Riconoscere e trattare il dolore negli animali è attualmente considerato clinicamente ed eticamente essenziale nella pratica veterinaria, sebbene in passato sia stata dedicata scarsa attenzione al problema, soprattutto negli animali selvatici o non convenzionali. Le logiche sottese a tale situazione possono essere state piuttosto eterogenee: ostacoli di ordine ideologico (ad esempio, l’idea che il dolore sia una risposta “naturale”, o che gli animali non lo percepiscano), difficoltà a riconoscerlo e quantificarlo, inconsapevolezza dei suoi effetti deleteri sul recupero dell’animale, paura degli effetti collaterali e della eventuale tossicità delle molecole da utilizzare e mancanza di familiarità con i protocolli terapeutici, possono tutti aver contribuito a rendere poco praticata l’analgesia negli animali non convenzionali. Il dolore rappresenta una entità fisiologicamente e psicologicamente complessa, definita dalla International Association for the Study of Pain (IASP) come “una spiacevole esperienza sensoriale ed emozionale associata ad un potenziale od effettivo danno tissutale”. Poiché gli animali non possono comunicare verbalmente, il termine nocicezione viene spesso utilizzato al posto di dolore. Per nocicezione si intende una risposta evocata da una irritazione tessutale dovuta ad una specifica stimolazione meccanica, termica o chimica di recettori posti sui terminali nervosi, denominati pertanto nocicettori. La mancanza di comunicazione verbale impedisce di valutare l’entità della sofferenza nell’animale e l’eventuale inadeguatezza della terapia analgesica scelta. Tra tutti, i rettili sono tra le specie più scarsamente comprese e comprensibili sotto questo aspetto. L’evidenza della capacità da parte dei rettili di percepire il dolore si fonda su diverse considerazioni: 1. comportamenti evocati come risposta ad uno stimolo algico, sebbene spesso complessi da interpretare, soprattutto in risposta al dolore cronico; 2. identificazione anatomica e fisiologica nei rettili delle stesse o analoghe strutture preposte alle vie del dolore nei mammiferi; 3. possibilità di modulazione farmacologia della risposta algica (almeno in alcune specie e con insorgenza dell’effetto a distanza di diverse ore dalla somministrazione dell’analgesico).

A 20-yr-old African fur seal (Arctocephalus pusillus) presented with a slowly growing mass located on the dorsum at the level of the last thoracic vertebrae. The mass was hard, 10 cm in diameter, and not adherent to the underlying tissues. Multiple biopsies were collected for histopathology and revealed extensive areas of necrosis, small nodules of malignant mesenchymal proliferation with areas of chondroid metaplasia, and atypical cells in vessel walls. The morphologic diagnosis was suggestive of malignant mesenchymal neoplasia originating from the vascular wall. The mass was removed 1 mo later due to ulceration and infection. Histologically, based on the World Health Organization’s classification of neoplastic processes in domestic animals, the tumor was consistent with malignant mesenchymoma. The margins of resection revealed the presence of neoplastic cells. Based on these results, the particular species involved, the high local invasiveness, and the high metastatic index of this malignant tumor in domestic mammals and humans, the prognosis was poor. The animal died 6 mo later with metatastic disease.

During the period October 2010 - October 2011 the WWF Rescue Centre of Molfetta (Italy) referred 134 loggerhead sea turtles (Caretta caretta) to the Faculty of Veterinary Medicine of Bari (Italy) for clinical evaluation following to bycatch in bottom trawling in Manfredonia Gulf (Southern Adriatic Sea, Italy). After biometric assessment, all the turtles underwent clinical evaluation and radiographic examination to check for lesions ascribable to the capture (carapace and plastron trauma, skull or limb fractures, pneumonia subsequent to forced submergence and drowning). Dorsoventral, lateral and craniocaudal (horizontal beams) projections of head, total body and limbs were performed. In 8 turtles (6%) the presence of fish hooks in upper gastrointestinal tract was assessed: 3 animals presented an evident fishing line, while the presence of the hooks resulted accidentally at the x-ray examination without apparent clinical abnormalities in the other subjects. 4 hooks were localized in the intracoelomatic tract of the esophagus, in correspondence of tracheal bifurcation, and the other ones in cervical esophagus. In one case the hook was manually removed after sedation, while the others required surgical procedures. The hooks located in upper esophageal tract were removed after cervical esophagotomy, while the removal of the ones positioned deeper in non papillated esophagus was achieved after a transversal supraplastron surgical approach to access the coelomic portion of the esophagus. During surgery, one of the turtles, presented in critical conditions, revealed a long fishing line attached to the hook, so a right prefemoral approach to coelomic cavity was performed in order to remove it from intestinal lumen with multiple enterotomies on the exteriorized small intestine. In 3 turtles the hook had pierced the esophageal wall and were located extra-lumen, giving rise to large inflammatory responses with granulomatous abscessations, which caused the displacement of trachea and the partial obstruction of esophageal lumen. Nonetheless, surgery proved solving, and adequate post-surgical management (with 2 to 5 weeks of hospitalization) allowed the total recovery and the release of the turtles. Data from this study show that the major risks of longline fishing bycatch are not only the presence of tracts of lines in the gastrointestinal tube, as reported by numerous Authors, but also the hook itself, as it can give rise to foreign body granulomatous reactions that can occlude the gastrointestinal tract, and impair the feeding capacity of the turtles.

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Data on reptile analgesia are scarce for nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids and almost completely lacking in sea turtles, even though emergencies requiring correct pain management are very frequent in their rehabilitative medicine; therefore, dosage regimens extrapolated from other species involve the risk of clinical failure and damage to the animals. We describe the pharmacokinetic behavior of meloxicam in the loggerhead sea turtle (Caretta caretta). We chose meloxicam because of its selective anticyclooxygenase- 2 activity and lesser adverse side effects. No data are available on the capacity of turtles to tolerate NSAIDs, so we chose a dose of 0.1 mg/kg of meloxicam. Plasma concentrations of meloxicam were unexpectedly low both for intravenous (IV; maximum concentration [Cmax]=0.04±0.02 µg/mL) and intramuscular (IM; Cmax =0.07±0.09 µg/mL) administration. A double-peak phenomenon occurred after both IV (time for second peak concentration Tmax2 = 10.33±10.89 h) and IM (Tmax2=1.17±0.75 h). The second peak after IM injection was premature, so some difficulty and delay in absorption appears to be an appropriate explanation. Furthermore, the area under the curve, and therefore systemic bioavailability (F531.82±28.24%), after both IV (0.30±0.29) and IM (0.10±0.03) injection appeared particularly limited. Terminal elimination slope and mean residence time indicated fast elimination after IM dosing; as a consequence, plasma concentrations dropped below analytic limits in 8 h. Considering that IM is the favored route of administration of drugs in rescue centers, it is unlikely that meloxicam at 0.1 mg/kg is an appropriate choice, particularly in long-term pain management protocols

We report the surgical techniques used to remove accidentally ingested hooks and branchlines localized in different parts of the digestive tract of 129 loggerhead sea turtles Caretta caretta, together with the characteristics and localization of lesions, and final outcome related to their severity. Hooks were removed from the cervical esophagus via the ventral surface of the neck, while the supraplastron approach was performed for hooks wedged in the intracoelomic portion of the esophagus. An approach through the left axillary region was preferred for fishhooks in the stomach, while hooks and long branchlines in the intestine or pyloric area were removed by approaching the coelomic cavity through the right or left prefemoral fossa. The ingestion of fishhooks, and/or longlines, often induces severe injuries in the digestive tract that could lead to the death of the turtles, with the extent of damage engendered by lines often more severe than that caused by hooks, leading to strangulation, intussusception, and tears that require resection of long tracts of intestine. Spontaneous expulsion of hooks, even where possible, involves long waiting times, with the possible impairment of the turtle's clinical condition, and should be avoided when the line is evident or suspected. The development of diversified surgical techniques enabled us to approach the coelomic cavity with minimally invasive and easy-to-perform methods, and survival rates proved very satisfactory.

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.