariate, and subgroup analyses were performed to identify variables associated with outcome.
RESULTS BUN concentrations ranged from 6.5 to 251.1 mg/dL (median, 18.7 mg/dL). Univariate analysis revealed that the risk of nonsurvival over the 15-day period for rabbits with a high BUN concentration (≥ 23.3 mg/dL) was 33% higher (relative risk, 1.33; 95% confidence interval [CI], 1.06 to 1.69) than that for rabbits with unremarkable BUN values. Subgroup analysis revealed that for rabbits with anorexia, a high (vs unremarkable) BUN concentration was associated with an increased risk of nonsurvival (relative risk, 1.69; 95% CI, 1.05 to 2.71). In the final multivariate model that controlled for age, sex, and appetite (anorexia vs no anorexia), the odds of nonsurvival for rabbits with BUN values > 24.74 mg/dL were 3 times that for rabbits with BUN values < 14.00 mg/dL (OR, 2.92; 95% CI, 1.29 to 6.58).
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that a high BUN concentration increased the risk of nonsurvival over a 15-day period for client-owned rabbits, particularly those with anorexia. Blood urea nitrogen concentration should be used together with other clinical indicators to provide prognostic information for rabbits receiving veterinary care.
OBJECTIVE To investigate the performance of a portable blood glucose meter (PBGM) designed for use in humans (hPBGM) and a PBGM designed for use in dogs and cats (vPBGM) when measuring blood glucose (BG) concentration in tigers (Panthera tigris) and lions (Panthera leo).
DESIGN Method comparison and diagnostic accuracy study.
SAMPLES 53 blood samples from tigers (n = 27) and lions (26).
PROCEDURES BG concentration was measured with 2 identical hPBGMs, 2 identical vPBGMs, and a reference laboratory analyzer. Bland-Altman bias plots and Passing-Bablok regression analysis were used to assess agreement. Sensitivity, specificity, and positive and negative predictive values with corresponding 95% confidence intervals were calculated for use in assessing diagnostic accuracy of the investigated PBGMs.
RESULTS Bias (95% limits of agreement) was −4.3 mg/dL (−46.3 to 37.6 mg/dL) for the hPBGM, −9.3 mg/dL (−64.6 to 46.0 mg/dL) for the vPBGM on canine setting, and 2.3 mg/dL (−47.9 to 52.6 mg/dL) for the vPBGM on feline setting. The hPBGM had better overall repeatability (coefficient of variation, 3.73%) than the vPBGM on canine (9.29%) or feline (9.44%) setting. Total error for the hPBGM, vPBGM on canine setting, and vPBGM on feline setting was 11.8%, 27.7%, and 20.9%, respectively. None of the PBGMs complied with the maximum allowable total error suggested by current guidelines when measuring BG in tigers and lions with hypo-, normo-, or hyperglycemia.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that the PBGMs evaluated were inadequate for measuring BG concentration in tigers and lions.
Objective—To evaluate performance of a human portable blood glucose meter (PBGM), a veterinary PBGM, and a veterinary benchtop analyzer for measuring blood glucose concentration in rabbits and to evaluate the effect of sample characteristics on their performance.
Procedures—Blood glucose concentration was measured with a human PBGM (n = 89 rabbits), a veterinary PBGM (89), and a benchtop analyzer (32) and compared with results obtained with plasma in a laboratory analyzer (hexokinase method).
Results—The human PBGM underestimated blood glucose concentration, had decreased accuracy at high Hcts, and had the lowest total error observed (11.4%). The veterinary PBGM overestimated blood glucose concentration, had decreased accuracy at low Hcts and at high blood glucose concentrations, and had the highest total error (15.5% and 29.8% for canine and feline settings, respectively). The benchtop analyzer had good accuracy and was not influenced by Hct or glucose concentrations. Clinical errors would have occurred in 0% of cases with the human PBGM and with the benchtop analyzer and in 9% (canine setting) to 6.7% (feline setting) of cases with the veterinary PBGM.
Conclusions and Clinical Relevance—Results suggested that use of the human PBGM evaluated in this study would be acceptable for point-of-care testing of blood glucose concentration in rabbits when benchtop analyzers are not available. The use of the veterinary PBGM evaluated in this study may alter both treatment and diagnostic decisions because of the overestimation of glucose concentrations in some rabbits.