Terrapin with "foot infection" - cellulitis / possible osteomyelitis?

Re: Terrapin with "foot infection" - cellulitis / possible osteomyelitis?

Ashley Sykes — Sat, 20 Apr 2013 11:44:58 GMT

Just an update on this. Managed to get subcarapacial blood (Tried but failed on jugular! Boss had a go too...). I realise it's not the best place, but better than nothing...

Results came back quite nice - I think. I compared using red eared reference values and some other chelonian values in the BSAVA reptile manual. Uric acid 192 / Urea 7.9, most other values look very normal and nice. CK >14,000, LDH also very high, but both to be expected with the tissue damage in that limb (?)

Plan for amputation on Tuesday :)

Re: Terrapin with "foot infection" - cellulitis / possible osteomyelitis?

Ashley Sykes — Tue, 16 Apr 2013 15:14:45 GMT

[quote user="Mark Rowland"]

With what you`ve got I would go for bup 0.1mg/kg IM then prop 10mg/kg IV

Goodluck

[/quote]

Brilliant, thanks again. I will contact the owner and see what she's up for.

Re: Terrapin with "foot infection" - cellulitis / possible osteomyelitis?

Mark Rowland — Tue, 16 Apr 2013 15:07:43 GMT

With what you`ve got I would go for bup 0.1mg/kg IM then prop 10mg/kg IV

Goodluck

Re: Terrapin with "foot infection" - cellulitis / possible osteomyelitis?

Ashley Sykes — Tue, 16 Apr 2013 14:51:53 GMT

[quote user="Mark Rowland"]

You really need radiographs of all 4 limbs under sedation so that they can be fully extended. Haematogenous spread is common in reptiles. Listen to the heart to check for any murmurs that may indicate valvular endocarditis. If the other limbs are affected or there is a murmur, the proverbial ship may have already sailed and the long term px will be guarded to poor. Some bloods wouldnt hurt.

Amputation-wise; was thiking something like moderate doses of metedetomidine / ketamine to facilitiate intubation / gaseous intubation and maintainence...

I would use opiod + Alfaxalone myself to induce, followed by intubation

At what level would you amputate to? Through a joint or mid shaft

Far enough up to be sure you have margins

Goodluck

[/quote]

Thanks Mark that's great! I'll get in to listen and see if the owner is keen for bloods, and poss sedation + proper rads.

Unfortunately we have (for the moment) no full agonists... opioid-wise it's buprenorphine. Also no alfaxalone, but of course propofol. Would you use opioid + ketamine premed to enable head extension, then jugular IV propofol and intubation?

[quote user="Marie Kubiak"]

I second Mark's points to radiograph other limbs and use opioid (I prefer morphine) and IV alfaxan, plus bloods to assess whether you have decent organ function and a working immune system.

Marie

[/quote]

Again thanks! I will see what the owner is up for.

Re: Terrapin with "foot infection" - cellulitis / possible osteomyelitis?

Marie Kubiak — Tue, 16 Apr 2013 14:03:47 GMT

I second Mark's points to radiograph other limbs and use opioid (I prefer morphine) and IV alfaxan, plus bloods to assess whether you have decent organ function and a working immune system.

Marie

Re: Terrapin with "foot infection" - cellulitis / possible osteomyelitis?

Mark Rowland — Tue, 16 Apr 2013 09:27:04 GMT

Amputation-wise; was thiking something like moderate doses of metedetomidine / ketamine to facilitiate intubation / gaseous intubation and maintainence...

I would use opiod + Alfaxalone myself to induce, followed by intubation

At what level would you amputate to? Through a joint or mid shaft

Far enough up to be sure you have margins

Goodluck