An avian Modified Glasgow Coma Scale as a prognostic indicator in raptors with head trauma.

OBJECTIVE: To develop a Modified Glasgow Coma Scale (MGCS) for use in raptors presenting with head trauma and assess the agreement of the MGCS scores between examiners with varying backgrounds, and to assess the prognostic value of the avian MGCS in raptors with head trauma. ANIMALS: 156 native raptorial species. METHODS: All raptors received an MGCS assessment within 8 hours of their presentation, between January 1, 2018, and December 31, 2019. For the first objective, the assessment was performed by a veterinary student, a wildlife veterinarian, and a board-certified or resident veterinary neurologist. Each animal received a score in 3 categories (motor activity, level of consciousness, and brain stem reflexes) and an overall score. For the second objective, the MGCS scoring was performed by the intaking clinical team member and survival after 48 hours was documented. RESULTS: Agreement between the 3 individual scores was assessed via Cronbach α and intraclass correlation. There was excellent-good agreement in all 3 assessment categories as well as the overall score. Univariate associations between survival and demographic factors were determined using the χ2 test. Overall, raptors with a total MGCS of < 10 were less likely to survive than those with a score > 12. CLINICAL RELEVANCE: An avian-specific MGCS demonstrated good-excellent agreement among raters of various backgrounds in assessing raptors with head trauma. Additionally, this study showed that an avian-specific MGCS may be correlated with the probability of survival within the first 48 hours after presentation to rehabilitation facilities in raptors with head trauma.

PROGNOSTIC INDICATORS FOR SURVIVAL OF ORPHANED EASTERN GRAY SQUIRRELS (SCIURUS CAROLINENSIS).

The eastern grey squirrel (EGS), Sciurus carolinensis, is a tree squirrel native to the eastern United States. This species commonly presents to wildlife medical clinics for a variety of human-related injuries including confrontations with road traffic and pet predation. The purpose of this study was to assess initial examination findings as prognostic indicators for survival in EGS. The medical record database of the University of Illinois Wildlife Medical Clinic was searched from January 2012 through December 2018 for records of EGS weighing <300 g. The squirrels were identified as survivors (individuals surviving, released, or transferred to a rehabilitator within 72 hr of intake) or nonsurvivors (individuals euthanized or dying within 72 hr of intake after receiving medical care). Presenting weight, health status, method of feeding, and singleton versus group presentation were categorically recorded for each case. The data were modeled using a series of candidate logistic regression models fitted using the generalized linear model. An information theoretical approach determined the best fit model. A total of 955 EGS were included in this study. Factors that predicted a nonsurvivor status included EGSs that presented with any health system abnormality (odds ratio [OR], 4.81; 95% confidence interval [CI], 3.34-6.72), EGSs that presented between December and May (OR, 1.60; 95% CI, 1.12-2.27) rather than between June and November, and individuals with neurologic signs (OR, 2.61; 95% CI, 1.51-4.51) compared with EGSs without neurologic signs. Despite not being included in the final model, the presence of respiratory signs (OR, 3.43; 95% CI, 2.41-4.89) and diarrhea (OR, 4.01; 95% CI, 1.59-10.09) were significantly associated with a higher likelihood of nonsurvival status. Wildlife medical clinics and rehabilitation centers may use this information by initiating more aggressive therapies or instituting distinct euthanasia protocols for EGS that present with body system abnormalities, particularly neurologic clinical signs, and those that present in the winter months.

PROGNOSTIC INDICATORS FOR SURVIVAL OF ORPHANED NEONATAL AND JUVENILE EASTERN COTTONTAIL RABBITS (SYLVILAGUS FLORIDANUS): 1,256 CASES (2012-17).

Orphaned eastern cottontail rabbits (ECRs; Sylvilagus floridanus) often present to wildlife clinics within their geographic range and require considerable dedication of time and resources. The objective of this analytical cross-sectional study was to assess initial examination findings to be used as prognostic indicators for orphaned neonatal and juvenile ECRs. The medical records of the University of Illinois Wildlife Medical Clinic were searched for ECRs presenting between 2012 and 2018. This criterion identified 1,256 ECRs that were then classified as survivors (survived and released) or as nonsurvivors (euthanized or natural death) within 72 h of admission. Presenting weight, body system abnormalities, hydration status, intervention prior to presentation, and singleton versus group presentation were categorically recorded for each individual ECR. The data were modeled using a series of logistic regression models fitted using the general linear model. Individuals were significantly more likely to be nonsurvivors if they presented as singletons (P<0.0001), presented with moderate/severe (P<0.001) or mild integumentary signs (P=0.0261), presented with multi-organ disease (P<0.001), presented with neurologic signs (P<0.0003), or had treatment provided prior to presentation (P=0.031). Factors that did not predict survival status in ECRs included body weight (P=0.210), presence of respiratory signs (P=0.674), and presence of dehydration (P=0.356). These findings may be used at wildlife medical clinics to make triage criteria for euthanasia as well as dedicate limited funds and labor to cases with the best prognosis for survival.

Effects of Isoflurane Anesthesia on the Hematologic Values of Rehabilitated Wild Owls.

Isoflurane anesthesia is commonly used for owls when they are being rehabilitated to minimize stress during treatments and procedures, as well as to ensure caretaker safety. However, the effects of isoflurane anesthesia on the hematologic response of owls are not known. To investigate the effects of isoflurane anesthesia on the hematology of owls, 3 phases of investigation were performed on the subject animals: 1) single, short manual- versus single, short isoflurane-restraint episodes (n = 12; 38%); 2) a single, prolonged isoflurane episode (n = 10; 31%); and 3) serial, short isoflurane episodes (n = 10; 31%). All owls were classified as adult, and the sex for most individuals was unknown. Twelve owls (38%) were included in phase 1: 5 great horned owls (Bubo virginianus; 42%), 2 eastern screech owls (Megascops asio; 17%), and 5 barred owls (Strix varia; 42%). A separate cohort of 10 novel owls (31%) were selected for inclusion in both phases 2 and 3: 4 great horned owls (40%), 2 eastern screech owls (20%), 2 barred owls (20%), 1 barn owl (Tyto alba; 10%), and 1 snowy owl (Bubo scandiacus; 10%). For each anesthetic episode, blood was collected within 3 minutes of capture and in 15-minute intervals according to the duration of the procedure. Phase 2 had additional blood collections with the patient awake at 2 and 24 hours after time 0 blood collection, whereas phase 3 had an additional blood collection at 24 hours after time 0 blood collection. Hematologic analyses included packed cell volume, total solids, total white blood cell count, heterophil to lymphocyte ratio, and absolute heterophil, lymphocyte, monocyte, eosinophil, and basophil counts. Total white blood cell count decreased significantly during phase 1; packed cell volume decreased significantly during phases 2 and 3; total solids decreased significantly in phase 2; phase 2 demonstrated a lymphopenia with a concurrent decrease in the heterophil to lymphocyte ratio; and phase 3 demonstrated a heteropenia and significant changes in the eosinophil count. All hematologic changes noted in the study were within appropriate reference intervals for the owls but do suggest that there are physiologic consequences of restraining and anesthetizing these avian patients.

Computed tomographic study of safe implantation corridors in rabbit lumbar vertebrae.

OBJECTIVES: A study was performed to evaluate the lumbar vertebrae of domestic rabbits using computed tomography (CT) in order to identify safe corridors for implant insertion. METHODS: Computed tomography imaging of 20 adult New Zealand white rabbits was evaluated using three-dimensional multiplanar reconstruction, and safe corridors were determined. Following corridor determination, implant placement was performed, and imaging was repeated. RESULTS: The cranial and caudal endplates contained the majority of the vertebral bone stock, and were an average of 3.14 and 3.30 mm in length, respectively. The mean safe corridor angle was 62.9 degrees (range: 58.8-66.7), and the mean width of the corridor was 2.03 mm (range: 1.60- 2.07). Post-placement imaging revealed that 35% of the pins demonstrated errors of placement, most commonly canal impingement. CONCLUSIONS: The results of the corridor evaluation indicate that an insertion angle of approximately 60 degrees relative to the sagittal midline is appropriate for implant insertion in the lumbar vertebrae of New Zealand white rabbits. Additionally, due to the hourglass shape of rabbit vertebrae, the endplates provide maximal bone stock for implant purchase, so insertion should be attempted in these regions. However, the high percentage of errors in placement indicate the need to more clearly define entry points to access the canal, and highlight the challenges of appropriate placement in the small bones of rabbits.

Cutaneous Hemangiosarcoma in a Pacific Parrotlet (Forpus coelestis).

A 2-month-old Pacific parrotlet (Forpus coelestis) was presented for assessment following a traumatic injury to the right wing that resulted in persistent swelling and inflammation. Six weeks postinjury the bird underwent surgical resection of a large hemorrhagic cavitated mass that had formed at the site of the original injury and a second, smaller mass on the body in direct contact with the wing mass. Histopathology of the wing mass confirmed a diagnosis of hemangiosarcoma. While commonly diagnosed in domestic species, hemangiosarcoma is uncommonly reported in avian species. To the authors' knowledge, this is the first report of hemangiosarcoma in a Pacific parrotlet and describes the development of hemangiosarcoma in a psittacine bird following trauma-induced inflammation.

Infiltrative Spinal Lipoma in a Canada Goose (Branta canadensis).

An adult Canada goose ( Branta canadensis ) was presented unable to walk. On physical examination, conscious proprioception was absent in both legs, and motor function was decreased. The bird did not improve with supportive care and was euthanatized and submitted for postmortem examination. Sagittal sectioning of the spine revealed an intradural growth causing segmental deformity of the lumbosacral spinal cord. The growth was diagnosed as an infiltrative spinal lipoma. Infiltrative lipomas are locally invasive, benign tumors that can be found in any host tissue. They have been documented in small and exotic companion animals, including birds; however, this is the first report of an infiltrative lipoma in the spinal canal of a bird or free-living wild animal.

Effects of ultraviolet radiation produced from artificial lights on serum 25-hydroxyvitamin D concentration in captive domestic rabbits (Oryctolagus cuniculi).

OBJECTIVE: To determine the effects of UVB radiation produced by artificial lights on serum 25-hydroxyvitamin D concentrations in domestic rabbits (Oryctolagus cuniculi). ANIMALS: 9 juvenile domestic rabbits. PROCEDURES: After an acclimation period, rabbits were anesthetized with isoflurane, and an initial blood sample was collected for determination of serum 25-hydroxyvitamin D concentration. Rabbits were randomly assigned to receive 12-hour exposure to UVB radiation produced by 2 compact fluorescent lights daily (n = 5) or no UVB supplementation (4) commencing on day 1. The UVB radiation emitted into the cage was measured at 9 points approximately 34 cm from the surface of the UVB light sources (representing the position of the rabbits in the cage) after 10 hours of exposure on days 1, 8, and 14. On day 14, another blood sample was collected from anesthetized rabbits for determination of serum 25-hydroxyvitamin D concentration. RESULTS: The UVB radiation level was 8.3 to 58.1 µW/cm² for the exposed rabbits and consistently < 0.001 µW/cm² for the control rabbits. Mean ± SD serum 25-hydroxyvitamin D concentrations in the rabbits that were or were not provided supplemental UVB radiation for 14 days differed significantly (66.4 ± 14.3 nmol/L and 31.7 ± 9.9 nmol/L, respectively). CONCLUSIONS AND CLINICAL RELEVANCE: Exposure to UVB radiation produced by artificial light significantly increased serum 25-hydroxyvitamin D concentration in juvenile rabbits. Because vitamin D is an essential hormone in vertebrates, these findings suggested that the provision of supplemental UVB radiation to captive rabbits may be important.

Measuring the Level of Agreement Between Cloacal Gram's Stains and Bacterial Cultures in Hispaniolan Amazon Parrots ( Amazona ventralis ).

Cloacal or fecal Gram's stains and bacterial cultures are routinely performed during avian physical examinations to assess the microbial flora of the gastrointestinal tract. Although cloacal or fecal Gram's stains and bacterial cultures are considered routine diagnostic procedures, the level of agreement between the individual tests has not been determined. To investigate the level of agreement between results from Gram's stain and bacterial culture when used to assess cloacal or fecal samples from psittacine birds, samples were taken from 21 clinically healthy Hispaniolan Amazon parrots ( Amazona ventralis ) and tested by Gram's stain cytology and bacterial culture. Most bacteria (97.2%) identified by Gram's stain were gram positive. However, gram-negative organisms were identified in 7 of 21 (33.3%; 95% confidence interval: 13.3%-53.3%) birds. Escherichia coli was the only gram-negative organism identified on culture. Agreement between results of Gram's stain and culture was fair (weighted κ = 0.27). The results of this study suggest that Gram's stains and bacterial culture may need to be performed with a parallel testing strategy to limit the likelihood of misclassifying the microbial flora of psittacine patients.

Antemortem diagnosis and successful management of noncompressive segmental myelopathy in a Siberian-Bengal mixed breed tiger.

A 10-yr-old female spayed mixed breed tiger presented for a 9-day history of acute and nonprogressive paralysis of the pelvic limbs. Magnetic resonance imaging revealed a lesion suggestive of fibrocartilaginous embolic myelopathy with regional spinal cord edema, decreased disk signal intensity at L2-L3, and mild intervertebral disk protrusion at L1-L2 and L2-L3. Cerebral spinal fluid analysis showed no overt evidence of infection or neoplasia. Medical therapy was instituted, including corticosteroids and gastroprotectants as well as nursing care and physical therapy. The tiger began showing clinical improvement 2 wk after initiating treatment, progressing to the point where the animal was standing and intermittently walking. Three months after diagnosis, the tiger had regained muscle strength of its hind limbs and walked regularly with improving coordination. This case is the first report of antemortem diagnosis and successful medical management of suspected fibrocartilaginous embolic myelopathy in a large exotic felid.

Advancement flap as a novel treatment for a pododermatitis lesion in a red-tailed hawk (Buteo jamaicensis).

Pododermatitis is a pathologic condition commonly reported in captive raptors and characterized by swelling, excoriation, ulceration, cellulitis, or abscessation of the plantar aspect of the foot. Its cause can be multifactorial, often involving abnormal weight bearing or poor sanitation, and medical and surgical techniques, in addition to environmental alterations, are hallmarks of treatment. In this case, a single pedicle advancement flap was used to treat chronic, nonresponsive grade V/VII pododermatitis of the right metatarsal pad in a red-tailed hawk (Buteo jamaicensis). The advancement flap was formed by using the interdigital skin between digits 3 and 4. The double layer of skin was incised and separated, and the leading edge of the flap was then advanced over the defect and secured with simple interrupted subcutaneous and skin sutures. The foot was bandaged after surgery to take pressure off the surgical site. At 58 days after the surgery, the hawk was deemed medically sound with no signs of pododermatitis and was released to a wildlife rehabilitator. The use of a single pedicle advancement flap has not previously been reported for the treatment of pododermatitis.

Cutaneous mast cell tumor and mastocytosis in a black-masked lovebird (Agapornis personata).

A 12-year-old female black-masked lovebird (Agapornis personata) with a cobalt color mutation was presented for self-mutilation of a mass located on the right lateral neck. Cytologic evaluation of the soft tissue mass revealed a predominance of poorly stained mast cells with metachromatic intracytoplasmic granules. The presumptive diagnosis was cutaneous mast cell tumor. Clinical evaluation, results of a complete blood cell count and biochemical analysis, and radiographs did not reveal systemic manifestation of mast cell disease. The mass was surgically resected, but surgical margins were limited because of the location of the mass and the small size of the patient. The lovebird died the day after surgery. Gross postmortem examination revealed splenomegaly, multifocal pinpoint white nodules throughout the liver parenchyma, severe thickening and yellow coloration of the great vessels, and pale pink swelling of the caudal right kidney. Histopathologic analysis of the resected mass revealed sheets of round cells that contain metachromatic granules, defined as neoplastic mast cells, within a fine fibrovascular stroma. Similar neoplastic cells were seen in the right kidney, hepatic sinusoids, splenic pulp, periovarian connective tissue, and bone marrow. The histopathologic diagnosis was a cutaneous mast cell tumor and disseminated mast cell disease, or mastocytosis. To the authors' knowledge, this is the first reported case of a cutaneous mast cell tumor and mastocytosis in a psittacine bird.

Evaluation of two point-of-care meters and a portable chemistry analyzer for measurement of blood glucose concentrations in juvenile white-tailed deer (Odocoileus virginianus).

OBJECTIVE: To evaluate agreement of blood glucose concentrations measured in juvenile white-tailed deer (Odocoileus virginianus) by use of 2 point-of-care (POC) blood glucose meters and 1 portable chemistry analyzer with values obtained in serum by use of a standard laboratory chemistry analyzer, and to evaluate agreement between results obtained with the 2 POC meters. DESIGN: Prospective evaluation study. SAMPLE: 14 venous blood samples from 14 healthy white-tailed deer fawns. PROCEDURES: Blood glucose concentration was measured with each of 2 POC meters. The remainder of the sample was divided into 2 tubes (1 that contained lithium heparin and 1 with no anticoagulant). Glucose concentration in anticoagulated whole blood was measured with the portable analyzer. Serum was collected from the remaining sample for measurement of glucose concentrations with the laboratory analyzer. Bland-Altman plots were used to assess agreement. RESULTS: Agreement between POC blood glucose meters and the laboratory analyzer was poor; mean values for bias were 2.9 mg/dL (95% limits of agreement [LOA], -70.2 to 76.0 mg/dL) and -30.8 mg/dL (95% LOA, -111.6 to 49.9 mg/dL), respectively. Agreement between the 2 POC meters was also poor (bias, 31.0 mg/dL; 95% LOA, -47.2 to 109.2 mg/dL). Agreement between the portable analyzer and the laboratory analyzer was good (bias, -1.6 mg/dL; 95% LOA, -15.3 to 12.1 mg/dL). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that the POC blood glucose meters used in this study are not appropriate for measurement of blood glucose concentrations in juvenile white-tailed deer.

Clinical utility of a complete diagnostic protocol for the ocular evaluation of free-living raptors.

OBJECTIVE: To describe a protocol for the examination of free-living raptors and report the ophthalmic examination findings of seven raptor species native to central Illinois, namely the barred owl, Cooper's hawk, eastern screech owl, great horned owl, American kestrel, red-tailed hawk, and turkey vulture and to determine if the findings relative to visual prognosis affected eligibility for future release. ANIMALS STUDIED: Seventy-nine free-living raptors. PROCEDURES: Under manual restraint, complete ophthalmic examination including slit-lamp biomicroscopy and indirect funduscopy, applanation tonometry, rebound tonometry, ocular morphometrics, B-mode ultrasound, and electroretinography (ERG) were performed on each bird. Histopathology of enucleated globes was performed after euthanasia or death in selected cases. RESULTS: The examination protocol was easily performed using manual restraint alone on all birds. Ocular lesions were detected in 48.1% of birds, with 47.3% affected unilaterally and 52.6% affected bilaterally. Ocular lesions were considered to be vision threatening in 29.0% of the unilaterally affected birds and 29.0% of the bilaterally affected birds. The most common case outcomes were discharge from hospital to rehabilitation facility (45.6%) followed by euthanasia (43.0%). The presence of an ocular lesion or a vision-threatening ocular lesion was not significantly associated with outcome. Reference ranges are reported for B-mode ultrasound, ocular morphometrics, and horizontal corneal diameter in all species. CONCLUSION: Complete ophthalmic examination can be supplemented by the use of ocular morphometrics, ultrasound, and ERG in the manually restrained raptor. These advanced diagnostic techniques may be useful in developing more objective criteria for evaluating eligibility for release following rehabilitation of free-living birds of prey.

Public health concerns associated with care of free-living birds.

Free-living birds are not only susceptible to certain infectious diseases; wild bird populations serve as reservoirs of several important diseases of public health concern. Bacterial and viral diseases endemic in populations of free-living birds such as tuberculosis, avian influenza, arboviral infections, and enteropathogens have been classified as emerging or reemerging. Providing care to wild avian patients increases the opportunity for direct contact with infected birds and the possibility of transmission of infectious disease to human handlers. Awareness of disease potential is critical to disease monitoring of wild populations and will allow for the implementation of precautionary measures when working with wild avian species. Biosecurity measures designed to minimize risk must be evaluated by individual facilities.

Total ear canal ablation and lateral bulla osteotomy for treatment of otitis externa and media in a rabbit.

CASE DESCRIPTION: A 7-year-old spayed female Miniature Rex European rabbit (Oryctolagus cuniculus) was evaluated because of scratching at the right ear. Physical examination revealed purulent exudate in the right ear canal. CLINICAL FINDINGS: Microbial culture of the exudate yielded Pseudomonas aeruginosa susceptible to marbofloxacin; however, the infection was refractory to appropriate medical treatment. Computed tomography revealed isoattenuating material within the right tympanic bulla and external ear canal with no enhancement following IV administration of contrast medium. The left tympanic bulla appeared normal. TREATMENT AND OUTCOME: A total ear canal ablation and lateral bulla osteotomy were performed on the right ear, and polymethylmethacrylate beads containing either gentamicin or cefazolin were placed within the bulla and surrounding tissues. Two weeks after surgery, the patient appeared comfortable with no signs of scratching at the right ear. CLINICAL RELEVANCE: Total ear canal ablation and lateral bulla osteotomy can be successfully performed for treatment of chronic otitis externa and media in rabbits. Cartilage plates that compose the external ear canal, a bony acoustic duct, lack of a horizontal ear canal, and thickness of the lateral aspect of the tympanic bulla are features unique to rabbits and have not been described in relation to these surgical procedures in rabbits. Rabbits also produce a caseous exudate, and it is difficult to resolve infections of bone and soft tissues. Placement of antimicrobial-impregnated polymethylmethacrylate beads is recommended to minimize the risk of recurrent infection.

Successful management of simple fractures of the femoral neck with femoral head and neck excision arthroplasty in two free-living avian species.

A red-tailed hawk (Buteo jamaicensis) and a Canada goose (Branta canadensis) were evaluated for unilateral pelvic limb lameness. Physical examination findings and results of diagnostic imaging revealed femoral neck fractures in both birds. Both birds were treated with a femoral head and neck excision arthroplasty. The affected legs were not immobilized, and the birds were encouraged to use the legs immediately after surgery to encourage formation of a pseudoarthrosis. Within 2 weeks, both birds were using the affected limb well enough to be either successfully released or transferred to a wildlife rehabilitation facility. Femoral head and neck excision arthroplasty without immobilization of the limb is recommended for managing avian femoral neck fractures, especially in free-ranging species in which a rapid and complete or near complete return to function is vital for survival in the wild.