Tympania of the stomach in turtles

The reasons:

Tympania and pneumonia are often confused. How to distinguish?

This issue is complicated by the fact that these diseases occur in red-eared turtles with almost the same clinical picture: respiratory syndrome (breathing with an open mouth), mucus secretion from the oral cavity, as a rule, anorexia and roll when swimming on any side. However, the etiology and pathogenesis of tympania and pneumonia in red-eared turtles differ dramatically. Tympania in a young red-eared turtle develops, as a rule, against the background of a lack of calcium in the diet, with this disease, dynamic intestinal obstruction occurs in red-eared turtles (calcium ions are needed for normal contraction of the muscular membrane of the intestine), intestinal overflow with gases.

Pneumonia in the red-eared turtle develops due to the penetration of the pathogen into the lung parenchyma. The penetration of the pathogen can be carried out both endogenously, that is, inside the body (for example, with sepsis), and exogenously – from the environment.

The pathogenesis of the disease “pneumonia” in the red-eared turtle is due to an inflammatory reaction with the formation of exudate (liquid) in the lung parenchyma, a change in the density of the lung tissue, resulting in a heel when swimming.

The differential diagnosis of pneumonia from tympania of the red-eared turtle consists in the analysis of anamnesis data, clinical examination and additional studies. Data of anamnesis and clinical examination for tympania in a red-eared turtle may include a roll when swimming on any side or elevation of the posterior half of the body relative to the anterior (with swelling of the colon), anorexia. Periodic or persistent mucous discharge from the mouth and nasal cavity (unlike pneumonia in the red-eared turtle, mucous discharge is associated with regurgitation of stomach contents into the oral cavity). With this disease, red-eared turtles are also observed: stretching of the neck and breathing with an open mouth, swelling of the skin of the inguinal pits and skin in the neck and armpits (the turtle cannot be completely removed under the shell – this cannot be done due to excessive gas formation in the gastrointestinal tract).

Of the additional studies to clarify the diagnosis of “tympania” in the red-eared turtle, as a rule, an X-ray examination is performed in the dorso-ventral projection (Fig. 1), to detect gas accumulation in the intestinal loops. As a rule, it is not possible to qualitatively conduct and interpret X-ray images of the lungs (craniocaudal and latero-lateral projection) in young red-eared turtles weighing from several grams to several tens of grams, if pneumonia is suspected. 

Another additional study to verify the diagnosis of the disease in red-eared turtles is a cytological examination of the mucous exudate released from the mouth. When tympania in a red-eared slider, a smear can show squamous non-keratinized epithelium of the mouth and esophagus, cylindrical epithelium of the stomach. With pneumonia in a red-eared turtle, a smear will determine the respiratory epithelium, inflammatory markers (heterophiles, macrophages), and a large number of bacteria.