Retrospective Analysis of Cataract Formation and Nutritional Etiology in a Managed Collection of Parakeet Auklets (Aethia psittacula).

The parakeet auklet (Aethia psittacula) is a piscivorous seabird with a natural diet of various invertebrate and teleost species, which is challenging to replicate in a managed collection. A high prevalence of early onset cataracts was observed in a managed collection of parakeet auklets at the North Carolina Zoo (Asheboro, NC, USA), which was hypothesized to be related to inappropriate vitamin A and E levels. From 1994 to 2002, these parakeet auklets were offered dietary supplementation comprising Vita-Zu small bird tablets. In June 2002, the birds were transitioned to only Thiamin-E paste (vitamin E and thiamin only). Plasma samples were collected from birds with and without cataracts from 1998 to 2005 and submitted for vitamin A (retinol) and vitamin E (α-tocopherol) analysis. Food items comprising the birds' diet were also evaluated for vitamin content. This information was combined with clinical and necropsy data from medical records from 1994 to 2015. A total of 78% of birds (39/50) developed cataracts, with a median age of onset of 7 years (range, 2-12 years). Cataracts ranged from incipient to hypermature during both routine ophthalmic examinations and postmortem evaluations. The median (range) of plasma retinol and α-tocopherol values were 1.99 µg/mL (0.20-6.68 µg/mL) and 15.39 µg/mL (3.40-96.27 µg/mL), respectively. There were no significant differences in plasma concentrations of vitamins based on the animals' sex, origin, presence of cataracts, or administered vitamin supplementation product. No other etiologies for cataract development were identified in the population. Further research in free-ranging parakeet auklet nutrition and cataract occurrence is warranted for continued species collection management.

Bilateral Phacoemulsification in an African Elephant (Loxodonta africana).

A 37-year-old bull African elephant (Loxodonta africana) at the North Carolina Zoo (NCZ) was diagnosed with bilateral cataracts leading to behavioral changes and significant weight loss secondary to functional blindness. On initial examination, a weight loss of 234 kg, a mature cataract in the right eye, and a focal cataract in the left eye were diagnosed. Ultrasound and electroretinography (ERG) indicated normal retinal attachment and both eyes were viable candidates for surgery. After careful planning and behavioral training, the left cataract was surgically removed via phacoemulsification and irrigation/aspiration. The right eye subsequently developed a ventral lens subluxation, and phacoemulsification and irrigation/aspiration were performed six months after the first procedure. Four years after surgery, menace response, palpebral reflex, dazzle reflex, and pupillary light reflexes were present in both eyes. Body weight was 5,515 kg, 88kg more than at the time of the second surgery. This is the first published report of an African bull elephant undergoing bilateral cataract removal using phacoemulsification and irrigation/aspiration. The lack of significant postoperative inflammation and uneventful recovery of the elephant suggests that this surgical procedure along with proper preoperative planning and postoperative medical management can be a safe and effective treatment option for elephants with cataracts.

Amoebic meningoencephalitis and disseminated infection caused by Balamuthia mandrillaris in a Western lowland gorilla (Gorilla gorilla gorilla).

CASE DESCRIPTION A 22-year-old male gorilla (Gorilla gorilla gorilla) housed in a zoo was evaluated for signs of lethargy, head-holding, and cervical stiffness followed by development of neurologic abnormalities including signs of depression, lip droop, and tremors. CLINICAL FINDINGS Physical examination under general anesthesia revealed a tooth root abscess and suboptimal body condition. A CBC and serum biochemical analysis revealed mild anemia, neutrophilia and eosinopenia consistent with a stress leukogram, and signs consistent with dehydration. Subsequent CSF analysis revealed lymphocytic pleocytosis and markedly increased total protein concentration. TREATMENT AND OUTCOME Despite treatment with antimicrobials, steroids, and additional supportive care measures, the gorilla's condition progressed to an obtunded mentation with grand mal seizures over the course of 10 days. Therefore, the animal was euthanized and necropsy was performed. Multifocal areas of malacia and hemorrhage were scattered throughout the brain; on histologic examination, these areas consisted of necrosis and hemorrhage associated with mixed inflammation, vascular necrosis, and intralesional amoebic trophozoites. Tan foci were also present in the kidneys and pancreas. Immunohistochemical testing positively labeled free-living amoebae within the brain, kidneys, eyes, pancreas, heart, and pulmonary capillaries. Subsequent PCR assay of CSF and frozen kidney samples identified the organism as Balamuthia mandrillaris, confirming a diagnosis of amoebic meningoencephalitis. CLINICAL RELEVANCE Infection with B mandrillaris has been reported to account for 2.8% of captive gorilla deaths in North America over the past 19 years. Clinicians working with gorillas should have a high index of suspicion for this diagnosis when evaluating and treating animals with signs of centrally localized neurologic disease.

USE OF CORTICAL BONE FENESTRATION, AUTOGENOUS FREE SKIN GRAFT, AND THERMOGRAPHY FOR WOUND TREATMENT AND MONITORING IN A RED WOLF (CANIS RUFUS GREGORYI).

A 2-yr-old female red wolf (Canis rufus gregoryi) sustained a degloving injury to the left thoracic limb while in a display habitat. Initial attempts to resolve the extensive wound by using conservative measures were unsuccessful. Subsequent treatment using a free skin graft consisted first of establishment of an adequate granulation bed via cortical bone fenestration. After establishment of a healthy granulation bed was achieved, free skin graft was harvested and transposed over the bed. To monitor viability and incorporation of the graft, serial thermographic imaging was performed. Thermography noninvasively detects radiant heat patterns and can be used to assess vascularization of tissue, potentially allowing early detection of graft failure. In this case, thermography documented successful graft attachment.

Malignant hypertension and retinopathy in a western lowland gorilla (Gorilla gorilla gorilla).

BACKGROUND: A 34-year-old western lowland gorilla presented with peracute blindness. METHODS: Clinical evaluation, diagnostic imaging, laboratory analyses, blood pressure measurements, and necropsy were performed. RESULTS: The clinical and postmortem findings supported malignant hypertension. CONCLUSIONS: We describe a case of naturally occurring hypertensive encephalopathy and retinopathy in a gorilla.

Reye's or Reye's-like syndrome in western lowland gorilla (Gorilla gorilla gorilla).

BACKGROUND: A 15-year-old western lowland gorilla (Gorilla gorilla gorilla) died shortly after transfer to the North Carolina Zoo. METHODS: Complete blood count, serum biochemical analysis, and necropsy were performed. RESULTS: Combination of compatible clinical signs, biochemical and histopathological findings fulfilled all of the CDC definition criteria of Reye's or a Reye's like syndrome. CONCLUSIONS: This report describes a case of Reye's syndrome or Reye's-like syndrome in a non-human primate.

Vesiculobullous skin reaction temporally related to firocoxib treatment in a white rhinoceros (Ceratotherium simum).

A 40 yr-old female white rhinoceros (Ceratotherium simum) suffered from chronic nail-bed abscesses. Due to worsening of clinical signs, the animal's nonsteroidal anti-inflammatory treatment was switched to firocoxib. Approximately 7 days after this change, the animal developed multifocal vesicles and bullae along the lateral aspects of the thorax and abdomen, the dorsum, and the proximal limbs. Cytology and culture did not identify an infectious etiology. Histologically, the lesions consisted of a severe, subacute vesiculobullous dermatitis with intraepidermal to subepidermal clefting with areas of individual keratinocyte necrosis and minor neutrophilic epidermal infiltrates. These findings are similar to those seen in some drug reactions in people; therefore an adverse drug reaction to the firocoxib was suspected.

Suspected anaphylaxis to leuprolide acetate depot in two elf owls (Micrathene whitneyi).

Two adult female elf owls (Micrathene whitneyi) were treated with leuprolide acetate depot injections to prevent egg laying. The birds were treated for several years without complications. Several years into the treatment regimen, both birds died immediately after receiving an injection of leuprolide acetate. Remaining drug was analyzed, revealing 95.7% potency. We suspect that either an immediate Type 1 hypersensitivity reaction occurred or a contaminant was present, resulting in the fatalities of these elf owls. No reports of anaphylaxis to leuprolide acetate in birds were identified in the literature. Clinicians should be aware of the possibility of anaphylaxis when administering this medication to avian patients.

Medical and surgical management of reproductive neoplasia in two western lowland gorillas (Gorilla gorilla gorilla).

BACKGROUND: Reports of female reproductive tract neoplasia are infrequent in great apes. METHODS: Two captive-born, female western lowland gorillas (Gorilla gorilla gorilla) housed at the North Carolina Zoological Park were diagnosed with reproductive neoplasia. RESULTS: The first gorilla had uterine endometrial thickening and uterine fibroids diagnosed during a routine annual examination. Subsequently, the animal underwent several uterine curettage procedures in an attempt to debulk the uterine mass. Biopsy results indicated uterine adenocarcinoma. The animal was treated with an ovariohysterectomy followed by a combination of megestrol acetate and medroxyprogesterone acetate. The second gorilla was diagnosed with squamous cell carcinoma of the vagina, cervix, and uterus after presenting for intermittent vaginal bleeding of 1-month duration. This animal underwent palliative radiation therapy, receiving two rounds of radiation treatment 8 weeks apart. CONCLUSIONS: The following report describes the diagnosis and management of the two cases.

Naturally transmitted herpesvirus papio-2 infection in a black and white colobus monkey.

CASE DESCRIPTION: A 6.5-year-old female eastern black and white colobus monkey (Colobus guereza) was evaluated after acute onset of ataxia and inappetence. CLINICAL FINDINGS: The monkey was ataxic and lethargic, but no other abnormalities were detected via physical examination, radiography, or clinicopathologic analyses. During the next 2 days, the monkey's clinical condition deteriorated, and its WBC count decreased dramatically. Cytologic examination of a CSF sample revealed marked lymphohistiocytic inflammation. TREATMENT AND OUTCOME: Despite supportive care, the monkey became apneic; after 20 hours of mechanical ventilation, fatal cardiac arrest occurred. At necropsy, numerous petechiae were detected within the white matter tracts of the brain; microscopic lesions of multifocal necrosis and hemorrhage with intranuclear inclusions identified in the brain and adrenal glands were consistent with an acute herpesvirus infection. A specific diagnosis of herpesvirus papio-2 (HVP-2) infection was made on the basis of results of serologic testing; PCR assay of tissue specimens; live virus isolation from the lungs; and immunohistochemical identification of the virus within brain, spinal cord, and adrenal gland lesions. Via phylogenetic tree analysis, the colobus HVP-2 isolate was grouped with neuroinvasive strains of the virus. The virus was most likely transmitted to the colobus monkey through toys shared with a nearby colony of baboons (the natural host of HVP-2). CLINICAL RELEVANCE: To the authors' knowledge, this is the first reported case of natural transmission of HVP-2 to a nonhost species. Infection with HVP-2 should be a differential diagnosis for acute encephalopathy in primate monkeys and humans, particularly following exposure to baboons.

Characterization of primate trypanosome lytic factors.

Humans are one of the few species that resist infection by Trypanosoma brucei brucei because the parasites are killed by lytic factors found in human serum. Trypanosome lytic factors (TLFs) are protein/lipid complexes that contain apolipoprotein A-I (apoA-I), and are therefore a class of high density lipoproteins (HDLs). Haptoglobin-related protein (Hpr) is a unique protein component of TLFs, and its expression has only been demonstrated in humans. Trypanolytic activity has only been found in the sera of five primates: humans, gorillas, mandrills, baboons and sooty mangabeys. We describe here previously unidentified components of highly purified human TLF1: apolipoprotein L-I (apoL-I), human cathelicidin antimicrobial peptide 18 (hCAP18) and glycosylphosphatidylinositol-specific phospholipase D (GPI-PLD). However, we found that hCAP18 and GPI-PLD, along with apoA-I, are common components of both lytic and non-lytic primate HDLs. In contrast, Hpr, which has been previously implicated as the main lytic component of TLF1, was a unique component of all trypanolytic primate HDLs. Furthermore, a polyclonal antiserum to Hpr neutralized the lytic activity from humans and baboons. ApoL-I, a candidate lytic component of human serum, was not immunologically or genetically detectable in two primate species with lytic activity. Polyclonal antiserum to apoL-I also did not neutralize TLF activity in a total human HDL preparation. These findings suggest that apoL-I is not essential in all primate TLFs, and apoL-I alone is not sufficient for optimal trypanosome lytic activity in human TLF.

Comparison of the cardiorespiratory effects of medetomidine-butorphanol-ketamine and medetomidine-butorphanol-midazolam in patas monkeys (Erythrocebus patas).

The cardiorespiratory effects, effectiveness, and reversibility of two injectable anesthetic combinations were compared in captive patas monkeys (Erythrocebus patas). Seven patas monkeys were hand-injected with medetomidine (40 microg/kg, i.m.), butorphanol (0.4 mg/kg. i.m.), and ketamine (3.0 mg/kg. i.m.), and seven were injected with the same dosages of medetomidine and butorphanol plus midazolam (0.3 mg/kg, i.m.). Heart rates decreased in monkeys in both treatment groups and were lower than those previously recorded in patas monkeys anesthetized with either ketamine or ketamine and isoflurane. Mean arterial pressures were highest in ketamine-treated monkeys but remained within normal limits for both groups. End tidal CO2 values increased gradually over time in both groups and were above physiologic norms after 20 min. Respiratory rates were similar between groups and remained constant throughout the procedures. Despite adequate ventilation parameters, initial low percent oxygen-hemoglobin saturation (SpO2) values were suggestive of severe hypoxemia. It was not clear whether these were accurate readings or an artifact of medetomidine-induced peripheral vasoconstriction. Oxygen supplementation restored SpO2 values to normal (>94%) in both groups. Both combinations effectively produced a state of light anesthesia, although spontaneous recoveries occurred after 30 min in three ketamine-treated monkeys. All monkeys were given i.m. atipamezole (0.2 mg/kg) and naloxone (0.02 mg/kg), whereas midazolam-treated monkeys also received flumazenil (0.02 mg/kg, i.v.), which resulted in faster (median recovery time = 5 min) and more complete recoveries in this group. Both combinations are safe to use when supplemented with oxygen, although the midazolam combination provided a longer anesthetic period and was more fully reversible.

Cardiorespiratory effects of medetomidine-butorphanol, medetomidine-butorphanol-diazepam, and medetomidine-butorphanol-ketamine in captive red wolves (Canis rufus).

Safe, effective, and reversible immobilization protocols are essential for the management of free-ranging red wolves (Canis rufus). Combinations using an alpha2-adrenoceptor agonist and ketamine have been shown to be effective for immobilization but are not reversible and can produce severe hypertension and prolonged or rough recoveries. To minimize hypertension and provide reversibility, 24 red wolves were immobilized using three medetomidine-butorphanol (MB) combinations without the use of ketamine in the initial injection. All wolves were administered medetomidine (0.04 mg/kg i.m.) and butorphanol (0.4 mg/kg i.m.). Seven wolves received no other immobilization agents (MB wolves), nine received diazepam (0.2 mg/kg i.v.) at the time they were instrumented (MBD wolves), and eight received ketamine (1 mg/kg i.v.) 30 min after instrumentation (MBK30 wolves). Physiologic parameters were monitored during immobilization. The heart rate was similar among the three groups for the first 30 min, and marked bradycardia was noted in one wolf from each group. Hypertension was observed initially in all three groups but was resolved within 10-30 min. The MBK30 wolves had significant elevations in heart rate and transient hypertension after intravenous ketamine administration. Most wolves had mild to moderate metabolic acidemia. Immobilizing drugs were antagonized in all wolves with atipamezole (0.2 mg/kg i.m.) and naloxone (0.02 mg/kg i.m.). The medetomidine-butorphanol-diazepam wolves were also given flumazenil (0.04 mg/kg i.v.). All wolves were standing within 12 min and were fully recovered within 17 min. Medetomamine-butorphanol and MBD combinations provided effective and reversible immobilization of red wolves without the sustained hypertension associated with the use of alpha2-adrenoceptor agonist-ketamine combinations. Delaying the administration of ketamine reduced its hypertensive effects.