Evaluation of diagnostic criteria in grey parrots (Psittacus erithacus) with suspected atherosclerosis.

OBJECTIVE: Atherosclerosis is a common disease in older psittacines living in captivity with inadequate housing conditions. However, diagnosis in the living bird remains difficult and the disease is often only recognized during post mortem examination. In this context, we aimed at investigating the diagnostic value of currently reported methods in African grey parrots (Psittacus erithacus). MATERIAL AND METHODS: 7 clinically healthy African grey parrots and 32 African grey parrots with suspected atherosclerosis were evaluated in this study. An overall scoring system was implemented based on clinical signs, measurement of blood cholesterol and triglyceride levels, a radiographic exam, and an echocardiogram in B-mode. Furthermore, measurements of the blood flow velocity in the aortic root, heart rate and velocity time integral were performed using the spectral Doppler ultrasonographic function. RESULTS: Measurements of the blood flow velocity in the aortic root showed highly significant differences between the clinically healthy group and a subset of the patient group. Significant differences between the groups also were evident concerning the results of the overall scoring and of the initial examinations. CONCLUSION: The results support that combining spectral Doppler ultrasonographic examination with other diagnostic options may be used to substantiate suspected atherosclerosis and provide additional information regarding the cardiovascular status of the patient. CLINICAL RELEVANCE: The presented findings indicate that employing the described diagnostic methods allows for an intra vitam diagnosis of atherosclerosis and therefore an earlier initiation of treatment.

Use of an Endoloop Ligature and a 2-Portal Coelioscopic Approach for the Removal of an Arrowhead Foreign Body in a Red-Tailed Hawk (Buteo jamaicensis).

A juvenile red-tailed hawk (Buteo jamaicensis) was presented to the Ontario Veterinary College from a wildlife rehabilitation facility for the assessment of an arrowhead foreign body injury. The hawk was found on the ground with the left wing in a dropped position. Radiographic images revealed an arrowhead foreign body superimposed over the left lung and thoracic air sacs, immediately medial to the ribs on the ventrodorsal view, and ventral to the scapulae on the right latero-lateral view. A coelioscopy was performed using a left lateral approach with a 2.7-mm rigid endoscope into the left caudal thoracic air sac, with an additional instrument port through the left abdominal air sac. The arrowhead was visualized adjacent to the left lung, separated from the cranial thoracic air sac cavity by a membrane of fibrous tissue. The tissue membrane was radiosurgically incised. Forceps were then used to guide an Endoloop around the arrowhead. The arrowhead was secured by tightening the Endoloop, and the body wall incision was extended to facilitate the arrowhead extraction.

Intraluminal Uropygial Gland Epithelioma in an African Grey Parrot (Psittacus erithacus).

A 27-year-old female African grey parrot (Psittacus erithacus) presented as a referral for surgical removal of an enlarged uropygial gland that was first observed by the owner 6 months prior. Antibiotic therapy was attempted by the referring veterinarian with limited treatment response. No abnormalities were noted in the results of a complete blood count and plasma biochemistry panel. Computed tomographic imaging of the parrot showed a left-sided uropygial gland mass with no evidence of metastasis or invasion into the underlying soft tissue or bone. The uropygial gland was surgically excised in an attempt to obtain clean margins devoid of tumor cells. Histopathological evaluation of the submitted tissue was suggestive of an intraluminal uropygial gland epithelioma. Intraluminal epithelioma should be considered as a differential diagnosis in psittacine species that are presented with an asymmetrically enlarged uropygial gland.

Intracoelomic Teratoma in an Eclectus Parrot (Eclectus roratus).

A 26-year-old, male eclectus parrot (Eclectus roratus) was presented to its primary care veterinarian for a 10-day history of increased respiratory effort, lethargy, and a single episode of regurgitation. Hepatomegaly, proventricular enlargement, cranial displacement of the ventriculus, and coelomic effusion were suspected based on a 1-view radiographic image, and the patient was referred for further evaluation. On presentation to the referral veterinary hospital, a distended coelom and dyspnea with abnormal respiratory sounds were abnormalities noted upon physical examination of the patient. The bird was hospitalized for supportive care, and diagnostic tests were performed. Initial radiographic images at the referral hospital revealed a large intracoelomic mass. A computed tomographic scan was performed; however, the origin of the mass could not be determined. A fine-needle aspirate and cytologic evaluation of the intracoelomic mass revealed a neoplastic process but no specific tissue type. Two days after presentation to the referral hospital, an exploratory coeliotomy to surgically resect the mass was attempted. The mass occupied most of the coelomic cavity, with multiple adhesions to internal organs. The mass was successfully resected; however, the patient destabilized and died despite resuscitation efforts. Histopathologic examination of submitted tissue from the mass with immunohistochemistry revealed mixed populations of neoplastic cells differentiated from 3 primordial germinal layers, confirming the diagnosis of teratoma. Teratomas appear to be a rare tumor in avian species but should be included in a list of differential disease diagnoses for abnormal tissue masses of unknown origin. Only 2 cases of teratomas have, to our knowledge, been reported in psittacine species.

DIFFUSIBLE IODINE-BASED CONTRAST-ENHANCED COMPUTED TOMOGRAPHY AS A NECROPSY AID: A CASE REPORT EVALUATING RESPIRATORY DISEASE IN MACROCEPHALON MALEO.

This study describes the novel use of diffusible iodine-based contrast-enhanced computed tomography (diceCT) as a digital necropsy aid. DiceCT was used postmortem to evaluate the cause of progressive respiratory disease in a juvenile maleo (Macrocephalon maleo). The technique facilitated soft-tissue contrast and a three-dimensional investigation of sinus and choanal anatomy as a means to identify normal and pathologic morphologies. Results showed right-sided narial occlusion by mucoid debris, along with left-sided choanal stenosis caused by osteomyelitis and reactive bone formation. The high spatial resolution afforded by diceCT enabled targeted histology and quantification of the clinical impact of pathologies, which contributed to an effective 60% loss in nasal airway aperture for this individual. This study demonstrates how adding diceCT to traditional necropsy can proffer additional understanding of an individual's pathology, and the resulting data can enhance research programs in vertebrate anatomy, evolution, and health.

Disseminated pancreatic adenocarcinoma in an eclectus parrot (Eclectus roratus).

CASE DESCRIPTION: A 15-year-old 0.412-kg (0.906-lb) sexually intact male eclectus parrot (Eclectus roratus) was evaluated because its owners found it lethargic and dyspneic at the bottom of its cage. CLINICAL FINDINGS: The parrot was thin and had generalized muscle wasting, diffuse feather loss, pale mucous membranes, and melena. The coelomic cavity was distended and soft on palpation, with coelomic effusion suspected. Results of a CBC indicated leukocytosis with left shift heterophilia, including toxic heterophils, lymphopenia, and anemia. Plasma biochemical analyses revealed severe hyperamylasemia. TREATMENT AND OUTCOME: Radiography revealed no evidence of a metallic foreign body but severe loss of coelomic detail, suggestive of a coelomic mass, coelomic effusion with coelomitis, or both. Ultrasonography and CT revealed severe accumulation of coelomic fluid; a large, heterogeneous, irregularly marginated, and moderately vascularized mass in the caudal aspect of the coelomic cavity; and multiple hepatic, coelomic, and pulmonary nodules. On the basis of a poor prognosis, the parrot was euthanized. Necropsy results confirmed exocrine pancreatic adenocarcinoma, with disseminated metastases in the liver, gastrointestinal tract, coelomic cavity, and lungs. CLINICAL RELEVANCE: In birds, pancreatic adenocarcinoma is rarely reported but should be considered a differential diagnosis for hyperamylasemia, coelomic mass, coelomic effusion, or abnormal gastrointestinal signs, alone or in combination. Ultrasonography and CT can be useful in further evaluating such patients and should be considered in the diagnostic plan.

Horner Syndrome With Ipsilateral Wing Paresis in a Wild, Juvenile Yellow-Tailed Black Cockatoo (Calyptorhynchus funereus).

A juvenile yellow-tailed black cockatoo (Calyptorhynchus funereus) was presented with paresis of the right wing, ptosis, and miosis of the right eye; feather erection of the right side of the head and neck; and a penetrating injury over the right pectoral muscle. Temporary reversal of ptosis, miosis, and feather erection after administration of phenylephrine drops confirmed a diagnosis of Horner syndrome. Computed tomographic imaging revealed a fractured rib, traumatic lung lesions, and subcutaneous emphysema. The right-sided Horner syndrome and wing paresis were attributed to a sympathetic nerve trauma of the eye and feathers and to the brachial plexus, respectively. This report describes the diagnosis and resolution of ptosis and miosis within 8 weeks and recovery of feather symmetry and wing function within 11 weeks of the cockatoo's initial presentation with a conservative-management treatment plan.

Removal of a Tracheal Myelolipoma in a Cockatiel (Nymphicus hollandicus) by Surgical Resection and Anastomosis.

A 17-year-old, female cockatiel (Nymphicus hollandicus) was presented for a 1-week history of respiratory distress. The clinical signs were consistent with tracheal obstruction; therefore, an air sac cannula was placed to reduce respiratory compromise. Radiographic images of the patient revealed a round, intraluminal, soft tissue opacity in the trachea. The obstruction could be visualized via transtracheal illumination, but tracheoscopy was not feasible because of the size of the patient. Attempts to manually extirpate the obstruction were unsuccessful, and the trachea subsequently avulsed in the midcervical region. Tracheal resection and anastomosis was performed, and the obstruction was removed with the associated tracheal ring. The patient recovered uneventfully and was doing well at follow-up evaluations at 9 days, 24 days, and 10 months after the surgical procedure. The histologic diagnosis was ossifying myelolipoma arising from bone marrow within the tracheal ring.

Imaging features of disseminated xanthogranulomatous inflammation in eclectus parrots (Eclectus roratus).

Xanthogranulomatous disease is a rare condition, which can be caused by infection, inflammation, hemorrhage, immunologic disease, or inherited lysosomal disorders. It is characterized by non-intracellular lipid and cholesterol deposits among an inflammatory infiltrate of vacuolated macrophages and giant cells. The diagnosis of xanthogranulomatous disease is challenging, with nonspecific imaging findings often misinterpreted as aggressive neoplastic processes in humans. In this retrospective case series study, we describe the diagnostic imaging characteristics of a disseminated xanthogranulomatous condition identified in five eclectus parrots (Eclectus roratus). Decreased serosal detail and celomic distension were present in all three birds radiographed, with multifocal variably sized celomic mineralization (3/3 birds), and extracelomic mineralized masses (1/3 birds). Celomic effusion with foci of celomic mineralization and hepatomegaly were identified in all birds (3/3) imaged with ultrasound. Finally, a mineralized mural ventricular mass was present in one of three patients imaged with CT, multifocal celomic mineralization with moderate to severe celomic effusion in two of three patients, diffuse severe proventricular and intestinal dilation in all three patients, and atherosclerosis of the major arterial trunks in all three patients. Veterinary radiologists should be aware of this inflammatory condition in birds, especially in eclectus parrots, and should be able to recognize the imaging features of xanthogranulomatous inflammation.

Osteofibrous Dysplasia in a Cockatiel (Nymphicus hollandicus).

Osteofibrous dysplasia is a rare and benign nonneoplastic condition of unknown etiology in humans and mammals. An adult female cockatiel (Nymphicus hollandicus) was presented with the following problems: a soft tissue mass on the left frontal area of the head that extended over the left eye, anorexia, lethargy, and emaciation. Computed tomographic imaging and ultrasonography revealed a soft tissue opacity in the left cranial area of the head with multifocal heterogeneous opacities and foci of mineralization. Cytological, histopathological, and immunohistochemistry examinations were performed on biopsy samples from tissue collected from the mass. Following surgical removal of the cranial mass the patient was treated with a nonsteroidal anti-inflammatory drug and antibiotic medication. The surgical site healed with no complications and through follow-up examinations there were no signs of reoccurrence of the abnormal tissue for 2 months. Through cytological and histopathological examination and immunohistochemistry testing of the submitted tissue, a diagnosis of osteofibrous dysplasia was determined.

Diagnostic value of plasma biochemistry, haematology, radiography and endoscopic visualisation for hepatic disease in psittacine birds.

BACKGROUND: Hepatic disease in psittacine birds is common but challenging to diagnose. This retrospective study evaluates the diagnostic value of plasma biochemistry, haematology, radiography and endoscopic visualisation in psittaciforms with suspected hepatic disease that underwent endoscopic liver biopsy. METHODS: Clinical records of 28 companion psittaciforms from a veterinary teaching hospital (2007-2016) were reviewed. Diagnostic results were categorised as abnormal or normal and compared with histopathology for agreement or disagreement. Statistical significance was determined by kappa test for agreement and McNemar's test for disagreement. RESULTS: 11 of 28 psittaciforms (39.3 per cent) had clinical signs considered specific for liver disease. 25 of 28 (89.3 per cent) psittaciforms had histopathological liver lesions. Gross changes radiographically and endoscopically agreed with histopathology in 57.1 per cent and 53.6 per cent of cases, respectively. Aspartate aminotransferase (AST) (48.1 per cent), creatine phosphokinase (73.1 per cent) and albumin by protein electrophoresis (50 per cent) showed the highest agreement. Kappa was not significant for any parameters, while McNemar's test for disagreement was significant for radiography, endoscopy, AST, lactate dehydrogenase, bile acid, total protein (chemistry), cholesterol, triglycerides, uric acid and glucose. CONCLUSION: Overall, changes on plasma biochemistry, radiography or endoscopy are non-specific and do not consistently agree with histopathology results. Endoscopic liver biopsy is highly recommended if there is clinical suspicion of hepatic disease.

Distraction Osteogenesis in Two Wild Raptors.

Distraction osteogenesis was used in 2 wild raptor patients for the repair of tibiotarsal fractures. The first case was a hatching year female peregrine falcon (Falco peregrinus) admitted with an open oblique right distal tibiotarsal fracture. The fracture was surgically managed with the external skeletal fixator intramedullary pin tie-in technique (ESF-IM pin tie-in). Appropriate healing of the fracture site occurred with the ESF-IM pin tie-in. However, there was significant pelvic limb shortening of the affected leg, and the bird consequently developed pododermatitis on the contralateral foot. The second case was an adult female great horned owl (Bubo virginianus) that was admitted with a closed, partially healed, overriding right tibiotarsal fracture. Because of the advanced stage of this fracture, which presented with a fibrous callus, and the already apparent pelvic limb shortening, the ESF-IM pin tie-in was not used. Both patients were fitted with a circular external skeletal fixator (CESF), and distraction osteogenesis was performed until the length of the pelvic limb was deemed anatomically adequate. It is critical that rehabilitated raptors be released without any physical conditions that may reduce their ability to survive and reproduce in the wild. Pelvic limb shortening can potentially predispose a raptor patient to pododermatitis, even with fatal consequences, in both captive and wild environments. The orthopedic technique used here proved useful to repair the limb shortening in both raptor cases, and each bird fully recovered and was released.

The use of a 3D-printed prosthesis in a Great Hornbill (Buceros bicornis) with squamous cell carcinoma of the casque.

The advent of new technologies in medical imaging and 3D printing in recent years has made customization of surgical tools and implants more accessible, revolutionizing many surgical fields. In many human diseases, these implants have led to superior surgical outcomes and greatly improved patients' quality of life. Thus, it is of great interest to apply these technologies to the treatment of animal diseases. In this study, we report the use of computed tomography (CT) and 3D printing for the treatment of a Great Hornbill at Jurong Bird Park that was diagnosed with squamous cell carcinoma of the casque. A 3D printed prosthesis that perfectly fitted the subject was implanted to replace its resected casque. The subject exhibited natural eating behaviour with no post-operative complications. Using this case as an example, the positive outcomes suggest a great potential in applying these technologies to the treatment of other wildlife diseases.

STANDING COMPUTED TOMOGRAPHY IN NONANESTHETIZED LITTLE PENGUINS (EUDYPTULA MINOR) TO ASSESS RESPIRATORY SYSTEM ANATOMY AND MONITOR DISEASE.

Multidetector computed tomography (MDCT) scans were performed in clinically healthy, nonanesthetized, standing little penguins (Eudyptula minor) to determine reference ranges for air-sac and lung volumes, as well as lung density. Five of 15 clinically healthy birds were diagnosed with pulmonary granulomas on initial MDCT scans. Granulomas were not readily apparent on radiographs, even in cases where the entire normal pulmonary parenchymal architecture was effaced on the MDCT scan. Serial MDCT scans after antifungal and antimycobacterial therapies demonstrated a response to treatment. MDCT scanning in nonanesthetized little penguins proved to be a well-tolerated, non-invasive imaging modality for respiratory diseases that are otherwise difficult to diagnose, including aspergillosis and mycobacteriosis.

Necrotizing Ventriculitis in Fledgling Chimney Swifts (Chaetura Pelagica) Associated With a Novel Adenovirus, Chimney Swift Adenovirus-1 (CsAdV-1).

Five chimney swift fledglings died following a progressive loss of appetite and condition while being cared for by an experienced wildlife rehabilitator. All animals had severe necrotizing and heterophilic ventriculitis, with myriad epithelial cells characterized by karyomegaly with intranuclear inclusion bodies. Transmission electron microscopy showed distention of epithelial cell nuclei and chromatin peripheralization by nonenveloped, icosahedral, 75- to 85-nm-diameter virions. Degenerate nested PCR for a highly conserved region of the adenovirus DNA polymerase gene was positive. BLAST analysis of the amplicon sequence indicated the presence of a novel adenovirus, with 74% homology to Antarctic penguin adenoviruses and 72% homology to a bat adenovirus, at low query coverages of only 65% and 63%, respectively. BLAST analysis of the predicted amino acid sequence generated the highest scores for squamate adenoviruses at 100% query coverage. Based on phylogenetic analysis of the partial amino acid sequence of the DNA polymerase, the chimney swift virus was a novel adenovirus most closely related to the Atadenovirus genus. Using a probe based on the novel viral sequence, DNA in situ hybridization identified viral nucleic acid in the nucleus. While the tentatively named chimney swift adenovirus-1 (CsAdV-1) is so far classified with the Atadenoviruses, it is relatively divergent from other members of that genus and may represent the first identified member of a new genus of Adenoviruses.

Multiple Infiltrative Intraosseous Lipomas in the Appendicular Skeleton of a Rose-breasted Cockatoo (Eolophus roseicapilla) with a Humeral Fracture.

A 9-year-old female rose-breasted cockatoo (Eolophus roseicapilla) was presented for a humeral fracture. At presentation, the bird was severely lethargic and obese. On physical examination, an open right humeral fracture, healed left ulnar fracture, and intertarsal joint swelling were present. Results of hematologic testing and biochemical analysis revealed severe leukocytosis with heterophilia and increased creatine kinase and aspartate aminotransferase activities consistent with musculoskeletal lesions. Radiographs confirmed a right humeral fracture and showed severe polyostotic lytic and expansile lesions of the appendicular skeleton, as well as an enlarged hepatic silhouette. Surgical repair of the fracture was attempted, but the bird died during the procedure. Postmortem examination revealed severe bone deformities involving the fractured humerus, both ulnas, and the left tibiotarsus. Histologic findings were consistent with multiple intraosseous lipomas of the long bones and severe hepatic lipidosis. To our knowledge, this is the first report of multiple intraosseous lipomas in a bird.

Erosive Enteritis and Intestinal Obstructions Caused by Decomposed Granite in a Flock of Lesser Flamingos (Phoeniconaias minor).

Decomposed granite is a material commonly used in zoos as a base for flamingo exhibits. In 2012, the artificial turf over the decomposed granite in the Fort Worth Zoo flamingo exhibit was removed and pressure washed, the granite was replaced, and the turf was then restretched in place. Approximately 8 months later, 3 lesser flamingos (Phoeniconaias minor) showed signs of lethargy and hematochezia. Results of physical examination revealed poor body condition in all birds, with variable hematologic abnormalities, including anemia, hypoproteinemia, and electrolyte disturbances. Radiographs of birds showed large amounts of radiopaque material in the ventriculus and dilated intestinal loops. Two birds died either during treatment or surgery, and 1 bird was euthanatized. Postmortem examination of all 3 birds revealed large amounts of fine, granite-like material in the ventriculus and intestines, severe congestion of intestinal mucosa, and obstruction of intestinal lumen by caseous plugs surrounded by fecal material. Microscopic evaluation of the material removed from the ventriculus showed birefringent crystals that corresponded to microscopic silica grains, consistent with the decomposed granite from the exhibit. Histologic examination of tissues showed marked chronic erosive colitis, mild erosive proventriculitis, and lesions in the muscular layer of the ventriculus. Subsequently, 82 remaining flamingos in the flock were radiographed. Results showed the same material in the ventriculus of most birds, but no intestinal obstructions were identified. Different treatment techniques were attempted unsuccessfully to remove the material from the flamingos that had the largest amount of decomposed granite in their gastrointestinal tracts. Ultimately, all birds were treated with oral gastrointestinal protectants, adsorbents, laxatives, and lubricants, along with antibiotics administered in drinking water. No further mortalities occurred once medical treatments were implemented.