Successful Emergency Treatment in Bradypus variegatus following Non-Hemorrhagic Hypovolemic Shock

Background: The brown-throated sloth (Bradypus variegatus) occurs from the Nicaragua to Brazil. In brazilian amazonian, these animals are rescued with illnesses caused by anthropic actions. Emergencial treatment of sloths is complex because is a lack of specie-specific information allied to a particularly physiology. They have low metabolism and physiological parameters during resting time is 4-7 breaths/min, 40-100 heartbeats/min and temperature between 32-35ºC. They are also folivores, predisposing cases of dehydration and even hypovolemic shock. This study aimed to report the emergency treatment performed on a specimen of Bradypus variegatus affected by hypovolemic shock due to dehydration.Case: A male sloth weighing 2.7 kg was attended at the Veterinary Hospital-Wild Animals Sector of the Federal University of Pará (HVSAS-UFPA), victim of untreated hypovolemic shock due three days of forced eating with inadequate food, which resulted in dehydration, non-hemorrhagic hypovolemic shock, and severe apathy. Physiological parameters were 8 breaths/min, heart rate 90/min and rectal temperature of 33°C. Treatment begun with fluid therapy taking account of 10% of body dehydration (270 mL Ringer lactate, 8 mL vitamin complex and 2 mL glucose), for respiratory decompensation nebulization was conducted with epinephrine (0.5 mL/kg), and intramuscular administration of vitamin B complex (1 mg/kg), metoclopramide (0.2 mg/kg), ranitidine (0.5 mg/kg), and dexamethasone (0.3 mg/kg) to metabolic stimulation improvement. Physiological parameters were monitored every 10 min for the first 12 h of hospitalization. The management were gradually established as the clinical conditions were improved, including forced feeding, daily walks, and enclosure adapted for the minimal behavioral and biological requirements. After 14 days of intensive treatment, the animal was considered ready for release.Discussion: Treatment of critically ill and unnourishment patients requires prompt interventions. Animals with low metabolism potentially have reduced chances of success, therefore, a prompt establishment of viable airways and body temperature maintenance would allow the efficient drugs metabolization. Severe dehydration can lead to animal death by hypovolemic shock, as a consequence of low blood volume, diminish in blood pressure and in the amount of oxygen in body supply, so fluid replacement is essential, as well as stimulating respiratory compensation through bronchodilator drugs. Furthermore, metabolic stimulation is important in cases to prevent numbness, which is common in very weak sloths. The constant monitoring of physiological parameters since at first moment of hospitalization provided parameter to decide about particular needs adaptations during the animal recovery time. Such protocols described for the brown-throated sloth was absent in the literature. In conclusion, the therapeutic and management protocol implemented and adapted to a particular patience, as brown-throated sloth, resulted in a gradual clinical improvement and allowed to its return for the natural environment

Use of Cost-effective Vacuum-assisted Closure Technique for Shell Fracture Repair and Coelomic Cavity Rupture Healing in a Chelonia carbonaria

Background: The vacuum-assisted closure (VAC) therapy system has been used as a noninvasive wound management technique for shell damage in Chelonians. These animals are excellent candidates for VAC therapy because of their unique shell anatomyconsists of dermal bones, which make bandage placement easier. Beyond that, they are suited for this technique behaviorally, because they are not inclined to remove the vacuum system intentionally. Considering the possibility of Testudines shell repair with the use of less invasive techniques that result in additional dermal bone lesions, the objective of the present study is to describe the adaptation of a vacuum dressing protocol using low-cost and easily accessible materials for post-traumatic shell healing of a specimen of Chelonoidis carbonaria.Case: A specimen of tortoise (Chelonoidis carbonaria), a male, weighing 630 g, approximately 3-year-old, was received at the Veterinary Hospital - Wild Animals Sector in the Federal University of Pará (UFPA) because of being run over by a vehicle. On physical examination, fractures of the dermal plaques and underlying bone structures were found, with rupture of the coelomic cavity. In addition, there was exposure and incarceration of an intestinal loop, with the presence of bleeding. According to the findings of the physical screening examination, the patient's prognosis was defined as good, as described in the literature that specifically focused on chelonian shell injuries. The animal was sent to the diagnostic imaging sector. Then, drug therapy was provided for pain control, vitamins were administered for nutritional support, and antibiotics and anti-inflammatory drugs were instituted. For the closure of the shell and coelomic cavity, a bandage was used with the VAC therapy system adapted as described for Chelonians in previous reports. After a complete osteosynthesis and closure of the coelomic cavity, repair of the integumentary component of the shell was possible. For this procedure, the animal did not need to be anesthetized. The patient was physically restrained by being placed in suspension on a support with a diameter smaller than the plastron. Complete asepsis of the shell was necessary. On top of the lesion, a polypropylene mesh and color less dental resin were applied. The animal continued to be evaluated after the repair to check for potential complications. This procedure ensured that the repaired plates remained stable. Furthermore, the animal did not seem to have any discomfort with the resin when moving, so the animal was discharged after 25 days of hospitalization.Discussion: Radiography was important to determine the condition of the animal and clinical prognosis, and thus, to perform the proper treatment. The VAC therapy system was successful in assisting the patient's recovery. It enabled the reduction of the healing time since shell injuries usually require four to eighteen months to heal. In this report, the healing process only required 17 days, demonstrating that the VAC therapy system is a beneficial treatment to treat traumatic injuries in Testudines. The restoration protocol of the integumentary component using dental resin is less invasive, and this type of material has been used previously by other authors. Drug treatment with aminoglycosides and sulphonamides administered prophylactically has proven to be effective and has been used successfully in reptiles. These drugs may be combined with maintenance fluid therapy to prevent adverse reactions from aminoglycosides, such as nephrotoxicity. It was concluded that the use of the VAC therapy system reduced the time of post-traumatic healing of the carapace and proved to be an innovative approach to treat traumatic injuries in Testudines in a less invasive way