Agreement between invasive and oscillometric arterial blood pressure measurement using a high-definition oscillometric device in normotensive New Zealand White rabbits using two different anaesthetic protocols.

OBJECTIVE: To use American College of Veterinary Internal Medicine (ACVIM) criteria to evaluate a high-definition oscillometric (HDO) blood pressure monitoring device versus invasive blood pressure (IBP) measurement in normotensive rabbits anaesthetized with two different anaesthetic protocols. STUDY DESIGN: Prospective experimental study. ANIMALS: A group of 20 healthy adult New Zealand White rabbits weighing 4.36 ± 0.37 kg (mean ± standard deviation). MATERIALS AND METHODS: Rabbits were premedicated with butorphanol 0.5 mg kg-1 and midazolam 0.5 mg kg-1 subcutaneously (SC, group BMA) or ketamine 25 mg kg-1 and medetomidine 0.4 mg kg-1 SC (group KM). Anaesthesia was induced with alfaxalone administered intravenously (group BMA) or isoflurane by face mask (group KM) and maintained with isoflurane in oxygen. IBP was measured from the central auricular artery. The cuff for the HDO monitor was placed distal to the left elbow and distal to the left tarsus. Agreement between invasive and HDO measurements was evaluated using Bland-Altman method. RESULTS: In group KM there was better agreement between the HDO device and IBP when the cuff was placed on the thoracic limb, with 100% and 91% of the readings for mean (MAP) and diastolic arterial pressure (DAP), respectively, within 10 mmHg of the IBP measurements. The agreement, although worse, also met the ACVIM criteria for systolic arterial pressure (SAP; 53% of the readings within 10 mmHg). In group BMA, the device met the criteria with the cuff on the thoracic limb only, and only for MAP and DAP (73% and 75% of the measurements within 10 mmHg of the IBP, respectively) but not for SAP (12%). CONCLUSION AND CLINICAL RELEVANCE: The HDO device met most of the ACVIM criteria for noninvasive blood pressure measurement in anaesthetized rabbits, specifically when the cuff was placed distal to the elbow and the anaesthetic protocol included ketamine and medetomidine.

Distichiasis in a ferret (Mustela putorius furo).

A 4-year-old intact male ferret was presented to the Ophthalmology Service of the Department of Clinical Sciences of Companion Animals of Utrecht University with chronic blepharospasm, epiphora, and conjunctivitis of the right eye. Examination of the eye revealed mild conjunctivitis and three hairs protruding from the openings of meibomian glands in the upper eyelid, providing the clinical diagnosis of distichiasis. The distichia were removed by transconjunctival unipolar electrocautery. Recovery was uneventful, but the original signs recurred 10 weeks after surgery. Ophthalmic examination revealed another distichia at a different location in the same eyelid and it was removed by full-thickness wedge excision. Histopathological examination failed to reveal the exact origin of the distichia. To our knowledge, this is the first reported case of distichiasis in a ferret.

Incisional colopexy for treatment of chronic, recurrent colocloacal prolapse in a sulphur-crested cockatoo (Cacatua galerita).

OBJECTIVE: To report a surgical technique for treatment of chronic, recurrent cloacal prolapse in a sulphur-crested cockatoo (Cacatua galerita). STUDY DESIGN: Clinical report ANIMALS: Sulphur-crested cockatoo (n = 1) METHODS: The bird was admitted with a 2-year history of periodic lethargy, decreased appetite, dyschezia, tenesmus, and colocloacal prolapse. An incisional colopexy was performed under general anesthesia to permanently reduce the colocloacal prolapse. To gain access to the coelomic cavity, a ventral U-shaped incision was made, after which the colon and cloaca were restored in their normal anatomic position. Subsequently, the distal colon was sutured to the left abdominal wall. RESULTS: Colocloacal prolapse was successfully reduced. One month later, cloacoplasty was performed to reduce cloacal width. Long-term follow-up, including a barium contrast study, revealed normal function and an intact colopexy, without recurrence of the prolapse. CONCLUSIONS: Incisional colopexy is feasible despite a bird's relative small body size.

Intervertebral disk disease in 3 striped skunks (Mephitis mephitis).

OBJECTIVE: To describe diagnostic findings, surgical technique, and outcome in 3 striped skunks (Mephitis mephitis) with a history of paraparesis. STUDY DESIGN: Case series. ANIMALS: Skunks (n = 3) with paraparesis. METHODS: Neurologic examination revealed upper motor neuron disease (T2-L2) in 2 skunks and lower motor neuron disease (L3-S3) in 1 skunk. Diagnostic imaging included radiography, myelography, CT, and MRI and confirmed intervertebral disk herniation (IVDH) in each skunk. Because initial treatment with pain medication and cage rest did not result in lasting improvement, spinal surgery was performed. RESULTS: Hemilaminectomy (2 skunks) and dorsal laminectomy (1 skunk) was performed with removal of extruded disk material. The skunks improved after surgery but all had minor residual neurologic deficits when examined at various times postoperatively. CONCLUSION: Thoracolumbar intervertebral disk herniation occurs in skunks, and must be included in the differential diagnosis of paraparesis.

Contrafreeloading Indicating the Behavioural Need to Forage in Healthy and Feather Damaging Grey Parrots.

Contrafreeloading (CFL) is a concept that describes the preference of an animal to work for food even when identical food is freely available, and reflects an intrinsic motivation to engage in foraging-related activities. However, altered brain neurochemistry, which can be induced by chronic exposure to a suboptimal living environment, may affect this intrinsic motivation in animals with abnormal repetitive behaviours (ARBs), including parrots with feather damaging behaviour. To determine whether this was the case, we evaluated CFL activity in healthy (n = 11) and feather damaging (n = 10) Grey parrots (Psittacus erithacus) by offering them a free choice to obtain identical food from a food bowl or from a foraging device. Differences in CFL activity were observed, with feather damaging Grey parrots displaying less CFL (as indicated by shorter foraging times and lower amounts of food consumed from the foraging devices) compared to healthy conspecifics, indicating altered 'motivation' and time allocation, for which the underlying mechanism needs to be clarified further. Nevertheless, despite the variable level, all birds displayed CFL, which, together with a seemingly positive correlation between CFL activity and the plumage condition of the birds, suggests that parrots are intrinsically motivated to forage and highlights the importance of providing foraging opportunities to captive parrots.

Ferret Dermatology.

Skin diseases commonly affect pet ferrets, with neoplastic, endocrine, and parasitic diseases being the most common. This review includes clinical presentation, diagnostic workup, and treatment of diseases with a dermatologic presentation in ferrets.

Eosinophilic keratoconjunctivitis in two rabbits.

The purpose of this case report is to describe the clinical course and cytologic findings, treatment, and outcome of eosinophilic keratoconjunctivitis in two rabbits. Ophthalmic examination revealed ocular discharge, dacryocystitis, blepharitis, conjunctivitis, white conjunctival and corneal plaques, corneal vascularization, and stromal infiltration with different degrees of severity in each case. In case 2 there was also ulcerative disease of the cornea. Computerized tomography scan of the head, corneal biopsy for histopathologic examination with additional Luna and Giemsa stain were performed in case 2 and conjunctival as well as corneal specimens were obtained for bacteriologic culture and cytologic examination in case 1. Based on test results, a diagnosis of eosinophilic keratoconjunctivitis was made in case 2 and a tentative diagnosis of eosinophilic keratoconjunctivitis was made in case 1. Response to treatment with a topical steroid and topical cyclosporin was supportive of the diagnosis in both cases and shared many similarities with the response to treatment previously described in cats. Eosinophilic keratitis should be considered as part of a differential diagnosis list in rabbits with a history of keratitis.

Ferret Cardiology.

Cardiac disease is relatively common in middle-aged to older ferrets and may comprise acquired or congenital disorders leading to problems with conduction, contractility, or outflow. Clinical signs are often seen in advanced stages of the disease, with lethargy, hind limb weakness, ascites, hepatosplenomegaly, and respiratory distress owing to pleural effusion or lung edema being prominent features. Diagnostic workup and therapeutic intervention largely follow guidelines such as those established for dogs and cats, with feline doses often serving as a starting point for therapy.

Gonadotrophin-Releasing Hormone Agonists and Other Contraceptive Medications in Exotic Companion Animals.

The use of a gonadotrophin-releasing hormone agonist slow-release implant (GnRH A-SRI) has become increasingly popular as an alternative for surgical contraception in many species. Although these implants have proven to be very effective in some species (eg, ferrets, rats, chicken, psittacines, and iguanas), they have been found less effective in other species (eg, male guinea pigs and rabbits, veiled chameleons, slider turtles, and leopard geckos). This review provides an overview of the available literature on the effects of GnRH A-SRIs in companion exotic animals.

Giant cell tumor of the bone in a scarlet macaw (Ara macao).

A 6-mo-old female scarlet macaw (Ara macao) was presented after a 2-mo period of anorexia and weakness. The bird was reluctant to fly 1 wk before referral due to a painful left wing. Physical examination revealed a firm swelling around the left shoulder. On radiographs, the diaphysis and proximal metaphysis of the left scapula were radiolucent. Computer tomography revealed an osteolytic process, suggestive of a bone tumor, affecting the left scapula. Cytology of a fine needle aspiration biopsy of the mass showed erythrocytes, a proliferation of spindle-shaped mesenchymal cells, and multinucleated giant cells (osteoclasts) suggestive of a giant cell tumor. The left wing, including the scapula, was amputated. The bird showed a fast recovery but died 1 hr later. Findings during the pathological examination were compatible with shock due to blood loss. The shoulder process was characterized as a giant cell tumor. To our knowledge, this is the first complete report of a giant cell tumor of the bone in a bird.

Chronic pulmonary interstitial fibrosis in a blue-fronted Amazon parrot (Amazona aestiva aestiva).

A 30-yr-old blue-fronted Amazon parrot (Amazon aestiva aestiva) was presented to the clinic with a history of sneezing more often during the last 2 mo. Physical examination revealed only a mild nasal discharge. Complete hematologic and plasma biochemical examination showed no abnormalities. Computerized tomography (CT) of the complete bird showed generalized lung alterations consistent with lung fibrosis. Two lung biopsies were taken. The results of the histologic examination of the biopsies confirmed the tentative CT diagnosis of pulmonary interstitial fibrosis. To our knowledge this is the first reported case of chronic pulmonary interstitial fibrosis diagnosed by means of a lung biopsy in an avian species. The histologic characteristics are discussed and compared with those of human idiopathic pulmonary fibrosis.

Ultrasonographic visualization of the adrenal glands of healthy ferrets and ferrets with hyperadrenocorticism.

A protocol was developed to compare the ultrasonographic characteristics of the adrenal glands of 21 healthy ferrets and 37 ferrets with hyperadrenocorticism. By using specific landmarks, the adrenal glands were imaged in 97% of the cases. The adrenal glands of ferrets with hyperadrenocorticism had a significantly increased thickness, with changes in shape, structure, and echogenicity compared to the adrenal glands of healthy ferrets. Based on the findings of the study, adrenal glands may be classified as abnormal when they have a rounded appearance, increased size of the cranial/caudal pole (thickness >3.9 mm), a heterogeneous structure, increased echogenicity, and/or signs of mineralization.

Ferret Oncology: Diseases, Diagnostics, and Therapeutics.

Neoplastic disease is common in ferrets. Approximately half of all tumors diagnosed in ferrets are located in the endocrine or hemolymphatic system. Many factors may influence the choice of treatment. Medical management of adrenal tumors has a greater disease-free period compared to adrenalectomy. In ferrets with an insulinoma, no difference is seen in the mean survival time of medically and surgically treated patients. Aside from medical and surgical treatment modalities, chemotherapy and radiation therapy have also been described in ferrets in other types of tumors. The outcome of these treatment modalities is not always favorable.

The composition and initial evaluation of a grimace scale in ferrets after surgical implantation of a telemetry probe.

Reliable recognition of pain is difficult in ferrets as many currently available parameters are non-specific, inconsistent and/or impractical. Grimace scales have successfully been applied to assess pain in different animal species and might also be applicable to ferrets. To compose a Ferret Grimace Scale (FGS), we studied the facial musculature of ferrets and compared lateral photographs of 19 ferret faces at six time points before and after intraperitoneal telemetry probe implantation. We identified the Action Units (AUs) orbital tightening, nose bulging, cheek bulging, ear changes and whisker retraction as potential indicators of pain in ferrets. To evaluate whether these AUs could reliably be used to identify photographs taken before and after surgery, the photographs were scored 0, 1 or 2 (not, moderately or obviously present) by 11 observers that were blinded to the treatment and timing of the photographs. All AU-scores assigned to the photographs taken five hours after surgery were significantly higher compared to their time-matched baseline scores. Further analysis using the weights that were obtained using a Linear Discriminant Analysis revealed that scoring orbital tightening alone was sufficient to make this distinction with high sensitivity, specificity and accuracy. Including weighted scores for nose bulging, cheek bulging and ear change did not change this. As these AUs had more missing values than orbital tightening, their descriptions should be re-evaluated. Including whisker retraction, which had a negative weight, resulted in lower accuracy and should therefore in its current form be left out of the FGS. Overall, the results of this study suggest that the FGS and the AU orbital tightening in particular could be useful in a multifactorial pain assessment protocol for ferrets. However, before applying the FGS in practice, it should be further validated by incorporating more time points before and after applying (different) painful stimuli, and different levels of analgesia.

Hypercalcemia in two Amazon parrots with malignant lymphoma.

Malignant lymphoma is a common malignancy in birds. Paraneoplastic syndromes, which are commonly observed in domestic animals, have not been reported in association with lymphoma in birds. Hypercalcemia and hyperglobulinemia were found on plasma chemistry in two Amazon parrots, which were presented with aspecific symptoms. In both cases radiography and ultrasound demonstrated signs of hepatomegaly, which proved to be due to malignant lymphoma on postmortem examination. The hypercalcemia was found to be most consistent with a paraneoplastic effect of the malignant lymphoma in these birds. The exact origin of the hyperglobulinemia remains unclear.

I plasma concentrations of adrenocorticotrophic hormone and alpha-melanocyte-stimulating hormone in ferrets (Mustela putorius furo) with hyperadrenocorticism.

OBJECTIVE: To determine plasma concentrations of adrenocorticotrophic hormone (ACTH) and alpha-melanocyte stimulating-hormone (alpha-MSH) in healthy ferrets and ferrets with hyperadrenocorticism. ANIMALS: 16 healthy, neutered, privately owned ferrets, 28 healthy laboratory ferrets (21 sexually intact and 7 neutered), and 28 ferrets with hyperadrenocorticism. PROCEDURES: Healthy ferrets were used for determination of reference plasma concentrations of ACTH and a-MSH. Diagnosis of hyperadrenocorticism was made on the basis of history, clinical signs, urinary corticoid-to-creatinine ratios, ultrasonography of the adrenal glands, and macroscopic or microscopic evaluation of the adrenal glands. Blood samples were collected during isoflurane anesthesia. Plasma concentrations of ACTH and alpha-MSH were measured by radioimmunoassay. RESULTS: Plasma concentrations of ACTH in 23 healthy neutered ferrets during the breeding season ranged from 4 to 145 ng/L (median, 50 ng/L). Plasma concentrations of alpha-MSH in 44 healthy neutered or sexually intact ferrets during the breeding season ranged from < 5 to 617 ng/L (median, 37 ng/L). Reference values (the central 95% of the values) for ACTH and alpha-MSH were 13 to 100 ng/L and 8 to 180 ng/L, respectively. Plasma concentrations of ACTH and alpha-MSH in ferrets with hyperadrenocorticism ranged from 1 to 265 ng/L (median, 45 ng/L) and 10 to 148 ng/L (median, 46 ng/L), respectively. These values were not significantly different from those of healthy ferrets. Plasma ACTH concentrations of sexually intact female ferrets in estrus were significantly higher than those of neutered females. CONCLUSIONS AND CLINICAL RELEVANCE: Ferrets with hyperadrenocorticism did not have detectable abnormalities in plasma concentrations of ACTH or alpha-MSH. The findings suggest that hyperadrenocorticism in ferrets is an ACTH and alpha-MSH-independent condition.

Expression of sfrp1 and activation of the Wnt pathway in the adrenal glands of healthy ferrets and neutered ferrets with hyperadrenocorticism.

Gonadectomy induces the pathogenesis of luteinising hormone receptor positive, androgen and oestrogen producing tumours in the adrenal cortex of ferrets. In mice, the castration-dependent appearance of adrenocortical tumours has been attributed to loss of expression of the tumour suppressor gene Secreted Frizzled Related Protein 1 (sfrp1), a dominant inhibitor of the Wnt pathway, which controls cell proliferation and 'cell faith' decisions. This study investigated whether sfrp1 and the Wnt pathway play a similar role in the pathogenesis of hyperadrenocorticism in ferrets. The expression of sfrp1 and three target genes of the Wnt pathway (c-myc, axin2 and cyclinD1) in seven adrenal glands from healthy ferrets and in 13 adrenocortical tumours were studied by quantitative real-time PCR. Nuclear ß-catenin staining was assessed by immunohistochemistry. Sfrp1 mRNA expression was up-regulated and axin2 and cyclinD1 were down-regulated in the tumour group in comparison with the control group. Decreased nuclear ß-catenin staining supported the decrease in active Wnt signalling in adrenocortical tumours in ferrets. Therefore, it is unlikely that the involvement of sfrp1 and the Wnt pathway in the pathogenesis of adrenocortical tumours in ferrets is similar to that described in mice.

Evaluation of a novel feather scoring system for monitoring feather damaging behaviour in parrots.

Feather damaging behaviour is common in captive psittacine birds and there is a need for reliable methods to evaluate the efficacy of therapeutic and preventive interventions. This study compared the inter- and intra-observer reliabilities of a novel feather scoring system with an existing system to assess the plumage of grey parrots (Psittacus erithacus). Regions of the body were photographed separately at 1 week intervals and shown at random to 35 examiners (avian veterinarians and veterinary students), who used the two scoring systems to assess plumage. Since the quality of the photographs was insufficient to allow accurate assessment of the individual flight and tail feathers, the novel scoring system was only evaluated for its reliability regarding covert and down feathers. Inter- and intra-observer reliabilities were determined using the intra-class correlation coefficient. Bland-Altman analysis was performed to determine absolute reliabilities for both systems. Correlation coefficients were 0.90 and 0.95 for intra-observer reliability and 0.83 and 0.89 for inter-observer reliability for the existing and novel feather scoring systems, respectively. When using the novel system, a change in plumage condition of ≥10% was needed to ensure that the change reflected a real difference in 95% of cases, while a change of ≥15% was needed for the existing system. Since it may take from 4 weeks (covert or down feathers) to over 1 year (flight or tail feathers) for feathers to regrow, sufficient time should be allowed to elapse between two scoring sessions to reliably evaluate the efficacy of preventive or therapeutic interventions for feather damaging behaviour.

Pain management in ferrets.

The growing popularity of ferrets as pets has created the demand for advanced veterinary care for these patients. Pain is associated with a broad range of conditions, including acute or chronic inflammatory disease, neoplasia, and trauma, as well as iatrogenic causes, such as surgery and diagnostic procedures. Effective pain management requires knowledge and skills to assess pain, good understanding of the pathophysiology of pain, and general knowledge of pharmacologic and pharmacodynamic principles. Unfortunately, scientific studies on efficacy, pharmacokinetics, pharmacodynamics, and safety of analgesic drugs in the ferret are limited. However, basic rules on the treatment of pain and mechanisms of action, safety, and efficacy of analgesic drugs in other species can be adapted and applied to pain management in ferrets. This article aims to make an inventory of what is known on the recognition of pain in ferrets, what analgesic drugs are currently used in ferrets, and how they can be adopted in a patient-orientated pain management plan to provide effective pain relief while reducing and monitoring for unwanted side effects.

Functional CD1d and/or NKT cell invariant chain transcript in horse, pig, African elephant and guinea pig, but not in ruminants.

CD1d-restricted invariant natural killer T cells (NKT cells) have been well characterized in humans and mice, but it is unknown whether they are present in other species. Here we describe the invariant TCR alpha chain and the full length CD1d transcript of pig and horse. Molecular modeling predicts that porcine (po) invariant TCR alpha chain/poCD1d/alpha-GalCer and equine (eq) invariant TCR alpha chain/eqCD1d/alpha-GalCer form complexes that are highly homologous to the human complex. Since a prerequisite for the presence of NKT cells is the expression of CD1d protein, we performed searches for CD1D genes and CD1d transcripts in multiple species. Previously, cattle and guinea pig have been suggested to lack CD1D genes. The CD1D genes of European taurine cattle (Bos taurus) are known to be pseudogenes because of disrupting mutations in the start codon and in the donor splice site of the first intron. Here we show that the same mutations are found in six other ruminants: African buffalo, sheep, bushbuck, bongo, N'Dama cattle, and roe deer. In contrast, intact CD1d transcripts were found in guinea pig, African elephant, horse, rabbit, and pig. Despite the discovery of a highly homologous NKT/CD1d system in pig and horse, our data suggest that functional CD1D and CD1d-restricted NKT cells are not universally present in mammals.