Clinical Pathology of the Vulnerable Gough Moorhen (Gallinula comeri).

The Gough moorhen (Gallinula comeri) is native to Gough Island, Tristan da Cunha, and listed as Vulnerable by the International Union for Conservation of Nature due to its restricted range and susceptibility to introduced predators. A planned ecosystem restoration by eradication of introduced house mice (Mus musculus) via aerially delivered rodenticide requires a reproductively balanced population of Gough moorhens to be held in captivity to avoid primary and secondary poisoning. To aid disease detection during the period of captivity, Gough moorhens (n = 43; 25 adult females and 18 adult males) were captured, measured and sampled to determine ease of sexing by morphometrics, to establish reference ranges for routine haematological and biochemical parameters and to identify any intestinal and haemoparasites as well as determine which faecal bacteria were present. Male Gough moorhens had significantly greater mean body mass (P = 0.019) and head and bill length (P = 0.001) compared with females, but the overlapping ranges showed genetic identification of sex was required for accurate determination. Plasma globulin and total protein concentrations were significantly greater in female compared with male birds (P = 0.032 and P = 0.012, respectively) and probably related to egg yolk production. No haemoparasites or gastrointestinal parasites were found in any bird and there were no sex-related differences in the haematology. Multiple bacterial taxa were isolated from the faeces of all birds including Enterococcus spp. (n = 42), Klebsiella spp. (n = 40), Staphylococcus aureus (n = 33), Staphylococcus intermedius (n = 16), Escherichia coli (n = 41) and Pseudomonas spp. (n = 7). No clinical or subclinical disease was found in any of the birds examined, suggesting they are suitable for short-term captivity but rapid on-island genetic-based sex determination will be essential to ensure a reproductively balanced population.

Clinical Pathology of the Critically Endangered Gough Bunting (Rowettia goughensis).

The Gough bunting (Rowettia goughensis) is indigenous to Gough Island and critically endangered due to predation by invasive house mice (Mus musculus). A planned ecosystem restoration by eradication of house mice via aerially delivered rodenticide requires a reproductively balanced population of Gough buntings being held in captivity to avoid primary and secondary poisoning. To aid disease detection during the period of captivity, Gough buntings (n = 25; five adult females, 15 adult males and five juveniles) were captured, measured and sampled to determine reference ranges for routine haematological and biochemical parameters and to identify any faecal bacterial species and intestinal and haemoparasites. Adult females had significantly higher blood glucose (P = 0.02 and 0.05 for different analyzers) and globulins (P = 0.02) than adult males or juveniles, and juveniles had consistently higher, although not significant, concentrations of creatine kinase. Juveniles had significantly (P = 0.007) more heterophils than adults; eosinophils were rare in adults and absent in juveniles and azurophils were absent from all individuals sampled. No parasite eggs were found in the faeces and no haemoparasites were found in blood smears. Several faecal bacterial species were recorded including Enterococcus spp. (n = 12), Klebsiella spp. (n = 7), Staphylococcus aureus (n = 6), Staphylococcus intermedius (n = 1), Escherichia coli (n = 1) and Pseudomonas spp. (n = 1). No overt clinical or subclinical disease was found in any of the birds examined, which suggests they are suitable for short-term captivity during ecosystem restoration and the data will provide key haematological and biochemical reference ranges for monitoring their health. However, the capture of a reproductively balanced population may require significant effort due to the relative difficulty with which females were caught.

An evaluation of the experiences of guide dog owners visiting Scottish veterinary practices.

Guide dogs and their owners will visit a veterinary practice at least twice a year. The aim of this study was to evaluate what guide dog owners thought about these visits, in order to identify areas of good practice which could be incorporated into the undergraduate curriculum. Nine guide dog owners volunteered to take part in the study and were interviewed by the primary researcher. Thematic analysis was carried out and several themes were identified: good experiences were highlighted where staff had an understanding of visual impairment and the work of a guide dog; the importance of good communication skills involving the owner in the consultation; the need for veterinary professionals to understand the bond between an owner and guide dog; how medication and information could be provided in a user-friendly format for someone affected by a visual impairment and concerns about costs and decision making for veterinary treatment. This work highlights the importance for veterinary staff to talk to, empathise with and understand the individual circumstances of their clients and identifies areas that should be included in veterinary education to better prepare students for the workplace.

An unusual presentation of Mycobacterium avium spp. paratuberculosis infection in a captive tundra reindeer (Rangifer tarandus tarandus).

This report describes an unusual presentation of paratuberculosis in a captive, 4-year-old female tundra reindeer (Rangifer tarandus tarandus). The gross and histological presentation was consistent with clinical paratuberculosis as previously reported for other ruminants, with poor body condition, subcutaneous oedema, granulomatous ileitis (multibacillary), mesenteric lymphadenitis and hepatitis. However, this animal also presented with unusual lung lesions, with necrosis and mineralization similar to that reported for Mycobacterium bovis in other wild and domestic ruminants. The presence of DNA of Mycobacterium avium subsp. paratuberculosis was confirmed by polymerase chain reaction (PCR) in intestine and lung tissue (IS900, Hsp65) and PCR tests for the detection of Mycobacterium tuberculosis complex and other members of the M. avium complex were negative.

Laparoscopic cholecystectomy under field conditions in Asiatic black bears (Ursus thibetanus) rescued from illegal bile farming in Vietnam.

Nine adult Asiatic black bears (Ursus thibetanus) previously rescued from illegal bile farming in Vietnam were examined via abdominal ultrasound and exploratory laparoscopy for liver and gall bladder pathology. Three bears demonstrated notable gall bladder pathology, and minimally invasive cholecystectomies were performed using an open laparoscopic access approach, standard 10 to 12 mmHg carbon dioxide pneumoperitoneum and a four-port technique. A single bear required insertion of an additional 5 mm port and use of a flexible liver retractor due to the presence of extensive adhesions between the gall bladder and quadrate and left and right medial liver lobes. The cystic duct was dissected free and this and the cystic artery were ligated by means of extracorporeal tied Meltzer knot sutures. The gall bladder was dissected free of the liver by blunt and sharp dissection, aided by 3.8 MHz monopolar radiosurgery. Bears that have had open abdominal cholecystectomies are reported as taking four to six weeks before a return to normal activity postoperatively. In contrast, these bears demonstrated rapid unremarkable healing, and were allowed unrestricted access to outside enclosures to climb trees, swim and interact normally with other bears within seven days of surgery.

The double-arch modified type-1b external skeletal fixator. Technique description and functional outcome for surgical management of canine antebrachial limb deformities.

OBJECTIVES: To describe acute correction of antebrachial angular and rotational limb deformities (ARLD) using a new external skeletal fixator (ESF). METHODS: Dogs that were presented with lameness caused by ARLD were treated by radial and ulnar osteotomies and acute realignment. A modified type-1b ESF incorporating double arches (DA-ESF) and a novel connecting configuration facilitated alignment with six degrees of freedom. Bilateral deformities were corrected surgically in the same session. Aseptic preparation of both antebrachii allowed comparison of limb alignment. Radiographic evaluation was performed using centre of rotation of angulation (CORA) methodology. RESULTS: Thirty-five antebrachii (22 dogs) underwent surgery. Postoperative limb function was graded as good (n = 31), fair (n = 2), or poor (n = 2). Persistent medial carpal instability was associated with a suboptimal outcome. Postoperative radiographic images of the frontal and sagittal plane joint angles and elbow-to-carpus translation were compared with values that were reported in previous studies, and were within published reference ranges in most cases. Complications included delayed radial osteotomy union (n = 5), delayed ulnar osteotomy union (n = 2) and implant-associated morbidity (n = 3). CLINICAL RELEVANCE: A practical technique for acute correction of complex antebrachial ARLD is suggested, incorporating a new configuration of ESF. Putative limitations of radiographic planning using CORA may be compensated by careful attention to intra-operative visual and palpatory assessment.

Cannabis intoxication in three Green iguanas (Iguana iguana).

This report describes clinical signs and plasma biochemical changes associated with significant cannabis consumption in three Green iguanas (Iguana iguana) which resulted in seizures, cardiovascular and digestive tract aberrations, elevated hepatic enzymes and bile acid concentrations for a number of weeks post recovery. One case required extensive antiseizuring therapy to recover. All Green iguanas eventually made a full recovery.

Severe necrotizing myocarditis caused by serratia marcescens infection in an axolotl (Ambystoma mexicanum).

This report provides the first account of the pathological changes associated with infection by Serratia marcescens in an adult male axolotl. The infection resulted in septicaemia with severe multifocal necrotizing myocarditis. The latter lesion evolved to cardiac rupture, haemopericardium and death resulting from cardiac tamponade. This animal was exposed to higher than usual temperatures (24-25 °C) 2 weeks before the onset of disease and this may have resulted in immunocompromise and opportunistic bacterial infection. S. marcescens was isolated from the coelomic and pericardial cavity. Both isolates were identical and were resistant to ß-lactam antibiotics, but not to aminoglycosides or fluoroquinolones. The production of red prodigiosin pigment by the bacterium suggested an environmental origin. Overall, the clinical and histopathological presentation suggests that S. marcescens should be included in the list of aetiological agents of the 'red-leg'/bacterial dermatosepticaemia syndrome of amphibians.

Prediction of future development of canine atopic dermatitis based on examination of clinical history.

OBJECTIVES: The aim of this study was to identify clinical features that could be used to identify individual dogs within the Guide Dogs for the Blind Association canine population at risk of being diagnosed as atopic in the future before they had fully developed the condition. METHODS: Clinical histories of atopic and non-atopic dogs from the Guide Dogs for the Blind Association population were analysed and statistically significant differences identified between the two groups. RESULTS: Atopic dogs were consistently affected by skin disease at a younger age than non-atopic dogs and that there was a significant difference in event curves between atopic and non-atopic dogs at 10 months of age. From a predictive point of view, dogs that suffered from four or more episodes of atopic-type skin disease by the age of 15 months were at an increased risk of developing atopic dermatitis. CLINICAL SIGNIFICANCE: It is suggested that the clinical history of all dogs from the Guide Dogs for the Blind Association about to undergo training should be examined for these factors to assess whether or not they should undergo training.

Partial tarsal arthrodesis and botulinum toxin A injection for correction of tarsal arthrogryposis in a cat.

An 11-week-old, domestic shorthair cat was presented for evaluation of a congenital right tarsal deformity. The cat was non-weightbearing lame on the right hindlimb. There was severe tarsal hyperextension and concurrent spasticity/contracture/shortening of the gastrocnemius muscle-tendon. The cat was otherwise healthy. Radiographically there was luxation of the proximal intertarsal joint and talocrural hyperextension. Treatment with 10 mu/kg botulinum toxin A (Botox; Allergan) intramuscular injections directly into the gastrocnemius muscle and passive physiotherapy marginally improved the range of motion in the talocrural joint. Definitive surgical treatment with partial tarsal arthodesis produced an excellent clinical outcome. This case report demonstrates the successful treatment of a severe congenital tarsal abnormality and also documents the first clinical use of botulinum toxin in a feline patient.

Use of biochemical markers of osteoarthritis to investigate the potential disease-modifying effect of tibial plateau levelling osteotomy.

OBJECTIVES: To evaluate the hypothesis that the concentration of the 1/20/5D4 epitope of keratan sulphate, cartilage oligomeric matrix protein and total sulphated glycosaminoglycans in synovial fluids from dogs with cranial cruciate ligament disease would be affected by tibial plateau levelling osteotomy. In addition, to evaluate the hypothesis that medial meniscal release or meniscal injury would alter the expression of these candidate biomarkers. METHODS: Forty-one dogs with naturally occurring cranial cruciate ligament disease were recruited prospectively. Synovial fluids were collected from the index joint before surgery and six weeks and six months postsurgery. Following tibial plateau levelling osteotomy, synovial fluids were assayed for 1/20/5D4 epitope of keratan sulphate and cartilage oligomeric matrix protein concentration using an inhibition ELISA and for sulphated glycosaminoglycans using a direct dye-binding assay. RESULTS: The sulphated glycosaminoglycans ratio did not change significantly during the study. Medial meniscal injury at entry was associated with lower concentrations of synovial fluid cartilage oligomeric matrix protein (P<0.05, unpaired t test). There was no association between medial meniscal release and the changes in marker concentrations, either from 0 to six weeks or 0 to six months. CLINICAL SIGNIFICANCE: Tibial plateau levelling osteotomy did not significantly alter the expression of the named candidate biomarkers. These findings reflect the limited nature of the arthrotomy or indicate that tibial plateau levelling osteotomy does not influence the progression of osteoarthritis (OA). From these studies, there is no evidence that tibial plateau levelling osteotomy affects cartilage metabolism.

Infection of a total hip prosthesis in a dog caused by Achromobacter(Alcaligenes) xylosoxidans.

A four-year-old male, neutered Labrador retriever was presented with progressive left hindlimb lameness 10 months following total hip replacement. Radiography revealed changes consistent with infection and culture of joint fluid from the left coxofemoral joint revealed Achromobacter (Alcaligenes) xylosoxidans. The prosthesis was removed. Culture of the acetabular cup confirmed Achromobacter xylosoxidans. Achromobacter xylosoxidans is an uncommon but serious cause of nosocomial epidemics in hospitals for human beings. To the authors' knowledge, this is the first report of total hip prosthetic infection with Achromobacter xylosoxidans. Little is reported about its pathogenicity in human beings and the authors failed to retrieve any reports of its clinical significance in animals.

The diagnostic and therapeutic impact of MRI: an observational multi-centre study.

AIM: To provide information about the diagnostic and therapeutic impact of magnetic resonance imaging (MRI) and to compare the findings across diagnostic groups. MATERIALS AND METHODS: A prospective, observational study of 2017 consecutive referrals for MRI of the head, spine or knee at four imaging centres. Clinicians completed questionnaires before MRI stating initial diagnoses, diagnostic confidence and treatment plans. After imaging, a second questionnaire evaluated clinicians' revised diagnosis and treatment plans in the light of imaging findings. Patients were grouped into nine diagnostic categories for analysis. Comparison between pre- and post-imaging was used to assess the diagnostic and therapeutic impact of MRI. RESULTS: In seven of nine diagnostic groups MRI findings were associated with a diagnostic impact. Diagnoses were revised or discarded following normal MR findings and diagnostic confidence was increased by confirmative MR findings. There was no statistically significant diagnostic impact for suspected pituitary or cerebello-pontine angle lesions. In five of nine diagnostic groups (knee meniscus, knee ligament, multiple sclerosis, lumbar and cervical spine) MRI findings had a clear impact on treatment plans. CONCLUSION: This study demonstrates that in most diagnostic categories, MRI influences diagnosis and treatment. However, experimental studies are needed to prove that these diagnostic and therapeutic impacts lead to improved health.Hollingworth (2000). Clinical Radiology55, 825-831.

Self reported health status and magnetic resonance imaging findings in patients with low back pain.

The authors present a prospective study of quality of life (SF-36) and MRI findings in patients with low back pain (LBP). Disc herniation and nerve root compression contribute to LBP and poor quality of life. However, significant proportions of asymptomatic subjects have disc herniation and neural compromise. Little is known about the influence of disc abnormalities and neural compression on quality of life in symptomatic patients. The purpose of this study was to assess the relationship between the extent of disc abnormality, neural impingement and quality of life. A total of 317 consecutive patients with LBP referred for MRI completed an SF-36 health status questionnaire immediately before imaging and again 6 months later. Patients were grouped according to the most extensive disc abnormality and any neural compromise reported at MRI. The relationship between symptoms, radiological signs and SF-36 scores was assessed. Eighty percent (255/317) and 65% (205/317) of patients completed the initial and 6-month SF-36, respectively. Thirty-six percent of patients (115/317) had one or more herniated discs and 44% (140/317) had neural impingement. There was little relationship between the extent of disc abnormality and quality of life. Patients with radiological evidence of neural impingement reported better general health (P < 0.01). SF-36 scores improved at 6 months in four dimensions, but general health deteriorated (P < 0.01). Patients with neural impingement had improved pain scores at 6 months (P < 0.05). The study results showed that the pain and dysfunction caused by disc herniation and neural compromise are not sufficiently distinct from other causes of back pain to be distinguished by the SF-36. Whilst neural compromise may be the best radiological feature distinguishing patients who may benefit from intervention, it cannot predict quality of life deficits in the diffuse group of patients with LBP.

New lumps in the breast following conservation treatment for early breast cancer.

A new lump in the breast following conservation treatment for early breast cancer may represent a recurrence of the disease or may be a benign lesion. Clinical evaluation of these lumps is often extremely difficult and, potentially, mammography would seem to be of great importance in the assessment. Between November 1981 and March 1986, 214 patients with operable breast cancers of 4 cm or less in diameter underwent conservative treatment. The conservation technique comprised synchronous excision of the primary tumour without a wide margin, axillary clearance, interstitial irradiation with iridium 192 (2000 cGy), and subsequent external beam radiotherapy to the breast (4600 cGy). After an average follow-up of 26 months, 17 patients developed a new lump in the treated breast necessitating further biopsy. Seven of these were malignant and 10 benign. In the latter category the most frequent finding was fat necrosis. Clinically, the lesions were indistinguishable from each other. The mammographic signs, which best predicted malignancy, were either of a mass or of a malignant type of microcalcification. This study illustrates the problems associated with deciding the nature of a new lump in the breast following conservation treatment. Mammography is complementary to physical examination, and a base-line mammogram six months after completion of therapy is helpful. Despite the use of mammography, biopsy is the only definitive way of excluding recurrence.