Diagnosis and Treatment of an Oronasocutaneous Fistula in a Sulcata Tortoise (Centrochelys sulcata)

A 10-year-old female sulcata tortoise (Centrochelys sulcata) was presented for evaluation of a non- healing wound on her left rostrum. Physical examination revealed a 5x5 mm defect dorsolateral to the left nares with compacted plant material inside. Intraoral examination revealed a 3x3 mm keratin defect at the level of the premaxilla with visible compacted plant material. A computed tomographic study was performed and revealed an oronasocutaenous fistula with compression nasomaxillary fractures and left- sided rhinitis and food impaction. PCR from a nasal flush sample for intranuclear coccidia was negative. The patient underwent general anesthesia for fistula repair. A rhinotomy and a rhinoscopy were performed to aid in the understanding of the extent of the fistula and treatment. The foreign plant material was removed and cleaned. The fistula was covered over the intraoral keratin defect and along the maxillary tomium with a dental bis-acryl composite resin and the cutaneous defect covered with a wound dressing patch. Postoperative plan included a course of tulathromycin for broad-spectrum antimicrobial coverage, in addition to meloxicam and tramadol for multimodal analgesia, which was initiated via esophagostomy tube. Subsequent rechecks were conducted at 3 and 7 weeks, and 7, 8, and 19 months postoperatively, with recheck CT scans performed at the 8-month and 19-month for healing monitoring. At the 19-month recheck the rostral cutaneous lesion was completely healed, there was no keratin defect along the oral rhinothecal ridge. Recheck CT demonstrated ongoing bone healing. This case documents the diagnosis and successful treatment of an oronasocutaneous fistula in a chelonian.