Diseases and other miscellaneous conditions Medical Environmental Research Learning INstitute Emaciation Not a disease itself, but the result of other conditions such as fractures, chronic disease, etc. Accompanied by immuno-compromise Usually seen in Dec-Feb First year birds experiencing their first winter Mid-winter anemia (Redig) Medical Environmental Research Learning INstitute How bad can it get? Keel score of 1 out of 5 RTHA 650-750 g (Normal > 1100) GHOW 900-1000 g (Normal > 1300) Total solids < 1 (we’ve seen 0.2) PCV < 20 (we’ve seen < 10) Extreme lethargy, hypothermia Medical Environmental Research Learning INstitute Keel scores Medical Environmental Research Learning INstitute Treatment Rehydration is critical LRS IO\SQ\PO route 2 x maintenance Can use D5W IO Add B vitamins to fluids Supplmental heat Medical Environmental Research Learning INstitute Fluid Therapy Daily maintenance = 50 ml\kg\day Can provide in multiple routes IO catheter Distal ulna Can maintain for 3 days max Max bolus = 25 ml\kg Medical Environmental Research Learning INstitute Fluid Therapy Daily maintenance = 50 ml\kg\day Can generally assume either 5 or 10% dehydration Replace deficits in 48 hours Can provide in multiple routes IO catheter Distal ulna Can maintain for 3 days max Max bolus = 25 ml\kg Medical Environmental Research Learning INstitute Fluid Therapy Example 900 g bird, 10% dehydrated Deficit = 900 X 10% = 90 Maintenance = 45 ml\day Bird needs 90 + 90 = 180 over next 48 hours Medical Environmental Research Learning INstitute Treatment Iron Dextrans 0.1 ml\kg IM q10d x 2 Fenbendazole 50 mg\kg SID x 5 d Broad-spectrum antibiotics? Itraconazole 10 mg\kg BID for juvenile RTHAs Medical Environmental Research Learning INstitute Feeding Furless whole mice Begin after 18-24 hours Start slow 10-30 g\kg TID Ramp up over next three days Continue aggressive hydration Monitor PCV\TP Formulas Useful if regurgitating whole food Oxbow Carnivore diet Medical Environmental Research Learning INstitute Prognosis Generally good if there isn’t a serious underlying cause. Recovery is quick Medical Environmental Research Learning INstitute Bumblefoot Refers to injuries or lesions on the pads of feet and toes. Usually husbandry related Improper perch size or covering No perch variability Poor ground substrate Can also be secondary to leg fractures or any other cause of lameness. Medical Environmental Research Learning INstitute Bumblefoot Clinical signs Redness, smoothening, loss of scale Swelling and visible inflammation Necrosis and open wounds Osteomyelitis, sepsis Medical Environmental Research Learning INstitute Bumblefoot Grades 1. 2. 3. 4. 5. Flatten, smooth epithelium. May be a little pink Infection of SQ tissue but no gross swelling Infected, hot, swollen foot without involvement of tendons or bone Involvement of tendon and\or bone End stage with loss of function. Medical Environmental Research Learning INstitute Bumblefoot Medical Environmental Research Learning INstitute Bumblefoot Treatment Pressure relieving bandages such as ball wraps or corn pads Topical meds Preparation H, Silvidine CEH Cream – Calendula, Echinacea, Hypericum Medical Environmental Research Learning INstitute Bumblefoot Treatment (continued) Aggressive surgical debridement Systemic antibiotics (Clavamox + Baytril) Chlorhexidine soaks Medical Environmental Research Learning INstitute Wrist wounds Husbandry related due to improper enclosures Leads to exposure of carpal joint\bones. Medical Environmental Research Learning INstitute Wrist wounds Medical Environmental Research Learning INstitute Wrist wounds Treatment Daily flushes Staged surgical debridements\parial closure Protect with telfa and tegaderm Prognosis is surprisingly good Medical Environmental Research Learning INstitute Barbed-wire injuries Usually Great-Horned Owls Can cause massive soft tissue trauma and patagial tendon transection. Medical Environmental Research Learning INstitute Barbed-wire injuries Treatment must be aimed at protecting the tendon from exposure and desiccation. Silvidine cream is helpful Medical Environmental Research Learning INstitute Barbed-wire injuries Medical Environmental Research Learning INstitute Barbed-wire injuries Medical Environmental Research Learning INstitute Barbed-wire injuries Medical Environmental Research Learning INstitute Tendon anastomosis Patagial transection was once thought to be hopeless. A recent case (GHOW 13112) has proven otherwise. Freshened edges Anastomosis with 6-0 Vicryl No PT for 2 weeks then very gradual increase in extension exercises under anesthesia for 6-8 weeks. Medical Environmental Research Learning INstitute Aspergillosis Very important disease in raptors, especially juvenile RTHA’s Fungus: Aspergillus fumigatus Ubiquitous Saprophytic Opportunistic Infectious Not contagious Not zoonotic, but… Medical Environmental Research Learning INstitute Aspergillosis – acute form Inhalation of a large mass of spores Tracheal granuloma Causes voice change, dyspnea and death Medical Environmental Research Learning INstitute Aspergillosis – chronic form Due to immunosuppression or secondary to weakened state Emaciation, anorexia, depression, anemic “Ain’t doin’ right” Granulomas\fungus in air sacs and lungs Respiratory signs not seen until late in disease Medical Environmental Research Learning INstitute Aspergillosis - diagnosis CBC Total count can be 30,000+ Monocytosis Cytology – cotton blue stain Tracheal culture Serology Histopathology Endoscopy Medical Environmental Research Learning INstitute Aspergillosis - diagnosis Medical Environmental Research Learning INstitute Aspergillosis – risk factors Damp organic bedding Poor ventilation Immuno-suppresion Stress Poor nutrition (Vit A deficiency) Extended antibiotic use Other illness like lead poisoning Species: Juvenile RTHA, GOSH, GYRF, RLHA, GOEA Medical Environmental Research Learning INstitute Aspergillosis – treatment Difficult, expensive and long-term Acute cases Place air-sac tube Can attempt to remove granuloma endoscopically or blindly with suction. Intratracheal Amphotericin B (1 mg\kg TID) Clinical signs due to tracheal obstruction Medical Environmental Research Learning INstitute Aspergillosis – treatment Chronic cases Lower stress Supportive – fluids, nutrition Reglan\tube feeding if necessary Amphotericin B 1.5 mg\kg IV\IO TID x 3 days. Dilute in D5W (maximum allowable bolus) Nebulize saline or F10 (1:250 dilution in NaCl) 20 minutes BID x 7 days Itraconazole (Sporonox) 10 mg\kg BID x 3 months. Monitor for liver problems (AST,CK) Compounded products are much cheaper but don’t work (studies done at NC State) Broad spectrum antibiotics Monitor CBC’s, weight Medical Environmental Research Learning INstitute Aspergillosis - Prevention Prophylactic itraconazole 10 mg\kg PO BID x 21 days (Especially in highlysusceptible species) Start 1 week before a stressful change Don’t use organic bedding Provide good ventilation Keep birds in good health Keep stress to a minimum Medical Environmental Research Learning INstitute West Nile Virus 1999 - first seen in western hemisphere Affects many bird species, humans, horses Mosquito vector, bird is a carrier. Clinical signs develop 10-12 days post infection. Now in most states Can see all types of neurologic disease Retinal pathology Diagnosis Can shed virus in both oral and cloacal cavities. Oral and chloacal swabs can be used for both ante- and postmortem diagnosis. It is not uncommon to see no gross changes at necropsy Medical Environmental Research Learning INstitute West Nile Virus Treatment is purely supportive Prognosis is poor Prevention Vaccine - Fort Dodge for horses Control mosquito exposure Medical Environmental Research Learning INstitute Trichomoniasis Carried by pigeons – called “canker”. Raptors are infected when eating pigeons. Don’t feed pigeons. Called “frounce” in falcons Clinical signs Affects the upper digestive and respiratory tracts Caseous lesions in oral cavity (under tongue, near choanal opening) and sinuses. Diagnosis – PE + cytology Medical Environmental Research Learning INstitute Trichomoniasis Diagnosis – PE + cytology [Cytology Picture of kestel?] DDx include capillaria or candida. Treatment – Carnidazole (Spartrix) 100-200 mg\kg PO once. May need to repeat in falcons. Surgical debridement Medical Environmental Research Learning INstitute Trichomoniasis Diagnosis – PE + cytology [Cytology Picture of kestel?] Treatment – Carnidazole (Spartrix) 100-200 mg\kg PO once. May need to repeat in falcons. Medical Environmental Research Learning INstitute Candidiasis Caused by Candida albicans Associated with malnutrition (Vit A deficiency) and long-term antibiotic use Will see white necrotic lesions in mouth, pharynx and crop and it causes with dysphagia and regurgitation. Diagnosis based on clinical signs, endoscopy of crop (may see “Turkish towel” appearance) and cytology (Gram +, oval, budding yeast) Medical Environmental Research Learning INstitute Candidiasis Treatment – Nystatin 300,000 IU\kg PO BID x 10 days. Needs contact time so oral lesions may require systemic antifungal treatment Medical Environmental Research Learning INstitute Lead Poisoning Sources: Gunshot, ingestion of contaminated prey Note that gunshot embedded in the musculature will not lead to system lead levels. Eagles\Ospreys more likely affected Medical Environmental Research Learning INstitute Lead Poisoning Clinical signs Can be acute or chronic Generalized weakness, anorexia, emaciation Regurgitation Ataxia, tremors, seizures, paresis, paralysis, blindness Hematuria, hemoglobinuria Medical Environmental Research Learning INstitute Lead Poisoning Diagnosis Blood lead level > 20 ug\dl Radiographs Treatment Supportive Stomach gavage, endoscopic removal Surgical removal CaEDTA 35 mg\kg SQ\IM BID, 4 days on, 3 days off for 4 weeks Medical Environmental Research Learning INstitute Other Poisonings OP toxicity SLUD not seen in birds Pupils not affected in birds Depression, seizures Treatment is supportive, atropine, valium to control seizures Medical Environmental Research Learning INstitute Other Poisonings Rodenticide toxicity Pulmonary hemorrhage and dyspnea are not commonly seen in birds. Bleeding from superficial wounds is more common Treatment: Vit K1 2.5 mg\kg SQ\IM BID for 3-4 days, then PO SID for 4 weeks. Medical Environmental Research Learning INstitute Mycobacterium (Avian TB) Mycobacterium Avium Complex (MAC) Generalized, chronic, granulomatous disease Infection usually by fecal-oral route Clinical signs Chronic emaciation Dyspnea SQ granulomas\tubercles Diarrhea – tubercles in intestine is a common presentation Arthritis or tubercle formation in leg muscles? Medical Environmental Research Learning INstitute Mycobacterium (Avian TB) Diagnosis Leukocytosis with monocytosis Histology or cytology – Acid fast organisms Acid fast stain of feces (5 days) Look for non-staining “ghosts” with Dif-Quick Culture is very difficult Treatment Not recommended due to zoonotic potential Note that the risk to an immunocompetent person is low Medical Environmental Research Learning INstitute Avian Pox Important disease in raptors Worldwide distribution Survive in dried scabs and in environment for years Three forms – dry, wet and septic Medical Environmental Research Learning INstitute Avian Pox Medical Environmental Research Learning INstitute Avian Pox Cutaneous or dry form Most common Spread by biting insects such as mosquitoes, but not all vectors are known. Also mechanical spread by fomites Medical Environmental Research Learning INstitute Avian Pox Cutaneous or dry form Vesicles ->pustules -> scabs on unfeathered areas of skin around eyes, mouth, feet. Can lead to severe scarring Can be self-limiting? Medical Environmental Research Learning INstitute Avian Pox Diptheritic or wet form Lesions on mucous membranes in mouth, pharynx, esophagus, trachea Vesicles -> ulcers Probably spread due to aerosol infection Can turn into septicemic form Prognosis is poor. Medical Environmental Research Learning INstitute Avian Pox Diagnosis Clinical signs EM – characteristic virion size\shape (bricks) Treatment is supportive, Vit A Medical Environmental Research Learning INstitute Avian Pox Prevention Pigeonpox and turkepox vaccines have been used with variable success Vector control Prevent spread by fomites and use quarantine procedures Medical Environmental Research Learning INstitute Questions? Dave Scott, DVM Carolina Raptor Center P.O. Box 16443 Charlotte, NC 28297 704-875-6521 Medical Environmental Research Learning INstitute