Analysis of gas evolution in the heart, liver, and kidney of turtles presenting with gas embolic pathology based on ultrasonography

Abstract

Human-caused disturbances of sea turtles can result in them presenting with gas embolic pathology which often leads to severe injury or death. While gas embolism has been previously observed in turtles using MRI and x-ray/CT, as well as ultrasound to a lesser degree, how the distribution of gas evolves in different organs over time, and its possible correlation to outcome, is poorly understood. We hypothesize that ultrasound imaging of the heart, kidney, and liver over time can help differentiate pathology resolution or worsening trajectory and may help refine veterinarians’ treatment algorithm in this population. The liver, kidney, and heart of 100 by-caught turtles were imaged, and gas amount in each ultrasound scan was graded on a scale from 0 (no gas) to 5 (gas completely shadowing organ anatomy). Turtles scanned on the boat had higher grades in all organs compared to turtles first scanned at shore which was on average 163 minutes later. Average pixel brightness in the top half of cardiac scans increased with grade as expected, apart from grade 5 likely due shadowing. Ultrasound brightness could become a quantitative metric for veterinarians to determine which turtles need hyperbaric oxygen treatment and which can be released.