Diagnosis and Treatment of a Swainson's Toucan (Ramphastos ambiguus swainsonii) With Rhinosinusitis.

A female Swainson's toucan (Ramphastos ambiguus swainsonii) was presented for examination with a 2-year history of mucoid nasal discharge and abnormal growth of the rhamphotheca. Nasal cytologic examination and culture results were consistent with mixed aerobic and anaerobic bacterial rhinitis. Radiographic and computed tomographic imaging demonstrated a deviated septum of the nasal diverticulum and multiple soft tissue densities in the caudal aspects of the maxillary and mandibular infraorbital diverticula of the infraorbital sinus. Results of rhinoscopy and biopsy confirmed bacterial rhinitis. Treatment included multiple nasal lavages with saline, gentamicin, and amphotericin B and systemic ciprofloxacin and tobramycin nebulizations for several weeks. Repeat radiographic imaging 4 years later showed resolution of most soft tissue opacities previously observed within the maxillary and mandibular diverticula but persistence of 3 areas of soft tissue, dense material within the maxillary sinus diverticulum. A sinus trephination procedure was performed through the maxillary bone for sinoscopy and sample collection and topical treatment. Results of aerobic bacterial cultures from the granulomas were negative. Biopsy results were consistent with keratin granulomas without bacterial or fungal infection. Two and a half years after trephination, the surgical site was fully healed with no recurrence of the nasal discharge. This is the first report, to our knowledge, of sinus trephination in a toucan and describes the advanced diagnostic and medical and surgical treatment of chronic rhinitis in this case.

Clinical features, treatment, and outcomes of cutaneous and oral squamous cell carcinoma in avian species.

OBJECTIVE To determine the clinical features, treatment, and outcomes of treatment for oral and cutaneous squamous cell carcinoma (SCC) in avian species. DESIGN Retrospective case series with nested cohort study. ANIMALS 87 client-owned birds of various species with histologically confirmed SCC of the skin or oral cavity. PROCEDURES Clinicians entered case information through an online survey tool. Data were collected regarding patient signalment, concurrent conditions, treatments, adverse effects, and clinical outcomes. Relationships were examined between complete excision and partial or complete response. Survival analysis was performed to compare outcomes among groupings of therapeutic approaches. RESULTS Only 7 of 64 (11%) birds for which full outcome data were available had complete remission of SCC; 53 (83%) had progressive disease, were euthanized, or died of the disease. The unadjusted OR for partial or complete response following complete tumor excision (vs other treatment approaches) was 6.9 (95% confidence interval [CI], 1.8 to 25.8). Risk of death was 62% lower (hazard ratio, 0.38; 95% CI, 0.19 to 0.77) for birds that underwent complete excision versus conservative treatment. Median survival time from initial evaluation for birds receiving complete excision was 628 days (95% CI, 210 to 1,008 days), compared with 171 days (95% CI, 89 to 286 days) for birds receiving monitoring with or without conservative treatment. Birds receiving any other additional treatment had a median survival time of 357 days (95% CI, 143 to 562 days). CONCLUSIONS AND CLINICAL RELEVANCE For birds with SCC, complete excision was the only treatment approach significantly associated with complete or partial response and increased survival time.