AIR SAC TREMATODES (CYCLOCOELIDAE STOSSICH, 1902) INFECTING BIRDS IN ZOOLOGICAL INSTITUTIONS IN THE UNITED STATES.

Air sac trematodes (Digenea: Cyclocoelidae) were detected in 23 avian species from eight aviaries in the United States. Most of the infected host species were passeriform birds, but a few species in other orders also were infected. Four species of adult flukes were encountered: Circumvitellatrema momota, Morishitium sp., Psophiatrema greineri, and Szidatitrema yamagutii. Findings from retrospective review of medical records, necropsy records, and author observations are presented. Potential terrestrial snail intermediate hosts were collected from three indoor aviaries. A high prevalence (47%) of larval trematode infections was demonstrated in one species of nonnative snail (Prosopeas achatinacea); one larva was isolated and matched to the adult species (C. momota) from birds using PCR. Problems with introducing potentially infected wild-caught birds into aviaries, and exchanging captive individuals between aviaries where they potentially may carry infections, are discussed.

MAST CELL NEOPLASIA IN THE GREEN IGUANA, IGUANA IGUANA.

This case series is the first description of mast cell neoplasia in green iguanas, Iguana iguana. All iguanas were adults. Six were females, and four were males. Lesions were associated with the oral cavity in 3 of 10 cases, and on the head in 3 of 10 cases. Three of the cases had masses over the trunk; a single case had a lesion on a limb. Single masses were most common involving the face or oral cavity (6 of 10), whereas four cases with neoplasia distributed along the trunk had multiple masses. One case developed peripheral blood mastocytosis. In most neoplasms, cells contained metachromatic granules in toluidine blue-stained sections. Polymerase chain reaction identified no internal tandem duplication mutation in exon 11 of c-kit, but a mutation in exon 8 in a single case. Compared with other reptiles, green iguanas may be predisposed to development of mast cell neoplasia.

Morphological features of hepatic lipid changes in bearded dragons (Pogona vitticeps), and a proposed grading system.

Hepatic lipidosis is commonly diagnosed in pet bearded dragons (Pogona vitticeps). However, there are no studies detailing the histological features of hepatic lipid changes in this species. This study describes the microscopic features of lipid change and details an associated scoring system. Histologic hepatic sections were retrospectively evaluated from 252 bearded dragons submitted for necropsy. Pathologic assessment was used to develop a grading scheme with 2 qualitative, 1 quantitative, and 6 semi-quantitative microscopic parameters, which were refined based on variability. The final grading system developed for diffuse and panlobular lipid accumulation included 2 semi-quantitative and 1 quantitative categories: percentage of hepatocellular vacuolation, fibrosis, and hepatocellular swelling, respectively. Hepatocellular swelling was indirectly quantified by counting the number of nuclei per unit area. There was a strong positive correlation (P < .001) between the percentage of hepatocellular vacuolation and lipid content, a strong negative correlation (P < .001) between nuclear count and lipid content, and a moderate correlation (P < .001) between fibrosis and lipid content. Each category was given a numerical value ranging from 0 to 4, with the sum of each representing the final grade. Cutoff values stratified microscopic changes into mild (final grade 1-4), moderate (5-7), and severe (≥8). There was strong interrater agreement for assessment of vacuolization, fibrosis, and severity classification and moderate for hepatocellular swelling. This study documents the features of hepatic lipid changes in bearded dragons. Although a cutoff to differentiate pathologic from nonpathologic lipid accumulation could not be estimated, the proposed grading scheme can be used to inform future studies.

Prevalence and risk factors of hepatic lipid changes in bearded dragons (Pogona vitticeps).

Hepatic lipidosis is a common disease of captive bearded dragons (Pogona vitticeps). Diagnosis, prevention, and treatment of this condition are challenging, as there is minimal information in the literature. Our study determined the prevalence and epidemiological risk factors associated with the grade and severity of hepatic lipid changes in bearded dragons submitted for necropsy in 2 North American institutions. A total of 571 postmortem cases were retrieved, and from each pathology report the demographic data (age, sex) and the list of final diagnoses were extracted. For each case diagnosed with hepatic lipidosis, the archived sections of liver were reviewed and the severity of lipid change was stratified using a standardized histologic grading system. Descriptive statistics were used to estimate the prevalence of each grade and severity class. Associations between grade and severity, as well as demographic data and concurrent diseases, were explored using ordinal logistic regression analysis. On multiple logistic models, the occurrence of infectious disease and neoplasia was associated with decreased grade and severity of hepatic lipid changes, while the female sex and adult age were associated with an increased grade and severity. None of the other variables were significantly associated with hepatic lipid changes. These results suggest that reproductively active females and adult bearded dragons are predisposed to increasing hepatic lipid changes, while those with an underlying disease process have reduced hepatic lipid accumulation and changes, possibly due to increased fat catabolism. Data in this study can serve to benchmark the prevalence of hepatic lipidosis in bearded dragons and allow further investigations.

Diagnosis of Seminoma With Metastasis to the Brain and Kidneys in a Moluccan Eclectus (Eclectus roratus) Using Advanced Contrast Based Imaging.

A 20-year-old male Moluccan eclectus (Eclectus roratus) was presented with a history of falling off the perch, ataxia, unilateral blindness, hyporexia, and progressive lethargy. The eclectus was found to have a leukocytosis (52 × 103 cells/µL), characterized by an absolute and relative heterophilia (42.6 × 103 cells/µL and 82%, respectively), relative lymphopenia (18%), elevated bile acids (88 µmol/L), and elevated triglycerides (236 mg/dL). Radiographic images revealed a mass effect within the caudal coelom. After 13 days of outpatient supportive care, the patient was rechecked and had normalized bile acids (<35 µmol/L), static triglycerides (232 mg/ dL), and hyperuricemia (18.6 mg/dL). Computed tomography was performed antemortem with and without iodinated contrast agent, 4 mL/kg IV over 2 minutes, and a mass was found associated with the left kidney. Due to worsening neurologic signs and involvement with surrounding structures, the owner elected euthanasia. Before the postmortem examination, a postmortem intravascular contrast agent was used to provide a more thorough visualization of internal anatomical structures, including left renal vasculature disruption, mass vasculature, caudal coelomic organ displacement, and increased irregular optic chiasm radiodensity. Postmortem, a 4 × 4.1 × 5.1-cm white to tan mass was identified. Histopathology confirmed a seminoma with metastasis to the kidneys and optic chiasm. Seminomas have been described in avian species; however, seminoma metastasis in an eclectus parrot confirmed by histopathology has not been reported, and optic chiasm metastasis of a seminoma has not been described in any avian species. This report describes postmortem computed tomographic angiography of metastatic seminoma in a Moluccan eclectus with metastasis to the optic chiasm.

Pathology in Practice.

In collaboration with the American College of Veterinary Pathologists.

Neuropathology of feral conures with bromethalin toxicosis.

Bromethalin is a widely used neurotoxic rodenticide sometimes affecting nontarget wildlife. However, the effects of bromethalin on avian species are largely unknown. Here, we report the neuropathology of 14 feral conures (Psittacara sp.) with bromethalin toxicosis. Clinically, all birds presented with different degrees of paraparesis that sometimes progressed to dysphagia, ataxia, and tetraparesis. Histologically, there was astrogliosis, pallor, and vacuolation of white matter in the brain. This was usually more prominent in the medial longitudinal fasciculus, pons, optic tectum, cerebellar peduncle, and ventral funiculus. In most affected areas, there was loss of oligodendrocytes, and axons had extensive myelin loss or marked intramyelinic edema with splitting of myelin sheaths at the intraperiod line. Conures with bromethalin toxicosis had neuropathological changes similar to those of mammals exposed to bromethalin but with a characteristic distribution, probably related to higher susceptibility to cytotoxic edema in certain regions of the avian brain.

Hepatic copper accumulates in ferrets with and without hepatobiliary disease.

OBJECTIVE: To determine hepatic copper concentrations and zonal distribution in ferrets with and without hepatobiliary disease, validate rhodanine-based qualitative copper scoring and digital copper quantification in ferret hepatic samples, and ascertain whether clinical features predicted copper accumulation. ANIMALS: 34 ferrets, including 7 with necroinflammatory disease, 5 with hepatocellular carcinoma, 13 with non-necroinflammatory disease, and 9 with no hepatobiliary disease. PROCEDURES: Rhodanine-based digital copper quantification was validated by use of liver dually measured by atomic absorption spectroscopy and digital scanning (R2 = 0.98). Clinical features and hepatic copper scores and concentrations (dry weight liver) were compared between groups. Zonal copper distribution was determined. RESULTS: Hepatic copper concentration was strongly correlated with copper scores (ρ = 0.88). Ferrets with hepatobiliary disease were significantly older and had significantly higher serum alkaline phosphatase and γ-glutamyltransferase activities and creatinine concentrations. Centrilobular copper accumulated in 23 of 34 (64%) ferrets with (n = 15) and without (8) hepatobiliary disease. Median copper concentrations were not significantly different between ferrets with and without hepatobiliary disease but were significantly higher within neoplastic hepatic tissue in ferrets with hepatocellular carcinoma. Hepatic copper concentrations exceeded feline (> 180 µg/g) and canine (> 400 µg/g) reference limits in 19 and 9 ferrets, respectively. Hepatic copper > 1,000 µg/g occurred in 5 ferrets with and 2 without hepatobiliary disease. Clinical features did not predict copper accumulation. CLINICAL RELEVANCE: Rhodanine-based digital copper quantification and qualitative copper scoring discerned liver copper accumulation in ferrets. Ferrets with and without hepatobiliary disease displayed a propensity for centrilobular hepatic copper accumulation of uncertain clinical importance. Clinical and clinicopathologic features could not exclusively implicate pathologic copper accumulation.

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.

Clinical, surgical, and pathological findings in client-owned rabbits with histologically confirmed appendicitis: 19 cases (2015-2019).

OBJECTIVE: To report clinical, surgical, and pathological findings in client-owned rabbits with histologically confirmed appendicitis. ANIMALS: 19 rabbits. PROCEDURES: Medical records for client-owned rabbits that had a histologic diagnosis of appendicitis were reviewed. RESULTS: Median age of the rabbits at presentation was 24.0 months (range, 4 to 84 months). Seventeen cases occurred during the summer and fall seasons. Decreased appetite (17/19 rabbits), abnormal rectal temperature (hyperthermia, 9/16 rabbits; hypothermia, 4/16 rabbits), hypocalcemia (8/11 rabbits), and hypoglycemia (7/15 rabbits) were common signs. Abdominal ultrasonography and CT findings were suggestive of appendicitis in 6 of 8 rabbits and in 1 of 2 rabbits, respectively. Of the 6 rabbits that received medical treatment, 3 died at 48 hours, 1 died at 24 hours after hospitalization, and 1 died at 10 days after presentation; 1 rabbit was alive at 1,030 days after presentation. Of the 8 rabbits that underwent appendectomy, 3 died before discharge from the hospital and 1 died 113 days after surgery; 4 rabbits were alive at 315, 334, 1,433, and 1,473 days after presentation. The remaining 5 rabbits either died or were euthanized before treatment could be instituted. In each of the 19 rabbits, the appendix had evidence of severe inflammation with mucosal ulceration, heterophilic inflammation, and necrotic debris. CLINICAL RELEVANCE: For rabbits with decreased appetite and an apparently painful abdomen, hyperthermia, hypocalcemia, or hypoglycemia, appendicitis should be considered as a differential diagnosis. Further comparisons of medical and surgical treatments are required to establish treatment recommendations for rabbits with appendicitis.

Retrospective Review of Mycobacterial Conjunctivitis in Cockatiels (Nymphicus hollandicus).

The etiologic disease organism responsible for causing mycobacteriosis in avian species is an acid-fast gram-positive bacterium. This bacterium causes granulomatous disease in various internal organs, but in cockatiels (Nymphicus hollandicus) it has been commonly identified within the conjunctival tissues. Twenty-six cases of mycobacterial conjunctivitis in cockatiels were diagnosed through histopathologic assessment of diseased tissue samples, Fite acid-fast staining, and polymerase chain reaction in this retrospective study. Clinicians who saw these cases were contacted, and information was obtained regarding recommended treatment protocols prescribed for the patients, the Mycobacterium species identified, and case outcomes. All patients in this retrospective study had a biopsy performed on the affected conjunctival tissue, and because of the small size of the patients, this excisional biopsy removed the affected tissue in its entirety or significantly debulked the lesion. Of the 26 cases, 10 were lost to follow-up, 4 were euthanatized, 7 died, and 5 were alive at the time this information was submitted for publication.

Pathology of Diseases of Geriatric Exotic Mammals.

The review covers select disease conditions most frequently described in aging rodents (rats, mice, hamsters, guinea pigs), rabbits, and ferrets. The conditions are categorized by general organ systems, infectious diseases, and neoplasms. Two data systems, the Veterinary Medical Teaching Hospital and Comparative Pathology Laboratory at the University of California, Davis and Zoo/Exotic Pathology Service, Citrus Heights, California were used in the determining disease conditions to describe.

Giant Cell Sarcomas in Domestic Rabbits (Oryctolagus cuniculus).

Multinucleated giant cells (MGCs) are a prominent histological feature of various mesenchymal neoplasms and are often considered a criterion of malignancy. Mesenchymal neoplasms with MGCs for which the cell lineage is unclear generally are referred to as giant cell sarcomas. Here we characterize the gross, histologic, and immunohistochemical features of 90 giant cell sarcomas in domestic pet rabbits. Based on the anatomic location and histologic and immunohistochemical findings, 18 cases were classified as histiocytic sarcomas (HS) and 72 cases as anaplastic sarcomas (AS). At postmortem examination, HS was either localized HS (n = 7) always affecting the lungs, or disseminated HS (n = 10) that affected the lungs (n = 10), liver (n = 6), kidneys (n = 4), pleura (n = 2), mediastinum (n = 2), heart (n = 4), skeletal muscle (n = 1), adipose tissue (n = 1), and lymph node (n = 1). Additionally, one cecal biopsy was consistent with HS. Microscopically, HS were characterized by sheets of neoplastic polygonal to round cells that contained single to several, often greatly enlarged nuclei as well as abundant cytoplasm. HS were always positive for CD204 and always negative for SMA and desmin. In contrast, AS arose most commonly from the skin or subcutis (n = 62) and rarely the skeletal muscle (n = 8) or abdominal organs (n = 2). In 29% of extra-abdominal AS, the tumor deeply invaded into surrounding connective tissue, skeletal muscle, tendons, and bone causing pathological fractures. Five of 9 postmortem cases metastasized to various organs often including the lungs. Microscopically, AS were characterized by sheets of spindle or pleomorphic cells admixed with variable numbers of MGCs. Immunohistochemically, AS were always negative for CD204 and often (71%) positive for SMA and/or desmin.

Emerging and Re-emerging Diseases of Selected Avian Species.

Emerging infections and re-emerging diseases in birds can be caused by numerous factors and need to be recognized and understood. This article introduces and summarizes author-selected emerging and re-emerging diseases of avian species. These diseases hold significance as they relate to scientific research, disease recognition and identification, avian welfare aspects, and ecosystem health. Some are significant in human health and others affect production medicine. These and many others remain important pathogens of worldwide consequence.

Development and validation of 2 probe-hybridization quantitative PCR assays for rapid detection of a pathogenic Coxiella species in captive psittacines.

Avian coxiellosis is an emerging cause of morbidity and mortality among captive psittacines, and the utility of a rapid detection test using easily obtained samples is paramount in a clinical setting. New sequences were obtained from 3 genes: groEL, dnaK, and rpoB. We developed probe-hybridization quantitative PCR (qPCR) assays using groEL and dnaK genes. Samples, including splenic aspirates, liver aspirates, whole blood, and choanal, conjunctival, and cloacal swabs, were collected from 4 psittacine species including 3 blue-and-gold macaws (Ara ararauna), 2 scarlet-chested parrots (Neophema splendida), 1 Timneh African grey parrot (Psittacus timneh), and 1 yellow-naped Amazon parrot (Amazona auropalliata). Retrospective review of postmortem findings from 3 of these psittacines included splenomegaly, hepatitis, and/or transmission electron microscopy confirmation consistent with previous reports of avian coxiellosis. There was 100% agreement between these assays and consensus PCR with sequencing. A Wilcoxon rank-sum test found a strong correlation between groEL and dnaK cycle threshold values (p < 0.001), validating these assays for detection of this avian Coxiella sp.

Mandibular squamous cell carcinoma in 2 psittacines.

A unilateral, malformed gnathotheca in a green-winged macaw (Ara chloropterus) was managed for 16 mo with periodic beak trims. Biopsy of the affected beak did not identify an underlying cause; however, at postmortem examination, a densely cellular neoplasm invaded the mandible from the beak, dissecting and effacing the cortex and trabecular bone and inciting periosteal proliferation. There was no evidence of metastasis. Neoplastic cells were strongly immunopositive for cytokeratin AE1/AE3, consistent with squamous cell carcinoma (SCC). A black-headed caique (Pionites melanocephalus) was presented with a similar clinical history, timeline, and gross appearance. Biopsy of the mandibular portion of the lesion resulted in a diagnosis of SCC. Medical management with toceranib at a palliative dose resulted in adverse side effects and was discontinued. Early diagnosis of mandibular SCC may allow for early intervention and development of treatment modalities. Our 2 cases suggest that the mandibular bone, not the beak, may be a preferred biopsy site in the diagnosis of mandibular SCC in psittacines.

Proposed grading scheme for inflammatory bowel disease in ferrets and correlation with clinical signs.

Inflammatory bowel disease (IBD) is an idiopathic, chronic, inflammatory disease of the gastrointestinal tract of companion animals, including ferrets (Mustela putorius furo). Clinical signs of IBD are nonspecific, and intestinal biopsies are necessary for a definitive diagnosis. A grading scheme has not been established for ferrets. Additionally, the association between histologic severity and clinical signs in ferrets is unknown. We evaluated enteric samples from ferrets diagnosed with IBD, compared histologic grading schemes, and correlated the results with the severity of clinical signs. Enteric sections from 23 ferrets with IBD were analyzed using grading schemes for intestinal inflammation in cats and dogs, and a correlation with clinical signs was evaluated. After dividing the histologic samples into groups based on the severity of clinical signs, main histologic differences were identified. Age and sex were also assessed for correlation with clinical signs. No significant correlation was found between the 2 grading schemes and clinical signs (rho = 0.02, p = 0.89; rho = 0.26, p = 0.18, respectively). Degree of villus fusion, hemorrhage and/or fibrin, epithelial damage, inflammation density, and crypt abscess formation were used retrospectively to create a ferret IBD grading scheme, which was significantly correlated with the severity of clinical signs (rho = 0.48, p = 0.01). A positive correlation was observed between age (p = 0.04) and females (p = 0.007) with severity of clinical signs. Our ferret grading scheme may have clinical utility in providing a more objective, consistent evaluation of IBD in ferrets.

Disease Overview of the Urinary Tract in Exotic Companion Mammals and Tips on Clinical Management.

Diseases of the urinary tract are reviewed, covering infectious (bacterial, viral, parasitic), degenerative, congenital, metabolic, nutritional, neoplastic, obstructive, and toxic causes. Some clinical presentations and diagnostic procedures are described for ferrets, rabbits, guinea pigs, hamsters, mice, rats, chinchillas, hedgehogs, and sugar gliders, as well as therapies.

Evidence of bromethalin toxicosis in feral San Francisco "Telegraph Hill" conures.

During 2018, four free-ranging conures, from a naturalized flock in San Francisco, presented with a characteristic set of neurologic signs that had been reported in other individuals from this flock. The cause of morbidity or mortality in historic cases has not been identified. From these four subjects, fresh feces were collected during their initial days of hospitalization and submitted to the University of Georgia Infectious Diseases Laboratory and Center for Applied Isotope Studies for bromethalin and desmethyl-bromethalin quantitation. Using High Performance Liquid Chromatography, the laboratory detected bromethalin, a non-anticoagulant, single-dose rodenticide, in fecal samples from three subjects; half of these samples were also positive for desmethyl-bromethalin, bromethalin's active metabolite. In three subjects that died, the UGA laboratory screened brain and liver samples and found bromethalin in all samples; desmethyl-bromethalin was detected in all but one brain sample, which was below the detection limit. Our findings suggest the conures are more resistant to bromethalin than are other species in which bromethalin has been studied, and/or that the conures may be ingesting the toxin at a sublethal dose. More data is needed to better assess the long-term effects of bromethalin on animals exposed at the subacute/chronic levels, and also to better understand the compartmentalization of bromethalin and desmethyl-bromethalin in a wider variety of species.