Veterinary Medicine - November 2008 - (Page 595)

Clinical Exposures illuminating images from patient files PEER-RE VIE WED Preovulatory stasis and dystocia in oviparous lizards Raffaele Melidone, Dr. med. vet.; Joyce S. Knoll, VMD, PhD, DACVP; and Nicola Parry, BSc, MSc, BVSc, DACVP 2-year-old intact female bearded dragon (Pogona vitticeps) was presented to Tufts University’s Cummings School of Veterinary Medicine for evaluation of weakness and anorexia of one day’s duration. On initial presentation, the bearded dragon was lethargic, with a distended coelom and pale mucous membranes. The results of the ini- A tial blood work revealed severe anemia; the patient’s packed cell volume was 6% (reference range = 24% to 36%).1 A dorsoventral radiograph revealed multiple rounded (about 1 cm in diameter), coalescing, soft tissue opacities throughout the caudal coelomic cavity (Figure 1). Preovulatory stasis was tentatively diagnosed. Coelomic ultrasonography was recommended to evaluate the abdominal opacities, but the owner declined further investigation. The bearded dragon was hospitalized, an intraosseous catheter was placed in the left tibia, and ﬂuid therapy was initiated. Reptile Ringer’s solution (i.e. one part lactated Ringer’s solution, two parts 2.5% dextrose/0.45% saline solution)1 was administered at a rate of 25 ml/kg/day. The lizard was placed in a heated, humidiﬁed cage with an ambient temperature of 85 F (29.5 C). The reptile became increasingly lethargic and weak over the next 12 hours. Because there was no improvement and the lizard’s condition carried a poor prognosis, the owner elected euthanasia and a postmortem examination. Necropsy revealed that the coelomic cavity contained about 10 ml of serosanguineous ﬂuid. Each ovary contained about 30 enlarged (1-cm-diameter), round, bright-yellow vitellogenic follicles (Figure 2). The liver was diffusely pale-yellow, a typical physiologic ﬁnding in species that lay large numbers of eggs. A histologic examination of the ovaries revealed that the follicles contained large amounts of bright eosinophilic proteinaceous yolk surrounded by several layers of ﬂattened epithelial cells. Bone marrow, collected from the proximal aspects of the humerus and femur, was atrophic and composed mostly of sheets of intact adipocytes with rare hematopoietic cells, explaining the low hematocrit. The liver showed diffuse fatty change. The clinical history and gross and histologic ﬁndings were most consistent with a diagnosis of preovulatory stasis (follicular stasis). Marrow aplasia, which was seen 1. A dorsoventral radiograph of a bearded dragon with preovulatory stasis. Note the multiple rounded coalescing soft tissue opacities throughout the caudal half of the coelomic cavity, consistent with follicles. This case report was provided by Raffaele Melidone, Dr. med. vet.; Joyce S. Knoll, VMD, PhD, DACVP; and Nicola Parry, BSc, MSc, BVSc, DACVP, Department of Biomedical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536. VETERINARY MEDICINE November 2008 595

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Veterinary Medicine - November 2008 Contents Leading Off Editors' Guest Just Ask the Expert Letters Practice Makes Perfect Clinical Exposures Practice Matters Idea Exchange Author Guidelines A Challenging Case: Esophageal Leiomyoma in a Dog Osteoarthritis in Cats: What We Now Know About Recognition and Treatment Product Preview CE Form/Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - November 2008

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