Multi-systemic: Necrotic Stomatitis

Necrotic stomatitis is a severe, often fatal oral infection in chelonians, marked by tissue necrosis and ulceration. This article provides an in-depth look at its etiology, signalment, transmission, clinical signs, diagnosis, treatment, prevention, and prognosis. It equips veterinarians with the knowledge needed to effectively diagnose and manage this critical condition.

Etiology

Necrotic stomatitis, also known as "mouth rot," in chelonians is primarily caused by opportunistic bacterial infections, typically involving Aeromonas spp., Pseudomonas spp., and Mycoplasma spp. These bacteria can invade the oral mucosa when the animal's immune system is compromised due to stress, poor nutrition, suboptimal environmental conditions, or concurrent diseases.

Signalment

Necrotic stomatitis can affect chelonians of all ages, species, and sexes. However, it is more frequently observed in captive animals subjected to poor husbandry practices. Tortoises and freshwater turtles, such as the red-eared slider (Trachemys scripta elegans), are commonly affected.

Transmission

The primary mode of transmission is through direct contact with contaminated surfaces, water, or other infected animals. Inadequate sanitation and overcrowding significantly increase the risk of disease spread. Stress and injury to the oral cavity are predisposing factors that can facilitate bacterial invasion.

Clinical Signs

Chelonians with necrotic stomatitis exhibit a range of clinical signs, including:

  • Necrosis and ulceration of the oral mucosa

  • Caseous (cheese-like) plaques in the mouth

  • Halitosis (bad breath)

  • Anorexia and weight loss

  • Excessive salivation

  • Swelling of the head and neck

  • Lethargy and weakness

  • Secondary respiratory infections if the infection spreads

Diagnosis

Diagnosis is based on clinical signs, history, and diagnostic tests. A thorough oral examination under sedation is crucial. Samples from oral lesions can be collected for cytology, culture, and sensitivity testing to identify the causative bacteria. Blood tests can help assess the animal's overall health and identify any concurrent conditions.

Treatment

Treatment involves aggressive management to control the infection and support healing:

  1. Systemic Antibiotics: Based on culture and sensitivity results, systemic antibiotics are administered. Common choices include enrofloxacin, ceftazidime, and metronidazole.

  2. Debridement: Necrotic tissue and plaques are carefully removed under sedation to reduce bacterial load and promote healing.

  3. Supportive Care: This includes maintaining optimal husbandry conditions (clean environment, proper temperature and humidity, balanced diet) and ensuring adequate hydration and nutrition. Fluid therapy may be necessary for dehydrated animals.

  4. Topical Treatments: Antiseptic mouthwashes or gels can be applied to the affected areas to control local infection.

Prevention

Preventive measures focus on improving husbandry and reducing stress:

  • Maintain clean and hygienic enclosures and water sources.

  • Provide a balanced diet with appropriate supplementation.

  • Ensure optimal temperature and humidity levels.

  • Minimize stress by reducing handling and environmental disturbances.

  • Quarantine new or sick animals to prevent disease spread.

Prognosis

The prognosis for chelonians with necrotic stomatitis depends on the severity of the infection and the timeliness of treatment. Early intervention generally results in a favorable outcome. However, advanced cases with extensive tissue necrosis and secondary infections carry a guarded prognosis.

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Multi-systemic: Conjunctivitis