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Turtle Mock Case. History. Good samaritan submitted a yellow-bellied slider to the UGA VTH on 05/08/14 for a “weird growth on its head.” Good sam found the turtle on the side of the road on 05/01/14, did not eat any of the cat food offered and “seems sick”. Step 1. Triage.

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Presentation Transcript

History
History

Good samaritan submitted a yellow-bellied slider to the UGA VTH on 05/08/14 for a “weird growth on its head.” Good sam found the turtle on the side of the road on 05/01/14, did not eat any of the cat food offered and “seems sick”.


Step 1 triage
Step 1. Triage

  • Determine whether the patient is in immediate risk of death (realistically if this were the case, the animal would already be stabilized before you arrive, but there is always a chance that the animal has declined in the cage after intake)


Step 2 identification
Step 2. Identification

Once the patient is stable, confirm species identification - Good Sams LOVE to try to be helpful and often provide information that may or may not be correct.



Physical exam
Physical Exam

  • Mentation: Depressed

  • Dehydrated

  • Integument: Round, 5mm x 5mm mass buldging from Left ear

  • Musculoskeletal: reduced withdrawl reflexes

  • Body Condition Score: thin



Fluids
FLUIDS!!

Fluids are never a wrong answer for wildlife patients. We assume at least a 5% dehydration in pretty much all cases. Replacing dehydration deficits can have a significant effect on the rest of the animal’s physical exam, diagnostics, and overall mental state.


Nutritional support
Nutritional Support

  • Most wildlife will be undernourished. Sick wildlife will definitely be undernourished.

  • Provide a variety of fruits and vegetables sprinkled with calcium powder. Consider Omnivore Critical Care

    • may require gastric feeding tube.

  • Look out for Hypovitaminosis A. Common in turtles.

    • Buldging eyes main clinical sign


Diagnostics
Diagnostics

Ear Mass:

  • Tumor?

  • Abscess?

  • Foreign body?

    Fine-Needle Aspirate:

  • Stick that sucker and find out!

    • Bacteria & White Blood Cells >> Abscess


Now what?

How would you treat next?


Antibiotics
Antibiotics???

  • Good thought. Abx are generally required in cases of bacterial infection.

  • However… abscesses specifically are a little different. Often walled off by the body, and so much cellular debris that antibiotics cannot penetrate.

  • What else can we do?


Surgery
Surgery!

  • A chance to cut is a chance to cure!

  • Remove the whole abscess, bacteria and all

  • Leave wound open. Abscesses form because bacteria are trapped and grow out of control.

    • Most important aspect of treating an abscess is to leave an exit route for any remaining bacteria and cellular debris to drain


Management
Management

  • Daily sun & water baths

  • Continue parenteral nutritional support if necessary

    • Will be determined based mostly on daily weight change plus voluntary eating

  • Wound care

    • daily flushing


Discharge
Discharge!

Once patient’s overall health has improved: brighter mentation, voluntary eating, weight stable or increasing, no residual signs of infection, confident that animal will continue to improve… Send for rehab or release!


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