Surgical Repair of Psittacine Femorotibial Luxation: A Case Series.

Luxation of the psittacine femorotibial joint most commonly occurs following trauma or as a development abnormality. Historically, this injury is considered to have a poor prognosis in birds; however, surgical management may result in acceptable and functional outcomes. This case series describes the surgical techniques, complications, and outcomes of 7 cases of femorotibial luxation in psittacine birds. Of the 7 cases, 6 were chronic injuries. Surgical repair methods included conjoined intramedullary pinning, transarticular pinning with an external skeletal fixator (ESF), a combination of extracapsular stabilization and ESF, ESF alone, and a combination of conjoined intramedullary pins with an ESF. An acceptable outcome was achieved in 75% (6/8) of luxated femorotibial joints managed with surgical methods. All cases were female birds of various species, suggesting a possible sex predisposition for stifle luxation.

Treatment of Recurrent Multifocal Cutaneous Squamous Cell Carcinoma in an African Grey Parrot (Psittacus erithacus) with Intralesional Carboplatin in Poloxamer 407.

A 16-year-old male Congo African grey parrot (Psittacus erithacus) was presented with an ulcerated wing mass that was excised and diagnosed on histopathology as squamous cell carcinoma (SCC). A second surgery was performed to completely excise the tumor margins, resulting in over 5 years of remission for the neoplasm. However, over the next 6 years the patient developed SCC in 3 new locations on the body, as well as 2 squamous papillomas. The 2 papillomas were surgically excised and did not recur. Due to their size and location, none of the 3 new SCCs were amenable to complete excision. Instead, the 3 SCCs were managed with a series of treatments with intralesional carboplatin in poloxamer 407 and carbon dioxide surgical laser debridements. This treatment regimen has resulted in long-term (52 months, 30 months, and 17 months) resolution for all 3 of the SCCs. The overall survival time for the patient, from the initial diagnosis to the time of this report, is over 2900 days. While being treated for the 3 SCCs, the African grey parrot had no overt signs of complications or adverse side effects.

Liposarcoma of Probable Medullary Bone Origin in a Lovebird (Agapornis roseicollis).

A 15-year-old female peach-faced lovebird (Agapornis roseicollis) was presented to the hospital for a possible left wing injury and an inability to fly after falling in its cage. On physical examination the left elbow was swollen and painful. Radiographic images revealed left wing soft tissue swelling surrounding the elbow and lysis of the distal humerus with extensive cortical thinning. Subsequent high-definition volumetric-imaging 3-dimensional computed tomography (HDVI 3D CT) revealed a pathological fracture, cortical lysis, periosteal reaction, and abnormal intraosseous soft tissue of the left humerus with associated soft tissue swelling, suggestive of neoplasia. No evidence of metastatic disease was identified. Surgical amputation of the left wing was elected. A liposarcoma and pathologic fracture of the humerus were diagnosed histologically and by oil red O staining for lipids in the neoplastic cells. The morphologic features of the tumor suggested that it developed within the adipocyte component of the medullary bone. The incision at the amputation site healed without complication. A follow-up HDVI 3D CT performed 4 months postsurgery showed no evidence of metastatic disease. To the authors' knowledge, this is the first report of a primary liposarcoma of medullary bone origin in an avian species.

Outcomes of Birds of Prey with Surgical or Traumatic Wing Amputation: A Retrospective Study from 1995 to 2017.

Surgical amputation of a limb is often required to treat raptor orthopedic injuries at rehabilitation centers. In some cases, amputation is an alternative to euthanasia if the bird's welfare is deemed appropriate under human care. The outcome for raptors maintained in a captive setting following wing amputation is poorly documented. A retrospective study was conducted in a Canadian raptor rehabilitation facility to assess the outcomes and complications observed in captive and free-living raptors with partial or complete, surgical or traumatic amputations of the wing. Data from raptors admitted to the rehabilitation center from 1995 to 2017 were reviewed. Overall, 32 records were included in this retrospective study from 11 species of raptors with surgical or traumatic wing amputations. Survival times of the 23 birds with an amputated wing (median: 1070 days, range: 68 days to 13 years and 1 month) were significantly (P = .02) longer than the survival times of the 404 non-amputated birds (median: 696 days, range 37 days to 27 years and 3 months). Complications occurred in 13 of 30 birds (43%) during the recovery period, with 9 of 30 (30%) birds developing life-threatening complications. Maladaptation to captivity was the leading cause of euthanasia during this period. After placement in captivity, 3/23 (13%) birds developed complications related to the amputation site. Based on this study, we conclude that some birds can tolerate partial or complete wing amputation, but the decision to place a bird in a captive setting should encompass the bird's ability to cope with human interaction and the availability of an adapted and safe enclosure for the animal.

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.

Salivary Gland Adenoma in a North Island Brown Kiwi (Apteryx mantelli).

A 7-month-old male North Island brown kiwi (Apteryx mantelli) was transferred from a European zoological park to a North American private aviary. The bird appeared clinically normal upon arrival, but within 30 days, it developed clinical disease signs of sneezing, stridor, and increased respiratory effort. Upon examination a 1-mm yellow plaque was identified on the glottis. After 14 days of empiric treatment with enrofloxacin, meloxicam, and itraconazole, on repeat examination, the glottal plaque had increased in size to a 7-mm-diameter friable mass attached to the right laryngeal cartilage and was partially obstructing the airway. Initially, 80% of the mass was manually dislodged, but within 4 days the tissue mass had again enlarged to approximately 3 mm × 4 mm × 4 mm, prompting surgical excision. On histopathologic examination, the mass was identified as a benign salivary gland adenoma without clear margins. Approximately 3 years postexcision, there is no evidence of tumor regrowth. The successful excision of a benign salivary tumor described in this report will serve as a valuable guide for future cases of similar neoplasms diagnosed in the oral cavity of kiwis and other avian species.

Iridociliary adenoma in a greater sulfur-crested cockatoo (Cacatua galerita galerita).

A 34-year-old female greater sulfur-crested cockatoo (Cacatua galerita galerita) was referred for suspected left globe rupture. Ophthalmic examination revealed effacement of the anterior chamber and cornea by a large mass. The left eye was enucleated due to suspicion of globe rupture, secondary to a neoplastic process or chronic trauma. Histopathological examination revealed complete effacement of the internal ocular structures by a neoplasm morphologically consistent with an iridociliary adenoma. The diagnosis was confirmed by Periodic acid-Schiff histochemistry and immunohistochemistry for S100, Melan-A/PNL2, and vimentin antigens. The cockatoo recovered well from surgery, with appropriate healing of the enucleation site, and no evidence of recurrence at 1-year follow-up. Key clinical message: To the authors' knowledge, this is the first report of iridociliary adenoma in a greater sulfur-crested cockatoo, and the third report of such a neoplasm in a psittacine species with a description of the use of immunohistochemistry to confirm a diagnosis of a rare tumor in a bird species.

Adénome iridociliaire chez un cacatoès à crête de soufre (Cacatua galerita galerita) . Une femelle cacatoès à crête de soufre (Cacatua galerita galerita) âgée de 34 ans a été référée pour suspicion de rupture du globe oculaire gauche. L'examen ophtalmique a révélé un effacement de la chambre antérieure et de la cornée par une masse importante. L'oeil gauche fut énucléé en raison d'une suspicion de rupture du globe oculaire, secondaire à un processus néoplasique ou à un traumatisme chronique. L'examen histopathologique a révélé un effacement complet des structures oculaires internes par un néoplasme morphologiquement compatible avec un adénome iridociliaire. Le diagnostic a été confirmé par histochimie avec coloration PAS (Periodic acid-Schiff ) et immunohistochimie pour les antigènes S100, Melan-A/PNL2 et vimentine. Le cacatoès s'est bien rétabli de la chirurgie, avec une guérison appropriée du site d'énucléation, et aucun signe de récidive à 1 an de suivi.Message clinique clé :À la connaissance des auteurs, il s'agit du premier rapport d'adénome iridociliaire chez un grand cacatoès à crête de soufre et du troisième rapport d'un tel néoplasme chez une espèce psittacidé avec une description de l'utilisation de l'immunohistochimie pour confirmer le diagnostic d'une tumeur rare chez une espèce d'oiseau.(Traduit par Dr Serge Messier).

Self-limiting Orbital Emphysema Following Ocular Evisceration and Demonstration of Nasolacrimal-Oropharyngeal Communication in a South African Ostrich (Struthio camelus australis).

A 25-year-old, male, sanctuary-owned, South African ostrich (Struthio camelus australis) was evaluated for orbital emphysema after evisceration of a nonvisual and chronically irritated eye. On initial ophthalmic examination, the ostrich's left eye displayed severe corneal fibrosis, broad anterior synechia, and a shallow anterior chamber, all suggestive of a previous corneal perforation. Conjunctival hyperemia and eyelid crusts were also present, reportedly associated with chronic rubbing. Evisceration of the left eye was performed by excising the eyelid margins, conjunctiva, nictitans, cornea, and intraocular contents. Four weeks postoperatively, a nonpainful, fluctuant swelling of the surgical site was noted. Trocarization of the surgical site verified orbital emphysema and served to temporarily decompress the orbit. Orbital emphysema reoccurred within 48 hours but gradually regressed without intervention over the subsequent 9 months. A Jones test was performed in the healthy, right eye and demonstrated clear communication to the oropharynx. To our knowledge, this is the first reported case of an evisceration performed on an ostrich and the first reported case of orbital emphysema in any avian species. It is probable that the emphysema noted in this case was secondary to nasolacrimal duct-oropharynx communication.

Asymmetrical Cloacoplasty for the Treatment of Chronic Cloacal Prolapse in Psittaciformes: A Case Series.

Chronic cloacal prolapse is a common condition in psittacine birds, particularly in cockatoos and African grey parrots (Psittacus erithacus). Techniques to permanently reduce the prolapse have been developed and include cloacal sutures, percutaneous cloacopexy, and open circumcostal or rib cloacopexy. Several complications, some of which are life-threatening, have been reported with these tissue reduction techniques. Cloacoplasty surgeries have also been advocated, but most often as an adjunct therapy. Recurrence of cloacal prolapse may occur in traditional symmetrical cloacoplasty techniques since straining pressure remains. In this case series, 5 psittacine birds (2 male and 2 female umbrella cockatoos [Cacatua alba] and 1 male African grey parrot) with chronic recurrent cloacal prolapses were treated with a novel asymmetrical cloacoplasty technique. A semicircular excision at the mucocutaneous junction from the right side with a 2-layer closure reduced the cloacal opening by 50%-75%. A tension-relieving suture was applied to aid in healing of the incision. All 5 cases had successful outcomes with no recurrent prolapses (6 months to 3 years of follow-up), except for 1 case, due to incisional dehiscence. This animal underwent a second surgical procedure that incorporated the tension-relieving suture and has not had a recurrent prolapse in over a year. This asymmetrical cloacoplasty technique provides a simple but effective method of cloacal prolapse treatment and prevention in cases of recurrent and chronic cloacal prolapses, and creates a midline physical barrier not present in symmetrical cloacoplasties. Long-term complications may include cloacolith formation or dystocia in females, and therefore reproductive management of female birds is required.

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.

Modified Tail Amputation Technique in a Blue and Gold Macaw (Ara ararauna) With Uropygial Gland Adenocarcinoma.

A 33-year-old male blue and gold macaw (Ara ararauna) presented with a 5-month history of an ulcerated lesion and feather loss at the tail base. Two 4-mm biopsies obtained by the primary care veterinarian were consistent with uropygial gland adenocarcinoma. The bird was examined at the Veterinary Medical Teaching Hospital, University of California, and on physical evaluation, the dorsal and ventral surface of the tail base were devoid of feathers, ulcerated and crusted without an identifiable uropygial gland. Complete blood count, plasma biochemistry panel, whole-body radiographs, and an echocardiogram were performed before surgery. The bird was anesthetized, and a complete amputation of the tail was performed. The skin was incised with a radiofrequency electrosurgical system approximately 2 mm circumferentially cranial to the diseased tissue. The musculature was transected to the level of the vertebral column, disarticulating between the second and third caudal vertebrae and transecting the spinal cord with a no. 15 blade. Lateral vertebral processes of the second vertebra were removed with a rongeur. Coccygeus lateralis muscles and tensor fasciae latae muscles and skin were closed laterolaterally with 2 layers and 3-0 polydioxanone suture. The bird recovered uneventfully and was discharged after 6 days of hospitalization. The histopathological diagnosis was adenocarcinoma with squamous differentiation, marked scirrhous response, and superficial epithelial ulceration. It was determined that narrow margins of unaffected tissue were achieved from the pathological examination of submitted material. The bird was evaluated 24 days after surgery and again 3.5 months after surgery, without evidence of complications or recurrence. Approximately 10 days after the last reexamination, the bird was euthanatized after being found minimally responsive at home. A postmortem examination was not performed.

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.

Management of corneal epithelial defects in a population of mature chuck-will's-widows (Antrostomus carolinensis) in South Florida.

PURPOSE: To describe ocular clinical findings, gross/histopathologic findings, and treatment regimens in a series of migratory chuck-will's-widows (Antrostomus carolinensis) (CWW) with corneal epithelial defects. METHODS: Seven CWW were presented to the South Florida Wildlife Center (SFWC). Four presented with bilateral (OU) corneal ulceration; two developed corneal ulceration OU; one had no ocular lesions. Treatment protocols for patients with corneal ulcers included the following: medical therapy only or medical therapy combined with an additional procedure. Four patients including the bird with no ocular lesions were euthanized, and one patient died. Their globes were submitted for histopathology. Two patients were released. RESULTS: Clinical findings prior to enucleation included superficial corneal ulceration with redundant epithelium persisting weeks to >1 month. On histopathology, epithelium in nonulcerated globes was remarkably thin; this was considered normal. Common histopathologic findings of ulcerated globes revealed epithelial and conjunctival attenuation with an acellular superficial stromal layer and hypercellular mid-stromal layer. One globe healed with medical therapy and cotton tip applicator debridement. Four globes healed by combination of medical therapy, equine amnion, nictitating membrane (NM) flap, and temporary tarsorrhaphy. No globes healed with diamond burr debridement or grid keratotomy. CONCLUSIONS: Factors that may be contributing to these corneal epithelial defects include, but are not limited to, normally thin epithelium, exposure keratopathy, neurotrophic disease, epithelial turnover and inadequate stem cell recruitment, inherited/genetic causes, and unidentified infectious agents (eg, viral etiologies). Of the 12 eyes treated, one healed with medical therapy/cotton tip applicator debridement, and four healed with medical therapy/equine amnion/nictitating membrane flap/temporary tarsorrhaphy.

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.

Rectricectomy With Pygostylectomy for Resolution of Feather Trauma in an Umbrella Cockatoo (Cacatua alba).

Feather trauma is a common problem among pet birds, especially those with trimmed wing feathers, and often affects remiges and rectrices. Damage can become chronic if new feathers remain unprotected by fully formed adjacent feathers. The follicles can become damaged and poorly functional over time. A 6-month-old male umbrella cockatoo (Cacatua alba) was presented for examination because of feather damage that occurred shortly after receiving a wing trim by the owner. Over the next 18 months, various medical, behavioral, and husbandry methods failed to allow normal regrowth of the tail feathers. The bird presented 25 times over the 18-month period for problems associated with broken blood feathers in the tail. Feather imping was ruled out because of the lack of hollow adult shafts to serve as a base. Diagnostic tests included hematologic testing and biochemical analysis, circovirus testing, feather biopsy, and radiographs, results of which were unremarkable. Because of the chronic pain associated with the frequent rectrix damage, a complete rectricectomy was performed. All of the rectrical follicles as well as the pygostyle were surgically removed. Healing was uneventful and the bird has been clinically normal with no further blood feather injury for 24 months after surgery.

Recurrent Subcutaneous Teratoma in an Adult Red-crowned Amazon Parrot (Amazona viridigenalis).

An approximately 42-year-old, wild-caught, red-crowned Amazon parrot (Amazona viridigenalis) was evaluated for a subcutaneous mass to the right of the keel. Cytologic examination of a fine needle aspirate of the mass were suggestive of granulomatous inflammation. The mass was surgically excised, and the parrot was treated with oral nonsteroidal anti-inflammatory drugs. Histologically, the mass was diagnosed as a teratoma with stratified squamous epithelial and neuroectodermal components. Tumor cells extended to surgical margins. Two years later, the neoplasm recurred, with regrowth of only the neuroectodermal component. The neoplasm was again removed surgically, but it recurred again 14 months later, necessitating a third surgery. Histopathologic examination confirmed recurrence of the original neoplasm in both instances, with incomplete margins on both excisions.

Long-term outcome of phacoemulsification in raptors-A retrospective study (1999-2014).

OBJECTIVE: To determine long-term outcome of phacoemulsification in raptors at the University of Tennessee Veterinary Medical Center. ANIMALS STUDIED: Seven nonreleasable diurnal raptors including, four bald eagles (Haliaeetus leucocephalus), two red-tailed hawks (Buteo jamaicensis), and one peregrine falcon (Falco peregrinus) that had undergone phacoemulsification. All birds showed behavioral changes attributable to visual deficits prior to surgery. PROCEDURES: All birds underwent phacoemulsification for cataracts. Four underwent bilateral phacoemulsification, and three had unilateral surgery. Due to a low sample size, statistics were not done. RESULTS: Six raptors (nine eyes) had long-term follow-up (median 75 months, range 28 to 105 months). Seven of these eyes (78%) were visual at last examination. Of those visual eyes, two developed mild to moderate posterior synechiae, four had mild to moderate capsular opacities, and one developed a lipid keratopathy. The remaining two eyes with long-term follow-up were from the same red-tailed hawk. Both eyes developed fibropupillary membranes that were blinding. One eye was pseudophakic, and the other was aphakic and also developed a rhegmatogenous retinal detachment. Another bald eagle was euthanized two months after surgery due to refractory glaucoma; one eye was pseudophakic. CONCLUSIONS: Phacoemulsification is a viable treatment for captive raptors with cataracts. The most severe complications occurred relatively soon after surgery. Captive raptors appear to adapt well to aphakia.