Disseminated coelomic xanthogranulomatosis in eclectus parrots (Eclectus roratus) and budgerigars (Melopsittacus undulatus).

Xanthogranulomatosis is an inflammatory lesion characterized by lipid-containing macrophages, extracellular lipid, hemorrhage, and necrosis. We describe disseminated intracoelomic xanthogranulomatosis in 5 eclectus parrots (Eclectus roratus) and 2 budgerigars (Melopsittacus undulatus). Postmortem, clinicopathologic, and historical case material was reviewed. Ages ranged from 3 to 24 years; there were 5 males and 2 females. Table food was included in the diet of 3/5 cases, and animal products were included in 2/3 cases. Common clinicopathologic abnormalities included leukocytosis (4/5 cases) and elevated concentrations of bile acids (3/4 cases) and cholesterol within 6 months prior to death (2/4 cases). At postmortem examination, all 7 birds had grossly visible, irregular, soft, tan to yellow, amorphous plaques distributed on the surfaces of the viscera and body wall. Histologic evaluation and oil red O stain revealed xanthogranulomatous inflammation with phagocytized and extracellular lipid, necrosis, cholesterol clefts, fibrosis, and mineralization. Infectious agents were not identified with special stains in all cases. Concurrent hepatobiliary disease was present in 6/7 cases, and 6/7 had lipid accumulation within the parenchyma of various visceral organs. Five cases had atherosclerosis of great vessels. We describe a unique form of disseminated coelomic xanthogranulomatosis in 2 psittacine species. This condition should be recognized as a differential diagnosis in cases of disseminated coelomic mass formation and coelomic distension in psittacine birds, particularly in eclectus parrots and budgerigars.

COMPUTED TOMOGRAPHY OF CUTANEOUS MYIASIS IN AN ORNATE BOX TURTLE (TERRAPENE ORNATA ORNATA).

A juvenile intact female ornate box turtle (Terrapene ornata ornata) was referred for evaluation of right-sided appendicular swelling that was nonresponsive to antimicrobial therapy. Computed tomography (CT) revealed severe soft tissue swelling of the limbs and neck, with multiple associated tortuous gas-filled sinus tracts extending from the cutaneous surface, which contained oblong soft tissue attenuating structures. These CT findings were most consistent with migrating dipterous larvae. Surgical exploration was performed and six sarcophagid larvae (Superfamily Oestroidea) were extracted. To our knowledge, this is the first case report in veterinary medicine providing antemortem CT imaging features of cutaneous myiasis in a reptile.

Disseminated pancreatic adenocarcinoma in an eclectus parrot (Eclectus roratus).

CASE DESCRIPTION: A 15-year-old 0.412-kg (0.906-lb) sexually intact male eclectus parrot (Eclectus roratus) was evaluated because its owners found it lethargic and dyspneic at the bottom of its cage. CLINICAL FINDINGS: The parrot was thin and had generalized muscle wasting, diffuse feather loss, pale mucous membranes, and melena. The coelomic cavity was distended and soft on palpation, with coelomic effusion suspected. Results of a CBC indicated leukocytosis with left shift heterophilia, including toxic heterophils, lymphopenia, and anemia. Plasma biochemical analyses revealed severe hyperamylasemia. TREATMENT AND OUTCOME: Radiography revealed no evidence of a metallic foreign body but severe loss of coelomic detail, suggestive of a coelomic mass, coelomic effusion with coelomitis, or both. Ultrasonography and CT revealed severe accumulation of coelomic fluid; a large, heterogeneous, irregularly marginated, and moderately vascularized mass in the caudal aspect of the coelomic cavity; and multiple hepatic, coelomic, and pulmonary nodules. On the basis of a poor prognosis, the parrot was euthanized. Necropsy results confirmed exocrine pancreatic adenocarcinoma, with disseminated metastases in the liver, gastrointestinal tract, coelomic cavity, and lungs. CLINICAL RELEVANCE: In birds, pancreatic adenocarcinoma is rarely reported but should be considered a differential diagnosis for hyperamylasemia, coelomic mass, coelomic effusion, or abnormal gastrointestinal signs, alone or in combination. Ultrasonography and CT can be useful in further evaluating such patients and should be considered in the diagnostic plan.

Imaging features of disseminated xanthogranulomatous inflammation in eclectus parrots (Eclectus roratus).

Xanthogranulomatous disease is a rare condition, which can be caused by infection, inflammation, hemorrhage, immunologic disease, or inherited lysosomal disorders. It is characterized by non-intracellular lipid and cholesterol deposits among an inflammatory infiltrate of vacuolated macrophages and giant cells. The diagnosis of xanthogranulomatous disease is challenging, with nonspecific imaging findings often misinterpreted as aggressive neoplastic processes in humans. In this retrospective case series study, we describe the diagnostic imaging characteristics of a disseminated xanthogranulomatous condition identified in five eclectus parrots (Eclectus roratus). Decreased serosal detail and celomic distension were present in all three birds radiographed, with multifocal variably sized celomic mineralization (3/3 birds), and extracelomic mineralized masses (1/3 birds). Celomic effusion with foci of celomic mineralization and hepatomegaly were identified in all birds (3/3) imaged with ultrasound. Finally, a mineralized mural ventricular mass was present in one of three patients imaged with CT, multifocal celomic mineralization with moderate to severe celomic effusion in two of three patients, diffuse severe proventricular and intestinal dilation in all three patients, and atherosclerosis of the major arterial trunks in all three patients. Veterinary radiologists should be aware of this inflammatory condition in birds, especially in eclectus parrots, and should be able to recognize the imaging features of xanthogranulomatous inflammation.

Mensuration of the rabbit pituitary gland from computed tomography.

The aim of this retrospective reference interval observational study was to determine the mensuration of the pituitary gland (hypophysis cerebri) by analyzing CT studies in rabbits without clinical evidence of pituitary disease or central neurologic signs. Though diseases of the rabbit pituitary gland are uncommon, the pituitary gland is essential in regulation of the rabbit's endocrine system, as in other species. Currently, there are minimal published studies that detail the rabbit head anatomy on cross-sectional imaging, and even less specifically examining the pituitary gland. The pituitary gland was measured by one observer at a single time point from transverse and reconstructed sagittal CT images in a soft-tissue algorithm in 62 rabbits for a total of 66 rabbit head CT studies. The rabbits ranged from 0.84 to 14 years in age (mean ± SD: 5.46 ± 3.05 years) and 0.92 to 4.95 kg in weight (2.21 ± 0.83 kg). Linear pituitary measurements were performed using electronic calipers. The mean ± SD pituitary height was 4.22 ± 0.57 mm, width was 4.48 ± 0.71 mm, and length was 6.02 ± 0.70 mm. The pituitary gland height-to-brain area ratio was 1.10 ± 0.16 mm-1 , which is much higher than the values reported in normal dogs and cats. The age, weight, and sex of the rabbits were not found to have a significant impact on pituitary gland mensuration. These measurements could be useful as a reference range for future rabbit head CT studies and to rule out pituitary enlargement or disease when evaluating rabbit pituitary glands.

Gastrointestinal Disease Associated with Non-albicans Candida Species in Six Birds.

A non-albicans Candida species was identified in 6 birds exhibiting clinical signs associated with gastrointestinal disease. The clinical disease signs noted in these 6 birds included diarrhea, regurgitation, and melena, and were considered concurrent or identified secondary to other comorbidities. Candida glabrata was identified in a yellow-naped Amazon parrot (Amazona auropalliata), a ring-necked dove (Streptopelia capicola), a blue-and-gold macaw (Ara ararauna), and 2 cockatiels (Nymphicus hollandicus). Candida krusei was identified in a white-crowned parrot (Pionus senilis). Fungal culture and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry identification was correlated with results of fecal and/or crop Gram's stains, and DNA sequencing was used in one case. Three cases resolved after treatment, 2 birds died, and 1 was lost to follow-up. Non-albicans Candida infections are an emerging issue in human health care and are known to have an increased resistance to antifungal drugs. Similar to Candida albicans, these non-albicans Candida species are often identified in patients that have a history of prior antibiotic exposure. Recent data in human medicine describe a shift in species distribution away from C albicans dominance and toward other species, including C glabrata and C krusei. Both species are considered normal flora within the human and bird mycobiota and may emerge to cause disease, especially when the normal gastrointestinal environment has been disrupted.

Vegetative Endocarditis due to Staphylococcus aureus in an Umbrella Cockatoo (Cacatua alba).

A 15-year-old, female cockatoo (Cacatua alba) was presented with a history of intermittent cloacal prolapse of 1-year duration. After each prolapse, the owner would digitally reduce the distended cloacal tissue within approximately 12-24 hours, for short-term resolution. The cockatoo was examined 3 times over a 7-month period and received supportive care with leuprolide acetate, behavioral modification, and diet change. After the third examination, the owner decided to proceed with a surgical cloacopexy. Five days after the last examination and before the procedure was scheduled, the cockatoo was reexamined for acute onset of weakness, anorexia, lethargy, and right-leg paresis. Despite supportive treatment, the cockatoo's clinical condition declined, and it went into respiratory arrest. Resuscitative efforts, including manual ventilation and cardiovascular support, were unsuccessful, and the bird died. Results of postmortem examination revealed vegetative endocarditis with intralesional bacteria cultured as Staphylococcus aureus, right-hindlimb myonecrosis, hepatitis, and nephritis. We suspect that the source of the hematogenous S aureus infection in this cockatoo was translocation from the owner's skin from the repeated manual manipulation and replacement of the prolapsed cloacal tissue.

Acute Necrotizing Pancreatitis in a Yellow-naped Amazon Parrot ( Amazona auropalliata).

A 25-year-old female yellow-naped Amazon parrot ( Amazona auropalliata) was presented for an acute onset of lethargy, ptyalism, and regurgitation. Results of hematologic testing and plasma biochemical analysis revealed severe leukopenia and heteropenia with toxic heterophils and marked hyperamylasemia and hypoproteinemia, consistent with gastrointestinal dysfunction. Survey radiograph findings were suggestive of coelomic effusion. Results of a contrast-enhanced computed tomography (CT) scan revealed a tubular, irregularly marginated structure along the medial aspect of the duodenum, consistent with an inflamed pancreas. The bird died soon after CT imaging, and acute necrotizing pancreatitis and pancreatic coagulative necrosis were observed at necropsy. This report describes the use of a less-invasive modality such as CT to aid in the antemortem diagnosis of acute pancreatitis in a psittacine bird. Pancreatitis should be considered a differential diagnosis in birds with gastrointestinal signs and coelomic effusion visualized on radiography, and the observation of an enlarged inflamed pancreas in the absence of a defined pancreatic mass on CT.

Multicentric Cryptococcosis in a Congo African Grey Parrot ( Psittacus erithacus erithacus).

An approximately 10-year-old, female Congo African grey parrot ( Psittacus erithacus erithacus) developed progressive, unilateral exophthalmos and buphthalmos. Survey radiographs revealed a large, coelomic, soft tissue mass, which was confirmed on computed tomography scan. Aspirates of both the contents of the buphthalmic globe and coelomic mass were consistent with Cryptococcus species. Initial results were later confirmed with serum antigen latex agglutination and polymerase chain reaction testing, and the organism was then identified as Cryptococcus neoformans with DNA sequencing. During the course of 1 year, the bird was treated with combinations of oral terbinafine, fluconazole, and flucytosine, as well as intraocular amphotericin B. The coelomic mass dramatically decreased in size during the course of treatment, but the globe continued to enlarge. The bird died after exhibiting ataxia and seizures approximately 13 months after initial diagnosis, and necropsy confirmed colonization of the cerebrum and meninges with Cryptococcus. Cryptococcus remains a rare fungal disease of birds that is often refractory to treatment.

Evaluation of Chlamydophila psittaci infection and other risk factors for atherosclerosis in pet psittacine birds.

OBJECTIVE: To determine whether the presence of Chlamydophila psittaci antigen, plasma cholesterol concentration, diet, sex, species, and age are risk factors for the development of atherosclerosis in pet psittacine birds. DESIGN: Retrospective case-control study. ANIMALS: 31 psittacine birds with atherosclerosis (study birds) and 31 psittacine birds without atherosclerosis (control birds). PROCEDURES: Necropsy reports were reviewed, birds with a histopathologic diagnosis of atherosclerosis were identified, and available medical records were reviewed. Signalment, history, clinicopathologic findings, and other relevant data were recorded and evaluated. Control birds did not have atherosclerosis and were chosen by both convenience sampling and population demographics. Histologic sections of great vessels from all birds (study and control birds) were reviewed and then submitted for immunohistochemical staining for the presence of C psittaci antigen. RESULTS: Result of immunohistochemical staining for C psittaci antigen in blood vessels was significantly associated with atherosclerosis. After adjusting for age, species origin, and type of illness, the odds of atherosclerosis was 7 times as high for birds with positive immunohistochemical staining for C psittaci antigen, compared with that of birds with negative immunohistochemical staining. Study birds and control birds differed significantly only with respect to plasma cholesterol concentrations. The median plasma cholesterol concentration of study birds (421 mg/dL) was significantly higher than that of control birds (223 mg/dL). CONCLUSIONS AND CLINICAL RELEVANCE: Infection with C psittaci and a high plasma cholesterol concentration may be risk factors for developing atherosclerosis in pet psittacine birds.