Blackwell's Five-Minute Veterinary Consult: Reptile and Amphibian. Javier G. Nevarez

       Calcium: start with calcium gluconate (100 mg/kg IM, SC q12–24h) followed by calcium glubionate (10–100 mg/kg PO q4–24h) long term

       Magnesium: magnesium sulfate 20 mg/kg IM, SC q24–72h or magnesium lactate (Rescue Cal+, Repashy Ventures, CA) 20 mg/kg PO q24h

       Crystalloid fluids: 20–30 ml/kg SC, IV q24h

       Meloxicam: 0.5 mg/kg PO, IM, SC q24–48h

       Morphine: 1–10 mg/kg IM, SC q24h

       Hydromorphone: 0.2–0.5 mg/kg IM, SC q12–24h

       Morphine and hydromorphone can cause sedation and respiratory depression.

       Dose and frequency of administration should be refined based on the patient’s response.

       If performing medical therapy alone, the weight of the chelonian should be recorded daily to every other day to provide an early indication that follicle atresia may be occurring.

       Any acute weight losses beyond 10% of the body weight should prompt re‐evaluation by a veterinarian.

       If an underlying disease process was diagnosed, appropriate follow‐up diagnostics should be performed to determine improvement of that condition or the need to alter therapy.

       For those undergoing surgery, a re‐evaluation with 1–2 weeks is recommended to evaluate the surgical site and overall recovery.

       Ultimately, the prognosis will depend on the underlying cause of follicular stasis and the required therapy.

       Cases with underlying infectious or metabolic disease that respond to medical therapy have a good prognosis.

       Many cases requiring surgical therapy have a good to guarded prognosis.

       The ultimate diagnosis of follicular stasis is based on interpretation of clinical signs, history, and results of physical exam and diagnostics.

       Before ovariectomy is performed, it is essential to have at least one confirmatory test that there are indeed follicles present in the coelomic cavity.

       It must be mentioned that the sex of the animals must be confirmed as female before surgery is performed.

       While this may seem obvious, in some chelonians species sex determination can be quite challenging, especially when of small size, and males may present with coelomic neoplasias or GI obstructions that clinically appear very similar to follicular stasis.

       Ca = calcium

       CBC = complete blood count

       CT scan = computed tomography

       GI = gastrointestinal

       IM = intramuscular

       Mg = magnesium

       MRI = magnetic resonance imaging

       NSHP = nutritional secondary hyperparathyroidism

       P = phosphorus

       PO = per os

       SC = subcutaneous

       UVB = ultraviolet B

      1 Chitty J, Raftery A. Follicular stasis. In: Chitty J, Raftery A, eds. Essentials of tortoise medicine and surgery. Oxford, UK: Wiley Blackwell; 2003:200–204.

      2 Jacobson ER. Overview of reptile biology, anatomy, and histology. In: Jacobson ER, ed. Infectious Diseases and Pathology of Reptiles: Color Atlas and Text. Boca Raton, FL: CRC Press; 2007:14–17.

      3 McArthur S. Problem‐solving approach to common diseases of terrestrial and semiaquatic chelonians. In: McArthur S, Wilkinson R, Meyer J, eds. Medicine and Surgery of Tortoises and Turtles. Ames, IA: Blackwell; 2004:309–378.