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Veterinarian Technician August 2006 (Vol 27, No 8) Focus: Reproduction

Case Report: "Coelomic Swelling in a Fiji Banded Iguana"

by Steve Culver, BS, RVT

    On June 18, 2005, a 3-year-old female Fiji banded iguana was presented to the hospital at the San Diego Zoo with coelomic distention and inappetence. In some reptiles, coelomic swelling is normal during the time leading up to egg laying. Fiji iguanas are on the endangered species list, and reproductive problems can be devastating to their survival.

    Species Characteristics and Endangered Status

    The Fiji banded iguana (Brachylophus fasciatus) is one of several lizard species found in the Fijian archipelago. This medium-sized arboreal lizard, however, is one of the most distinctive in the world. Males are dark green, with white or pale-blue spots and vertical bands along the sides of their bodies.1 Females are usually solid green, with occasional spots and partial bands.1

    Currently, there are fewer than 10,000 Fiji banded iguanas in the wild. Because of the species' critically en­dangered status, a comprehensive species survival plan has been outlined to better maintain the health, husbandry, and genetic diversity of this dwindling population of reptiles. To fulfill one of the directives of this project, a breeding plan has been established to maintain genetic diversity within the captive population of Fiji banded iguanas in zoos. The desire to achieve this goal makes the reproductive health of each individual critically important.

    The San Diego Zoo has three breeding pairs of Fiji banded iguanas at its facility, making it one of the most important caretakers and successful breeders of this species in the world. More than 100 offspring have been produced at the San Diego Zoo.

    Reproductive Concerns

    Fiji iguanas typically lay three to seven eggs annually, usually in a single clutch. In San Diego, most clutches are laid between April and July, although these iguanas have been known to lay eggs in all other months as well. Therefore, given the reproductive behavior of this species, the patient was initially evaluated for the presence of eggs and was given a thorough physical examination.

    Diagnostic Testing

    Blood was drawn from the ventral tail vein and placed in lithium heparin for a complete blood cell count and plasma biochemistry panel. Hematology values obtained included white blood cell count and differential, packed cell volume, and cellular morphologic assessments.

    Blood chemistries revealed hypercalcemia (calcium: 18.4 mg/dl; normal: 8.8 to 14.0 mg/dl), slight hyperphosphatemia (phosphorus: 6.4 mg/dl; normal: 4 to 6 mg/dl), and an elevated creatine phosphokinase (7,492 IU/L; normal: 140 to 420 IU/L). Elevations in calcium and, to a lesser extent, phos­phorus can be seen during folliculo­genesis. Other chemistries analyzed included the following:

    • Aspartate aminotransferase: 52 IU/L (normal: 5 to 52 IU/L)
    • Glucose: 136 mg/dl (normal: 169 to 288 mg/dl)
    • Uric acid: 1.2 mg/dl (normal: 1.2 to 2.4 mg/dl)
    • Total protein: 5.6 g/dl (normal: 5 to 7.8 g/dl)
    • Albumin: 1.2 g/dl (normal: 2.5 to 3.9 g/dl)

    The only abnormal finding on the complete blood cell count was a leukocytosis of 45,000/µl (normal: 3,000 to 10,000/µl). The differential revealed 71% moderately toxic heterophils (normal: 17% to 43%) and 13% azurophils (normal: 0 to 1.7%). The packed cell volume was normal at 27%.

    Dorsoventral and horizontal beam lateral whole-body radiography showed eggs as well as probable free fluid in the coelom, suggesting coelomitis and possible egg stasis. Although ultrasonography did not confirm the presence of free fluid in the coelom, fine-needle aspiration of the coelom revealed easily identifiable egg material. Cytologic evaluation of the material suggested the probability of yolk coelomitis. The aspirate revealed few cells or bacteria.

    The iguana was initially prescribed the antibiotic ceftazidime at 20 mg/kg every 3 days for 3 weeks, but this was changed to ceftriaxone because of toxic changes in the blood work. Cef­tri­axone, a third-generation cephal­osporin antibiotic, was prescribed at 100 mg/kg IM every 3 days for 4 weeks.a Both ceftazidime and ceftriaxone are effective against a broad range of gram-negative and gram-positive bacteria. They are also effective against bacteria that are resistant to ampicillin and other cephalosporins. Dinoprostone (Prepidil, Upjohn) was applied deep into the cloaca at a dosage of 0.11 mg/kg to aid in oviposition (Bicknese E: Personal communication, Zoological Society of San Diego, 2005). Dinoprostone stimulates myometrial contractions. In humans, it also has a local effect of dilation of the cervix.

    Given the endangered status of this species, plans were made for surgical intervention in the event that this iguana's condition did not improve. After 10 days of inactivity and no egg laying by the iguana, the decision was made to perform an exploratory celiotomy. Preoperative blood work showed a continued leukocytosis of 19,900/µl (60% heterophils, 5% azurophils), continued hypercalcemia (calcium: 47.6 mg/dl), and hyperphosphatemia (phosphorus: 32.0 mg/dl). The patient's creatine phosphokinase level decreased to 1,836 IU/L.

    Exploratory Celiotomy

    Desflurane was administered via a precision vaporizer to induce and maintain anesthesia in the iguana. Desflurane, like isoflurane, is a halogenated ether inhalation gas anesthetic. This gas is the preferred anesthetic agent at the San Diego Zoo because it provides relatively quick induction and recovery times in reptilian species. Patients are typically induced at 16% desflurane and maintained at about 10% to 12%. A 16-gauge catheter was used as an endotracheal tube and was held in place with paper tape and a tongue depressor. During surgery, the iguana was given 8 ml of half-strength lactated Ringer's solution and 2.5% dextrose subcutaneously as well as 18 mg of ceftriaxone intramuscularly. Cardiac quality was evaluated by small animal Doppler ultrasonography throughout the procedure. Because respiratory frequency and quality could easily be seen, no other monitoring equipment was necessary. A heated surgical table facilitated thermoregulation, an important factor in reptilian anesthetic quality and recovery.

    To avoid the ventral abdominal vein, a ventral left paramedian incision was made into the coelom using electrocautery. Multiple large-yolk ovules were observed at the left ovary; some were misshapen and showed evidence of prior rupture. A similar picture was seen in the right ovary. The abnormal ova were dissected and removed from the left ovary by electrocautery. Hema­clips were used to ligate the vessels at the base of the left ovary where the ovules originated, and a partial left ovar­i­ectomy was performed. This process was repeated on the iguana's right side; however, most of the right ovary was removed. The coelom was flushed with sterile saline, the abdominal wall was closed with 4-0 polydioxanone sutures in a continuous pattern, the skin was closed using 4-0 polyglycolic acid sutures in a horizontal mattress pattern, and Nexa­band topical tissue adhesive (Ab­bott Laboratories) was ap­plied to the closed incision. Keto­pro­fen, an NSAID, was given post­opera­tively at a dose of 1.1 mg/kg IM.2

    The iguana was hospitalized for 3 days for observation following surgery. During that time, ketoprofen was continued once daily and 8 ml of half-strength 2.5% dextrose was given sub­cutane­ously every other day. The incision area and the pa­tient's appetite were as­sessed daily. The iguana was then released back to the reptile department. Sutures were removed 40 days after surgery.

    Outcome

    In the final assessment, it was determined that this Fiji banded iguana had follicular stasis leading to egg yolk coelomitis. Survey radiographs were valuable in revealing the early signs of follicular stasis, and the diagnostic information collected indicated the need for an exploratory celiotomy. Subsequent follow-up examinations showed healing of the celiotomy incision site and a resolving leukocytosis (10,100/µl; 42% heterophils, 16% azurophils) with normal cell morphology. No further treatment was necessary.

    1. Zug GR: The Lizards of Fiji: Natural History and Systematics. Honolulu, HI, Bishop Museum Press, 1991.

    2. Carpenter JW: Exotic Animal Formu­lary, ed 3. Philadelphia, WB Saunders, 2004, p 78.

    *Information for this article was obtained from John Kinkaid: Taxon Management Account: Fijian Banded Iguana, Zoological Society of San Diego, 1999.

    References »

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