Evaluation of Neoplasia, Treatments, and Survival in Lizard Species

Neoplasia has been reported in lizards, but more research is needed to accurately document the prevalence and prognosis of the various known neoplasms that affect lizards. This study reviewed medical records from an online database, the Exotic Species Cancer Research Alliance (ESCRA), and reviewed published literature to determine the prevalence of neoplasia, malignancy, metastasis, treatment strategies, and outcomes by species and sex. Records from 55 individual lizards, 20 different species, and 37 different tumors were identified. In the literature, 219 lizards, 59 species, and 86 unique tumors were identified from 72 published case reports. Potential signalment factors such as age, sex, and species were evaluated to see if they affected case outcome. Additional factors including neoplasia type, presence of metastasis, and types of pursued treatments were also evaluated. Statistical analysis was performed to determine whether a factor was significantly associated with animal death due to the identified neoplasia or with animal survival or death due to other causes (non-neoplastic outcomes). Komodo dragons and savannah monitors were more likely to die from neoplasia compared to other lizard species. Cases where the status of metastasis was unknown were significantly associated with death due to neoplasia. Having an unknown status of male versus female was significantly associated with non-neoplastic outcomes of death. Leukemia and islet cell carcinoma were significantly associated with death due to neoplastic causes. Chondrosarcoma, myxosarcoma, osteosarcoma, and squamous cell carcinoma were significantly associated with non-neoplastic outcomes of death. Surgery alone and radiation therapy alone each were significantly associated with non-neoplastic outcomes of death, while lizards not receiving treatment were significantly associated with death due to neoplasia. Benign neoplasia was significantly associated with non-neoplastic outcomes of death. These results will aid in the improved diagnosis and management of neoplasia in lizard species, as well as expanding our understanding of prognostic indicators of neoplasia in lizards.

Case report: Intracoelomic neoplastic mass of undetermined origin in an Asia minor spur-thighed tortoise (Testudo graeca ibera)

This article describes the diagnostic, treatment and attempted characterization of a neoplasia of undetermined origin in a Asia minor spur-thighed tortoise. A 21-year-old male Asia minor spur-thighed tortoise (Testudo graeca ibera) was admitted for a 4-month history of diarrhea, and a 2-month history of anorexia and lethargy. Physical examination revealed a firm midcoelomic mass in the right prefemoral fossa. Blood biochemistry indicated hypocalcemia and mild elevation of aspartate aminotransferase. Supportive care was administered in the form of heating, baths, and calcium injections. Ultrasound examination of the coelomic cavity revealed a 6-cm diameter, highly vascularized mass with liver-like echogenicity. Neoplasia was suspected, and endoscopy was performed, revealing a brown circumscribed mass with smooth edges. Surgical removal of the mass was evaluated by CT scan and achieved via a plastrotomy; however, the patient died 1 day post-surgery. The mass was located on the dorsal right side of the coelomic cavity in the anatomic location of the right testicle. Histopathology revealed neoplastic cells organized in packets supported by fibrous septa. Neoplastic cells showed moderate and inconsistent positive immunohistochemical labeling for S100 and NSE, and negative immunohistochemical labeling for pan-cytokeratin, vimentin, CD3, CD79a, chromogranin A, and synaptophysin. The prominent histological and anatomical characteristics of the mass indicated a possible testicular or neuroendocrine (e.g., adrenal gland) origin. Due to inconclusive immunohistochemical profiles and poorly differentiated neoplastic cells, only a final diagnosis of intracoelomic malignant tumor of undetermined origin could be established. This case underscores the difficulties encountered in achieving definitive diagnoses of neoplastic diseases in reptile medicine.

Case report: Androgen-secreting adrenocortical tumors in eight cats

Urine marking, aggression, and other behavioral concerns are common reasons for cat owners to seek veterinary care. Empiric treatment for lower urinary tract disease or primary behavior disorders are commonly pursued, especially in those cases with normal routine laboratory evaluations. Herein, we report the clinicopathologic findings in eight sexually altered cats that were diagnosed with androgen-secreting adrenocortical tumors. Nearly all cats (n = 7) initially were evaluated for inappropriate urination and pungent urine, with additional behavioral concerns including aggression (n = 3) and excess vocalization (n = 4) commonly reported. Penile barbs (n = 5) were identified in all five male cats, and an enlarged clitoris was observed in one female cat. Testing of serum androgen concentrations revealed abnormally high androstenedione (n = 1) or testosterone (n = 7) concentrations. In the five cases with available adrenal tissue, histopathologic evaluation identified either an adrenocortical adenoma (n = 3) or adrenocortical carcinoma (n = 2). Hormonal abnormalities resolved and clinical signs improved in the four cats that underwent surgical adrenalectomy, with each of these cats surviving >1 year. However, clinical signs were minimally impacted with medical treatments, including one cat in which trilostane treatment failed to improve clinical signs or testosterone concentrations. This collection of cases underscores the importance of a detailed physical examination as well as the consideration of endocrine disturbances in cats undergoing evaluation for inappropriate urination or aggression. Furthermore, this report adds to the growing body of evidence that sex-hormone secreting adrenal tumors in cats may be an under-recognized syndrome.

Histological Variants of Squamous and Basal Cell Carcinoma in Squamates and Chelonians: A Comprehensive Classification

In the present study, the histological characteristics of squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs) obtained from 22 squamate and 13 chelonian species were retrospectively evaluated. While the examined tissues were originally diagnosed as 28 SCCs and 7 BCCs based on histological evaluation by a specialty diagnostic service, eight SCCs could be re-classified as BCCs and three SCCs proved to be non-neoplastic lesions. In addition, all SCCs and BCCs were classified into distinct histological variants. The SCCs could be categorized as one SCC in situ, three moderately differentiated SCCs, seven well-differentiated SCCs, and six keratoacanthomas. BCCs were classified as five solid BCCs, four infiltrating BCCs, five keratotic BCCs, and one basosquamous cell carcinoma. In addition, the present study reports the occurrence of BCCs in seven reptile species for the first time. In contrast to what has been documented in humans, IHC staining with the commercially available epithelial membrane antigen and epithelial antigen clone Ber-EP4 does not allow differentiation of SCCs from BCCs in reptiles, while cyclooxygenase-2 and E-cadherin staining seem to have discriminating potential. Although the gross pathological features of the examined SCCs and BCCs were highly similar, each tumor could be unequivocally assigned to a distinct histological variant according to the observed histological characteristics. Based on the results of this study, a histopathological classification for SCCs and BCCs is proposed, allowing accurate identification and differentiation of SCCs and BCCs and their histological variants in the examined reptile species. Presumably, BCCs are severely underdiagnosed in squamates and chelonians.

Endocrine Diagnostics for Exotic Animals

Endocrine disease in exotic species is less common than in small animals. Nevertheless, the diagnostic principles used in small animals can be adapted to evaluate endocrine disease in many of the exotic species although species-specific aspects need to be considered. This article covers important diseases such as thyroid dysfunction in reptiles and birds, hyperthyroidism in guinea pigs, and hyperadrenocorticism in ferrets. Glucose metabolism in neoplasms affecting normal physiology, such as insulinoma in ferrets and gastric neuroendocrine carcinoma in bearded dragons, is discussed. Calcium abnormalities, including metabolic bone disease in reptiles and hypocalcemia in birds, are also covered.

Diagnostic Clinical Pathology of the Bearded Dragon (Pogona vitticeps)

The bearded dragon (Pogona vitticeps), an omnivorous Agamid lizard native to inland Australia, is one of the most popular reptile pets due to their sociable behavior, tame demeanor, low-maintenance care, and relative ease of breeding. Because they are generally stoic animals, thorough physical examination in conjunction with routine clinicopathologic data can prove invaluable in identifying disease and implementing appropriate therapy in a timely manner. The goal of this article is to assist the practicing clinician, based on literature review, on how to approach the diagnostic challenge encountered in everyday practice when working up various conditions in bearded dragons.

Successful treatment of ivermectin overdose in a bearded dragon (Pogona vitticeps) using gastric lavage and intravenous lipid emulsion

OBJECTIVE

To describe the clinical signs and outcome following ivermectin overdose in a bearded dragon. This case also describes the novel use of intravenous lipid emulsion (ILE) as a rescue therapy in reptiles, as well as the use of aggressive gastrointestinal decontamination.

CASE SUMMARY

A 4-year-old female intact bearded dragon (Pogona vitticeps) (0.6 kg) was admitted to the ICU at a specialty hospital following accidental overdose of 40 mg (66.7 mg/kg) of ivermectin enterally. The patient was physically inverted to allow passive reflux of the medication, then sedated for gastric lavage. A 20% ILE was administered intravenously due to the high risk for fatality. Additional treatments included 2 doses of activated charcoal, as well as SC fluids, enteral nutrition, and sucralfate. The patient was profoundly sedate until day 4 when mild improvements in mentation were noted. The patient started ambulating on its own on day 6 and was discharged from the hospital on day 13. The patient was alive 720 days postdischarge.

NEW OR UNIQUE INFORMATION PROVIDED

This is the first case report describing the events following ivermectin overdose and the use of ILE therapy and activated charcoal in a bearded dragon. These therapies were tolerated with no adverse effects noted in this patient. This report provides evidence that complete recovery from ivermectin overdose is possible.

Use of computed tomography to determine a species-specific formula for body surface area in bearded dragons (Pogona vitticeps)

OBJECTIVE

To use CT-derived measurements to calculate a shape constant (K constant) and create a formula to calculate body surface area (BSA) on the basis of body weight in bearded dragons (Pogona vitticeps).

ANIMALS

12 adult client-owned bearded dragons that underwent CT between December 4, 2019, and April 2, 2020.

PROCEDURES

Each bearded dragon in this prospective cohort study underwent physical examination, body weight measurement, and CT. A 3-D surface model was then reconstructed from CT data with available software and used for BSA calculations. Animals were considered collectively and grouped by sex and age. Nonlinear regression analysis of BSA versus body weight was performed, and a species-specific formula was derived for calculating BSA in bearded dragons.

RESULTS

Mean age, body weight, and CT-derived BSA were 2.1 years, 356 g, and 580 cm². The calculated K constant was 11.6 (R² = 0.994; SE = 0.275) for the 12 bearded dragons, and the CT-derived BSA formula was as follows: BSA in cm² = 11.6 × (body weight in g)^2/3. The K constant differed substantially for bearded dragons grouped by age (12.1 for younger [between 1 and ≤ 2 years of age; n = 8] vs 10.9 for older [> 2 years of age; 4] animals) but did not differ on the basis of sex.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that because the K constant for bearded dragons in the present study was larger than the preexisting K constant of 10 used for reptiles or the various K constants established for some companion mammals, doses of chemotherapeutic drugs needed to treat affected bearded dragons may be higher than previously thought.

Gross, histologic, and immunohistochemical characteristics of cutaneous chromatophoromas in captive bearded dragons

Chromatophoromas are neoplasms that develop from the dermal pigment-bearing and light-reflecting cells (chromatophores) in the skin of reptiles, fish, and amphibians. Seventeen cutaneous chromatophoromas were identified from 851 bearded dragon submissions (2%) to a private diagnostic laboratory in a 15-y period. No sex predilection was found. Ages ranged from 9 mo to 11 y. Chromatophoromas most commonly were single, raised, variably pigmented masses or pigmented scales on the trunk, and less commonly the extremities or head. Microscopically, iridophoromas, melanophoromas, mixed chromatophoromas, and nonpigmented chromatophoromas were identified. Neoplasms were often ulcerated and invaded deep into the subcutis and muscle. Most commonly, nuclear atypia was mild-to-moderate, and mitotic count was low. Six neoplasms had abundant, periodic acid-Schiff-positive, mucinous stroma. Histologic examination was often adequate to diagnose chromatophoromas in bearded dragons given that 11 of 17 had some degree of pigmentation, although it was often scant. IHC for S100 and PNL2 could be helpful to diagnose poorly pigmented neoplasms. No lymphatic invasion or metastases at the time of excision were noted in any of the cases. Follow-up data were available for 6 cases, with no reports of recurrence or neoplasia-related death. Two cases had elevated mitotic counts and nuclear pleomorphism, which has been associated with metastasis in other reports of bearded dragon chromatophoromas. In general, it appears that aggressive surgical excision is often curative, but monitoring may be warranted for cases in which tumors had high mitotic count and nuclear pleomorphism.

Lymphoid leukemia in five bearded dragons (Pogona vitticeps)

CASE DESCRIPTION

2 male and 3 female adult bearded dragons (Pogona vitticeps) were evaluated at the North Carolina State University College of Veterinary Medicine's Exotic Animal Medicine Service between September 2018 and October 2019 because of severe lymphocytosis.

CLINICAL FINDINGS

All 5 bearded dragons had nonspecific clinical signs, including lethargy, poor appetite, ocular discharge, and weight loss. Clinicopathologic testing revealed extremely high lymphocyte counts with morphological findings consistent with lymphocytic leukemia.

TREATMENT AND OUTCOME

All 5 patients were treated with lomustine, prednisolone, and antimicrobials. In addition, 1 or 2 doses of L-asparaginase were administered when the drug was available. Partial remission was achieved in all 5 patients. One patient, after disease progression was documented, was treated with cyclophosphamide and achieved a second partial remission. One of the 5 patients was still alive and continuing to receive chemotherapy at the time of final follow-up 244 days after the initial diagnosis. Survival times (ie, times from initial diagnosis to euthanasia) for the other 4 patients were 57, 157, 330, and 416 days.

CLINICAL RELEVANCE

The present report represented the first description of lomustine as a primary chemotherapeutic agent for the treatment of lymphocytic leukemia in bearded dragons and provided information on response to treatment, adverse effects, and survival times.

Metastatic Cholangiocarcinoma in a Bearded Dragon (Pogona vitticeps)

A 6.5-year-old female bearded dragon (Pogona vitticeps) was presented with a swollen right pelvic limb. A tissue core biopsy from the swollen area was performed and a presumptive histopathological diagnosis of adenocarcinoma was made. This diagnosis was confirmed after limb amputation. Two months after amputation a sudden deterioration in the overall health of the patient occurred. Ultrasound examination of the coelomic cavity revealed hypoechoic lesions in the liver. The patient was euthanized and submitted for necropsy which revealed a severely enlarged liver with multiple coalescing yellowish nodules. Cholangiocarcinoma of the liver with metastases to the spleen, left mesovarium and right pelvic limb was diagnosed after histopathological examination.

Ocular Iridociliary Adenoma in a Congo African Grey Parrot (Psittacus erithacus)

A 19-year-old female Congo African grey parrot (Psittacus erithacus) presented for an oval, solid, pigmented, suspected intraocular mass with extrascleral extension through the inferior cornea of the left eye. The eye was nonvisual, and intraocular portions of the mass significantly altered the posterior chamber. Neoplasia was confirmed by biopsy, and enucleation was performed because of the severity of ocular disease, loss of vision, enhancement of patient comfort, and potential metastasis. Histopathologic examination of the entire globe revealed a pigmented iridociliary adenoma. Iridociliary adenomas have been rarely reported in birds, and this case report details diagnosis and treatment. Iridociliary adenomas in other species are often benign, indicating this neoplasia can be successfully treated with no reoccurrence by complete excision.

Retrospective review of neoplasms of captive lizards in the United Kingdom

BACKGROUND

Neoplasia has historically been regarded as an unusual occurrence in reptiles. The aim of the present study was to evaluate the prevalence of neoplasms in routine diagnostic samples submitted to a specialist exotic animal laboratory.

METHODS

Over a 10-year period, 690 lizard samples were submitted for histopathological or cytopathological examination by Royal College of Veterinary Surgeons specialists in Veterinary Pathology (Zoo and Wildlife). Records were reviewed retrospectively and non-neoplastic diagnoses excluded from further analysis.

RESULTS

158 neoplasms were diagnosed in 149 lizards, with 22.9% of submissions resulting in a diagnosis of neoplasia. The skin was the most commonly affected organ, and squamous cell carcinomas were the most common neoplasms identified (17.7% of all neoplastic diagnoses).Bearded dragons and panther chameleons had a statistically significant higher proportion of neoplasia diagnosis than the lizard population as a whole, and geckos had a statistically significantly lower proportion.Several neoplasms identified in this study have not been previously reported in lizards, including a testicular Sertoli cell tumour, testicular granulosa cell tumour, splenic haemangiosarcoma, gastric adenocarcinoma and basal cell carcinoma.

CONCLUSION

The results suggest that the prevalence of neoplasia in captive lizards may be higher than previously reported, and that there is variation in prevalence between different lizard species and families. It is unclear whether these differences relate to genetic or management factors.

Specific anatomy and radiographic illustration of the digestive tract and transit time of two orally administered contrast media in Inland bearded dragons (Pogona vitticeps)

The aim of this study was to describe the specific gross and radiographic anatomy of the digestive tract of inland bearded dragons (Pogona vitticeps). Eleven bearded dragon cadavers of both sexes (6 females, 5 males) were dissected to examine, measure, and document the specific gross anatomy of the alimentary canal. Measurements collected from the cadavers included snout-vent length, total length of the alimentary canal, and the lengths of the individual sections of the gastrointestinal tract, including the esophagus, stomach, small intestine, ampulla coli, isthmus coli, rectum, and the distance from the coprodeum to the vent opening. Twenty-two healthy adult bearded dragons (13 females, 9 males) maintained under standardized husbandry conditions underwent a physical examination, blood collection, and whole-body dorsoventral and lateral survey radiographs; these animals were used to provide the radiographic images of the complete digestive tract. For the subsequent contrast passage studies, two different contrast media, barium sulfate (BaSO₄, Barilux suspension) and an iodinated ionic radiocontrast agent (Sodium meglumine amidotrizoate [SMAT], Gastrografin), were used. Water-diluted Barilux suspension (dose 9 ml/kg) was administered orally to 5 bearded dragons, while Gastrografin (dose 5ml/kg) was administered orally to 21 bearded dragons. Four animals were used for both contrast media studies, but received a break of four weeks in between. Dorsoventral and laterolateral radiographs were collected at 0 (baseline), 15, 30, and 45 minutes and 1, 2, 3, 4, 5, 6, 8, 10, 12, 24, 30, and 36 hours after each contrast medium was administered. Both contrast media were found to illustrate the alimentary tracts in the adult bearded dragons. Transit time was substantially faster with SMAT, and SMAT illustrated the entire gastrointestinal tract within 36 hours; BaSO₄ did not fully illustrate the gastrointestinal tract in 36 hours. These results might serve as a guideline for the interpretation of subsequent contrast studies in this lizard species.

Mixed Malignant Pancreatic Tumour in a Rhesus Macaque (Macaca mullata)

Pancreatic islet cell tumours are rare in non-human primates. The majority of reported cases are benign islet cell adenomas in rhesus macaques (Macaca mullata). Here we describe a pancreatic tumour composed of both exocrine and endocrine cells known as a mixed acinar-neuroendocrine carcinoma in a captive rhesus macaque. A diagnosis of a mixed tumour requires intermingling of neoplastic exocrine and neuroendocrine cells and must be differentiated from ductal adenocarcinomas in which only the ductal component is neoplastic with interspersed normal neuroendocrine cells. Immunohistochemistry, including antibodies against cytokeratin 7 and chromogranin A, was used to demonstrate that both exocrine and endocrine neoplastic cells exhibited cellular atypia, invasion into the adjacent parenchyma and intraparenchymal metastasis consistent with a mixed malignant tumour. Expression of multiple hormones such as gastrin, insulin, pancreatic polypeptide and somatostatin was also observed throughout the neoplastic cell population, while the endocrine component of the neoplasm was predominantly positive for glucagon.

Immunohistochemical staining patterns of alpha-keratins in normal tissues from two reptile species: implications for characterization of squamous cell carcinomas

Background

Cytokeratins with epitopes in common with those of alpha (acidic and basic) mammalian keratins have been immunohistochemically demonstrated in the epidermis of reptiles. However, there are no reports of immunohistochemical staining patterns of alpha-keratins in other tissues from reptiles. Because the epithelial tumours usually retain the keratin patterns of their normal epithelial origin, it is necessary to know in advance these patterns in the major normal epithelia and organs. We used anti-alpha human keratin AE1 and AE3 monoclonal antibodies to study the staining patterns of alpha-keratins in the major normal epithelia and organs from two reptile species [the bearded dragon (Pogona vitticeps) and the loggerhead sea turtle (Caretta caretta)]. We also studied the immunolocalization of alpha-keratins in squamous cell carcinomas (SCCs) in a bearded dragon and two loggerhead turtles.

Results

Acidic alpha-keratin (AE1 positive) was detected in many of the epithelial tissues of the bearded dragons; however, the detection of basic alpha-keratin (AE3 positive) was much more limited. Alpha-keratins were detected in a greater number of tissues of loggerhead turtles compared with those observed in bearded dragons. In the bearded dragon SCC, all layers of the nests of neoplastic cells, including the cornified layer of the keratin pearls, were strongly reactive with the AE1 antibody. However, a weak reactivity using the AE3 antibody was detected in the basal and intermediate layers of these nests. In the cutaneous SCCs of both sea turtles, acidic alpha-keratin was detected in the basal and suprabasal layers, and in all of the invasive neoplastic cords, while basic alpha-keratin was mainly detected in the invasive neoplastic cords. The pattern observed in the metastases in both turtles consisted of immunohistological detection of acidic alpha-keratin in all metastatic foci, and limited or lack of detection of basic alpha-keratin.

Conclusions

This study provides, for the first time, information about the immunohistochemical staining patterns of alpha-keratins in normal tissues from bearded dragons and loggerhead sea turtles, and confirms the usefulness of AE1 and AE3 monoclonal antibodies in these reptile species. The use of these antibodies also contributed to a better characterization of SCCs in these species.

Gastrinoma and Zollinger-Ellison syndrome in canids: a literature review and a case in a Mexican gray wolf

Gastrinoma, an infrequent diagnosis in middle-aged dogs, occurs with nonspecific gastrointestinal morbidity. Laboratory tests can yield a presumptive diagnosis, but definitive diagnosis depends on histopathology and immunohistochemistry. We describe a malignant pancreatic gastrinoma with lymph node metastases and corresponding Zollinger-Ellison syndrome in a Mexican gray wolf ( Canis lupus baileyi) and review this endocrine neoplasm in domestic dogs. A 12-y-old, captive, male Mexican gray wolf developed inappetence and weight loss. Abdominal ultrasonography revealed a thickened duodenum and peritoneal effusion. Two duodenal perforations were noted on exploratory celiotomy and were repaired. Persisting clinical signs led to a second celiotomy that revealed a mesenteric mass, which was diagnosed histologically as a neuroendocrine carcinoma. During the following 16 mo, the wolf received a combination of H₂-receptor antagonists, proton-pump inhibitors, gastroprotectants, and anti-emetics, but had recurrent episodes of anorexia, nausea, acid reflux, and remained underweight. Worsening clinical signs and weakness prompted euthanasia. The antemortem serum gastrin concentration of 414 ng/L (reference interval: 10-40 ng/L) corroborated hypergastrinemia. Autopsy revealed a mass expanding the right pancreatic limb; 3 parapancreatic mesenteric masses; duodenal ulcers; focal duodenal perforation with septic fibrinosuppurative peritonitis; chronic-active ulcerative esophagitis; and poor body condition. The pancreatic mass was diagnosed histologically as a neuroendocrine carcinoma and the parapancreatic masses as lymph node metastases. Immunohistochemistry of the pancreatic mass was positive for gastrin and negative for glucagon, insulin, pancreatic polypeptide, serotonin, somatostatin, and vasoactive intestinal peptide.

MULTIHORMONAL ISLET CELL CARCINOMAS IN THREE KOMODO DRAGONS (VARANUS KOMODOENSIS)

  Multihormonal pancreatic islet cell carcinomas were found in one female and two male captive geriatric Komodo dragons (Varanus komodoensis). Gross changes in the pancreas were visible in two of the cases. Clinical signs noted in the Komodo dragons were lethargy, weakness, and anorexia. Histologically, the tumors were comprised of nests and cords of well-differentiated neoplastic islet cells with scant amounts of eosinophilic cytoplasm and round, euchromatic nuclei, with rare mitoses. Infiltration by the islet cell tumor into the surrounding acinar tissue was observed in all cases, but no metastatic foci were seen. Multihormone expression was observed in all tumors, which labeled strongly positive for glucagon and somatostatin and focally positive for polypeptide. Pancreatic islet cell neoplasms should be considered in the differential diagnosis for geriatric Komodo dragons presenting with weakness, lethargy, and poor appetite.

Oncology of Reptiles: Diseases, Diagnosis, and Treatment

Based on necropsy review, neoplasia in reptiles has a comparable frequency to that of mammals and birds. Reptile neoplasia is now more frequently diagnosed in clinical practice based on increased use of advanced diagnostic techniques and improvements in reptilian husbandry allowing greater longevity of these species. This article reviews the current literature on neoplasia in reptiles, and focuses on advanced diagnostics and therapeutic options for reptilian patientssuffering neoplastic disease. Although most applied clinical reptile oncology is translated from dog and cat oncology, considerations specific to reptilian patients commonly encountered in clinical practice (turtles, tortoises, snakes, and lizards) are presented.

Radiographic anatomy and barium sulfate contrast transit time of the gastrointestinal tract of bearded dragons (Pogona vitticeps)

The positive contrast gastrointestinal study is a common non-invasive diagnostic technique that does not require anesthesia and enables good visualization of the digestive tract. Radiographic anatomy and reference intervals for gastrointestinal contrast transit time in inland bearded dragons (Pogona vitticeps) were established using seven animals administered 15 ml/kg of a 35% w/v suspension of barium by esophageal gavage. Dorso-ventral and lateral radiographic views were performed at 0, 15, 30 min, 1, 2, 4, 6, 8, 12 h, and then every 12 h up to 96 h after barium administration. Gastric emptying was complete at a median time of 10 h (range 4-24 h). Median jejunum and small intestinal emptying times were 1 h (range 30 min-2 h) and 29 h (range 24-48 h), respectively. Median transit time for cecum was 10 h (range 8-12 h). Median time for contrast to reach the colon was 31 h (range 12-72 h) after administration. Results were compared to those obtained in other reptilian species. This technique appeared safe in fasted bearded dragons and would be clinically applicable in other lizard species.

Benign gastric neuroendocrine tumors in three snow leopards (Panthera uncia)

Neuroendocrine tumors are relatively rare neoplasms arising from neuroendocrine cells that are distributed throughout the body and are predominant in the gastrointestinal tract. This report describes benign, well-differentiated gastric neuroendocrine tumors in three captive snow leopards (Panthera uncia). All tumors were well circumscribed, were within the gastric mucosa or submucosa, and had histologic and immunohistochemical features of neuroendocrine tumors. Histologic features included packeted cuboidal to columnar epithelial cells that were arranged in palisades or pseudorosettes and contained finely granular cellular cytoplasm with centrally placed, round nuclei. Cytoplasmic granules of neoplastic cells strongly expressed chromogranin A, variably expressed neuron-specific enolase, and did not express synaptophysin or gastrin. Each leopard died or was euthanatized for reasons unrelated to its tumor.

Claudin-7-positive synchronous spontaneous intrahepatic cholangiocarcinoma, adenocarcinoma and adenomas of the gallbladder in a Bearded dragon (Pogona vitticeps)

In this study, synchronous spontaneous, independent liver and gallbladder tumours were detected in a Bearded dragon (Pogona vitticeps). The multiple tumours consisted of intrahepatic cholangiocarcinoma as well as in situ adenocarcinoma and two adenomas of the gallbladder. The biliary epithelial cells and the cholangiocarcinoma showed membranous cross-immunoreactivity for claudin-7. The gallbladder epithelial cells, its adenoma and adenocarcinoma showed basolateral cross-reactivity for claudin-7. We think that the humanised anti-claudin-7 antibody is a good marker for the detection of different primary cholangiocellular and gallbladder tumours in Bearded dragons. The cholangiocytes, the cholangiocarcinoma, the endothelial cells of the liver and the epithelial cells and gallbladder tumours all showed claudin-5 cross-reactivity. The humanised anti-cytokeratin AE1-AE3 antibody showed cross-reactivity in the biliary epithelial cells, cholangiocarcinoma cells, epithelial cells and tumour cells of the gallbladder. It seems that this humanised antibody is a useful epithelial marker for the different neoplastic lesions of epithelial cells in reptiles. The humanised anti-α-smooth muscle actin (α-SMA) antibody showed intense cross-reactivity in the smooth muscle cells of the hepatic vessels and in the muscle layer of the gallbladder. The portal myofibroblasts, the endothelial cells of the sinusoids and the stromal cells of the cholangiocarcinoma and gallbladder tumours were positive for α-SMA. The antibovine anti-vimentin and humanised anti-Ki-67 antibodies did not show crossreactivity in the different samples from the Bearded dragon.

A Gastric Neuroendocrine Carcinoma Expressing Somatostatin in a Bearded Dragon (Pogona Vitticeps)

A metastatic gastric neuroendocrine carcinoma in a 2.5-year-old inland bearded dragon ( Pogona vitticeps) with a chronic history of anorexia, weight loss, depression, and acute melena is described. Histologic examination of the gastric mass revealed a densely cellular tumor arranged in nests and occasional rosettes of hyperchromatic cells with oval to spindle-shaped nuclei and minimal cytoplasm; the tumor was supported by a moderate fibrovascular stroma. Similar cells invaded through the gastric mucosa, and there were multiple hepatic metastases. The neoplastic cells were weakly immunopositive for neuron-specific enolase and moderately positive for somatostatin but were negative for chromogranin AB and gastrin. Ultrastructural studies revealed scattered neurosecretory granules in the neoplastic cells, confirming the diagnosis of a neuroendocrine carcinoma.