Metabolic diseases - Faculty of Veterinary Medicine

Metabolic diseases in reptiles 

univ. prof. Zdenek denek Knotek, Knotek, 

DVM, PhD 

University of Veterinary and Pharmaceutical Sciences Brno 

Czech Republic

Common diseases 

Selected diseases 

3. disorders related to management 

5. disorders related to nutrition

Energy 

Physiology - metabolism 

poikilotherms (fishes, amphibians) 

ectotherms (reptiles) 

homeotherms (birds, mammals) 

reptiles 

POTZ 

energy 1/8 (of mammals), anaerobic 

glycolysis 

periferal gluconeogenesis

Metabolisms – body weight 

Stevens a Hume (1995)

Metabolism – body weight 


Metabolism – body temperature 


Metabolizmus – potřeba kyslíku 


Physiology 

herbivors, insectivors, carnivors (specialists)

Temperature ( °C) Transit time Reference 

GIT motility 

Transit time 


Energy 

ektotherm species 

Reptilian physiology 

prefered optimum for temperature 

hyperthemia and behavioral hyperthermia 

energy - 1/8 (in comparison with mammals), anaerobic glycolysis 

peripheral gluconeogenesis 

Respiration and oxygen consumption 

lungs, skin, special organs (turtles) 

tolerance to limited oxygen in tissues 

Food, nutrition, metabolism 

herbivores, insectivores, carnivores 

Excretion 

urea, amonium, uric acid 

kidney x urinary bladder 

Reproduction 

oviparous reptiles, viviparous reptiles

Energy 












Excretion 



Reproduction 


Energy 












Excretion 



Reproduction 


Energy 












Excretion 



Reproduction 


Energy 












Excretion 



Reproduction 


Blood biochemistry 

Plasma x serum ??? 

Biochemistry of urine 

pH, SG, minerals, proteins 

Biochemistry of different tissues 

enzymes – liver, kidney,muscles

Blood biochemistry 

Plasma x serum 

Plasma 

- volume of the fluid for analyses 

- short time, quicker – no time necessary for clothing 

- in comparison with the serum the concentration of 

plasma proteins could be higher (fibrinogen)

Plasma biochemistry – external and internal factors 

venipuncture 

hemolysis, low K concentration, high concentration of heparin 

anorexia (reptiles : birds : mammals) x postprandial values 

uric acid, bile acids 

circadian x circanual differences 

gender (hormones, reproduction) 

CB, cholesterol, TAG, Ca 

methods used in the laboratory 

TP: biurett method x refractometry 

standards used (specific for human medicine) 

electrophoresis (albumin, α,β,γ globulins) 

clinical use of results obtained – only very different values

TP 

(CREA) 

(UREA) 

Uric acid 

Plasma biochemistry

Plasma biochemistry 

GLUCOSE


ALP 

ALT 

AST 

bile acids


Ca P

HEALTH PROBLEMS THAT HAVE EMERGED DURING 

KEEPING CROCODILES IN CAPTIVITY 

Caiman spp., Crocodylus spp., Tomistoma schlegelii, 

insufficient nutrition overfeeding 

chronic metabolic problems 

renal disease traumatic lesions poor husbandry 

Symptoms limited movement, general weakness, lethargy, anorexia 

hind legs paresis 

Laboratory TP, BUN, uric acid, ALT, AST Ca, P,

Young crocodiles 

hypovitaminoses 

vit A, vit B, vit D 3 

mineral deficit - Ca 

Metabolic diseases 

Adult crocodiles 

obesitas 

bad nutrition, overfeeding !!!! 

hypovitaminoses of the vit B complex 

suboptimal feeding, diseases of the GIT


KEEPING CHELONIANS IN CAPTIVITY 

Testudo spp., Agrionemys spp., Trachemys scripta elegans 

insufficient nutrition poor husbandry 


PHA syndrome 

hibernation POFS POES 

pre-ovulatory follicle stasis post-ovulatory egg stasis 


colon constipation, runny nose syndrome, 

hind legs paresis 

Laboratory TP, uric acid, ALT, AST, BA, Ca, P,

Young tortoises 

hypovitaminosis 

vit A, vit B, vit D 3 

Calcium defficiency 


Adult tortoises 

obesitas, bad nutrition 

PHA syndrom 

hypovitaminoses of the vit B complex 

suboptimal feeding, diseases of the GIT 

complications related to reproduction – egg retention 

SGS syndrom (after ATB treatment ?)

MANAGEMENT nad TREATMENT of METABOLIC PROBLEMS 

Management 

– temperature 

– air humidity 

– fotoperiode 

– internal architecture 

– type and form of feeding 

Rehydratation (minimum 20 ml/kg ) 

Energy 

– per os 

– probe 

– parenteral forms 

• SC 

• IPP

9 year old female Marginated tortoise (T. marginata) 

History 

Problem 

- blepharospasm 

Treatment 

- vitamin B12 

- antibiotics (amoxycillin) 5 days 

Tortoise presented to AEAC 

- anorexia 

- upper respiratory tract disease 

- lethargy

Skin - neck, front legs, hind legs moist and red 

Eyelids – oedematous 

Mouth cavity mucose – pale

The blood profile was characterised by extremely low values 

for TP, haemoglobin concentration, PCV and total number of 

RBCs and WBCs. 

Values 

Haemoglobin 

PCV 

RBCs 

WBCs 

TP 

Units 

g/l 

l/l 

T/l 

G/l 

g/l 

15 

0. 07 

0.16 

2.00 

4.8 

Ref. 

40 - 80 

0.25 – 0.40 

0.50 – 1.30 

6 - 16 

30 - 60

Radiography revealed area of gas in GIT 

and grey-white pattern of the shell skeleton.

Intensive treatment 

antibiotics (cephalosporin) 

tube feeding – powder (Milupa) + water + vitamins 

vitamin C, calcium inj. 

Duphalyte inj. 

The tortoise died after nine days.

Post mortem examination 

parathyroid gland 

enlargement 

bleeding on 

the hearth 

muscle 

small liver


yellowish-green kidneys 

the shell extremely soft 

colon distension

Conclusion 

chronic metabolic bone disease (MBD) 

breakdown of the liver and kidneys function 

secondary inflammation with hemorrhages in the skin.

Iguana iguana 


KEEPING LIZARDS IN CAPTIVITY 

insufficient nutrition poor husbandry 


secondary hyperparathyroidism 

renal disease POFS POES 

pre-ovulatory follicle stasis post-ovulatory egg stasis 


large swelling of the hind legs, colon constipation 

tremor and hind legs paresis 

Laboratory TP, Ca, P, uric acid, ALT, AST

Carnivores 

obesitas 

non-optimal diet 

overfeeding 

biotin defficiency 

Metabolic diseases

Carnivores 

obesitas 

non-optimal diet 

overfeeding 

biotin defficiency 


1.5 year old male bearded dragon (P. vitticeps) 

Patient presented to AEAC 

-green spots on the dorsal part of the body (+ head, legs) 

-lethargy, anorexia

1.5 year old male bearded dragon (P. vitticeps) 

Patient presented to AEAC 

-green spots on the dorsal part of the body (+ head, legs) 

-lethargy, anorexia

Radiography revealed area of gas in the colon and foreign 

body in the stomach.

Bacteriology (skin sample) 

Anaerobic bacteria – 0 

Fungi - 0 

Aerobic bacteria Enterococcus faecalis 

Parasitology (faeces sample) 

Oxyurids - ++++ 

Enterobacter aerogenes

Values 

Haemoglobin 

PCV 

RBCs 

WBCs 

Heterophils 

Eosinophils 

Basophils 

Monocytes 

Azurophils 

Lymphocytes 

Units 

g/l 

l/l 

T/l 

G/l 

G/l 

G/l 

G/l 

G/l 

G/l 

G/l 

Haematology 

I. 

115 

0.37 

1.25 

2.00 

0.30 

0 

0.20 

0.10 

0.20 

1.20 

II. 

97 

0.33 

1.06 

5.52 

1.71 

0 

0.06 

1.21 

1.27 

1.27

Values 

TP 

Glucose 

ALP 

ALT 

AST 

CK 

Uric acid 

Ca 

P 

Plasma chemistry 

Units 

g/l 

mmol/l 

μkat/l 

μkat/l 

μkat/l 

μkat/l 

μmol/l 

mmol/l 

mmol/l 

I. 

45.1 

12.64 

5.21 

0.92 

0.15 

34.11 

125.8 

2.6 

1.3 

II. 

50.2 

22.13 

4.43 

3.29 

2.95 

742.9 

78.3 

2.7 

1.6

Intensive treatment 

antibiotics (enrofloxacin inj.) 

tube feeding (Feline Concentration Instant Diet) 

Duphalac p.o. 

The lizard was euthanasied after 14 days (T61 – i.v.)


obesitas


distension of the stomach (foreign body – stone)


enteritis pale brown liver

Conclusion 

obesitas 

foreign body in the stomach 

enteritis 

secondary inflammation of the skin

Insectivores 

Ca and vitamin D 3 deficit 

rachitis, osteodystrophy 


Insectivores 

Ca and vitamin D 3 deficit 

rachitis, osteodystrophy 


Herbivorous reptiles 


MBD - Ca and vitamin D 3 

rachitis, osteodystrophy, X acute hypocalcemia 

complications related to reproduction – egg retention 

SGS syndrom

Nutrition 

Young leaves 

flowers 

insects (worms, crickets ……)? 

Adult leaves 

flowers 

fruit 

(insects, small vertebrates ?)

Iguana iguana (MBD) calcium - problems

Anorexia 

pain - distension urinary bladder 

caecum, colon 

paralysis – hind legs + anorexia

Anorexia 

GIT obstipation 

Gout + nephromegaly + CRF

Iguanas – renal disease Healthy iguanas 

Boyer et al. (1996) Knotek et al. 

(2002) 

Knotek et al. (1999) 

TP g/l 63,00 53,51 22,0 – 78,2 

Gluco 

Uric 

acid 

Creat 

mmol 

/l 

μ 

mol/l 

μ 

mol/l 

9,55 10,07 8,3 – 16,5 

428,26 306,70 70,2 – 145,3 

52,20 61,07 8,8 – 66,3 

ALT μkat/l 3,52 0,74 0,1 – 1,2 

AST μkat/l 3,11 5,02 0,1 – 1,6 

K 

Ca 

P 

mmol 

/l 

mmol 

/l 

mmol 

/l 

6,10 4,18 1,3 – 5,2 

1,95 2,06 2,2 – 3,5 

7,69 5,95 1,4 – 3,1

POOS x POFS 

Clinical examination, RTG - USG, biochemistry - Ca

Females (POFS + POOS) Healthy iguanas 

Knotek et al. 

(2003) 

Knotek et al. 

(1999) 

TP g/l 38,2 - 72,2 22,0 – 78,2 

Gluk 

UA 

mmol/ 

l 

μ 

mol/l 

6,2 - 24,6 8,3 – 16,5 

61,4 - 815,6 70,2 – 145,3 

ALT μkat/l 0,5 - 4,5 0,1 – 1,2 

AST μkat/l 0,8 - 17,8 0,1 – 1,6 

ALP μkat/l 0,0 - 0,3 0,7 – 4,9 

Ca 

P 

mmol/ 

l 

mmol/ 

l 

2,1 - 7,1 2,2 – 3,5 

1,6 - 11,9 1,4 – 3,1

FEMALES 

POOS 

TP g/l 59,3 

Gluco 

Uric 

acid 

CHOL 

mmol/ 

l 

μ 

mol/l 

μ 

mol/l 

12,7 

151,1 

8,2 

ALT μkat/l 0,4 

AST μkat/l 0,8 

Ca 

P 

mmol/ 

l 

mmol/ 

l 

2,1 

3,7

FEMALES 

POOS 

MALES 

TP g/l 59,3 49,3 

Gluko 

Uric 

acid 

CHOL 

mmol/ 

l 

μ 

mol/l 

μ 

mol/l 

12,7 12,7 

151,1 90,5 

8,2 5,1 

ALT μkat/l 0,4 0,5 

AST μkat/l 0,8 0,3 

Ca 

P 

mmol/ 

l 2,1 2,8 

mmol/ 

l 3,7 2,1

FEMALES 

POFS 

MALES 

TP g/l 56,8 49,3 

Gluko 

Uric 

acid 

CHOL 

mmol/ 

l 

μ 

mol/l 

μ 

mol/l 

12,3 12,7 

320,6 90,5 

9,1 5,1 

ALT μkat/l 0,3 0,5 

AST μkat/l 0,8 0,3 

Ca 

P 

mmol/ 

l 6,9 2,8 

mmol/ 

l 3,5 2,1

FEMALES 

POOS POFS 

MALES 

TP g/l 59,3 56,8 49,3 

Gluko 

UA 

CHOL 

mmol/ 

l 

μ 

mol/l 

μ 

mol/l 

12,7 12,3 12,7 

151,1 320,6 90,5 

8,2 9,1 5,1 

ALT μkat/l 0,4 0,3 0,5 

AST μkat/l 0,8 0,8 0,3 

Ca 

P 

mmol/ 

l 2,1 6,9 2,8 

mmol/ 

l 3,7 3,5 2,1

1 year old female veiled chameleon (Chamaeleo calyptratus) 

showing very limited activity and a visible colour change was 

presented for “skin disease”. Both eyes were closed and the 

mouth mucose was pale.

The blood profile was characterised by leukocytosis due to 

increased number of azurophils and monocytes, very high plasma 

concentrations of uric acid and phosphorus. 

Values 

WBCs 

Azurophils 

Monocytes 

Uric acid 

P 

Units 

G/l 

G/l 

G/l 

μmol/l 

mmol/l 

30.50 

15.60 

6.10 

4 549.0 

5.71 

Ref. 

3 - 12 

0 – 1 

0 – 1 

80 - 250 

1 - 2

Radiographically a number of follicles and deformation on the long 

bones was demonstrated. 

Conclusion: 

chronic metabolic bone disease (MBD) 

with preovulatory follicle stasis (POFS)


KEEPING SNAKES IN CAPTIVITY 

Python spp., Boa spp., Epicrates spp., Sanzinia spp., Morelia spp. 

infections overfeeding 


renal disease traumatic lesions poor husbandry 

Symptoms anorexia 

dysecdysis 

Laboratory TP, uric acid, ALT, AST (Ca, P)

Metabolic diseases - Faculty of Veterinary Medicine

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