Lizard Endoscopic Techniques With
Particular Reference to the Green Iguana
(Iguana iguana)
StephenJ. Divers, BSc (Hons), BVetMed, CertZooMed, CBiol MIBiol,
MRCVS, RCVS Certificate in Zoological Medicine
Endoscopy has proven to be a most useful diagnostic
tool in veterinary medicine. In the field of zoological
medicine, the application of diagnostic endoscopy has
shown great promise in a variety of species, but has
probably been most exploited by avian veterinarians. To
date, endoscopy in reptiles has not enjoyed widespread
acceptance, although there are numerous reports to
indicate its use since the 1960s. The aim of this article is
to introduce the clinician to lizard, and more specifically,
iguana endoscopy, using new developments in equip-
ment. Preferred instrumentation, patient preparation,
and endoscopic techniques, including tissue biopsy, will
be described.
Copyright 9 1999 by IN. B. Saunders Company.
Key words: Endoscopy, coelioscopy, renal biopsy, iguana,
lizard, reptile.
lthough still in its infancy, reptile endoscopy
A has proven itself to be a most useful and
versatile diagnostic tool. 1-3T h e majority of previ-
ous papers describe the use of the endoscope to
examine, or retrieve foreign objects from, the
gastrointestinal tract. 4-7 T h e r e are some descrip-
tions of laparoscopy and bronchoscopy and more
general descriptions of practical reptile endos-
copy, particularly in Chelonia. 3,7a9 The use of
endoscopy for sex determination and for inter-
nal examination of the urogenital system has also
been documented. 13,14
With the exception of urogenital assessment,
there seems to be a relative dearth of informa-
tion, specifically with regard to lizards, which is
unfortunate given their popularity as pets and
frequent presentation to the veterinarian. The
green iguana ( I g u a n a iguana) has been the most
From The Exotic Animal Centre, Essex, UK.
Address reprint requests to Stephen J. Divers, BSc (Hons),
BVetMed, CertZooMed, CBiolMIBiol, MRCE$, RCVS Certificatein
Zoological Medicine, The Exotic Animal Centre, 12 Eitzilian Ave,
Harold Wood, Romford, Essex RM3 0QS, UK.
Copy~Jght9 1999 by W..B. Saunders Company.
1055-937X/99/O803-OOO6~glO.00/0
122 Seminars in Avian and Exotic Pet Medicine, Vol 8, No 3 (July), 1999: pp 122-129
popular for many years, but with increasing
interest in b e a r d e d dragons (Pogona vitticeps),
water dragons (Physigrtathus cocincinus), p l u m e d
basilisks (Basiliscus plumifrons), and various other
species, the n e e d for improved, versatile diagnos-
tic techniques cannot be ignored.
Preferred Equipment
The great benefit of endoscopy over explor-
atory coeliotomy for the examination of internal
structures is its minimal invasiveness. The ability
to use endoscopy effectively relies on good tech-
nique and an ability to differentiate between
normal and abnormal structures, both of which
are heavily d e p e n d e n t on the optical quality of
the endoscope. A thorough knowledge of sau-
rian anatomy is an obvious prerequisite.
T h e r e is a variety o f e q u i p m e n t currently
available, and the following c o m m e n t a r y is cer-
tainly not a review, but merely the author's
personal experiences and preferences.
Flexible Endoseopes
The majority of our pet lizards weigh less than
3 kg, and therefore, the use of long flexible
endoscopes is seldom required. T h e r e may be
times, particularly when dealing with the larger
iguanas and monitors, in which small flexible or
semirigid scopes may be useful for negotiating
the pylorus and examining the small intestine, or
surpassing the tracheal bifurcation to investigate
lower respiratory tract disease. The main disad-
vantage of flexible, fiber-optic endoscopes is that
the image quality is much p o o r e r c o m p a r e d with
rigid scopes of a similar diameter. 2 A 55-cm or
100-cm, 2.5-mm flexible broncho-fibrescope with
1.2-mm instrument channel (60003 VB, 60292
VC; Storz UK, Slough, England) is only pre-
ferred when flexibility is essential and a rigid
scope cannot be used.
 Lizard Endoscopic Techniques 123

Rigid Endoscopes is used, it must be connected to the endoscope

via a flexible, fiber-optic cable. The light inten-
The small body size of most pet lizard species,
sity is, however, reduced as the cable length is
coupled with their large pleuroperitoneal cavity,
increased. Having had to e n d u r e the fatigue
makes them excellent candidates for rigid endos-
associated with operating the endoscope using
copy. In many situations, a rigid endoscope can
the eyepiece, the author can testify to the greater
be used to examine the u p p e r respiratory and
comfort and ease of use when using an en-
gastrointestinal tracts via a buccal approach,
dovideo camera to p e r m i t visualization on a
whereas the cloaca, colon, and bladder can be
color m o n i t o r (see Fig 1).
examined via the vent. Conventional rigid scopes
incorporate a convex glass lens system, in which
the small glass lenses are separated by large air Equipment and Patient Preparation
spaces. In contrast, the rod lens telescope, in-
It is important to use properly sterilized equip-
vented by Harold Hopkins (Dept. of Physics,
ment to prevent infection, especially from one
University of Reading, WhiteKnight, UK), uti-
patient to the next. Autoclaving is seldom recom-
lizes comparatively longer rods of glass and
m e n d e d because, even in those items that can be
smaller air spaces. T h e advantages of the rod lens
autoclaved, the longevity of the e q u i p m e n t is
system are greater light transmission, better im-
reduced through high temperature and pressure
age resolution, wider field of view, and image
sterilization. The two practical options are gas
magnification. The author has used various makes
sterilization using ethylene oxide or cold steriliza-
and models, but is of the opinion that rod lens
tion using a 2% glutaraldehyde solution (as
scopes are far superior and currently prefers the
r e c o m m e n d e d by the endoscopy manufacturer).
diagnostic system designed by Taylor in associa-
General anesthesia is r e c o m m e n d e d for exami-
tion with Karl Storz Endoscopy (Storz UK, Slough,
nation of the coelomic cavity and respiratory
England) .2 This system, originally designed for
tract, although it is often practical to endoscope
birds, is equally applicable to reptile medicine.
the cloaca of the conscious, physically restrained,
The a u t h o r has been unable to locate a
lizard. Examination of the buccal cavity and
mamffacturer, other than Karl Storz, that can
u p p e r gastrointestinal tract u p p e r is possible in
provide a fully integrated range of accessories
the conscious or sedated saurian when using a
designed for the exotic animal veterinarian. The
m o u t h gag, but the a u t h o r prefers general anes-
instrument channel of the Taylor sheath permits
thesia so as not to risk damage to the e q u i p m e n t
the introduction o f various instruments, the
or the animal.
most useful of which are the flexible scissors
With the animal adequately anesthetized, the
(11501 EK; Storz), 5F flexible grasping forceps
lizard can be appropriately positioned depend-
(26161 T; Storz), 5F elliptical cup flexible biopsy
ing on the route of entry. For buccal approaches
forceps (67161 Z; Storz), and fine aspiration/
injection needle with Teflon guide (67071 X;
Storz).

Light Sources, Cameras, and Recording

Equipment
There are two major types of light source
available, the cheaper tungsten-halogen, and
more expensive, rare-earth xenon. Halogen is
certainly sufficient when using a rigid telescope
via the eyepiece and is passable when using a
video camera. Howevel; if quality video record-
ing is required, then a x e n o n source is strongly
r e c o m m e n d e d and is certainly essential when
Figure 1. Coelioscopic examination of a green iguana.
confronted with the p o o r e r optics of fine flexible The endoscopy camera and video monitor make
endoscopes. Still, photo-endoscopy requires spe- endoscopy and biopsy procedures easier to accom-
cialized flash generators. Whatever light source plish.
124 Stephen J. Divers
to the gastrointestinal and respiratory tracts, the
lizard can be placed in normal or dorsal recum-
bency with h e a d and neck extended at the edge
of the examination table. This helps to prevent
the work surface from contacting and hindering
the clinician's h a n d and endoscope during the
procedure. A similar technique can be used for
examination o f the cloaca, bladder, and lower
gastrointestinal tract. Precise positioning for coe-
lomic endoscopy depends on the type of lizard
(dorsoventrally or laterally compressed), the
structure (s) of particular interest, and the prefer-
ence of the endoscopist.
Endoscopic Techniques
Coelioscopy
Reptiles lack a muscular diaphragm, and there-
fore, the term laparoscopy is inappropriate and
should be replaced by coelioscopy. Given the
relatively small size of most pet lizards, a single
midcoelomic entry point, either in a paramedian
or paralumbar area, will usually permit examina-
tion of most, if not all, of the coelomic struc-
tures. The precise point of entry and position of
the lizard will d e p e n d on the particular organ or
system of interest and tile preferences of the
veterinarian. For the purposes of this article, the
green iguana will serve as a model for saurian
endoscopy. The author prefers a left lateral
approach, unless physical examination and other
diagnostic tests indicate a right-sided problem.
The iguana is positioned in right lateral recum-
bency, with the left hindlimb taped caudally
against the tail base. The entry area is b o r d e r e d
by the ribs, spine, and hindlimb and should be
aseptically p r e p a r e d and draped (see Fig 2). T h e
author prefers the use of adhesive sprays and
clear plastic drapes to permit better visualization
of the lizard during anesthesia, endoscopy, and
insufflation. Taking aseptic precautions, a small
skin incision is made in the center of the defined
area. A pair of small hemostats should be em-
ployed to bluntly enter the coelomic cavity. It is
wise to reduce tile force of artificial ventilation or
temporarily cease ventilating until the scope has
been introduced into the coelom, thereby reduc-
ing the possibility of damage to the inflated lung.
The small, 3- to 4-ram incision requires a single
skin suture or tissue glue for closure.
D e p e n d i n g on the procedure to be carried
out and the presenting pathology, insufflation
i i~ii!i~i~i!i!ii!iii
Figure 2. Positioning of a green iguana in preparation
for a right-sided coelioscopic approach. The entry
area is bordered dorsally by the spine, cranially by the
ribs, and caudally by the hindlimb.
may or may not be required. Inflation is useful
for improving exposure, but thought must be
given to the effects on lung ventilation and
respiration. Various gases can be used for insuffia-
tion, namely carbon dioxide, nitrous oxide, and
air. A variety of specialized gas supplies, filtration
units, and insuffiation devices are available, but
the author has enjoyed success using an inexpen-
sive aquarium air p u m p with controllable air
output. Intravenous giving set tubing can be
used to connect the insuffiation gas supply to
one of the ports on the sheath via a standard luer
fitting from the cut-down barrel of a 1-mL
syringe or a three-way tap. Air pressure can be
controlled by using a finger as a valve over the
second, open, sheath port.
Once the endoscope has been inserted, it is
often necessary to gently touch the tip of the
scope against a coelomic m e m b r a n e to clean the
terminal lens.
Starting at the caudal extremity of the coe-
loln, the cranial pole of the left kidney is usually
visible, but the right kidney may be more difficult
to approach. In cases of renomegaly, the kidneys
will extend into the caudodorsal coelom, facilitat-
ing biopsy. Following the dorsally located renal
veins cranially will lead to the paired gonads,
ovaries or testicles. Sex determination, follicular
or testicular activity, and gross pathologies affect-
ing the gonads may be assessed. In close associa-
tion with the gonads are the adrenal glands.
Observation of the left gland usually poses no
problems, but the right may be more difficult to
locate. In cases of advanced folliculogenesis,
direct recognition of the adrenals may be hin-
 Lizard Endoscopic Techniques 125

dered. The left oviduct is easily documented,

especially if the lizard is a gravid female, but the
right is more difficult to determine. The ureters
can be followed from the kidneys, caudally to the
u r o d e u m of the cloaca, and the bladder is
usually located in a caudoventral position, overly-
ing the coelomic fat bodies. The bladder may
vary dramatically in size (and indeed may be
absent in some species), and so care is required
not to damage the thin bladder wall during the
endoscopic examination.
The e x p a n d e d lung is a thin, sac-like structure
that can be observed cranially during intermit-
tent positive pressure ventilation, whereas the
liver is located in a more ventral position. It is
often possible to gently advance the scope crani-
ally past the liver to the ventral aspect of the
p l e u r o p e r i t o n e u m that permits visualization of
the heart and more cranial lung areas. Caudal to Figure 3. Incising through the serosal capsule of a
the liver, the stomach, spleen, and pancreas are pale and enlarged liver in a green iguana.
located in close proximity, whereas the remain-
ing intestinal tract, including the large, often edge of the liver, in which good biopsy bites can
voluminous, caecum, occupies most of the mid- be more easily obtained (see Fig 4). It is particu-
caudal coelom, particularly on the right side. larly important to correlate histopathologic and
Lizards do not possess diffuse adipose tissue; microbiological biopsy results with clinicopatho-
however, they have localized fat bodies emanat- logic data when dealing with hepatic and renal
ing from the caudoventral coelom. When en- diseases.15,16
doscoping obese iguanas, these fat bodies may be
very large and occupy m u c h of the ventral body
cavity.
One of the great benefits of endoscopy is that
when an abnormal structure or pathological
lesion is observed, biopsies can be taken u n d e r
direct visual control. Biopsies can be harvested
from the kidneys, gonads, liver, spleen, pancreas,
fat body, and coelomic membranes.
The visceral organs are covered by serosal
membranes that can be difficult to break through
using the delicate biopsy forceps, and repeated
bite attempts may have to be made before the
m e m b r a n e is breached and tissue is obtained.
The author prefers to use the flexible endoscopy
scissors to incise the serosal membrane, which
permits the entry of the biopsy forceps and
greatly facilitates taking a good, clean tissue
biopsy (see Fig 3). Kidney biopsies are more
difficult to obtain unless renomegaly is evident,
because the normal paired kidneys are located Figure 4. Inserting tile biopsy forceps through the
within the pelvic canal of green iguanas, al- capsular incision and into the liver parenchyma to
obtain a clean tissue biopsy. Multiple biopsies for
though the cranial surface is usually available for histology and microbiology can be obtained via the
sampling. 13 In cases of diffuse liver pathology, same capsular incision. See Figure 4 (Divers) on page
the most accessible sampling site is the caudal 100.
126 Stephen J. Divers
The author uses the 5F elliptical cup flexible
biopsy forceps to harvest tissue samples for
histopathology and microbiology. The relatively
small sample size permits the taking of several
biopsies for multiple laboratory tests, the taking
of sequential biopsies to monitor progress, and
the use of endoscopic biopsy techniques in
patients as small as 100 g (see Fig 5).
The 5F grasping forceps are useful for manipu-
lating tissues, debridement, and retrieving for-
eign objects, including parasites. The fine aspira-
t i o n / i n j e c t i o n n e e d l e can be used for the
aspiration of fluid from cystic structures in which
biopsy may be contraindicated because of post-
sampling leakage. The author has also used the
needle instrument for r e m o t e aspiration, irriga-
tion, and drug administration.
Endoscopic Renal Examination and Biopsy
Reptile clinicians are regularly confronted by
the pet saurian with renal disease, especially the
mature green iguana. 15,~7 Although there have
been some excellent reviews on reptile renal
physiology and renal diseases, there still exists a
significant void in our ability to definitively
diagnose the etiology and instigate more specific
therapeutics at an early stage, ls,19 Diagnosis fre-
quently relies on microbiology, histology, and
other laboratory tests which, in the past, were
only feasibly obtained from a necropsy examina-
Figure 5. Minor hemorrhage after liver biopsy is
normal, but major hemorrhage is very rare.
tion. Such clinical investigations may be appropri-
ate in a large colony situation, but are untenable
when c o n f r o n t e d by the single pet lizard.
Diagnostic imaging using radiography and
ultrasonography have their uses, but based on a
recent review, endoscopy has been neglected in
reptile medicine. 9~ Only endoscopy permits the
clinician to directly visualize the kidneys and
assess their surface contours, vasculature, size,
coloration, and capsule, while permitting the
collection of tissue biopsies u n d e r direct visual
control. Biopsies may be taken percutaneously
or with ultrasound guidance, but the author
prefers the precision and security of optically
guiding the procedure.
When confronted by a sick iguana, pretreat-
m e n t blood samples and medical stabilization
are essential before anesthesia and endoscopic
examination. ~5 The main biochemical indicators
of renal disease are decreased plasma calcium,
increased phosphorus, a n d / o r increased uric
acid values. T h e paralumbar approach, as previ-
ously described, can be used when specifically
interested in the kidneys. If there is no evidence
to support a unilateral right-sided problem, then
a standard left-sided approach is preferred. In
the normal iguana, the paired kidneys are lo-
cated within the pelvic canal and will be difficult
to find without insufflation, being hidden by the
terminal colon, fat bodies, and bladder. In cases
of renomegaly, there will be no problem locating
the kidneys because they protrude from the
pelvic canal into the coelomic cavity. In most
cases it is difficult, but not impossible, to ad-
equately examine both kidneys from a unilateral
entry point. A more midline approach may aid
examination of both kidneys, but the midline
vein and the associated suspensory ligament can
still be a hindrance, and therefore, the author
prefers to make a contralateral entry point if
required. It is important to examine as m u c h of
the surface of the kidney as possible to deter-
mine whether a disease process seems to be
focal, multifocal, or diffuse. In cases of diffuse
renal disease (eg, tubulonephrosis, nephrocalci-
nosis), two or three biopsies taken from the most
convenient sites are generally diagnostic. Ultra-
sound-guided and blind, percutaneous biopsy
techniques can be as effective in diagnosing
diffuse renal disease, but the risk of iatrogenic
trauma is much higher. Most diagnostic failures
occur because of poor tissue selection for biopsy,
 Lizard Endoscopic Techniques 127

and this is especially true when dealing with focal

lesions such as abcesses and neoplasms or multi-
centric pathology such as f o u n d in mycobacterio-
sis. In these cases, direct visualization offers the
best chances of sampling the diseased area(s). In
cases of focal or multifocal renal disease, single
or multiple discrete lesions are visible, a n d biop-
sies should ideally be harvested f r o m the edge of
the lesion, taking n o r m a l and a b n o r m a l tissue in
the same biopsy sample for both microbiology
and histology. Alternatively, and technically m u c h
easier, small biopsies can be collected f r o m the
a b n o r m a l and n o r m a l areas and submitted to-
gether for comparison. T h e kidney is situated
retroperitoneally. T h e author prefers to use single
action endscopy scissors to incise the perito-
n e u m and renal capsule to facilitate biopsy
collection. T h e scissors are opened, a n d the
Figure 7. The capsular incision of this kidney is
fixed blade is gently inserted through the renal obvious and permits the entry of the biopsy forceps.
capsule, but not into the renal parenchyma.
Maintaining the jaws open, the scissors are ele-
vated, and the renal capsule is incised as the which prevents the forceps f r o m slipping back
scissors are advanced (see Fig 6). O n c e the t h r o u g h the incision, and a clean tissue biopsy
incision is sufficiently large e n o u g h to p e r m i t the can be taken (see Fig 8). Multiple biopsies can be
introduction of the biopsy forceps, the blades of taken through the same incision. T h e r e is often
the scissors are closed and retracted (see Fig 7). some m i n o r postsampling bleeding, which, as a
T h e biopsy forceps can now be inserted t h r o u g h result of magnification, often looks significantly
the incision, k e e p i n g the jaws closed. O n c e worse than it actually is (see Fig 8).
below the capsule, the biopsy forceps are opened,

Figure 8. With the capsular incision, the renal paren-

chyma is not only visible, but also easily accessible. The
Figure 6. Endoscopic view of an enlarged kidney in a biopsy forceps are inserted through the capsular
green iguana. The renal capsule is incised using the incision and opened to take a tissue biopsy. See Figure
endoscopy scissors. 8 on page 100.
128 Stephen J. Divers

Gastrointestinal Endoscopy using artery forceps. O n c e the coelomic cavity

has b e e n entered, the ribs are retracted to
T h e same rod-lens telescope can be used to
provide better visualization. T h e lizard is then
examine the gastrointestinal tract f r o m the buc-
held at m a x i m u m inspiration to maintain the
cal cavity to the stomach a n d sometimes beyond.
lung against the lateral thoracic wall. W h e n
Air insutIlation is useful to dilate the alimentary
visualized, the lung can be grasped and held
tract and aid foreign body retrieval and identifi-
using artery forceps before pushing the scope
cation of gross lesions. It is sometimes useful to
through the thin m e m b r a n e and directly into
turn off all the r o o m lights, so that the precise
the lung space proper. T h e endoscopist can then
location of the endoscope can be seen and n o t e d
search t h r o u g h o u t the lung for evidence of
if exploratory coeliotomy is later required.
p n e u m o n i a , abscessation, parasites, and even
Where examination of the delicate m u c o s a is
foreign bodies. O n removal of the scope, the
necessary, the use of sterile saline is p r e f e r r e d
lung m e m b r a n e is sutured using fine absorbable
over air because it permits a better appreciation
suture naaterial before the artery forceps release
of the mucosal architecture. A standard liter of
the lung back to a m o r e n o r m a l position within
sterile saline suspended above the clinician can
the coelomic cavity. T h e a u t h o r has not f o u n d it
be c o n n e c t e d to a p o r t on the sheath using an
necessary to close the intercostal muscle layer,
intravenous administration set. A second admin-
but again fine suture material can be used if
istration set can be c o n n e c t e d to the other port,
required. T h e small skin incision is closed in a
terminating in a collection bowl u n d e r the exami-
routine manner. T h e lateral ' t h o r a c o t o m y ' ap-
nation table. By turning the input and o u t p u t
proach can be easily repaired and is therefore
ports on or off, the degree of fluid distension can
p r e f e r r e d over a coelioscopic entry into the
be controlled, and irrigation can be undertaken.
lungs, in which closure of the lung and pleuro-
Similar techniques can be used to examine the
p e r i t o n e u m c a n n o t be assured.
cloaca and large intestine, and with practice, the
bladder can also be entered and e x a m i n e d via
the urethral o p e n i n g of the u r o d e u m . External Endoscopy
The excellent optics and magnification should
Respiratory Endoscopy encourage the clinician to use the endoscope
whenever possible. Examination of the external
In large iguanas, the sheathed endoscope can
tympanic m e m b r a n e , eye, external nares, in-
be used to examine the glottis and trachea down
verted hemipenes, integument, and specialized
to the level of the bifurcation, but it is i m p o r t a n t
skin structures is possible and will reveal m o r e
for the h e a d and neck to be extended. Using the
than the unaided eye.
scope alone permits examination in smaller
lizards, and the use of instruments is not necessar-
ily p r e v e n t e d because the trachea itself can act as
a guide. Even complete occlusion of the trachea
Summary
for a few minutes is of little consequence in the As in birds, endoscopy in reptiles permits high
anesthetized reptile because of their relative resolution examination of tissues with guided
tolerance of hypoxia. D e p e n d i n g on the size of sample collection. In addition, the identification
the lizard, it is often possible to insert the of sex in juvenile and m o n o m o r p h i c species
endoscope into a p r i m a r y bronchus and exam- remains a valuable application for herpetocultur-
ine lung tissue. A m o r e complete examination of alists. Foreign body retrieval and m i n o r surgical
the lungs can be m a d e via a small midlateral procedures are readily accomplished. T h e poten-
' t h o r a c o t o m y ' incision between two ribs; how- tial for future applications of endoscopic surgery
ever, care must be taken to be aware of the in the reptile is unlimited.
position of the heart, which varies with species. Reading a b o u t endoscopy is only half the
In the case of the iguana, the heart is located story, because practical experience is essential to
between the forelimbs and seldom presents a b e c o m e c o m p e t e n t with the instrumentation. To
problem. A small skin incision is m a d e in the this end, it is i n c u m b e n t on the clinician inter-
midlateral area of the thoracic region, and the ested in pursuing this facet of reptile medicine to
intercostal muscle fibers are gently separated gain practice on necropsies and to participate in
 Lizard Endoscopic Techniques
continuing education forums, s u c h as p r a c t i c a l
endoscopy wet-laboratories.
References
1. Brearley MJ, CooperJE, Sullivan M: ColourAtlas of Small
Animal Endoscopy. Endoscopy in Exotic Species. St
Louis, MO, Mosby-Year Book, 1991, pp 111-122
2. Taylor M: Endoscopic examination and biopsy tech-
niques, in Ritchie BW, Harrison GJ, Harrison LR (eds):
Avian Medicine: Principles and Application. Lake Worth,
FL, Wingers, 1994, pp 327-354
3. Jenkins JR: Diagnostic and clinical techniques, in Mader
DR (ed): Reptile Medicine and Surgery. Philadelphia,
PA, Saunders, 1996, pp 275-276
4. Schildger B: Zur technik der Gastroskopie bei Schildkro-
ten. Internationalen Symposiums uber die Erkrankun-
g e n d e r Zoo und Wildtiere. Zurich, Switzerland, Schweiz,
1997, pp 73-75
5. AckermannJ, CarpenterJW: Using endoscopy to remove
a gastric foreign body in a python. Vet Med 90:761-763,
1995
6. Lumeij JT, Happe RP: Endoscopic diagnosis and removal
of gastric foreign bodies in a Caiman (Caiman crocodilus
crocodilus). Vet Q 7:234-236, 1985
7. Coppoolse KJ, Zwart P: Cloacoscopy in reptiles. Vet Q
7:243-245, 1985
8. Gobel T, Jurina K: Endoskopie des Respirationstraktes
bei Reptilien. Kleintierpraxis 39:791-794, 1994
9. Schildger B, Wicker R: Endoskopie bei Reptilien und
Amphibiens--Indikationen, Methoden, Befunde. Prakti-
sche-Tierarzt 73:516-526, 1992
129
10. Wood JR, Wood FE, Critchley I~l:I, et ah Laparoscopy of
the green sea turtle, Chelonia mydas. B J Herpetol
6:323-327, 1983
11. Divers SJ: Reptile endoscopy. Autumn Meeting of the
British Veterinary Zoological Society, London, UK, No-
vember 14-15, 1997
12. Kraut M: Endoskopie bei Schildkroten unter Praxisbedin-
gungen. Munchen, Germany, Tierarztliche Fakultat, Lud-
wig-Maximilians-Universitat, 1995
13. Schildger B: Endoscopic examination of the urogenital
tract in reptiles. Proc Assoc Reptil Amphib Vet, 1994, pp
60-61
14. Frye FL: Reproduction in reptiles, in Frye FL (ed):
Biomedical and surgical aspects of reptile husbandry.
Melbourne, FL, Krieger, 1996, pp 275-276
15. Divers SJ: A clinician's approach to renal disease in
lizards. Proc Assoc Reptil Amphib Vet, 1997, pp 5-11
16. Divers SJ: Reptilian liver and gastro-intestinal testing, in
Fudge AM (ed): Laboratory Medicine: Avian and Exotic
Pets. Philadelphia, PA, Saunders, 1999, in press
17. Divers SJ: Reptilian renal and reproductive disease diag-
nosis, in Fudge AM (ed): Laboratory Medicine: Avian
and Exotic Pets. Philadelphia, PA, Saunders, 1999, in
press
18. Braun EJ: Comparative renal function in reptiles, birds
and mammals. Semin Avian Exotic Pet Med 7:62-71, 1998
19. Miller HA: Urinary diseases of reptiles: Pathophysiology
and diagnosis. Semin Avian Exotic Pet Med 7:93-103,
1998
20. Canny C: Gross anatomy and imaging of the avian and
reptilian urinary system. Semin Avian Exotic Pet Med
7:72-80, 1998