Blackwell's Five-Minute Veterinary Consult: Reptile and Amphibian. Javier G. Nevarez

from 100–125 mg/kg PO once, then repeated after 14 days to 50 mg/kg PO q24h for 3–5 days for severe infections.

      PRECAUTIONS/INTERACTIONS

       Hepatotoxicity and CNS toxicity have occasionally been reported in other species following metronidazole use, so care should be taken if pre‐existing hepatic dysfunction is suspected.

FOLLOW‐UP

      PATIENT MONITORING

       Response to therapy is usually monitored by a reduction in clinical signs (e.g., improved appetite).

       Repeat blood samples can also be taken to recheck renal parameters.

      EXPECTED COURSE AND PROGNOSIS

       The prognosis for patients with extensive biliary or renal damage is poor, but if diagnosed early the condition can be managed successfully.

       If left untreated, the disease will slowly progress to renal failure and death.

MISCELLANEOUS

      COMMENTS

      N/A

      ZOONOTIC POTENTIAL

      N/A

      SYNONYMS

      N/A

      ABBREVIATIONS

       CNS = central nervous system

       PO = per oram

      INTERNET RESOURCES

      Veterinary Information Network: www.vin.com

Suggested Reading

      1 Johns JD. Urogenital system. In: Girling SJ, Raiti P, eds. BSAVA Manual of Reptiles, 2nd ed. Quedgeley, UK: BSAVA; 2004:261–272.

      2 Zwart P, Truyens EHA. Hexamitiasis in tortoises. Vet Parasitol 1975;1(2):175–183.

      Author Joanna Hedley, BVM&S, DZooMed (Reptilian), DECZM (Herpetology), MRCVS

      Hyperglycemia

      

BASICS

      DEFINITION/OVERVIEW

      Hyperglycemia is abnormally high blood glucose concentration. In most species, glucose concentrations fluctuate. Normal glucose concentration ranges from 60 mg/dl to 200 mg/dl (3.3–11 mmol/l).

      ETIOLOGY/PATHOPHYSIOLOGY

       The etiology is largely unknown

       Transient hyperglycemia may be postprandial or stress induced.

       Elevated glucose may be seen during ovulation, and in certain neoplastic conditions.

       Iatrogenic from prior glucose or glucocorticosteroid administration.

       Hyperglycemia has been documented in parasitic pancreatitis (Serpinema microcephalus).

       It is speculated that endocrine pancreas disease may lead to insulin deficiency resulting in a diabetes mellitus‐like syndrome, but this has not been documented.

      SIGNALMENT/HISTORY

      N/A

      CLINICAL PRESENTATION

       Unspecific

       Possibly increased water consumption, increased urine (urate) production, and weight loss.

      RISK FACTORS

       Husbandry

       Largely unknown

       Stress from handling or improper housing may predispose.

       Others

      N/A

DIAGNOSIS

      Blood glucose levels above 200 mg/dl (11 mmol/l) indicate hyperglycemia.

      DIFFERENTIAL DIAGNOSIS

      N/A

      DIAGNOSTICS

       Blood glucose measurements should be repeated, as a single elevated value is likely insignificant.

       Persistent hyperglycemia is a more relevant finding.

       Glucosuria should be evaluated to identify chronic hyperglycemia.

       Underlying causes should be investigated: ovarian activity, neoplasia (particularly stomach and pancreas), metabolic disease.

      PATHOLOGICAL FINDINGS

       The etiology for persistent hyperglycemia is unknown, but endocrine pancreas should be thoroughly evaluated.

TREATMENT

      APPROPRIATE HEALTH CARE

      N/A

      NUTRITIONAL SUPPORT

      N/A

      CLIENT EDUCATION/HUSBANDRY RECOMMENDATIONS

      N/A

MEDICATIONS

      DRUG(S) OF CHOICE

       In cases with persistent hyperglycemia, where systemic disease has been ruled out, experimental insulin treatment may be attempted.

       Suggested starting dose: 1–5 iu q24–48h.

      PRECAUTIONS/INTERACTIONS

      N/A

FOLLOW‐UP

      PATIENT MONITORING

      Follow up with repeated glucose measurements, and monitor general health of patient.

      EXPECTED COURSE