Metabolic diseases - Faculty of Veterinary Medicine
Metabolic diseases - Faculty of Veterinary Medicine
Metabolic diseases - Faculty of Veterinary Medicine
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<strong>Metabolic</strong> <strong>diseases</strong> in reptiles<br />
univ. pr<strong>of</strong>. Zdenek denek Knotek, Knotek,<br />
DVM, PhD<br />
University <strong>of</strong> <strong>Veterinary</strong> and Pharmaceutical Sciences Brno<br />
Czech Republic
Common <strong>diseases</strong><br />
Selected <strong>diseases</strong><br />
3. disorders related to management<br />
5. disorders related to nutrition
Energy<br />
Physiology - metabolism<br />
poikilotherms (fishes, amphibians)<br />
ectotherms (reptiles)<br />
homeotherms (birds, mammals)<br />
reptiles<br />
POTZ<br />
energy 1/8 (<strong>of</strong> mammals), anaerobic<br />
glycolysis<br />
periferal gluconeogenesis
Metabolisms – body weight<br />
Stevens a Hume (1995)
Metabolism – body weight<br />
Stevens a Hume (1995)
Metabolism – body temperature<br />
Stevens a Hume (1995)
Metabolizmus – potřeba kyslíku<br />
Stevens a Hume (1995)
Physiology<br />
herbivors, insectivors, carnivors (specialists)
Temperature ( °C) Transit time Reference<br />
GIT motility<br />
Transit time<br />
Stevens a Hume (1995)
Energy<br />
ektotherm species<br />
Reptilian physiology<br />
prefered optimum for temperature<br />
hyperthemia and behavioral hyperthermia<br />
energy - 1/8 (in comparison with mammals), anaerobic glycolysis<br />
peripheral gluconeogenesis<br />
Respiration and oxygen consumption<br />
lungs, skin, special organs (turtles)<br />
tolerance to limited oxygen in tissues<br />
Food, nutrition, metabolism<br />
herbivores, insectivores, carnivores<br />
Excretion<br />
urea, amonium, uric acid<br />
kidney x urinary bladder<br />
Reproduction<br />
oviparous reptiles, viviparous reptiles
Energy<br />
ektotherm species<br />
Reptilian physiology<br />
prefered optimum for temperature<br />
hyperthemia and behavioral hyperthermia<br />
energy - 1/8 (in comparison with mammals), anaerobic glycolysis<br />
peripheral gluconeogenesis<br />
Respiration and oxygen consumption<br />
lungs, skin, special organs (turtles)<br />
tolerance to limited oxygen in tissues<br />
Food, nutrition, metabolism<br />
herbivores, insectivores, carnivores<br />
Excretion<br />
urea, amonium, uric acid<br />
kidney x urinary bladder<br />
Reproduction<br />
oviparous reptiles, viviparous reptiles
Energy<br />
ektotherm species<br />
Reptilian physiology<br />
prefered optimum for temperature<br />
hyperthemia and behavioral hyperthermia<br />
energy - 1/8 (in comparison with mammals), anaerobic glycolysis<br />
peripheral gluconeogenesis<br />
Respiration and oxygen consumption<br />
lungs, skin, special organs (turtles)<br />
tolerance to limited oxygen in tissues<br />
Food, nutrition, metabolism<br />
herbivores, insectivores, carnivores<br />
Excretion<br />
urea, amonium, uric acid<br />
kidney x urinary bladder<br />
Reproduction<br />
oviparous reptiles, viviparous reptiles
Energy<br />
ektotherm species<br />
Reptilian physiology<br />
prefered optimum for temperature<br />
hyperthemia and behavioral hyperthermia<br />
energy - 1/8 (in comparison with mammals), anaerobic glycolysis<br />
peripheral gluconeogenesis<br />
Respiration and oxygen consumption<br />
lungs, skin, special organs (turtles)<br />
tolerance to limited oxygen in tissues<br />
Food, nutrition, metabolism<br />
herbivores, insectivores, carnivores<br />
Excretion<br />
urea, amonium, uric acid<br />
kidney x urinary bladder<br />
Reproduction<br />
oviparous reptiles, viviparous reptiles
Energy<br />
ektotherm species<br />
Reptilian physiology<br />
prefered optimum for temperature<br />
hyperthemia and behavioral hyperthermia<br />
energy - 1/8 (in comparison with mammals), anaerobic glycolysis<br />
peripheral gluconeogenesis<br />
Respiration and oxygen consumption<br />
lungs, skin, special organs (turtles)<br />
tolerance to limited oxygen in tissues<br />
Food, nutrition, metabolism<br />
herbivores, insectivores, carnivores<br />
Excretion<br />
urea, amonium, uric acid<br />
kidney x urinary bladder<br />
Reproduction<br />
oviparous reptiles, viviparous reptiles
Blood biochemistry<br />
Plasma x serum ???<br />
Biochemistry <strong>of</strong> urine<br />
pH, SG, minerals, proteins<br />
Biochemistry <strong>of</strong> different tissues<br />
enzymes – liver, kidney,muscles
Blood biochemistry<br />
Plasma x serum<br />
Plasma<br />
- volume <strong>of</strong> the fluid for analyses<br />
- short time, quicker – no time necessary for clothing<br />
- in comparison with the serum the concentration <strong>of</strong><br />
plasma proteins could be higher (fibrinogen)
Plasma biochemistry – external and internal factors<br />
venipuncture<br />
hemolysis, low K concentration, high concentration <strong>of</strong> heparin<br />
anorexia (reptiles : birds : mammals) x postprandial values<br />
uric acid, bile acids<br />
circadian x circanual differences<br />
gender (hormones, reproduction)<br />
CB, cholesterol, TAG, Ca<br />
methods used in the laboratory<br />
TP: biurett method x refractometry<br />
standards used (specific for human medicine)<br />
electrophoresis (albumin, α,β,γ globulins)<br />
clinical use <strong>of</strong> results obtained – only very different values
TP<br />
(CREA)<br />
(UREA)<br />
Uric acid<br />
Plasma biochemistry
Plasma biochemistry<br />
GLUCOSE
Plasma biochemistry<br />
ALP<br />
ALT<br />
AST<br />
bile acids
Plasma biochemistry<br />
Ca P
HEALTH PROBLEMS THAT HAVE EMERGED DURING<br />
KEEPING CROCODILES IN CAPTIVITY<br />
Caiman spp., Crocodylus spp., Tomistoma schlegelii,<br />
insufficient nutrition overfeeding<br />
chronic metabolic problems<br />
renal disease traumatic lesions poor husbandry<br />
Symptoms limited movement, general weakness, lethargy, anorexia<br />
hind legs paresis<br />
Laboratory TP, BUN, uric acid, ALT, AST Ca, P,
Young crocodiles<br />
hypovitaminoses<br />
vit A, vit B, vit D 3<br />
mineral deficit - Ca<br />
<strong>Metabolic</strong> <strong>diseases</strong><br />
Adult crocodiles<br />
obesitas<br />
bad nutrition, overfeeding !!!!<br />
hypovitaminoses <strong>of</strong> the vit B complex<br />
suboptimal feeding, <strong>diseases</strong> <strong>of</strong> the GIT
HEALTH PROBLEMS THAT HAVE EMERGED DURING<br />
KEEPING CHELONIANS IN CAPTIVITY<br />
Testudo spp., Agrionemys spp., Trachemys scripta elegans<br />
insufficient nutrition poor husbandry<br />
chronic metabolic problems<br />
PHA syndrome<br />
hibernation POFS POES<br />
pre-ovulatory follicle stasis post-ovulatory egg stasis<br />
Symptoms limited movement, general weakness, lethargy, anorexia<br />
colon constipation, runny nose syndrome,<br />
hind legs paresis<br />
Laboratory TP, uric acid, ALT, AST, BA, Ca, P,
Young tortoises<br />
hypovitaminosis<br />
vit A, vit B, vit D 3<br />
Calcium defficiency<br />
<strong>Metabolic</strong> <strong>diseases</strong><br />
Adult tortoises<br />
obesitas, bad nutrition<br />
PHA syndrom<br />
hypovitaminoses <strong>of</strong> the vit B complex<br />
suboptimal feeding, <strong>diseases</strong> <strong>of</strong> the GIT<br />
complications related to reproduction – egg retention<br />
SGS syndrom (after ATB treatment ?)
MANAGEMENT nad TREATMENT <strong>of</strong> METABOLIC PROBLEMS<br />
Management<br />
– temperature<br />
– air humidity<br />
– fotoperiode<br />
– internal architecture<br />
– type and form <strong>of</strong> feeding<br />
Rehydratation (minimum 20 ml/kg )<br />
Energy<br />
– per os<br />
– probe<br />
– parenteral forms<br />
• SC<br />
• IPP
9 year old female Marginated tortoise (T. marginata)<br />
History<br />
Problem<br />
- blepharospasm<br />
Treatment<br />
- vitamin B12<br />
- antibiotics (amoxycillin) 5 days<br />
Tortoise presented to AEAC<br />
- anorexia<br />
- upper respiratory tract disease<br />
- lethargy
Skin - neck, front legs, hind legs moist and red<br />
Eyelids – oedematous<br />
Mouth cavity mucose – pale
The blood pr<strong>of</strong>ile was characterised by extremely low values<br />
for TP, haemoglobin concentration, PCV and total number <strong>of</strong><br />
RBCs and WBCs.<br />
Values<br />
Haemoglobin<br />
PCV<br />
RBCs<br />
WBCs<br />
TP<br />
Units<br />
g/l<br />
l/l<br />
T/l<br />
G/l<br />
g/l<br />
15<br />
0. 07<br />
0.16<br />
2.00<br />
4.8<br />
Ref.<br />
40 - 80<br />
0.25 – 0.40<br />
0.50 – 1.30<br />
6 - 16<br />
30 - 60
Radiography revealed area <strong>of</strong> gas in GIT<br />
and grey-white pattern <strong>of</strong> the shell skeleton.
Intensive treatment<br />
antibiotics (cephalosporin)<br />
tube feeding – powder (Milupa) + water + vitamins<br />
vitamin C, calcium inj.<br />
Duphalyte inj.<br />
The tortoise died after nine days.
Post mortem examination<br />
parathyroid gland<br />
enlargement<br />
bleeding on<br />
the hearth<br />
muscle<br />
small liver
Post mortem examination<br />
yellowish-green kidneys<br />
the shell extremely s<strong>of</strong>t<br />
colon distension
Conclusion<br />
chronic metabolic bone disease (MBD)<br />
breakdown <strong>of</strong> the liver and kidneys function<br />
secondary inflammation with hemorrhages in the skin.
Iguana iguana<br />
HEALTH PROBLEMS THAT HAVE EMERGED DURING<br />
KEEPING LIZARDS IN CAPTIVITY<br />
insufficient nutrition poor husbandry<br />
chronic metabolic problems<br />
secondary hyperparathyroidism<br />
renal disease POFS POES<br />
pre-ovulatory follicle stasis post-ovulatory egg stasis<br />
Symptoms limited movement, general weakness, lethargy, anorexia<br />
large swelling <strong>of</strong> the hind legs, colon constipation<br />
tremor and hind legs paresis<br />
Laboratory TP, Ca, P, uric acid, ALT, AST
Carnivores<br />
obesitas<br />
non-optimal diet<br />
overfeeding<br />
biotin defficiency<br />
<strong>Metabolic</strong> <strong>diseases</strong>
Carnivores<br />
obesitas<br />
non-optimal diet<br />
overfeeding<br />
biotin defficiency<br />
<strong>Metabolic</strong> <strong>diseases</strong>
1.5 year old male bearded dragon (P. vitticeps)<br />
Patient presented to AEAC<br />
-green spots on the dorsal part <strong>of</strong> the body (+ head, legs)<br />
-lethargy, anorexia
1.5 year old male bearded dragon (P. vitticeps)<br />
Patient presented to AEAC<br />
-green spots on the dorsal part <strong>of</strong> the body (+ head, legs)<br />
-lethargy, anorexia
Radiography revealed area <strong>of</strong> gas in the colon and foreign<br />
body in the stomach.
Bacteriology (skin sample)<br />
Anaerobic bacteria – 0<br />
Fungi - 0<br />
Aerobic bacteria Enterococcus faecalis<br />
Parasitology (faeces sample)<br />
Oxyurids - ++++<br />
Enterobacter aerogenes
Values<br />
Haemoglobin<br />
PCV<br />
RBCs<br />
WBCs<br />
Heterophils<br />
Eosinophils<br />
Basophils<br />
Monocytes<br />
Azurophils<br />
Lymphocytes<br />
Units<br />
g/l<br />
l/l<br />
T/l<br />
G/l<br />
G/l<br />
G/l<br />
G/l<br />
G/l<br />
G/l<br />
G/l<br />
Haematology<br />
I.<br />
115<br />
0.37<br />
1.25<br />
2.00<br />
0.30<br />
0<br />
0.20<br />
0.10<br />
0.20<br />
1.20<br />
II.<br />
97<br />
0.33<br />
1.06<br />
5.52<br />
1.71<br />
0<br />
0.06<br />
1.21<br />
1.27<br />
1.27
Values<br />
TP<br />
Glucose<br />
ALP<br />
ALT<br />
AST<br />
CK<br />
Uric acid<br />
Ca<br />
P<br />
Plasma chemistry<br />
Units<br />
g/l<br />
mmol/l<br />
μkat/l<br />
μkat/l<br />
μkat/l<br />
μkat/l<br />
μmol/l<br />
mmol/l<br />
mmol/l<br />
I.<br />
45.1<br />
12.64<br />
5.21<br />
0.92<br />
0.15<br />
34.11<br />
125.8<br />
2.6<br />
1.3<br />
II.<br />
50.2<br />
22.13<br />
4.43<br />
3.29<br />
2.95<br />
742.9<br />
78.3<br />
2.7<br />
1.6
Intensive treatment<br />
antibiotics (enr<strong>of</strong>loxacin inj.)<br />
tube feeding (Feline Concentration Instant Diet)<br />
Duphalac p.o.<br />
The lizard was euthanasied after 14 days (T61 – i.v.)
Post mortem examination<br />
obesitas
Post mortem examination<br />
distension <strong>of</strong> the stomach (foreign body – stone)
Post mortem examination<br />
enteritis pale brown liver
Conclusion<br />
obesitas<br />
foreign body in the stomach<br />
enteritis<br />
secondary inflammation <strong>of</strong> the skin
Insectivores<br />
Ca and vitamin D 3 deficit<br />
rachitis, osteodystrophy<br />
<strong>Metabolic</strong> <strong>diseases</strong>
Insectivores<br />
Ca and vitamin D 3 deficit<br />
rachitis, osteodystrophy<br />
<strong>Metabolic</strong> <strong>diseases</strong>
Herbivorous reptiles<br />
<strong>Metabolic</strong> <strong>diseases</strong><br />
MBD - Ca and vitamin D 3<br />
rachitis, osteodystrophy, X acute hypocalcemia<br />
complications related to reproduction – egg retention<br />
SGS syndrom
Nutrition<br />
Young leaves<br />
flowers<br />
insects (worms, crickets ……)?<br />
Adult leaves<br />
flowers<br />
fruit<br />
(insects, small vertebrates ?)
Iguana iguana (MBD) calcium - problems
Anorexia<br />
pain - distension urinary bladder<br />
caecum, colon<br />
paralysis – hind legs + anorexia
Anorexia<br />
GIT obstipation<br />
Gout + nephromegaly + CRF
Iguanas – renal disease Healthy iguanas<br />
Boyer et al. (1996) Knotek et al.<br />
(2002)<br />
Knotek et al. (1999)<br />
TP g/l 63,00 53,51 22,0 – 78,2<br />
Gluco<br />
Uric<br />
acid<br />
Creat<br />
mmol<br />
/l<br />
μ<br />
mol/l<br />
μ<br />
mol/l<br />
9,55 10,07 8,3 – 16,5<br />
428,26 306,70 70,2 – 145,3<br />
52,20 61,07 8,8 – 66,3<br />
ALT μkat/l 3,52 0,74 0,1 – 1,2<br />
AST μkat/l 3,11 5,02 0,1 – 1,6<br />
K<br />
Ca<br />
P<br />
mmol<br />
/l<br />
mmol<br />
/l<br />
mmol<br />
/l<br />
6,10 4,18 1,3 – 5,2<br />
1,95 2,06 2,2 – 3,5<br />
7,69 5,95 1,4 – 3,1
POOS x POFS<br />
Clinical examination, RTG - USG, biochemistry - Ca
Females (POFS + POOS) Healthy iguanas<br />
Knotek et al.<br />
(2003)<br />
Knotek et al.<br />
(1999)<br />
TP g/l 38,2 - 72,2 22,0 – 78,2<br />
Gluk<br />
UA<br />
mmol/<br />
l<br />
μ<br />
mol/l<br />
6,2 - 24,6 8,3 – 16,5<br />
61,4 - 815,6 70,2 – 145,3<br />
ALT μkat/l 0,5 - 4,5 0,1 – 1,2<br />
AST μkat/l 0,8 - 17,8 0,1 – 1,6<br />
ALP μkat/l 0,0 - 0,3 0,7 – 4,9<br />
Ca<br />
P<br />
mmol/<br />
l<br />
mmol/<br />
l<br />
2,1 - 7,1 2,2 – 3,5<br />
1,6 - 11,9 1,4 – 3,1
FEMALES<br />
POOS<br />
TP g/l 59,3<br />
Gluco<br />
Uric<br />
acid<br />
CHOL<br />
mmol/<br />
l<br />
μ<br />
mol/l<br />
μ<br />
mol/l<br />
12,7<br />
151,1<br />
8,2<br />
ALT μkat/l 0,4<br />
AST μkat/l 0,8<br />
Ca<br />
P<br />
mmol/<br />
l<br />
mmol/<br />
l<br />
2,1<br />
3,7
FEMALES<br />
POOS<br />
MALES<br />
TP g/l 59,3 49,3<br />
Gluko<br />
Uric<br />
acid<br />
CHOL<br />
mmol/<br />
l<br />
μ<br />
mol/l<br />
μ<br />
mol/l<br />
12,7 12,7<br />
151,1 90,5<br />
8,2 5,1<br />
ALT μkat/l 0,4 0,5<br />
AST μkat/l 0,8 0,3<br />
Ca<br />
P<br />
mmol/<br />
l 2,1 2,8<br />
mmol/<br />
l 3,7 2,1
FEMALES<br />
POFS<br />
MALES<br />
TP g/l 56,8 49,3<br />
Gluko<br />
Uric<br />
acid<br />
CHOL<br />
mmol/<br />
l<br />
μ<br />
mol/l<br />
μ<br />
mol/l<br />
12,3 12,7<br />
320,6 90,5<br />
9,1 5,1<br />
ALT μkat/l 0,3 0,5<br />
AST μkat/l 0,8 0,3<br />
Ca<br />
P<br />
mmol/<br />
l 6,9 2,8<br />
mmol/<br />
l 3,5 2,1
FEMALES<br />
POOS POFS<br />
MALES<br />
TP g/l 59,3 56,8 49,3<br />
Gluko<br />
UA<br />
CHOL<br />
mmol/<br />
l<br />
μ<br />
mol/l<br />
μ<br />
mol/l<br />
12,7 12,3 12,7<br />
151,1 320,6 90,5<br />
8,2 9,1 5,1<br />
ALT μkat/l 0,4 0,3 0,5<br />
AST μkat/l 0,8 0,8 0,3<br />
Ca<br />
P<br />
mmol/<br />
l 2,1 6,9 2,8<br />
mmol/<br />
l 3,7 3,5 2,1
1 year old female veiled chameleon (Chamaeleo calyptratus)<br />
showing very limited activity and a visible colour change was<br />
presented for “skin disease”. Both eyes were closed and the<br />
mouth mucose was pale.
The blood pr<strong>of</strong>ile was characterised by leukocytosis due to<br />
increased number <strong>of</strong> azurophils and monocytes, very high plasma<br />
concentrations <strong>of</strong> uric acid and phosphorus.<br />
Values<br />
WBCs<br />
Azurophils<br />
Monocytes<br />
Uric acid<br />
P<br />
Units<br />
G/l<br />
G/l<br />
G/l<br />
μmol/l<br />
mmol/l<br />
30.50<br />
15.60<br />
6.10<br />
4 549.0<br />
5.71<br />
Ref.<br />
3 - 12<br />
0 – 1<br />
0 – 1<br />
80 - 250<br />
1 - 2
Radiographically a number <strong>of</strong> follicles and deformation on the long<br />
bones was demonstrated.<br />
Conclusion:<br />
chronic metabolic bone disease (MBD)<br />
with preovulatory follicle stasis (POFS)
HEALTH PROBLEMS THAT HAVE EMERGED DURING<br />
KEEPING SNAKES IN CAPTIVITY<br />
Python spp., Boa spp., Epicrates spp., Sanzinia spp., Morelia spp.<br />
infections overfeeding<br />
chronic metabolic problems<br />
renal disease traumatic lesions poor husbandry<br />
Symptoms anorexia<br />
dysecdysis<br />
Laboratory TP, uric acid, ALT, AST (Ca, P)