American journal of veterinary research · 2026
Prefemoral cystotomy in 45° dorsolateral recumbency is effective for urolith removal in African spurred tortoises (Centrochelys sulcata).
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Nackley Selina, Di Girolamo Nicola
Аннотация
OBJECTIVE: To describe the feasibility, outcomes, and complications of prefemoral cystotomy in 45° dorsolateral recumbency in African spurred tortoises (Centrochelys sulcata) for cystolith removal.
ANIMALS: African spurred tortoises that underwent prefemoral cystotomy for cystolith removal by a specialist in herpetological medicine from May 2017 through May 2025.
CLINICAL PRESENTATION: Records for 8 tortoises from 4 different institutions met inclusion criteria. The age of tortoises ranged from 3 to over 30 years, and body weight ranged from 1.5 to 47.9 kg.
RESULTS: Preoperative diagnostic imaging showed 1 to 3 cystoliths, with the longest diameter of the cystoliths ranging from 21% to 65% of the maximum carapacial width. Positioning the tortoises at a 45° dorsolateral recumbency provided adequate exposure to the cystoliths and allowed extraction in all cases. In 2 cases, a circumferential wound protector/retractor was used as a conduit toward the lumen of the urinary bladder to limit celomic contamination. Seven of the 8 tortoises survived to discharge and to last available follow-up, 75 to 1,081 days from surgery. Common postoperative complaints included inappetence (4 cases), decreased urination and defecation (4 cases), and reduced activity (3 cases). Two cases experienced local complications: 1 required wound debridement for dehiscence, and the other developed cellulitis that resolved with medical treatment.
CLINICAL RELEVANCE: Prefemoral cystotomy in 45° dorsolateral recumbency is an effective treatment for cystoliths in African spurred tortoises regardless of urolith or animal size. The technique described herein may reduce some of the challenges associated with treatment of cystolithiasis in chelonians.
ANIMALS: African spurred tortoises that underwent prefemoral cystotomy for cystolith removal by a specialist in herpetological medicine from May 2017 through May 2025.
CLINICAL PRESENTATION: Records for 8 tortoises from 4 different institutions met inclusion criteria. The age of tortoises ranged from 3 to over 30 years, and body weight ranged from 1.5 to 47.9 kg.
RESULTS: Preoperative diagnostic imaging showed 1 to 3 cystoliths, with the longest diameter of the cystoliths ranging from 21% to 65% of the maximum carapacial width. Positioning the tortoises at a 45° dorsolateral recumbency provided adequate exposure to the cystoliths and allowed extraction in all cases. In 2 cases, a circumferential wound protector/retractor was used as a conduit toward the lumen of the urinary bladder to limit celomic contamination. Seven of the 8 tortoises survived to discharge and to last available follow-up, 75 to 1,081 days from surgery. Common postoperative complaints included inappetence (4 cases), decreased urination and defecation (4 cases), and reduced activity (3 cases). Two cases experienced local complications: 1 required wound debridement for dehiscence, and the other developed cellulitis that resolved with medical treatment.
CLINICAL RELEVANCE: Prefemoral cystotomy in 45° dorsolateral recumbency is an effective treatment for cystoliths in African spurred tortoises regardless of urolith or animal size. The technique described herein may reduce some of the challenges associated with treatment of cystolithiasis in chelonians.