Endoscopic pathology and liver biopsy, various reptiles

Endoscopic pathology and liver biopsy. A) Grossly distended small intestine in a Russian tortoise (Agrionemys horsfieldii). This herbivorous tortoise was fed dairy products, which resulted in fermentative enteritis (left prefemoral approach). B) Retained, inspissated yolk sac (y) in a juvenile radiated tortoise (Astrochelys radiata) that presented for intermittent anorexia and poor growth. Clinicopathology and diagnostic imaging were unremarkable but endoscope-assisted removal proved curative (left prefemoral approach). C) Chronic hepatic fibrosis in a green iguana (Iguana iguana) that presented for anorexia and occasional regurgitation. Diagnostic imaging was unremarkable, and the only clinicopathologic abnormality was a mild increase in postprandial bile acids. Endoscopic biopsy confirmed the diagnosis of severe hepatic fibrosis with cholestasis (left lateral coelioscopy). D) Pale liver (l) in an Aldabra tortoise (Aldabrachelys gigantea) that presented with intermittent anorexia. All liver parameters were unremarkable, but severe hepatic lipidosis was diagnosed after liver biopsy (left prefemoral approach). E) Diffuse hepatomegaly (l) in a green iguana that presented with lethargy and anorexia. Diagnostic imaging and liver biochemistry were unremarkable; however, moderate leukocytosis, predominantly heterophilia and azurophilia, was evident. Endoscopic liver biopsy confirmed the diagnosis of bacterial hepatitis due to Klebsiella, and appropriate treatment proved curative (left lateral coelioscopy). F) Biopsy from the edge of the chelonian liver (l) using 1.7-mm biopsy forceps (b) (left prefemoral approach).