Raptor Pediatrics.

Neonatal and juvenile raptors may differ from adults in their husbandry, disease predispositions, and medical therapies. There are differences between captive bred juveniles and those presented for rehabilitation to the wild, which must be taken into consideration for successful long-term outcomes. In captive settings, many metabolic and infectious diseases may be linked to problems with diet. The successful rehabilitation and release of wild raptor chicks requires special precautions beyond avoiding imprinting.

Intralipid Emulsion Therapy for the Treatment of Suspected Toxicity in 2 Avian Species.

Intravenous lipid emulsion (ILE) therapy has shown promise as a treatment option for a variety of lipophilic toxins. Two birds presented for suspected ingestion of a toxic substance. A blue-and-gold macaw (Ara ararauna) presented after chewing a block of bromethalin rodenticide without overt clinical signs at the time of presentation. Additionally, a free-ranging bald eagle (Haliaeetus leucocephalus) was found weak and depressed near a municipal landfill after presumptive ingestion of pentobarbital. Both birds were treated with ILE therapy for potential intoxication without any adverse events. The macaw was clinically normal after 3 days of hospitalization and at a 1-week reevaluation. The eagle was transferred to a rehabilitation center after markedly improved mentation and strength and was released 7 days later. Clinicians should consider ILE therapy for the treatment of lipophilic toxicities; however, monitoring is recommended for persistent lipemia and other adverse effects that have been reported in the veterinary literature.

Cardiac Disease of Raptors.

Cardiac disease, in its various presentations, is being recognized as a common raptor health problem. Evidence suggests that the prevalence of cardiac disease varies between captive and wild bird of prey populations, probably because of differences in activity levels and diet. However, a wide variety of cardiovascular diseases have been reported to affect raptor species (captive and free living), including atherosclerosis, pathogenic arrhythmias, infectious cardiomyopathies, and endocarditis. Diagnostic testing used to identify cardiac abnormalities include radiographic imaging, electrocardiogram, echocardiogram, and computed tomography angiograms. Information pertaining to therapeutic treatment for raptor cardiac disease patients is inadequate or has not been investigated. This review of cardiac disease will provide current information regarding cardiac diseases that are diagnosed in birds of prey, diagnostic testing, and treatment options.

Causes of admission, length of stay and outcomes for common kestrels in rehabilitation centres in the Czech Republic.

Rehabilitation centres help injured animals to recover and return back to the wild. This study aimed to analyse trends in intake and outcomes for the common kestrels (Falco tinnunculus) admitted into rehabilitation centres in the Czech Republic. From 2010 to 2019, a total of 12,923 kestrels were admitted to 34 rehabilitation centres with an increasing trend (rSp = 0.7697, P < 0.01) being found during the monitored period. Subadult kestrels (34.70%) and kestrels injured by power lines (26.57%) were most often admitted. Most kestrels in the rehabilitation centres died or had to be euthanized (81.66%), only 15.90% of the birds could be released back into the wild. The median length of stay in rehabilitation centres for kestrels that were subsequently released was 35 days. Considering survival rates, the most critical threat to kestrels was poisoning (100% of the cases resulted in death) but mortality of the kestrels admitted for most other reasons also exceeded 80%. Given the low success rate of the care of kestrels in rehabilitation centres and the relatively small proportion returned to the wild, it is essential to eliminate the causes leading to their admission, that is, to protect their natural habitats and to prevent unnecessary capture.

A RETROSPECTIVE STUDY OF FEMORAL FRACTURES IN WILD BIRDS OF PREY: 119 CASES.

A retrospective study was performed to describe patient and fracture characteristics, treatments, complications, and outcomes associated with femoral fractures in free-ranging birds of prey. Cases were identified from the electronic database and included raptors admitted with femoral fractures at the Bird of Prey Clinic of the Université de Montréal, from 1986 to 2018. In total, 119 individuals from 24 species, with 123 femoral fractures, were included in the study. Twenty-seven birds (23%) were declared dead upon arrival. Ninety-two birds (77%) were admitted alive; 80 with acute fractures and 12 with a fracture that had already healed. A conservative treatment (cage rest) was used to manage eight fractures. Surgical repair was attempted on 34 femoral fractures in 33 birds. An intramedullary pin alone was used in 28 cases (82%), and an external skeletal fixator-intramedullary pin tie-in fixator was used in 6 cases (18%). For surgically treated fractures, 19 healed (in 18 birds), 4 did not heal, and 11 birds died or were euthanized before healing could be achieved. Of the 23/34 fractures where the healing process could be assessed, healing rate for comminuted fractures (11/23) was 91% (10/11). Surgical complications occurred in 10 cases (including 7 cases of migration and loosening of the pin, and 1 case of osteomyelitis), leading to euthanasia in 4 cases. Out of the 21 birds with acute femoral fracture upon presentation that were released, 14 had received a surgical treatment and 7 had received a conservative treatment. Nine of the 21 released birds (43%) had at least one other fractured bone. The majority of deaths and euthanasia occurred within 2 wk after admission (51/59; 86%). Thirteen birds were euthanized primarily because of their femoral fracture. Thirteen birds died in treatment and 33 were deemed nonreleasable and euthanized because of a comorbidity not related to the femoral fracture.

Management of Knuckling in an Ostrich (Struthio camelus) Using a Custom-Made Orthotic Shoe.

A 4-year-old female ostrich (Struthio camelus) developed knuckling on its left foot after a traumatic event. Conservative treatment, rest, and traditional splinting methods failed to resolve the gait abnormality or improve mobility. A dynamic multicomponent orthotic shoe was then custom designed and fabricated with an ultra-high-molecular weight, low-pressure polyethylene polymer (St 1000 DIN16972 TG2) to correct the foot malposition. The affected foot and leg were wrapped with soft padding and the orthosis was attached and secured by nylon belts (Nylon PA [polyamide] 6, a semicrystalline polyamide polymer) with self-locking modified wrench straps. The orthosis immediately prevented knuckling and improved ambulation. After 2 weeks, this shoe was replaced with a modified orthotic shoe of lighter weight to improve kinetics and ease of use by the bird. The modified orthosis dramatically improved ambulation and was left attached to the affected leg for 7 more weeks. Thereafter, the bird was able to ambulate comfortably without the aid of the shoe, even though permanent anatomical changes to the affected leg seemed to restrict its speed of locomotion. The ostrich had another unfortunate traumatic event 10 weeks later, the result of which was knuckling on the contralateral (right) foot. After routine medical and supportive care, the orthosis was then applied to the right foot for a period of 9 weeks. During this period the bird was able to ambulate well, despite having to support the bulk of its weight on the previously affected left limb. At the end of 9 weeks, the orthosis was removed, and the bird was able to ambulate without aid, although the bird's speed of locomotion was considerably reduced. After recovery of its leg problems, the ostrich was confined to a relatively small paddock for the rest of its life.

End-of-Life Decisions: Palliative Care, Hospice, and Euthanasia for Exotic Animals.

A great deal of attention has been directed toward developing better options for palliative care and hospice, and improving euthanasia techniques in all species. Euthanasia of exotic pets is technically more difficult because of anatomic differences and small patient size. Traditional intravenous euthanasia techniques in conscious patients are stressful and should generally be avoided in exotic pets; simple intramuscular administration of high dosages of anesthetics followed by delivery of euthanasia solutions is preferred. Options for mammals, birds, and reptiles are presented.

Causes of Fatal Cyathostomiasis in Brown Booby (Sula leucogaster) from Brazil: Identification of Pathogen and Implications for Management.

Fatal infection by Cyathostoma (Cyathostoma) phenisci (Nematoda: Syngamidae), was identified in 2 of 52 brown boobies (Sula leucogaster) collected on beaches in the state of Rio de Janeiro, Brazil, and admitted to the veterinary clinic for rehabilitation. Both infected birds were in poor physical condition, with atrophied pectoral muscles, and died soon after starting treatment. The parasitological and pathological examination of the carcasses revealed the presence of C. (C.) phenisci in the trachea, resulting in tracheitis, as well as severe parasitic granulomatous bronchopneumonia caused by eggs deposited in the lungs. In our opinion, these serious pathological changes were the primary cause of chronic respiratory illness. This is the first description of fatal cyathostomiasis in a fish-eating avian host caused by infection by a member of the subgenus Cyathostoma (Cyathostoma). Therefore, it is reasonable to consider C. (C.) phenisci to be a real threat to a wide range of their definitive hosts, and cyathostomiasis should be considered in the differential diagnosis for fish-eating marine birds, even in cases without respiratory signs. This is also the first record of the genus Cyathostoma in Brazil.

Use of Margarine for the Successful Removal of Polyisobutylene in an Anhinga (Anhinga anhinga) and Great Blue Heron (Ardea herodias).

Two great blue herons (Ardea herodias) and an anhinga (Anhinga anhinga) were presented to the Wildlife Center of Texas with extensive plumage soiling from polyisobutylene (PIB), a synthetic rubber polymer used in manufacturing. All animals were provided supportive care and sedated for evaluation for hematologic and plasma biochemical values; one of the great blue herons was critically ill, based on the diagnostic evaluations and died approximately 24 hours after admission. On postmortem examination, it was diagnosed with coelomic migration of Eustrongylides species resulting in verminous peritonitis that was likely the primary cause of its poor condition and death, rather than the PIB exposure. Standard decontamination efforts with commercial liquid dish soap were unsuccessful. Application of margarine was used to emulsify the PIB on the remaining 2 birds and was followed by standard wash protocols for successful removal. These animals were successfully released after decontamination. The use of margarine for decontamination of PIB is unreported and could prove useful in future decontamination events in birds and other wildlife when traditional methods to remove hydrocarbon compounds are unsuccessful.

Clinical Management of Avian Renal Disease.

Treatment of avian renal disease relies on supportive care, such as fluid therapy and nutritional support. Analgesia and adaptations of the environment are indicated in cases of renal disease associated with painful joints. Other treatments vary with the underlying etiology and may include systemic antibiotics, antifungal therapy, vitamin A supplementation, or chelation therapy.

Distraction Osteogenesis in Two Wild Raptors.

Distraction osteogenesis was used in 2 wild raptor patients for the repair of tibiotarsal fractures. The first case was a hatching year female peregrine falcon (Falco peregrinus) admitted with an open oblique right distal tibiotarsal fracture. The fracture was surgically managed with the external skeletal fixator intramedullary pin tie-in technique (ESF-IM pin tie-in). Appropriate healing of the fracture site occurred with the ESF-IM pin tie-in. However, there was significant pelvic limb shortening of the affected leg, and the bird consequently developed pododermatitis on the contralateral foot. The second case was an adult female great horned owl (Bubo virginianus) that was admitted with a closed, partially healed, overriding right tibiotarsal fracture. Because of the advanced stage of this fracture, which presented with a fibrous callus, and the already apparent pelvic limb shortening, the ESF-IM pin tie-in was not used. Both patients were fitted with a circular external skeletal fixator (CESF), and distraction osteogenesis was performed until the length of the pelvic limb was deemed anatomically adequate. It is critical that rehabilitated raptors be released without any physical conditions that may reduce their ability to survive and reproduce in the wild. Pelvic limb shortening can potentially predispose a raptor patient to pododermatitis, even with fatal consequences, in both captive and wild environments. The orthopedic technique used here proved useful to repair the limb shortening in both raptor cases, and each bird fully recovered and was released.

Functional analysis and treatment of self-injurious feather plucking in a black vulture (Coragyps atratus).

The etiology and maintenance of self-injurious feather plucking (FP) have been attributed to biological and environmental processes, yet a definitive solution has not been found. The current study investigated the application of a functional analysis and function-based treatment to reduce the FP of a black vulture (Coragyps atratus). FP was found to be maintained by positive reinforcement in the form of contingent attention. A treatment consisting of noncontingent reinforcement decreased FP, and levels of FP remained low during schedule thinning. The current study further demonstrates the validity of function-based assessment and treatment with captive animals.

Key Ring Fixator: A Novel External Fixation Technique for Avian Long Bone Stabilization.

A 12-year-old blue-fronted Amazon parrot (Amazona aestiva) of unknown sex (case 1) and a 14-year-old female hybrid Catalina macaw (Ara ararauna × Ara macao) (case 2) were evaluated and treated for an open tarsometatarsal fracture and a tibiotarsal fracture, respectively. In case 1, 1 month of external coaptation resulted in a delayed union, significant osteolysis, and presumptive osteomyelitis, which led to the decision to treat with a key ring fixator. In case 2, a key ring fixator was chosen for fracture repair because of presumed resistance to destruction by the bird. In both cases, fractures were stabilized with makeshift circular external fixators composed of key rings, K-wires, orthopedic wire, and acrylic resin. After key ring fixator removal, radiographs confirmed complete bone healing. Both patients had acceptable function of the affected limbs 5 years (case 1) and 2 years (case 2) after their procedures. The key ring fixator described in this report is a viable option for fracture repair in pelvic limbs of moderately sized birds (300-1500 g).

Successful, Full-Thickness Skin Graft in a Bald Eagle (Haliaeetus leucocephalus).

A subadult, male bald eagle (Haliaeetus leucocephalus) was evaluated after being found unable to fly, with large eschars on the dorsal head and right stifle. Because of the appearance and location, the lesions were believed to be caused by an electrical injury. Treatment included oral antibiotics, nonsteroidal anti-inflammatory drugs, pain medication, surgical debridement of the eschars, and trephining of the affected inner table of the cranium. A full-thickness skin graft was performed to expedite wound healing and minimize holding time. After 6 weeks, the bird had new feather growth on its dorsal head and was released. This is the first report, to our knowledge, of a nonmesh, full-thickness skin graft in an avian species. Full-thickness skin grafts should be considered as a surgical option in juvenile or adult avian patients with large dorsal head wounds.

Inclusion Body Herpesvirus Hepatitis in Captive Falcons in the Middle East: A Review of Clinical and Pathologic Findings.

Inclusion body hepatitis in falcons is caused by a herpesvirus designated Falconid HV-1. This herpesvirus and other herpesviruses affecting birds of prey have not been assigned to a genus and include inclusion body herpesvirus hepatitis in eagles (Accipitrid HV-1) and inclusion body herpesvirus hepatitis in owls (Strigid HV-1). Herpesvirus infections have been diagnosed in both captive and free-living raptors across Europe, North America, and Asia in different species of the family Falconidae. Herpesviruses affecting owls and falcons have been found to be antigenically similar to pigeon herpesvirus (Columbid HV-1) and distinct from other avian herpesviruses. When the herpesvirus isolates from owls, falcons, and pigeons were compared by sequencing a fragment of the herpes viral DNA polymerase gene from those birds naturally infected with the virus, the sequences from these 3 sources were found to be nearly identical. The authors of this study concluded that the Falconid HV-1, Strigid HV-1, and Columbid HV-1 were the same virus. Furthermore, the authors also proposed that the virus therefore be referred to as Columbid HV-1 (CoHV-1), because pigeons may be responsible for the transmission of the virus to birds of prey. Pigeons are often carriers of the virus without showing any clinical signs. It has long been suspected that raptors may contract the infection by the ingestion of infected pigeons. Some studies have suggested that falcons may not contract the infection through the oral route by ingesting carrier pigeons, but through the ocular or nasal route. Inclusion body herpesvirus hepatitis is a frequently diagnosed disease in the captive falcon population used for falconry, racing, and breeding in the Middle East, and it seems to be associated with the extensive use of pigeons for training and as a food item. This paper reviews the clinical and pathological findings in falcons affected by inclusion body herpesvirus hepatitis in the Middle East.

Erosive Enteritis and Intestinal Obstructions Caused by Decomposed Granite in a Flock of Lesser Flamingos (Phoeniconaias minor).

Decomposed granite is a material commonly used in zoos as a base for flamingo exhibits. In 2012, the artificial turf over the decomposed granite in the Fort Worth Zoo flamingo exhibit was removed and pressure washed, the granite was replaced, and the turf was then restretched in place. Approximately 8 months later, 3 lesser flamingos (Phoeniconaias minor) showed signs of lethargy and hematochezia. Results of physical examination revealed poor body condition in all birds, with variable hematologic abnormalities, including anemia, hypoproteinemia, and electrolyte disturbances. Radiographs of birds showed large amounts of radiopaque material in the ventriculus and dilated intestinal loops. Two birds died either during treatment or surgery, and 1 bird was euthanatized. Postmortem examination of all 3 birds revealed large amounts of fine, granite-like material in the ventriculus and intestines, severe congestion of intestinal mucosa, and obstruction of intestinal lumen by caseous plugs surrounded by fecal material. Microscopic evaluation of the material removed from the ventriculus showed birefringent crystals that corresponded to microscopic silica grains, consistent with the decomposed granite from the exhibit. Histologic examination of tissues showed marked chronic erosive colitis, mild erosive proventriculitis, and lesions in the muscular layer of the ventriculus. Subsequently, 82 remaining flamingos in the flock were radiographed. Results showed the same material in the ventriculus of most birds, but no intestinal obstructions were identified. Different treatment techniques were attempted unsuccessfully to remove the material from the flamingos that had the largest amount of decomposed granite in their gastrointestinal tracts. Ultimately, all birds were treated with oral gastrointestinal protectants, adsorbents, laxatives, and lubricants, along with antibiotics administered in drinking water. No further mortalities occurred once medical treatments were implemented.

Comparison of Two Treatment Modalities and PCR to Assess Treatment Effectiveness in Macrorhabdosis.

Macrorhabdosis is a debilitating disease condition that affects budgerigars (Melopsittacus undulatus), cockatiels (Nymphicus hollandicus), and many other bird species worldwide. Macrorhabdus ornithogaster is a pathogen which leads to nonspecific clinical signs, and to date, diagnosis as well as therapy are still challenging. In this study, medical histories of 32 budgerigars and 7 cockatiels with macrorhabdosis diagnosed clinically and by polymerase chain reaction (PCR) within a period of 24 months (from January 2016 to January 2018) were retrospectively analyzed. Macrorhabdus ornithogaster was diagnosed through fecal samples collected over several days and analyzed by microscopic examination or PCR. The effectiveness of 2 different amphotericin B treatment regimens were investigated by PCR. In 23 cases, treatment was performed with amphotericin B via drinking water at 0.1 mg/mL for 28 days. For the remaining 16 birds, an alternative treatment regimen of amphotericin B at 100 mg/kg PO q12h for 10 days was combined with administration of amphotericin B via drinking water at 0.1 mg/mL for 28 days. Fecal samples of all treated flocks were reexamined by PCR 10-14 days post-amphotericin B treatment. More than half (56.4%) of the treated birds tested negative for M ornithogaster irrespective of the treatment regimen. In addition to clinical improvement and microscopic examination of droppings, PCR was used for the first time to evaluate treatment response in birds diagnosed with M ornithogaster. Administration of amphotericin B via drinking water proved to be effective in more than 50% of cases, indicating a less stressful alternative to the oral administration of amphotericin B twice daily.

Percloacal Ovocentesis in the Treatment of Avian Egg Binding: Review of 20 Cases.

Egg binding is one of the most commonly diagnosed reproductive disorders in avian medicine. Often, egg binding is caused by multiple factors, including inappropriate diet and husbandry, reproductive tract pathology, and/or systemic disease. Treatment of egg binding can include medical management or egg removal either percloacal or through surgical means. Percloacal ovocentesis is a commonly described technique in avian practice. The aim of this study was to consider the signalment, success of facilitating egg removal, associated complications, and outcome when percloacal ovocentesis was performed. Data were obtained from an avian first-opinion and referral center in the United Kingdom over a 10-year period. Of the 20 cases that met the inclusion criteria, the following orders were represented (Psittaciformes (n = 15; 75%), Anseriformes (n = 1; 5%), Accipitriformes (n = 2; 10%), and Strigiformes (n = 2; 10%) were represented. Patient age ranged from 2 to 26 years, with an average age of 9.4 years. Percloacal ovocentesis successfully facilitated egg removal in 16 of 20 cases (80%) with no complications observed in 14 of 20 cases (70%). Percloacal ovocentesis is not without potential complications; eggs fragmented in 2 of 20 (10%) cases, with coelomic penetration and coelomitis suspected in a single case (5%). Careful risk assessment and case selection should be performed before the use of this technique. In cases that are refractory to medical management, and in which surgical intervention is high risk or not a feasible option, percloacal ovocentesis can facilitate successful resolution of egg binding in an avian patient and should be considered as a viable treatment option.