Case series: Computed tomography (CT) demonstrates lacrimal canal involvement in koalas (Phascolarctos cinereus) with maxillary incisor dental disease.

Dental disease is common in wild and captive koalas. Effective treatments are limited and dental disease may not be recognised until it is quite severe. We describe the appearance of varying severities of dental disease on computed tomography (CT) images in a case series of six koalas. This case series demonstrates the use of CT to detect both mild and severe dental disease in koalas. The study also documents the normal CT appearance of the nasolacrimal duct in the koala. The only clinical abnormality in koalas with the mildest dental disease was ocular discharge. Computed tomography findings associated with ocular discharge were periapical lysis of first maxillary incisors, lacrimal canal remodelling and subsequent nasolacrimal duct obstruction. Dental disease should be a differential diagnosis for ocular discharge in koalas and CT examination enables visualisation of early stages of dental disease.

An outbreak of severe iodine-deficiency goitre in a sheep flock in north-east Victoria.

BACKGROUND: Several outbreaks of goitre, considered to be related to iodine deficiency, occurred in sheep flocks throughout Victoria in 2010. OBJECTIVE: We describe one outbreak in Merino-Border Leicester-cross ewes and their lambs in north-east Victoria that appeared to be associated with increased rainfall and pasture growth, particularly during the preceding summer and autumn. RESULTS: The outbreak was characterised by a four-fold increase in neonatal lamb deaths and goitre, alopecia and poor skeletal development in the lambs. Most cases occurred in lambs born to 2-year-old crossbred ewes that had grazed long, lush perennial pastures throughout their entire pregnancy, whereas few cases occurred in mature crossbred or Merino ewes that had grazed shorter, annual pastures on hill country for 3 weeks in late pregnancy but were otherwise managed similarly. CONCLUSION: Existing recommendations for south-eastern Australia are that only spring-lambing ewes in iodine-deficient areas require iodine supplementation to prevent goitre in years with high autumn-winter rainfall. Aspects of this outbreak suggest that ewes lambing at other times of the year and grazing abundant pasture for prolonged periods may also require supplementation to prevent goitre, even if autumn-winter rainfall does not exceed previously established thresholds.

Fibrotic myopathy of the iliopsoas muscle in a dog.

Fibrotic myopathy of the iliopsoas muscle developed in a dog, following extensive migration of a grass awn within the muscle and adjacent subcutaneous tissue. The dog was initially presented for evaluation of a fluctuant swelling over the right flank region. The clinical and imaging findings were suggestive of iliopsoas fibrotic myopathy and the diagnosis was confirmed by histopathology. This is the third report of iliopsoas fibrotic myopathy in a dog, the first report to describe the postmortem pathologic changes and the first report of iliopsoas fibrotic myopathy subsequent to foreign body migration.

Outbreak of equine herpesvirus type 1 myeloencephalitis: new insights from virus identification by PCR and the application of an EHV-1-specific antibody detection ELISA.

Five of 10 pregnant, lactating mares, each with a foal at foot, developed neurological disease. Three of them became recumbent, developed complications and were euthanased; of the two that survived, one aborted an equine herpesvirus type 1 (EHV-1)-positive fetus 68 days after the first signs were observed in the index case and the other gave birth to a healthy foal on day 283 but remained ataxic and incontinent. The diagnosis of EHV-1 myeloencephalitis was supported by postmortem findings, PCR identification of the virus and by serological tests with an EHV-1-specific ELISA. At the time of the index case, the 10 foals all had a heavy mucopurulent nasal discharge, and PCR and the ELISA were used to detect and monitor EHV-1 infection in them. The status of EHV-1 infection in the five in-contact mares was similarly monitored. Sera from three of the affected mares, taken seven days after the index case were negative or had borderline EHV-1-specific antibody titres. In later serum samples there was an increase in the titres of EHV-1-specific antibody in two of the affected mares. In contrast, sera from the five unaffected in-contact mares were all EHV-1-antibody positive when they were first tested seven or 13 days after the index case.

The role of the advanced clinical nurse in a hypertension clinic.

The use of advanced clinical nurses (ACNs) has enabled expansion of the Hypertension Clinic at the Johannesburg Hospital. The ACNs care for elderly patients whose hypertension is stable and who require a minimum of drugs. Blood pressure control in this group of patients is satisfactory and the default rate is low. The ACN therefore appears acceptable, at least to the patient. However, problems of continuing education, evaluation and official recognition remain. The case for allowing the ACN to prescribe from a limited pharmacopoeia is presented.