Intravenous ketamine-medetomidine anesthesia in combination with intrathecal lidocaine for prefemoral coeliotomy in red-eared sliders (Trachemys scripta elegans): A case series study

Background: Coeliotomy in chelonian species is performed to gain access to the abdominal cavity and requires general anesthesia. In reptile medicine, alfaxalone and propofol are often preferred, although the usage of these drugs is limited by cost and/or vascular access. Furthermore, according to a recent study, propofol produces significant oxidative stress in red-eared sliders (Trachemys scripta elegans), and in such cases, a ketamine and medetomidine combination may provide a better choice. Case description: Three owned red-eared sliders were separately presented with a history of recent lethargy, inappetence, dyspnea, and restlessness. Findings/treatment and outcome: In these three cases of chronic dystocia, a ketamine and medetomidine combination was used to achieve anesthesia induction for surgical treatment. Additionally, intrathecal administration of lidocaine was performed to achieve a potential analgesic effect in deeper intracoelomic reproductive organs. Preoperative changes in blood parameters were observed in one animal, suggesting abnormal kidney function. The same animal showed signs of resedation postoperatively, prolonged recovery, and had a fatal outcome 48 h after the surgery with signs of kidney damage in histopathological evaluation. In the recovery period, none of the surviving animals (n=2) showed neurological or respiratory complications that could be associated with subcarapacial sinus anesthesia administration or intrathecal local anesthesia. Conclusion: According to our observations, intrathecal lidocaine administration provided sufficient analgesia during prefemoral coeliotomy and reproductive organ manipulation. These modes of anesthesia in chelonians require further investigation.