{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T13:40:15Z","timestamp":1786628415841,"version":"build-2736575974"},"reference-count":23,"publisher":"American Veterinary Medical Association (AVMA)","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ajvr"],"published-print":{"date-parts":[[2026,8,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"sc_a1\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      Evaluate multidose bioencapsulated terbinafine for the treatment of\n                      <jats:italic>Emydomyces testavorans<\/jats:italic>\n                      in naturally infected Blanding\u2019s turtles (\n                      <jats:italic>Emydoidea blandingii<\/jats:italic>\n                      ) and determine if this protocol resulted in therapeutic drug concentrations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a2\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Blanding\u2019s turtles housed within a quarantine facility were treated with oral terbinafine (30 mg\/kg) bioencapsulated within earthworms delivered every 48 hours for 12 months in this experimental study. For all turtles, plasma terbinafine concentrations were quantified, and turtles were routinely tested for of\n                      <jats:italic>E testavorans<\/jats:italic>\n                      through quantitative PCR of combined oral, cloacal, and carapace\/plastron swabs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a3\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      13 Blanding\u2019s turtles were enrolled, and no turtle consistently tested negative via quantitative PCR for\n                      <jats:italic>E testavorans<\/jats:italic>\n                      after 12 months of treatment. The median plasma terbinafine concentrations at months 3 and 6 (trough concentrations) were 18 ng\/mL (11 to 78 ng\/mL) and 36 ng\/mL (10 to 76 ng\/mL), respectively. The median plasma terbinafine concentrations at months 9 and 12 (peak concentrations) were 163 ng\/mL (61 to 575 ng\/mL) and 100 ng\/mL (13 to 247 ng\/mL), respectively. Plasma terbinafine concentrations inconsistently measured above the MIC for\n                      <jats:italic>E testavorans<\/jats:italic>\n                      . No correlation was observed between plasma terbinafine concentrations and\n                      <jats:italic>E testavorans<\/jats:italic>\n                      target copy number by quantitative PCR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a4\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Multdose treatment at 30 mg\/kg with orally administered, bioencapsulated terbinafine every 48 hours for 12 months failed to achieve molecular resolution of natural\n                      <jats:italic>E testavorans<\/jats:italic>\n                      infection in Blanding\u2019s turtles and failed to consistently achieve appropriate plasma concentrations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a5\">\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Emydomyces testavorans<\/jats:italic>\n                      is associated with a challenging disease process and is of increasing concern for the health, welfare, and conservation of chelonian species. Further investigation of alternative dosing regimens and\/or the use of oral terbinafine as part of multimodal treatment protocols is warranted.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/ajvr.26.06.0242","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T12:54:25Z","timestamp":1786625665000},"page":"1-6","source":"Crossref","is-referenced-by-count":0,"title":["12-month clinical trial of bioencapsulated terbinafine yielded inconsistent resolution for the treatment of Emydomyces testavorans in the Blanding\u2019s turtle (Emydoidea blandingii)"],"prefix":"10.2460","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0885-6466","authenticated-orcid":true,"given":"David J.","family":"Minich","sequence":"first","affiliation":[{"name":"Illinois Zoological and Aquatic Animal Residency, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL"},{"name":"Watson Armour III Center for Animal Health and Welfare, Shedd Aquarium, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7567-3451","authenticated-orcid":true,"given":"Anthony J.","family":"Cerreta","sequence":"additional","affiliation":[{"name":"Watson Armour III Center for Animal Health and Welfare, Shedd Aquarium, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Nix","sequence":"additional","affiliation":[{"name":"Watson Armour III Center for Animal Health and Welfare, Shedd Aquarium, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Thompson","sequence":"additional","affiliation":[{"name":"Forest Preserve District of DuPage County, Wheaton, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilyvette","family":"Barajas","sequence":"additional","affiliation":[{"name":"Chicago Academy of Sciences, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Portala","sequence":"additional","affiliation":[{"name":"Chicago Academy of Sciences, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dania","family":"Gamez","sequence":"additional","affiliation":[{"name":"Chicago Academy of Sciences, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Sacerdote-Velat","sequence":"additional","affiliation":[{"name":"Chicago Academy of Sciences, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R.","family":"O\u2019Connor","sequence":"additional","affiliation":[{"name":"Georgia Aquarium, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3021-5075","authenticated-orcid":true,"given":"Jennifer M.","family":"Reinhart","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5184-900X","authenticated-orcid":true,"given":"Sherry","family":"Cox","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Adamovicz","sequence":"additional","affiliation":[{"name":"Illinois Zoological and Aquatic Animal Residency, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL"},{"name":"Wildlife Epidemiology Lab, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karisa N.","family":"Tang","sequence":"additional","affiliation":[{"name":"Watson Armour III Center for Animal Health and Welfare, Shedd Aquarium, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew C.","family":"Allender","sequence":"additional","affiliation":[{"name":"Illinois Zoological and Aquatic Animal Residency, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL"},{"name":"Wildlife Epidemiology Lab, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL"},{"name":"Brookfield Zoo Chicago, Brookfield, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"3","key":"B1","series-title":"Vet Pathol","first-page":"578","article-title":"Shell lesions associated with Emydomyces testavorans infection in freshwater aquatic turtles","volume":"58","author":"Woodburn DB","year":"2021","unstructured":"Woodburn DB, Kinsel MJ, Poll CP, et al. Shell lesions associated with Emydomyces testavorans infection in freshwater aquatic turtles. Vet Pathol. 2021;58(3):578\u2013586. doi:10.1177\/0300985820985217"},{"issue":"2","key":"B2","series-title":"J Clin Microbiol","first-page":"e00628-18","article-title":"Emydomyces testavorans, a new genus and species of onygenalean fungus isolated from shell lesions of freshwater aquatic turtles","volume":"57","author":"Woodburn DB","year":"2019","unstructured":"Woodburn DB, Miller AN, Allender MC, Maddox CW, Terio KA. Emydomyces testavorans, a new genus and species of onygenalean fungus isolated from shell lesions of freshwater aquatic turtles. J Clin Microbiol. 2019;57(2):e00628-18. doi:10.1128\/JCM.00628-18"},{"issue":"4","key":"B3","series-title":"Ichthyol Herpetol","first-page":"958","article-title":"Turtle shell disease fungus (Emydomyces testavorans): first documented occurrence in California and prevalence in free-living turtles","volume":"109","author":"Lambert M","year":"2021","unstructured":"Lambert M, Rosenblum E, Hern\u00e1ndez-G\u00f3mez O, et al. Turtle shell disease fungus (Emydomyces testavorans): first documented occurrence in California and prevalence in free-living turtles. Ichthyol Herpetol. 2021;109(4):958\u2013962. doi:10.1643\/h2020151"},{"key":"B4","first-page":"34","article-title":"Characterizing the clinical course of an emerging fungal pathogen (Emydomyces testavorans) in the state-endangered alligator snapping turtle (Macrochelys temminckii)","year":"2019","unstructured":"Adamovicz L, Woodburn DB, Boers K, et al. Characterizing the clinical course of an emerging fungal pathogen (Emydomyces testavorans) in the state-endangered alligator snapping turtle (Macrochelys temminckii). In: Proceedings of the American Association of Zoo Veterinarians Annual Conference. American Association of Zoo Veterinarians; 2019:34."},{"key":"B5","first-page":"30","article-title":"Fungal shell disease associated with Emydomyces testavorans in a zoo collection of western pond turtles (Actinemys marmorata)","year":"2019","unstructured":"Browning G, Wright L, Wack RF, Gjeltema JL. Fungal shell disease associated with Emydomyces testavorans in a zoo collection of western pond turtles (Actinemys marmorata). In: Proceedings of the American Association of Zoo Veterinarians Annual Conference. American Association of Zoo Veterinarians; 2019:30."},{"issue":"suppl 2","key":"B6","series-title":"Vet Clin Pathol","first-page":"164","article-title":"What is your diagnosis? Ulcerative shell lesions from a diamond-backed terrapin (Malaclemys terrapin)","volume":"53","author":"Hastain SA","year":"2024","unstructured":"Hastain SA, Buchy JM, Dombrowski DS, Womble MA, Armwood AR, Gruber EJ. What is your diagnosis? Ulcerative shell lesions from a diamond-backed terrapin (Malaclemys terrapin). Vet Clin Pathol. 2024;53(suppl 2):164\u2013166. doi:10.1111\/vcp.13291"},{"key":"B7","series-title":"J Exot Pet Med","first-page":"49","article-title":"Emydomyces testavorans DNA is detected from shell swabs of companion chelonians","author":"Brunner TJ","year":"2024","unstructured":"Brunner TJ, Wong AD, Adamovicz L, Simmons A, Ospina E, Keller KA. Emydomyces testavorans DNA is detected from shell swabs of companion chelonians. J Exot Pet Med. 2024;50:49\u201353. doi:10.1053\/j.jepm.2024.05.005"},{"issue":"4","key":"B8","series-title":"J Wildl Dis","first-page":"850","article-title":"Emydomyces testavorans surveillance in multiple free-ranging terrestrial and aquatic chelonian species in Illinois, USA","volume":"60","author":"Fredrickson K","year":"2024","unstructured":"Fredrickson K, Adamovicz L, Terio K, et al. Emydomyces testavorans surveillance in multiple free-ranging terrestrial and aquatic chelonian species in Illinois, USA. J Wildl Dis. 2024;60(4):850\u2013859. doi:10.7589\/JWD-D-23-00164"},{"issue":"2","key":"B9","series-title":"Vet Clin North Am Exot Anim Pract","first-page":"263","article-title":"Emerging infectious diseases of chelonians","volume":"23","author":"Adamovicz L","year":"2020","unstructured":"Adamovicz L, Allender MC, Gibbons PM. Emerging infectious diseases of chelonians. Vet Clin North Am Exot Anim Pract. 2020;23(2):263\u2013283. doi:10.1016\/j.cvex.2020.01.014"},{"key":"B10","unstructured":"The IUCN Red List of Threatened Species: Blanding\u2019s Turtle. International Union for Conservation of Nature and Natural Resources (IUCN). Accessed September 10, 2025. https:\/\/www.iucnredlist.org\/en"},{"issue":"sp12","key":"B11","series-title":"Northeast Nat","first-page":"E68","article-title":"Post-release survivorship in a new population of Blanding\u2019s turtles established using headstarted and directly released turtles","volume":"31","author":"Green JM","year":"2024","unstructured":"Green JM, Koch SL, Buhlmann KA, et al. Post-release survivorship in a new population of Blanding\u2019s turtles established using headstarted and directly released turtles. Northeast Nat. 2024;31(sp12):E68\u2013E84. doi:10.1656\/045.031.s1210"},{"issue":"sp12","key":"B12","series-title":"Northeast Nat","first-page":"E25","article-title":"Recovery of a Blanding\u2019s turtle population through nest protection and headstarting","volume":"31","author":"McElroy CL","year":"2024","unstructured":"McElroy CL, Windmiller B, Berkholtz J, et al. Recovery of a Blanding\u2019s turtle population through nest protection and headstarting. Northeast Nat. 2024;31(sp12):E25\u2013E42. doi:10.1656\/045.031.s1203"},{"issue":"1","key":"B13","series-title":"J Wildl Dis","first-page":"30","article-title":"Hematology, plasma biochemistry, protein electrophoresis, and pathogen surveillance in headstarted and wild-reared populations of Blanding\u2019s turtles (Emydoidea blandingii) in three Northern Illinois, USA, counties","volume":"61","author":"Davidson A","year":"2023","unstructured":"Davidson A, Kendall MW, Ryan M, et al. Hematology, plasma biochemistry, protein electrophoresis, and pathogen surveillance in headstarted and wild-reared populations of Blanding\u2019s turtles (Emydoidea blandingii) in three Northern Illinois, USA, counties. J Wildl Dis. 2023;61(1):30\u201345."},{"issue":"5","key":"B14","series-title":"J Wildl Manage","first-page":"e70219","article-title":"Modeling long-term population viability to inform recovery of a functionally extinct urban Blanding\u2019s turtle population","volume":"90","author":"Fortier RA","year":"2026","unstructured":"Fortier RA, Gabarrini DML, Adderley-Heron KH, Drader CA, Thorne TJ. Modeling long-term population viability to inform recovery of a functionally extinct urban Blanding\u2019s turtle population. J Wildl Manage. 2026;90(5):e70219. 10.1002\/jwmg.70219"},{"issue":"1","key":"B15","series-title":"Am J Vet Res","first-page":"):ajvr.22.08.0138","article-title":"Bioencapsulation is a feasible method of terbinafine administration in Emydomyces testavorans-infected western pond turtles (Actinemys marmorata)","volume":"84","author":"Cerreta AJ","year":"2022","unstructured":"Cerreta AJ, Reinhart JM, Forsythe LR, et al. Bioencapsulation is a feasible method of terbinafine administration in Emydomyces testavorans-infected western pond turtles (Actinemys marmorata). Am J Vet Res. 2022;84(1):ajvr.22.08.0138. doi:10.2460\/ajvr.22.08.0138"},{"issue":"1","key":"B16","series-title":"J Herpetol Med Surg","first-page":"48","article-title":"Pharmacokinetics of nebulized terbinafine in plasma and keratin of northwestern pond turtles (Actinemys marmorata) associated with emydomycosis","volume":"32","author":"Flaminio KP","year":"2022","unstructured":"Flaminio KP, Cox S, Haman K, Allender M, Groves B, Court M. Pharmacokinetics of nebulized terbinafine in plasma and keratin of northwestern pond turtles (Actinemys marmorata) associated with emydomycosis. J Herpetol Med Surg. 2022;32(1):48\u201355. doi:10.5818\/JHMS-D-20-00022"},{"issue":"1","key":"B17","series-title":"J Wildl Dis","first-page":"234","article-title":"Evaluating the efficacy of disinfectant methods against Emydomyces testavorans, a fungus associated with shell disease in freshwater aquatic turtles","volume":"61","author":"Liszka NC","year":"2025","unstructured":"Liszka NC, Adamovicz L, Moorhead KA, Daleo MJ, Grochowski K, Allender MC. Evaluating the efficacy of disinfectant methods against Emydomyces testavorans, a fungus associated with shell disease in freshwater aquatic turtles. J Wildl Dis. 2025;61(1):234\u2013240. doi:10.7589\/JWD-D-24-00094"},{"issue":"4","key":"B18","series-title":"J Wildl Dis","first-page":"860","article-title":"Characterizing the performance of multiple testing modalities to detect Emydomyces testavorans in Blanding\u2019s turtles (Emydoidea blandingii)","volume":"61","author":"Moorhead KA","year":"2025","unstructured":"Moorhead KA, Burke DM, Adamovicz LA, et al. Characterizing the performance of multiple testing modalities to detect Emydomyces testavorans in Blanding\u2019s turtles (Emydoidea blandingii). J Wildl Dis. 2025;61(4):860\u2013871. doi:10.7589\/JWD-D-25-00001"},{"issue":"3","key":"B19","series-title":"Am J Health Syst Pharm","first-page":"243","article-title":"Stability of terbinafine hydrochloride in an extemporaneously prepared oral suspension at 25 and 4 degrees C","volume":"56","author":"Abdel-Rahman SM","year":"1999","unstructured":"Abdel-Rahman SM, Nahata MC. Stability of terbinafine hydrochloride in an extemporaneously prepared oral suspension at 25 and 4 degrees C. Am J Health Syst Pharm. 1999;56(3):243\u2013245. doi:10.1093\/ajhp\/56.3.243"},{"issue":"5","key":"B20","series-title":"J Liq Chromatogr Related Tech","first-page":"607","article-title":"Determining terbinafine using HPLC in plasma and saline","volume":"38","author":"Cox S","year":"2015","unstructured":"Cox S, Hayes J, Hamill M, et al. Determining terbinafine using HPLC in plasma and saline. J Liq Chromatogr Related Tech. 2015;38(5):607\u2013612. doi:10.1080\/10826076.2014.922479"},{"issue":"2","key":"B21","series-title":"J Zoo Wildl Med","first-page":"520","article-title":"Terbinafine pharmacokinetics following single-dose oral administration in red-eared slider turtles (Trachemys scripta elegans): a pilot study","volume":"52","author":"Eshar D","year":"2021","unstructured":"Eshar D, KuKanich B, Avni-Magen N, Joo H. Terbinafine pharmacokinetics following single-dose oral administration in red-eared slider turtles (Trachemys scripta elegans): a pilot study. J Zoo Wildl Med. 2021;52(2):520\u2013528. doi:10.1638\/2020-0079"},{"issue":"4","key":"B22","series-title":"J Am Vet Med Assoc","first-page":"567","article-title":"Evaluation of client compliance with short-term administration of antimicrobials to dogs","volume":"226","author":"Adams VJ","year":"2005","unstructured":"Adams VJ, Campbell JR, Waldner CL, Dowling PM, Shmon CL. Evaluation of client compliance with short-term administration of antimicrobials to dogs. J Am Vet Med Assoc. 2005;226(4):567\u2013574. doi:10.2460\/javma.2005.226.567"},{"issue":"1","key":"B23","series-title":"J Herpetol Med Surg","first-page":"63","article-title":"Comparison of biochemistry values from plasma and lymph in Krefft\u2019s River turtles (Emydura macquarii krefftii)","volume":"32","author":"Glassman AR","year":"2022","unstructured":"Glassman AR, Gamblin KM, Zachariah TT. Comparison of biochemistry values from plasma and lymph in Krefft\u2019s River turtles (Emydura macquarii krefftii). J Herpetol Med Surg. 2022;32(1):63\u201372. doi:10.5818\/JHMS-D-20-00017"}],"container-title":["American Journal of Veterinary Research"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/aop\/ajvr.26.06.0242\/ajvr.26.06.0242.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/ajvr\/aop\/ajvr.26.06.0242\/ajvr.26.06.0242.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T13:09:13Z","timestamp":1786626553000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/aop\/ajvr.26.06.0242\/ajvr.26.06.0242.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":23,"URL":"https:\/\/doi.org\/10.2460\/ajvr.26.06.0242","relation":{},"ISSN":["0002-9645","1943-5681"],"issn-type":[{"value":"0002-9645","type":"print"},{"value":"1943-5681","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,12]]}}}