Oliveri Matteo, Agudelo Carlos Fernando, Cermakova Eva, Knotkova Zora, Krizova Petra, Luciani Alessia, Knotek Zdenek
GWANA VET, Exotic Animal Hospital, Madrid, Spain.
Faculty of Veterinary Medicine, Teaching Veterinary Hospital, University of Teramo, Teramo, Italy.
Vet Med (Praha). 2022 Feb 4;67(5):263-269. doi: 10.17221/67/2021-VETMED. eCollection 2022 May.
A two-year-old male veiled chameleon () was referred for a gular oedema and bilateral blepharoedema. The echocardiography revealed a ventricular hypertrophy, pericardial effusion, and valvular regurgitation of the right atrioventricular valve. Treatment with hydrochlorothiazide, enalapril, and carvedilol was commenced. Within 3 weeks of treatment, the valvular regurgitation was noticeably decreased. In the 4 week of treatment, the echocardiography revealed a reduction in the myocardium hypertrophy. After an additional month of home treatment, the patient was presented with anorexia and decreased activity. Despite the supportive care, the patient died. The histopathology revealed mild to moderate fibrosis of the epicardium. Moderate to severe fibrosis, degeneration of the myofibrils, fatty atrophy, interstitial oedema and mild calcification was seen in the atria. The tunica intima, media and adventitia of the major cardiac vessels were moderately fibrotic, swollen and interfused by myxoedema. The kidney histopathology revealed moderate sclerosis and atrophy of the glomeruli, vacuolation of the tubular epithelium, fibrosis, and infiltration of the leucocytes in the interstitium. The therapeutic protocol with hydrochlorothiazide, ACE inhibitor enalapril and β-blocker carvedilol reduced the myocardium hypertrophy and the valvular regurgitation; however, the prolonged use of diuretics jeopardized the renal function in our patient. Frequent blood analyses are necessary using diuretics in reptile patients.
一只两岁的雄性蒙面变色龙因喉部水肿和双侧眼睑水肿前来就诊。超声心动图显示心室肥厚、心包积液和右房室瓣瓣膜反流。开始使用氢氯噻嗪、依那普利和卡维地洛进行治疗。治疗3周内,瓣膜反流明显减少。治疗4周时,超声心动图显示心肌肥厚减轻。在家继续治疗一个月后,该变色龙出现厌食和活动减少。尽管给予了支持性护理,该变色龙仍死亡。组织病理学显示心外膜有轻度至中度纤维化。心房可见中度至重度纤维化、肌原纤维变性、脂肪萎缩、间质水肿和轻度钙化。主要心脏血管的内膜、中膜和外膜有中度纤维化、肿胀,并伴有黏液性水肿融合。肾脏组织病理学显示肾小球中度硬化和萎缩、肾小管上皮细胞空泡化、纤维化以及间质白细胞浸润。使用氢氯噻嗪、ACE抑制剂依那普利和β受体阻滞剂卡维地洛的治疗方案减轻了心肌肥厚和瓣膜反流;然而,在我们的病例中,利尿剂的长期使用损害了肾功能。在爬行动物患者中使用利尿剂时,需要频繁进行血液分析。