Ovarian Sarcoma in a Bearded Dragon (Pogona vitticeps)

PATIENT DETAILS

A female 2 year old 340g Bearded Dragon (Pogona vitticeps) presented in October 2011. She was kept with another 2 Bearded Dragons in a vivarium with optimal temperatures (including a basking area and a cool end). Lighting included visible, ultraviolet A and B spectrum through a fluorescent tube. Her diet consisted of insects (including locusts and crickets) that were gut loaded and also a vegetable mix. Supplementation was carried out twice weekly with a multivitamin and calcium carbonate powder.

PRESENTATION/CLINICAL SIGNS

She presented with a one week history of constipation, lethargy and anorexia. She had been treated at another practice with lactulose with no improvement.

INVESTIGATION

On clinical examination she was quiet, alert and responsive. She had pink mucous membranes with a slight yellow tinge (considered normal for this specie). The single abnormality noted was a solid mass in the cranial coelom that was not reducible on palpation.

Two radiographs were taken (lateral/lateral horizontal beam and dorso/ventral projections) that showed a soft tissue mass of approximately 12cm x 5cm.

An exploratory laparotomy was performed in view of either surgical excision if possible or euthanasia depending on the findings.

DIAGNOSIS

The mass was removed through ovariectomy following an exploratory laparotomy and sent for histopathology. A poorly differenciated sarcoma with neoplastic cells reaching margins of most sections carrying a poor prognosis was diagnosed.

TREATMENT/PROCEDURE

She was hospitalised for stabilisation prior to surgery for 24h. Antibiotics (Ceftazidime 20mg/kg; Fortum® 100mg/ml; Glaxosmithkline), analgesia (Meloxicam 0.2mg/kg; Metacam 1.5mg/ml; Boehringer Ingelheim) were given and also 7ml of critical care formula (CCF) (Vetark) over a 24h period. She also received two 15min baths and was kept within the preferred optimal temperature zone (POTZ) with a 12h photoperiod including the ultraviolet B spectrum.

Induction with Alfaxalone (Alfaxan® 10mg/ml; Vetoquinol) was used, she was intubated and maintained with Isofluorane (Isoflo®; Abbott Laboratories) and oxygen.  This was carried out via intermittent positive pressure ventilation (IPPV) at 6 breaths per minute. Heat pads were placed under her. Anaesthesia monitoring was performed through toe pinch, corneal reflex, cloacal reflex and heart rate via doppler readings.

A paramedial incision was made avoiding the abdominal vein and ovarian tissue was visualised in the coelomic cavity. The affected ovary was removed including the associated poorly demarked mass. The vessels, surrounding tissue and adhesions clamped and polydioxanone (PDS II®; Ethicon) encircling ligatures were placed. Routine closure of the coelomic cavity was performed closing the body wall with polydioxanone (PDS II®; Ethicon) using a continuous pattern, followed by the skin through an everting continuous pattern. Recovery from anaesthesia was uneventful and after 2 days she was sent home with analgesia and antibiotic therapy. The ovarian tissue was sent for histopathology.

OUTCOME

A poor prognosis was given based on histopathology. She continued on antibiotic therapy and analgesia for a further 10 days post surgery. She started eating and putting on weight. Two months after surgery she presented with lethargy, anorexia and weight loss. Thickened areas were palpated on clinical examination and the owner opted for euthanasia.

COMPLICATIONS

Two weeks after surgery she presented with diarrhoea. A faecal examination inhouse revealed high numbers of oxyurid (pinworm) ova. She was treated with a single dose of 50mg/kg Fenbendazole (Panacur® 2.5%; Schering plough’s). A faecal examination was repeated after 10 days showing a massive reduction of pinworm ova and resolution of clinical signs, in this case diarrhoea.