Young hermanns with respiratory disease

Re: Young hermanns with respiratory disease

Ashley Sykes — Fri, 10 Jan 2014 21:58:23 GMT

Sorry for the late reply! Yes that makes sense thanks Arlo :)

As for an update - the owner decided to go for referral and endoscopy, which is nice! So will await the results of this :) Thanks for your help Marie!

Re: Young hermanns with respiratory disease

Arlo Guthrie — Tue, 31 Dec 2013 11:22:00 GMT

[quote user="Marie Kubiak"]I suspect Arlo deleted it as no reason for anonymous posting.[/quote]

Yes, that's right. Ashley, the anon account is only for use by members who want to ask advice from members about something sensitive.

Because the anon account is completely anon, to my mind it renders any advice given using that account as utterly useless (even I don't know the author of posts under the anon account). By contrast, you can make your own judgement about advice given by named members of the site (partly based on their track record), and stuff from Diplomates and RCVS Specialists is the gold standard.

Re: Young hermanns with respiratory disease

Ashley Sykes — Mon, 30 Dec 2013 20:23:29 GMT

That's brilliant advice thanks Marie! Appreciate it. Will chat with the owners tomorrow and see what they want to do. No there is no dyspnoea with this one, no real resp effort above normal. Will let you know how I get on.

Re: Young hermanns with respiratory disease

Marie Kubiak — Mon, 30 Dec 2013 19:54:01 GMT

I suspect Arlo deleted it as no reason for anonymous posting.

Any dyspnoea with the noise?

2 wks would usually be long enough, odd that nothing grew given it should be a pretty dirty site at the best of times. If lower resp cause is present what grows from URT may not be reflective of responsible pathogens anyway. I would repeat culture but from LRT- with the lung wash I pass a sterile urinary catheter into the trachea, in ventral recumbency, and advance it until I start to feel resistance as airways narrow. I find endoscopic sampling impossible due to size of patient in all but the giant tortoises. Use 2ml/kg sterile saline and reaspirate after minimal movement. Submit a culture sample and also one for cytology if poss. You can do mycoplasma serology as culture is difficult due to fragility, and also consider chlamydia screening too - PALS have run both serologies for me in the past. herpes is less likely in a tortoise lacking more severe signs and oral lesions but if retesting do a broad herpes consensus PCR rather than test for THV-1 or 4 alone.

Marie

Re: Young hermanns with respiratory disease

Ashley Sykes — Mon, 30 Dec 2013 19:39:16 GMT

Thanks for the reply Marie - I am confused now as to where the Anon reply went?!

The squeaking has been going on for some months now, along with the increased respiratory noises evident with and without the sethoscope. I suspect lower, given the noise on auscultation. As for husbandry I cannot remember exactly off the top of my head, but it is of course the first questions with all the reptiles I see, and she had a good set-up. (It was something pretty standard: tortoise table / good basking spot / UV fluorescent / nutrobal on food etc).

I stopped all anti-microbials 2 weeks before and swabs were taken, would that have been long enough? Fungal culture was included in the C+S and was negative also. The rads are better viewed on our screen, not under-exposed on there and still looked to be as you say - slight diffuse patterning.

Yeh endoscopy would be great, I will see if they are keen. Interesting case report! Would you agree my first plan of action would be repeat culture (+ Myco / Herpes?) on a lung wash? Sedate + catheter into trachea and flush saline in and out? In sternal (plastron?!) recumbency?

Many thanks again!

Re: Young hermanns with respiratory disease

Marie Kubiak — Mon, 30 Dec 2013 13:00:06 GMT

How long has the squeaking been going on? Has it had any episodes before? Is it upper or lower resp tract in origin? As above, more husbandry details would be useful (not sure why the Anon log in was used to post though, didn't seem that controversial!).

Mycoplasma and other bacterial causes may well have been masked by antibiotics if used recently. I would stop all meds if they have made no improvement and then look to repeat cultures, ideally on a lung wash. There are no marked opacities on the rads, but perhaps a mild diffuse increase bilaterally (though this can be low exposure artefact).

May be worth referring on for endoscopy (or even CT) to evaluate airways and lungs if no progress - there was a nice case reported recently of intermittent tracheal collapse and bronchial stenosis in a Testudo that had increased respiratory effort/noise. Best to rule out horses before zebras though!

Marie