Diseases and other miscellaneous

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• Diseases and other miscellaneous
• conditions

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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)

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How bad can it get?

• Keel score of 1 out of 5
• RTHA 650-750 g (Normal gt 1100)
• GHOW 900-1000 g (Normal gt 1300)
• Total solids lt 1 (weve seen 0.2)
• PCV lt 20 (weve seen lt 10)
• Extreme lethargy, hypothermia

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Keel scores
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Treatment

• Rehydration is critical
• LRS IO\SQ\PO route
• 2 x maintenance
• Can use D5W IO
• Add B vitamins to fluids
• Supplmental heat

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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

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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

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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

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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

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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

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Prognosis

• Generally good if there isnt a serious
  underlying cause.
• Recovery is quick

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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.

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Bumblefoot

• Clinical signs
• Redness, smoothening, loss of scale
• Swelling and visible inflammation
• Necrosis and open wounds
• Osteomyelitis, sepsis

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Bumblefoot

• Grades
• 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.

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Bumblefoot
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Bumblefoot

• Treatment
• Pressure relieving bandages such as ball wraps or
  corn pads
• Topical meds
• Preparation H, Silvidine
• CEH Cream Calendula, Echinacea, Hypericum

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Bumblefoot

• Treatment (continued)
• Aggressive surgical debridement
• Systemic antibiotics (Clavamox Baytril)
• Chlorhexidine soaks

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Wrist wounds

• Husbandry related due to improper enclosures
• Leads to exposure of carpal joint\bones.

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Wrist wounds
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Wrist wounds

• Treatment
• Daily flushes
• Staged surgical debridements\parial closure
• Protect with telfa and tegaderm
• Prognosis is surprisingly good

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Barbed-wire injuries

• Usually Great-Horned Owls
• Can cause massive soft tissue trauma and patagial
  tendon transection.

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Barbed-wire injuries

• Treatment must be aimed at protecting the tendon
  from exposure and desiccation.
• Silvidine cream is helpful

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Barbed-wire injuries
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Barbed-wire injuries
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Barbed-wire injuries
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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.

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Aspergillosis

• Very important disease in raptors, especially
  juvenile RTHAs
• Fungus Aspergillus fumigatus

Ubiquitous Saprophytic Opportunistic Infectious No
t contagious Not zoonotic, but
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Aspergillosis acute form

• Inhalation of a large mass of spores
• Tracheal granuloma
• Causes voice change, dyspnea and death

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Aspergillosis chronic form

• Due to immuno-suppression or secondary to
  weakened state
• Emaciation, anorexia, depression, anemic
• Aint doin right
• Granulomas\fungus in air sacs and lungs
• Respiratory signs not seen until late in disease

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Aspergillosis - diagnosis

• CBC
• Total count can be 30,000
• Monocytosis
• Cytology cotton blue stain
• Tracheal culture
• Serology
• Histopathology
• Endoscopy

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Aspergillosis - diagnosis
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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

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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
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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 (1250 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 dont
  work (studies done at NC State)
• Broad spectrum antibiotics
• Monitor CBCs, weight

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Aspergillosis - Prevention

• Prophylactic itraconazole 10 mg\kg PO BID x 21
  days (Especially in highly-susceptible species)
• Start 1 week before a stressful change
• Dont use organic bedding
• Provide good ventilation
• Keep birds in good health
• Keep stress to a minimum

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West Nile Virus

• 1999 - first seen in western hemisphere
• Now in most states
• Affects many bird species, humans, horses
• Mosquito vector, bird is a carrier.
• Clinical signs develop 10-12 days post infection.
• 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

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West Nile Virus

• Treatment is purely supportive
• Prognosis is poor
• Prevention
• Vaccine - Fort Dodge for horses
• Control mosquito exposure

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Trichomoniasis

• Carried by pigeons called canker. Raptors are
  infected when eating pigeons. Dont 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

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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

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Trichomoniasis

• Diagnosis PE cytology Cytology Picture of
  kestel?
• Treatment Carnidazole (Spartrix) 100-200 mg\kg
  PO once. May need to repeat in falcons.

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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)

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Candidiasis

• Treatment Nystatin 300,000 IU\kg PO BID x 10
  days. Needs contact time so oral lesions may
  require systemic antifungal treatment

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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

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Lead Poisoning

• Clinical signs
• Can be acute or chronic
• Generalized weakness, anorexia, emaciation
• Regurgitation
• Ataxia, tremors, seizures, paresis, paralysis,
  blindness
• Hematuria, hemoglobinuria

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Lead Poisoning

• Diagnosis
• Blood lead level gt 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

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Other Poisonings

• OP toxicity
• SLUD not seen in birds
• Pupils not affected in birds
• Depression, seizures
• Treatment is supportive, atropine, valium to
  control seizures

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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.

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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?

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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

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Avian Pox

• Important disease in raptors
• Worldwide distribution
• Survive in dried scabs and in environment for
  years
• Three forms dry, wet and septic

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Avian Pox
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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

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Avian Pox

• Cutaneous or dry form
• Vesicles -gtpustules -gt scabs on unfeathered areas
  of skin around eyes, mouth, feet.
• Can lead to severe scarring
• Can be self-limiting?

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Avian Pox

• Diptheritic or wet form
• Lesions on mucous membranes in mouth, pharynx,
  esophagus, trachea
• Vesicles -gt ulcers
• Probably spread due to aerosol infection
• Can turn into septicemic form
• Prognosis is poor.

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Avian Pox

• Diagnosis
• Clinical signs
• EM characteristic virion size\shape (bricks)
• Treatment is supportive, Vit A

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Avian Pox

• Prevention
• Pigeonpox and turkepox vaccines have been used
  with variable success
• Vector control
• Prevent spread by fomites and use quarantine
  procedures

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Questions?

• Dave Scott, DVM
• Carolina Raptor Center
• P.O. Box 16443
• Charlotte, NC 28297
• 704-875-6521

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