Exotic Animal Practice in West Asia/Middle East.

Middle East is a diverse and developing exotic animal market. Undergraduate, postgraduate, and continuing professional development (CPD) education are noticeably absent except in few countries. Avian species are the most commonly kept due to traditional falconry or aviculture. Small mammal and reptile pet numbers are increasing. Endangered wildlife is still illegally kept and trafficked. Common diseases are similar to other continents related heavily with poor diet and husbandry due to uneducated, financially restrained, and prejudiced owners. There is a significant lack of board-certified specialists, teaching facilities, or dedicated private practitioners who thirst for CPD. Clinical research is absent except falcons.

Safety of an Intravenous Formulation of Voriconazole as an Intramuscular Injection in Pigeons (Columba livia f. domestica).

Aspergillosis is a common disease in birds. Currently, avian aspergillosis is treated with voriconazole administered orally, although intramuscular (IM) administration increases bioavailability and is more effective in treating generalized aspergillosis. The objective of this study was to evaluate the safety of the intravenous formulation of voriconazole as an IM injection in the pectoral muscles of pigeons (Columba livia f. domestica) as a model for other avian species. Sixteen healthy pigeons received IM injections of voriconazole (12.5 mg/kg) and sterile saline in the right and left pectoral muscles, respectively, twice a day for 7 days. Additionally, 4 birds acted as controls (no injections). Eight birds in the treatment group and 2 of the control pigeons were humanely euthanized 1 day (group 1) and 14 days (group 2) after the final injection. Hematologic and plasma biochemistry panels were performed prior to the birds being euthanized. Gross and histopathological evaluations of the pectoral muscles were completed postmortem. Statistical analysis revealed significant differences in multiple parameters, including aspartate aminotransferase and lactate dehydrogenase, but all biochemical analytes remained within the reference intervals for the species. The group 1 birds had advanced gross and histopathological pectoral muscle lesions associated with the voriconazole injections compared with the contralateral side, the group 2 birds, and the negative controls. After 14 days, the pectoral muscles did not reveal any gross or histopathological changes associated with the voriconazole or sterile saline injections. These results indicate that the intravenous formulation is safe for IM use twice per day for 1 week in pigeons. Further investigation is needed to extrapolate these findings to other avian species and to evaluate the roles of longer treatment periods and higher doses of voriconazole.

Infectious disease threats to amphibians in Greece: new localities positive for Batrachochytrium dendrobatidis.

In the early 2000s, numerous cases of European amphibian population declines and mass die-offs started to emerge. Investigating those events led to the discovery that wild European amphibians were confronted with grave disease threats caused by introduced pathogens, namely the amphibian and the salamander chytrid fungi Batrachochytrium dendrobatidis (Bd) and B. salamandrivorans (Bsal) and ranaviruses. In Greece, Bd was previously documented among wild amphibian populations in 2 different locations and 3 different species. However, no disease-related mass declines or mortality events have been reported. In this work, we build upon previous findings with new, subsequently obtained data, resulting in a 225-sample dataset of 14 species from 17 different locations throughout Greece, in order to examine the occurrence status of all 3 pathogens responsible for emerging infectious diseases in European amphibians. No positive samples for Bsal or ranavirus were recorded in any location. We confirmed the presence of Bd in 4 more localities and in 4 more species, including 1 urodelan (Macedonian crested newt Triturus macedonicus) and 1 introduced anuran (American bullfrog Lithobates catesbeianus). All insular localities were negative for Bd, except for Crete, where Bd was identified in 2 different locations. Again, no mass declines or die-offs were recorded in any Bd-positive area or elsewhere. However, given the persistence of Bd across Greece over the past ~20 yr, monitoring efforts should continue, and ideally be further expanded.

Reference intervals for Cu, Mg, and Zn in captive gyrfalcons and other falcon species in the United Arab Emirates.

Falconry is a long-standing tradition in the United Arab Emirates (UAE), and in 2016, falconry was included by UNESCO in the list of intangible cultural heritage of humanity. The health and wellness of falconry raptors is a priority for the local culture; plasma chemistry analysis plays an important role in monitoring, assessing, and managing diseases in avian patients. Imbalances of Cu, Mg, and Zn have been linked to several diseases in avian species; therefore, determining the reference intervals (RIs) of these minerals has important implications in the clinical management of falcons. We determined the RIs in plasma for Cu, Mg, and Zn in captive (falconry-managed) falcons according to the Quality Assurance and Laboratory Standards Committee of the American Society for Veterinary Clinical Pathology, and the Clinical Laboratory Standards Institute guidelines. Blood chemistry analyses were carried out on 252 clinically healthy falcons examined at the Dubai Falcon Hospital in the UAE: 124 gyrfalcons (Falco rusticolus) and 128 falcons of other species. We observed no significant variation in RIs of Cu (1.5-7.0 µmol/L), Mg (0.49-0.78 mmol/L), or Zn (11.8-34.1 µmol/L) based on different species or sex.

Disposition of posaconazole after single oral administration in large falcons (Falco spp): Effect of meal and dosage and a non-compartmental model to predict effective dosage.

Posaconazole has been used anecdotally to treat aspergillosis in falcons resistant to voriconazole. In human medicine, it is used prophylactically in immunosuppressed human subjects with invasive pulmonary aspergillosis. So far, no studies have been performed in birds. The aim of this study was to evaluate the in-vivo pharmacokinetic behavior of oral posaconazole after a single administration in six large falcons (i.e gyrfalcons, saker falcons). Posaconazole oral suspension (Noxafil, 40 mg/ml, Schering-Plough) was administered per os without meal in a single dosage of 12.5 mg/kg in 3 falcons. A comparison was done in two more falcons, one with a natural fatty meal at the same single dose, and one with a natural fatty meal and a higher dosage (20 mg/kg). Finally, six falcons received posaconazole pre-dissolved in corn oil with a natural low-fat meal in the higher single dose (20 mg/kg). No side effects were observed in the falcons in any of the experiments. In starved state posaconazole was poorly absorbed, more so than in other species. As expected, absorption of posaconazole was higher with the administration of meal or in the presence of plant (corn) oil, with a fourfold increase in apparent bioavailability. Despite the preferential absorption in the presence of fat, for both dosing schemes the AUC24 : MIC ratio was lower than described in human medicine to achieve a therapeutic effect. The AUCinf : MIC which is an indicator of efficacy after steady-state, while variable, did indicate that the drug is worth trying when susceptibility testing shows to be the only effective drug. LAY ABSTRACT: The focus of this work is to determine the pharmacokinetic parameters of oral posaconazole in large falcons for the first time after a single dose. Posaconazole has higher bioavailability when administered with meal and fatty components. No adverse reactions have been observed. The ratio of the area under the curve (AUC24) to minimum inhibitory concentration was lower compared to the therapeutic level in human.

Multicentric Septic Osteomyelitis and Arthritis Caused by Staphylococcus aureus in a Gyrfalcon (Falco rusticolus).

An adult female gyrfalcon (Falco rusticolus) was presented with a right-wing droop and weight loss. Radiographic images revealed osteolysis and osseous proliferation of the right shoulder and the mobile vertebra between the notarium and synsacrum. The tentative diagnosis was vertebral osteomyelitis secondary to septic arthritis. The bird did not respond to antibiotic and anti-inflammatory therapy and represented 10 days later, with feathers soiled with feces, an impacted, dilated cloaca, and an inability to stand due to spastic paralysis of the hind legs. The bird's condition did not improve with 24 hours of supportive care and its quality of life was considered poor; therefore, the patient was euthanatized and submitted for postmortem examination. Multicentric septic osteomyelitis and arthritis were confirmed in the mobile vertebra between the notarium and synsacrum and the right shoulder. Despite 10 days of antibiotic therapy, Staphylococcus aureus was isolated from within the 2 locations in which septic osteomyelitis and arthritis were identified. This report describes the clinical features, diagnosis, and pathologic findings of septic osteomyelitis and arthritis caused by S aureus in a falcon.

The current status of avian aspergillosis diagnoses: Veterinary practice to novel research avenues.

Aspergillus fungal infections continue to be a significant cause of morbidity and mortality in birds that can, in part, be attributed to the lack of a diagnostic "gold standard" for Aspergillus infection, and which delays the diagnosis, treatment, and outcome of avian patients. At present, none of the available methods in veterinary care can detect aspergillosis early enough and with the accuracy, precision, and specificity required of an ideal diagnostic tool. Therefore, researching methods of Aspergillus detection is still an active area of inquiry, and novel techniques continue to emerge. This review will provide a brief overview of current clinical methods, with an emphasis on avian care, in addition to a series of techniques in development that could offer distinct advantages over existing methods.

First detection of Cryptosporidium parvum in falcons (Falconiformes): Diagnosis, molecular sequencing, therapeutic trial and epidemiological assessment of a possible emerging disease in captive falcons.

Cryptosporidiosis in raptors and falcons is well-known to be caused by Cryptosporidium baileyi and associated mainly with respiratory pathology. This report presents the diagnosis of an atypical cryptosporidiosis event caused by Cryptosporidium parvum, that to the authors' knowledge, is a case observed for the first time in falcons. Two falcons (Gyrfalcon x Peregrine hybrids) were presented for annual check without any clinical signs. Hematology, biochemistry, fecal and crop parasitology, radiographic and endoscopic examinations were performed. Endoscopy revealed microcystic formation of the caudal lung field in the two falcons, adhesions and air sac alterations. Sampling and subsequent cytology revealed fungal spores and acid fast stain organisms (identified as Cryptosporidium spp.). Feces and affected lung tissue was further send for Cryptosporidium spp.-DNA detection. Fecal samples and lung tissue tested positive for Cryptosporidium spp. gp60 gene by PCR. By sequence analysis of the gp60 gene locus, diagnosis of C. parvum was confirmed with 100% homology. Despite the fact that falcons didn't recover after 1 month of therapy, eight months after the initial examination they were clinically healthy and had satisfactory flying performance. No other falcons were observed with C. parvum infections in the facility so far. The possible source, infection route and implications are discussed.

Avian luxations: occurrence, diagnosis and treatment.

Whereas the treatment of fractures in birds has been a matter of multiple studies and reviews, comparatively little information is available for the treatment of luxations in birds. In this article, we review the current knowledge regarding the frequency, etiology, clinical presentation, diagnosis, and treatment of luxations in birds, aiming to guide the clinician in private practice as well as future research. The type, the localization, and the frequency of luxation do not follow a concrete pattern. In general, pet and aviary birds are more susceptible to leg and spinal luxations while in wild birds wing luxations are more frequently observed. Diagnosis is made on the basis of detailed orthopedic and radiographic examinations. Conservative management and coaptation has been successfully used in carpal, minor elbow, shoulder, coracoid, and metatarsophalangeal luxations. Surgical management is recommended in palatine bone, metacarpophalangeal, severe elbow, coxofemoral, stifle, and intertarsal joint luxations. The techniques, which have been applied, include arthrodesis, femoral head osteotomy, polymer rods, bone plates, and internal and external fixation in various combinations. Currently, there are no controlled studies, which underline the advantages and disadvantages of each technique.

Optical coherence tomography as a diagnostic tool for retinal pathologies in avian ophthalmology.

PURPOSE: Optical coherence tomography (OCT) is an established diagnostic tool for retinal pathologies in human eyes and has been adapted to small animal models. However, there have been only a few attempts to use OCT for examination of avian eyes, and little is known about structural details of healthy or pathologically affected retinas in living birds. METHODS: We used SD-OCT (high-resolution spectral domain OCT) to investigate eyes of various avian species including birds of prey. The birds were anesthetized by isoflurane application during OCT examination. Eyes of a common buzzard (Buteo buteo) could be used for a comparative analysis of OCT images and histologic/immunohistochemical examinations. RESULTS: We investigated 45 wild and domestic birds (25 different species, 40 g-7.7 kg body mass) without and with diverse pathologic indications (e.g., body or head trauma). Animals were generally and ophthalmologically examined, and the diagnostic findings of direct ophthalmoscopy and OCT were compared. The OCT examination revealed an increased number of animals with clinical findings and allowed a detailed assessment of structural changes in retinal and choroidal tissue compared to simple direct ophthalmoscopy. Common findings were retinal and choroidal degeneration, retinal detachment, choroidal schisis, drusen, and drusenoid changes. Histologic and immunohistochemical analysis of retinal tissue confirmed the findings of the OCT examination. CONCLUSIONS: Spectral domain OCT of eyes in living birds is applicable and useful as a diagnostic tool in veterinary clinical practices and for vision research in general. Optical coherence tomography improves the quality of the common assessment methods in avian ophthalmology, and expands the diagnostic possibilities with respect to identification and prognosis of diseases. This will be particularly important for hereditary retinal defects, especially of precious breeding individuals, or estimation of treatment success in traumatized wild birds with the aim of release back into the wild.

A complicated, metastatic, humeral air sac cystadenocarcinoma in a timneh African grey parrot (Psittacus erithacus timneh).

A 9-year-old male timneh African grey parrot (Psittacus erithacus timneh) was presented because of inability to fly and suspected trauma. The owner also had observed dyspnea, with tail bobbing and open-beak breathing. On clinical examination, a hard, painful mass was palpable in the left proximal humerus and axillary area. Radiographs revealed a radiodense soft tissue mass of the left humerus with no bony involvement, multifocal opacities in lung and air sacs, and an enlarged spleen. An asymmetric, vascularized cyst was detected in the mass by ultrasound examination. Results of biopsy of the mass revealed multifocal cysts composed of unilayer isoprismatic cells laying in vascularized connective tissue. Because of the severity of clinical signs and the poor clinical condition, the bird was euthanatized. On postmortem examination, the findings were air sac cystadenocarcinoma involving the humeral air sac with metastases in the spleen and kidneys, atherosclerosis, pneumoconiosis, and mycotic granulomatous pneumonia and airsacculitis with isolation of Aspergillus niger.