Successful Treatment of a Cervical Injury and Myopathy Using Integrative Medicine Techniques in an Eclectus Parrot (Eclectus roratus) Following Cervical Entrapment.

A 2-year-old female eclectus parrot (Eclectus roratus) was presented for suspected cervical myopathy due to trauma. Severe ventroflexion of the cervical spine and mental depression were identified during the physical examination. The bird was responsive to stimuli but otherwise quiet. Plasma biochemistry results were suggestive of a myopathy, based on marked elevations of both aspartate transaminase (25 652 U/L) and creatine kinase (253 240 U/L). Whole-body radiographic images were unremarkable. Treatment was initiated with supportive therapy for presumptive shock, dehydration, pain, myopathy, and possible spinal swelling. Allopathic therapy included subcutaneous fluids; vitamins A, D, and E; dexamethasone sodium phosphate; hydromorphone; and gavage feeding to treat the acute inflammatory process and provide nutritional support during healing. Supportive care through the Integrative Medicine Department (Louisiana State University, Baton Rouge, LA, USA) was also performed on the patient. Photobiomodulation, acupuncture, Tui-na massage, and rehabilitation exercises were instituted to provide adjunct treatment for relieving pain, promoting muscle healing, improving patient demeanor, and improving cervical mobility. Integrative therapies were well tolerated by the patient, with no sedation required. By day 3, mentation had subjectively improved by 50% despite the persistent cervical ventroflexion. By day 8, the elevated serum enzyme activities had decreased, the patient could eat and drink on its own, and it could readily step up and seek attention during handling. The bird was able to lift its head and could hold it at approximately 50% of normal posture. Integrative therapies were continued throughout hospitalization. The bird was released from the hospital 20 days after initial intake, with head carriage in approximately 80% of the expected normal position and no apparent cervical pain based on palpation. This case demonstrates the benefits of integrative therapies as an adjunct treatment for cervical pain and myopathy in a psittacine species.

Effects of Fluorescent Lighting Versus Sunlight Exposure on Calcium, Magnesium, Vitamin D, and Feather Destructive Behavior in Hispaniolan Amazon Parrots (Amazona ventralis).

Low exposure to ultraviolet light, and resulting vitamin D deficiency, has recently been linked to autism spectrum disorder in people. Captive psittacine birds that exhibit feather destructive behavior share similarities with people affected by autism spectrum disorder, such as repetitive (stereotypies) and self-harming behaviors. The metabolic and psychological effects of housing pet parrots indoors without ultraviolet B lighting are not typically considered in animal husbandry or veterinary care. Calcifediol (serum vitamin D), ionized calcium, and ionized magnesium levels were compared between 10 Hispaniolan Amazon parrots (Amazona ventralis) housed indoors and 10 Hispaniolan Amazon parrots historically housed outdoors. Although ionized calcium and magnesium levels were not significantly different, calcifediol levels were significantly greater in the colony of birds housed outdoors. Further, these 2 research colonies of individually housed birds were feather scored. Subjectively, the birds that were housed indoors had greater self-inflicted feather damage than did those housed outdoors; however, the difference was not statistically significant.

Pneumonia in a Captive Central Bearded Dragon With Concurrent Detection of Helodermatid Adenovirus 2 and a Novel Mycoplasma Species.

A 4-year-old captive male central bearded dragon ( Pogona vitticeps) was presented for recurrent episodic dyspnea and anorexia with occasional expulsion of oral mucoid discharge. Despite empirical antimicrobial therapy and supportive care, the animal died and was submitted for autopsy. Defining histologic features included heterophilic and lymphocytic interstitial pneumonia, with occasional amphophilic intranuclear inclusions and prominent type II pneumocyte hyperplasia. Transmission electron microscopy revealed intranuclear 80-nm, nonenveloped, hexagonal viral particles within pneumocytes. Helodermatid adenovirus 2 (HeAdV2) was determined as the etiologic agent through pan-adenoviral consensus polymerase (PCR) chain reaction and sequencing. Nucleic acid from a novel Mycoplasma sp. (provisionally called Mycoplasma pogonae) was identified by pan-generic PCR targeting the mycoplasma 16S ribosomal RNA gene with sequencing and phylogenetic analysis. As bacteria morphologically consistent with Mycoplasma sp. were not observed by special stains and transmission electron microscopy, the detection of M. pogonae nucleic acid is of indeterminate significance; however, M. pogonae and HeAdV2 coinfection may have exacerbated disease.

Diabetes Mellitus With Concurrent Cerebellar Degeneration and Necrosis in a Domestic Goose ( Anser anser domesticus).

A 5-year-old sexually intact male Toulouse goose ( Anser anser domesticus) was presented for ataxia, polyuria, and polydipsia. The goose was cachectic and exhibited head tremors. Results of plasma biochemical analysis and point-of-care glucometry revealed persistent hyperglycemia. Despite supportive care and oral glipizide, the goose died within 48 hours of presentation. Necropsy revealed severe pancreatic atrophy and fibrosis with regionally extensive cerebellar encephalomalacia and generalized Purkinje cell degeneration and necrosis. On a wet basis, hepatic zinc concentration was determined to be twice the reference interval by atomic absorption spectroscopy. Based on these findings, the pancreatic insufficiency with secondary diabetes mellitus was attributed to chronic zinc toxicosis. Despite birds' relative resistance to high blood glucose concentrations, prolonged hyperglycemia is suspected to have caused selective Purkinje cell degeneration and necrosis by glial activation, mitochondrial dysfunction, and glutamate toxicity, which resulted in the clinically observed motor deficits. This is consistent with experimental diabetic rat models. This case highlights the need for further investigation of the complex pathophysiology of diabetes mellitus in birds.

MYCOBACTERIOSIS IN CAPTIVE PSITTACINES: A BRIEF REVIEW AND CASE SERIES IN COMMON COMPANION SPECIES (ECLECTUS RORATUS, AMAZONA ORATRIX, AND PIONITES MELANOCEPHALA).

In 2015, three psittacines were presented within 30 days, each with differing clinical signs and patient histories. A 13-yr-old male eclectus parrot (Eclectus roratus) was presented for weakness, depression, and acute anorexia. On presentation it was determined to have a heart murmur, severely elevated white blood cell count (93.9 103/µl) with a left shift (2.8 103/µl bands), and anemia (30%). Severe hepatomegaly was noted on radiographs, ultrasonography, and computed tomography. A cytological sample of the liver obtained through a fine needle aspirate revealed intracellular acid-fast bacilli identified as Mycobacterium avium. A 20-yr-old female double yellow-headed Amazon parrot (Amazona oratrix) was presented for a 1-mo history of lethargy and weight loss despite a good appetite. The parrot's total white blood cell count was 16.8 103/µl and the PCV was 35%. Following its death, a necropsy revealed a generalized granulomatous condition that involved the small intestines, lungs, liver, spleen, and medullary cavities of the long bones, with intracellular acid-fast bacilli identified as Mycobacterium genavense. The third case, an 18-mo-old female black-headed caique (Pionites melanocephala), was presented with a 1-day history of lethargy and depression. On presentation, the caique had a heart murmur, distended coelom, palpable thickening of the coelomic organs, and increased lung sounds. Following the caique's death, a complete necropsy revealed mycobacteriosis of the liver, spleen, small intestines, pericardial fat, and bone marrow. The infection was identified as Mycobacterium genavense. The importance of advances in Mycobacterium spp. identification, continued presence of this organism in captive avian populations, difficulty in obtaining a definitive antemortem diagnosis, and conflicting recommendations regarding treatment are thought-provoking areas of focus in this case series.

A Novel Surgical Approach to Avian Femorotibiotarsal Luxation Repair.

A 3-month-old male umbrella cockatoo (Cacatua alba) was presented because of acute non-weight-bearing lameness of the right leg. Marked soft tissue swelling was present around the femorotibiotarsal (stifle) joint, and the radiographic diagnosis was right medial femorotibiotarsal subluxation. Surgical management was elected, and the stifle joint was approached via a lateral parapatellar incision. Joint exploration revealed damage to the lateral meniscus, tendon of origin of the cranial tibial muscle, and cranial cruciate ligament. After debriding the disrupted meniscus, the stifle joint was anatomically reduced. The femorotibiotarsal joint was stabilized by using a lateral extracapsular suture in a modified technique using a self-tapping cortical screw in the lateral femoral condyle and a hole through the proximal tibiotarsus. The bird regained function of the femorotibiotarsal joint for 3 months after surgery, allowing sufficient time for the bird to establish a physiologic perching angle so that ankylosis occurred to maintain functionality of the leg as a unit. This combination of orthopedic techniques adapted from techniques commonly used in small companion-animal species may be considered to provide young birds with femorotibiotarsal luxations and subluxation a good quality of life despite ankylosis of the joint.

Comparison of Calculated Radiation Delivery Versus Actual Radiation Delivery in Military Macaws (Ara militaris).

The skin and oral cavity are common sites of neoplasia in avian species. Radiation therapy has been described for the treatment of these tumors in birds; however, its observed effectiveness has been variable. One possible explanation for this variability when radiation is used to treat the head is the unique anatomy of the avian skull, which contains an elaborate set of sinuses not found in mammalian species. To compare a calculated dose of radiation intended to be administered and the actual amount of radiation delivered to the target area of the choana in 3 adult military macaws (Ara militaris), computed tomography scans were obtained and the monitor unit was calculated to deliver 100 cGy (1Gy) by using radiation planning software. The birds received 3-4 radiation treatments each from a megavoltage radiation therapy unit. A thermoluminescent dosimetry chip (TLD) placed in the choana of the birds was used to measure the amount of ionizing radiation delivered at each treatment. The TLDs were kept in place using Play-Doh as a tissue analog. The actual dose of radiation delivered was lower than the 100-cGy calculated dose, with the 95% confidence limits of predicted bias values between 2.35 and 5.39 (radiation dose from 94.61 to 97.65 cGy). A significant difference was identified between the actual amount of radiation delivered and the calculated radiation goal (P < .001). None of the TLDs received the intended dose of 100 cGy of radiation. The results revealed that the amount of radiation delivered did not reach intended levels. Because the combination of the significance of this discrepancy and the standard dose inhomogeneity could lead to greater than 10% dose inhomogeneity, future investigation is warranted for accurate dose calculation and efficacy of radiation therapy for neoplasia at the lumen of the choana in birds.

Nannizziopsis guarroi infection in 2 Inland Bearded Dragons (Pogona vitticeps): clinical, cytologic, histologic, and ultrastructural aspects.

Chrysosporium-related infections have been increasingly reported in reptiles over the last 2 decades. In this report, we describe clinical, cytologic, histopathologic, and ultrastructural aspects of Chrysosporium-related infection in 2 Inland Bearded Dragons (Pogona vitticeps). Case 1 was presented for an enlarging raised lesion over the left eye and multiple additional masses over the dorsum. Case 2 was submitted to necropsy by the referring veterinarian for suspected yellow fungus disease. Impression smears of the nodules in case 1 revealed granulomatous to pyogranulomatous inflammation and many septate, variably long, 4-10 µm wide, often undulated hyphae, and very rare conidia. Postmortem impression smears of the superficial lesions of case 2 contained large numbers of solitary conidia and arthroconidia and low numbers of hyphae with similar morphology to case 1. Histopathology of the 2 cases revealed severe, multifocal, chronic, ulcerative, nodular pyogranulomatous dermatitis, with myriad intralesional septate hyphae, and arthroconidia. Fungal culture and molecular sequencing in both cases indicated infection with Nannizziopsis guarroi.

Plasma Drug Concentrations of Orally Administered Rosuvastatin in Hispaniolan Amazon Parrots (Amazona ventralis).

Atherosclerotic diseases are common in pet psittacine birds, in particular Amazon parrots. While hypercholesterolemia and dyslipidemia have not definitely been associated with increased susceptibility to atherosclerosis in parrots, these are important and well-known risk factors in humans. Therefore statin drugs such as rosuvastatin constitute the mainstay of human treatment of dyslipidemia and the prevention of atherosclerosis. No pharmacologic studies have been performed in psittacine birds despite the high prevalence of atherosclerosis in captivity. Thirteen Hispaniolan Amazon parrots were used to test a single oral dose of 10 mg/kg of rosuvastatin with blood sampling performed according to a balanced incomplete block design over 36 hours. Because low plasma concentrations were produced in the first study, a subsequent pilot study using a dose of 25 mg/kg in 2 Amazon parrots was performed. Most plasma samples for the 10 mg/kg dose and all samples for the 25 mg/kg dose had rosuvastatin concentration below the limits of quantitation. For the 10 mg/kg study, the median peak plasma concentration and time to peak plasma concentration were 0.032 µg/mL and 2 hours, respectively. Our results indicate that rosuvastatin does not appear suitable in Amazon parrots as compounded and used at the dose in this study. Pharmacodynamic studies investigating lipid-lowering effects of statins rather than pharmacokinetic studies may be more practical and cost effective in future studies to screen for a statin with more ideal properties for potential use in psittacine dyslipidemia and atherosclerotic diseases.

Successful treatment of a radioulnar synostosis in a Mississippi kite (Ictinia mississippiensis).

A Mississippi kite (Ictinia mississippiensis) was presented to the Wildlife Hospital of Louisiana, School of Veterinary Medicine, Louisiana State University, for an inability to fly and was subsequently diagnosed with a minimally displaced, closed, simple, short oblique, diaphyseal fracture of the distal third of the right ulna. A figure-8 bandage was initially applied to the wing to stabilize the fracture. Over a 5-week period, the kite developed progressive reduction in wing extension, and serial radiographs revealed a bridging callus at the ulnar fracture site, as well as development of a radioulnar synostosis. To restore wing function and extension, surgical excision of the bony union between the radius and the ulna was performed, after which a polypropylene mesh implant was interposed between the 2 bones. Within 2 weeks after the surgical procedure, the kite had recovered normal wing extension and was able to fly without noticeable impairment. The bird was released 2 weeks after surgery. This case illustrates a common complication of external coaptation used as sole means of managing fractures of the avian ulna, radius, or both, which results from lack of interosseous soft tissue in the antebrachial area. On the basis of the successful outcome in this case, surgical excision of the interdiaphyseal callus and interposition of a polypropylene mesh could be a viable option for management of posttraumatic radioulnar synostosis in birds of prey.

Magnesium therapy in a hypocalcemic African grey parrot (Psittacus erithacus).

Hypocalcemic-induced seizure activity is a clinical entity that is commonly diagnosed in neurologic African grey parrots (Psittacus erithacus). Plasma calcium levels are typically less than 6.0 mg/dL at the time of seizure activity, and although the underlying cause of the hypocalcemia has not yet been determined, many theories have been proposed. An African grey parrot that had been fed a seed diet for 8 years was presented with hypocalcemia and seizures and exhibited precipitously declining plasma calcium levels, despite aggressive calcium and vitamin A, D, and E supplementation for 4 days. Baseline magnesium levels in this parrot were determined to be 1.9 mg/dL; therefore, magnesium sulfate was administered at a dose of 20 mg/kg IM once. Twenty-four hours after supplementation, the plasma magnesium level was 3.3 mg/dL, and no further seizure activity was observed. We believe that a primary dietary magnesium deficiency may have been present in this African grey parrot, similar to a syndrome in leghorn chicks, which is frequently characterized by progressive hypocalcemia that is unable to be corrected by calcium supplementation alone.

Chemotherapeutic treatment for leukemia in a bearded dragon (Pogona vitticeps).

A 4.5-yr-old, captive-bred, male bearded dragon (Pogona vitticeps) presented for lethargy, anorexia, and increased mucoid salivation with upper respiratory clicks. Diagnostics were declined and the bearded dragon was prescribed ceftazidime 20 mg/kg i.m. q 72 hr. The patient presented again 1 wk later with a marked monocytosis, heterophilia, and lymphocytosis, and a clinical diagnosis of chronic monocytic leukemia was made. Chemotherapy with cytosine arabinoside (100 mg/m2 over 48 hr i.v.) was initiated. Forty-four hours into the treatment the dragon became acutely unresponsive and died within 1 hr. Adverse effects as a result of i.v. cytosine arabinoside therapy were not identified despite previous reports suggestive that the drug induces renal failure.

Endocardial fibrosarcoma in a reticulated python (Python reticularis).

A female, reticulated python (Python reticularis) of unknown age was presented with a history of lethargy, weakness, and distended coelom. Physical examination revealed severe dystocia and stomatitis. The reticulated python was euthanized due to a poor clinical prognosis. Postmortem examination revealed marked distention of the reproductive tract with 26 eggs (10-12 cm in diameter), pericardial effusion, and a slightly firm, pale tan mass (3-4 cm in diameter) adhered to the endocardium at the base of aorta. Based on histopathologic and transmission electron microscopic findings, the diagnosis of endocardial fibrosarcoma was made.

Cloacolith in a blue-fronted amazon parrot (Amazona aestiva).

A 4-year-old blue-fronted Amazon parrot (Amazona aestiva) was admitted for vocalization secondary to constipation. Saline infusion cloacoscopy revealed the presence of a 2-cm-diameter cloacolith within the coprodeum that was obstructing the rectal opening. The cloacolith was fragmented with a pair of biopsy forceps and the pieces removed. The cloacolith was subsequently analyzed and was composed of 100% uric acid salts. The bird improved completely and was able to defecate normally after the procedure. Cloacoliths are relative uncommon cloacal conditions, and this case documents cloacoscopic findings, rectal obstruction, and confirmation of its uric acid composition by urolith analysis.

Evaluation of a pediatric blood filter for whole blood transfusions in domestic chickens (Gallus gallus).

Blood filters that prevent clots, microaggregates, and other debris from being passed from the donor blood into the recipient are an essential component of blood transfusions in mammalian species but have not been consistently recommended in avian transfusions. To evaluate the hemolytic effect of an 18-microm filter in chickens, 9 mL of blood was collected from each of 30 chickens (Gallus gallus) into a syringe containing 1 mL of citrate phosphate dextrose adenine (CPDA-1) to obtain a 1:9 dilution of CPDA-1 to blood. One half of each sample was then run through a pediatric blood filter before separating the plasma. The level of hemolysis in both filtered and unfiltered portions was determined by measuring the concentration of free hemoglobin in the plasma. All samples had low hemoglobin concentrations (less than 30 mg/dL) with no significant difference between the unfiltered and filtered portions. Based on these results, an 18-microm blood filter can be used safely for blood transfusions in domestic chickens as it does not cause significant hemolysis.