Librito Exóticos

Endoscopy in Birds,
Reptiles, Amphibians and Fish
Michael J. MURRAY
Bernd SCHILDGER
Michael TAYLOR
2 Endoscopy in Birds, Reptiles, Amphibians and Fish
Important notes: Endoscopy in Birds, Reptiles, Amphibians and Fish

Medical knowledge is ever changing. As new Michael J. Murray, DVM, U.S.A.
research and clinical e xperience broaden our Bernd Schildger, DVM, Switzerland
knowledge, changes in treatment and therapy Michael Taylor, DVM, Canada
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Endoscopy in Birds, Reptiles, Amphibians and Fish 3
Contents
1.0 Endoscopy in Birds . . . . . . . . . . . . . . . . . 7 2.0 Endoscopy in Reptiles
1.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . 7 and Amphibians . . . . . . . . . . . . . . . . . . . 31
1.2 Anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . 8 2.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . 31
1.3 Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . 8 2.2 Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . 32
1.4 Indications . . . . . . . . . . . . . . . . . . . . . . . . . 9 2.3 Indications . . . . . . . . . . . . . . . . . . . . . . . . . 34
1.5 Endoscopic Technique . . . . . . . . . . . . . . . 9 2.4 Anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . 34
1.5.1 Examination of the Major Air Sacs 2.5 Endoscopic Techniques . . . . . . . . . . . . . . 36
and Coelom . . . . . . . . . . . . . . . . . . . . . . . . 9 2.5.1 Endoscopic Examination of the
1.5.2 Endodocumentation . . . . . . . . . . . . . . . . . 10 Pleuroperitoneal Cavity . . . . . . . . . . . . . . . 36
1.5.3 Non Invasive Endoscopy in Birds . . . . . . . 11 2.5.2 Non Invasive Endoscopic Techniques . . . 38
1.5.3.1 Oropharynx . . . . . . . . . . . . . . . . . . . . . . . . 11 2.6 Endoscopic Examination of the
1.5.3.2 Trachea . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Pleuroperitoneal Cavity . . . . . . . . . . . . . . . 40
1.5.3.3 Esophagus and Ingluvies . . . . . . . . . . . . . 12 2.6.1 The pleuroperitoneal cavity . . . . . . . . . . . . 40
1.5.3.4 Proventriculus, Ventriculus . . . . . . . . . . . . 13 2.6.2 Heart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
1.6.1 Major Air Sacs and Coelom . . . . . . . . . . . 14 2.6.3 Lungs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
1.6.2 Lungs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 2.6.4 Liver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
1.6.3 Liver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 2.6.5 Spleen . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
1.6.4 Heart and Pericardial Sac . . . . . . . . . . . . . 18 2.6.6 Stomach and Intestines . . . . . . . . . . . . . . 47
1.6.5 Spleen . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 2.6.7 Gonads . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
1.6.6 Gastrointestinal Tract . . . . . . . . . . . . . . . . 20 2.6.8 Kidneys . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
1.6.7 Kidney . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 2.6.9 Bladder . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
1.6.8 Gonads . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 2.6.10 Fat Bodies . . . . . . . . . . . . . . . . . . . . . . . . . 53
1.6.9 Ureters . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 2.7 Non Invasive Endoscopy in Reptiles . . . . 54
1.6.10 Adrenal Glands . . . . . . . . . . . . . . . . . . . . . 25 2.7.1 Tracheoscopy, Pneumonoscopy . . . . . . . 54
1.7 Non Invasive Endoscopy in Birds . . . . . . 26 2.7.2 Oesophagoscopy, Gastroscopy . . . . . . . . 54
1.7.1 Oral Cavity . . . . . . . . . . . . . . . . . . . . . . . . . 26 2.8 Endoscopy in Amphibians . . . . . . . . . . . . 55
1.7.2 Trachea . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 2.9 Literature . . . . . . . . . . . . . . . . . . . . . . . . . . 56
1.7.3 Esophagus, Ingluvies,
Proventriculus and Ventriculus . . . . . . . . . 27
1.8 Literature . . . . . . . . . . . . . . . . . . . . . . . . . . 28 3.0 Endoscopy in Fish . . . . . . . . . . . . . . . . . . 59
3.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . 59
3.2 Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . 59
3.3 Indications . . . . . . . . . . . . . . . . . . . . . . . . . 60
3.4 Anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . 61
3.5 Endoscopic Technique . . . . . . . . . . . . . . . 63
3.6 Samples of Endoscopic Features of Fish . 67
3.7 Literature . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Acknowledgements . . . . . . . . . . . . . . . . . 75
Recommended Endoscopes and Instruments

Video Documentation Systems and
Accessories for Endoscopy in Birds,
Reptiles, Amphibians and Fish . . . . . . . . . . . . . . 77
Extracts from the following catalog:
VETERINARY ENDOSCOPY
– SMALL ANIMALS –
including section:
TELEPRESENCE – IMAGING SYSTEMS
Accessories for Illumination, Documentation
and Data Storage
Endoscopy in Birds
Michael TAYLOR, DVM
Service Chief, Avian / Exotic Animal Medicine
University of Guelph, Canada
Veterinary Teaching Hospital
Guelph, Ontario,
N2G 2W1, Canada
Phone: +1-5 19-8 24 41 20
Fax: +1-5 19-7 63 12 76
e-mail: [email protected]
Endoscopy in Birds 7
1.0 Endoscopy in Birds
1.1 Introduction
Fine diameter rigid endoscopes have been used for diagnostic purposes in
birds since the late 1970‘s. During the decade of the 1980‘s this technology
began to be employed with greater vigour by veterinarians in zoological and
private practice. The value of a minimally traumatic procedure that allowed
excellent visualization of internal structures even in very small patients soon
became evident to many practitioners. Enhanced diagnostic sampling
procedures were slower to develop. Avian medicine has seen spectacular
growth in its knowledge base over the past fifteen years.
Rigid endoscopes were first employed in birds to visualize the gonads for
purposes of sex identification in those species where external characteristics
were difficult or impossible to rely upon. As private and public captive breeding
programs began to flourish the need for reliable sex identification services
drove the early clinical applications of endoscopic technology (HARRISON
1978, MACDONALD 1982 and JONES 1984). The superior resolution and
light transmission characteristics of even the earliest rod lens endoscopes
made them far superior to other optical systems for avian applications. A
number of pioneering avian veterinarians soon realized that endoscopy
offered far more than gonad identification capabilities. The unique anatomy
of the avian respiratory system allowed relatively easyaccess to many organ
systems. SATTERFIELD 1981 and KOLLIAS 1984 for example, described
diagnostic uses of endoscopy that moved beyond organ visualization.

Secondary hand instruments could be guided into the viewing field to collect
biopsies or retrieve materials. Endoscopic collection of hepatic and renal
biopsies allowed precise targeting of lesions with minimal patient trauma.
LUMEIJ 1987 provided the first comprehensive overview of endoscopic
access points for the bird, using the pigeon as a model. He was also the
first to suggest the use of some method whereby hand instruments could be
manipulated in concert with the endoscope.
A new endoscope and sheath system for avian use was developed in 1992
by the author (TAYLOR 1993). The sheath design allowed a variety of hand
instruments to be guided to the tip of the endoscope through an instrument
channel increasing operator ease and preventing iatrogenic trauma.
(14.5 F. sheath 67065 CC and 2.7 mm endoscope 64018 BS, KARL STORZ
Veterinary Endoscopy, Goleta, CA). The author first described an anatomic
approach to better understand the most applicable access points for avian
endoscopy in a comprehensive review (TAYLOR 1994).
1.2 Anesthesia
Isoflurane gas anesthesia has become the standard for avian anesthesia
since its introduction to the field in the mid 1980’s. A number of parenteral
agents, either singly or in combination, have been used such as ketamine,
xylazine, diazepam, midazolam and propafol. In the author’s opinion,
none of these agents has proven to be as safe or consistently effective as
isoflurane for endoscopic procedures. Birds are readily intubated by placing
ncuffed endotracheal tube into the unencumbered glottis (Fig. 1).
a soft, u
Remember that in most species the tracheal rings are complete.
1.3 Anatomy
1 Oropharynx. The unique anatomy of the avian respiratory system facilitates endoscopic
Great horned owl (Bubo virginianas).
Endotracheal tube in place for gas examination. The lungs are fixed to the dorsolateral ribs and do not change
anesthesia. significantly in volume during the respiratory cycle. The air sacs of the bird
arise from a variety of ostia in the lung and extensively invaginate the coelom
(TAYLOR 1994). They provide access to most internal organs without the
need for secondary insufflation. The caudal thoracic air sacs are the key
entry points to the avian air sac system. The cranial thoracic and abdominal
air sacs can be easily accessed from a single entry point into the caudal
thoracic sacs via the lateral thoracic wall (Fig. 2). This permits inspection of
most of the respective right or left hemicoelom. The peritoneum is partitioned
by the invaginations of the air sacs. The liver is surrounded by the right and
left ventral and dorsal hepatic peritoneal cavities. The rest of the abdominal
viscera are suspended within the midline intestinal peritoneal cavity as they
would be in the typical mammal.
2 Primary entry site for avian coeleoscopy.

Green winged macaw (Ara chloroptera) positioned in right lateral recumbency with the
left leg positioned cranially.
1.4 Indications
Table 1: Indications for Endoscopic Examination
Acute/Chronic • Dyspnea
• Sneezing
Ingluvitis • Crop Burns or Trauma
Abnormal radiographic • Lung
findings (plain or contrast) • Organomegaly
eg. air sacs • Gastrointestinal
Abnormal Biochemical • Elevated Uric Acid Levels (Kidney)
Studies • Elevated Bile Acids (Liver)
Persistent Leukocytosis • Unexplained
• Non-responsive to Treatment
Acute/Chronic • Systemic Disease
Reproductive System • Suspect Infertility
Polyuria, Polydipsia
Follow-up examination to check on lesion resolution (Second look).
1.5 Endoscopic Technique
1.5.1 E
xamination of the Major Air Sacs
and Coelom
An approach to the caudal thoracic; air sacs has been developed that
is based upon precise landmarks that are reproducible among a wide
variety of species (TAYLOR 1994). The entry site is located by finding the
point where the semimembranosus muscle (m. flexor cruris medialis)
3 Caudal thoracic tir sac.
crosses the last rib. A blunt entry is recommended through the thin body Red tailed hawk (Buteo jamaicensis).
wall just caudal to the last rib, beneath the reflected semimembranosus Note the large ostium of the air sac visible
on the lung surface. This is the standard
muscle. Except in individuals with moderately to markedly increased fat entry point for most avian coeleoscopy.
reserves, the landmarks are located easily and the entry site was found to
be very reproducible in members from a wide variety of orders including
psittaciformes,
passeriformes, columbiformes, gruiformes, anseriformes,
falconiformes and strigiformes. A major advantage in placing the leg forward
is that the thin, lateral body wall can be more easily approached without the
interference of the femoral musculature. This becomes particularily important
in birds with heavily muscled upper thighs (eg. many psittaciformes). With
this approach the endoscope enters the caudal thoracic air sac at or near
its caudal border. Upon entering the left caudal thoracic air sac and looking
cranially the lateral septal surface of the lung with its large ostium will be
visible (Fig. 3). Running from approximately two to three o‘clock is the
transparent membrane formed by the confluent walls of the caudal thoracic
air sac and the abdominal air sac. Passing through this wall would place the
endoscope within the abdominal air sac (Fig. 4). At four to six o‘clock is the
ventrolateral border of the proventriculus and ventriculus. The lateral edge of
the left lobe of the liver may be seen at seven to eight o‘clock, draped upon 4 Caudal thoracic air sac.
the ventriculus. From nine to ten o‘clock is another transparent membrane View through to abdominal air sac –
composed of the walls of the confluent caudal thoracic air sac and cranial red tailed hawk (Buteo jamaicensis).
thoracic air sacs. Passing through this membrane would place the tip of the
endoscope in the cranial thoracic air sac.
1.5.2 Endodocumentation
The greatest practical advances in endodocumentation have occurred in the
field of video imaging. Improvements in CCD chips allow greater sensitivity
to low light levels combined with higher resolution when recorded on
formats such as S-VHS and Hi8. Specialized endovideo cameras consist
of a soakable hand piece that contains the CCD chip, a focusable lens and
a quick connector. This unit is attached to the controller by a sealed cable.
The controller, which contains all of the electronic circuitry for the camera, is
placed out of the surgical field.
The sterilized camera may be used for the real time visualization of
procedures and is preferred by some clinicians as an aid to performing
certain m
anipulations. The procedure is observed on a monitor without the
need for the surgeon to view the ocular. Portions or all of the examination can
be recorded for later review. This can be a valuable research tool allowing
comparison of many different examinations. Still images can be captured
from recorded material using a video printer. These prints are adequate for
the medical record or for client use.
High quality still photographs may only be obtained by the use of a

specialized flash generator (eg. KARL STORZ TTL-Computer Flash Unit 600
C) with a single lens reflex camera fitted with a proprietary zoom lens. The
photographs for this volume were exposed using this equipment.
Uses of Endovideo Documentation

Improved Ergonomics: As an aid to performing instrumented proce-
dures avoiding the need to keep head at eyepiece during instrument
manipulation, more procedures can be performed with less fatigue.
ForCase Documentation: Particularily useful for showing relation-
ships in space and time, medico-legal recording.
Teaching and Demonstration: Superb education and marketing tool
for clients, colleagues, staff.
1.5.3 Non Invasive Endoscopy in Birds
1.5.3.1 Oropharynx
The oral cavity is easily approached in most avian species. The bill may
be held open manually or a speculum can be employed. In species with
strong mandibular musculature such as psittacines, it is recommended that
the patient be anesthetized for most oral examinations. If manual restraint is
used extra care must be taken to prevent damage to equipment.
The avian tongue may exhibit a number of adaptions for food prehension
and manipulation. In many species it is a flat, triangular shaped organ with a
relatively smooth epithelium. Psittaciforms have large, fleshy tongues ideally
suited to food manipulation. They are the only order with intrinsic lingual
muscles that allow a great variety of movement and flexibility. In many
species, including parrots there are a group of mucus secreting salivary
glands at the base of the tongue. Inspissation of keratinized debris due to
squamous metaplasia will be seen in birds suffering from hypovitaminosis A
(Fig. 5).
The laryngeal mound is visualized at the base of the tongue on the midline of
the caudal floor of the oropharynx. The paired, fleshy laryngeal prominences
open and close to form the conspicuous glottis. There is no epiglottis.
5 Chronic hypovitaminosis A.
Yellow naped amazon (Amazona ochrocephala).
Note the white, inspissated appearance of the salivary lingual glands.
1.5.3.2 Trachea
The trachea may be entered at the larynx by passing through the glottis of
an anesthetized patient. The avian larynx does not contain vocal chords.
Tracheal rings of the bird are usually calcified and are completely circular.
The tracheal mucosa consists of a smooth stratified squamous epithelium.
The syrinx is the site of sound production and is located where the trachea
bifurcates into the primary bronchi. Tracheoscopy to the level of the syrinx is
possible in medium to large birds using a 180 mm long 2.7 mm endoscope.
Smaller patients may be examined with a 1.9 mm endoscope. Visualization
can be improved by extending the neck.
1.5.3.3 Esophagus and Ingluvies

The esophagus is easily entered by passing caudally into the pharynx and
over the laryngeal mound. The surface of the esophagus is thrown into a
series of longitudinal folds that vary depending upon the types of food items
that the species consumes. For example, the number and size of folds and
the degree of distensibility are less in insectivores and seed eaters than in
carnivores like hawks and owls (Fig. 6).
6 Oropharynx and esophageal folds.

Great horned owl (Bubo virginianus).
Birds that consume large boluses of food have noticeable folds of the esophageal
mucosa.
The ingluvies can be examined with either a flexible or rigid endoscope after
passing through the cervical portion of the esophagus. Insufflating the crop
with air will help with visualization. Some pressure will need to be maintained
around the proximal cervical esophagus to retain the infused air within the
crop. It is also important to remember to fast patients undergoing elective
ingluvioscopy for several hours before the procedure to reduce the effects of
retained food materials upon visualization.
1.5.3.4 Proventriculus, Ventriculus

The proventriculus and the ventriculus may be examined using either flexible
or rigid equipment. Due to the tremendous amount of work that has been
done in mammalian gastroscopy, the clinician might assume that a flexible
endoscope would be the first choice for this examination. The smallest 7 Ingluvies and esophageal sphincter
of the thoracic esophagus.
practical flexible endoscopes with an instrument channel are pediatric Moluccan Cockatoo (Cacatua moluccensis).
bronchoscopes at 4.0 mm and 5.0 mm diameter. Smaller flexible instruments The esophageal sphincter is open due to the
degree of insufflation present.
lack the optical quality of the KARL STORZ 2.7 mm endoscope and sheath.
I recommend a midline ingluviotomy to enter the thoracic esophagus using

the endoscope and instrumented sheath. Once into the thoracic esophagus
the pathway becomes a relatively straight one continuing into the
proventriculus and then the ventriculus. Birds are anesthetized, intubated
and placed in dorsal recumbency. A small skin incision was made over the
middorsal portion of the crop and the crop wall is incised. The entrance
to the thoracic esophagus is located on the the ventral, midline border of
the crop (Fig. 7, 8) and the telescope and sheath are introduced. Whenever
possible, patients are fasted for five to six hours to aid in emptying of the
proventriculus. Care must be taken to avoid the passage of proventricular
content into the trachea or choana. This can be prevented by inserting an
absorbent gauze tampon into the cranial cervical esophagus and ensuring
that the endotracheal tube is close fitting. The crop incision is closed using
standard techniques.
8 Esophageal sphincter of the thoracic
In species that are large enough and particularily those without a crop, a esophagus.
Green winged macaw (Ara chloroptera).
flexible pediatric bronchosope or a larger human colonosope may be used
to enter the proventriculus and ventriculus. This is especially indicated in
species with long necks such as Gruiformes and some Anseriformes.
1.6.1 Major Air Sacs and Coelom

The respective caudal thoracic air sac is the major entry point for avian air sac
and coelomic endoscopy. From this site the cranial thoracic and abdominal
air sacs can be entered. The left approach is usually the first site to be used
because the greatest number of structures can be visualized from here.
9 Caudal thoracic air sac.

Red breasted merganser
(Mergus serrator).
Large ostium on the lung surface is visible.
In many diving birds the caudal thoracic air
sac is very large and the cranial thoracic air
sac is relatively small.
10 C ranial thoracic air sac.

Orange winged amazon
(Amazona amazonica).
In this air sac the key landmark is the heart
beating within the pericardial sac.
11 C
audal thoracic air sac. 12 Abdominal air sac (left).
View through to abdominal air sac – Red tailed hawk (Buteo jamaicensis).
Red tailed hawk (Buteo jamaicensis). The spleen and ovary are visible in this view of the cranial portion of the left abdominal
Note the puncture that has been made in air sac.
the confluent walls of the caudal thoracic
and abdominal air sacs.
 Pathological Alterations
13 Granulomatous airsacculitis. hronic air sac granuloma.

14 C
Green winged macaw (Ara chloroptera). White capped pionus (Pionus senilis).
Typical pattern seen with both inhaled and hematogenous air sac Common avian response to large acumulations of debris.
inflammation.
15 L
arge air sac rent.
Orange winged amazon (Amazona amazonica).
This unnecessarily large hole in the air sac was created using an
otoscope speculum instead of a fine diameter endoscope.
1.6.2 Lungs
16 Normal lung.

Orange winged amazon (Amazona amazonica).
17 P
nemoconiosis. 18 Granulomatous pleuritis. 19 P
ulmonary congestion and chronic
Blue fronted amazon (Amazona aestiva). Yellow shouldered amazon inflammation.
The multifocal, black areas in the lung (Amazona barbidensis). Blue and yellow macaw (Ara ararauna).
represent accumulations of inhaled carbon This granulomatous debris has accumulated This pattern of lung inflammation is
particulates. in the pleural space between the air sac wall commonly seen in chronic obstructive
and the lung. pulmonary disease of macaws.
1.6.3 Liver
20 N
ormal hepatic border. 21 Normal liver.
Green winged macaw (Ara chloroptera). Pigeon (Columbia livia). Left and right
View from the left caudal thoracic air sac. lobes of the liver viewed from the midline
approach to the ventral hepatic peritoneal
 Pathological Alterations cavities. Note the lack of a ventral
mesentery separating the left and right
Figs. 22–25 cavities in this pigeon.
22 Amyloidosis of the liver. 23 Bile duct carcinoma.

Trumpeter swan (Olor buccinator). Yellow headed amazon
The left lobe of the liver is pale brown to tan (Amazona ochracephla).
and swollen. Proliferating bile ducts appear as white,
raised nodules.
24 Biopsy of the liver. 25 Chlamydiosis.

Orange winged amazon Red-lored amazon
(Amazona amazonica). (Amazona autumnalis).
Left lobe of the liver approached from the Marked bilverdin staining of the hepatic
caudal thoracic air sac via an incision into parenchyma.
the ventral hepatic peritoneal cavity.
1.6.4 Heart and Pericardial Sac
26 Pericardial effusion.

King Parrot (Alisterus amboinensis).
Pericardial effusions are relatively common
in systemic diseases of birds.
This parrot had avian chlamydiosis.
27 Normal heart.

Blue fronted amazon (Amazona aestiva).
1.6.5 Spleen
28 Normal spleen. 29 Normal spleen. 30 Normal spleen and splenic lobe of
Blue and yellow macaw (Ara ararauna). Indian hill mynah (Gracula religiosa). pancreas.
Typical rounded spleen of psittacines. Sausage shaped spleen of passerines. Orange winged amazon (Amazona amazonica).
The splenic lobe of the pancreas is frequently
visible near the gastric border of the spleen.
 Pathological Alterations
31 Splenic enlargement.

Umbrella cockatoo (Cacatua alba).
Enlargement of the spleen can occur in a variety of systemic diseases of birds.
1.6.6 Gastrointestinal Tract
ormal intestinal loops.

32 N 33 Proventricular dilation.
Orange winged amazon (Amazona amazonica). Orange winged amazon (Amazona amazonica).
A large portion of the proventriculus can be viewed from the caudal
thoracic and abdominal air sacs. In this case the proventriculus is
more dilated than normally expected for this species. In birds that
consume large meals (eg. raptors) this appearance may be normal.
34 N
ormal duodenum and pancreas. 35 Serosal granulomas of avian mycobacteriosis.
Green winged macaw (Ara chloroptera). Blue headed pionus (Pionus menstrus).
Raised subserosal granulomas are frequently found on the intestinal
loops of parrots suffering from avian mycobacteriosis.
1.6.7 Kidney
36 N
ormal kidney. 37 U
rates in tubules.
Umbrella cockatoo (Cacatua alba). Orange winged amazon
Normal cranial and middle divisions of the (Amazona amazonica).
kidney. The ureter is visible as it emerges Urates may become visible in kidney
from behind the iliac artery and vein. tubules during normal as well as abnormal
renal physiology. This bird was clinically
dehydrated but otherwise normal.
38 Chronic renal disease. 39 Fusion of the middle and caudal
Green cheeked amazon (Amazona viridigenaiis). divisions.
This bird has suffered chronic renal changes due to ongoing kidney disease. Orange winged amazon
(Amazona amazonica).
Fusion may occur for developmental
reasons or occasionally due to pathology.
1.6.8 Gonads
ormal mature ovary.

40 N 41 Normal mature ovary.
Red tailed hawk (Buteo jamaicensis). Umbrella cockatoo (Cacatua alba).
This unpigmented ovary has a typical “cluster of grapes” appearance. In some species the ovary and/or the testicle may be melanistic.
In most species only the left testicle develops after hatching.
42 Normal mature testicle. 43 Normal mature testicles.

Trumpeter swan (Olor buccinator). Yellow headed amazon (Amazona ochrocephala).
The mature testicle has a bean shaped appearance. Frequently the right testicle may be viewed through the dorsal
mesentery.
44 N
ormal immature ovary. 45 N
ormal immature ovary. 46 Normal immature testicle.
Tucuman amazon (Amazona tucumana). Blue and yellow macaw (Ara ararauna). Green winged macaw (Ara chloroptera).
The immature ovary has sulci and gyri In some species the ovary may be partially The immature testicle is quite different from
reminiscent of the surface of the brain. or fully melanistic. the immature ovary.
Primary follicles are not yet clearly evident. This macaw exhibits partial melanism. It is three-dimensionally raised and sausage
The prominent dorsal ligament of the ovary shaped.
is visible crossing the cranial division of the
kidney.
48 Normal mature ovaries. 47 M

ature ductus deferens.
Sharp-shinned hawk (Accipiter striatus). Yellow headed Amazon
Some species such as the Accipiters develop a prominent right ovary. (Amazona ochrocephala).
Here the right ovary is seen near the left giving a “horsehoe” appearance. The ductus deferens of the hormonally active
male bird becomes very sinuous.
1.6.9 Ureters
 Pathological Alteration
49 Normal ureter. 50 Ureteral dilation.

Blue and yellow macaw (Ara ararauna). Green cheeked amazon
(Amazona viridigenalis).
51 Normal ureter entering the urodeum.

Trumpeter swan (Olor buccinator).
1.6.10 Adrenal Glands
52 Adrenal Gland. 53 Adrenal congestion.

Blue Fronted Amazon Blue and gold macaw (Ara ararauna).
(Amazona aestiva). This adrenal gland is abnormally congested
with a dark, meaty texture.
54 Adrenal gland.

Red tailed hawk (Buteo jamaicensis).
Note the normal yellow colour of the adrenal gland of this carnivorous bird.
1.7 Non Invasive Endoscopy in Birds
1.7.1 Oral Cavity
55 Normal oropharynx.

Yellow crowned amazon (Amazona ochrocephala).
56 Chronic hypovitaminosis A. 57 Palatine abcess. 58 Glottal papillomatosis.

Yellow naped amazon Yellow naped amazon Yellow naped amazon
(Amazona ochrocephala). (Amazona ochrocephala). (Amazona ochrocephala).
Note the white, inspissated appearance of Unlike the inspissated appearance that A virus is implicated as the cause of these
the salivary lingual glands. occurs with hypovitaminosis A, this abcess oropharyngeal (and cloacal) papillomas.
contained a pure culture of bacteria. They may be difficult to detect without
the illumination and magnification that the
endoscope affords.
1.7.2 Trachea
59 N
ormal trachea. 60 Normal trachea.
Orange winged amazon Red tailed hawk (Buteo jamaicensis).
(Amazona amazonica). Unlike the parrot the hawk has a simple
Note the syringeal folds visible at the syrinx with little syringeal development.
base.
1.7.3 Esophagus,
Ingluvies,
Proventriculus
and Ventriculus
61 Oropharynx and esophageal folds.

62 Ingluvies and esophageal sphincter
Great Horned Owl (Bubo virginianus). of the thoracic esophagus.
Birds that consume large boluses of food Moluccan Cockatoo (Cacatua moluccensis).
have noticeable folds of the esophageal The esophageal sphincter is open due to the
mucosa. degree of insufflation present.
63 Esophageal sphincter of the thoracic 64 Proventricular mucosa. 65 Ventriculus.
esophagus. Pigeon (Columbia livia). Green winged macaw (Ara chloroptera).
Green winged macaw (Ara chloroptera). The proventricular glands can been seen as Note the bile staining of the koilin layer.
A magnified view of the foliate distinct round openings.
appearance of the closed sphincter that
empties the ingluvies into the thoracic
esophagus.
1.8 Literature
1. Harrison GJ: Endoscopic examination of avian gonadal tissue
Vet Med Small Anim Clin 73:479-484, 1978.
2. Jones DM et al: Sex determination of monomorphic birds by

fibreoptic endoscopy. Vet Rec 115:596-598, 1984.
3. Kollias GV: Liver biopsy techniques in avian clinical practice.

Vet Clin North Am l4(2):287-298, 1984
4. Lumeij TJ: Endoscopy. In A Contribution to Clinical Investigative

Methods for Birds with Special Reference to the Racing Pigeon
(Columbia livia domestica). Utrecht, 1987, pp 151-166.
5. McDonald SE: Surgical sexing of birds by laparoscopy.

Calif Vet 5:16-22, 1982.
6. Satterfield W: (1981). Early diagnosis of avian tuberculosis by

laparoscopy and liver biopsy. In Recent Advances in the Study of
Raptor Diseases, (eds) J.E.Cooper and A.G. Greenwood,
Chiron Publications, Keighley, UK pp 105-106.
7. Taylor M: Diagnostic application of a new endoscopic system for

birds. Proc Eur Conf Avian Med Surg, Utrecht, NL, 1993, pp 127-131.
8. Taylor M: Endoscopic examination and biopsy techniques.

In: Ritchie BW, Harrison GJ, Harrison LR (eds). Avian medicine:
principles and application. Lake Worth, FL: Wingers Publishing Inc,
1994:327-354.
Endoscopy in Reptiles and Amphibians

Bernd Schildger, DVM
Director
Tierpark Dählhölzli
Tierparkweg 1
CH-3005 Bern, Switzerland
Phone: +41-3 13 57 15 15
Fax: +41-3 13 57 15 10
Endoscopy in Reptiles and Amphibians 31
2.0 E
ndoscopy in Reptiles
and Amphibians
2.1 Introduction
Endoscopy in reptiles and amphibians has developed from a method to
identify the sex of monomorphic reptiles to an important diagnostic tool in
reptile medicine.
The techniques are readily learned. The interpretation of the results doesn't
require years of experience like in ultrasonography. During endoscopic
exploration the inner organs appear in their natural size, shape, position and
colour. Surface alterations can easily be diagnosed. Even very small s tructures
(less than 1 mm in size) like juvenile ovaries or mycobacterial granulomas in
small reptiles (less than 20 g BM) are visible. Modern e ndoscopic equipment
permits the sterile biopsy of organs for further microbiological or histological
examination and the removal of foreign bodies or parasites. In addition
endoscopic equipment is less expensive than other diagnostic imaging
methods. Using one basic equipment set, for example the 2.7 mm 30° rigid
endoscope, the surgeon is able to examine reptiles from 50 g to 20 kg.
Endoscopy is of great value in reptile medicine because many of the

commonly used mammalian clinical techniques such as measurement of
body temperature, respiration and heart rates and palpation of lymph nodes
are of only limited value.
Endoscopic examination of the pleur-operitoneal cavity (coelioscopy) in

reptiles was first described for Chelodina mydas by WOOD et al. (1983).
Predicting the sex and stage of gonadal development has been described
for various lizard and chelonian species such as Trachydosaurus rugosus,
Tiliqua spp., Heloderma spp., Varanus spp. and Chelodina spp (KUCHLING
1989, HAEFELI 1994, SCHILDGER and WICKER 1987, 1992, SCHILDGER
et al. 1993, 1998). Coelioscopy soon developed into a method of clinical
diagnostic imaging of inner organs like the heart, liver, lungs, intestines
and kidneys (SCHILDGER and WICKER 1992, SCHILDGER et al. 1994,
SCHILDGER 1995).
Non invasive endoscopic examination in reptiles has rarely been published.

In 1982, COPPOOLSE first described the examination of the cloaca in
reptiles. COOPER and SCHILDGER (1991) portrayed oesophagoscopy
in chelonians. Gastroscopic techniques in chelonians were specified by
SCHILDGER (1997). Endoscopic examination of the respiratory tract in
reptiles (tracheoscopy and pulmonoscopy) were described by GOEBEL and
JURINA (1994).
Amphibians display a pleuroperitoneal cavity as undivided as most of the

lizards. Coelisocopy was used to identify the sex (e.g. Andrias davidianus)
and for diagnostic imaging of inner organs (SCHILDGER and WICKER 1992).
The methods for endoscopic examination of reptiles and amphibians have

been established. The following chapters should allow the reader to evolve
impressions about the endoscopic appearance of normal and pathologically
alterated organs and to use this powerful tool in reptile medicine.
2.2 Anatomy
Primitive reptiles, such as most of the lizards, possess an undivided
paraperitoneal cavity. The only seperate compartment is the pericardium.
It is placed far cranially in the pleuroperitoneal cavity, between the s houlder
joints. Genera of the families Scincidae, Iguanidae, H elodermatidae,
Agamidae and Geckonidae belong to this group. In monitors and crocodiles
a septum postpulmonale seperates the peritoneal cavity from the pleural
cavity which is divided into two bilaterally symmetric cavities by the
mediastinum (DUNKER 1978). The descensus cordis in monitors leads to
the heart and liver placed caudally, close to the center of the body cavity.
The intestines are only fixed dorsally by the mesentery. Ventrally, the left
and right peritoneal cavities communicate. In Chelonians, the lungs are fixed
dorsally, adherent to the carapace. They are separated ventrally from the
other inner organs by a septum horizontale. Both the septum postpulmonale
and the septum horizontale are translucent. It is possible to examine the
lungs endoscopically through the septum. In lizards, two symmetric fat
bodies are placed retroperitoneally and laterally. They originate close to the
pelvis and may extend far cranially (lateral to the heart) in obese animals. The
more or less uncompartmented pleuroperitoneal cavity in most of the lizards
and chelonians permits the endoscopic examination of gonadal structures,
kidneys, bladder, liver, spleen, intestines and lungs using a single approach.
In snakes, the point of entry for the endoscope must vary with the organ to
be examined because of the elongated anatomy.
Anatomical principles in Lizards (Iguanids), Chelonians and Snakes, 1 = Endoscope, introduced, 6 = Stomach,
different endoscopic routes to enter the pleuroperitoneal cavity 2 = Heart, 7 = Intestines,
3 = Liver, 8 = Gonads,
3a = Gallbladder, 9 = Kidneys,
4 = Lungs 10 = Bladder
5 = Spleen, 11 = Fat bodies
a b
1 Lizard, laterolateral. Lizard, dorsoventral.
c
Chelonian, laterolateral.
d
Chelonian, dorsoventral.
e
1 Snake, laterolateral.
2.3 Indications
Indications for Endoscopy in Reptiles
Sex identification of monomorphic reptiles

(e.g., Varanidae, Scinciciae, He/odermatidae, Chelidae)
Sex identification in juvenile reptiles
(monomorphic and dimorphic species)
Staging and Control of reproductive state
(e.g., endangered species breeding programs)
Diagnostic imaging of internal organs
(suspected diseases such as gout, abscesses, tumors,
ascites, mycobacteriosis, arteriosclerosis, amoebiasis)
Removal of foreign bodies or parasites
(Filariae, Austramphilina spp., Pentastomides)
Endoscopic surgery
(sterilization, castration, splenectomy)
2.4 Anesthesia
Endoscopic examination of the pleuroperitoneal cavity in reptiles is invasive
and therefore requires anesthesia. In former times this was the greatest
disadvantage of endoscopy in reptiles. With modern anesthetics such as
isoflurane (Forene®, Abbott), there is little risk to anesthesize reptiles for these
procedures. In 700 cases the mortality rate associated with the anesthesia
and endoscopic examination of reptiles was zero%. The recommended
regime to anesthesize lizards, chelonians and snakes for endoscopic
examination is listed below. For species-specific problems it is advisible to
refer to the literature (see BENNETT 1991, FRYE 1991, SCHILDGER et al.
1993, GABRISCH and ZWART 1998).
Anesthesia regime for endoscopic examination in lizards,

chelonians, snakes
Presurgical heating of the animals to 25 – 35°C (ectothermes)

Introduction
– Isoflurane 5% in snakes and lizards via face mask
– Ketamine 50 mg / kg i. p. in tortoises
– Ketamine 75 mg/kg i. p. in turtles
Surgical tolerance
Intubation, positive pressure insufflation (3 – 4/min)
Isofluran 4 to 1%
Wake up period
20 – 22 °C, room air ventilation
In most of the chelonians, the ketamine dose is sufficiant for short endoscopic
examinations (10–15 minutes). The ketamine dosage can vary in some
genera. In the crocodilia species, specific dosages and application routes
are recommended.
2 Isoflurane anesthesia.
Introduction via face mask, Green Iguana (Iguana iguana).
3 Isoflurane anesthesia.
Intubation, positive pressure insufflation. Boid snake (Corallus caninus).
2.5 Endoscopic Techniques
2.5.1 Endoscopic Examination of the

Pleuroperitoneal Cavity
Pre-endoscopic fasting facilitates endoscopic viewing. The less filled the
stomach and intestines are, the greater the space between the front lens
and organ to be examined. Carnivorous reptiles like monitors and most of
the turtles, with short intestines and short passage time of the ingesta should
be fasted between 3 to 7 days. In herbivorous reptiles like Tiliqua spp. or
Testudo spp. fastening time may be extended up to 4 weeks. Under field
conditions (free ranging animals) even some hours are sufficient.
4 Endoscopic examination in lizards.

The endoscope is introduced.
5 Endoscopic examination in
chelonians.
The endoscope has not been introduced and
the tip indicates the point of introduction.
The anesthetized reptile is placed in lateral right recumbancy and fixed

(manually or taped). The area for introduction of the endoscope is cleaned,
disinfected and covered using a clear, sterile drape. Skin should be incised
using scissors. Muscles and peritoneal serosa can be perforated bluntly using
either scissors, forceps or a trocar. In cases where the endoscope is used
without a sheath (including working channel or verres cannula insufflation)
it should be introduced between the smoothened sides of the forceps. In
chelonians the scope is introduced in the center of the left knee fold. In
lizards the endoscope is inserted at the beginning of the last body third
(Figs. 1, 4, 5). In snakes the introduction area depends on the organs which
are be examined. The point of entry can vary in lizards and c helonians too,
depending on the target organ. The endoscopic technique for e xamination
of the pleuroperitoneal cavity in amphibians is similar to the one used in
lizards.
Insufflation, in addition to fasting, further improves the optical conditions.

Especially in small reptiles (< 100 g BM) a good overview of the topographic
anatomy can only be achieved with insufflation. The distended body cavity
under insufflation enables the examiner to move organs. For example a fat
body lying over the gonadal structure can easily be moved ventrally with
the tip of the endoscope or biopsy forceps to improve visualization. For
endoscopic surgery insufflation is obligatory to extend the working area.
Filtered air or medical CO2 can be used. An insufflation pressure of 10 mmHg
is sufficient. The easiest way to realize both is to use an automatic insufflator.
Under field conditions a hand held air ballon can be useful. For insufflation
of the body cavity a sheath including valves or an endoscope including a
working channel and valves should be used. Especially in small reptiles the
use of a Verres cannula requiring a second puncture is not useful.
The endoscopes to be used for endoscopic exploration of the pleuroperi-

toneal cavity should be rigid. The Hopkins® rod lens system provides a
much higher optical quality than any flexible scope can achieve. The
diameter is always a compromise between the demand of the examiner for
maximum optical view (large diameter) and the right of the patient to the
smallest diameter. The diameter used will depend on the size of the reptile
to be examined. The 2.7 mm scope with sheath including working channel
is a good compromise to examine reptiles of 50 g BM up to 20 kg BM. For
smaller reptiles a 1.9 mm scope with sheath or the 3 mm triangular scope
including a working channel are recommended. In reptiles, bigger than 500 g
BM, a 4-mm-endoscope with sheath provides a superb optical quality even
for documentation. Endoscopes with an angled front lens (20°–30°) are
preferrable. They provide more flexibility to vary the view to an organ.
Rigid endoscopes for examination of the pleuroperitoneal cavity

in reptiles (all serial numbers KARL STORZ):
Diameter 1.9 mm, 0°, length 95 mm (64301 A)
Diameter 2.7 mm, 25°, length 190 mm (64018 BS) Sheath 14,5 Fr.
(67075 CC), biopsy forceps (67161 Z)
Diameter 3 mm, triangular, 30°, length 140 mm (27030 B) including
working channel and valves, biopsie forceps, diameter 1 mm (27071 ZJ)
Diameter 4 mm, 25°, length 180 mm (64200 BW) sheath including
valves (26181 HL).
Endovideo cameras or reflex cameras for slides can be used for

documentation. The video camera works with the normal light of the light
source used for endoscopic examination. In addition the examiner definitely
knows the contents of the film he is documentating. The positive slide camera
requires a flash generator and the contents of the film is only known after
processing. At this time slides represent the maximum quality achievable.
After the examination is finished and the endoscope removed an antibiotic

should be instilled into the pleuroperitoneal cavity. Serosa, muscles and skin
are sutured in single or double layer with a U-type pattern. The patients are
controlled until the first movements appear.
2.5.2 N
on Invasive Endoscopic Techniques
(Tracheoscopy, Pulmonoscopy,
Oesophagoscopy, Gastroscopy)
Endoscopic examination of the trachea, oesophagus and stomach can be
performed in small to mid size (5 kg BM) reptiles using the rigid scopes listed
above. To examine larger animals a flexible scope is preferred, for example
the 5 mm, 55 cm length (600001 VB). In snakes, because of their elongated
topographic anatomy and the unicameral lung design it is also possible
to use extra long rigid endoscopes, especially for scientific purposes. The
examination of the trachea, lungs, oesophagus or stomach in reptiles

requires anesthesia. The patients are placed in dorsal or ventral recumbancy
on a vacuum pillow. The head and neck should be straightened. The mouth,
especially in cases where flexible scopes are used, should be fixed open.
6 Endoscopic examination in the field.

Examination of free ranging monitors (Varanus gouldii) in Australia,
endovideo equipment for documentation.
In cases of oesophagoscopy or gastroscopy the endoscope should

be forwarded slowly and carefully. The permanent insufflation permits
visualisation of the widening oesophagus. If the scope enters the stomach
care must be taken not to over insufflate. Flexible endoscopes allow the front
lens to turn in three directions whereas rigid scopes with angled front lenses
allow the field of view to vary by rotating the scope. If foreign bodies are to
be extracted care should be taken for sharp edges (e.g. fish hooks) not to
be directed towards the oesophageal wall. If the choosen rigid endoscope
is too short, for example in long neck turtles, a lateral transoesophageal
approach on the right side of the neck is possible.
Endoscopic examination of the respiratory tract requires endoscopes

smaller in diameter than the trachea. The introduction via the glottis is easy
in reptiles because of the lack of an epiglottis. In crocodiles there is a septum
rostral to the glottis which needs to be lifted to allow access to the glottis. 8 Gastroscopy in a turtle.
(Mata mata), lateral transoesophageal
While the scope is moved forward in the tracheal lumen, care must be taken approach.
not to touch the mucosal surface. The tracheal mucosa is very fragile and
tends to irritate easily if manipulated. In addition most of the tracheal rings
are closed in reptiles and therefore the lumen is not flexible. In snakes and
lizards the scope can be forwarded through the bifurcation into the lumen
of the lungs. Primitive reptiles like most of the lizards and the snakes have
unicameral lungs that can be easily examined and biopsied. In monitors and
chelonians the lungs are multicameral and only the two main bronchi may
be examined. In addition the brochi in chelonians curve dorsally to enter the
lungs. Therefore only flexible scopes are recommended.
7 Gastroscopy in a turtle.
Read Eared Silder (Pseudemys scripta elegans), 5 mm flexible endoscope.
2.6 E
ndoscopic Examination of the
Pleuroperitoneal Cavity
 Pathological Alterations The endoscopic examination of the pleuroperitoneal cavity begins with the
cranial aspects of the coelom, heart, lungs, liver, spleen, serosal surface and
large vessels (Aorta). Following the aorta caudally, the intestines, gonadal
structures, kidneys and bladder are examined. Turning the endoscope
ventrally and cranially, the intestines arid the liver are visible. While removing
the scope, the fat bodies are examined. To follow this route of e xamination
prevents the surgeon from overlooking important structures. This route was
established for the lizard, primarily. The examiner has to match it to the
patient and the indication for the endoscopic examination.
9 Infestation with Filaria spp.

Grey monitor (Varanus griseus)
view to the caudal part of the coelom
2.6.1 The Pleuroperitoneal Cavity
Left and center:
grey serosa covering the colon
Right:  Normal Endoscopic Appearance
cloaca, on the surface of the serosa a Filaria
spp. moving slowly away from the light
source, endoscopic removal using forceps.
10 Ascites. 11 Pleuroperitoneal cavity, cranial aspect.

Green Iguana (Iguana iguana). Green Iguana (Iguana iguana).
Ventral: altered grey liver Center: red deflated left lung with longitudinal superficial vessels,
(bile duct carcinoma) ventral brown left lobe of the liver with sharp edges,
with irregular shape and surface, left: blue-red pericardium,
left: rib cage, top: vertebral column and rib cage.
top left: blue-red pericardium,
top right: red lung
center: green coloured ascitic fluid.
2.6.2 Heart
 Normal Endoscopic Appearance
12 Pericardium and heart. 13 Pericardium and ventral fixation.

Green Iguana (Iguana iguana) Shingle Back (Trachydosaurus rugosus)
the thin, blue pericardium is translucent in most of the lizards the pericardium is
with superficial vessels, the red heart is fixed to the sternum ventrally by soft tissue
displayed through the pericardium, (not in monitors). The pericardium is more
right: the red lung. grey and less translucent in this species,
left: attachment to the sternum by orange
coloured soft tissue with distinct vasculari-
sation.
14 A
bscess at the base of the heart. 15 Visceral gout.
Uromastix (Uromastix acanthinurus) Green iguana (Iguana iguana)
center: Pericardium, center: the grey pericardium is not
right: lung translucent (compare to fig. 12), white flakes
left: rib cage on the left lateral aspect of of uric acid are deposited subserosally in
the pericardium a large, yellow abscess is the pericardium, they can not be removed
visible, endoscopic biopsy and microbiology endoscopically.
revealed it to be caused by Salmonella spp.
2.6.3 Lungs
16 Insufflated unicameral lung of a

lizard.
Green Iguana (Iguana iguana).
The thin walled insufflated lung displays
a typical honey comb like structure, the
faveoli are surrounded by thin walls of
muscles which enables the lung to insufflate
during endoscopic examination under
insufflation, large vessels run subserosally
over the surface.
eflated multicameral lung of a turtle.

17 D
(Dermatemys marnii).
Ventral: the grey colon with distinct vessels,
top: the carapace covered by blue grey serosa,
center: the left, deflated red lung, honey comb
like appearance (multicameral structure)
the septum horizontale is attached to the lung’s surface and translucent.
(compare to the unicameral normal lung in fig. 9).
19 I nfestation with pentastomes.

Goulds Monitor (Varanus gouldii).
Pentastomes are common parasites,
especially in monitors, the yellow,
curved parasite is visible through the
thin wall of the lung, it is possible to
incise the lung and extract the parasite
endoscopically, afterwords the lung is
sutured.
18 Perforation of the lung.

Monitor (Varanus varius).
The unintentional perforation of the lung can be a complication during introduction of
the endoscope if the chosen point of entry is too far cranial, especially in monitors,
because the lungs are fixed to the septum postpulmonale. It is important to control for
bleeding while removing the scope slowly. Haemostatics can be instilled through the
working channel. Parasites could be removed via an intentional entrance (compare fig. 18).
20 A bscesses in the lung.

In the center and ventral aspect, yellow
alterations with a central dens are visible,
biopsy and microbiology revealed this to
be a infection with Morganella morganii,
response after treatment can be examined
endoscopically.
2.6.4 Liver
 Pathological Alterations  Normal Endoscopic Appearance
21 Fatty degeneration.

Shingle Back (Trachydosaurus rugosus)
center: liver, ventral: ribs, top: stomach.
This is a common endoscopic diagnosis in
captive reptiles, especially in carnivorous
species like monitors, the liver is dark to
bright yellow in colouration, the surface is
irregular and the borders are rounded. It
was never found in wild caught animals,
independent from their nutritional condition.
23 Liver.
Green Iguana (Iguana iguana)
the liver is brown, with smooth serosal surface and sharp borders, typical for reptiles are
the melanomacrophages seen in a black, honey comb like pattern.
22 Hepatitis.
Turtle (Dermatemys marnii)
the yellow, fatty liver displays distinct large
superficial vessels, the inflammation can
be infectious, or non-infectious as in this
case (diposits of uric acid).
24 Liver Abscesses. 25 Amoebiasis.

Herman’s Tortoise (Testudo hermanni). Pacific Monitor (Varanus indicus).
Center and ventral: liver, grey colouration, irregular borders with Left to center: brown liver with multiple white focal necrosis,
inflammation, on the dorsal aspect a distinct yellow abscess, biopsy typically for infestation with Entamoeba sp., examination of fecal
and microbiology revealed a Salmonella sp. infection, dorsal white samples are recommended to verify the diagnosis.
stomach, right dorsal yellow ovarian follicles.
26 Liver cysts. 27 Liver carcinoma.

Bearded Lizard (Amphibolurus vitticeps). Green Iguana (Iguana iguana).
The liver is covered by a dark serosa in some species, the yellow Ventral and left: sternum and rib cage, top left: deflated pink left
bubbles are subserosal liver cysts, they can be punctured and lung, center: blue white liver with irregular surface and white bumps,
evacuated endoscopically. right: endoscopic biopsy forceps introduced, further histological
examination revealed this case to be a liver carcinoma.
2.6.5 Spleen
28 Amoebiasis.
Pacific Monitor (Varanus indicus).
The red bean shaped spleen displays
multiple yellow button like necroticareas
caused by Entamoeba sp. infection,
examination of fecal samples are
recommended to verify the diagnosis.
30 Spleen.
The spleen is laying dorsal on the intestinesjust caudal of the liver, the shape varies
inter-specifically, bean shaped in chelonians, snakesand Monitors, cigar shaped in Iguanids.
The colour is red to red brown, the surface smooth, like in this Iguana to cauliflowerlike in
some monitors, distinct superficial vessel are seen.
29 Visceral Gout.

Philipin Monitor (Varanus cumminghii).
The bean shaped red spleen displays
multiple irregular subserosal white flakes,
biopsy revealed them to be deposits of
uric acid.
2.6.6 Stomach and Intestines
31 Stomach. 32 Small and large intestines.

Green Iguana (Iguana iguana). Gould’s Monitor (Varanus gouldii).
Center to right ventral: the white stomach Mid left: the grey white stomach proceeds
displays typical longitudinal folds and is into the short small and large intestines
covered by the translucent mesentery, which are more yellow pink coloured,
distinct superficial vessels running in the the large vessels run through the
serosa. mesenterium.
33 Obstipation (Ileus). 34 P

aralytic Ileus, Ascites.
Shingle Back (Trachydosaurus rugosus). Green Iguana, (Iguana iguana).
Left: rib cage ventral: abdominal wall and Center and ventral: the paralyzed enlarged,
serosa, dorsal: vertebral column, blue colon, center dorsal: yellow green
center: green yellow, irregular surface the ascites, in this case caused by ingesting of
colon, the colon wall is closely applied to unwashed sharp stone gravels.
the dehydrated ingesta.
2.6.7 Gonads
35 Ovary, juvenile. 36 Ovary, subadult. 37 O vary, adult, previtellogenic follicles.
Gould’s Monitor (Varanus gouldii) Long necked turtle (Chelodina longicollis) Salvator’s Monitor (Varanus salvator)
endoscopic examination permits the center: the yellow flat ovary with bright center: the pink grey previtellogenic
identification of the sex even in juvenile yellow primary follicles is displayed, follicles are displayed, small vessels
reptiles (in this case 30g BM, dorsal: the white oviduct runs from the left running superficially, ventral: yellow fat
3 months old) to the right, ventral: intestinal loops are body, dorsal to the ovary the white pink
dorsal: grey white peritoneal cavity visible. oviduct, dorsal: one artery crossing from
center left: yellow adrenal gland with the aorta to the lateral body wall.
distinct superficial vessels, attached to the
right the ovary, light pink, cigar shaped,
attached to the right the blue, translucent
oviduct, cranial to the adrenal gland the
dark blue aorta.
38 Ovary, adult, vitellogenic follicles. 39 Ovary, Corpora lutea. 40 F ollicles in resorption.
Green Iguana (Iguana iguana). Blue tongue scink (Tiliqua scincoides). Chuckwalla (Sauromalus obesus).
The large yellow vitellogenic follicles are Corpora lutea display as bright yellow Reptiles are able to resorb even large
covered by distinct superficial vessels, buttonswith central dens in between the vitellogenic follicles.
on the left are some small previtellogenic white previtellogenic follicles, which are The large yellow vitellogenic follicle is
follicles with amber colouration visible, covered by distinct superficial vessels. covered with broad vessels without
dorsal to the ovary the pink, curved distinct borders, dorsal: pink coloured
oviduct is displayed, ventral to the ovary oviduct.
the yellow, flat fat body is visible.
41 Testicle, juvenile. 42 Testicle, adult. 43 Testicle, adult, sexual active.
Gould’s Monitor (Varanus gouldii). Shingle back, (Trachydosaurus rugosus). Green Iguana (Iguana iguana).
Mid left: the yellow adrenal gland with The yellow testicle is covered by sagittal The colour of the testicle is species
distinct superficial vessels, mid right: the superficial vessels, dorsal the vas deferens specific, in Iguanas it is white. The large
bean shaped light pinkcoloured testicle runs caudally. testicle shows the typical sagittal superficial
with small superficial vessels. vessels, dorsal to the testicle the
enlarged epididymidis and the Vas
deferens running caudally is displayed,
ventral to the left vas deferens the right
one can be seen.
44 Y
olk depositions in the ovary.
Ventral: the degenerated ovary, dorsal: the
white oviduct and the blue mesoviduct are
displayed, the ovary contains disposed
white yolk material and only a few amber
coloured follicles.
2.6.8 Kidneys
45 K
idney.
Philipine Monitor (Varanus cumminghii).
The red brown kidney is built of slices like
segments.
idney, colour variations.

47 K
Gila monster (Heloderma suspectum)
in some species, especially in older individuals the colour of the kidney can turn into brown
black, the white tissue induration is also typical for older animals.
46 Kidney, sexual segment.

Pacific Monitor (Varanus indicus)
the sexual segment of the kidney is found
in some reptile genera, it enlarges in
sexually active individuals and displays as
white parts within the parenchyma,
the kidney shows a red white alternating
pattern, in these genera no epididymis is
verifiable.
49 Gout.
Deposits of uric acid display as white or
golden coloured stripes or confluent dots,
histological examination or direct
microscopy of endoscopic biopsies will
verify the diagnosis.
48 Tumor (adenoma).

Left: the blue rectum, right: the kidney displays as a grey white enlarged body with
superficial yellow dots of uric acid, ventral: the biopsy forceps are introduced to extract
a sample.
2.6.9 Bladder
51 Bladder, filled.

Green Iguana (Iguana iguana)
the bladder is a blue colour, the superficial
vessels ar elongated, dorsal: bodywall,
the filled bladder can occupy some space
in the caudal body cavity, caremust be
aken not to perforate the bladder with the
endoscope (scope directed cranially while
introducing) .
50 Bladder, empty.

The empty bladder displays as a white flat body with distinct superficial twistedvessels,
dorsal: fluid filled rectum.
53 Bladder, ruptured.

Marginated tortoise (Testudo marginata)
green urine and uric acid sludge (ventral
right) is dispersed over the entire body
cavity, left the caudal part of the left liver
lobe is a dark grey colour with distinct
superficical vessels (hepatitis),
dorsal: white stomach, tortoise dropped
while being handled by the owner is a
common reason, therapy: multiple rinses
can be performed through the scopes
working channel.
52 Bladder, uric acid sludge.
Water Monitor (Varanus mertensi).
Within the filled bladder yellow flakes
of uric acid can be demonstrated.
2.6.10 Fat Bodies
55 Fat body, enlargening.

Monitor (Varanus varius)
growing fat bodies can occupy largeparts
of the coelomic cavity in lizards, they
are characterized by yellow colour and
lobulated structure with distinct vessels
running over and between the lobes (right).
54 Abscesses.
Pacific monitor (Varanus indicus)
within the orange coloured fat body is a yellow round abscess with hemorrhagic walls,
endoscopic biopsy and microbiological examination revealed a bacterial infection (E. coli).
56 F at body, in resorption.

In fasting periods the fat bodies are
resorbed, the colour turns to orange pink
(ventral), dorsal: body wall, left: green
grey large intestine, blue aorta and white
vas deferens, right: white bladder.
2.7 Non Invasive Endoscopy in Reptiles

2.7.1 Tracheoscopy, Pneumonoscopy (Fig. 57)
2.7.2 Oesophagoscopy, Gastroscopy (Fig. 58 + Fig. 59)
57 Tracheal mycobacteriosis.

Boid snake (Corallus caninus).
Within the trachea multiple white nodules
are visible, endoscopic biopsy (right) and
direct Ziehl Nielsen staining revealed a
mycobacterial infection.  Pathological Alterations
58 Oesophagoscopy. 59 G

astric foreign body.
Red Eared Slider Turtle (Mata mata).
(Pseudemys scripta elegans) The endoscopic biopsy forceps (ventral) are introduced through the working channel to
the typical longitudinal red white stripes remove snail shells from the stomach.
of the oesophageal wall are displayed.
2.8 Endoscopy in Amphibians

The principles of endoscopic techniques and diagnosis in amphibians are
quite similar to the ones in lizards.
61 Testicle.
Giant Salamander (Andrias davidianus).
Endoscopic examination permits the
identification of the sex in amphibians,
the yellow, cigar shaped testicle and the
 Normal Endoscopic Appearance white twisted vas deferens are displayed
in the center.
60 Oviduct with larvae. 62 Liver, Mycobacteriosis.

Toad (Bufo alvarius). Toad (Pipa pipa).
Within the translucent oviduct multiple black larvae with white yolk sacs are displayed. The dark brown liver is displayed in the
center and the bottom, right: white stomach
with twisted vessels, dorsal: pale yellow
pleuroperitoneal wall, in the center a small
yellow granuloma is displayed at the rim
of the liver, left: the endoscopic biopsy
forceps, Ziehl Nielsen staining of the sample
revealed a mycobacterial infection.
2.9 Literature
1. Bennett RA: A Review of Anesthesia and Chemical Restraint In
Reptiles. J. Zoo Anim. Med. 22(3): 282-303, 1991.
2. Cooper JE, Schildger BJ: Exotic animals. In: Brearley, M.J., J.E.
Cooper, M. Sullivan (ed.) Coloured atlas of small animal endoscopy.
Wolfe Publishing, London, 93-107, 1991.
3. Coppoolse K: Endoscopy of the cloaca of the turtle.
Voorjaarsdagen, Proceedings, Rai-Congresscentre Amsterdam.
No. 14, 60-63, 1982.
4. Dunker HR: Coelom-Gliederung der Wirbeltiere – Funktionelle
Aspekte. Verh. Anat. Ges. 72, 91-112, 1978.
5. Frye FL: Biomedical and surgical aspects of captive reptile
husbandry. Malabas, Krieger Publ., 4:21-437,1991.
6. Gabrisch K, Zwart P: Krankheiten der Heimtiere, K. Gabrisch und
P. Zwart (ed.). Schlutersche, Hannover, 663-859,1998.
7. Gobel T, Jurina K: Endoskopie des Respirationstraktes bei
Reptilien. Kleintierpraxis, 39, 791-794, 1994.
8. HÄfeli W: Endoskopische Geschlechtsbestimmung juveniler
Schildkröten. Verh. ber. Erkrg. Zootiere, 36, 159-162, 1994.
9. Kuchling G: Assessment of ovarian follicles and oviductal eggs by
ultra-sound scanning in live Freshwater Turtles, Chelodina oblonga.
Herpetologica 45(1): 89-94, 1989.
10. Schildger BJ, Wicker R: Endoskopische Geschlechtsbestimmung
bei Trachydosaurus rugosus (GRAY 1827). Salamandra, 23, 97-106,
1987.
11. Schildger BJ, Wicker R: Endoskopie bei Reptilien und Amphibien –
Indikationen, Methoden, Befunde. Prakt. Tierarzt, 6, 516-526, 1992.
12. Schildger BJ, Kramer M, Sporle H, Gerwing M, Wicker R:
Vergleichende bildgebende Ovardiagnostik bei Echsen am Beispiel
des Chuckwallas (Sauromalus obesus) und des Arguswarans (Varanus
panoptes). Salamandra, 29 (2/3), 79-86, 1993.
13. Schildger BJ ,Baumgartner R, HÄfeli W, Rubel A,
IsenbÜgel E: Narkose und Immobilisation bei Reptilien.
Tierarztl. Praxis, 21, 361-376, 1993.
14. Schildger BJ, Geyer B, Kramer M, Tenhu H, Gerwing M:
Vergleichende bildgebende Diagnostik der Leber bei Reptilien.
Verh.ber. Erkrg. Zootiere 36, 151-158, 1994.
15. Schildger BJ: Endoskopische Untersuchungen des Urogenital-
traktes bei Reptilien. Verh. ber. Erkr. Zootiere, Dresden, 305-308, 1995.
16. Schildger BJ, Kuchling G: Endoscopic diagnosis and therapy
of Austramphilina sp. infection in the narrow-breasted snake-necked
turtle. Herpethopathologica, 67-68, 1995.
17. Schildger BJ: Zur Technik der Gastroskopie bei Schildkröten.
Verh. ber. Erkrg. Zootiere, 38, 73-75, 1997.
18. Schildger BJ, HÄfeli W, Kuchling G, Taylor M, Tenhu H,
Wicker R: Endoscopic examination of the pleuroperitoneal cavity in
reptiles. Sem. Avian Exotic Pet Med., 1998, in press.
19. Wood CR, Wood FE, Chrichtley KH, Wildt DE, Bush M:
Laparoscopy of the green turtle, Chelonia mydas. Brit. J. Herpetol. 6,
323-327, 1983.
Endoscopy in Fish
Michael J. MURRAY, DVM
Monterey Bay Aquarium
886 Cannery Row
Monterey, CA 93940
Phone: +1-40 86 48 48 00
Fax: +1-40 86 48 48 10
Endoscopy in Fish 59
3.0 Endoscopy in Fish
3.1 Introduction
There has been a veritable explosion in the popularity of the public a
quarium
throughout the world over the past decade. Coupled with the newer artificial
seawater and enhanced life support systems, newer aquaria are no longer
limited to marine coastal areas. This increased public interest in the aquatic
habitat and its inhabitants has been accompanied by an enhanced awareness
of the impact that man has upon the fresh and marine waters of the planet.
This change in attitude has carried into the captive management of the fish.
No longer is the treatment of choice for the fish merely replacement therapy.
Additionally, aquaculture has become increasingly important as a source for
food fish for human consumption.
These changes have placed an increased emphasis on the veterinarian‘s

ability to diagnose and subsequently treat diseases of the fish. At the same
time, the availability of high quality rigid endoscopic equipment has increased.
While rigid endoscopy has typically been applied to avian and equine s pecies
in the veterinary field, modifications of human-use equipment are easily
utilized in the piscine patient. These fine diameter, rigid endoscopes permit
the veterinarian visualization of a variety of coelomic structures with minimal
invasiveness. A sheath system may be added, allowing the collection of a
variety of targeted biopsy specimens for evaluation. Rigid endoscopy with
its inherent focal, directed illumination with magnification allows the clinician
the opportunity to directly visualize coelomic structures, as well as collect 1 Endoscopic examination of the spiney
dogfish (Squalus acanthias).
diagnostic samples for an etiopathogenic diagnosis, even in species often (Photo courtesy of Randy Wilder, Monterey
deemed problematic, such as fish. Bay Aquarium).
3.2 Anatomy
In no other vertebrate group is there as much variation in anatomy, as one
encounters in the fishes. While one may tend to create a „generic“ fish, such
as the trout, a fusiform teleost, dramatic diversity exists. External form varies
from the fusiform shape, to dorsoventrally or laterally compressed, and even
eel-like body configurations. In each, arrangement of the coelomic viscera
has been modified. It is, therefore, incumbent upon the clinician to be aware
of the anatomy of the fish in question. Application of even the minimally
invasive endoscopic procedures require this basis before use.
Despite this idiosyncrasy, piscine laparoscopy provides excellent visualization

of a variety of viscera. While in most cases, the liver will be the most readily
visualized organ, gonad, spleen, gastro-intestinal tract, peritoneal fat, and
unique organs such as the rectal gland of sharks and the spiral valve of elas-

mobranchs is often accessible. As the telescope is advanced cranially, the
pericardial space is visualized. In most species, the heart may be observed
to beat within this cavity. More dorsally located structures, such as the swim
bladder or kidneys require rotation of the fish to a more lateral or ventral
position for adequate examination.
Of particular note in the discussion of anatomy is the effect that increased

amounts of abdominal fat have upon thorough endoscopic examination. Fat
not only obscures normal anatomy, but also tends to foul the distal tip of the
telescope interfering with visual resolution. This increased fat is most likely
secondary to the relatively sedentary life style of many of the fish maintained
in public aquaria. Additional reduction in endoscopic working space is noted
in the gravid female fish. In these cases, exceptional care must be taken to
avoid damaging either the ovary or the ventrally displaced colon.
3.3 Indications
The use of endoscopy in fish is not a novel idea. While limited, there are some
reports of the use of the rigid endoscope as a diagnostic aid in p
iscine s pecies.
Most applications suggest the laparoscope for evaluation of reproductive
status in fish. In an early report, a single puncture technique using a 1.7 mm
rigid telescope with a 2.0 mm trocar sleeve is described. (Moccia, et al
1984) In this report, insufflation is accomplished through the injection port
associated with the trocar sleeve. Other researchers have described the use
of the genital pore as an access point, when the indication for laparoscopy
is the determination of reproductive status (Ortenburger, et al 1996). A
very limited description of the use of laparoscopy in the shark has also been
published (Stoskopf 1993).
In general, however, the indications for endoscopy in fishes mirror

those described for other species. Endoscopy may be employed for
sex identification in rnonomorphic or juvenile species; management of
reproduction; examination of coelomic viscera and collection of diagnostic
specimens; removal of foreign bodies; and performance of minimally invasive
surgical techniques. The endoscope may also be used to examine regions of
„external anatomy“ which cannot be accessed otherwise, such as the area
around the gills and oral cavity.
2 The coelomic cavity of the “typical fusiform teleost” fish (striped bass, Marone saxatilis)
leaves little working room for the endoscopist. The ovary is the paired, granular
structure, one of which is being reflected. Also visible is the pale yellow liver, silver swim
bladder, and the dark red spleen.
3.4 Anesthesia
Fish physiologists continue to argue whether or not fish perceive pain. All
agree that the fish is capable of sensing environmental cues, but it is not
clear whether noxious stimuli are recognized as such within the central
nervous system. That being said, however, veterinarians should ere on their
patients‘ behalf and administer appropriate forms of anesthesia to preclude
pain sensation, assuming there is such a thing in the fish. Regardless of
their ability to sense pain, fish will definitely respond, often violently, to the
minimally invasive techniques associated with laparoscopy. The force of the
struggling piscine patient is best not unleashed against the relatively delicate
nature of the rigid endoscope and associated equipment.
Tricaine methanesulfonate (MS-222) is the anesthetic of choice for

laparoscopy. This compound is a derivative of benzocaine, to which an
additional sulfonate radical has been added. This addition makes tricaine
more water soluble, but in solution is acidic. Advantages of this anesthetic
compound include its availability, relative inexpense, rapid onset and rapid
recovery. A further advantage is that tricaine is a compound that has been
approved for use in food fish. This is not only important in aquaculture, but also
in the public aquarium industry when the potential for release of anesthetized
fishes which may enter the human food market is to be considered. The
withdrawal time in the USA is 21 days. The primary d isadvantage of tricaine
is its inherent acidity in aqueous solution. Sea water tends to have adequate
buffering capacity to ameliorate the effects, however, fresh water anesthetic
baths must be buffered to preclude substantial irritant effects upon the gills.
Tricaine has also been noted to act as a hypoxic agent. This may occur
secondary to depression of the medullary respiratory center, bradycardia,
and changes in blood flow through the gill lamellae. There may be post
anesthetic changes in renal function, causing electrolyte loss, for up to 7
days after recovery.
Fish are anesthetized in a bath containing 75–100 ppm (mg/L) of tricaine

methanesulfonate into which an air stone is placed. Freshwater species are
immersed in a similar concentration to which sodium bicarbonate is added
to buffer the water to a pH of 7.0-8.0 (typically 1 part MS-222 : 2 parts
NaHCO3). As the fish enters a state of deep narcosis, it can be removed
from the induction bath. This stage of anesthesia is identified by a loss of
response to postural changes, a slightly decreased respiratory rate, loss of
equilibrium, decreased muscle tone, and a slight to moderate response to
painful stimuli.
The fish can then be placed in dorsal recumbency within a „water table“
and foam rack with padded, non-abrasive vertical sides. Anesthesia is
then maintained with a concentration of tricaine between 60–75 ppm
administered with a recirculating anesthetic machine (Lewbart 1995). This
device c onsists of two vessels of water, one with tricaine, one without. An
immersible pump is attached to a flexible tube placed in the fish‘s mouth
directing flow over the gills. A T-valve located at the outflow of the water table
permits the anesthetist to direct outflow water to either reservoir. The goal of
the a nesthetic is to maintain the patient within a light anesthetic plane, with
a total loss of muscle tone; slow, but regular respiratory rate; and response
only to deep pressure. As the fish enters too deep a plane of anesthetic; loss
of any reactivity, very slow or absent respiratory rate, the pump is shifted to
move non-anesthetic laden water over the gills. In this way, the appropriate
anesthetic level can be maintained. Following laparoscopy, the fish is moved
into a vessel of clean water with an elevated dissolved oxygen content.
Assisted swimming in order to continue the forward motion of the fish may
be utilized until the fish becomes ambulatory.
Other anesthetic protocols may have application for laparoscopy. Certain

species, such as the Scombridae, tunas and mackerel, may not adapt well to
the confinement associated with tricaine induction. Parenteral agents, such
as ketamine, may be indicated for anesthetic induction, followed by „inhalant“
agents as indicated. Tonic immobility, induced by hyperoxygenation and
postural changes is probably inadequate for the degree of stimulation
provided by an endoscopic examination.
3 The anesthetic water table in which anesthetic laden water is pumped from the reservoir
underneath to the gills of the fish. The red-handled valve can divert water back into the
reservoir, or to discharge. At that point, non-anesthetic laden water can be pumped over the
fish ‘s gills to lighten the anesthetic plane.
3.5 Endoscopic Technique

As with any other species, laparoscopy should be performed utilizing a septic
technique. With the fish in dorsal recumbency, insertion points may be
gently prepared utilizing a povidone-iodine solution. In scaled fish, individual
scales may be removed with forceps to facilitate entry. A sterile, clear drape
may be utilized to isolate the surgical field. As towel clamps are excessively
traumatic, the drape may be „adhered“ to the fish by pressing it into a thin
bead of gel placed around the incision. The barrier must be substantial
enough to keep water out of the incision, as the area should be periodically
moistened to keep the fish‘s skin from drying out.
Attempts to visualize viscera without distention of the body cavity may

be problematic. The tightly packed coelomic cavity leaves little room for
instrument manipulation without iatrogenic trauma. Attempts to distend the
coelom with saline infused through the injection port of the trocar sleeve may
increase the working space, however, visualization may be hampered as a
result of the suspension of fat droplets within the instilled saline.
Traditional insufflation with carbon dioxide gas is the preferred technique.

Carbon dioxide is relatively inert, non-combustible, and appears to be well
tolerated by the patient. In human and veterinary laparoscopy, carbon
dioxide is the insufflation gas of choice. In the piscine patient, as much CO2 as
possible should be removed from the coelom at the end of the laparoscopic
procedure. Residual gas appears to have no significant effect on the fish‘s
ability to maintain its position and posture within the water column. Fish with
or without swim bladders seem relatively unaffected post-operatively.
4 In scaled fish, individual scales should be plucked to facilitate entry of both the Veress
needle and the endoscopic equipment.
5 A properly placed Veress needle without

trauma to viscera, facilitating adequate
insufflation for endoscopic examination.
6 The Veress needle is ‘inserted just caudal to the pectoral girdle. A shallow angle of entry
decreases the chances of iatrogenic trauma to coelomic structures.
7 Inadvertent entrapment of coelomic fat

by the Veress needle. A shallower angle
of entry and a slower introduction of the
needle aid in prevention of this iatrogenic
problem.
8 After surgical preparation, barrier drape placement, the coelom is insufflated.

The hemostatic forceps have bluntly dissected through the body wall prior to
introduction of the endoscope.
It was found that use of a Veress needle provides the best insufflation. The
needle is inserted on the ventral midline just caudal to the pectoral girdle.
Following appropriate skin preparation, a 1mm stab incision is made just
through the skin with a #11 scalpel blade. The Veress needle is then gently
advanced at an angle just off parallel to the skin to enter the coelomic cavity.
This increased tunneling, contrary to the perpendicular approach employed
in mammalian laparoscopy, facilitates a more water tight seal after the
needle has been removed. Additionally, the body wall can not be elevated
in the mammalian fashion, therefore, a more shallow angle decreases the
chances of iatrogenic trauma.
Once the Veress needle is in place, CO2 insufflation can occur. In most cases,
a peak insufflation pressure of 10 mm Hg is adequate. In some species, such
as the bat ray, Myliobatis californica, pressures of 10 mm Hg may cause
prolapse through the rectum. Lower pressures combined with occlusion of
the excretory orifice provide adequate insufflation.
Once the coelomic cavity has been adequately distended, the telescope
may be inserted. The exact point of entry is determined by the nature of
the laparoscopic procedure. In most cases, the author has found the best
approach to be located on or just lateral to the ventral midline just cranial to
the vent or genital pore. In some species, such as many teleosts or potentially
gravid females, entry lateral to the midline is be advisable. This reduces the
potential for inadvertent perforation of the gastro-intestinal or reproductive
tracts.
9 The tip of the endoscope is introduced very slowly to permit re-inflation of the coelom
by the insufflator.
Once the entry site is prepared, a 1–2 mm stab incision is made through the
skin. A pair of fine mosquito forceps may then be used to bluntly dissect
between muscle fibers to enter the coelomic cavity. Entry into this space
is confirmed by the audible sound made by the escape of insufflation gas.
The forceps are then removed and the telescope inserted in their place. The
tip of the telescope should initially be placed just within the coelomic cavity.
This will allow maximal distention of the cavity, as some of the gas tends
to escape during entry. Once the telescope is in place the remainder of the
laparoscopic examination may proceed as in any other species, including
the collection of diagnostic specimens utilizing the sheath system and its
integral instrument channel. After completion of the laparoscopic procedure,
as much CO2 gas as possible should be milked out of the body cavity. The
skin defect may then be closed with a monofilament, polyglactin suture ma-
terial. The Veress needle defect tends to be self-sealing, but may be sutured
if indicated.
To facilitate visualization, the patient may be rotated into lateral or even

ventrolateral recumbency. In certain species, the swim bladder occupies
a relatively large proportion of the coelomic cavity. In these cases, the
swim bladder may be partially deflated utilizing the Teflon guarded needle
associated with the sheath system. These fish tend to return to a normal
position within the water column within a very short period.
10 W hile unique, the fish ‘s coelomic cavity will permit the entire range of endoscopic
procedures routinely utilized in birds and reptiles. Note the padding underneath the fish.
Notches have been cut out to accommodate the dorsal fins of this leopard shark
(Triakis semifasciata).
3.6 Samples of Endoscopic Features of Fish
ttachment of the gill filament (primary lamellae) to the gill arch

11 A 12 Parasitic copepod, Naobranchia occidentalis, attached to the
of the gopher rockfish (Sebastes carnatus). The white colored distal aspect of the gill filament of the same gopher rockfish
gill raker is located on the cranial aspect of the gill arch; the presented in figure 12. Parasites such as this commonly cause
lamellae on the caudal edge. significant gill pathology, such as the shortening and blunting noted
here.
13 Heavy infestation with the monogenic trematode, Nitzschia second view of the previous case. Note the blunted
14 A
quadritestes, in the white sturgeon, Acipenser transmontanus. appearance of the gill filament and the development of
While the flukes seen here are quite obvious protruding from the pigmentary changes secondary to the chronic irritation
operculum, they may be cryptically concealed in the depths of caused by the parasites.
the gill chamber, in which endoscopy is a valuable diagnostic aid.
iew of the gill rakers from the oral cavity of the wolf-eel
15 V 16 The caudal aspect of the oral cavity of the wolf-eel has this
(Anarrhichthys ocellatus). These structures serve to preclude protrusion upon which the translucent pharyngeal teeth are
the entry of food material into the gas exchange area of the gills. located. They tend to aid in holding prey items in the appropriate
Their shape is often used as a taxonomic aid and may suggest the orientation for swallowing.
dietary habits of the fish, in this case hard shelled invertebrates
and fishes. The roseate shaped opening of the esophagus is also
visible.
17 In the wolf-eel there is a dramatic demarcation between the 18 A view of the distended coelomic cavity of the copper rockfish
relatively aglandular esophagus and the glandular stomach. (Sebastes caurinus) in dorsal recumbency. The liver is the
The openings of the gastric glands can be visualized as the miliary yellowish structure in the background. The off-white colored fat
white foci within the stomach lumen depicted here. is another predominant feature with a small portion of the spleen
visible as the deep red colored organ within the fatty tissue.
nother view of the coelom of the same copper rockfish.

19 A he liver of this gopher rockfish (S. carnatus) contains multiple
20 T
In addition to the liver and fat, the yellow-orange testes is parasitic cysts. The exact etiopathogenesis of this type of gross
also noted in the foreground. change is difficult to determine without biopsy.
21 As the telescope is advanced cranially, the heart can be 22 Gopher rockfish (S. carnatus) in lateral recumbency. The ventral
visualized within the pericardial space. Looking into this region, body wall is identified by the presence of the metallic tip of the
one can easily identify the heart’s ventricle with the apex Veress needle. The reflective, silver swim bladder is somewhat over
directed upwards (the fish is in dorsal recumbency). distended, as this fish was captured in deeper waters. The ovary is
partially exposed within the fat adjacent to the ventral body wall.
23 Parasitic changes are visible as irregular white plagues on the 24 A portion of the liver is observed overlying the ventral aspect of
ventral aspect of the liver in this Pacific mackerel (Scomber the swim bladder of the Pacific mackerel. The dark pigmented
japonicus). The heart is visible within the pericardial space, and regions in the sub-peritoneal area are caused by accumulations of
the distal aspect of the stomach is the red-pink structure in the melano-macrophages.
foreground. Several of the pyloric cecae are identified just under
the hepatic lesions.
25 Pyloric cecae in the Pacific mackerel (S. japonicus). Similar 26 The pale liver of the bat ray (Myliobatis californica) overlying the
structures are found in the region of the pylorus of salmonids, stomach. Accumulations of large amounts of fat within the liver
such as trout and salmon. of fish, particularly elasmobranchs, is common, as it is used as an
energy depot. The increased vascular pattern on the surface of the
organ is commonly observed, and appears to be within normal limits.
27 The caudal margin of the liver is easily elevated and quite post liver biopsy photograph in the gopher rockfish
28 A
accessible for biopsy. Again, the degree of hepatic lipidosis (S. carnatus). The degree of hemorrhage associated with
is not unusual in this species, the leopard shark, Triakis liver biopsy is typically quite limited.
semifasciata.
29 Subserosal nematode parasitism in the Pacific mackerel he large red spleen of the leopard shark (Triakis semifasciata)
30 T
(S. japonicus). Nematodes are commonly found in this group is easily identified just ventral to the stomach. This organ has
of fish, the Scombridae. both hematopoetic and Iymphomyeloid tissue.
31 T he kidney, located retroperitoneally may be difficult to identify ilated intestinal loops in the wolf-eel (Anarrhichthys ocellatus).
32 D
and access in many fish. With the fish rotated into ventro-Iateral In this case, the distension was iatrogenically induced by
recumbency, viscera may be moved away from the dorsal body wall, insufflation of the stomach for endoscopic examination.
thereby exposing the kidney. In certain individuals, partial deflation
of the swim bladder is also helpful. This photo was taken in the
gopher rockfish (S. carnatus).
33 The ventral mesentery of the gopher rockfish (S. carnatus)

contains minimal vasculature and multiple fat bodies. The ovary
is the yellowish structure with overlying vessels.
The colon is seen as a white, tubular structure associated with
the mesentery.
aired, yellow-orange testes in the leopard shark

34 P 35 With the testicle reflected slightly laterally, its arborizing vascular
(T. semifasciata). The testes are found on the ventral supply is easily visualized. A cestode is also observable within
floor of the coelom just undemeath the gastro-intestinal tract; the coelomic cavity.
here seen as the off-white organs with the vascular supply.
The liver is barely visible in the background (cranially).
he testicles of the gopher rockfish (S. carnatus) are seen here

36 T
closely associated with the intestine.
Looking cranially, one can also identify the liver.
aturing ova within the ovary of the king salmon

37 M 38 While not quite so obvious, one can distinguish the ovary of
(Onchorhynchus tshawytscha) are readily identified. this gopher rockfish (S. carnatus) by its somewhat granular
The medial aspect of the ribs can also be visualized appearance.
in this photograph.
39 The dorsal and ventral suspensory ligaments of the ovary are
easily distinguished. The shape of the ovary becomes more
tapered at it nears the genital pore. In this case, the fish is in
ventral recumbency, with the more vascular suspensory ligament
extending dorsally.
3.7 Literature
1. T
aylor M: Diagnostic application of a new endoscopic system for
birds. Proc Eur Conf Avian Med Surg, 1993; 127-131.
2. M
occia RD, Wilkie EJ, Munkittrick KR, Thompson WD:
The use of fine needle fibre endoscopy in fish for in vivo examination of
visceral organs, with special reference to ovarian evaluation.
Aquaculture 1984; 40: 255-259.
3. O
rtenburger Al, Jansen ME, Whyte SK: Nonsurgical
videolaparoscopy for determination of reproductive status of the
Arctic charr.
Can Vet J 1996; 37: 96-100.
4. S
toskopf MK: Surgery. In: Stoskopf MK (ed).
Fish Medicine. Philadelphia, PA: WB Saunders Co, 1993: 91-97.
5. Brown LA: Anesthesia and restraint. In: Stoskopf MK (ed).
Fish Medicine. Philadelphia, PA: WB Saunders Co, 1993: 79-90.
6. Lewbart GA, Stone EA, Love NE: Pneumocystectomy in a Midas
cichlid. JAVMA 1995; 207(3): 319-321.
7. L acy A, Blanch S, Visa J: Alternative gases in laparoscopic
surgery. In: Rosenthal RJ, Friedman RL, Phillips EH (eds):
The pathophysiology of pneumoperitoneum.
New York: Springer-Verlag, 1998: 7-17.
8. H
ulka JF, Reich H: Textbook of laparoscopy (2nd ed). Philadelphia,
PA: WB Saunders Co, 1985: 85-102.
Acknowledgements
The author would like to thank Hans J. Lunemann, KARL STORZ Endoscopy,
Tuttlingen, Germany for his generous technical and equipment support;
Dr. Christopher Chamness, Karl Storz Veterinary Endoscopy, America
for his support and advice; Dr. Michael Taylor, Ontario Veterinary College for
his endophotography; and the dedicated husbandry staff at the Monterey
Bay Aquarium for their professionalism and efforts in maintaining such
incredible creatures for this project.
Recommended Endoscopes and Instruments

Video Documentation Systems and Accessories
for Endoscopy in Birds, Reptiles, Amphibians and Fish
Extracts from the following catalog:

VETERINARY ENDOSCOPY
– SMALL ANIMALS –
including section:
TELEPRESENCE – IMAGING SYSTEMS

Accessories for Illumination, Documentation and Data Storage
HOPKINS® Telescope
Standard Telescope, diameter 4 mm, length 18 cm
Recommended for universal use
64230 BWA HOPKINS® Wide Angle Forward-Oblique Telescope 30°,

enlarged view, diameter 4 mm, length 18 cm, autoclavable,
fiber optic light transmission incorporated,
color code: red
Trocar
for use with HOPKINS® Telescope 64029 BA and Sheath 64018 US
62117 GK Trocar, size 3.9 mm, color code: red,

including:
Conical obturator
Trocar canula with outer thread,
length 5 cm, with LUER-Lock
connector for insufflation
Silicon valve
Slender HOPKINS® Telescopes, 2.7 mm

Short version: length 11 cm – for examination only
Long version: length 18 cm – for single puncture examination and diagnostic biopsy sampling
67208 BA HOPKINS® Forward-Oblique Telescope 30°,

diameter 2.7 mm, length 11 cm, autoclavable,
color code: red
64029 BA HOPKINS® Forward-Oblique T elescope 30°,

enlarged view, diameter2.7 mm, length 18 cm, autoclavable,
color code: red
Operating Sheath 67065 CV see page 79
It is recommended to check the suitability of the product for the intended procedure prior to use.
Examination and Protection Sheath

for use with long version slender HOPKINS® Telescope 64029 BA
64018 US Protection and Examination Sheath,

diameter 3.5 mm, working length 17 cm
Trocar, size 3.5 mm

for use with HOPKINS® Telescopes 67208 BA and 64029 BA
62114 GK Trocar, size 3.5 mm

including:
Trocar with pyramidal tip,
Trocar cannula with outer thread,
length 5 cm, with Luer-lock connector
for insufflation
Silicone leaflet valve
Operating Sheath, 14.5 Fr.

for use with HOPKINS® Telescope 64029 BA
67065 CV Operating Sheath, 14.5 Fr., with built-in

instrument channel 5 Fr. and obturator 67065 CB,
for use with 5 Fr. instruments
The versatility of this sheath system is enhanced by an
assortment of hand instruments that allow the clinician
to p
erform many procedures. Each is a tool that e xtends
our ability to complete a task in the s afest, most efficient
manner.
67161 Z Biopsy Forceps, flexible, oval,
double-action jaws, 5 Fr.
This is the most versatile biopsy forceps. It can be
employed in most tissues and collects a deeper,
longitudinal sample compared to the round cup.
Also useful for sampling exudate and debris.
67161 T Grasping Forceps, flexible,
double-action jaws, oval, 5 Fr.
This is the standard forceps and has large s errations.
Particularly useful for grasping medium to large objects
and removing exudate or debris.
Slender HOPKINS® Telescope and Operating Sheath

Diameter 1.9 mm, length 10 cm
64301 BA HOPKINS® Forward-Oblique Telescope 30°,

diameter 1.9 mm, length 10 cm, autoclavable,
color code: red
61029 D Examination Sheath, 9 Fr., with obturator

61029 DO and instrument channel 3 Fr.,
color code: red
Operating Telescope, 9.5 Fr.

for use with instruments up to 3 Fr.
67030 BA Operating Telescope with Forward-Oblique

Telescope 30º, 9.5 Fr., a utoclavable,
fiber o
ptic light transmission incorporated,
instrument c hannel 3 Fr. and 2 LUER-Lock cones,
color code: red
61071 TJ Grasping Forceps, for removing foreign bodies,

double-action jaws, flexible, 3 Fr., length 28 cm
61071 ZJ Biopsy Forceps, double-action jaws, flexible, 3 Fr.,

length 28 cm
61770 AA Ball Electrode, 3 Fr., length 53 cm

Additional Instruments
for use with Examination Sheath, 14.5 Fr.
62501 EK Scissors, semi-rigid, single action jaws,

4 Fr., length 34 cm
The scissors are an essential part of the
operating system. Air sac, peritoneal and
pleural membranes can be easily incised.
67023 VK Stone Basket, flexible, 5 Fr., length 60 cm

including:
3-ring Handle
Wire Basket
Coil
Some smooth or rounded objects can only be grasped by
the use of a retrieval basket such as this.
67772 A Needle Electrode, 5 Fr.

The needle can be energized using a high frequency
generator for incision and coagulation of structures.
67161 M Messurement instrument, flexible, diameter 5 Fr.,

length 40 cm, scale in mm
67071 X Injection/Aspiration Needle System, 5 Fr.,

with outer tube, length 31 cm
The needle can be used for fluid sampling, injection, or incision of air sacs.
67159 L High Frequency Snare, 5 Fr.

This instrument can be used for retrieval of foreign
bodies, or castration in birds and reptiles when
connected to a high frequency generator.
For Double Puncture Technique:
69133 Biopsy Forceps, with 3 mm oval cupped jaws,

sheath diameter 1.5 mm, working length 14 cm

69117 Z Biopsy Forceps, round cupped jaws,

diameter 1.7 mm, working length 15 cm
This forceps is the same as the oval but has a round,
shallow cup suited for collecting smaller samples.
CO2 ENDO-ARTHROFLATOR -VET TM
Recommended SystemConfiguration
Special Features:
## One unit with laparoscopy mode and ## Visual and acoustic alarm signals in the event
arthroscopy mode of patient overpressure
## High operating safety ## Fully automatic, electronically controlled gas
## Easy to use refill (e.g. in case of gas loss when changing
instruments)
## Continuously adjustable insufflation pressure
62 4325 01 CO2 ENDO-ARTHROFLATOR™-VET

including:
CO2 ENDO-ARTHROFLATOR™-VET,
power supply 100 – 240 VAC, 50/60 Hz
Mains Cord
Mains Cord, US-version
Silicone Tubing Set, sterilizable
Universal Wrench
mtp* C O2/N2O Gas Filter, sterile,
for single use, package of 10
62 4325 20
Specifications:
Operating Mode - ARTHRO mode Parameter Display - Insufflation Pressure
- LAPARO mode - Intraabdominal Press. (mmHg):
Gas Flow - 0-20 l/min 0-100 (13.3kPa)
- 0-20 l/min - Gas Flow (l/min): 0-20
- Gas Consumption (l): 0-999
Pressure - 50-100 mmHg (6650 Pa-13332 Pa)
- 0-15 mmHg (1999 Pa) Power Supply 100-240 VAC, 50/60 Hz
Gas CO2 Dimensions, w x h x d 305 x 112 x 234 mm
Measuring/Control electronic Weight 5.5 kg
System Certified to IEC 601-1, CE
Optional Accessories:
20 4000 21 High Pressure Tube CO2, American connection/German connection, length 55 cm
20 4000 27 Same, length 102 cm
20 4000 22 High Pressure Tube CO2, A
merican connection/Pin-Index Connection, length 55 cm
20 4002 22 High Pressure Tube CO2, A
merican connection/ISO connection, length 102 cm
26 4000 90 CO2 Bottle, empty, with German connection
26 4000 92 Same, filled, with German connection
26 4000 91 CO2 Bottle, empty, with Pin-Index connection
26 4000 93 Same, filled, with Pin-Index connection
20 4004 21 Low Pressure Tube, for the central CO2 gas supply, length 150 cm
mtp* Tubing Set with CO2/N2O Gas Filter, for single use, sterile, package of 10
*
Fiber Optic Light Cables

for Cold Light Fountains
69495 NL Fiber Optic Light Cable,

with straight connector, diameter 3.5 mm,
length 180 cm
69495 NA Same, diameter 3.5 mm, length 230 cm
69495 NB Same, diameter 4.8 mm, length 180 cm
Cold Light Fountain VETERINARY

with built-in insufflation pump
69 1110 01 Cold Light Fountain VETERINARY,

with integrated insufflation pump,
power supply: 230 VAC, 50/60 Hz
including:
Mains Cord
103 Spare Lamp, 150 watt, 15 volt
Video Documentation
Cold Light Fountain XENON NOVA® 175
691315 01 Cold Light Fountain XENON NOVA® 175

lamp type: 175 W XENON lamp,
power supply: 100 – 125/220 – 240 VAC,
50/60 Hz
including:
Cold Light Fountain XENON NOVA® 175
Mains Cord
Spare Lamp, 175 watt, 15 volt
Veterinary Video Camera III

Single-Chip Video Camera – Color Systems PAL, NTSC
69 2360 01 Veterinary Video Camera III,

color system PAL, single-chip technology,
power supply 100 – 240 VAC, 50/60 Hz,
with C-mount lens 20 2000 43, f = 38 mm,
set, ready for use
69 2361 01 Same, color system NTSC
Please note:
The complete camera head can be disinfected by
soaking in a suitable solution or sterilized in gas.
The use of a sterile cover is recommended.
Accessories
for KARL STORZ Camera Systems – Color Systems PAL, NTSC
69275 N Color Monitor 17", LCD,

NeovoX-17P, desktop version,
color systems PAL/NTSC,
max. resolution 1280 x 1024,
screen diagonal 17", 1x S-Video in,
1x DVI-D, VGA input,
power supply 100 – 240 V
69275 N
TELE PACK VET X LED

The Complete Mobile Endoscopic Video and Documentation System
RP100S1 TELE PACK VET X LED, endoscopic video unit for use with all KARL STORZ
TELECAM one-chip camera heads, veterinary video camera heads and
video endoscopes, with integrated insufflation pump, incl. LED light source
similar to Xenon technology, with integrated digital Image Processing Module,
15" LCD TFT monitor with LED backlight, USB/SD memory module,
color systems PAL/NTSC, power supply 100 - 240 VAC, 50/60 H,
including:
KARL STORZ USB Flash Drive, 8 GB
Mains Cord
Mains Cord, US plug
Case
RP100S2 TELECAM one-chip camera heads, veterinary video camera heads and
video endoscopes, with integrated insufflation pump, incl. LED light source
similar to Xenon technology, with integrated digital Image Processing Module,
15" LCD TFT monitor with LED backlight, USB/SD memory module,
color systems PAL/NTSC, power supply 100 - 240 VAC, 50/60 Hz
including:
KARL STORZ USB Flash Drive, 8 GB
Mains Cord
Mains Cord, US plug
Optional Accessories
20 0141 30 One-Pedal Footswitch, two stage
20 0143 30 Two-Pedal Footswitch, one stage
495 KS Adaptor, for standard KARL STORZ fiber optic light cable (not 495 NCS)
20 0402 40DE Keyboard, with German character set
20 0402 40ES Keyboard, with Spanish character set
20 0402 40FR Keyboard, with French character set
20 0402 40IT Keyboard, with Italian character set
20 0402 40PT Keyboard, with Portuguese character set
20 0402 40RU Keyboard, with Russian character set
20 0402 40US Keyboard, with US-English character set
Notes:
with the compliments of
KARL STORZ — ENDOSKOPE

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Endoscopy in Birds,

Reptiles, Amphibians and Fish

Important notes: Endoscopy in Birds, Reptiles, Amphibians and Fish

Recommended Endoscopes and Instruments

1.0 Endoscopy in Birds

2﻿ Primary entry site for avian coeleoscopy.

Follow-up examination to check on lesion resolution (Second look).

1.5 Endoscopic Technique

High quality still photographs may only be obtained by the use of a

Uses of Endovideo Documentation

1.5.3 Non Invasive Endoscopy in Birds

1.5.3.3 Esophagus and Ingluvies

6﻿ Oropharynx and esophageal folds.

1.5.3.4 Proventriculus, Ventriculus

I recommend a midline ingluviotomy to enter the thoracic esophagus using

1.6.1 Major Air Sacs and Coelom

9﻿ Caudal thoracic air sac.

10﻿ C ranial thoracic air sac.

13﻿ Granulomatous airsacculitis.  hronic air sac granuloma.

16﻿ Normal lung.

22﻿ Amyloidosis of the liver. 23﻿ Bile duct carcinoma.

24﻿ Biopsy of the liver. 25﻿ Chlamydiosis.

1.6.4 Heart and Pericardial Sac

26﻿ Pericardial effusion.

27﻿ Normal heart.

31﻿ Splenic enlargement.

1.6.6 Gastrointestinal Tract

 ormal intestinal loops.

 ormal mature ovary.

42﻿ Normal mature testicle. 43﻿ Normal mature testicles.

48﻿ Normal mature ovaries. 47﻿ M

49﻿ Normal ureter. 50﻿ Ureteral dilation.

51﻿ Normal ureter entering the urodeum.

1.6.10 Adrenal Glands

52﻿ Adrenal Gland. 53﻿ Adrenal congestion.

54﻿ Adrenal gland.

1.7 Non Invasive Endoscopy in Birds

1.7.1 Oral Cavity

55﻿ Normal oropharynx.

56﻿ Chronic hypovitaminosis A. 57﻿ Palatine abcess. 58﻿ Glottal papillomatosis.

61﻿ Oropharynx and esophageal folds. 

2. Jones DM et al: Sex determination of monomorphic birds by

3. Kollias GV: Liver biopsy techniques in avian clinical practice.

4. Lumeij TJ: Endoscopy. In A Contribution to Clinical Investigative

5. McDonald SE: Surgical sexing of birds by laparoscopy.

6. Satterfield W: (1981). Early diagnosis of avian tuberculosis by

7. Taylor M: Diagnostic application of a new endoscopic system for

8. Taylor M: Endoscopic examination and biopsy techniques.

Endoscopy in Reptiles and Amphibians

Endoscopy is of great value in reptile medicine because many of the

Endoscopic examination of the pleur-operitoneal cavity (coelioscopy) in

Non invasive endoscopic examination in reptiles has rarely been published.

Amphibians display a pleuroperitoneal cavity as undivided as most of the

The methods for endoscopic examination of reptiles and amphibians have

 Sex identification of monomorphic reptiles

Anesthesia regime for endoscopic examination in lizards,

 Presurgical heating of the animals to 25 – 35°C (ectothermes)

2.5 Endoscopic Techniques

2.5.1 Endoscopic Examination of the

4﻿ Endoscopic examination in lizards.

2 Primary entry site for avian coeleoscopy.

6 Oropharynx and esophageal folds.

9 Caudal thoracic air sac.

10 C ranial thoracic air sac.

13 Granulomatous airsacculitis. hronic air sac granuloma.

16 Normal lung.

22 Amyloidosis of the liver. 23 Bile duct carcinoma.

24 Biopsy of the liver. 25 Chlamydiosis.

26 Pericardial effusion.

27 Normal heart.

31 Splenic enlargement.

ormal intestinal loops.

ormal mature ovary.

42 Normal mature testicle. 43 Normal mature testicles.

48 Normal mature ovaries. 47 M

49 Normal ureter. 50 Ureteral dilation.

51 Normal ureter entering the urodeum.

52 Adrenal Gland. 53 Adrenal congestion.

54 Adrenal gland.

55 Normal oropharynx.

56 Chronic hypovitaminosis A. 57 Palatine abcess. 58 Glottal papillomatosis.

61 Oropharynx and esophageal folds.

Sex identification of monomorphic reptiles

Presurgical heating of the animals to 25 – 35°C (ectothermes)

2.5.1 Endoscopic Examination of the

4 Endoscopic examination in lizards.

6 Endoscopic examination in the field.

9 Infestation with Filaria spp.

10 Ascites. 11 Pleuroperitoneal cavity, cranial aspect.

12 Pericardium and heart. 13 Pericardium and ventral fixation.

16 Insufflated unicameral lung of a

eflated multicameral lung of a turtle.

19 I nfestation with pentastomes.

18 Perforation of the lung.

20 A bscesses in the lung.

21 Fatty degeneration.

24 Liver Abscesses. 25 Amoebiasis.

26 Liver cysts. 27 Liver carcinoma.

29 Visceral Gout.

31 Stomach. 32 Small and large intestines.

33 Obstipation (Ileus). 34 P

idney, colour variations.

46 Kidney, sexual segment.

48 Tumor (adenoma).

51 Bladder, filled.

50 Bladder, empty.

53 Bladder, ruptured.

55 Fat body, enlargening.

56 F at body, in resorption.

57 Tracheal mycobacteriosis.

58 Oesophagoscopy. 59 G

60 Oviduct with larvae. 62 Liver, Mycobacteriosis.

Despite this idiosyncrasy, piscine laparoscopy provides excellent visualization

5 A properly placed Veress needle without

7 Inadvertent entrapment of coelomic fat

8 After surgical preparation, barrier drape placement, the coelom is insufflated.

ttachment of the gill filament (primary lamellae) to the gill arch

nother view of the coelom of the same copper rockfish.