Severely debilitated or post-surgical sea turtles often suffer from anorexia, making their management very challenging. In cases like these, a nutritional support is mandatory. Common practice in rescue centres is assisted feeding, daily administered via a soft tube passed by mouth to stomach. This procedure is relatively easy in most reptile species, but it results very difficult in chelonians, and particularly in large sea turtles, as access to mouth and oesophagus can become impossible if the animal withdraw the head. Furthermore, this practice can result a source of considerable stress in wild animals, and in sea turtles it becomes very messy because of the particularly narrow gastroesophageal sphincter. The placement of a permanent oesophagostomy tube can considerably simplify the daily administration of assisted nutrition. Drugs (antibiotics, vitamins, etc.) and fluids, essential in the clinical management, are as well easily administered through the permanent oesophagostomy. This procedure was performed in 5 severely ill Loggerhead sea turtles (Caretta caretta) in order to assure a correct assisted feeding. All patients were anaesthetized with 4-5 mg/kg intravenous propofol. Before placement, the tube length was pre-measured from the lateral side of the neck to the left pectoral scute, then permanently marked. With the extended neck, a curved hemostat was introduced through the mouth into the esophagus and laterally displaced. This caused the skin to tent and the carotid and jugular veins to slip dorsally or ventrally to avoid them to be incised. A small incision was made trough the skin and the wall of the esophagus with a scalpel blade at the tip of the hemostat, that has been forced outside by blunt. The incision has to be as caudal as possible in the neck to avoid the turtle to entangle a limb and extract the tube. The tip of the tube was grasped with the clamp, pulled through the incision and withdrawn trough the mouth to the marked point. Then, the tube was redirected into the oesophagus and pushed up to the stomach. Levin’s tubes 4-5 mm diameter with radiopaque guide were used, to verify the correct placement by x-ray examination. After placement the tube was sutured to the skin just next to the incision with nonabsorbable sutures; the extended length of the tube was secured to the edge of the nucal scute with a suture and to the carapace with cyanoacrylic glue. Broad spectrum antibiotics were administered after the surgical procedure. Patients were fed daily through the tube with homogenized fish and shellfish, supplemented with vitamins. After food administration, the tube was washed with few millilitres of saline solution to avoid its obstruction. The tube was well tolerated, and the turtles were able to eat normally in 2-3 weeks while it was still in place. The tube was kept in place for two more weeks after appetite had returned to normal. If the tube has to be held in place for several weeks, it is possible that reparative reactions expel stitches and the tube needs to be sutured again.

The use of oesophagostomy tube for the force-feeding in sea turtles

DI BELLO, Antonio Vito Francesco;VALASTRO, CARMELA;LAI OR;
2011-01-01

Abstract

Severely debilitated or post-surgical sea turtles often suffer from anorexia, making their management very challenging. In cases like these, a nutritional support is mandatory. Common practice in rescue centres is assisted feeding, daily administered via a soft tube passed by mouth to stomach. This procedure is relatively easy in most reptile species, but it results very difficult in chelonians, and particularly in large sea turtles, as access to mouth and oesophagus can become impossible if the animal withdraw the head. Furthermore, this practice can result a source of considerable stress in wild animals, and in sea turtles it becomes very messy because of the particularly narrow gastroesophageal sphincter. The placement of a permanent oesophagostomy tube can considerably simplify the daily administration of assisted nutrition. Drugs (antibiotics, vitamins, etc.) and fluids, essential in the clinical management, are as well easily administered through the permanent oesophagostomy. This procedure was performed in 5 severely ill Loggerhead sea turtles (Caretta caretta) in order to assure a correct assisted feeding. All patients were anaesthetized with 4-5 mg/kg intravenous propofol. Before placement, the tube length was pre-measured from the lateral side of the neck to the left pectoral scute, then permanently marked. With the extended neck, a curved hemostat was introduced through the mouth into the esophagus and laterally displaced. This caused the skin to tent and the carotid and jugular veins to slip dorsally or ventrally to avoid them to be incised. A small incision was made trough the skin and the wall of the esophagus with a scalpel blade at the tip of the hemostat, that has been forced outside by blunt. The incision has to be as caudal as possible in the neck to avoid the turtle to entangle a limb and extract the tube. The tip of the tube was grasped with the clamp, pulled through the incision and withdrawn trough the mouth to the marked point. Then, the tube was redirected into the oesophagus and pushed up to the stomach. Levin’s tubes 4-5 mm diameter with radiopaque guide were used, to verify the correct placement by x-ray examination. After placement the tube was sutured to the skin just next to the incision with nonabsorbable sutures; the extended length of the tube was secured to the edge of the nucal scute with a suture and to the carapace with cyanoacrylic glue. Broad spectrum antibiotics were administered after the surgical procedure. Patients were fed daily through the tube with homogenized fish and shellfish, supplemented with vitamins. After food administration, the tube was washed with few millilitres of saline solution to avoid its obstruction. The tube was well tolerated, and the turtles were able to eat normally in 2-3 weeks while it was still in place. The tube was kept in place for two more weeks after appetite had returned to normal. If the tube has to be held in place for several weeks, it is possible that reparative reactions expel stitches and the tube needs to be sutured again.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11586/137601
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