Anorexia and constipation in reptiles can have multiple causes, including parasitism, ingestion of foreign objects, poor husbandry, neoplasia, and metabolic disorders.1,2 It is often difficult to determine the cause of these clinical signs in reptiles, and radiography can be a valuable diagnostic tool. The use of contrast radiography, usually an upper gastrointestinal (GI) barium contrast study, aids in the assessment of GI transit time and the detection of foreign bodies.3-5
In this article, we discuss the use of a different method of contrast radiography—a partial iohexol enema—to differentiate the large bowel from the small bowel and to diagnose an intestinal stricture in a bearded dragon.
An adult intact male bearded dragon (Pogona vitticeps) weighing 419 g was presented to the Kansas State University Zoological Medicine Service for evaluation of a two-week history of anorexia and weight loss. Whole body radiography performed by the referring veterinarian had revealed a focal area of mixed opacity in the caudal coelomic cavity that seemed to be located in the intestinal tract.
An upper GI barium contrast study performed by the referring veterinarian had revealed contrast flowing normally through the stomach and small intestine but then pooling anterior to a heterogeneous mass in the distal GI tract. Small amounts of barium were able to bypass the mass and were excreted, although fecal output was markedly decreased.
INITIAL EVALUATION AND TREATMENT
On physical examination, the patient was emaciated but bright and alert; its body condition score was 2/5. Complete blood count and serum chemistry profile results showed mild anemia with a low hematocrit (14%; reference range = 19% to 40%) but were otherwise unremarkable.6,7
Because of the patient's poor body condition and anesthetic risk, conservative therapy was initiated to relieve the obstruction. Therapy consisted of warm-water enemas with sterile lubrication, oral liquids (water) delivered via an orogastric tube, fluids (45 ml/kg lactated Ringer's solution with 2.5% dextrose and 0.05 ml of a vitamin B complex administered subcutaneously), and warm-water soaks in a shallow bowl for 20 minutes three times daily so the patient could absorb water through the cloaca.
No clinical improvement was noted after 24 hours of medical therapy, and the mass was still palpable in the abdomen. Repeat survey radiographs confirmed the accumulation of heterogeneous material mixed with barium consistent with a GI impaction; it was unclear if the impaction involved the small or large intestine.