Surgery on a G. sulcata



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Sick african spurred tortoise (G. sulcata) was brought in after being seen by another vet.

He suspected pneumonia so gave antibiotics without any clinical result.


The animal was brought in very sick. Not eating not moving around for 3-4 weeks already.

I decided to take an X-ray because it didn't look like pneumonia to me (but who am I to judge...).
























X-ray image: urolith visible in bladder (pushed lateral by gas in intestines)




So it was clear the animal didn't suffer from pneumonia, but had another problem.

The uroliths are 'common' in G. sulcata and other herbivore species.

It is uric acid deposited in the bladder which forms stones during for example dehydration or hibernation.


After discussing the case with the owner they decided to let me do surgery on the animal and remove the stone.


There are 2 ways of doing so:

- first is opening the skin in the pre-femoral fossa

- second way is plastronotomy (opening the shell)


Because the stone was too big we had to go in via the plastron.






























After opening the plastron you cut the underlying muscles and coelomic membrane



Anesthesia was done using alfaxolone IV (dorsal tail vein) and isoflurane (manual ventillation).


The incision in the plastron was done via a circular moving saw-blade and frequent flushing with NaCl to reduce heat-induced trauma to the tissue.


After cutting the plastron you disect the piece loose from the underlying tissue

keeping the caudal connection intact so the piece of plastron still has blood circulaton for better healing afterwards.


















Incising the plastron



Then the coelomic membrane is cut, keeping in mind the ventral abdominal vein!


The bladder with stone is located and incised in a way similar to the cystotomy in cats and dogs.


The stone was removed and the bladder was sutered with monofilament suture.

The coelomic cavity was flushed.


















The bladder (opened) visible in the coelomic cavity




Then I closed the coelomic membrane and the overlying muscles, also with monofilament suture material.



















Closing the coelomic membrane




The piece of plastron is put back in to place and then a protective gel was applied so that the epoxy resin does not touch the soft tissue.


Finished up by putting epoxy resin was applied to keep the piece of plastron in place.




















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