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

MEDICATIONS

      DRUG(S) OF CHOICE

       Silverstone et al (2007) treated a diamondback terrapin (Malaclemys terrapin) suffering from lymphoblastic leukemia with prednisone 0.6 mg/kg PO q48h, cytosine arabinoside 6 mg/kg SQ q7d for two treatments, and chlorambucil 1 mg/kg PO q7d for two treatments; at 24 days post-treatment, the WBC count and the turtle’s activity had improved, but it died 46 days after the beginning of treatment.

       Cytosine arabinoside is the most frequently used treatment for small mammals with chronic monocytic leukemia, whereas prednisone therapy is widely used and accepted for small mammals with lymphoid leukemia and lymphoma; it is not effective for myeloid leukemias.

      PRECAUTIONS/INTERACTIONS

       Suspected cytosine arabinoside toxicity characterized by renal failure has been reported in a rhinoceros viper.

FOLLOW-UP

      PATIENT MONITORING

      Complete blood count must be done for monitoring the overall WBC count and different leukocyte counts to gauge response to the drugs.

      EXPECTED COURSE AND PROGNOSIS

      The prognosis of the disease, especially in acute leukemia, is poor.

MISCELLANEOUS

      COMMENTS

      N/A

      ZOONOTIC POTENTIAL

      N/A

      SYNONYMS

      N/A

      ABBREVIATIONS

       PO = per os

       SC = subcutaneous

       WBC = white blood cells

Suggested Reading

      1 Bezjian M, Diep AN, de Matos R, Schaefer D. Chinese box turtle (Cuora flavomarginata) with lymphoid leukemia characterized by immunohistochemical and cytochemical phenotyping. Vet Clin Path 2013;42:368–376.

      2 Mauldin GN, Done LB2. Oncology. In: Mader DR, ed. Reptile Medicine and Surgery. 2nd ed. St. Louis, MO: Elsevier Saunders; 2006:299–322.

      3 Silverstone AM, Garner MM, Wojcieszyn JW, et al. Acute lymphoblastic leukemia in a diamondback terrapin. J Herp Med Surg 2007;17:92–99.

      Author Jorge Orós, DVM, PhD, DECZM