Month: November 2015

Reptile Feeding Tube

Share This!

We will routinely use feeding tubes in tortoises that are not eating well even though some reptiles can go many days without eating. Sometimes they are not eating due to a traumatic injury or internal illness. Other times they might be recovering from surgery, either a bladder stone removal, or a removal of their eggs. This section will show you how we put a feeding tube into a California Desert Tortoise (CDT).

Graphic photos on this page.

Tube Placement

This is what it looks like inside of the mouth of a CDT. They have a fleshy tongue and horny plates for teeth. Once it is in place the feeding tube will be bypassing this oral cavity and food that is administered through the tube will go directly into the esophagus.

In reptiles the esophagus is found towards the right side of the neck. This is also true in birds, and the opposite of mammals. In this picture the tortoise is on its back and its head is towards the left. A hemostat has been passed through its oral cavity into the esophagus at the point where the feeding tube will be inserted. The arrow points to the hemostat as it bulges just under the skin.

CDT-FeedingTube1

A nick is made in the skin with a scalpel blade right over the bulge. This allows the hemostat to gently advance through the wall of the esophagus and the skin to the outside.

CDT-FeedingTube2

The hemostat is used to grab the tip of the feeding tube. The hemostat and feeding tube will be pulled back out through the oral cavity. It is not possible to just pass the tube down into the esophagus at this point in the procedure, it must first come out through the mouth and then be passed down into the esophagus.

CDT-FeedingTube3

This view shows several things. Under the tip of the orange feeding tube you can see the breathing tube we use to administer anesthesia. You can also see the orange feeding tube passing into the esophagus in the upper right part of the picture and out through the mouth. We have taken off the hemostat that was used to pull it through so you can have better visualization. We will replace the hemostat on the tip of the tube and gently place the tip of the tube past the original incision we made in the esophagus.

CDT-FeedingTube4

This close-up shows the feeding tube properly in place, having been passed down the esophagus to a previously measured point. This technique of pulling the feeding tube from the esophagus, out through the mouth, and then back down the esophagus, is called retrograde placement.

CDT-FeedingTube5

The tube is sutured at its insertion point into the esophagus and the remainder of the tube is taped to the top of the shell. The tube can be used to administer food, water, and medication for an extended period of time.

This closeup shows how we secure the tube

CDT-FeedingTube

CDT-FeedingTube6

This x-ray of the tortoise on its back shows how the tub looks like on the inside. The arrow on the left actually shows the part of the tube that is taped to the top of the shell. The arrow towards the right shows the tube in the esophagus.

We also put feeding tubes in mammals, especially cats.

Continue Reading

Tegu Oral Tumor

Share This!



Reptiles get tumors in numerous locations in their body. This page describes how we treated an oral tumor, called a squamous cell carcinoma, in a Tegu. Squamous cell carcinomas also occur in mammals, especially the ears of white cats that are exposed to the sun. We have a page describing this disease in a cat.

Click on any photo to enlarge it.

Treatment

 

This is the Tegu upon presentation to our office. This growth had been present for several weeks according to the owner. In reality, it was probably growing on the inside of the mouth for a much longer period of time.

Tegu-oraltumor1

We anesthetized it (you can see the breathing tube in its windpipe) and assessed the degree of involvement. As expected it went deep into the oral cavity.

Tegu-oraltumor

We used cautery to remove it since this location has an extensive blood supply and cautery minimizes bleeding both during and after the procedure. The appearance of the mouth is much nicer with the tumor removed.

Tegu-oraltumor1-2

Tegu-oraltumor1-3

Diagnosis

 

The cancerous tissue was submitted to the pathologist for analysis. It is a squamous cell carcinoma, a malignant tumor. Due to the aggressive nature of this tumor there is a high chance that it will recur in this spot, although usually it does not spread to the rest of the body.

This is the actual report we received from our pathologist. It is from a doctor that specializes in reading tissue samples from reptiles.

Continue Reading

Heart Disease

Share This!

The purpose of the cardiovascular system (heart and blood vessels) is to provide the cells of the body with oxygen, nutrition, and essential fluids. It also helps these same cells rid themselves of waste products, and distributes hormones and enzymes to allow for normal physiologic processes. It is even a big part of temperature regulation.All of this is no small feat when you consider the fact that the cardiovascular system must supply these needs to a body that contains billions of individual cells.

The cardiovascular system is very complicated and does not lend itself to a simple explanation and categorization of its functions. Therefore, the sections on physiology and pathophysiology are a little complex, but if you get through them it will help in your understanding when we talk about specific diseases along with their diagnosis and treatment. You may need to go through them more than once. You might notice that we repeat important concepts, and from different angles.

Hopefully this will help put it all together.You can bypass all the background information and go directly to specific diseases like HeartwormCardiomyopathy, and Valve disease, the most common heart diseases we encounter. We also have a summary page on Heart Disease if you find this page contains more detail than you need. It will give you background information but in a condensed format.

This page has actual pictures of the heart and the organs of the chest. Most people will not be bothered by their graphic nature, and will actually find them fascinating. The mechanisms of heart failure in the dog and cat are very similar to humanoids. The explanation of congestive heart failure applies directly to people in many cases. The main drugs used to treat heart failure are almost identical in people and animals.

Heart disease and its diagnosis is complicated stuff. We commonly call in our cardiologist Dr. Fred Brewer to assist in many cases. He specializes only in cardiology, and has extensive knowledge that he is willing to share.

Here is Dr. Brewer explaining heart sounds to one of our externs

Cardiology-Teaching

We work on a wide variety of species that get heart disease in addition to dogs and cats. This guinea pig has heart failure.

Cardiology-GuineaPig

This is the heart of a 50 pound dog. It is about the size of your fist. You can easily see some of the coronary arteries that supply blood to the heart muscle in the same manner that the heart supplies blood to the rest of the body.

The pericardium has been removed for better visualization

This is a ferret heart, obviously much smaller. You can see the pericardium, the layer over the heart as it is pulled away.

Rocky Walker 21218 Ferret Gastric tumor Picture of normal pericardiumThe heart starts beating before birth, and continues until death. Think of how many beats that is in the lifetime of any living organism. Lets have fun with math and play with some basic numbers:

Average heart rate in a cat- 150 beats per minute

This is 9,000 beats in one hour

This is 216,000 beats in one day

This is 78,840,000 beats in one year

This is 788,400,000 beats in 10 years.

Many cats have a heart rate greater than 150 beats per minute, and live much longer than 10 years. They will have over a billion heart beats in their lifetimes!

Later in this page we will be referring to the right heart and left heart, which might give you the impression there are two hearts. There is only one heart- we do this only because it helps to understand the flow of blood through the heart.

Glossary of heart terminology

cardiac– pertaining to the heart aerobic– dependent on oxygen for normal physiology
arrhythmia– irregular heart beat anaerobic– not dependent on oxygen for normal physiology
murmur-abnormal flow of blood through the heart valves anemia– low number of red blood cells
atrium-two of the smaller heart chambers systole– when the heart muscle contracts and ejects blood to the arteries
ventricles– two of the larger heart chambers diastole– when the heart relaxes after systole and fills up with blood
hypertrophy-abnormally thickened heart muscle ascites- fluid buildup within the abdomen
cardiomegaly- an enlarged heart pleural effusion– fluid buildup within the thoracic cavity
pulmonary edema– fluid buildup within the lungs polycythemia- excess number of red blood cells
myocardium– the heart muscle microcardia– a small heart

We will repeat this terminology throughout this page to help you eventually get your Latin down pat. Just as it starts making sense we will add more later!

Follow the links to continue on with our heart page:

Vascular Anatomy & Physiology

Heart Anatomy & Physiology

Causes and Symptoms of Heart Disease

How We Diagnose Heart Disease

Cardiac Diseases and Treatments

Continue Reading