Psittaciformes Flashcards

Question

What is the most common neoplasm of the psittacine GI tract? Describe its behavior. What species are commonly represented? What anatomic site is the tumor predisposed to?

Answer 1

1. Gastric carcinomas and adenocarcinomas 1. Common in budgies, gray-cheeked parakeets, lovebirds, cockatiels, conures, and Amazons 2. Tumors often at the proventricular–ventricular junction. 1. Wall is thick and irregular, inflamed, hemorrhage and necrotic. 3. If cells extend to serosa – peritonitis, adhesions 4. Mets uncommon, but can occur Terio

Answer 2

1. Papillomatosis 1. Most common neoplasm of the oral cavity and cloaca in New World psittacines. 2. Oral lesions more common in macaws – choana, base of tongue, glottis 1. Cauliflower appearance, may be obstructive. 3. Cloacal lesions have cobblestone appearance. May prolapse, ulcerate. 4. Linked to infection with psittacid herpesvirus (PsHV) genotypes 1, 2, and 3 Terio

Answer 3

1. Testicular tumors – best described in budgies. 1. Seminomas and Sertoli cell tumors are the most common 2. Seminomas = tumors of immature germ cells and grossly soft, yellow-red, and cause enlargement of the testis. 3. Sertoli cell tumors = tumors of the gonadal-stroma. Generally firm, gray-white, nodular neoplasms. 1. Some are functional, resulting in feminization 2. Change in cere color in budgies and feather changes in a Nyasa lovebird 2. Renal tumors 1. Young middle aged male budgies 2. Unilateral lameness or paresis 1. due to compression of ischiatic nerve it passes through the kidney or from tumor growth into and adjacent to the synsacrum and ilium. 3. Nephromas, (adeno)carcinomas do not appear to compromise renal function. 4. (Adeno)carcinomas are irregular, nodular, occasionally cystic masses that fill most of the coelomic cavity. 5. Adenomas rarely cause gross lesions – diagnosed histologically 6. Nephroblastomas (embryonal nephromas) 1. Typically large unilateral multilobular masses. 2. Budgies presents similar adenocarcinoma, but paresis is uncommon. Terio

Answer 4

1. Psittacine beak and feather disease virus (PBFDV) = circovirus (PsCV) 1. More common Old World psittacines 2. Acute fatal disease nestling cockatoos. Chronic disease in older birds. 3. Viral proliferation in germinal cells in feather follicles and the rhamphotheca and results in feather and beak deformities. 4. Inclusions are intracytoplasmic, basophilic. 5. Also causes necrosis and lymphoid depletion of the bursa of Fabricius, thymus and circulating cells = immunosuppression and opportunistic infections. 6. Examine the bursa for lesions Terio

Answer 5

1. Nestlings typically die within 2 weeks. 2. Affects all growing feathers. Flight feathers take longer to develop 1. Only the flight feathers may be affected in older nestlings. 3. Examine the bursa for lesions 4. Older birds – signs at first molt 1. Dystrophic feathers replace normal ones. 2. The feathers have thick sheaths, hemorrhage within shafts, and pinch off at the base. 5. Cockatoos – powder feather affected = shiny beak 1. Classically present with generalized feather dystrophy, delayed molt, beak elongation, and fracture (white cockatoos) 6. Lovebirds and eclectus – 2 presentations. 1. Peracute – pneumonia, enteritis, feather deformities, death 2. Chronic – feather degeneration, beak deformity 3. Possible that the majority of infected lovebirds infected have no signs 7. African greys 1. Significant immunosuppression. Feather issues are rarely seen. 2. Secondary infections, sepsis, pneumonia, enteritis, death 3. Severe leukopenia, anemia from infected bone marrow.

Answer 6

1. Virus shed in the feces, crop secretions, and feather dust. 2. Minimum incubation period is 21–25 days, maximum up to several years. 3. Diagnose with PCR or histopath Terio

Answer 7

SUCCESSFUL REDUCTION OF FEATHER-DAMAGING BEHAVIOR BY SOCIAL RESTRUCTURING IN A GROUP OF GOLDEN CONURES (GUARUBA GUAROUBA) Dislich M, Neumann U, Crosta L. Journal of Zoo and Wildlife Medicine. 2017 Sep;48(3):859-67. Background: FDB is multifactorial in nature and can include stress/boredom/sexual frustration Can be secondary to inadequate husbandry regarding enrichment and social structure). Reduce with enriched environment, places to hide, good nutrition/husbandry, not overcrowded. Key Points: Flock of golden conures 🡪 FDB began w. secondary feathers bilaterally then extended to covert and tail feathers. All birds (affected + non-affected) had higher H:L ratio when compared to published RR Removing the most severely affected birds and restructured group to M:F ratio 1:1 (higher bird density) caused: Normal H:L ratio Recovering feathers 5x increase in number of hatched chicked Normal H:L ratio + either fully recovered or recovering feathers. Conclusions: Golden conure flock had reduced FDB, increased fecundity, and normal H:L ratio when male to female ratio was decreased to 1:1.

Answer 8

**EFFECT OF ROUTINE HANDLING AND TRANSPORTATION ON BLOOD LEUKOCYTE CONCENTRATIONS AND PLASMA CORTICOSTERONE IN CAPTIVE HISPANIOLAN AMAZON PARROTS (AMAZONA VENTRALIS)** McRee AE, Tully TN Jr, Nevarez JG, Beaufrere H, Ammersbach M, Gaunt SD, Fuller RG, Romero LM. J Zoo Wildl Med. 2018 Jun;49(2):396-403. Background: - Corticosterone (the primary avian glucocorticoid) can increase with stress in just a few minutes in birds - In birds, heterophilia and lymphopenia (and increased H:L ratio) have been commonly reported in stress. - Although, extreme stress in chickens can cause heteropenia and basophilia Key Points: - Treatment group had a higher mean corticosterone concentration than control by 60% - Mean corticosterone levels increased in both groups by 20 minutes and then plateaued - Total white blood cells in the treatment group were higher than the control group by 40 minutes - Heterophil to lymphocyte (H:L) ratio was higher in the treatment group after 60 minutes - There was not a significant lymphopenia, though it has been documented in other avian species Conclusions: Changes to the avian leukogram (increased heterophils and H:L) can occur within 1 hour of a stress, and corticosterone levels can indicate acute stress in psittacines.

Answer 9

Establishing Stress Behaviors in Response to Manual Restraint in Cockatiels (Nymphicus hollandicus) Turpen KK, Welle KR, Trail JL, Patel SD, Allender MC. Journal of avian medicine and surgery. 2019 Mar;33(1):38-45. Physical exam → stress response + behavior changes Increased: Reactionary behaviors, resting, corticosterone Decreased: Locomotion, feeding, interaction with the environment, displays of aggression Change in quality but not amount of maintenance behaviors (preening, defecating, etc.) Conclusions: Cockatiels have changes in behavior and higher corticosterone after physical exam.

Answer 10

Effects of Fluorescent Lighting Versus Sunlight Exposure on Calcium, Magnesium, Vitamin D, and Feather Destructive Behavior in Hispaniolan Amazon Parrots (Amazona ventralis) Jennifer A. West et al. Journal of Avian Medicine and Surgery 33(3):235–244, 2019Authors Housing Amazon parrots outdoors had: Improved serum vitamin D (calcifediol) Improved feather quality Both outdoors and indoors could maintain calcium and magnesium Indoor group could not maintain vitamin D levels Conclusions: Outdoor housing improved vitamin D status and feather quality of Hispaniolan Amazon parrots.

Answer 11

IRON STORAGE DISEASE IN AFRICAN GREY PARROTS (PSITTACUS ERITHACUS) EXPOSED TO A CARNIVOROUS DIET O'Connor MR, Garner MM. J Zoo Wildl Med. 2018 Mar;49(1):172-177. Key Points: Iron storage disease (ISD) is caused by elevated serum iron that is stored in the liver as hemosiderin Encountered commonly in frugivorous or nectivorous birds (increased ascorbic acid increases iron absorption) Clinical signs of ISD: ascites, hepatomegaly, cardiomegaly, dyspnea, abdominal distension, depression, death Diagnosis: Liver biopsies are the gold standard Treatment: low-iron diet, increased tannins/phytates, repeated phlebotomy, chelation therapy Phlebotomy removes circulating iron-storing ferritin bound to transferrin → replenished with iron stores Hemosiderosis: iron overload without toxic damage Hemochromatosis: iron overload where organ damage occurs Conclusions: Exposure to a carnivorous diet likely caused iron storage disease in three African grey parrots.

Answer 12

Outcome following inhalation anesthesia in birds at a veterinary referral hospital: 352 cases (2004–2014) Seamon AB, Hofmeister EH, Divers SJ. Journal of the American Veterinary Medical Association. 2017 Oct 1;251(7):814-7. Outcomes of birds anesthetized with inhalants: survived (86%) \>\>\>\> euthanized \> died in ICU \> anesthetic death No factors were associated with likelihood of survival Birds are less tolerant of apnea due to limited functional residual lung volume Conclusions: Anesthesia-related mortality rate in birds is higher than mammals but no clear risk factors.

Answer 13

Evaluation of the anesthetic and cardiorespiratory effects of intramuscular alfaxalone administration and isoflurane in budgerigars (Melopsittacus undulatus) and comparison with manual restraint Balko JA, Lindemann DM, Allender MC, Chinnadurai SK. J Am Vet Med Assoc. 2019 Jun 15;254(12):1427-1435. Alfaxalone 5 mg/kg vs. 10 mg/kg IM 10 mg/kg IM produced reliable, safe sedation without adverse effects 5 mg/kg IM only produced mild sedation Some excitability was noted Isoflurane vs. alfaxalone 10 mg/kg IM vs. manual restraint Isoflurane produced recumbency (1 min) quicker than alfaxalone (2.5 min) Lactate was higher in manually restrained birds Respiratory rate was lower than baseline for all anesthetized birds, and isoflurane more bradypneic than either group Conclusions: Intramuscular alfaxalone administration produced effective and dose-dependent sedation in healthy budgerigars and provided a viable alternative to isoflurane anesthesia.

Answer 14

Sedative, Cardiorespiratory, And Thermoregulatory Effects Of Alfaxalone On Budgerigars (Melopsittacus undulatus) Romano J, Hasse K, Johnston M. Journal of Zoo and Wildlife Medicine. 2020 Mar;51(1):96-101. Both doses of alfaxalone (15 and 20 mg/kg) in budgies caused: Safe and effective sedation Decrease in respiratory rate At 15 mg/kg alfaxalone, budgie had transient decrease in HR right after injection At 20 mg/kg alfaxalone, budgies lost glottal tone At 25 mg/kg alfaxalone, budgies had seizures Conclusions: Alfaxalone at 15 and 20 mg/kg IM in budgies provided good sedation and a decrease in respiratory rate.

Answer 15

The Use of Alfaxalone in Quaker Parrots (Myiopsitta monachus) Whitehead MC, Hoppes SM, Musser JM, Perkins JL, Lepiz ML. Journal of avian medicine and surgery. 2019 Dec;33(4):340-8. Key Points: Lower dose alfaxalone (10 mg/kg) had (compared to other groups): Slower induction More response to noxious stimuli (compared to high-dose alfaxalone only) Shorter recovery Lower respiratory rate Biggests decline in heart rate Respiratory rates increased in alfaxalone-midazolam and high dose alfaxalone groups Hyperexcitation and muscle tremors were seen in all groups but subjectively smoother in alfaxalone-midazolam 50 mg/kg alfaxalone IM caused respiratory arrest Heart rate changes with alfaxalone: Increased: swans (IV), bullfrogs, dogs, calves Decreased: flamingos (IV), Bengalese finance (with midaz SC), iguanas (IM), red-eared sliders (IM), crocodiles (IV), tortoises (IV), terrapins (IV) Yellow-legged gulls also had excitatory effects after alfaxalone Conclusions: Alfaxalone at high doses (25 mg/kg) and alfaxalone (10 mg/kg) with midazolam had increased respiratory rate.

Answer 16

**Comparison of the Sedative Effects of Alfaxalone and Butorphanol-Midazolam Administered Intramuscularly in Budgerigars (Melopsittacus undulatus)** Escalante GC, Balko JA, Chinnadurai SK. Journal of avian medicine and surgery. 2018 Dec;32(4):279-85. Background: - Amazon parrots have increased respiratory rate and body temperature when handled - Intranasal midazolam improved body temperature and decreased corticosterone - Midazolam-butorphanol decreases isoflurane MAC and improve induction quality - Alfaxalone had shorter induction times than isoflurane in rose flamingos Key Points: - Alfaxalone 15 mg/kg in budgies (compared to midazolam-butorphanol 2.5-2.5 mg/kg) had: -- Faster induction and peak effect -- More success in obtaining radiographs -- Shorter recovery - Bradycardia (n=2) Both protocols: - Provided sedation - No effect on RR or lactic acid - Did not stop response to noxious stimuli Conclusions: Alfaxalone has a faster onset of action and shorter duration of effect when compared to non-reversal of midazolam-butorphanol in budgies.

Answer 17

Assessment of sedation after intranasal administration of midazolam and midazolam-butorphanol in cockatiels (Nymphicus hollandicus) Doss GA, Fink DM, Mans C. American journal of veterinary research. 2018 Dec;79(12):1246-52. Midazolam-butorphanol intranasally in budgies (compared to midazolam alone or saline) had: Less struggling during restraint Deeper sedation Sedation with midazolam or midazolam-butorphanol intranasally in budgies: Lessened tachypnea during handling No effect on body temperature or HR (both still increased) No adverse effects (not even sneezing) Conclusions: Midazolam or midazolam-butorphanol can reduce tachypnea during handling of cockatiels and midazolam-butorphanol can reduce struggling.

Answer 18

Effects of three fentanyl plasma concentrations on the minimum alveolar concentration of isoflurane in Hispaniolan Amazon parrots (Amazona ventralis) Hawkins MG, Pascoe PJ, DiMaio Knych HK, Drazenovich TL, Kass PH, Sanchez-Migallon Guzman D. American journal of veterinary research. 2018 Jun;79(6):600-5. Fentanyl reduces isoflurane MAC in red-tailed hawks and chickens In this study, fentanyl in Hispaniolan Amazons: Decreased heart rate and blood pressure Increased body temperature Reduced isoflurane MAC Conclusions: Fentanyl IV decreases isoflurane MAC in Hispaniolan Amazons but also decreases heart rate and blood pressure.

Answer 19

Pharmacokinetics of fentanyl after intravenous administration in isoflurane-anesthetized red-tailed hawks (Buteo jamaicensis) and Hispaniolan Amazon parrots (Amazona ventralis). Pascoe PJ, Pypendop BH, Pavez Phillips JC, DiMaio Knych HK, Sanchez-Migallon Guzman D, Hawkins MG. Am J Vet Res. 2018 Jun;79(6):606-613. Background: Fentanyl is a synthetic mu opioid agonist with a short time to action and short duration of action when given IV Reported to decrease MAC in red-tailed hawks and Hispaniolan Amazon parrots (Hawkins 2018) Key Points: There were large differences between the half life in RTH (90 min) and Amazons (51 minutes) Fentanyl was cleared more rapidly in the Amazons than in any avian species Conclusions: Interspecies differences exist among birds, so PK extrapolation should be performed with caution.

Answer 20

EFFECTS OF TRAMADOL ON THE MINIMUM ANESTHETIC CONCENTRATION OF ISOFLURANE IN WHITE-EYED PARAKEETS (PSITTACARA LEUCOPHTHALMUS) Escobar A, da Rocha RW, Midon M, de Almeida RM, Filho DZ, Werther K. J Zoo Wildl Med. 2017 Jun;48(2):380-387 Minimum anesthetic concentration (MAC) of an inhalant anesthetic is the dose that prevents movements in 50% of individuals exposed to a noxious stimulus Tramadol is a synthetic opioid that enhances the release of serotonin and norepinephrine and inhibits their reuptake In Hispaniolan Amazon, antinociceptive effects of tramadol last for up to 6hs PO and up to 4hrs IV 10 wild-caught white-eyed parakeets Determined isoflurane MAC → 2.45% Much greater than all other avian MACs Determined isoflurane MAC 15 min and 30 min after 10mg/kg tramadol IM → 2.49% Not statistically different from isoflurane alone No significant differences in HR, RR, and anesthetic recovery time with tramadol Cloacal temperatures higher at 15 min after tramadol One bird treated with tramadol regurgitated 4 minutes after extubation One bird treated with tramadol developed second-degree atrioventricular block Opioid-induced arrhythmias in birds under inhalant anesthesia described in guineafowl and chickens Recommended to monitor ECG in anesthetized birds Tramadol may still have analgesic effects even if no significant change in MAC Conclusion: Tramadol did not affect MAC in white-eyed parakeets.

Answer 21

Sedative Effects of Intranasal Midazolam Administration in Wild Caught Blue-fronted Amazon (Amazona aestiva) and Orange-winged Amazon (Amazona amazonica) Parrots. Schaffer DPH, de Araújo NLLC, Raposo ACS, Filho EFM, Vieira JVR, Oriá AP. J Avian Med Surg. 2017 Sep;31(3):213-218. Background: Intranasal administration is good because there is no pain associated with injection Midazolam is a hydrosoluble benzodiazepine with anxiolytic and muscle-relaxant properties Reported adverse effects of intranasal midazolam in birds include persistent sneezing, upper airway noise, trembling, myoclonic seizures, and muscle tremors. Key Points: Light to moderate sedative effects were produced with no difference between the sedation scores of the 2 species Use of a catheter improved accuracy and safety of administration Similar length of sedation to other psittacines at the same dose (about 15-40 minutes) No adverse effects except two birds sneezed Conclusions: Intranasal midazolam at 2 mg/kg was an effective light-to-moderate sedative for wild-caught blue-fronted and orange-winged Amazons.

Answer 22

Effects of Midazolam and Midazolam-Butorphanol on Gastrointestinal Transit Time and Motility in Cockatiels (Nymphicus hollandicus) Martel A, Mans C, Doss GA, Williams JM. Journal of avian medicine and surgery. 2018 Dec;32(4):286-93. Midazolam or midazolam-butorphanol sedation in cockatiels: Increased overall transit time Reduced ventricular contraction frequency Reduced esophageal bolus frequency (midazolam-butorphanol only) Effects were more pronounced with midazolam-butorphanol than midazolam alone Conclusions: Midazolam and midazolam-butorphanol can slow GI transit time in cockatiels.

Answer 23

Laniesse, D., Sanchez-Migallon Guzman, D., Smith, D. A., Douglas, J. M., Mosley, C., Beaufrère, H., & Paul-Murphy, J. (2020). Evaluation of the thermal antinociceptive effects of subcutaneous administration of butorphanol tartrate or butorphanol tartrate in a sustained-release poloxamer 407 gel formulation to orange-winged Amazon parrots (Amazona amazonica). *American journal of veterinary research*, *81*(7), 543-550. **Key Points**: * Thermal or electric withdrawal used as antinociception model in multiple avian species * Butorphanol – k opioid receptor – great analgesic but lasts 2-3 hours * To extend use it was added to P407 base and worked well in Hispaniolan amazons * The control butorphanol worked great (for \>30 but \<90 minutes) but the P407 did not **Take-Home**: Species differences exist. Butorphanol in P407 appears to work in Hispaniolan but not Orange-Winged Amazon parrots

Answer 24

Greunz, E. M., Limón, D., & Bertelsen, M. F. (2021). Alfaxalone sedation in black-cheeked lovebirds (Agapornis nigrigenis) for non-invasive procedures. *Journal of Avian Medicine and Surgery*, *35*(2), 161-166. * 12.6 mg/kg SC alfaxalone provided nearly 1 hour of excellent sedation for noninvasive procedures in black-cheeked lovebirds * loss of reaction to noxious stimulation was not achieved * SC injection was effective and reliable * majority of inductions and recoveries were rough, characterized by uncoordinated movement * SpO2 values were consistently high and RR acceptable

Answer 25

![]() ## Footnote Beaufrère, H., Laniesse, D., Kabakchiev, C., Axelson, R., & Zur Linden, A. (2019). Multiple fractures and luxations of palatofacial bones in a hawk-headed parrot (Deroptyus accipitrinus). *Journal of the American Veterinary Medical Association*, *254*(2), 251-256.

Answer 26

Compendium of Measures to Control Chlamydia psittaci Infection Among Humans (Psittacosis) and Pet Birds (Avian Chlamydiosis), 2017 Gary Balsamo, Angela M. Maxted, Joanne W. Midla, Julia M. Murphy, Ron Wohrle, et. al. Journal of Avian Medicine and Surgery 31(3):262–282, 2017 **Infection in Birds (Avian Chlamydiosis)** Transmission: Excreted in ocular and nasal discharges or feces. Length of time shedding varies by sps of bird and chlamydia strain In organic debris, organism can remain infective for a month Can have subclinical carriers and shedders. Shedding can be exacerbated by stress, reproduction, shipping, crowding, illness Clinical Signs: 3d to weeks incubation Subtle resp illness OR mild conjunctivitis OR Death Usually nonspecific signs: lethargy, anorexia, conjunctivitis, ocular or nasal discharge, URI, diarrhea, liver disease (abN colored feces) Case definitions: needs at least one of the following Isolation of C psittaci from clinical specimen ID chlamydia DNA (PCR). IHC is NOT diagnostic 4x or greater change in serologic titer in 2 specimens from same bird at least 2 weeks apart assayed simultaneously at the same lab ID of intracellular bacteria stained with Gimenez or Macchiavello stain + detection of C psittaci DINA in same tissue A suspected case= CS + one of the following Chlamydia (nonspecific) PCR on conjunctival, choanal, cloacal swabs OR blood OR feces Chlamydia antigen IFA on feces, cloacal swab, resp secretion (IFA cross reacts with non chlamydia- FYI) Epidemiological linked to a known/confirmed case Diagnosis Combination of culture, PCR-based detection, and antibody detection is recommended. No epidemiological evidence of increased risk of disease to young, elderly, or immunocompromised patients. CS birds: cloudy air sacs, enlargement of liver or spleen. Post-mortem spleen or liver are preferred for culture Live birds: combo of conjunctival-choanal-cloacal swab culture or liver bx and culture If using feces, need to collect serial fecal specimens for 3-5 consecutive days and pool into single sample for culture Ab tests: positive serologic test just indicates exposure at some point, but not that the animal is still infectious. False negative in acute infection 4 fold or greater increase in serologic titer OR a combination of positive titer and antigen ID is needed Elementary body agglutination (elementary body is the infectious form of C psittaci). Favors detection of IgM which reach high levels in acute stage of infection. Titers 10 or higher are positive. But increased titers can persist after successful treatment Indirect fluorescent ab test: IgG ab. Sensitivity and specificity not great, can get cross reaction Complement fixation: more sensitive than agglutination, but false negatives esp form parakeets, African gray parrots and lovebirds. High titers persist after treatment Modified direct more sensitive than direct Tests for antigen: do not require live organisms. Can get false positives. And cross reaction can occur. False negatives if shedding is intermittent. ELISA not recommended Fluorescent ab test: used to detect organism on impression smears . lots of cross reactivity. Not recommended. Test for DNA -PCR is sensitive and specific to detection of target DNA sequences. , but results differ between labs because no standardized primers and lab techniques. Not all PCR can tell apart different chlamydia In-situ hybridization preferred method for documenting chlamydial organisms with in fixed tissue. Additional testing Genotyping: Genotype A predominates in psittacines. Genotype B predominates in columbiformes. Screening protocols using diagnostic tests: Use PCR that can distinguish C psittaci from other related Chlamydia. At least test cockatiels, lovebirds, larger psittacines tested on conj-choana-cloaca swab during quarantine. Conjunctiva is most sensitive for detecting chronically infected cockatiels with minimal CS In budgies ONLY- house 20-25 birds together for 12-24 hours and then collect composite swab from the floor, perches, rims of water and food bowls, and feces, pool it and test. Not shown to be effective in other sps.

Answer 27

Compendium of Measures to Control Chlamydia psittaci Infection Among Humans (Psittacosis) and Pet Birds (Avian Chlamydiosis), 2017 Gary Balsamo, Angela M. Maxted, Joanne W. Midla, Julia M. Murphy, Ron Wohrle, et. al. Journal of Avian Medicine and Surgery 31(3):262–282, 2017 Treatment Historically, treatment periods are 45 days. More recent info suggests 21-30 days of treatment could be effective. Remove extra dietary calcium from environment as ca can inhibit absorption of tetracyclines Doxycycline: Drug of choice for birds- eliminated slower and better absorption than other tetracyclines so lower dose and less freq administration needed. Signs of toxicosis: yellow or green urates, lethargy, elevated LE Budgies and cockatiels have a medicated feed that is approved Medicated water- PK studies for some sps. 400-600mg/L water in larger psittacines. Do NOT use medicated water for budgies- does not maintain therapeutic concentrations PO or injectable works too. Only one form of doxy is acceptable for IM injections, all other forms may cause severe tissue reactions if given IM Alternative drugs: Azithromycin: COckatiels treated for 21 days had resolution Oxytetracycline injectable, long acting SQ given every 3 days in larger psittacines. Causes irritation at injection site. Chlortetracycline medicated feed: available as mash, pellets, extruded (Doxycycline is better) It is NOT recommended to treat water with Chlortetracycline, Oxytet or other tetracycles Part 3: Recommendations for controlling infection among humans and birds Educate persons at risk: respiratory or influenza-like symptoms should seek prompt medical attention and let health care provider know about bird contact. Reduce risk of transmission to humans: PPE: coveralls, gloves, eyewear, footwear, N95 mask. NX of suspect cases in biosafety cabinet - maintain accurate records of bird related transactions for at least 1 year Avoid purchase or selling birds with resp illness could be associated with chlamydia Avoid mixing birds from multiple sources Quarantine new birds Test birds for chlamydia status before acquiring birds Screen birds with frequent public contact Practice preventative husbandry- non-dusty bedding, clean things regularly, disinfect (susceptible to detergents, heat. Resistant to alkali and acid)- best to use quaternary ammonium compounds or oxidizing agents. Care for sick birds last

Answer 28

SURVEILLANCE FOR CHLAMYDIA SPP. WITH MULTILOCUS SEQUENCE TYPING ANALYSIS IN WILD AND CAPTIVE BIRDS IN VICTORIA, AUSTRALIA Amery-Gale J, Legione AR, Marenda MS, Owens J, Eden PA, Konsak-Ilievski BM, Whiteley PL, Dobson EC, Browne EA, Slocombe RF, Devlin JM. Journal of wildlife diseases. 2020 Jan;56(1):16-26. C. psittaci obligate intracellular bacterial pathogen Notifiable disease Primary infects birds (highest prevalence in psittacines and columbiformes) Signs: respiratory, hepatitis, splenitis, wasting, death or subclinical carrier Treatment with tetracyclines Key Points: Higher prevalence of Chlamydia psittaci in captive birds (8%) vs. wild (0.7%) Males \>\> females Many positive birds in this study also had beak and feather disease virus (suppresses immune system) Conclusions: Male captive birds were the most commonly affected by Chlamydia psittaci in opportunistic screening in Australia.

Answer 29

MYCOBACTERIOSIS IN CAPTIVE PSITTACINES: A BRIEF REVIEW AND CASE SERIES IN COMMON COMPANION SPECIES (ECLECTUS RORATUS, AMAZONA ORATRIX, AND PIONITES MELANOCEPHALA) McRee AE, Higbie CT, Nevarez JG, Rademacher NT, Tully TN Jr. J Zoo Wildl Med. 2017 Sep;48(3):851-858. Mycobacteriosis has been identified in a wide variety of captive and free-ranging avian populations Historically Mycobacterium avium subsp. Avium and M. genavense M. avium subsp. Paratuberculosis has not been identified in avian cases of Mycobacteriosis Transmission is likely fecal-oral, though inhalation of aerosolized particles is possible Mycobacteria can persist in the environment for years. Infectious vacilli is ingested, colonizes liver and small intestines Dissemination can cause disease of bone marrow, lungs, air sacs, spleen, gonads, kidneys, and pancreas Affected organs are enlarged with diffuse macrophage accumulation +/- granulomas Clinical signs: weight loss, unkempt feathers, polyuria, polyphagia, diarrhea, and coelomic distension Marked leukocytosis with heterophilia and monocytosis, anemia Enlarged cardiohepatic silhouette, thickened intestinal loops, increased opacity of endosteal bone of humerus, tibia, ulna, and femur Acid-fast bacteria in feces in later stages Diagnosis is confirmed by culture, isolation, and genetic identification, though this takes months Gold standard for mycobacteriosis = biopsy of affected tissue with consistent histopathology, culture, and nested PCR Most common mycobacterial isolate in humans is M. avium susp. Hominissuis, though M. genavense infection is possible Environment is more likely to be a source of infection rather than birds Euthanasia is recommended due to zoonotic threat, poor prognosis Treatment is difficult, and treatment with combination therapy for \>12 months is recommended M. tuberculosis from human to macaw has been reported Have your caregivers screened Conclusion: Mycobacterium spp. still persists as a relevant disease and should be kept as a differential for any insidious, nonspecific, disease process in psittacines.

Answer 30

Retrospective Evaluation of Clinical Signs and Gross Pathologic Findings in Birds Infected With Mycobacterium genavense. Schmitz A, Rinder M, Thiel S, Peschel A, Moser K, Reese S, Korbel R. J Avian Med Surg. 2018 Sep;32(3):194-204. Mycobacterium avium subspecies avium has been thought to be the primary pathogen of mycobacteriosis in psittacines Mycobacterium genavense has been shown as the causative agent in passerine and psittacine cases Clinical signs of mycobacteriosis are nonspecific Necropsy may show enlarged liver, granulomatous tubercules, or no lesions at all M genavense is highly pathogenic for immunocompromised people. Key Points: Wide range of clinical findings (feather disorders, GI signs, falling off the perch, no signs, seizures, ocular disease) Ocular signs typically involved the adnexa with periocular swelling Most common pathologic findings were enlarged liver, dilated intestines, reddish lungs White nodules found in 21% of birds Coinfections were very common with fungal infections (47%, e.g. Macrorhabdus ornithogaster) more common than bacterial infections (14%) Psittacine birds were more likely to have a poor body condition, hepatomegaly, and nodules compared to passerines 51% of birds had mild to absent pathologic findings Cases found in a wide range of avian orders Conclusions: Mycobacterium genavense presents with a wide variety of clinical syndromes and orders, and is associated with coinfections in birds.

Answer 31

Retrospective Review of Mycobacterial Conjunctivitis in Cockatiels (Nymphicus hollandicus) Stephanie K. Lamb, Drury Reavill, Rebecca Wolking, Bob Dahlhausen J. of Avian Medicine and Surgery, 34(3):250-259 (2020) Mycobacteria spp.: slow growing, aerobic, acid-fast, resistant to extremes within environment Most common species of psittacine with mycobacteriosis: Budgies, brotogeris parakeets, Amazons, pionus (common reports) Cockatiels, Amazons (in a postmortem study) Most common Mycobacteria spp. in psittacines = M. genavense Most common locations = intestines, liver, spleen, bone marrow Key Points: Cockatiels had granulomatous inflammation of conjunctiva with acid-fast positive bacteria Confirmed mycobacteriosis with PCR of biopsy (most were M. genavense) Variable survival Conclusions: Mycobacterium genavense can cause granulomatous conjunctivitis in cockatiels.

Answer 32

Superficial Chronic Ulcerative Dermatitis (SCUD) in Psittacine Birds: Review of 11 Cases (2008-2016) Abou-Zahr T, Carrasco DC, Shimizu N, Forbes NA, Dutton TA, Froehlich F, De Bellis F. Journal of avian medicine and surgery. 2018 Mar;32(1):25-33. Background: Superficial chronic ulcerative dermatitis (SCUD) = described bacterial dermatitis lesions secondary to self-mutilation Common isolates = Staphylococcus aureus, Enterobacter cloacae Common species = Lovebirds Key Points: Most common species for SCUD in this study = African greys Common features of birds with SCUD: Hand-reared, indoors Imprinted on owners Sexually mature and expressing sexual behaviors towards owners No avian companions Feather-damaging behavior Most common isolates for SCUD in this study = Enterobacter cloacae (\> E. coli, S. aureus) Most common SCUD location = axilla No age or sex predisposition This study had 100% treatment success with antibiotics based on culture results. Conclusions: Superficial cutaneous ulcerative disease was common in African parrots and axillae caused by Enterobacter cloacae.

Answer 33

Antemortem Diagnosis of Coxiellosis in a Blue and Gold Macaw (Ara ararauna) Flanders AJ, Rosenberg JF, Bercier M, Leissinger MK, Black LJ, Giglio RF, Craft SLM, Zoll WM, Childress AL, Wellehan JFX. J Avian Med Surg. 2017 Dec;31(4):364-372. Avian coxiellosis is an emerging infectious disease with significant morbidity and mortality among captive birds Reported in 9 species of birds (8 psittacines, 1 toucan) Clinical Signs: lethargy, weakness, cardiac/neurologic abnormalities Pathology: Splenomegaly and hepatomegaly Histo: Coxiella-like bacteria within macrophages of spleen, liver, bone marrow, kidneys, and adrenals Granulomatous encephalitis and myocarditis in lorikeets and eclectus parrots Diagnosis: FNA of organs of concern for cytology, culture, and PCR Unknown zoonotic potential Coxiella spp. are obligate intracellular, gram-negative bacteria Coxiella burnetii causes Q fever, an important zoonotic disease Transmitted via direct contact or aerosol transmission from infected ruminants, ticks, or rodents Contact with ruminant placental fluids increase risk for transmission Not pathogenic in birds Coxiella-like endosymbionts have been described in \>40 species of ticks Unknown if avian coxiellosis is transmitted via ticks Conclusion: Avian coxiellosis is an emerging disease of concern in captive avian species, causing hepatosplenomegaly and non-specific clinical signs. Antemortem diagnosis is possible through PCR of FNA of affected organs.

Answer 34

A Disseminated Cryptococcus gattii VGIIa Infection in a Citron-Crested Cockatoo (Cacatua sulphurea citrinocristata) in Québec, Canada Maccolini ÉO, Dufresne PJ, Aschenbroich SA, McHale B, Fairbrother JH, Bédard C, Hébert JA. J Avian Med Surg. 2017 Jun;31(2):142-151. Cryptococcus species are basidiomycetous fungi with C. gattii and C. neoformans as most common pathogens C. neoformans = opportunistic pathogen; C. gattii = primary pathogen Recent increase in C. gattii cases in North America Inhalation is most common route of infection Strain isolated in this case is most common isolate of ongoing outbreak in British Columbia and PNW In Australia, C. gattii infects immunocompetent birds as a primary pathogen causing URI and upper beak lesions C. gattii with cutaneous and pneumatic bone lesions is increasingly reported outside of Australia C. neoformans infects immunocompromised birds with neurologic and lower respiratory signs More common than C. gatti in North America and Europe C. gattii should be a differential for upper respiratory infection and beak lesions in birds Conclusions: Case of disseminated Cryptococcus gattii infection in an immunocompetent bird in a nonendemic region

Answer 35

Multicentric Cryptococcosis in a Congo African Grey Parrot (Psittacus erithacus erithacus). Schunk RSK, Sitinas NE, Quesenberry KE, Grodio JL. J Avian Med Surg. 2017 Dec;31(4):373-381. Key Points: C. neoformans most common species of Cryptococcus in birds; affects immunocompromised C. gatti associated with warmer climates and eucalyptus trees; affects immunocompetent Clinical signs: respiratory disease that progresses to gastrointestinal system and CNS. Thick gelatinous exudate is a hallmark of Cryptococcus infection. Infection is most commonly acquired from the environment, not infected animals Debulking gross lesions is recommended (e.g. eye and coelomic mass in this case); prognosis is always guarded. Conclusions: Cryptococcosis became fatally disseminated despite treatments in a Congo African grey parrot.

Answer 36

**Sarcocystosis In A Captive Flock Of Thick-billed Parrots (Rhynchopsitta Pachyrhyncha) From 2005 To 2016: Morbidity, Mortality, Diagnostics, And Management Strategies** Anne E. Rivas, Kenneth Conley, Tracie A. Seimon, Charlotte Hollinger, Heather Knych, Robert P. Moore, and Jean A. Pare Journal of Zoo and Wildlife Medicine 52(1): 206–216, 2021 Background: - Sarcocystis spp.: intracellular coccidia protozoa - Definitive hosts = carnivores, omnivores -- Site of sexual reproduction -- Signs: Mild enteritis, diarrhea, weight loss - Intermediate hosts = herbivorous or prey species -- Site of asexular reproduction -- Signs: sarcocysts (containing brady/merozooites) in muscle, brain → severe morbidity, mortality - Spread by paratenic hosts (e.g. arthrpods) - Sarcocystis falcatula is the common species in psittacines -- Definitive host = Virginia opossum Key Points: - Primary cause of mortality in young adult thick-billed parrots at Queens zoo - Clin path: elevated CK (sometimes) - Histo: interstitial pneumonia, skeletal muscle myositis, myocardial myositis, encephalitis - Treated birds had tubular necrosis, visceral gout, aspergillosis - Chronic cases had abnormal posture, fluffed feathers, difficulty flying - Diagnosis via PCR was more sensitive earlier in disease - Treatment that resolved clinical signs = ponazuril + TMS + pyrimethamine x 6 months - Did not clear infection - Risk factor for death: dyspnea - Primarily diagnosed in young adult birds. Effective prevention measures: - Food stations that exclude arthropod/rodent hosts seemed to help - Daily prophylactic diclazuril also seemed helpful Conclusions: Disseminated avian sarcocystosis (usually caused by S. falcatula in psittacines) is difficult to prevent, diagnose, and treat, with potential for significant morbidity and mortality.

Answer 37

HINDLIMB PARALYSIS SYNDROME IN WILD CARNABY'S COCKATOOS (CALYPTORHYNCHUS LATIROSTRIS): A NEW THREAT FOR AN ENDANGERED SPECIES Anna Le Souëf, Simone Vitali, Rick Dawson, Rebecca Vaughan-Higgins, Kristin Warren J Wildl Dis. 2020 Jul;56(3):609-619. Background: An increasing number of wild Carnaby’s cockatoos were presented to the Perth Zoo with hindlimb paresis/paralysis Organophosphates (OP) = anti-cholinesterase (anti-ChE) toxins that hydrolyze and inhibit acetylcholine Acute clinical signs: fatal respiratory or cardiac arrest Absorption via oral, inhalational, or dermal routes OPs can be stored in fat and mobilized with physical exertion (e.g. migration) OPs are readily metabolized are rarely found on diagnostics OP-induced delayed neuropathy = peripheral neuropathy 2-3 wks post-OP exposure in humans, chickens, and a white-fronted Amazon Key Points: Carnaby’s cockatoos with hindlimb paralysis syndrome were unable to stand +/- foot clenching, hindlimb paresis/paralysis Normal neurologic status in wings and head with an intact appetite Varying body condition Some had keel ulceration and eschar formation from prolonged sternal recumbency Most commonly presented in the summer and fall No sex or age predilection No other local avian species known to be affected Few ticks but none known to cause paralysis Elevated AST +/- elevated CK and heterophils +/- hypoproteinemia No significant toxins detected (no OPs, only n=1 with nicatinoids) Consistent with hypothesize of delayed-onset polyneuropathy from OP exposure No significant depression of brain and plasma AChE activity consistent with delayed polyneuropathy syndrome Fair survival rate (21/33) with supportive care (fluids, antibiotics, meloxicam) Average recovery = 8 days No need for atropine because the OPs are already metabolized Hypothesize that OP exposure from agriculture during inland breeding then developed signs after migration to coastal Perth Conclusion: Hindlimb paralysis syndrome in Carnaby’s cockatoos is hypothesized to be from an organophosphate-induced delayed-onset neuropathy that can resolve with supportive care.

Answer 38

Cloacal Diseases in Companion Parrots: A Retrospective Study of 43 Cases (2012–2018) Kristin S. Gill, Peter J. Helmer J. of Avian Medicine and Surgery, 34(4):364-370 (2020). Background: Cloacal components: Coprodeum: rectum Urodeum: ureters, paired ductus deferens or left oviduct Proctodeum: connects coprodeum/urodeum to environment Bursa of Fabricius: B cell maturation within proctodeum 2 syndromes of cloacal prolapse Excess hormone stimulation + hypersexual behavior Progressive idiopathic coprodeal prolapse + straining Usually cockatoos (umbrellas, Moluccans); also Amazons + B/G macaws Male, single-parrot household, pair bonded to a human, prolonged weaning period Key Points: Most common species with cloacal disease = Umbrella cockatoos Risk factors for cloacal disease: Inappropriate sexual behaviors (50% of birds) Umbrella cockatoos (most common species) Female Cloacal or coelomic mass Abnormal egg laying Most common organ prolapse = cloacal wall In raptors, colon is more often prolapsed No factors for survival identified Conclusions: Most common cloacal disease scenario was female cockatoos with inappropriate sexual behavior prolapsing a cloacal wall.

Answer 39

Horner Syndrome With Ipsilateral Wing Paresis in a Wild, Juvenile Yellow-Tailed Black Cockatoo (Calyptorhynchus funereus) McLelland JM, McLelland DJ, Massy-Westropp N, Wigmore B, Loftus WK, Read RA. Journal of Avian Medicine and Surgery. 2020 Jul;34(2):186-91. Horner’s syndrome in birds has unilateral signs: Ptosis (eyelid drooping) Erect feathers and neck (only on the affected side) +/- Miosis (small pupil) Topical phenylephrine → transient resolution within 30 minutes Confirms diagnosis of Horner’s syndrome Conclusions: Use topical phenylephrine to diagnose Horner’s syndrome in birds.

Answer 40

A Retrospective Study of Horner Syndrome in Australian Wild Birds, 2010-2016. Hill AG. Journal of avian medicine and surgery. 2018 Jun;32(2):115-21. Horner’s = oculosympathetic paresis results from interruption of nerves Sympathetic n. originates at the hypothalamus → thoracolumbar spinal cord → cranial cervical ganglion → innervate the eye, vasculature, and feather follicles of head and neck. Signs in birds: unilateral ptosis, erection of facial feathers +/- miosis No anhidrosis (seen in mammals) Key Points: Horner’s syndrome in wild, Australian birds was more common in: Adults Trauma Concurrent neurologic deficits Poor prognosis (release rate of 32%) Signs can persist beyond resolution of soft tissue trauma Improved resolution with meloxicam All cases unilateral No seasonality or temporal pattern with admission for Horner’s Conclusions: Horner’s in avian species is most likely caused by trauma and presents with unilateral raised feathers and ptosis.

Answer 41

Organ Histopathology and Hematological Changes Associated With Heat Exposure in Australian Desert Birds Shangzhe Xie, Lucy Woolford, Todd J. McWhorter J. of Avian Medicine and Surgery, 34(1):41-51 (2020). Key Points: Congestion and lymphoid aggregates in liver, lungs, kidneys, and/or intestine were common in all groups Primary organ affected differed by species Lung congestion most common overall Myocardiocyte vacuolation and airway hemorrhage were only seen in doves Clinicopathologic changes varied by species and heat: Budgies: increased heterophils and decreased PCV Doves @ 35 C: decreased eosinophils Conclusions: Mild heat exposure can induce subclinical heat stress in birds.

Answer 42

**Clinical features, treatment, and outcomes of cutaneous and oral squamous cell carcinoma in avian species** Zehnder AM, Swift LA, Sundaram A, Speer BL, Olsen GP, Hawkins MG, Paul-Murphy J. Journal of the American Veterinary Medical Association. 2018 Feb 1;252(3):309-15. Background: - Squamous cell carcinoma (SCC) is often locally invasive - Common locations: skin, mouth, upper GI, , uropygial gland - Common species: cockatiels, Amazons, budgies Key Points: - Most common species for SCC in this study: cockatiels > Amazons > conures - Common concurrent conditions: hypovitaminosis A > bacterial infection > FDB - Most common SCC locations: skin > mouth > uropygial gland - Cockatiels = skin - Amazons = mouth - Conures = mouth/beak - Complete remission most common with complete excision (vs. other nonsurgical treatments) Conclusions: Squamous cell carcinoma can be cured with complete surgical excision in psittacines.

Answer 43

Asymmetrical Cloacoplasty for the Treatment of Chronic Cloacal Prolapse in Psittaciformes: A Case Series. Zaheer O, Beaufrère H, Jajou S, Gardhouse S. Journal of Avian Medicine and Surgery. 2020 Jul;34(2):172-80. Idiopathic cloacal prolapse syndrome is most common in sexually mature male umbrella cockatoos (different from review paper which states female, Umbrella cockatoos) Also seen in females, other cockatoos, and African grey parrots Acute management of cloacal prolapse = 2-3 transverse sutures between ent lips to reduce opening Rectal opening in psittacines is on the right side (unlike pigeons, chickens, and birds of prey) * Ways to surgically manage cloacal prolapse: Name Technique Notes Percutaneous cloacopexy Sutures placed percutaneously to adhere cloaca to abdominal wall Does not alter vent and will re-prolapse Coelomic cloacopexy Suture from craniolateral urodeum around ribs +/- sutured to abdominal incision Invasive Incisional cloacopexy Incise the serosal surface of the coprodeum then suture to abdominal wall Invasive Incisional colopexy Tack colon to abdominal wall Invasive Cloacoplasty Excise two triangular wedges bilaterally at vent edges, then suture Reduces cloacal opening but intermittent prolapse can still occur Conclusions: Asymmetrical cloacoplasty can successfully resolve chronic cloacal prolapse in cases of mild idiopathic cloacal prolapse. Creates a midline physical barrier not present in symmetrical cloacoplasties. ![]()

Answer 44

Percloacal Ovocentesis in the Treatment of Avian Egg Binding: Review of 20 Cases Tariq Abou-Zahr, Daniel Calvo Carrasco, Sara Louise Jones, Thomas Anthony George Dutton J. of Avian Medicine and Surgery, 33(3):251-257 (2019). Common species: Psittaciformes \>\>\> Accipitriformes = Strigiformes \> Anseriformes Common signs: unproductive straining, blood from cloaca, lameness, dyspnea, anorexia, coelomic distention Most common cause of dystocia = oversized egg Recommended management: Confirmed presence of egg via rads or palpation/gross visualization of egg in cloaca SC or IV fluids, butorphanol, calcium gluconate If not obstructed (dystocia) - oxytocin 5-10U/kg IM Dark enclosures, towels, 35-30F ambient temp Anesthetized with isoflurane and placed in dorsal recumbency Percloacal ovocentesis had good success (80%) Complications = egg fracture, coelomitis Conclusions: Dystocia most commonly occurred in psittacines secondary to an oversized egg and percloacal ovocentesis has good success.

Answer 45

Retrospective Evaluation of Tibiotarsal Fractures Treated With Tape Splints in Birds: 86 Cases (2006-2015). Wright L, Mans C, Olsen G, Doss G, Amene EW, Britsch G, Christman J, Heatley J. J Avian Med Surg. 2018 Sep;32(3):205-209. Key Points: Species: Psittaciformes \> Passeriformes \> Columbiformes Causes: Unknown \> owner mishandling \> falling of a perch \> dog/cat attack Most fractures were mid-diaphyseal and closed Tape splints were used in 92% of cases often without an intramedullary pin. Factors for unsuccessful outcomes: removing the original tape splint before 14 days, deep pain loss, dog/cat attack. Location of fracture was not associated with different outcomes Conclusions: Tape splint external coaptation has a high rate of success in tibiotarsal fractures under 200 g.

Answer 46

A Novel Surgical Approach to Avian Femorotibiotarsal Luxation Repair McRee AE, Tully TN Jr, Nevarez JG, Sumner J, da Cunha AF. J Avian Med Surg. 2017 Jun;31(2):156-164. Key Points: Avian stifle (4 articulations): proximal tibiotarsus, fibular head, medial and lateral condyles of femur Supporting structures: medial and lateral collateral ligaments, cranial and caudal cruciate Ligaments, menisci, joint capsule, patellar ligament Tibial and fibular nerve (branch of ischiadic nerve) course along lateral stifle Fibular n → craniolateral crus and pes = tarsal flexion, digital extension Tibial n → extensors of tarsus and digital flexors Disadvantages of methods of fixation/stabilization External coaptation – inguinal web limits proximal bandage/splint, Transarticular ESF – risk of iatrogenic fracture of femur or tibiotarsus during pinning, longer anesthesia/sx, higher risk of osteomyelitis FESSA (pigeons) – Decreased ROM, regressive lameness, pododermatitis, muscle atrophy IM pinning – penetration of articular cartilage, risk of septic arthritis, decreased ROM Permanent arthrodesis if irreparable damage to joint – Chronic ambulation difficulty Intra-articular/extra-capsular – Disruption cartilage & ankylosis No fabella (unlike in dogs) so need modified anchor (screw in this case) if want to stabilize drawer Summary: Clinical report of a cockatoo with stifle luxation repaired via modified extracapsular (lateral) suture technique, which established a normal perching angle within 3 months post-op with joint ankylosis. Complication of screw migration.

Answer 47

Comparison of a Point-of-care Cholesterol Meter With a Reference Laboratory Analyzer in Companion Psittaciformes Barboza T, Beaufrère H J Avian Med Surg. 2019 Mar 25;33(1):7-14. Background: - Hypercholesterolemia and dyslipidemia is relatively common in captive psittacine birds - Associated with atherosclerosis, cardiovascular disease, reproductive disease, obesity, and xanthomas - Risk factors: age, female sex, concurrent reproductive disease, and certain genera - Differentials for hypercholesterolemia: postprandial synthesis, nutritional imbalances, lack of physical activity, vitellogenesis in female birds - In psittacines, triglycerides are produced in the liver and lipogenesis is only in adipose tissue - Bird birds have some unique lipoproteins, such as vitellogenin and very low-density lipoprotein yolk labeled (VLVLy) - Birds lack lipoprotein (a), apolipoprotein E (ApoE), and apolipoprotein B48 (ApoB48) - HDL is the main cholesterol carrier in birds, unlike LDL in people. - This study defined hypercholesterolemia as \>8 mmol/L (or 390 mg/dL) Key Points: - Accuracy of laboratory analyzer (Cobas) was adequate - Point-of-care analyzer (CardioChek) tended to underestimate cholesterol and lacked accuracy - Lipemia and hemolysis strongly increased bias - PCV, glucose, and genus had no effect on bias - Using the CardioChek could result in false negatives for hyperlipidemia Conclusions: The CardioChek point-of-care analyzer lacks accuracy and cannot be used without specific reference intervals.

Answer 48

Method Comparison Using 2 Point-of-Care Meters and a Reference Analyzer for Measuring Blood Triglycerides in Psittacine Birds Katherine L. Irvine, Christoph Mans, Kristen R. Friedrichs Journal of Avian Medicine and Surgery 33(3):229–234, 2019 In birds, blood triglyceride (TG) concentrations increase w/ increased estrogen levels, may be used as alternative to direct estrogen measurement. When measuring triglycerides in psittacine samples: CardioChek had high correlation and reasonable agreement with reference analyzer Accutrend had poor, erratic performance. Conclusions: If you are measuring triglycerides as a proxy for estrogen levels in psittacines without a reference lab, use a CardioChek.

Answer 49

Comparison of Two Methods for Determining Prevalence of Macrorhabdus ornithogaster in a Flock of Captive Budgerigars (Melopsittacus undulatus) Sullivan PJ, Ramsay EC, Greenacre CB, Cushing AC, Zhu X, Jones MP. Journal of avian medicine and surgery. 2017 Jun;31(2):128-31. Background: M. ornithogaster = ascomycetous yeast. Most common in budgies, parrotlets, lovebirds, canaries, finch species Key Points: Fecal PCR is more sensitive than fecal Gram Stain to detect M. ornithogaster. Negative fecal Gram Stain not definitive. Fecal samples: Fresh fecal Gram Stain preparations Pool several days of feces for M. ornithogaster PCR M. ornithogaster found in most healthy budgies Conclusions: Use PCR to diagnose Macrorhabdus ornithogaster in budgies over a fecal wet mount.

Answer 50

Comparison of Dorsoventral Erect and Ventrodorsal Supine Radiographic Views for the Evaluation of Intracoelomic Organs in Clinically Normal African Grey Parrots (Psittacus erithacus) Graham Zoller, Lucile Chassang, Olivia van Steyvoort, Minh Huynh J. of Avian Medicine and Surgery, 33(3):218-228 (2019). * In dorsoventral erect radiographs of macaws (compared to ventrodorsal): * Better visualization of cardiohepatic silhouette , intestines, proventriculus, ventriculus * Worse visualization of lungs, air sacs * More motion artifact, limb superimposition * Wider liver * Larger heart * Both protocols had good views of the heart * CT of red-tailed hawks and humboldt penguins had increased lung density in sternal recumbency Dorsoventral erect Ventrodorsal Proventriculus visibility Better visualized Ventriculus visibility Difficult to evaluate but better visualized Difficult to evaluate Cardiac-thoracic width ratio Larger Smaller Hepatic width Larger Smaller Parabronchi visibility Better visualized Air sac volume Larger Conclusions: In macaws, the dorsoventral radiograph visualizes visceral organs better while ventrodorsal recumbency visualizes the respiratory system better. ![]()

Answer 51

Comparison of Feather Damage Associated With the Application of Pressure-sensitive Adhesive Tapes Andrew G. Hill J. of Avian Medicine and Surgery, 34(3):268-273 (2020). Key Points: * Damage is likely due to stiffness of tape’s backing and degree of adhesion to feather barbs * Micropore surgical tape (MST) and Scotch blue original painter's tape (SBOPT) were most appropriate, followed by Transparent tape (TT) and Nitto Denko Yu-Ki Ban nonwoven cloth tape (YBNWT) * Transpore surgical tape (TST) is NOT recommended * MST is the least likely to cause permanent damage Conclusions: The higher the flexibility of the backing and lower adhesion means the better tape on the feathers. Micropore surgical tape performed the best and transpore surgical tape (human) is the worst. ![]() ![]()

Answer 52

Pharmacokinetics of meloxicam during multiple oral or intramuscular dose administration to African grey parrots Montesinos A, Encinas T, Ardiaca M, Gilabert JA, Bonvehí C, Orós J. American journal of veterinary research. 2019 Feb;80(2):201-7. Background: - Meloxicam is COX-2 selective but binds to COX-1 at high dosages - Half life in avian species: chickens, pigeons \>\>\>\> ostriches, ducks, turkeys - N-acetyl-β-d-glucosaminidase (NAG) = lysosomal enzyme released into blood and urine when cell necrosis occurs - Indicator of acute renal injury in mammals and birds Key Points: - Accumulation of meloxicam in Amazons administered 1.6 mg/kg over 7 days - At 1.6 mg/kg dosage, urine and blood NAG increased but not outside of reference intervals - No signs of illness or any other clin path changes Conclusions: Repeated dosing in African grey parrots at 1.6mg/kg caused a light increase in plasma and urine NAG but no clinical adverse effects.

Answer 53

Pharmacokinetics of a Sustained-release Formulation of Meloxicam After Subcutaneous Administration to Hispaniolan Amazon Parrots (Amazona ventralis) Guzman DS, Court MH, Zhu Z, Summa N, Paul-Murphy JR. J Avian Med Surg. 2017 Sep;31(3):219-224. Meloxicam SR is commercially available from Wildlife Pharmaceuticals Pharmacokinetic study in Hispaniolan Amazon parrots (n=12) administered 3mg/kg SC Half life ranged from 12 to 96 hours 4 birds has noticeably rapid declines in plasma meloxicam concentrations at 12 hours (\<2mcg/mL compared to \>10mcg/mL in other birds) Significantly higher plasma half-life, AUC, and Cmax in “slow” parrots (n=8) No difference in tmax Injection site mild hematomas and white crusts noted Conclusion: Meloxicam sustained release administered at 3mg/kg SC in Hispaniolan Amazon parrots had a half life of 12 to 96 hours with significant interindividual variability.

Answer 54

Development of an In Vivo Lipopolysaccharide Inflammation Model to Study the Pharmacodynamics of COX-2 Inhibitors Celecoxib, Mavacoxib, and Meloxicam in Cockatiels (Nymphicus hollandicus) Elke Gasthuys, Renee Houben, Roel Haesendonck, Siegrid De Baere, Joachim Morrens, Gunther Antonissen Journal of Avian Medicine and Surgery 33(4):349–360, 2019 Background: - NSAIDs competitively inhibit cyclooxygenase (COX) enzyme activity - COX-1 → gastric protection, regulation of homeostasis, renal blood flow, platelet aggregation, in most tissues - COX-2 → vasodilation, increased vascular permeability, chemotaxis, hyperalgesia, potentiates histamine; Induced in response to inflammation - Meloxicam = preferential COX-2 inhibitor at low doses but COX-1 at high doses -- Side effects such as GI tox, CV effects, nephrotoxicity - Celecoxib, mavacoxib - selective COX-2 inhibitors that do not alter COX-1 activity. - Lipopolysaccharide (endotoxin) → immune response → change in body temp, cytokine production, signs of illness Key Points: - Cockatiels given 2 LPS injections at 1-day intervals → pronounced hypothermia - Control LPS and meloxicam groups had: Hypothermia, Obtundation (also in celecoxib), Ruffled feathers - Prostaglandin E levels: control \> mavacoxib \> celecoxib \> meloxicam - PGE levels did not correlate with clinical illness seen Conclusions: Mavacoxib reduced clinical signs the most but meloxicam decreased prostaglandin levels the most in cockatiels administered lipopolysaccharides.

Answer 55

Evaluation of the thermal antinociceptive effects and pharmacokinetics of hydromorphone hydrochloride after intramuscular administration to cockatiels (Nymphicus hollandicus). Houck EL, Guzman DS, Beaufrère H, Knych HK, Paul-Murphy JR Am J Vet Res. 2018 Aug;79(8):820-827 Results/Discussion: Sedation observed at with 0.3 and 0.6 mg/kg No significant change in thermal withdrawal threshold at any time The plasma hydromorphone concentration remained \> 6 ng/mL for at least 3 hours and decreased to \< 1 ng/mL (ie, the therapeutic concentration for most other species) by 6 hours after IM drug administration. Shorter half life in the cockatiels (0.99 hours) compared to kestrels (1.26 hours) at the same dose and route. In American kestrels, IM administration of hydromorphone at 0.1, 0.3, and 0.6 mg/kg increased the thermal nociception threshold for 3 to 6 hours; however, some birds developed moderate to severe sedation when administered the highest dose. Conclusion: Despite plasma drug concentrations considered therapeutic for other species, IM administration of hydromorphone at 0.1, 0.3, and 0.6 mg/kg did not significantly affect the thermal withdrawal threshold of cockatiels but did produce significant sedation at the 0.3- and 0.6-mg/kg doses.

Answer 56

Evaluation of the thermal antinociceptive effects of hydromorphone hydrochloride after intramuscular administration to orange-winged Amazon parrots (Amazona amazonica) Sanchez-Migallon Guzman D, Douglas JM, Beaufrère H, Paul-Murphy JR. American journal of veterinary research. 2020 Oct;81(10):775-82. Background: Hydromorphone PD Review: American kestrels at 0.1, 0.3, 0.6 mg/kg had increased thermal threshold + sedation at higher doses Cockatiels at up to 0.6 mg/kg had no change in thermal threshold + mild sedation Key Points: Thermal withdrawal threshold increased with hydromophone: For 0.5 - 3 h at 1 mg/kg For 1.5 - 6 h at 2 mg/kg Increased agitation score (nausea, miosis, ataxia) at 1 and 2 mg/kg for 3 hours Regurgitation (n=1) Changes in thermal threshold change greater with hydromorphone than butorphanol in this species. Conclusions: Orange winged amazon parrots showed significant increase in thermal foot withdrawal with 1mg/kg & 2mg/kg hydromorphone IM but also had increased agitation.

Answer 57

Pharmacokinetics of hydromorphone hydrochloride after intramuscular and intravenous administration of a single dose to orange-winged Amazon parrots (Amazona amazonica) Sanchez-Migallon Guzman D, Knych H, Douglas J, Paul-Murphy JR. American journal of veterinary research. 2020 Nov;81(11):894-8. Hydromorphone: a μ-opioid receptor agonist with 5 to 7 times the potency of morphine Does not cause histamine release when administered IV Hydromorphone did not change thermal withdrawal response in cockatiels at 0.1, 0.3, and 0.6 mg/kg IM Hydromorphone at 1 and 2 mg/kg IM increased thermal foot withdrawal thresholds in orange-winged Amazons But caused agitation, nausea, beak opening, moving the tongue back and forth, ataxia, miosis Very short half-life (1.74 h) and rapid plasma clearance Conclusions: Hydromorphone in orange-winged Amazons increases thermal withdrawal but causes adverse effects (agitation, ataxia) and has rapid PK parameters.

Answer 58

Evaluation of the thermal antinociceptive effects and pharmacokinetics after intramuscular administration of buprenorphine hydrochloride to cockatiels (Nymphicus hollandicus). Guzman DS, Houck EL, Knych HK, Beaufrère H, Paul-Murphy JR. American journal of veterinary research. 2018 Dec;79(12):1239-45. Buprenorphine, a μ-opioid receptor agonist and κ- and δ-opioid receptor antagonist Increased thermal withdrawal in American kestrels for 6 hours with 0.1, 0.3, 0.6 mg/kg IM 0.6 mg/kg exceeded target concentrations for 9 hours No increase in thermal withdrawal thresholds in African grey parrots and Timneh parrots at 0.1 mg/kg IM Conclusions: Buprenorphine at 0.6, 1.2, 1.8 mg/kg IM did NOT affect thermal-withdrawal threshold or agitation-sedation scores in cockatiels.

Answer 59

Pharmacokinetics of butorphanol tartrate in a long-acting poloxamer 407 gel formulation administered to Hispaniolan Amazon parrots Laniesse D, Guzman DS, Knych HK, Smith DA, Mosley C, Paul-Murphy JR, Beaufrère H American journal of veterinary research. 2017 Jun;78(6):688-94. Background: Butorphanol is a kappa opioid receptor agonist and a mu receptor antagonist Analgesic effects in Amazon parrots, African grey, green cheeked conures No analgesia in kestrels or cockatiels MAC-sparing effect of isoflurane in Cockatoos and of sevoflurane in Hispaniolan Amazons and guinea fowl Polyaxamer 407 is a thermosensitive hydrogel Hydrogel = “reverse gelatin” = liquid at room temp and solid gel at body temps Key Points: Butorphanol-P407 was above therapeutic levels for 3-8 h 2 birds vomited at the approximate time Cmax of high dose SQ injections resulted in a lower Cmax, but a longer duration in the blood compared to IM Conclusions: Butorphanol in a long acting poloxamer 407 gel may provide analgesia for 4-8hours in Hispianiolan Amazon parrots.

Answer 60

**EVALUATION OF THE THERMAL ANTINOCICEPTIVE EFFECTS OF SUBCUTANEOUS ADMINISTRATION OF BUTORPHANOL TARTRATE OR BUTORPHANOL TARTRATE IN A SUSTAINED-RELEASE POLOXAMER 407 GEL FORMULATION TO ORANGE-WINGED AMAZON PARROTS (AMAZONA AMAZONICA)** Laniesse D, Sanchez-Migallon Guzman D, Smith DA, Douglas JM, Mosley C, Beaufrère H, Paul-Murphy American Journal of Veterinary Research. 2020 Jul;81(7):543-50. Key Points: - Butorphanol IM vs control → significant difference of thermal thresholds at 30-90 min - Butorphanol-P407 vs P407 → No significant difference of thermal thresholds - Butorphanol-P407 was sedative - But-P407 vs Saline → No significant difference of thermal thresholds. Conclusions: Butorphanol has a small antinociceptive effect in orange-winged Amazons but butorphanol-P407 was not effective.

Answer 61

Pharmacokinetics of amantadine after oral administration of single and multiple doses to orange-winged Amazon parrots (Amazona amazonica) Berg KJ, Sanchez-Migallon Guzman D, Knych HK, Drazenovich TL, Paul-Murphy JR. American journal of veterinary research. 2020 Aug;81(8):651-5. Background: Amantadine - NMDA antagonist (increases dopamine release in CNS), decreases tolerance to opioid medications Helps decrease central sensitization (response of sensory neurons to noxious and non-noxious stimuli) Key Points: Single oral dose of 10mg/kg - above therapeutic concentration for up to 48 hours Multiple dose 5mg/kg PO q24h x 6d - above target concentration for at least 24h Accumulation index was low for multiple doses No adverse effects Conclusions: Amantadine lasts for 48 h after a single 10 mg/kg dose and 24h after 5 mg/kg dose

Answer 62

The Incidence and Treatment Outcomes of Macrorhabdus ornithogaster Infection in Budgerigars (Melopsittacus undulatus) in a Veterinary Clinic Püstow R, Krautwald-Junghanns ME. Journal of avian medicine and surgery. 2017 Dec;31(4):344-50. Background: Macrorhabdus ornithogaster: anamorphic, ascomycetous, weakly Gram + yeast Found in healthy animals but disease with stressors Signs: vomiting, diarrhea, weight loss with a good appetite, undigested seeds in feces Poor prognosis if melena +/- dilated proventriculus Necropsy: emaciation and hemorrhagic, ulcerative proventriculitis Most commonly affects the glands of the isthmus Diagnose with examination of fresh feces Yeast load does not correlated with severity of disease Low sensitivity due to intermittent shedding Treatment only if clinical signs Often resistant to nystatin Amphotericin may be more effective but a more stressful treatment regimen Key Points: Most specific sign of M. ornithogaster in budgies = undigested seeds Proventricular dilation difficult to see on radiographs Most common in males No age predilection Amphotericin B was not consistently effective and was very stressful Prevalence of M. ornithogaster is associated with co-occurrence of other pathogens Conclusions: Macrorhabdus ornithogaster causes gastrointestinal (especially undigested seeds) and there is not an ideal treatment regime.

Answer 63

COMPARISON OF TWO TREATMENT MODALITIES AND PCR TO ASSESS TREATMENT EFFECTIVENESS IN MACRORHABDOSIS Poleschinski JM, Straub JU, Schmidt V. Journal of Avian Medicine and Surgery. 2019 Sep;33(3):245-50. Background: Macrorhabdus ornithogaster = anamorphic ascomycetous yeast commonly in proventriculus of psittacines. Signs: Lethargy, vomiting, diarrhea, undigested seed, weight loss Death often from aspiration after regurgitation, proventricular ulceration Diagnosis: microscopic exam or PCR of feces Key Points: Most common clinical signs = gastrointestinal Also polyuria/polydipsia (n=9) About half (56.4%) tested negative after amphotericin B water treatment Combination amphotericin B in drinking water & oral administration→ 62.5% M ornithogaster DNA - negative fecal samples No statistically significant differences between 2 treatment options evaluated No difference in treatment protocols, age, sex, body weight Conclusions: Amphotericin B in drinking water x 28 days +/- orally administered x 10 days only reduced Macrorhabdus ornithogaster in half of budgies and cockatiels. Flock treatment is not recommended, except in cases with significant morbidity and mortality

Answer 64

**CHLAMYDIA PSITTACI IN FERAL ROSY-FACED LOVEBIRDS (AGAPORNIS ROSEICOLLIS) AND OTHER BACKYARD BIRDS IN MARICOPA COUNTY, ARIZONA, USA** Edouard O. Maccolini, DV, IPSAV (Zoological Medicine), Philippe J. Dufresne, PhD, Sophie Ann Aschenbroich, DVM, Dipl ACVP, Brittany McHale, DVM, MPH, Julie-He ́le`ne Fairbrother, DVM, MSc, Dipl ACVM, Christian Be ́dard, DVM, MSc, Dipl ACVP, and Julie A. He ́bert, DVM, Dipl ABVP (Avian) **Key Points:** * Population of feral Rosy-faced lovebirds – estimated at 2500 * 18 birds died in 2013, 75 in 2014 * DNA positive, but antibody negative birds could reflect environmental exposure or contamination from sampling * Lovebirds and pigeons remained with higher prevalences when that was considered * Lovebirds also positive for both psittacine circovirus pathotypes 1 & 2 (2 is less virulent – found in lories which recovered well from disease) **Take Home**: Rosy-faced lovebirds or rock doves in Arizona at feeders may be spreading Chlamydia psittaci. Other feral parrot populations may pose a similar risk for transmission.

Answer 65

Donnelly, K. A., Wellehan Jr, J. F., & Quesenberry, K. (2019). Gastrointestinal disease associated with non-albicans Candida species in six birds. *Journal of Avian Medicine and Surgery*, *33*(4), 413-418. * Candida glabrata and Candida krusei identified as causative agents of GI dz in birds. * Behavior is similar to Candida albicans. Related to previous tx with abx. * Treatment with terbinafine 15 mg/kg PO q24h x 6 wks was successful in one individual. Fluconazole 20 mg/kg PO q12h x 14d +/- nystatin for 28 days successful others. * Diagnosis achieved with cytology or histo i.e. fecal or crop Gram’s stain, culture. * Part of normal mycoflora, so ID on cytology is not sufficient for dx without CS. * C. glabrata is more commonly being diagnosed in humans in hospital settings, supports role of abx and immunosuppression as risk factors for infection. Second most common vs C. albicans in humans. * Spp ID of Candida can be performed with MALDI-TOF (mass spec) technology. Takeaways: C. glabrata and C. krusei (non-albicans Candida spp) may be up and coming pathogens. Empirical use of abx and immunosuppression likely contributing to onset of Candida overgrowth and clinical signs of disease.

Answer 66

Hébert, J. A. (2019). Closed Reduction of a Rostroparasphenopalatal Luxation in a Red-crowned Parakeet (Cyanoramphus novaezelandiae). *Journal of avian medicine and surgery*, *33*(3), 285-288. ![]()

Answer 67

Modified Tail Amputation Technique in a Blue and Gold Macaw (Ara ararauna) With Uropygial Gland Adenocarcinoma. Robertson, J., Guzman, D.S.M., Sinnott, D., Woolard, K., Nesset, A. and Paul-Murphy, J.R. *Journal of avian medicine and surgery*, 2020;34(1):57-64. * Uropygeal gland tumors: carcinoma (SCC), adenomas, and adenocarcinomas; other ddx adenitis, Vit A deficiency with glandular metaplasia * Surgical resection (except water birds) +/- post-op radiation (strontium 90) or chemo * Previously described dorsoventral closure **Key Points** * Surgical resection of locally invasive uropygial gland adenocarcinoma with pygostyle amputation * Laterolateral closure reduced tension and resulted in more ventral position of vent reducing post-op contamination of surgical site * Euthanized ~4 mo post-op, had healed well but was found minimally responsive and dyspneic **Conclusions** * Novel surgical technique reported for locally invasive uropygial gland adenocarcinoma involving pygostyle amputation and reduction of lateral vertebral processes with laterolateral closure * Reduces tension and post-op contamination due to more ventral vent position

Answer 68

*Journal of Avian Medicine and Surgery* 35(2):187–195, 2021 **Comparison of Serum Thyroid Hormone Levels in Greenwinged Macaws (Ara chloropterus) Using Radio and Chemiluminescent Immunoassays** Ka ́ssia R. A. Vieira, MS, Ana C. L. Faillace, MS, L ́ıgia R. Oliva, DVM,Mathias Dislich, DVM, Zalmir S. Cubas, MS, Adalfredo R. Lobo-J ́unior, PhD,and Marcelo I. S. Santana, PhD Radioimmunoassay is considered the method of choice in measuring total T4 and T3 in birds, but it has a high limit of detection for the typically low concentrations of thyroid hormones in birds The chemiluminescent immunoassays have good sensitivity, long shelf life, and don’t produce radioactive waste and have been used in people, dogs, cats, horses, and guinea pigs Females had higher concentrations of T3 – estrogen upregulates pituitary T3 receptors, and higher levels of total and free T4, and TSH are observed in women as well · Differences in avian thyroid physiology Lack thyroxine binding globulin (T3/T4 transport protein) so hormone levels are less affected by plasma protein levels; other plasma proteins have a much lower binding affinity to T3 compared with T4 Limits of the canine CLIA – all values of T4 were the same (human products have been successfully used); TSH levels had the greatest variability but levels are near the limits of detection for both tests **Take Home**: The CLIA is consistent with RIA in measuring T3 levels but not T4 or TSH.

Answer 69

Béland, K., Ferrell, S. T., Beaufrère, H., Lair, S., & Desmarchelier, M. (2021). Impact of Dietary Fructose on the Lipid Profile in Six Macaws. *Journal of Avian Medicine and Surgery*, *35*(2), 196-203. Atherosclerosis in parrots o Characterized by deposits of lipids, collagen, inflammatory cells, calcium salts, cellular debris within intima media of arteries o CS – lethargy, weakness, exercise intolerance, balance loss, difficulty perching, feather destructive behavior, self-mutilation, claudication-like syndrome, neurological signs, respiratory distress, sudden mortality o Risk factors – age (20-30 years), genus (Psittacus, Amazona, Nymphicus), sex (usually female) § Hypercholesterolemia, hypertriglyceridemia, elevated LDL-C, decreased HDL-C (increases in birds put on an exercise regimen). Linked to dyslipidemia o Birds carry most cholesterol as HDL-C rather than LDL-C in humans; they also use portomicrons rather than chylomicrons to transport triglycerides (fat transported by vesicles directly to bloodstream rather than through lymphatics first like in mammals); estrogen upregulated lipoproteins for vitellogenesis o Birds fed high cholesterol diets can have atherosclerosis induced · Role of fructose - Simples sugars are linked to atherosclerosis in humans o Fructose is primarily absorbed by hepatocytes and metabolized by fructolysis which skips the phosphofructokinase step of glycolysis where most glucose regulation happens – meaning the liver metabolizes fructose as long as it is available – which results in a lot of fatty acid synthesis · This study failed to find changes with the short duration of fructose administration o Birds also had access to each other’s bowls so things were not as controlled as they should have been **Take Home**: Excessive fructose may be an additional risk factor for atherosclerosis in avian species

Answer 70

Baron, H. R., Stevenson, B. C., & Phalen, D. N. (2021). Comparison of In-Clinic Diagnostic Testing Methods for Macrorhabdus ornithogaster. *Journal of Avian Medicine and Surgery*, *35*(1), 37-44. Macrohabdus ornithogaster o Yeast found primarily in the isthmus between proventriculus & ventriculus o 20-80 micrometer long, strait rods with rounded ends and a refractile nuclei o Typically present on the surface of the isthmus, but can penetrate the glands of the proventriculus and the koilin of the ventriculus in severe cases using in a lymphoplasmacytic ventriculitis o CS – vomiting, dark tarry feces, chronic wasting, death – or asymptomatic o Diagnostics – PCR is better than gram stain, mini-FLOTAC is comparable to gram stain · This study – macrosuspension was the best in-clinic diagnostic; detection at follow-up is better than at the end of treatment **Take Home**: Macrosuspension technique is the best in-clinic testing for macrorhabdus detection

Answer 71

McCready, J. E., Gardhouse, S. M., Appleby, R., & Beaufrěre, H. (2021). Mortality rate of birds following intravenous administration of iodinated contrast medium for computed tomography. *Journal of the American Veterinary Medical Association*, *259*(1), 77-83. * only 6 deaths during 131 contrast-enhanced CT examinations * **Decreasing body weight significantly increased odds of death by 83% per 100 g after contrast medium administration** * **small birds (body weight ≤ 150 g) had significantly increased odds of dying shortly following administration of contrast medium, compared with larger bird** * overall rate of death - 4.6% * large birds – 0.8% * small birds - 45.4% * **present study - evidence that bolus injection of nonionic iodinated contrast medium associated with substantial rate of deaths in small unhealthy psittacines** * birds with respiratory disease may be at increased risk of death following contrast medium admin or simply have an increased risk of dying in general

Answer 72

* AKA Budgie fledgling disease.Similar signs to PBFD. * Respiratory exposure leads to viremia even in asymptomatic birds. * Many infections are asymptomatic * Virus shed in droppings, secretions, and feather dander. * Disease and death due predominantly in nestlings \< 14 weeks old. * Budgies, lovebirds, macaws, conures, caiques, eclectus, and ring-necked parrots. * Cockatoos, Amazons, and African grays uncommon. * Lesions – stunted growth, abnormal feathers * hydropericardium, myocardial hemorrhage, ascites, hepatomegaly, hepatic necrosis, renal swelling, petechial, and general tissue pallor. * Histo: Enlarged nuclei (karyomegaly) and have granular, basophilic to amphophilic inclusion – spleen, liver, kidney. * Nonbudgie nestling psittacines typically develop normally * But fatal infections can occur. ![]()

Answer 73

* Pacheco’s disease (PD) - peracute to acute cause of fatal hepatitis in psittacines. * Caused by **psittacid herpesvirus type 1 (PsHV-1)** * Alphaherpesvirus closely related to infectious laryngotracheitis virus. * 4 genotypes * Amazons most commonly infected – all 4 genotypes * African greys – genotypes 2-4 (not 1) * Genotype 4 is most commonly associated disease in macaws and conures * genotype 3 is rare and genotype 1 has not been found in these species * Cockatoos seem refractory to disease * Clinical signs minimal or absent. Birds die in good condition. * Necropsy: enlarged, mottled, friable, hemorrhagic liver.Crop also affected. * DDX: bacterial hepatitis, chlamydiosis, lead poisoning, polyomavirus, adenovirus, and reovirus * Histo: Hepatic necrosis, intranuclear inclusion bodies – deeply eosinophilic * Not all infections cause disease.Some birds are asymptomatic carriers. * PsHV-1 associated mucosal papillomas – NW birds * PsHV-2, has been identified in cutaneous papillomas in African greys * PsHV-1, 2, and 3 (but not 4) have been identified in mucosal papillomas

Answer 74

* Proventricular Dilatation Disease (PDD) – cause by Avian Bornavirus. * Nine pathogenic genotypes. Has been isolated from healthy animals. * Not reported in free ranging birds. * Clinical signs: ileus, severe emaciation with marked pectoral muscle & adipose atrophy * Gross: flaccidity and dilatation of any portion of the GI tract. * Proventriculus, ventriculus, and crop being most common * Often filled with seeds * Histo: lymphoplasmacytic inflammation * Myenteric plexus of esophagus, crop, or GI tract * Inflammatory infiltrate * Proventricular dilatation is characteristic, but not pathognomonic * Other differentials – clostridial infections, gastric mycobacteriosis, fungal gastritis, lead toxicity, peritonitis or serositis, ulcerative/erosive gastritis

Answer 75

* * Gram negative bacilli – Enterobacteriacea * S. typhimurium – high mortality in lories & African greys * Transmission by ingestion of contaminated food or water or aerolization of feces or feather dust * Feces from carrier birds most common * Clinical signs: depression, lethargy, anorexia, weight loss, diarrhea, pasty vents, lameness, abscess formation, convulsions, poor hatching or excessive fledgling mortality, dehydration & crop stasis, meningitis, osteoarthritis, suddent death. * Gross: hepatosplenomegaly, pneumonia, catarrhal to hemorrhagic enteritis * Histo: mulifocal random necrosis & heteropohilic to. Lymphohistiocytic inflammation * GI tract, liver, spleen

Answer 76

* Chlamydia psittaci * Obligate intracellular, Gram-negative, zoonotic bacterium * Biphasic life cycle – infective elementary body, replicative reticulate body * Aerosol inhalation & ingestion are primary routes of transmission * Clinical Signs: * Young birds more susceptible than old birds * Sinusitis, dyspnea, conjunctivitis, polyuria, diarrhea, lethargy, anorexia, yellow-green droppings, poor feathering, flaccid paralysis of the legs, chronic weight loss, opisthotonos, tremos. * Increased in ovo deaths, decreased fertility, early chick death * * Hepatic & splenic enlargements * Pericarditis and air sacculitis * Histo: lymphoplasmacytis and histiocytic inflammation – multifocal to confluent necrosis * Stains with Giminez’s stain for intracellular organisms

Answer 77

* Sarcocystis falcatula * Virginia opossum is the definitive host, cowbirds & grackles are the intermediate hosts * Asexual reproduction occurs int eh endothelium of intermediate host, causing real damage in aberrant hosts * Shcizogony is followed by the formation of sarcocysts in muscles * New World psittaicnes appear resistant as adults, but CS are reported.Old World psittacines are highly susceptible to fatal respiratory disease * Gross: severe pulmonary congestion, edema, hemorrhage * Histo: fibrin, edema, & hemorrhage within the lungs; lymphoplasmacytis accumulation around blood vessels & bronchi; protozoal merozoites within pulmonary vessles * Other forms * Muscle – severe weakness & lethargy, elevated CK/AST, protzoal cysts in skeletal muscle with lymphoplasmacytis myositis * Neuro – severe ataxia, incoordinated head movements.Schizonts within cerebellum & brainstem with lymphoplasmacytic meningoencpehlitis

Answer 78

* To clear flock, test all birds with direct/indirect tests * Separate birds into 3 groups based on results – positive, questionable, negative * Ethically, euthanasia of positive, non-clinical birds not recommended * Retest questionable/negative groups 4-6 weeks later * Continue testing and maintain separation until only negative birds remain * Only quarantined, tested birds can enter flock * Take eggs away from positive parents, disinfect, hand-raise and test * ABV negative eggs common form positive parents * If negative, can be given to foster parents * May need to rehome positive, non-clinical birds * * Antibodies not protective and disease is immune-mediated * Difficult to develop vaccine Speer

Answer 79

Pacheco’s disease * * Most common in parrots – no age, sex, species predilection * Macaws, amazons, cockatoos, African gray parrots are highly susceptible * Some spp of conure appear to be subclinical shedders * Also found in passerines * Clinical manifestation * Acute, rapidly fatal * Clinical signs are non-specific * Biliverdin-stained urates prior to death (yellow/green) * * Blood work (if alive) – leukopenia, elevated AST * Usually necropsy (due to acute mortality) * Hepatic lipidosis, hepatomegaly, splenomegaly, multifocal hepatic necrosis, pancreatitis, enteritis * Histopathology – pan-nuclear eosinophilic inclusions in liver/spleen * * Acyclovir has been effective at preventing mortality * 80-100 mg/kg PO q8h x10d * Birds that survive will be carriers of the virus

Answer 80

* Psittacid herpes 1 * Demographics * Most prevalent in Amazons, macaws, conures, hawk-headed parrots; also found in other species * Clinical manifestation * Raised, pink, proliferative papillomas found in cloaca and oral cavity * Oral: most often choanal margins or tongue base; rarely extend into upper GI tract; loss of pigmentation * Diffuse cloacal lesions: cobblestone appearance * Lesions may wax/wane, disappear completely, or become progressive * Signs: dyspnea, straining to defecate, hematochezia, regurgitation, chronic wasting * Diagnosis * PE – oral/cloacal exam (evert with lubed CTA), crop thickening * PCR – not usually nece * ssary for papillomas * Biopsy – not usually necessary for papillomas * Histopathology – papillomas: multiple fibriae w/ fibrovascular core and cuboidal/columnar epithelial cells * * Benign neglect if not causing clinical signs (may regress) * Surgery – debulk w/ sharp dissection, laser surgery, radiosurgery; treat w/ topical silver nitrate

Answer 81

Bile duct and pancreatic duct carcinomas * Common sequelae of mucosal papillomatosis * Months to years after onset * Clinical manifestation * Chronic hepatic disease (weight loss, overgrown beak, poor feather quality) * Does not seem to be metastatic * * Rads – hepatomegaly * Ultrasound – multifocal to coalescing hyperechoic liver * Blood work – elevated GGT * Liver biopsy * * Chemotherapy – case report of carboplatin in green-winged macaw

Answer 82

Psittacid herpesvirus 2 Clinical manifestation * Subclinical carriers * Mucosal and mucocutaneous papillomas of oral cavity and eye (benign but can be extensive) * r/o: parrot papillomavirus-1 (PePV-1) (rare; only reported in wild-caught birds) Diagnosis * Biopsy – fibropapillomatous lesions without viral inclusions * PCR – oral/cloacal swabs Treatment * No reports of treatment attempts * Surgical removal if lesions interfere w/ airflow * Acyclovir will not be effective bc lesions are not thought to be associated w/ replicating virus

Answer 83

Psittacid herpesvirus 3 Demographics * Found in Bourke’s parrots in USA and 2 eclectus parrots in Australia Clinical manifestation * Targets the trachea - upper respiratory signs (cough, dyspnea, oculonasal discharge) * Non-specific signs (lethargy, anorexia, weight loss) Diagnosis * Antemortem – no work has been done * Cytology of conjunctiva/trachea – syncytial cells w/ eosinophilic intranuclear inclusion bodies * PCR – partial sequence is known * * Gross – conjunctivitis, tracheitis, changes associated w/ pneumonia and airsacculitis * Histo – syncytial cells w/ eosinophilic intranuclear inclusion bodies in respiratory tract Treatment * Acyclovir has been used

Answer 84

* Hemagglutinating virus -\> agglutinates erythrocytes from guinea pigs, geese, and many psittacine species * BFDV exhibits host-generalism with wide species susceptibility * Suspect Loriinae subfamily (lorikeets, lories, fig parrots, budgerigars) are more robust or host adapted * Hemagglutination inhibition gold standard as it avoids cross-reactivity between different species

Answer 85

* Toxin is most important virulence factor, which is bound to EBs * Clinical infection depends on relationship between EBs and macrophages * * EBs can be found in feces, urine, tears, nasal discharge, oropharyngeal mucus, and crop milk * Infection occurs by inhalation or ingestion of infectious particles * Infection is rapid and *C. psittaci* will replicate in lungs, air sacs, pericardium 24 hours after infection * Within 48 hours, in bloodstream * Within 72 hours, bird can shed into environment * Vertical transmission demonstrated in duck, black-headed gull, and budgies * Direct transmission from dogs, cats, horses, pigs, humans to conspecifics does not occur

Answer 86

Infection in Humans (Psittacosis) - Transmission – exposure to birds – human inhales organisms that have been aerosolized from dried feces or respiratory tract secretions - Other means – mouth to beak exposure or handling plumage and infected tissues - Adverse pregnancy outcomes have been reported - Clinical signs – mild illness to severe pneumonia, typically starts with fever, chills, headache, malaise, myalgia; radiographs show interstitial infiltrates - Diagnosis – MIF is more sensitive (cross-reactivity with other C species), PCR is more reliable (blood, tissues, respiratory secretions) - Labs – CDC’s respiratory diseases division - Tx – tetracycline Infection in Birds (Avian Chlamydiosis) - Excreted in ocular or nasal discharges or feces - Can remain infective for a month in feces – shedding exacerbated by stress - Clinical signs – lethargy, anorexia, ruffled feathers, conjunctivitis, ocular or nasal discharge, green urates - Case definition -- Confirmed - isolation, PCR followed by sequencing, fourfold increase in titers, intracellular bacteria on tissue impression -- Suspected – Chlamydial PCR, fluorescent antibody swab, epidemiologically linked to a human case - Diagnosis – many labs (see table)

Answer 87

**Intranasal butorphanol and midazolam administered prior to intramuscular alfaxalone provides safe and effective sedation in Quaker parrots (Myiopsitta monachus)**. Conner CM, Hoppes SM, Stevens BJ, Simon BT. American Journal of Veterinary Research. 2022;83(12). Background - Alfaxalone - neuroactive steroid anesthetic, acts on y-aminobutyric acid subtype A (GABAA) -- Alfaxan Multidose IDX recently added to US FDA Index of Legally Marketed Unapproved New Animal Drugs for Minor Species with an indexed indication for sedation and anesthesia of Psittaciformes -- IM alfaxalone in Quaker parrots had potential hyperexcitation and muscle tremors, reduced but not abolished with IM midazolam premedication -- IM alfaxalone alone had dose dependent sedation in budgies, SQ alone allowed radiographs in black-cheeked lovebireds, dose-dependent reduced induction time and increased anesthesia duration in Bengalese finch, IV had shorter, smoother induction than iso facemask and reduced iso requirements during ortho sx of flamingos - Midazolam - GABAA receptor agonist - Butorphanol - K-agonist and either u-antagonist or weak u-agonist Key Points - All birds were sedated by 15 min, no difference in sedation score between high and low dose alfaxalone but duration of high dose was longer than low dose - HR didn’t change from baseline and wasn’t different between high and lose dose - RR was higher compared to baseline, no difference between high and low dose - Cloacal temp decreased from baseline, no difference between high and low dose - High dose had more muscle tremors/fasciculations than low dose - Both low and high dose facilitated intubation and radiograph positioning right after sedation but high dose allowed positioning for longer (at later time points) - Both groups retained response to toe pinch and feather pluck - this sedation protocol does not provide adequate analgesia - No difference in vocalizations between high and low dose - Full recovery of all birds (one died from cloacal rupture) - One bird experienced respiratory distress that resolved with oxygen supplementation - Birds lost weight throughout the study - possibly from being separated and handled Conclusions - Intranasal midazolam-butorphanol (2 mg/kg each) and IM alfaxalone (2 and 5 mg/kg) was a safe and effective method for sedation of Quaker parrots for intubation and radiographs - Recommend 2 mg/kg to reduce muscle fasciculations, produced the same level of sedation as 5 mg/kg - Provide oxygen, heat support, and analgesia if indicated

Answer 88

**Qualitative investigation of µ-and κ-opioid receptor distribution in the brains of budgerigars (Melopsittacus undulatus)** Sojka PA, Smith SM, Greenacre CB, Newkirk K, Mountain DJ Key Points: - Historically, studies have supported the use of κ-agonist and µ-antagonist drugs, such as nalbuphine or butorphanol, for analgesia in psittacine species - Fluorescent in situ hybridization (FISH) is an older technology that has seen a resurgence with the advent of highly sensitive and specific probes that can target mRNA, DNA, and proteins -- This study was facilitated by the publication of the budgerigar genome -- This information allowed for the development of highly sensitive and specific probes for µ- and κ-opioid receptor mRNA specific for this species - This qualitative study supports the clinical impression that many psittacine birds have an analgesic response to κ-opioid receptor agonist and µ-opioid antagonist drugs -- The findings are most consistent with those observed in earlier pigeon studies: -- There is a higher relative predominance of κ- over µ-opioid receptors in the forebrain but no relative predominance in the midbrain -- Conversely, in the day-old chick forebrain and midbrain, µ-opioid receptors predominate over κ-opioid receptors - The distribution of the δ-opioid receptor was not included in the scope of this study -- The function of the δ-opioid receptor in avian species is still unclear -- The δ-opioid receptor is widely expressed in the CNS & PNS and is usually found in different cell types than the µ-opioid receptor -- It may also be more efficacious in inflammatory, neuropathic, and chronic pain than µ-opioid receptors, which are more effective in acute pain TLDR: Consistent with previous studies in pigeons and domestic chicks, κ-opioid receptors were more abundant than µ-opioid receptors

Answer 89

**Pharmacokinetics of butorphanol tartrate in a poloxamer P407 gel formulation administered to orange-winged Amazon parrots (Amazona amazonica)**. American Journal of Veterinary Research. 2022;83(8):online Background - Butorphanol reduces minimum alveolar concentration of iso in cockatoos, grey parrots - Terminal half life in Hispaniolan Amazon parrots was very short (½ hr at 5 mg/kg), RTHA 0.9 hr, GHOW 1.8hr - Oral bioavailability in Hispaniolan Amazon parrots is poor (6%) - Poloxamer 407 - hydrogel, liquid at room temp, becomes a gel at body temp after injection via micellar packing, allows for slow dissolution and sustained release of hydrophilic and hydrophobic drugs - Hispaniolan amazon parrots given But-P407 8.3 mg/kg had plasma conc 2x higher SQ than IM and good absorption of 12.5 mg/kg SQ - Orange-winged Amazon parrots had increased thermal withdrawal latency for IM but not SQ Key Points - Mean plasma conc in OW parrots were above therapeutic range in other spp. by ½ hr and stayed high at 4 hr, then dropped by 8 hr. -- 1 bird never achieved therapeutic concentrations for other species but did reach antinociceptive concentration for HA parrots in previous studies of torb. - Similar Tmax as HA parrots but slightly lower Cmax, shorter terminal half life (about half) - No explanation for lack of effect in previous PD study, torb appears to be well absorbed so maybe P407 is not an effective vehicle - causes alterations in lipid metabolism in rabbits and rodents so may alter lipid transport across the blood-brain-barrier reducing torb transport to target opioid receptors Conclusions - Absorption of butorphanol from a P407 25% base SQ in OW Amazon parrots followed a PK profile consistent with that of a sustained release drug. - Plasma levels of 12.5 mg/kg SQ would be expected to provide antinociception for at least 4-8 hrs but this effect was not seen in a previous PD study in this species, while butorphanol tartrate in its standard form has been shown effective.

Answer 90

AJVR 2022 83(8) online **Evaluation of weight-bearing, locomotion, thermal antinociception, and footpad size in a carrageenan-induced inflammatory model in the cockatiel (Nymphicus hollandicus)** Key Points: - Carageenan is a sulfated mucopolysaccharide extracted from Irish moss, stimulates local inflammatory responses when injected into rodent tissues -- Has been used to study weight bearing and behavioral changes in rats with significant findings -- Wt bearing abilities have differed significantly between rats injected vs controls -- Reduction of thermal threshold tolerance -- Induction of footpad edema at injection site - Weight loading: Treated birds had a significant decrease in weight loading on their treated foot at 143 hr and 167 hr compared to baseline, no difference over time in the control group -- Decrease in treated group vs control group at 120, 143 and 167 hr - Rotational perching: No differences at any time point - Thermal stimulus perch: No effect of treatment or time was seen - Footpad imaging/ swelling grading: treatment increased vertical size and horizontal size of the footpad vs control -- Significant increase in footpad area from 47hr - 504 hr in treated group compared to control group -- Treated birds had footpads that remained significantly greater in size compared to footpad of control birds for the first 3 weeks after injection - Footpad lesion significantly decreased weight bearing on that leg Take home message: - SC injection of carrageenan into the left footpad of cockatiels prompted the formation of inflammation and altered weight bearing of the affected limb - Some showed wt bearing changes as early as 1.5 hr while others did not show differences until 96 hr, making prediction of peak effects difficult - Assessment of weight-bearing load and footpad dimensions was sensitive and reliable assessments of inflammation and differentiating treatment from control cockatiels. - In contrast, thermal threshold withdrawal and rotational perch locomotion were not found to significantly differ between groups, despite being reliable methods

Answer 91

AJVR 2023 84(4) Twice-daily oral administration of a cannabidiol and cannabidiolic acid–rich hemp extract was well tolerated in orange-winged Amazon parrots (Amazona amazonica) and has a favorable pharmacokinetic profile Intro - Chronic pain management options needed in avian species - The cannabinoid receptors CB1 and CB2 are involved in different physiological processes such as neuronal plasticity, pain, inflammation, and immune regulation among others - In birds, CB1 receptor has been identified in chickens and budgerigars, - In mammals, CBD is metabolized by the liver to its active metabolite 7-hydroxy-cannabidiol (7-OH-CBD) - Objectives: determine the plasma concentrations and pharmacokinetic profile of 8 CBs following oral administration of a full spectrum hemp-extract (single and multi dose) and to evaluate safety parameters after multiple-dose administration Results and discusssion - One bird in the lowest dose pilot study had a single seizure. Birds in the highest dose group were markedly sedated but had no other adverse affects - Single dose study (middle dose)--no adverse affects - Multiple dose study–All birds maintained their body weight with less than 10% fluctuation, none of the birds had signs of appetite, sedation/agitation, or behavior changes, and none, except for 1 bird in the treatment group that developed intermittent diarrhea, had changes in urofeces as subjectively assessed. - The predominant metabolite was 11-hydroxy-9-tetrahydrocannabinol. - no significant effect of time or treatment on the lipid panel and on chlorides, bicarbonates, phosphorus, total calcium, ALP, GLDH, and uric acid - Plasma glucose, potassium, and total proteins (TP) were significantly higher after treatment. None of the elevations were clinically significant - The pharmacokinetic parameters of CBG, CBC, CBN, and the metabolites 7-COOH-CBD, COOH-THC, COOH-THCGlu, and 7-OH-CBD were not able to be determined because the plasma concentrations were below the limit of quantitation at most time points at the doses evaluated. - **twice daily administration of the evaluated hemp extract is well tolerated in healthy OWAP and results in plasma concentrations above 50 ng/ mL at a dose of hemp extract based on 30/32.5 mg/ kg of CBD/CBDA for at least 6 hours without significant adverse effects** - The birds in this study received hemp extract without food administration. CBD and THC are highly lipophilic substances;therefore, coadministration of a high-lipid meal could enhance their solubility and absorption - Compare to study in hispaniolan amazons–very different results at higher doses

Answer 92

JAMS 2022 36(2):121-127 **Pharmacokinetics of Cannabidiol in the Hispaniolan Amazon Parrot (Amazona ventralis)** Carpenter JW, Tully TN Jr, Rockwell K, KuKanich B Background: - Phytocannabinoids = chemicals from botanical sources that affect the endocannabinoid system -- Cannabinoid receptors are expressed in most animals -- THC = major psychoactive cannabinoid -- Cannabidiol (CBD) = major non-psychoactive cannabinoid -- CBD is not synthesized in the cannabis plant directly -- Instead synthesized during plant extraction from cannabidiolic acid (CBDA) -- CBD associated with anecdotal health benefits in humans & animals Key Points: - Prospective PK study (n = 12 Hispaniolan Amazon parrots) -- CBD solution = Canna Companion -- Pilot Study: 10 mg/kg & 20 mg/kg CBD PO -> serum half-life peaked at 2 hours -- Tolerability Study: no adverse clinical signs at 60 mg/kg & 120 mg/kg CBD PO -- Main PK Study: 60 mg/kg & 120 mg/kg CBD PO - CBD formulation used had a short half-life, even at 60 mg/kg and 120 mg/kg -- Additionally, plasma concentrations achieved were extremely variable - Plasma concentration variability may have been related to: -- Small sample size -- Interindividual pharmacokinetic differences -- Interindividual differences in first pass metabolism -- Amount of food in the crop at the time of dosing TLDR: Oral CBD given to Hispaniolan parrots with empty crops failed to produce sustained plasma concentrations

Answer 93

JAMS 2022 36(2) 145-152 **An Evaluation of Three Diet Conversion Methods in Psittacine Birds Converting from Seed-Based Diets to Pelleted Diets** Cummings AM, Hess LR, Spielvogel CF, Kottwitz JJ. An Evaluation of Three Diet Conversion Methods in Psittacine Birds Converting from Seed-Based Diets to Pelleted Diets. Key Points - Seed based diets are highly palatable and cheap, contain excess fat, deficient in vitamin A, D, +/- E, K, B12, riboflavin, pantothenic acid, choline, niacin and major minerals - Ca, P, Na, Mn, Zn, Fe, Iodine, Se and imbalance in the amino acids lysine and methionine. -- Linked to egg binding/dystocia, NSHP, hypocalcemia seizures, renal disease, gout, skin and feather defects and FDB, ocular disease and immunodeficiencies. -- Excessive fat also results in metabolic diseases - cardiac dz, athero, hypercholesterolemia, hyperTGemia, fatty liver, lipoma, joint disease and pododermatitis - New commercial pellet diets recommended as 75% of the diet - This study was conducted at homes with owners, who selected 1 of 3 methods and asked to fill out a survey. Converted if pellets became 60% or more of the diet. -- Birdies Choice" was a reward-based method in which birds were offered 3 different pelleted diets on a tabletop. If there was a positive interaction and the bird ate one or more of the diets, the bird was rewarded. The preferred pellet was then gradually transitioned into their food dishes. -- In the "Slow and Steady" method, pellets were alternated with familiar food at varying intervals to increase the birds' exposure to the pellets. -- The "Tough Love" method maximized exposure to new pellets by introducing a small portion of familiar food for a limited time, along with multiple dishes of new pellets. - 83 client owned birds representing 24 species, all age classes and both sexes - 96% converted to the pellet diet regardless of the method used -- 90% converted in <30 days, median time to diet conversion was 5.5 days -- Diet conversion time did not differ between the different methods used. Sex, life stage, and taxonomic family did not impact diet conversion, either. - In the minority that did not take to the pelleted diet, birds reacted by screaming/aggression, food tossed/dumped from bowls, or fear/rejection of the food - No birds left the study because of health concerns. I.e. weight loss. - The TL method resulted in 100% conversion in the shortest amt of time, likely bc it provided maximal exposure to the pellets in the birds favorite places in the enclosure. The other two methods required owner’s direct positive reinforcement of the bird’s interaction with the pellets. Take home message - 96% conversion rate indicates that parrots can convert from seed-based to pellet-based diets rapidly (i.e. within 1 month, and for most <1week) and successfully at home when the owners are committed to the process and understand the transition methods

Answer 94

Journal of Avian Medicine and Surgery, 36(2): 178-186 **Evaluation of a Fluoroscopic Angiography Protocol in Hispaniolan Amazon Parrots (Amazona ventralis)** Aller, Theresa L., Guzman, David Sanchez-Migallon, Stern, Joshua A., Douglas, Jamie M., Golsen, Bryce M., et al. Key Points: - Most common vascular disease in bird is atherosclerosis -- Radiography often first line to evaluate size, contour and opacity of the great vessels and cardiac silhouette -- Poor means for determining vascular disease -- Brachiocephalic trunks and descending aorta most commonly affected in atherosclerosis -- Radiographs are insensitive for diagnosis but often first line diagnosis. Transesophageal echo has improved resolution and ability to use M-mode over regular and contrast ultrasound from ventromedial and parasternal approaches -- Angiography can provide more complete vascular evaluation and reliable measurements not complicated by anatomy – useful for visualization of great vessels, measuring vascular diameter and eval of vessel lumens - Angiograms could be reliably measured across observes with near perfect intraclass correlation coefficients for intraobserver variability and moderate ICC for interobserver variability -- Moderate interobserver variability and near perfect intraobserver variability in the measurements were obtained for the left brachiocephalic trunk, right brachiocephalic trunk, and descending aorta -- VD outperformed lateral measurements - Visualization of cardiac vasculature was not as hindered by adjacent or overlapping soft tissue structures Take-Home Message: - Performing nonselective fluoroscopic angiography with patients under general anesthesia and administering 3 mL/kg of nonionic iodinated contrast medium intravenously at a constant rate of 1–2 mL/kg per second is a reliable technique with relatively consistent vascular measurements obtained. - Protocols used in this project were considered safe for all the parrots involved and effective for the real-time evaluation of the contrast-enhanced chambers of the heart and lumen of the great vessels during the cardiac cycle.

Answer 95

**Treatment of Recurrent Multifocal Cutaneous Squamous Cell Carcinoma in an African Grey Parrot (Psittacus erithacus) with Intralesional Carboplatin in Poloxamer 407**. Adair JE, Riggs GL. Journal of Avian Medicine and Surgery. 2022 Aug;36(2):200-5. Key Points: - SCC - commonly reported malignant avian neoplasia - typically irregular, ill-defined area of proliferative, often ulcerated tissue -- Some species predilections for locations on the body, commonly mucocutaneous junctions and oral cavity - Risk factors considered same as humans: hypovitaminosis A, chronic inflammation (trauma, UV), and skin infections - Not likely to met, often locally invasive, can be difficult to completely excise Take Home: - Intralesional carboplatin in poloxamer 407 combined with surgical debridement with CO2 laser resulted in long-term (>2yr) resolution of SCC, similar to complete excision - No clinically relevant adverse side effects, outpatient procedure

Answer 96

JAMS 2022 36(2):206-214 **Pathogenic Idiopathic Extramedullary Hematopoiesis in a Yellow-Collared Macaw (Primolius auricollis)** Coutant T, Cococcetta C, Phouratsamay A, et al Background: - Extramedullary hematopoiesis (EMH) = development of blood cells outside the bone marrow -- Usually trilineage (erythropoiesis, myelopoiesis, and thrombopoiesis) -- However, 1-2 cell lines may predominate, depending on pathogenesis -- Two most frequent sites: liver and spleen -- Other sites include kidneys, lungs, peritoneal cavity, paraspinal region, and lymph nodes (in mammals) -- Generally considered an incidental finding, usually no serious clinical implications - In human medicine, causes of EMH can be classified into 5 categories: 1. Bone marrow failure 2. Myelostimulation 3. Inflammatory process 4. Abnormal chemokine production 5. Hematopoietic neoplasm Key Points: - Case report describes the diagnosis of idiopathic EMH in a yellow-collared macaw -- In the present case, the erythroid lineage predominated - Most prominent feature was the severity of the lesions (severe hepatomegaly and hepatopathy) - Tentative treatment was performed using hydroxyurea -- Hydroxyurea inhibits DNA synthesis; used for polycythemia vera and leukemia

Answer 97

Journal of Avian Medicine and Surgery, 36(2) : 215-219 **Liposarcoma of Probable Medullary Bone Origin in a Lovebird (Agapornis roseicollis)** Lofgren, Nicolle T., Malka, Shachar, Renna, Caitlin M., Banuelos, Rosa M., Dennison-Gibby, Sophie, et al. Key Points: - 15 yo female lovebird presented for reluctance to fly after falling from perch - Cx: painful and swollen left elbow with subcutaneous mass -- CBC – mild anemia -- CT – pathologic fx of left humerus with abnormal soft tissue within the medullary cavity of the humerus fragments and periosteal reaction and lucent lesions of the cortices. - Surgical amputation of left wing performed -- Histo – malignant round cell tumor in the medullary cavity of the humerus with minimal invasion into surrounding soft tissue. Oil red O stain for lipid confirmed liposarcoma.

Answer 98

JAMS 2022;36(3):250-261 **Hematologic Reference Intervals and Comparison of Natt-Herrick Technique and Smear-Based Leukocyte Estimation in Cockatiels (Nymphicus hollandicus)** Monopoli MR, Guzman DS, Kass PH, Kol A Key Points - WBC quantification in birds typically involves a hemocytometer + specific stains -- Two of the most common stains are the Phloxine B and Natt & Herrick solutions -- Phloxine B = semidirect, only stains granules of heterophils and eosinophils -- Total WBC count is measured mathematically from a manual differential -- Natt-Herrick technique (NHT) = direct, all leukocytes are stained -- Blood smear technique w/ Wright-Giemsa also an economic and efficient method - Lymphocytes = predominant leukocyte, a trend recognized anecdotally among avian clinicians -- Contradicts previously published cockatiel RI, but consistent with other avian species -- Stress-induced heterophilia = common avian response to handling & confounding factor **TLDR**: No significant difference between Natt-Herrick and blood smear techniques for WBC estimation in cockatiels; however, blood smear seems to be the more accessible, affordable, and rapid option

Answer 99

Journal of Avian Medicine and Surgery 36 (2022) 295-301 **MEDICAL AND SURGICAL MANAGEMENT OF PHAEOHYPHOMYCOSIS IN A KEA (NESTOR NOTABILIS)** Nick Kirk, DVM, Natalie Antinoff, DVM, Dipl ABVP (Avian), and M. Scott Echols, DVM, Dipl ABVP (Avian) – Reviewed by AJC Key Points: - 2.5 yo FI kea presented for acute onset of abnormal behavior (laying on sternum w/ head resting on ground, wings splayed; lethargic, tripping on perches/toys, disinterested in treats, running into walls) -- Lived in a public outdoor enclosure w/ indoor holding, examined yearly for CBC/CHEM & Chlamydia -- PE: QAR, stumbling gait, decreased grip strength bilaterally (LMN process) -- CBC leukocytosis, CHEM nsf -- Awake radiographs: 2.8 x 2.1 irregular soft tissue radiodense mass compressing abdominal & caudal thoracic air sacs -- CT: 2.3 x 2.7 x 2.6 cm soft tissue mass medial/dorsal to proventriculus & pressing on proventriculus; appeared to originate from L ovary; mass wall or capsule not differentiated from L cranial renal division - Given Lupron injection 🡪 10 days later performed exploratory celiotomy 🡪 L lateral approach (also on voriconazole throughout) -- Multiple adhesions to dorsal, medial, & medial ventral surfaces of mass; able to bluntly dissect away from kidney & excise from proventriculus; small inactive ovary identified during surgery -- Cytology of mass – RBCs, abundant mixed WBCs, septated pigmented fungal hyphae -- Cultures from mass – all negative -- Histo – fungal granuloma, specifically phaeohyphomycosis - Voriconazole discontinued after 6 month CT showed no signs of recurrence

Answer 100

JAMS 2022 36(3):308-315 **Cerebellar Hypoplasia in Two Juvenile African Grey Parrots (Psittacus erithacus)** Taggers A, Kelly-Bosma M, Mastakov A, Allavena R, Doneley RJT Key Points: - First report of cerebellar hypoplasia of African grey parrots -- Radiographs & lab work were unremarkable -- Necropsy findings were consistent w/ diagnosis -- Possible genetic sex-linked etiology, given the third unaffected clutch mate was male -- Hereditary sex-linked cerebellar hypoplasia found in light Sussex chickens - Historically, cerebellar hypoplasia, abiotrophy, and dysplasia have been used interchangeably -- Modern histopathological diagnostic techniques have allowed enhanced differentiation - In birds, secondary acquired cerebellar hypoplasia has been attributed to parvovirus, avian leukosis virus, Chlamydia psittaci, and cryptococcosis

Answer 101

Journal of Avian Medicine and Surgery, 2022: 36(3), 316-324. **Multiple myeloma with aberrant CD3 expression in a red-lored Amazon parrot (Amazona autumnalis)**. Tovar-Lopez, G., Evans, S., Gutiérrez, J. F. M., Moore, A. R., & Sadar, M. J Key Points: - Multiple myeloma – rare lymphoproliferative disorder characterized by systemic proliferation of PCs that can result in excessive Ig secretion, approx. 1% of tumors in dogs and humans -- Diagnostic criteria – at least 10% clonal bone marrow plasma cells, presence of monoclonal gammopathy in serum or urine, and evidence of end organ damage or presence of >1 lesion -- Diagnosis in dogs requires presence of neoplastic cells in the BM + monoclonal proteins in serum or urine or osteolytic lesions - 20 yr F red-lored Amazon presented for 2 wk of weakness. Toxic hets and reactive lymphs on -- CBC 2 weeks prior on annual exam. Biochem – mild hyperproteinemia (normal albumin, moderate hyperglobulinemia). -- PE findings – QAR, fluffed, mild dehydration, distended coelom, mild ataxia, minor hematochezia -- Imaging – bilateral renomegaly, hypoechoic thickening of the muscular layer of the ventriculus. -- CBC at referral center – anemia, eosinophilia, monocytosis, intermediate to large lymphs with nuclei 1-1.5x that of a heterophil; atypical lymphs were immunoreactive for CD3 -- Chem – hyperphosphatemia, hyperproteinemia, analbuminemia (0 g/dl) and hyperglobulinemia (13.6). -- Monoclonal gammopathy on agarose gel plasma protein electrophoresis -- Multiple myeloma suspected based on lack of inflammatory leukogram, monocloncal gammopathy, and atypical circulating lymphoid cells. - Euthanized -- Nx: no gross lesions -- BM samples revealed 17% plasma cells, 24% large immature cells with occ plasmacytoid features

Answer 102

JAMS 2023;36(4):345-355 **Comparison of Lipoprotein Analysis Using Gel-Permeation High-Performance Liquid Chromatography and a Biochemistry Analyzer in Normolipidemic and Dyslipidemic Quaker Parrots (Myiopsitta monachus)** Beaufrère H, Wood D Key Points: - Lipoprotein analysis compared between a bench-top biochemistry analyzer vs. GP-HPLC -- Acceptable agreement for HDL-C for normotriglyceridemic samples -- No method for LDL was found to be clinically equivalent to GP-HPLC -- Including direct biochemistry, Friedewald formula, and alternative formulas -- Hypertriglyceridemia associated with strong interference effects in lipoprotein analysis - 0.3% cholesterol diet caused transient/severe hypercholesterolemia, increased all lipoproteins -- 20% fat diet had minimal effects on plasma lipids - > 20% of samples that were hypertriglyceridemic -- Likely associated with either female vitellogenesis or postprandial hyperlipidemia - Because HDL-C was reliable in this study in normotriglyceridemic plasma samples, calculating non–HDL-C to determine risk factors is the most practical, reliable, and straightforward method -- Non–HDL-C encompasses all atherogenic lipoproteins -- Non–HDL-C = Total cholesterol – HDL-C - Total cholesterol/HDL-C ratio (i.e., atherogenic index) is widely used in humans -- May also be a better risk factor than simple LDL-C measurements - Total cholesterol, non–HDL-C, & total cholesterol/HDL-C recommended for clinical psittacine patients for diagnosis & monitoring of dyslipidemias (assuming patient isn’t hypertriglyceridemic) -- Most hypertriglyceridemia in birds is postprandial or due to female reproductive status -- Obtaining fasted samples on nonreproductive birds is also recommended

Answer 103

JAMS 2023 36(4) 356-361 **Evaluation of Prothrombin Time and Activated Partial Thromboplastin Time in Native and Citrated Whole Blood in Hispaniolan Amazon Parrots (Amazona ventralis) With a Handheld Point-of-Care Analyzer** Key Points: - For birds, factors XI and XII, in particular, are reported to be found in low concentrations - Therefore, previous studies investigating avian coagulation have primarily focused on prothrombin time (PT), which measures the extrinsic and common pathways of coagulation and does not significantly assess the intrinsic pathway - InSight qLabs point-of-care unit in HAP’s: Low reliability measuring PT, high reliability measuring aPTT (especially on whole blood) but clinical relevance unclear

Answer 104

**Evaluation of dexmedetomidine-midazolam sedation in budgerigars (Melopsittacus undulatus)** Lauren E. Mumm, DVM; Christoph Mans, Dr med vet, DACZM, DECZM JAVMA | JULY 2022 | VOL 260 | NO. 10 Key Points: - Alpha 2 receptor agonist – dexmedetomidine with sedative, analgesic and muscle relaxing effects -- Side effects – dose dependent respiratory depression, bradycardia, and arrhythmogenesis - Aim- evaluate dexmed-midazolam (DM) at both high and low doses of dexmedetomidine - Time to sedative effect did not differ between high (HD - 40 mcg/kg) and low dexmed (LD - 10 mcg/kg) group both with 3 mg/kg midaz -- All in HD group were sternal recumbent and 8/10 in LD. All retained withdrawal response -- Could position for rads in 7/10 in HD. More mild sedation in LD with 4/10 able to take rads -- Peak effect at 15 mins -- Better sedation than prev study with butor-midaz, more individuals could be positioned for rads. -- No adverse signs seen (versus hyperexcitability during sedation/recovery and transient arrhythmia with alfax in budgies) - HR and RR decreased significantly over time – resolved after reversals given - After reversals, all birds were standing < 5 min after reversals with no difference between HD or LD -- Majority of birds were eating < 1 hr later -- 60 min after reversal, most birds showed signs of resedation though considered not clinically relevant (mild ataxia and loss of visual response)

Answer 105

**ENVIRONMENTAL FACTOR INVESTIGATION OF EXUDATIVE CLOACITIS IN KĀKĀPŌ (STRIGOPS HABROPTILUS) ON WHENUA HOU (CODFISH ISLAND), NEW ZEALAND**. Jayasinghe M, Vallee E, Bolwell C, Digby A, Roe W, Midwinter A, Gartrell B. The Journal of Wildlife Diseases. 2022;58(4):769-781. Key Points: - Kakapo: critically endangered, nocturnal parrot endemic to New Zealand, breeding populations intensively managed on 3 predator-free offshore islands including regular supplemental feeding - Exudative cloacitis first noticed in 2002, found only on Whenhua Hou -- Inflammation of the vent margin or cloaca, often ulcerated, covered in crusty exudate, debilitating, can lead to reduced fertility -- Underlying cause/factors are unknown Conclusions: - Exudative cloacitis in kakapo is geographically restricted to Whenhua Hou, is slowly progressive with sporadic cases varying per year. - No age or sex predilection, no effect of climate - Does not appear to be infectious - Possible association with ammonia levels (ie. fecal/urate build up) and moisture content in roost sites but no true statistical evidence

Answer 106

**Wildmann, A. K., Cushing, A. C., Pfisterer, B. R., & Sula, M. J. M. (2022). Retrospective review of morbidity and mortality in a population of captive budgerigars (melopsittacus undulates)**. Journal of Zoo and Wildlife Medicine, 53(2), 433-441. Key Points: Neoplasia #1 - Carcinomas (35), -- 22/35 renal, mets in 4 -- MC comorbidity - Macrorhabus, gout (visceral pericardial lesions MC) -- Proventricular location 2nd MC for carcinoma - Sarcomas (11) - MC undifferentiated (4), splenic (3) -- Multicentric lymphoma (5) - Benign neoplasms (33), MC reproductive - Sertoli cell Infectious - MO diagnosed in 56 cases, MC finding proventriculus at the isthmus of the proventriculus and ventriculus ; 5/7 proventricular adenocarcinomas involved MO - Sarcocystis in 17 cases (7 coinfections with MO) - interstitial pneumonia MC lesion atypical biliary hyperplasia and EMH also seen -- Opportunistic bacterial infections in 14 cases Metabolic - Hepatic lipidosis MC, 19/26 cases had comorbidities - neoplasia MC Trauma - 41 cases - head trauma MC

Answer 107

JZWM 2022 53(2) 461-469 **EVALUATION OF CLINICAL DIAGNOSTICS FOR PROVENTRICULAR NEMATODIASIS DUE TO SYNHIMANTUS NASUTA IN LORIKEETS (TRICHOGLOSSUS SPP.)** Background: - Synhimantus nasuta, formerly Dispharynx nasuta or Dispharynx spiralis, is an acuarioid spirurid nematode with a cosmopolitan distribution, and infection has been reported in multiple avian taxa - Attachment of the nematode’s head within the lamina propria of the proventriculus causes significant inflammation, resulting in dilatation of the organ, thickening of its wall, focal ulcerations with mucosal hemorrhage, overproduction of mucus, and potentially mechanical obstruction of the lumen - Although clinical signs generally are nonspecific, combined observations from physical examination and initial diagnostic investigation may raise the suspicion of proventricular nematodiasis in a living bird - Hard to diagnose antemortem–shedding is intermittent and there is a long prepatent period so fecals can result in false negatives - Intermediate host is the pill bug (Armadiliidiidae) - In this case series, clinical investigations were pursued during an S. nasuta infection in a flock outbreak situation to better define possible presentations Key Points: - n=4 confirmed cases - An increased PKR (proventriculus-keel ratio) was observed only in birds that were actively shedding ova and was the only parameter with a statistically significant difference between confirmed and suspected cases - The two lorikeets with the highest scores were confirmed cases and were the only ones that presented with clinical signs of severe anemia (lethargy and a pale iris color) confirmed by a low PCV. - The other two confirmed cases had similar scores to the suspected cases and their main clinical sign was weight loss - Birds were treated with ivermectin and then topical selamectin - Fecal occult blood was also seen on birds with confirmed infections?