Blackwell's Five-Minute Veterinary Consult: Reptile and Amphibian. Javier G. Nevarez

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       Proper education about the correct diet and formulation of vitamin A for the species.

       Education about differences between water soluble and fat‐soluble vitamins.

       Discontinuing supplementation of non‐ beta carotene vitamin A.

       Other treatment focuses on supportive therapy and managing secondary infections.

       Systemic fluid therapy may be needed but with the goal of transitioning to oral fluids or passive soaking.

       Pain management can be important.

       Judicious topical use of silver sulfadiazine cream for epidermal ulcers can help.

       Vitamins E and K and taurine administration have all been shown to help mitigate hypervitaminosis A in rat studies, but no studies are available in reptiles.

       Oversupplementation of vitamin A can have negative interactions with other fat‐soluble vitamins (D, E, K) leading to either decreased absorption or excess accumulation.

       Reassessment of clinical manifestation

       Review of current diet plan

       Repeat liver biopsy if feasible

       In the acute form, hypervitaminosis A generally resolves quickly and clinical manifestation is uncommon (except in very high overdosing).

       The chronic form is most common. Clinical resolution can take many months, with most dermatological manifestations resolving, although skeletal and hepatic damage may be permanent.

       OTC = over the counter

       UVB = ultraviolet B

      1 Chen LP, Huang CH. Effects of dietary β‐carotene levels on growth and liver vitamin A concentrations of the soft‐shelled turtle, Pelodiscus sinensis (Wiegmann). Aquacult Res 2011;42:1848–1854.

      2 Chen LP, Huang CH. Estimation of dietary vitamin A requirement of juvenile soft‐ shelled turtle, Pelodiscus sinensis. Aquacult Nutr 2015;21:457–463.

      3 Mans C, Braun J. Update on common nutritional disorders of captive reptiles. Vet Clin North Am Exot Anim Pract 2014;17(3):369–395.