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Pneumonia

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Introduction

  • Cause: bacterial, viral, fungal (sometimes concurrently).
  • Signs: dyspnea, increased respiratory rate, open-mouth breathing, increased abdominal effort, nasal discharge.
  • Diagnosis: computed tomography, radiography, transtracheal lavage/percutaneous lung wash, endoscopy, hematology, biochemistry.
  • Treatment: antimicrobials in cases of bacterial infection, nebulization, fluid/nutritional support.
  • Prognosis: guarded to poor in advanced cases.
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Presenting signs

  • Early signs of pneumonia are commonly missed.
  • Cases of pneumonia are often advanced and progressed before presentation to a veterinarian. By this stage, reptiles may have decompensated and be showing severe respiratory signs.
  • Dyspnea is commonly a feature, generally inspiratory and occasionally expiratory concurrently:
    • Increased respiratory rate.
    • Open mouth breathing.
    • Increased abdominal effort.
    • Increased movement fore-limbs in chelonian.
    • Extension of the head and neck is frequently seen – most obvious in chelonia and lizards.
    • Aquatic species may not swim level due to consolidation of one lung lobe.
    • In cases of concurrent URT disease nasal discharge is seen.
    • Concurrent stomatitis Stomatitis is a common finding.
  • Systemic clinical signs are a common feature:
    • Anorexia Anorexia.
    • Extension of infection to bacteremia/septicemia.

Acute presentation

  • Collapse.
  • Death prior to showing obvious clinical signs.

Public health considerations

  • Zoonotic disease, eg Mycobacteria spp, Salmonella spp.

Cost considerations

  • Culture and sensitivity testing.
  • Radiography and other imaging.
  • Intensive care.
  • Culling of collection, eg ferlavirus outbreak Ferlavirus infection.

Special risks

  • Zoonosis.
  • Spread to collection.

Pathogenesis

Etiology

  • Bacterial, viral and fungal etiologies are seen (sometimes concurrently).
  • Bacteria:
    • Mycoplasma, particularly common in chelonian.
    • Pseudomonas, Aeromonas, E. coli, Klebsiella, Proteus, Salmonella most commonly isolated.
  • Viral:
    • Ferlavirus Ferlavirus infection is occasionally isolated in outbreaks of respiratory disease in snakes.
    • Herpes virus Herpes virus infection is common in chelonian.
    • Some snakes with arenavirus will present with respiratory disease.
  • Fungal:
    • Rare and usually associated with poor husbandry, in particular low environmental temperature or excessive humidity.
  • Parasitic:
    • Nematodes.
    • Metazoan parasite.
    • Trematodes.

Predisposing factors

General

  • Husbandry deficiencies Chelonia husbandry Lizard husbandry Snake husbandry:
    • Chronically low temperature below POTZ leading to immunosuppression.
    • Excessive humidity.
    • Ectoparasitism (spread disease, in particular viral pathogens).
    • Any cause of stress, eg transport.
  • Ineffective or absent quarantine Quarantine of new animals in a collection.
  • Nutritional deficiency - hypovitaminosis A Hypovitaminosis A.

Pathophysiology

  • Varies according to the pathogen involved.

Timecourse

  • Varies according to the pathogen involved.

Epidemiology

  • Varies according to the pathogen involved.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Bodewes R et al (2014) Novel divergent nidovirus in a python with pneumonia. J Gen Virol 95 (Pt 11), 2480-2485 PubMed.
  • Kycko A et al (2013) Granulomatous pneumonia and hepatitis associated with Providencia rettgeri infection in a crocodile monitor lizard (Varanus salvadorii). Acta Vet Hung 61 (1), 51-58 PubMed.
  • Papp T et al (2013) A novel type of paramyxovirus found in Hungary in a masked water snake (Homalopsis buccata) with pneumonia supports the suggested new taxonomy within the Ferlavirus genus. Vet Microbiol 162 (1), 195-200 PubMed.

Other sources of information

  • Schmidt R & Reavill D (2010) Cardiopulmonary Disease in Reptiles. In: Proc Association of Reptilian and Amphibian Veterinarians. Association of Reptilian and Amphibian Veterinarians, USA. pp 90-98.
  • Jacobson E R (2007) Infectious Diseases and Pathology of Reptiles: Color Atlas and Text. CRC Press, USA.