of cytochemical characterization of blood cells for most reptiles. CD3 antibody identifies T-cell lymphocytes and Pax-5 and BLA36 antibodies identify B-cell lymphocytes (Silverstone et al, 2007; Bezjian et al, 2013). L1-calprotectin antibody has been used to identify myeloid cells in lizards.
Transmission electron microscopy can be attempted to determine histogenesis and to identify viral particles.
PATHOLOGICAL FINDINGS
Cytological evaluation of blood smears and/or bone marrow aspirates can reveal abnormal cell morphology of the neoplastic cells, abnormal nuclear to cytoplasm ratio, and anisokaryosis; mitotic figures are frequently detected.
Histopathologic examination of tissue samples can reveal infiltration of neoplastic cells in several organs and occasional mitotic figures.
APPROPRIATE HEALTH CARE
N/A
NUTRITIONAL SUPPORT
An esophagostomy tube should be considered in anorexic animals or for long-term administration of medications.
CLIENT EDUCATION/HUSBANDRY RECOMMENDATIONS
An early diagnosis can maximize the success of therapy.
DRUG(S) OF CHOICE
Silverstone et al (2007) treated a diamondback terrapin (Malaclemys terrapin) suffering from lymphoblastic leukemia with prednisone 0.6 mg/kg PO q48h, cytosine arabinoside 6 mg/kg SQ q7d for two treatments, and chlorambucil 1 mg/kg PO q7d for two treatments; at 24 days post-treatment, the WBC count and the turtle’s activity had improved, but it died 46 days after the beginning of treatment.
Cytosine arabinoside is the most frequently used treatment for small mammals with chronic monocytic leukemia, whereas prednisone therapy is widely used and accepted for small mammals with lymphoid leukemia and lymphoma; it is not effective for myeloid leukemias.
PRECAUTIONS/INTERACTIONS
Suspected cytosine arabinoside toxicity characterized by renal failure has been reported in a rhinoceros viper.
PATIENT MONITORING
Complete blood count must be done for monitoring the overall WBC count and different leukocyte counts to gauge response to the drugs.
EXPECTED COURSE AND PROGNOSIS
The prognosis of the disease, especially in acute leukemia, is poor.
COMMENTS
N/A
ZOONOTIC POTENTIAL
N/A
SYNONYMS
N/A
ABBREVIATIONS
PO = per os
SC = subcutaneous
WBC = white blood cells
Suggested Reading
1 Bezjian M, Diep AN, de Matos R, Schaefer D. Chinese box turtle (Cuora flavomarginata) with lymphoid leukemia characterized by immunohistochemical and cytochemical phenotyping. Vet Clin Path 2013;42:368–376.
2 Mauldin GN, Done LB2. Oncology. In: Mader DR, ed. Reptile Medicine and Surgery. 2nd ed. St. Louis, MO: Elsevier Saunders; 2006:299–322.
3 Silverstone AM, Garner MM, Wojcieszyn JW, et al. Acute lymphoblastic leukemia in a diamondback terrapin. J Herp Med Surg 2007;17:92–99.
Author Jorge Orós, DVM, PhD, DECZM
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