Advances in Reptile Clinical Therapeutics

The standard of today's reptile practice calls on clinicians to use an ever-increasing array of diagnostic tools to gather information and obtain a definitive diagnosis. Few, if any, pathognomonic signs exist for reptile diseases, and for most clinical syndromes there is a lack of information regarding pathophysiology for one to define standard therapeutic protocols based solely on clinical signs without objective diagnostic information. For example, in the relatively distant past, clinicians treating reptile patients would routinely administer parenteral calcium to green iguanas (Iguana iguana) with the primary presenting clinical sign of muscle tremors. Today, veterinarians who treat reptiles recognize that the risk of soft tissue mineralization and permanent damage to arteries, renal tubules, and other tissues usually outweighs the potential short-term benefit of calcium therapy. Before calcium therapy is initiated, it is best to know the patient's ionized calcium concentration to reduce the risk of potential adverse therapeutic side effects. A problem-oriented diagnostic approach directed toward minimizing risk and maximizing therapeutic benefit is now the standard of reptile practice.