Intravenous ketamine-medetomidine anesthesia in combination with intrathecal lidocaine for prefemoral coeliotomy in red-eared sliders (Trachemys scripta elegans): A case series study

Document Type : Scientific report

Authors

1 Department of Clinical Science, Veterinary Faculty, University of Sarajevo, Sarajevo, 71000, Bosnia and Herzegovina

2 DVM Student, Department of Clinical Science, Veterinary Faculty, University of Sarajevo, Sarajevo, 71000, Bosnia and Herzegovina

10.22099/ijvr.2025.49481.7275

Abstract

Background: Coeliotomy in chelonian species is performed to gain access to the abdominal cavity and requires general anesthesia. In reptile medicine, alfaxalone and propofol are often preferred, although the usage of these drugs is limited by cost and/or vascular access. Furthermore, according to a recent study, propofol produces significant oxidative stress in red-eared sliders (Trachemys scripta elegans), and in such cases, a ketamine and medetomidine combination may provide a better choice. Case description: Three owned red-eared sliders were separately presented with a history of recent lethargy, inappetence, dyspnea, and restlessness. Findings/treatment and outcome: In these three cases of chronic dystocia, a ketamine and medetomidine combination was used to achieve anesthesia induction for surgical treatment. Additionally, intrathecal administration of lidocaine was performed to achieve a potential analgesic effect in deeper intracoelomic reproductive organs. Preoperative changes in blood parameters were observed in one animal, suggesting abnormal kidney function. The same animal showed signs of resedation postoperatively, prolonged recovery, and had a fatal outcome 48 h after the surgery with signs of kidney damage in histopathological evaluation. In the recovery period, none of the surviving animals (n=2) showed neurological or respiratory complications that could be associated with subcarapacial sinus anesthesia administration or intrathecal local anesthesia. Conclusion: According to our observations, intrathecal lidocaine administration provided sufficient analgesia during prefemoral coeliotomy and reproductive organ manipulation. These modes of anesthesia in chelonians require further investigation.

Keywords

Main Subjects


Alves-Júnior, JRF; Bosso, ACS; Andrade, MB; Werther, K and Santos, ALQ (2012). Association of midazolam with ketamine in giant Amazon river turtles Podocnemis expansa breed in captivity. Acta Cir. Bras., 27: 144-147.
Cermakova, E; Ceplecha, V and Knotek, Z (2017). Efficacy of two methods of intranasal administration of anaesthetic drugs in red-eared terrapins (Trachemys scripta elegans). Vet. Med., 62: 87-93.
Di Bello, A; Valastro, C and Staffieri, F (2006). Surgical approach to the coelomic cavity through the axillary and inguinal regions in sea turtles. J. Am. Vet. Med. Assoc., 228: 922-925.
Divers, SJ and Innis, CJ (2019). Urology. In: Divers, SJ and Stahl, SJ (Eds.), Mader’s reptile and amphibian medicine and surgery. (3rd Edn.), St. Louis, Missouri, USA, Elsevier. PP: 624-648.
Došenović, M; Radaković, M; Vučićević, M; Vejnović, B; Vasiljević, M; Marinković, D and Stanimirović, Z (2020). Evaluation of the effects of two anaesthetic protocols on oxidative status and DNA damage in red-eared sliders (Trachemys scripta elegans) undergoing endoscopic coeliotomy. Acta Vet. Hung., 4: 337-344.
Gibbons, PM; Whitaker, BR; Carpenter, JW; McDermott, CT; Klaphake, E and Sladky, KK (2019). Hematology and biochemistry tables. In: Divers, SJ and Stahl, SJ (Eds.), Mader’s reptile and amphibian medicine and surgery. (3rd Edn.), St. Louis, Missouri, USA, Elsevier. PP: 333-350.
Greer, LL; Jenne, KJ and Diggs, HE (2001). Medetomidine-Ketamine anesthesia in red-eared slider turtles (Trachemys scripta elegans). Contemp. Top. Lab. Anim. Sci., 40: 9-11.
Heatley, JJ and Russell, KE (2019). Clinical chemistry. In: Divers, SJ and Stahl, SJ (Eds.), Mader’s reptile and amphibian medicine and surgery. (3rd Edn.), St. Louis, Missouri, USA, Elsevier. PP: 319-332.
Kischinovsky, M; Duse, A; Wang, T and Bertelsen, MF (2012). Intramuscular administration of alfaxalone in red-eared sliders (Trachemys scripta elegans) – effects of dose and body temperature. Vet. Anaesth. Analg., 40: 13-20.
Lutvikadić, I and Maksimović, A (2023). A comparison of anesthesia induction by two different administration routes and doses of ketamine and medetomidine in red-eared sliders (Trachemys scripta elegans). Ankara Univ. Vet. Fak. Derg., 71: 231-237. doi: 10.33988/auvfd.1145264.
Mans, C (2014). Clinical technique: Intrathecal drug administration in turtles and tortoises. J. Exot. Pet. Med., 23: 67-70.
McArthur, S (2004). Anaesthesia, analgesia and euthanasia. In: McArthur, S; Wilkinson, R and Meyer, J (Eds.), Medicine and surgery of tortoises and turtles. (1st Edn.),
Oxford, UK, Blackwell Publishing. PP: 379-401.
Meredith, A (2015a). Apendix II: Protocols. In: Meredith, A (Ed.), BSAVA small animal formulary. (9th Edn.), Gloucester, UK, BSAVA. PP: 315-322.
Meredith, A (2015b). Propofol. In: Meredith, A (Ed.), BSAVA small animal formulary. (9th Edn.), Gloucester, UK, BSAVA. PP: 247-249.
Murray, MJ (2006). Cardiology. In: Mader, D and Divers, S (Eds.), Reptile medicine and surgery. (2nd Edn.), St. Louis, Missouri, USA, Saunders, Elsevier. PP: 181-195.
Perry, SM and Mitchell, MA (2019). Routes of administration. In: Divers, SJ and Stahl, SJ (Eds.), Mader’s reptile and amphibian medicine and surgery. (3rd Edn.), St. Louis, Missouri, USA, Elsevier. PP: 1130-1138.
Phie, J; Heleagrahara, N; Newton, P; Constantinoiu, C; Sarnyai, Z; Chilton, L and Kinobe, R (2015). Prolonged subcutaneous administration of oxytocin accelerates angiotensin-II induced hypertension and renal damage in male rats. PloS One. 10: e0138048.
Quesada, RJ; Aitken-Palmer, C; Conley, K and Heard, DJ (2010). Accidental submeningeal injection of propofol in gopher tortoises (Gopherus polyphemus). Vet. Rec., 167: 494-495.
Rivera, S; Divers, SJ; Knafo, SE; Martinez, P; Cayot, LJ; Tapia-Aguilera, W and Flanagan, J (2011). Sterilization of hybrid Galapagos tortoises (Geochelone nigra) for island restoration. Part 2: Phallectomy of males under intrathecal anaesthesia with lidocaine. Vet. Rec., 168: 78.
Rockwell, K; Rademacher, N; Osborn, ML and Nevarez, JG (2022). Extravasation of contrast media after subcarapacial vessel injection in three chelonian species. J. Zoo. Wildl. Med., 53: 402-411.
Scarabelli, S and Di Girolamo, N (2022). Chelonian sedation and anesthesia. Vet. Clin. Exot. Anim. Pract., 25: 49-72.
Stahl, SJ (2019). Reproductive tract. In: Divers, SJ and Stahl, SJ (Eds.), Mader’s reptile and amphibian medicine and surgery. (3rd Edn.), St. Louis, Missouri, USA, Elsevier. PP: 1077-1089.
Stahl, SJ and DeNardo, DF (2019). Theriogenology. In: Divers, SJ and Stahl, SJ (Eds.), Mader’s reptile and amphibian medicine and surgery. (3rd Edn.), St. Louis, Missouri, USA, Elsevier. PP: 849-893.
Turner, RC; Gatson, BJ; Hernandez, JA; Alexander, AB; Aitken-Palmer, C; Vigani, A and Heards, DJ (2021). Sedation and anesthesia of Galapagos (Chelonoidis nigra), Aldabra (Aldabrachelys gigantea), and African spurred tortoises (Centrochelys sulcata): A retrospective review (2009-2019). Animals (Basel), 11: 2920.
Wüst, E and Divers, SJ (2019). Chelonian prefemoral coeliotomy. In: Divers, SJ and Stahl, SJ (Eds.), Mader’s reptile and amphibian medicine and surgery. (3rd Edn.), St. Louis, Missouri, USA, Elsevier. PP: 1054-1056.