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Definition
Nutritional Secondary Hyperparathyroidism (NSHP), is the most common disease in captive reptiles
Etiology
Calcium (Ca) deficiency results from inadequate dietary Ca, a low Ca:P ratio in the diet, and/or lack of vitamin D. Many reptiles and amphibians seem to be more dependent on ultraviolet light (UVB, 290–300 nm) to synthesize vitamin D3 or cholecalciferol than on dietary vitamin D.
Clinical presentation
Common clinical signs include weakness, musculoskeletal deformities, anorexia, poor growth or weight loss.
A host of additional signs can be seen in lizard and chelonians:
Lizards
Lizards
Piable jaw bones
Swollen leg, swollen jaw
Leg fractures
Deviated spine or scoliosis
Turtles and tortoises
Turtles and tortoises
Soft or misshapen shell that may appear too small for the body
Uneven scute growth
Overgrown and beak and nails
Diagnosis
Clinical signs, combined with detailed dietary history, often will suggest a diagnosis. Radiographs are useful to assess fractures and overall bone radiopacity. Blood calcium and phosphorus levels can also prove helpful.
Treatment
Provide support for the presenting patient with supplemental heat and fluid therapy as needed.
Continue chronic treatment over weeks to months to correct deficiencies of calcium and/or vitamin D3.
Correct specific husbandry issues related to NSHP such as diet (calcium and phosphorus intake) and exposure to ultraviolet lighting.
Prognosis
Prognosis is dependent on severity of clinical signs; lizards and crocodilians respond better than chelonians. Early diagnosis and aggressive veterinary treatment is essential; chronic NSHP has a poorer prognosis.
Prevention
Ca is deficient in many vegetables, most fruits, and almost all insects, as well as organ and muscle meats. All whole vertebrates are excellent sources of Ca (because of their bone). Good nutrition with adequate Ca supplementation and UV light is critical.
References:
Divers S. and Stahl S. (2019) Mader's Reptile and Amphibian Medicine and Surgery. 3rd ed. Elsevier, St. Louis, USA.
Doneley, B.; Monks, D.; Johnson, R. and Carmel, B. (2018) Reptile Medicine and Surgery in Clinical Practice. Wiley Blackwell. Oxford, UK.
URL: http://www.reptilesmagazine.com/Metabolic-Bone-Disease-In-Reptiles/
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