COMMENTS
The ultimate diagnosis of dystocia is based on interpretation of clinical signs, history, and results of physical exam and diagnostics.
In all cases, it is essential to have at least one confirmatory test that there are indeed eggs present in the coelomic cavity.
It must be mentioned that the sex of the animals must be confirmed as female before surgery is performed.
While this may seem obvious, in some chelonians, sex determination can be quite challenging and males may present with coelomic neoplasias or GI obstructions that clinically appear very similar to dystocia.
ZOONOTIC POTENTIAL
N/A
SYNONYMS
Egg bound
Postovulatory follicular stasis ABBREVIATIONS
ABBREVIATIONS
Ca = calcium
CBC = complete blood count
CT scan = computed tomography
GI = gastrointestinal
ICe = intracoelomic
IM = intramuscular
IO = intraosseous
IV = intravenous
Mg = magnesium
MRI = magnetic resonance imaging
NSHP = nutritional secondary hyperparathyroidism
P = phosphorus
PO = per os
SC = subcutaneous
UVB = ultraviolet B
Suggested Reading
1 Chitty J, Raftery A. Egg retention/dystocia. In: Chitty J, Raftery A, eds. Essentials of Tortoise Medicine and Surgery. Oxford, UK: Wiley Blackwell; 2003:195–197.
2 Hochleithner C, Holland M. Ultrasonography. In: Mader DR, Divers SJ, eds. Current Therapy in Reptile Medicine and Surgery. St. Louis, MO: Elsevier Saunders; 2014:107–127.
3 Jacobson ER. Overview of reptile biology, anatomy, and histology. In: Jacobson ER, ed. Infectious Diseases and Pathology of Reptiles: Color Atlas and Text. Boca Raton, FL: CRC Press; 2007:14–17.
4 McArthur S. Problem‐solving approach to common diseases of terrestrial and semi‐aquatic chelonians. In: McArthur S, Wilkinson R, Meyer J, eds. Medicine and Surgery of Turtles and Tortoises. Ames, IA: Blackwell; 2004:309–378.
Author Javier G. Nevarez, DVM, PhD, DACZM, DECZM (Herpetology)
Egg Yolk Coelomitis
DEFINITION/OVERVIEW
Egg yolk coelomitis occurs when yolk material is released into the coelomic cavity as a result of a ruptured follicle or egg due to oophoritis, follicular stasis, dystocia, salpingitis, or aggressive palpation.
ETIOLOGY/PATHOPHYSIOLOGY
In all cases, yolk coelomitis is a result of yolk material free within the coelomic cavity overwhelming the body’s activity to resorb the material. This leads to an intense inflammatory response that is often sterile but can also be associated with secondary bacterial infection.
It can progress to adhesions throughout the coelomic cavity, septicemia, and death.
SIGNALMENT/HISTORY
Egg yolk coelomitis occurs in female chelonians of reproductive age or size, usually older than 1 year.
Most animals have a history of inadequate husbandry, being housed alone without access to a male, and lacking an appropriate area for laying eggs or giving birth.
The majority of cases occur in captive animals, but the author has diagnosed yolk coelomitis in free‐ranging gopher tortoises (Gopherus polyphemus).
CLINICAL PRESENTATION
Chelonians with yolk coelomitis often present with non‐specific clinical signs such as anorexia and lethargy.
Other abnormalities identified in physical exam may include hind‐limb weakness/ paresis, dehydration, poor body condition score, and pliable bones.
Some animals may present obtunded due to rapid progression of the disease.
RISK FACTORS
Husbandry
Any factors that may result in follicular stasis or dystocia are also contributing factors to yolk coelomitis.
These include inadequate husbandry, nutrition, brumation, and nesting environment.
Others
A less discussed topic is the effect that lack of exposure to males may have on the reproductive cycle of reptiles.
Many reptiles display courtship and breeding behaviors that likely influence the proper hormonal stimulation of prospective females.
Many female chelonians in captivity are kept alone without the benefit of behavioral cues from a male counterpart.
This possibility of a behavioral effect must be considered, especially when animals are maintained in proper husbandry and are otherwise healthy.
DIFFERENTIAL DIAGNOSIS
Follicular stasis
Dystocia
Neoplasia
Ovarian cysts
GI obstruction
Septicemia
DIAGNOSTICS
Cytology
Evaluation of free fluid in the coelomic cavity will be a confirmatory test of yolk coelomitis. In acute cases, fluid is yellow to white, with a high amount of proteinaceous material and inflammatory cells.
In chronic cases the fluid may appear cloudier.
Blood and bacteria may also be observed with either presentation.
Imaging
Radiography: findings may include free fluid, follicles, or ruptured eggs.
Ultrasound: aspiration of any free fluid can be used to diagnose egg yolk coelomitis.