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Flashcards in Exotics MSK diseases Deck (71)
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List your differentials for a falcon presented with swelling of the foot

- Bumblefoot
- Gout
- Neoplasia
- Foreign body
- Abscess


What factors need to be investigated in a bird with a swelling of the foot?

- Need to ask about the diet
- Need to ask about the perch
- Previous injury/illness
- Any concurrent signs


List the investigations needed in a case of suspected bumblefoot and justify

- Individual investigation of each individual toe
- Radiography (assess presence/degree of damage to the bone)
- Swab for culture, sensitivity and cytology (needed for treatment)
- Surgical debridement samples (ensures demonstration of infective agent rather than just commensal skin microbes)
- Blood tests (haematology, biochem - may be systemic disease, look for underlying cause that can be treated)
- Palpate origins of tendons


What is the notarium of a bird?

The fused thoracic vertebrae


Explain why the great vessels of older parrots may be visible on radiography

Atherosclerosis, either as a cause or result of cardiovascular compromise


Which skeletal structures need to be assessed in particular in a case of bumblefoot and why?

- Spine and HL
- May show evidence of abnormal weight bearing


What may be seen radiographically in severe cases of bumblefoot?

Progression of skin infection into the bone, which may be seen as lysis or fracture of the bone


How many phalanges are normal in the first, second, third and fourth digits of birds?

- First and second: 2 phalanges + claw
- Third: 3 phalanges + claw
- Fourth: 4 phalanges+ claw


Discuss the prognosis for a case of bumblefoot

- Guarded, with treatment ~80%
- Poor outcome usually related to owner not revealing underlying cause, or not addressing underlying case
- Commonly concurrent diseases


List concurrent diseases that are commonly identified in cases of bumblefoot

- Obesity
- Nutritional
- Aspergillosis
- Amyloidosis
- Heart disease
- Anything affecting circulation
- Anything affecting the immune system


Outline the treatment for early stage bumblefoot

- No surgery required
- Improve husbandry
- Meticulous cleaning of perches to prevent infection


Outline the treatment of bumblefoot if infection is present

- Topical or systemic antibiotics based on C+S, 1 week minimum, but usually requires several weeks treatment
- Amoxyclav, marbofloxacin can be used, avoid gentamycin systemically
- Clindamycin good bone penetration
- Fluoroquinolones can be used if needed, good penetration
- Metronidazole if Clostridia


Outline the treatment of bumblefoot lesions with deep infection and granulomatous material

- Surgical debridement
- Protective dressings after surgery, regular changes
- NSAIDs/analgesia
- if unable to grasp food or perch, prognosis poor, consider euthanasia


Outline the general approach to a lameness case in an exotic species

- Same as dog/cat
- History, clinical examination, radiography, cytology, biopsy, joint fluid analysis
- Endoscopy/arthroscopy possible in some, coelioscopy to look at internal organs esp. kidneys
- Sedation/GA often needed


What are the categories of lameness in exotics?

- Metabolic and nutritional
- Traumatic
- Degenerative
- Infection
- Neoplastic


Discuss traumatic causes of lameness in exotics

- Common from cage mates, other pets, owners
- Most reptiles should be kept alone, owners commonly think should be in pairs


Outline pododermatitis in rabbits

- No pads on feet, hair only
- Overgrown claws, overweight, DJD increase risk
- Most rabbits have degree of pododermatitis


Where does degenerative joint disease most commonly occur in rabbits?

- Stifles and spine most common
- Cranial cruciate disease common


What spinal deformity commonly occurs in older rabbits?



Which spinal deformities commonly occur in rabbits generally?

- Spondylosis
- Kyphosys
- Lordosis
- Scoliosis


What factors are risk factors for spinal deformities in rabbits?

- Small cages
- Lack of exercise


What do spinal deformities commonly occur as a result of in younger rabbits?



Outline the potential consequences of spinal deformities in rabbits

- May interfere with locomotion, caecotrophy, urination, grooming
- May result in faecal soiling, urine scald, unkempt co, Cheyletiella, facial dermatitis
- Pain may lead to aggression, depression, GI stasis


What is kyphosis?

Excessive curvature of the spine


What are the most common sites of fracture in rabbits?

- Spine and limbs
- Jaw also common
- Tibia most common


Discuss the development of nutritional secondary hyperparathyroidism in rabbits

- Common due to feeding of muesli mix, lack of UV-B
- Cause of dental disease in rabbits
- Indoor rabbits or outdoor rabbits shielded from sunlight


What are the most common sites of luxation in rabbits?

Hip, elbow and tarsus


What is the most common tumour that may cause metastatic musculoskeletal disease in rabbits?

Uterine adenocarcinoma


Explain the relationship between renal failure and musculoskeletal disease in rabbits

Leads to hypercalcaemia (normally excess excreted in urine), leading to soft tissue calcification and bone hypercalcification


How is musculoskeletal disease secondary to renal failure diagnosed in rabbits?

- Biochem and haematology may be normal
- If see hypercalcification and calcification of soft tissues on radiography is enough for diagnosis


What are the 3 main causes of muscular weakness in rabbits?

- Floppy bunny syndrome
- Splayleg
- Nutritional muscular dystrophy


Describe floppy bunny syndrome (presentation, cause, treatment)

- Generalised flaccid paralysis but rabbit often still very alert with good appetite
- Exact cause unknown: hypokaalemia, hypoMg, plant toxicity, myasthenia gravis, E. cuniculi suggested
- E. cuniculi most likely
- Majority recover within 3-4 days with supportive care


Describe splayleg in rabbits (presentation, cause, treatment)

- HL or FL affected, usually one or two rather than all 4
- Usually younger rabbits
- Poor prognosis vs. floppy bunny, often will not resolve
- Treatment: supportive +/- euthanasia


Describe nutritional muscular dystrophy in rabbits (presentation, cause, treatment)

- Mostly commercial units, unlikely to be seen in pets
- Similar to sheep/cattle (Se deficiency)


Describe the general treatment of musculoskeletal disorders in rabbits

- Analgesia essential (opioids/NSAIDs)
- Ensure soft, clean bedding
- Ensure clean wounds, perineum, face, ears
- Casts and splints contraindicated generally
- Cage rest and pain relief effective


Why are casts/splints generally contraindicated in rabbits?

- Bones are wide proximally, thin distally - difficult to place
- Often exacerbate injury due to pendulum effect


What is the preferred treatment for fractures in rabbits?

External fixation for most fractures


What are the main risks associated with surgical fixation of fractures in rabbits?

- Rabbit bone has thin cortices, shatters easily
- Osteomyelitis significant risk with open wound, poor surgical technique, difficult to manage


What are the main complications of hindlimb amputation in rabbits?

- Contralateral pododermatitis
- Ipsilateral otitis
- But usually do well if generally well


Which species of rodent in particular are prone to pododermatitis?

- Guinea pigs
- Chincillas
- Rats


What commonly leads to degenerative joint disease in guinea pigs?

- Metastatic calcification
- Can occur in lung/joints
- Older guinea pigs usually, cause poorly documented


What are key differentials for a ferret presented with HL paresis?

- MSK disease
- Hypoglycaemia
- Cardiomyopathy
- Generalised lymphooma
- Generalised disease
- Abscessation of spine


Identify the common MSK diseases of ferrets

- Spinal abscesses
- Trauma
- Long bone fracture
- Elbow luxation
- Vertebral disc prolapse and spinal neoplasia reported


What is the most common cause of lameness and fractures in many exotic mammal species?

Nutritional secondary hyperparathyroidism (NSHP)


Outline the general treatment of MSK disorders in exotic mammals

- Cage rest
- Analgesia
- Supplement calcium and vit-D
- Correct diet
- UV-B provision


Describe the clinical signs of lameness disease in birds

- Can be very subtle
- Abnormal stance +/- reduced grip on perch
- Using beak/ipsilateral wing for support
- Affected leg may be warmer
- Bumblefoot on contralateral limb


List orthopaedic causes of lameness in birds

- Fractures
- Bumblefoot
- Luxation
- Spinal injury
- Growth deformities
- Septic arthritis
- Osteomyelitis
- Osteoarthritis
- Tendon injury
- Tenosynovitis


Describe state of fractures in birds

Commonly compound and contaminated, esp. wild birds


Which cause of lameness are waterfowl, raptors and budgies especially prone to?



Where do spinal injuries most commonly occur in birds? Why?

At the vertebral synsacral junction - this is the only moveable part of the spine


Name 2 common orthopaedic growth deformities in birds

- Luxated gastrocnemius tendon
- Juvenile osteodystrophy


When does juvenile osteodystrophy most commonly occur in birds?

- Hand rearing (too much space, move too much, excessive strain on bones too soon)
- Parents with inappropriate diet


How do tendon injuries most commonly occur in birds?

- Bites from companions/prey
- Equipment on legs e.g. rings
- Extension of skin infection


Name the causative agent of tenosynovitis in birds

Mycoplasma synoviae


Identify the non-orthopaedic causes of lameness in birds

- Nephritis
- Renal and testicular neoplasia
- Gout
- Mass effect in cloaca e.g. egg binding
- Lead poisoning
- Viral


Explain how nephritis can cause lameness in birds

- May be bacterial, parasitic, coccidial, fungal
- Kidney swells, presses on nerve, causes sciatica type pain
- Presents as paresis of limb


Describe the lameness that may occur with renal and testicular neoplasia in birds

- Most common in budgie
- Unilateral lameness


What does gout in birds often occur secondary to?

Renal disease


Describe the common presentation of lameness as a result of a cloacal mass effect

- Pushes against kidney, leading to pain or lameness
- Budgie, cockatiel, ducks most common
- May have regurgitation


Explain how lead poisoning may lead to lameness in birds

- Neuro and renotoxic
- Leads to limb weakness
- Raptors may be seen holding own feet i..e one on top of the other


Outline viral disease as a cause of lameness in birds

- Marek's disease in chickens
- Young birds presented with progressive lameness, death
- No MSK injury, one leg and one wing outstretched


What are the key considerations for fractures in birds?

- Lifestyle: wild need perfect restoration, caged can cop with less aggressive treatment
- Compound fractures or close to joints carry poor prognosis for return to normal function
- Ocular damage in 80% of impact injuries, damage to pecton probably PTS
- Surgical repair only once patient stable for at least a day


What is the pecton and explain its significance in birds?

- Black segmented patch in eye of bird
- Provides nutritional supply to the retina
- Must be visualised prior to release, minor damage can do well, significant damage means euthanasia


When do tibiotarsal fractures of birds most commonly occur?

In newly-jessed falconry birds


Discuss the tethering of falconry birds

- Should be short tether
- Prevent bird getting up too much speed before being held back


Describe the treatment of fractures in birds

- Immobilisation of joints more than 3-5 days may lead to permanent disability
- Casts and splints generally contraindicated
- Supportive body sling if trouble standing
- Ex-fix and IM pin most useful
- Must anaesthetise for each bandage change
- Need physiotherapy


What fractures in birds can have casts/splints applied?

- Distal tarsometatarsal
- Tibiotarsal in very small birds


List the factors that predispose to the development of bumblefoot

- Poor perching surfaces
- Trauma
- Excessive weight bearing
- Hypovitaminosis A


Describe the clinical signs of lameness in reptiles

- Can be very subtle even with severe fractures
- Abnormal stance/gait +/- reduced grip
- Often may just seem lethargic
- Deformity of spine/limbs +/- generalised limb swelling may indicate metabolic bone disease


Identify the orthopaedic causes of lameness in reptiles

- Fractures
- Luxation
- Tendon/ligament injury or infection
- Spinal injury(trauma, NSHP, burns)
- Septic arthritis/osteomyelitis (solid pus)


Identify the non-orthopaedic causes of lameness in reptiles

- Gout and pseudogout
- Pre- and post-ovulatory oostasis (POOS)
- Urolithiasis
- Hypocalcaemia
- Viral (herpes in tortoise)