SA Exotics Flashcards

Question

What is the stimulus for respiration in mammals, reptiles and birds? How does this affect oxygen therapy?

Answer 1

Mammals: hypercapnia - give 100% oxygen | Reptiles and birds: hypoxia - give 30-50% oxygen

Answer 2

1% BW (1ml/100g) | Include anticipated haemorrhage/haematoma

Answer 3

``` Gluocse Ca2+ PCV TS Lactate ```

Answer 4

Mammals: 50-80ml/kg Birds: 60-120ml/kg Reptiles: 40-80ml/kg

Answer 5

``` – Jugular – Cranial Vena Cava – Saphenous – Cephalic – Lateral tail vein (rats) – Marginal auricular vein (rabbits) ```

Answer 6

– Right jugular – Medial metatarsal vein – Basilic/ulnarvein

Answer 7

``` Lizards: – Ventral coccygeal vein (avoid hemipenes), care autotomy – Ventral abdominal vein Snakes: – Cardiocentesis – Ventral coccygeal vein (avoid hemipenes) Chelonia: – Jugular – Sub-carapacial sinus (lymph) – Dorsal tail vein ```

Answer 8

``` kcal/day = K x BW(kg)^0.75 Placental mammals: K=70 Marsupial mammals: K=49 Passerines: K=129 Non passerines: K=78 Reptiles: K=10 ```

Answer 9

``` Rabbits: - PLACE antibiotics - Fipronil - Corticosteroids Rodents: - PLACE antibiotics - Corticosteroids - more tolerant than rabbits but still avoid Birds: - Itraconazole - care in grey parrots (lower dose to avoid hepatotoxicity) - Fenbendazole when in moult - Corticosteroids Chelonia: - Ivermectin ```

Answer 10

Quadriceps Epaxial muscles Hedgehogs - orbicularis muscle

Answer 11

Pectoral muscles - caudal 2/3 to avoid brachial plexus, care with flying birds e.g. racing pigeons Quadriceps

Answer 12

Chelonia - triceps/biceps/any palpable muscle mass Lizards - triceps/quadriceps, epaxial muscles - care re autotomy Snakes - epaxial muscles (33% itv length)

Answer 13

Prolonged anorexia Blood sugar stabilises but glycogen stores are depleted Feeding -> blood sugar peaks -> insulin release -> glucose shunted intracellularly in order to replenish glycogen stores, K+ and phosphorous Leads to hypokalaemia and hypophosphataemia Clinical signs particularly cardiac signs e.g. bradycardia, as well as neurological signs Potentially fatal

Answer 14

Feed 1/3 of caloric requirement on first day Feed 2/3 of caloric requirement on second day Feed 3/3 of caloric requirement on third day Slower in reptiles

Answer 15

5 compressions to one breath

Answer 16

Rescuscitation and maintenance Hypertonic saline works synergistically with colloids in resuscitation 3-5ml/kg over 10 mins

Answer 17

IV volume expanders - can expand blood volume by 1.4x Rescuscitation Reduced crystalloid requirements (40-60%) Administer with crystalloids to avoid interstitial volume depletion 20ml/kg for hetastarch

Answer 18

Indicated where increased O2 delivery needed Non antigenic so no cross matching needed Very effective for haemorrhagic shock 2-5ml/kg

Answer 19

Not usually for emergency resuscitation Indicated if loss or depletion of albumin, coagulation factors, platelets or RBCs >20% blood volume lost Aim to get a PCV > 25% 10-20ml/kg plus other resuscitation fluids

Answer 20

Hypocalcaemia IM or IV calcium salts required for emergency treatment + benzodiazepine for seizures

Answer 21

Reasons: high rate of uterine adenocarcinoma, social animals - prevents unwanted litters Midline approach Bicornuate uterus, two cervices, no true uterine body Prone to adhesions - careful tissue handling Fat around ovaries and in mesometrium Cranial vagina Synthetic monofilament suture material as prone to reactions Intradermal skin sutures following routine closure of muscle

Answer 22

Reasons: behaviour/integration, social animals - prevent unwanted litters Testes cranial to penis Able to retract testes into abdomen Prescrotal or scrotal approach Semi closed or closed technique Open inguinal ring - must close tunic to prevent herniation Intradermal sutures or tissue glue Can be fertile up to 6 weeks post neutering

Answer 23

``` Prevention of disease: - cystic ovarian disease (guinea pigs) - mammary tumours and pituitary tumours (rats) - pyometra - neoplasia Ovariohysterectomy vs ovariectomy Midline vs flank Intradermal skin sutures Local anaesthesia ```

Answer 24

``` Reason: reproductive control Prescrotal vs scrotal vs abdominal Infection risk Semi closed or closed technique Splash block (lidocaine/bupivocaine) Intradermal skin sutures ```

Answer 25

Control of musky odour Oestrogen toxicity Consider alternatives due to adrenal disease

Answer 26

Ventral midline approach Similar procedure to cat ovariohysterectomy Ovary small and embedded in fat Intradermal suture pattern Synthetic absorbable suture material Consider deslorelin implant post neutering

Answer 27

Control of musky odour Reproductive control (social groups) Aggression Risk of drenal gland disease Open, scrotal approach - similar to cat Tend to bleed more in breeding season (vessels larger) Consider deslorelin implant post neutering or as alternative

Answer 28

Jills are induced ovulators 75% cessation of oestrus on first mating No risk of adrenal disease Can be fertile ? 7 weeks post vasectomy

Answer 29

``` Polygactin 910 (Vicryl) Polydioxanone (PDS) ```

Answer 30

Everting skin sutures as reptile skin naturally inverts when healing Strong suture material Delayed suture removal - 6 weeks (prolonged healing), ecdysis may lead to premature loss

Answer 31

12-18 weeks | Acrylic/epoxy resin left for 6-12 months

Answer 32

'Belly jelly' Use as topical gel/sheet to aid tissue lubrication post-op for mammals Left in coelom/abdomen after surgery

Answer 33

``` Deslorelin implant - licensed in male ferrets hCG Proligestone Leuprolide acetate Aglepristone ```

Answer 34

``` Reproductive disease Chronic egg laying Behaviour Dystocia Deslorelin Leuprolide ```

Answer 35

Pre and post ovulatory stasis Deslorelin Leuprolide

Answer 36

Pigeons - PMV, Pox Chickens - IBD, IB, Salmonella, CAV Psittacines (USA/Canada) - Polyoma virus

Answer 37

RHD1-myxo - from 5 weeks, annual | RHD2/RHD1 - from 30 days, 2 weeks apart from RHD1 vaccination

Answer 38

Ferrets - rabies, distemper (not licensed) | Rodents - guinea pig Bordetella vaccine?

Answer 39

Amidostomum/Echinuria (waterfowl) - praziquantel/pyrantel | Roundworms, Syngamus, hairworm, caecal worm (poultry) - flubendazole (0 day egg withdrawal)

Answer 40

Ferrets - fipronil and S-methoprene (frontline combo), imidocloprid/moxidectin (advocate) Rabbits - imidacloprid licensed for fleas (advantage), cyromazine (rearguard), ivermectin, selamectin Fipronil toxic in rabbits!

Answer 41

Fenbendazole Not for routine worming Encephalitozoon cuniculi

Answer 42

Nothing licensed Fibronil spray (wipe) Ivermectin - not chelonia

Answer 43

Fenbendazole

Answer 44

Symmetrical only Primary feathers only Postpone if blood feathers found

Answer 45

``` Permanent flight prevention Waterfowl downies < 10 days old only Unilateral amputation of distal wing tip, distal to alula Act of veterinary surgery 3-4 days old, cartilage, skin, down Alula must be preserved Metacarpals should be as short as possible Silver nitrate for haemostasis Consider myiasis ```

Answer 46

Birds - most LHS pectoral, ratites LHS pipping muscle, penguins SQ base of neck Reptiles - L hindlimb (SQ) in chelonia and lizards, LHS body 3 head spaces back from head in snakes (BVZS) or LHS cloaca

Answer 47

Class 1 = fit and healthy, no systemic disease Class 2 = mild to moderate systemic disease only e.g. skin tumour, chronic arthritis, fracture without shock Class 3 = severe systemic disease, causing mild symptoms/limiting activity but not incapacitating e.g moderate hypovolaemia, anaemia or pyrexia, mild to moderate heart failure Class 4 = severe systemic disease that is a constant threat to life e.g. severe uraemia, toxaemia, hypovolaemia, heart failure Class 5 = moribund patient that is not expected to survive 24h with or without operation e.g. extreme sepsis/shock

Answer 48

Lack of alertness/reduced mentation/lack of interest in surroundings Hiding Shifting/throwing themselves around/unable to get comfortable Sitting in hunched position Failure to use/move certain parts of the body Head pressing Increased/unusual aggression

Answer 49

``` = behaviours that are rarely seen prior to painful stimulus but often afterwards Twitching Wincing Staggering Flinching Belly pressing Slow postural adjustments Shuffling gait ```

Answer 50

Respiratory depression Gut motility Nausea Excitation

Answer 51

Profound immune suppressive effect - WBC lysis | Lots of exotics may have underlying clinical pathology

Answer 52

Morphine: pure u agonist (rarely used in rabbits) Methadone: synthetic pure u agonist Fentanyl: pure u agonist (can be used alone or in combo with fluanisone) Buprenorphine: partial u agonist (slow onset but safe) Butorphanol: mixed u agonist/antagonist (ceiling effect = dose above which no additional effect)

Answer 53

``` Birds = primarily k Reptiles = vary between k and uncategorised receptors which are similar to mammalian mu receptors ```

Answer 54

Monitor carefully: hydration status and renal function GI side effects May affect caecotrophy/coprophagy Increased dosing frequency in rabbits/rodents e.g. BID Decreased dosing frequency in reptiles e.g. q 2 days Meloxicam - COX 2 selective, few side effects, good safety, palatable liquid Carprofen Ketofen

Answer 55

u receptor agonist Seratonin and adrenaline re-uptake inhibition Alpha-2 agonist Appears to be very safe and effective for most exotic species

Answer 56

Anti-convulsant that modifies the perception of neuropathic pain Can see ataxia and sedation

Answer 57

At very low doses blocks NMDA receptors | Prevents wind up pain

Answer 58

Visceral, musculoskeletal and neuropathic pain

Answer 59

Centrally acting anti-nausea drug due to effect on CTZ | Also good anti-inflammatory and show to be anaesthetic sparing in dogs

Answer 60

Generally ketamine with other medications e.g. morphine and lidocaine Constant delivery of analgesia Requires very good patient monitoring Requires accurate fluid delivery ie infusion pump or syringe driver Really useful to prevent wind up pain and where planned interventions are likely to be painful

Answer 61

Topical local analgesia | Lidocaine with prilocaine

Answer 62

Benzodiazepines - good muscle relaxation and anxiolysis, midazolam - amnesia Ketamine - poor muscle relaxation but good analgesia, supports BP A2 agonists - good muscle relaxation and some analgesia but haemodynamic issues (reduced by combining with other drugs) Alfaxolone/propofol - good muscle relaxation and promotes unconsciousness but no analgesia

Answer 63

Triple combination - a2 agonist + opiate + ketamine Ketamine + benzodiazepine Benzodiazepine + opiate + propofol or alfaxolone + volatile agent Opiate/ACP + propofol or alfaxolone + gas Volatile agent alone

Answer 64

A2 agonists: atipamezole Benzodiazepines: flumazenil (NB anxiety, restlessness and lowered seizure threshold can occur) Opioids: naloxone (repeat doses may be needed, also reverse analgesia so can leave patient in acute pain)

Answer 65

No Risk of hypoglycaemia Can't vomit/low risk Take food out 0.5-1h before and check mouth for food once anaesthetised

Answer 66

``` Palatial ostia in rodents - v difficult Long oral cavities with limited gape Fleshy tongue Size of patient Risk of tracheal trauma/hypoxia Risk of tube blockage (check mouth) ```

Answer 67

Direct visualisation - laryngoscope, endoscope, pull tongue forwards, topical anaesthetic, stylette Blind technique - ventral recumbency, hyperextend head and neck, listen/feel, advance on inspiration with twist, confirm placement with IPPV or condensation, risk of pushing food into trachea and of traumatising larynx

Answer 68

``` V-gel Quick and easy to insert No risk of tracheal trauma/stricture Expensive Ideally use capnography to ensure correct porition ```

Answer 69

Within 1 hour recovery

Answer 70

``` Lateral recumbency Care with disorientation, wing flapping Ensure awake prior to extubation Muscle twitching common Hold until able to perch Crop tube if not eating soon post GA ```

Answer 71

Birds - don't cuff tubes | Rabbits?

Answer 72

Induce in vertical posistion Maintain in lateral - only compromises 50% of air sacs, care to not restrict wind movement (pneumatised humeri/femurs) Dorsal recembency - viscera puts pressure on caudal airsick, reduces effective ventilatory volume Ventral recumbency - limits ventral chest excursions and abdominal viscera press on air sacs

Answer 73

Birds - rely on movement of air sacs and ventral chest excursions Reptiles - rely on chest excursions (legs in chelonia)

Answer 74

May be quite resistant to reduced ventilation/apnoea | May not breathe frequently enough on gas anaesthesia to keep themselves asleep

Answer 75

Short ETT Essential for IPPV as apnoea common Rostral glottis in snakes and carnivorous lizards Herbivores glottis at base of fleshy tongue

Answer 76

Righting reflex Toe and tail pinch Head withdrawal - toe is pinched and head is slightly withdrawn Palpebral response Vent response Tongue withdrawal in snakes – remains present at sx plane Corneal reflex – remains present at sx plane (except snakes) Jaw tone Reflexes lost cranial to caudal and return caudal to cranial Cardiovascular and respiratory systems monitoring

Answer 77

Ventilate with room air in recovery - Ambu-bag, spontaneous breathing will return more quickly Doxapram hydrochloride = effective respiratory stimulant used in apnoeic snakes Fluids POTZ Recovery can take 10-30 mins Full recovery may take up to 24 hours

Answer 78

MS222 - make up buffered solution, add to known volume of tank water, volume of drug added correlates to anaesthetic depth 2-Phenoxyethanol - can be used at increased dose for euthanasia, once level of anaesthesia reached remove from water, place on wet surface and can maintain with anaesthetic solution pumped over the gills Recovery - fresh tank water, until fish remains normally upright

Answer 79

Stage 1: light - reduced reactivity Stage 2: deep sedation - loss of reactivity other than strong pressure, normal equilibrium Stage 3: Light anaesthesia - partial loss of equilibrium, erratic swimming and increased gill movements Stage 4: Deep anaesthesia - total loss of equilibrium, reacts only to strong pressure, reduced opercular movements Stage 5: Loss of reflex activity, shallow opercular movements, no reaction to pressure Stage 6: Medullary depression - gasping followed by gill movements stopping Monitoring - initially visually and use of reflexes, can use doppler probe for auditory heart monitoring

Answer 80

Strong muscular cardiac sphincter

Answer 81

Very large Folded around 3 times = gyri Vermiform appendix secretes HCl to control pH Sacculus rotundus Where most digestion occurs Digestible fibre sent back from colon to caecum for further digestion

Answer 82

Separates the large indigestible fibre particles from smaller digestible particles Haustra act as as an elevator moving digestible particles towards caecum Proximal colon - 3 hausfrau, 3 taenia Fusus coli - controlled by aldostereone and prostaglandins, pacemaker of the gut, no taenia? Distal colon - strong muscular contractions for hard faeces phase, rapid more gentle contraction for soft faeces phase

Answer 83

Interstitial fluid flows into gut - dehydration Painful Potentially fatal, electrolyte derangement as not secreted/reabsorbed so GA not option

Answer 84

History - reduced/absent appetite and faecal production Often lethargic Lack of gut sounds or abnormally loud borborygmi on abdominal auscultation Abdominal palpation - 'empty' abdomen, or dilated/fluid filled gut loops, or may be painful, or impactions of viscera felt Blood glucose levels (>18mmol/L suspicious of GI blockage but poor se and sp) Abdominal ultrasonography Radiography Contrast studies CT/MRI? Exploratory surgery

Answer 85

GI blockage | Dysbiosis

Answer 86

Surgical intervention Must stabilise prior to surgery Pro-kinetics are contraindicated pre and post-op

Answer 87

= A challenge to or alteration of the gut bacteria Causes: antibiotic usage, alteration in body temperature, change in gut motility, drastic alteration in diet Signs: change in faecal consistency, alteration of appetite Possibly production of endotoxins if pathogenic bacteria such as Clostridia prevail Treatment: adsorbents (cholestyramine, activated charcoal) may help in addition to aggressive treatment for the underlying cause

Answer 88

Change in taste of caecotrophs (diet change, medications, infection) Change in caecotroph consistency e.g. more runny (infection/inflammation/mural lesion in caecum) Inability/unwillingness to turn around and eat them (pain-dental disease, spondylosis, osteoarthritis, poor balance-head tilt due to inner ear disease/E.cuniculi)

Answer 89

True emergency Gut motility is seriously disordered Rapid fluid loss and significant electrolyte imbalance May be due to protozoan parasites e.g. coccidia, or bacterial infection and endotoxin production e.g. Clostridium piriformis (Tyzzers disease)

Answer 90

Distinct diarrhoea complex usually of juvenile rabbits Often related to very low fibre diets Small and large intestines are dilated with mucoid diarrhoea Few/no histological changes found Causative agent unknown - thought to be a contagious infection Treatment is often unrewarding

Answer 91

Defined as gut loops filled with gas Intensely painful Bacteria within gut produce gas either when multi biome changes, or diet changes Can cause functional obstruction of pyloric outflow - gastric dilatation Rabbit stomachs do not usually progress to torsion May require surgery in order to allow the gas to pass out of the stomach

Answer 92

Fills with ingesta and fails to empty Often will continue to produce normal hard faeces but no normal caecotrophs passed Caecum gets progressively more and more full Painful Weight loss as caectrophs that would be absorbed as calories or nutrients are sequestered in the caecum No really helpful treatment - PGF2a suggested

Answer 93

Weanlings (immune prior to weaning) Risk factors: poor hygiene, overstocking, stress Disease rare in adults Infection common, disease rarer - species vary in pathogenicity Enteric forms: diarrhoea (+/- mucus/blood), stunting, weight loss, lethargy, anorexia, death Hepatic forms: subclinical or weight loss, stunting, ascites, jaundice, hepatomegaly

Answer 94

Coccidia Passalurus ambiguus - common pinworm, part of multi biome and potentially helps in caecal contents mixing/digestion Obeliscoides cuniculi - stomach worm, not reported in pet rabbits in UK Trichostrongylus retortaeformis - intestinal worm in Europe and Australia Taenia - intermediate host Routine worming not indicated for most rabbits in UK

Answer 95

= dysfunction of the ANS (degenerative changes in autonomic neurones) Sometimes called megacolon Often weanlings but adults can be affected Risk factor = low fibre diet Palpable large bowel impaction, pain, reduced gut function - stomach and caecum also don't empty Swallowing difficulties and urinary incontinence may also be notes Cause unknown (C botulinum suspected for grass sickness) No effective treatment - don't use oral meds as risk of inhalation pneumonia

Answer 96

Metaclopramide, cisapride, ranitidine, domperidone Contraindicated if GI obstruction and after gut surgery where lumen of gut has been opened Acts to promote stomach emptying or general persistalsis but many clinicians feel not needed if diagnose and treat underlying issue

Answer 97

When not eating and not obstructed Until voluntary eating returns To ensure gut function is maintained and gut motility is promoted

Answer 98

Any animal that is not eating voluntarily should be assumed to be at least 5% dehydrated 2-4ml/kg/hr or 100ml/kg/24hr

Answer 99

Evidence for and against Worst case is don't work Unlikely to do harm

Answer 100

Hypsodont = no true root Elodont = open rooted, constantly growing Diphyodont = 2 sets of teeth, first lost at/around birth so should never be seen clinically Grow 1-3mm/week

Answer 101

Congenital Acquired - anorexia Trauma - fractured teeth/jaw

Answer 102

Anorexia Drooling Tooth grinding Wet below chin/on front paws Change in dietary preference - stops eating either hay/vegetables or pellets where previously ate them May be no clinical signs until things are fairly advanced

Answer 103

Make certain gut is working Correct fluid and electrolyte imbalances Provide analgesia Once stable, consider GA, dental X-rays, burring teeth

Answer 104

2/3 of tooth is within jaw | 5 views

Answer 105

Maxillary arcades are wider than mandibular Occlusal surface of teeth approximately horizontal to 10 degrees off with mandibular arcades higher on lingual than buccal edge - slope is slightly down away from tongue Only one side of the dental arcades can be occluding at any one time Check for specific spurs, loose teeth, areas that appear abnormal Check ROM

Answer 106

Mandibular arcades are wider than maxillary arcades Occlusal surface is approximately 30 degrees off horizontal with the mandibular arcades being lower on the lingual than buccal sides The caudal portion of the dental arcades are closer together than the rostral portions - distance between the arcades becomes very narrow at the back of the mouth

Answer 107

Mandibular arcades slightly wider than maxillary - not as pronounced as in guinea pigs Occlusal surface is between horizontal and 10- 15 degrees off with the slope being down towards the lingual side of the mandibular teeth Jaw ROM is similar to guinea pigs Degus are very similar to chinchillas

Answer 108

Secondary to trauma/bite wounds, post-op or dental disease Best treatment method is radical/complete surgical excision and primary closure of a clean wound - not always possible Remove affected teeth if dental abscess Long course of antibiotics Antibiotic Impregnated Poly Methyl Methacrylate beads (AIPMMA beads)

Answer 109

``` Risk factors: - (No foot pads) - obesity - soiled bedding - wire floors - rex rabbits Treatment: - deep bedding - analgesia, antibiotics - surgical intervention in severe cases ```

Answer 110

Dominant conspecific | Insufficient dietary fibre

Answer 111

Psoroptes cuniculi (ear mites) Cheyletiella parasitovorax (walking Dandruff) Sarcoptes scabiei Leporacarus gibbus Haemodipsus ventricosus (rabbit sucking louse - uncommon) Ctenocephalides felis, C. canis, Spilopsyllus cuniculi (fleas) Lucilia (flystrike)

Answer 112

Sedation for through exam and exploration Analgesia Clip and clean lesions Insecticidal e.g. F10 and Cypermethrin Ivermectin Surgical intervention/debridement in severe cases Prevention - cyromazine (rearguard)

Answer 113

Treponema cuniculi (rabbit syphilis): - genital lesions - auto-innoculation - facial lesions, lips, eyelids - sexually transmitted disease - treat with parenteral penicillin Myxomatosis - poxvirus - insect vectors - systemic form - facial and genital oedema - cutaneous form Trichophyton metagrophytes/Microsporum canis - crusty, erythematous alopecia +/- pruritus - young animals (pet shops with high stocking densities) - zoonotic

Answer 114

RHD1: - european brown hare is reservoir - high mortality: acute death or within hours of becoming ill - febrile, severely lethargic, may bleed from nose/mouth - reverse age susceptibility (young are immune until 5-6 weeks) RHD2: - lower mortality rates - longer incubation - similar clinical signs Diagnosis by PM often and PCR of tissue e.g. liver

Answer 115

Pasteurella multocida ± other pathogens e.g. Bordetella bronchiseptica Related to stress, husbandry, strain of bacteria present Signs may be related to URT - nasal discharge, sneezing LRT - coughing rare, rapid deep breathing is good clue Also abscesses, balanoposthitis, pyometra

Answer 116

Get a good diagnosis Deep nasal swabs Radiographs Antibiosis is warranted NSAIDs, decongestants, fluids, supplemental oxygen Correct husbandry and address potential stressors May never completely clear but immune system should be able to cope as long as the factors surrounding are addressed

Answer 117

Can be consequence of respiratory infection - tracking up into middle/inner ear via Eustachian tube Can be secondary to Encephalitozoon cuniculi infection May be peripheral or central nervous system at fault Central disease can mimic peripheral disease, but peripheral disease can never mimic central disease Horizontal vs vertical/rotatory nystagmus Diagnostics - EC titres (not diagnostic), radiographs, CT Often surgical treatment required NSAIDs, antibiosis, anti- vertigo drugs (Meclizine, prochloperazine etc)

Answer 118

Microsporidian parasite Up to 75% of rabbit populations have been exposed May result in neurological disease or renal disease Oral infection from spores shed in urine of infected animals (NB paratenic hosts) Treatment - fenbendazole is effective in removing organisms but clinical signs are caused by the host reaction to the organism and may be years after infection May be related to ‘Floppy Rabbit Syndrome’ and posterior paralysis

Answer 119

Day 1: spores ingested, inhaled or transplacentally transferred Day 7: intradermal testing positive Day 14: IgM titres positive Day 14-28: IgG titres positive Day 31: Infection can be detected in organs with high blood flow Day 38: IgM titres now negative Day 42: Urinary shedding of spores detectable Day 56: Urinary shedding at its peak Day 63: Antibody response is maximal Day 63-70: Lesions are visible in the brain and kidney Day 90: Urinary spore shedding stops Day 98: Organisms histologically visible in organs of predilection

Answer 120

Common in older rabbits Poor appetite/ weight loss May not see polydipsia consistently Phosphorus levels are key Can be related to encephalitozoonosis Aging results in reduced GFR, reduced renal blood flow and reduced ability to maintain acid-base balance and fluid homeostasis Affects appetite and therefore gut motility as a secondary issue Treatment - fluids, dietary correction if needed (often isn’t in rabbits), ACE-I or angiotensin receptor blockers, oral phosphate binders (that do not contain calcium)

Answer 121

Uptake from gut is related directly to dietary content Not reliant on vitamin D, PTH or calcitonin until dietary levels become very low Most calcium is excreted via kidneys into urine - suspended, not dissolve

Answer 122

Calcium settles onto ventral bladder wall if mobility restricted - thick paste that is hard to void Calcium crystals are irritant to urethra in high concentrations - reluctant to void/adopt correct stance May see haematuria Likely to see urine scalding May be coincidental finding on radiography Treatment - treat underlying cause, consider flushing out bladder, consider medications that will alter solubility of the calcium salts (cannot acidify herbivore urine), fluids, dietary modification

Answer 123

History - reluctance/inability to void Progression from urine sludging Solidification of urine calcium salts into a discrete stone/s May be in bladder, renal pelvis, ureters or urethra Blood work essential - need to know renal function not compromised and the degree of hypercalcaemia/hyperphosphataemia present May have calcification of other soft tissues eg the aorta Surgical treatment required Post-op - fluids, analgesia, correction of underlying causes, dietary manipulation and treatment of co-morbidities such as renal disease

Answer 124

Phantom pregnancy - nesting, fur pulling, lactation without production of kits Abortion - Pasturella, Treponema Uterine varices - severe episodes of bleeding (blood can pool in vagina so may only be voided at urination) Uterine adenocarcinoma - repeated empty cycles predisposes to neoplasia: hyperplasia -> adenoma -> adenocarcinoma Mastitis - hot swollen mammary glands during milk production, doe may be very unwell, kits may need hand-rearing, mammary glands need to be milked out Mammary neoplasia - result of long term hormonal stimulation on mammary glands (intact females or result of ovarian remnants post-spay) Adrenal disease - pituitary production of gonadotrophic hormones is usually shut down after neutering but doesn't always happen -> LH and FSH remain at stimulatory levels in the blood without gonads to act on -> induces receptor formation on adrenal surface -> LH and FSH bind to the receptors and stimulate adrenal gland to produce active reproductive hormones (very similar to ferrets)

Answer 125

Guinea pigs, Chinchillas, Degus Reliant on a high fibre/low succulent diet Hind gut fermenters Susceptible to high levels of sugar in the diet Social species

Answer 126

Hind gut fermenters Poorly adapted to processing simple sugars Very basic ability to produce caecal faeces - not proper caecotrophs as in rabbits Coprophagic - from others and their own

Answer 127

Caecal diarrhoea Causes: infectious agents or mural lesions, sudden dietary change Causes similar metabolic and fluid balance issues to those seen in other species Severe cases will develop endotoxaemia, septicaemia and eventually shock resulting in death

Answer 128

Eimeria caviae, Eimeria chinchillae, Giardia duodenalis Ris factors: stress, overcrowding, poor hygiene Diagnosis: faecal flotation, wet mount Treatment: TMPS, metronidazole, toltrazuril, aggressive supportive care, address environmental issues

Answer 129

Gastric tympany in chinchillas - doesn't usually twist Gastric dilation/volvulus in guinea pigs Hunched posture, metabolic/electrolyte/fluid balance issues due to gut not moving Pain Dilation impedes blood supply -> haemodynamic changes Size of dilated gut impedes breathing Treatment of GDV is surgical Bloat without torsion can potentially be managed medically Simethicone - surfactant to make gas bubbles smaller and allow them to pass Analgesia, fluids, pro-kinetics Care needs to be aggressive

Answer 130

Severe pneumonia in guinea pigs - especially juveniles Rabbits can carry in nasopharynx without clinical signs (ie risk for guinea pigs housed with rabbits) Risk factors: stress, overcrowding, poor ventilation, hypovitaminosis C Diagnosis: culture, radiography, possibly clinical suspicion NB Streptococcus pneumoniae is a DDx NB respiratory disease can extend into the middle/inner ear

Answer 131

Viral infection in newly purchased guinea pigs May be low level infection - inapparent clinical signs Or may be severe signs - pneumonia and even death May be age related differences in susceptibility and stressors may impact clinical manifestation Supportive care only: oxygen, NSAIDs, decongestants, mucolytics, antibiotics?, nebulisation? Can be hard to differentiate from bacterial respiratory pathogens without testing

Answer 132

Guinea pigs: dilated and hypertrophic cardiomyopathies, pericardial effusions Chinchillas: hypertrophic cardiomyopathy, VSDs and right ventricular outflow tract obstruction All species can suffer from valvular disease Clinical signs may be subtle - exercise intolerance, open mouth breathing, weight loss May hear adventitious sounds over lung fields and potentially a heart murmur if heart rate low enough

Answer 133

ECG, radiography, echocardiography, pro-BNP markers? Animals with HCM cannot improve cardiac contractility so pimobendan is contra-indicated DCM can benefit from pimobendan. Reduce the pre- and afterload - diuretics, ACE-I, oxygen supplementation in the acute phase Analgesia Nitroglycerine?

Answer 134

(Ectoparasites are rare in degus and chinchillas) Trixacarus caviae - symptomless carrier state can occur, although infection can occur Chirodiscoides caviae - guinea pig fur mite/fur clasping mites Cheyletiella parasitovorax - scaling and pruritis along dorsum, rabbits implicated Demodex caviae - life cycle unknown but mite numbers directly related to hosts level of immunity Lice: Gliricola porcelli and Gyropus ovalis - common but clinical signs related more to debilitation or poor mobility

Answer 135

Chronic inflammation or swelling of palmar or plantar pads Risk factors: obesity, substrate/floor surface, lack of ability to move properly Can become infected and affect underlying tendons/bone Pressure related ischaemia causes the lesions. Analgesia, correct husbandry problems, surgery/dressings may be indicated Consider use of drugs that will improve blood flow to the area - pentoxyfylline

Answer 136

Fur matting - lack of grooming/lack of ability to dust bathe in chinchillas, length/type of fur in guinea pigs Barbering - overcrowding/stress related behaviours

Answer 137

Fur-slip = predator avoidance mechanism in chinchillas: large patches of fur can be released during handling to leave a smooth clear area of skin, may require several months to regrow, no treatment required Tail slip = predator avoidance mechanism in degus: degloving injury to distal end of tail during rough handling, tail will require amputation

Answer 138

Often around base of penis leading to paraphimosis - sedation and removal of the ring of fur is required Can also occur around digits - may be human hair or hair from another pet, not just from that animal - the hair constricts around the appendage, affecting blood flow and venous return causing swelling and pain - will often resolve once the ring is removed, although severe cases may require amputation

Answer 139

Primarily Trichophyton mentagraphytes Less commonly Microsporum canis or Microsporum gypseum Zoonotic Often see focal alopecia with scaling but subclinical carriers are common Fomites can remain infective Young or immune compromised animals more likely to develop clinical signs - generally not pruritic unless concurrent bacterial skin disease Culture required for specific diagnosis Topical or parenteral treatment with itraconazole, terbinafine, enilconazole Clipping and using lime-sulphur dips NB environmental decontamination - bleach

Answer 140

Common in guinea pigs (>1/3 of adult females) and other rodents May not cause clinical signs Can cause bilateral symmetrical alopecia - non-pruritic, underlying skin appears normal, hairs easily epilated Can be large enough to impact breathing and gut function - anorexia may be the presenting signs 3 types - follicular, luteal (commonest) or parovarian (rare) hCG is a common treatment but often fails Percutaneous drainage is reported Surgery likely to be required to resolve the condition

Answer 141

Ovarian cysts Pyometra Pregnancy toxaemia Uterine torsion

Answer 142

2 forms: metabolic and circulatory Metabolic form: - obese females - foetal growth demands put them into negative energy balance so fat is mobilised for use as energy source - fluid therapy, glucose, nutritional supplementation may help Circulatory form: - due to uteroplacental ischaemia - size of uterus compresses blood vessels - rapidly fatal - emergency - c-section/OVH may be only option

Answer 143

``` Acute pain Shock Lateral recumbency Dyspnoea Seizures ```

Answer 144

Guinea pigs lack L-gulonolactone oxidase so cannot synthesise vitamin C -> depend on dietary intake Require 10mg/kg/day for maintenance and 30mg/kg/day during pregnancy or if unwell Hypovitaminosis C reduces resistance to disease and can cause dental disease, swollen joints, lameness, poor fur condition, delayed wound healing Oral supplementation may be required - avoid supplementation in water as rapidly decomposes and can reduce water intake.

Answer 145

Most calculi in guinea pigs are calcium based (so are radiopaque) Common in older guinea pigs and especially in guinea pigs kept indoors - correlation to FLUTD in cats? Also correlated with bacterial cystitis - perhaps more of a management issue? Pain on urination, haematuria, palpable stones, urine scalding, anorexia Depending on location and size, either surgical or medical treatment Recurrence is common and environmental issues need to be addressed

Answer 146

Very common Can be very frustrating to treat Often related to crystalluria but not always - see also interstitial cystitis Animals generally well but vocalise when voiding urine, then immediately go back to normal Herbivores have high calcium load in alkaline urine, and this urine cannot be acidified but oral medications can affect how soluble the calcium salts are Analgesia alongside potassium citrate and hydrochlorothiazide - to keep animal passing dilute urine can help

Answer 147

Very common in guinea pigs - related to unwillingness to void urine Haematuria, abdominal discomfort, anorexia, generally unwell Bladder lining is so inflamed that when the bladder fills the lining becomes discontinuous and urine can contact the underlying smooth muscle causing even more inflammation Very painful condition and difficult to resolve Antibiotics, NSAIDs, glucosamine, pentosan polysulphate, type A proanthocyanidins (cranberry extract) and correction of environmental factors

Answer 148

Lymphoma in guinea pigs: - relatively common - generalised lymphadenopathy, weight loss - often in younger guinea pigs - chemotherapy reported but generally not well tolerated Liposarcoma in guinea pigs: - multiple masses under the skin - differentiate from lipomas and abcesses- - local recurrence after removal, not malignant Fibrosarcoma in degus: - often on/around hindlimbs and can become large rapidly, making removal challenging - local recurrence and invasion a feature and confounding factor - thought to be from a related group of animals originally

Answer 149

Weight loss Poor hair coat PU/PD Soft faeces Appetite may not be increased and may even be reduced Thyroid gland may be palpable Transdermal and oral liquid methimazole are both good options for treatment Thyroidectomy possible but risk of calcium metabolism issues post-op if parathyroid glands are damaged Eventually thyroid tumours may become malignant

Answer 150

Guinea pigs, chinchillas and degus PU/PD Good appetite but weight loss Glucosuria (may only be seen in acute stages, may normalise in chronic disease) Hyperglycaemia May see cataracts Related to their relative inability to deal with simple carbohydrates in the diet Treatment: dietary correction, oral hypoglycaemics, potentially insulin therapy - will need ongoing monitoring and may not result in stabilisation NB hystricomorph insulin is less biologically active than other mammalian insulin but they have more insulin receptors so insulin therapy can be very unpredictable

Answer 151

Older guinea pig boars Cloacal area becomes filled with normal faecal pellets May be related to reduction in testosterone Lining of cloaca produces white, strongly smelling discharge which increases with age Boars on a high carbohydrate/low fibre diet may be predisposed Manual removal advocated

Answer 152

Streptococcus zooepidemicus causes caseous masses in intermandibular space Removal or marsupialisation is necessary

Answer 153

Rats, mice, hamsters, gerbils Much less specialised guts (except hamsters!) Omnivorous Incisors grow constantly, cheek teeth don’t

Answer 154

Relatively rare in rats/mice due to more simple gut physiology Hamsters more prone - tend to cache food and this can become spoiled, have a more complex gut physiology Increased frequency of defaecation, production of liquid faeces/diarrhoea Risk factors: stress and overcrowding Lethargic, perineal soiling (wet tail), anorexia, weight loss, hunched posture

Answer 155

C difficile – use of inappropriate antibiotic (PLACE antibiotics)

Answer 156

Most commonly Lawsonia intracellularis: - obligate gram negative intracellular bacterium - causes proliferative ileitis - hamsters <5wo are most prone, appear to develop immunity after 12wo - fluids, supported feeding, analgesics (opiates) - risk of intussusception, rectal prolapse if gut motility severely affected Ddx: Clostridium piliforme, Clostridium difficile, E.coli, Campylobacter, Salmonella

Answer 157

Usually used to store food in evaginations of lateral buccal mucosa Can become impacted or everted Diagnosis by examination (GA may be needed) - NB cheek pouches can be massive in comparison to body size May be related to overfeeding, feeding incorrectly, dental disease Manual removal of impacted material and flushing if impacted Change feeding practices Manual reduction of pouch eversions (if tissue viable) with stay sutures placed to keep pouch in correct position

Answer 158

Acute bacterial pneumonia Can be commensals of nasopharynx Usually secondary to immunosuppression/concurrent infection e.g. Mycoplasmosis Laboured breathing, sneezing, oculonasal discharge, head tilt, lethargy, cyanosis, porphyrin staining Chest radiography indicates lung consolidation Serology available for C.Kutscheri Often require oxygen therapy and supportive care, antibiotics are indicated Improve husbandry and reduce stress

Answer 159

Mycoplasma pulmonis Certain strains of rat are genetically predisposed Risk factors: ventilation, hygiene, stress, nutrition Respiratory signs - similar to COPD May also see otitis media, torticollis and reproductive disease Primary lesion is subacute chronic bronchitis Chronic inflammation and hypersecretion of mucus, poor mucociliary clearance contribute to clinical signs Biofilm is produced protecting the mycoplasms from host defences and most antibiotics

Answer 160

Oxygen therapy if very dyspnoeic - will often also need fluids/support feeding NB antibiotics will NOT eliminate infection Doxycycline - immunomodulatory properties and is secreted by respiratory epithelium Enrofloxacin, tylosin, azithromycin all suitable Decongestants/mucolytics are helpful to break down mucus hypersecretion and overcome biofilm Corticosteroids Nebulisation with hypertonic saline +/- other agents

Answer 161

Gram negative organism that is hard to culture Implicated in chronic respiratory disease of rats where mycoplasmas have been ruled out Horizontal and vertical transmission Mucopurulent bronchopneumonia progressing to bronchiolectasis Can be either a sole, or a contributory pathogen

Answer 162

Dermatophytosis - Trichophyton spp and Microsporum spp Ectoparasitosis - lice, mites and fleas Bacterial dermatitis Abscesses -bite wounds, trauma, immunosuppression Neoplasia - tends to be benign in rats and malignant in mice Ring tail in rats/mice/gerbils - due to low humidity Tail slip in gerbils/rats - improper handling Nasal dermatitis in gerbils and hamsters Barbering - dominant animal usually, but removing the individual only helps for a while

Answer 163

Scent glands - can become infected, hyperplastic and neoplastic Hamster polyomavirus (HaPV) - transmitted via urine, juveniles get mesenteric lymphoma that metastasises, older animals develop epitheliomas (epitheliotrophic lymphoma) Hormonal skin disease related to HAC: - thin skin, hyperpigmentation, bilateral symmetrical alopecia - lesions often in adrenal cortex so overproduction of mineralocorticoids - PU/PD and change in shape of abdomen - treatment can be difficult due to size of animal and risks of side effects with trilostane - use of the injectable medication may be promising if dose can be accurately titrated

Answer 164

Lice - Polyplax spinulosa, P.serrata Fleas - Ctenocephalides felis, Xenopsyllus spp Mites - Demodex merone, D.criceti, D.musculi, D.ratticola, Notoedres notoedres, Notoedres muris, Notoedres cati, Sarcoptes scabiei (var cuniculi) Trixacarus caviae, Liponyssoides sanguineus, Ornithonyssus bacoti, Dermanyssus gallinae In most cases, host and parasite should be in balance Parasitic infestations generally a reflection of stress (physical and psychological), environmental inadequacies and potentially nutritional deficiency

Answer 165

Endoparasites rarely cause problems in rodents Protozoa: Giardia muris, Tritrichomonas muris, Spironucleus muris Cryptosporidium spp Nematodes: - rarely if ever cause clinical disease - various species of pinworms may be noted: Sylphacia obvelata can cause tail base pruritis and mutilation in many species of rodents Cestodes - clinical disease is rare - Hymenolepsis diminuta (rat tapeworm) and R.nana (dwarf tapeworm)

Answer 166

Pyometra - hamsters, see vulval discharge, usually open, abdominal distension and may have more systemic signs of illness, treatment is ovariohysterectomy Hydrometra and mucometra recognised in mice Dystocia - not uncommon in many rodent species, c- sections are possible but NB interference may lead to cannibalism Cannibalism - seen in many rodent species, associated with post birth stress/disturbance Infertility - may be noted in breeding colonies, can be associated with cystic ovaries

Answer 167

High incidence in females >2 years 12-20 months of age- incidence is 47% in gerbils Abdominal distension, bilateral symmetrical alopecia, weight loss and anorexia, infertility Diagnosis presumptive on palpation (NB cannot rule out neoplasia) Ideal treatment = ovariohysterectomy HCG can be effective in some cases Percutaneous decompression can be tried but cysts usually refill fairly rapidly

Answer 168

``` Common presentation in many rodents Urine can pool in the vaginal vault, so production of blood stained urine will occur if the blood is of uterine or urinary origin Differentials: - cystitis (bacterial less common, interstitial) - urolithiasis (hamsters and rats) - uterine varices - uterine neoplasia - renal neoplasia ```

Answer 169

12 mammary glands within mammary chain Commonest tumours in rats Fibroadenoma or adenocarcinoma Females >1yo Can also occur in males, rats on high fat diets, associated with pituitary tumours All rats with mammary tumours have elevated levels of prolactin regardless of whether the pituitary involved - oestrogen stimulates prolactin secretion, prolactin levels are also elevated in older rats of both genders Early neutering of females can reduce risk, and neutering at time of mass removal reduces risk/rate of recurrence due to reduced oestrogen stimulation Cabergoline, deslorelin and leuprolide are suggested treatments, tamoxifen only with diagnosis of oestrogen receptor exhibiting adenocarcinoma

Answer 170

Pituitary adenomas Also known as chromophobe tumours Hypersecrete prolactin so often associated with mammary neoplasia or abnormal lactation Tamoxifen suppresses prolactin secretion and cabergoline is a prolactin inhibitor May also be bilateral exophthalmus and neurological signs as disease progresses Tumours can be induced by oestrogen NB not all mammary tumours in rats are associated with pituitary tumours, but in these cases prolactin levels will still be elevated

Answer 171

Bunyaviridae Zoonotic - direct contact with rodents or contact with urine/droppings Do not cause disease in rodents Primarily carried by wild rodents but infection/exposure has been proven in UK pet rat population Can lead to Hantavirus Pulmonary Syndrome (HPS) (Sin Nombre virus- New World) Old World (Seoul) hantavirus can cause Haemorrhagic Fever with Renal Syndrome (HFRS)

Answer 172

Arenavirus Zoonotic - exposure to urine, droppings, saliva or fomites from infected rodents can lead to infection Owners of pet mice or hamsters from infected colonies at risk of infection, otherwise wild rodents are more of a risk Can be asymptomatic in humans or mild febrile illness Severe forms result in a febrile illness 8-13 days after exposure, followed by a short recovery period then a relapse into fever associated with neurological signs Most humans recover

Answer 173

Rodents, esp. rats, are reservoir for Leptospirosis Weils disease can cause renal damage, meningitis, liver failure, respiratory distress and death Spread via urine from infected rats Can survive for long periods in soil or water courses Pets can be asymptomatic and shed bacteria in urine intermittently Pets are usually infected by contact with wild rodents - directly or indirectly but are not a major source of disease

Answer 174

Porphyrin pigmented tears secreted by Harderian gland Fluoresce under Woods Lamp Risk factors: stress, overcrowding, poor husbandry, underlying disease (mycoplasmosis, SDAV) May also see laboured breathing or anorexia, poor hair coat due to reduced grooming - all result of underlying disease not the condition itself Symptom rather than a specific disease - needs investigation Improve husbandry and minimise stress whilst treatments/diagnostics are ongoing

Answer 175

Obligate carnivore Rapid gut transit time (2.5-3h) Fat main energy source >20% (Arachidonic acid) Protein 35-40% (Taurine) Poor utilisation of CHO and fibre not digested well Good quality dry ferret food (dry cat food in emergency) Food intake increases 30% in winter Some owners feed fresh carcass

Answer 176

<2yo or stressed/sick/diet change Faecal-oral infection to kits from older ferrets D+, V+, abdo pain, chronic gastritis, duodenitis, melaena, mesenteric lymphadenopathy, anaemia Stress may precipitate ulcer formation Chronic infection may result in development of gastric adenocarcinoma or gastric mucosa - associated lymphoid tissue lymphoma Diagnosis – Silver staining to visualise organism – Serologic assay – PCR on gastric swab PLUS gastric biopsies Treatment – Ranitidine, Omeprazole – ABs (Metronidazole, Amoxicillin)

Answer 177

``` Epizootic Cattarhal Enteritis – Green slime disaese – 48-72 hour incubation period – V+, green/mucoid d+, weight loss – More severe in older ferrets – Supportive care, broad spectrum ABs, GI protectant, quarantine Ferret Systemic Coronavirus (FIP) – mutated form of Coronavirus – Granulomatous form – Diarrhoea, weight loss, lethargy, anorexia and hindlimb weakness – Splenomegaly, Mesenteric lymphadenopathy, pyrexia – Ddx Lymphoma – Hypergammaglobulinaemia – Young Ferrets (c. 11 mo) – Survival 2 mo ```

Answer 178

Lawsonia intracellular Usually younger ferrets, proliferative bowel Chloramphenicol 14-21 days

Answer 179

Salmonellosis - profuse diarrhoea Campylobacteriosis - mucoid bloody diarrhoea, weanlings, asymptomatic carriers can occur, erythromycin? Colibacillosis - food borne diarrhoea Giardiasis - potentially zoonotic Cryptosporidium parvum Coccidiosis - Eimeria, lethargy, diarrhoea and wasting GI nematodes - Toxascaris leonina, Dipylidium cancinum, Ancylostoma spp

Answer 180

Spring/summer

Answer 181

Bite wounds - secondary to mating or territorial disputes Alopecia - endocrinopathy, neoplasia, barbering, parasites Wounds Allergy Contact dermatitis Dermatophytosis - Microsporum canis (Trichophyton mentagrophytes) Bacterial pyoderma Distemper

Answer 182

``` Sarcoptes scabiei Lynxacarus mustelae - facial fur mite, kits, immunosuppresion Demodex Otodectes cynotis Ticks, fleas, myiasis ```

Answer 183

Jills are seasonal polyoestrus Come into season in Spring (Feb-March) Induced ovulatory - ovulate 30-40h post mating Unmated jills remain in oestrus for prolonged period (up to 6 months) - 50% develop aplastic anaemia Signs: swollen vulva, pale mucous membranes Prevented by neutering Treatment - 'jill jab' proligestone or hCG, blood transfusion

Answer 184

Aetiology - genetics, indoor housing/photoperiod, neutering On average 3.4 years post neutering Zona reticularis - elevated androgen hormones (hyperandrogegism) - androstenedione, 17ahydroxyprogesterone and oestrodiol

Answer 185

Stimulus is increasing day length Regulated by melatonin produced by pineal gland Longer days -> less melatonin -> GnRH production by hypothalamus

Answer 186

Normally: hypothalamus produces GnRH -> pituitary gland produces FSH and LH -> Gonads produce testosterone/oestrogen with negative feedback on pituitary Removal of gonads stops the negative feedback More FSH and LH produced by pituitary gland -> hyperplasia/neoplasia of adrenal gland -> production of androgens from ZR of adrenal gland -> clinical signs of adrenal disease

Answer 187

Adrenal hyperplasia -> adenoma -> adenocarcinoma ``` Androgen stimulation Bilateral symmetrical alopecia - seasonal, cranially progressive Pruritus (25%) Behaviour change/aggression Vulval swelling - elevated oestradiol Gynaceomastia Prostateomegaly -> dysuria ```

Answer 188

History and clinical signs Serum adrenal panel: - oestradiol, androstenedione, 17 hydroxyprogesterone - doesn’t distinguish between ovarian remnant as hormones identical - can have false negatives Radiography usually unremarkable - prostatomegaly - useful preoperative information and for concurrent conditions eg heart disease Abdominal ultrasound - adrenomegaly - 85% unilateral: 15% bilateral - can identify ovarian remnant as primary DDX - abdominal palpation if adrenal gland very large ACTH stim/L/HDDS not diagnostic Treatment Trial?

Answer 189

Exploratory surgery: - Gold standard - Concurrent insulinomas common so measure glucose esp perioperatively - Rule out ovarian remnant - Remove left adrenal gland if affected - Debulk right adrenal gland if affected (attached to caudal vena cava) GnRH analogue: - Leuprolide Acetate (Lupron) monthly (GnRH superagonist) - Deslorelin (Suprelorin) implant - In early stages of disease - Less effective once disease advanced/neoplastic - Following left side adrenalectomy to prevent contralateral disease - Surge of hormones for 2 weeks - NB Don’t inhibit tumour growth Melatonin

Answer 190

Outdoors Alternatives to neutering: - Deslorelin in spring: GnRH agonist implant every 12-24 months, licensed, surge of hormones 14d following implant - Proligestone ('Jill jab'): when comes into season in spring, single dose, pyometra risk nay require more doses if early season or warm autumn - owner observation important - Buserelin: GnRH agonist, induces ovulation and pseudopregnancy and return to season after 1-2mo - Vasectomised hob: mating is violent and goblets smell like entire hobs, care re sharing teaser hobs

Answer 191

Castration Implant with suprelorin - lasts 4 years Neuter +/- implant at same time (re adrenal disease)

Answer 192

``` B cell tumours - adenoma or adenocarcinoma Dietary and genetic factors Often males, 4-6yo Clinical signs: - hindlimb weakness/ataxia - stargazing - dull - seizures - may resolve following meal - collapse - salivation/pawing at mouth (nausea) ```

Answer 193

Diagnosis: - Persistent hypoglycaemia (BG<3.4) after withholding food for 4 hours - Combined with appropriate clinical signs - Can assay insulin - ALT elevated Treatment: - Emergency stabilisation: glucose - Surgical: nodulectomy and/or partial pancreatectomy - Medical: prednisolone for gluconeogenesis, diazoxide to inhibit insulin release - Dietary adjunctive: meals high in fat and protein, no simple sugars

Answer 194

Dilated, spherical left ventricular chamber with thin walls, depressed wall motion and variable degrees of left atrial enlargement Right atrium and ventricle may also be affected NOT related to taurine deficiency in ferrets Diagnosis: echocardiography Treatment: pimobendan could be considered even when asymptomatic

Answer 195

Left ventricular hypertrophic cardiomyopathy - Small or normal left ventricular chamber size - Normal or hyperdynamic left ventricular wall motion Restrictive cardiomyopathy - Significant left or bilateral atrial enlargement - Normal left ventricle thickness and contractility Treatment - Neither are amenable to treatment with positive inotropes - No additional capacity to increase force of cardiac contraction - Symptomatic treatment of CHF

Answer 196

Thickening of heart valves and regurgitation at one or more valves Commonest echocardiographic finding in ferrets Aortic valve > mitral Aortic insufficiency may not be clinically significant but -> CHF, particularly if mitral valve is affected concurrently Diagnosis - heart murmur, arrhythmias, gallop rhythms and adventitious lung sounds, echocardiography

Answer 197

``` Dirofilaria immitis (Heart Worm) - Vector borne intravascular parasite that sits in the pulmonary arteries, right hand side of the heart and the vena cava - Often decompensate rapidly: dyspnoea, pallor, severe lethargy and exercise intolerance, heart murmur audible Angiostrongylus vasorum (Lungworm) ```

Answer 198

Orthomyxoviridae -strains of human flu virus A and B are infectious to ferrets Anthroponotic and zoonotic Causes mainly URT signs - lethargy, sneezing, pyrexia, nasal discharge, conjunctivitis In neonates can cause bronchiolitis and pneumonia 7-14 day clinical course Supportive care will be required (fluids, feeding), antibiosis only if secondary bacterial infection

Answer 199

``` Canine distemper virus Paramyxovirus (morbillivirus) Most canids and mustelids are susceptible - up to 100% mortality Airborne/droplet exposure, contact with urine/faeces Catarrhal phase (may not always occur) followed by neurological phase Clinical signs: - Photosensitivity - Anorexia - Pyrexia - Serous -> mucopurulent oculonasal discharge - Ataxia, tremors and paralysis - Hyperkeratosis of foot pads - Erythema/chin lesion - Death can occur in as little as 12 hours Diagnosis: - IFA testing available - clinical signs - panleucopenia - PM - serum Ab titres Treatment - No specific treatment - Supportive care - 100% mortality rate - Vaccination ```

Answer 200

Highly infectious parvovirus (wild mink possible reservoir) 2-4yo Immune complex mediated disorder Clinical signs: - Multiple organ failure - Progressive weight loss, weakness, hepatomegaly, and splenomegaly, renal failure, posterior ataxia, mild incoordination, ascending paresis, tremors, paraplegia - NB Asymptmatic carriers shed virus in faeces Diagnosis: - Severe hypergammaglobulinemia most consistent finding - Positive antibody titre - Serology: ELISA - NB posiive titres in some clinically normal ferrets - PCR Treatment - No specific treatment - Anti-inflammatories and immunosuppresants e.g. prednisolone and cyclophosphamide - Melatonin: immune modulation & anti-oxidant Vaccination? - Immune mediated disease so contraindicated

Answer 201

1. insulinoma 2. adrenal gland disease 3. lymphoma

Answer 202

Juvenile form more aggressive (<2yo) - lymphoblastic form: often initial focus thymus, respiratroy signs (mediastinal mass) Non specific clinical signs in adults (5-7 yo) - Lymphocytic form - Insidious onset - Malaise, inappetance, weight loss - Enlarged peripheral or internal lymph nodes - Multicentric or gastrointestinal Diagnosis: - Infectious agent? (Clusters) FeLV/ADV - Immunophenotyping (T Vs B) - Staging (1-5), A (no clinical signs) or B (Clinical signs) - Helicobacter assoc with gastric lymphoma - Haematology - Diagnostic imaging - FNA/excisional biopsy of lymph node - Bone marrow biopsy - Chemotherapy protocols - Palliative treatment - poor long term prognosis but some good results possible in early stage disease with chemotherapy

Answer 203

``` Common finding Extra hepatic haematopoiesis Chronic inflammation Neoplasia Tranient splenomegaly by certain anaesthetic agents ```

Answer 204

Imidacloprid/Moxidectin Fipronil-S-methoprene Rarely get pathogenic burdens of endoparasites and routine treatment not warranted

Answer 205

Very high in carbohydrates

Answer 206

``` Air sacs Rigid lungs Internal gonads Single ovary (usually left) No urinary bladder Fused vertebrae No teeth Proventriculus - secretory portion of stomach Ventriculus - muscular, grinding portion of stomach ```

Answer 207

Common in captive birds (grey parrots), wildlife during rehabilitation (wood pigeons, collared doves) or cockatiels that are chronic layers Signs: - muscle fasciculations and weakness - tremors - seizures - pathological fractures - bone growth deformities Causes: - dietary (lack of calcium, excess phosphorus, hypovitaminosis D, hypervitaminosis A and E) - secondary to lack of UV light - related to chronic egg laying Diagnosis: bloods to check total and ionised Ca Treatment: - oral (calcium gubionate) or parenteral (calcium gluconate) supplementation - correct underlying cause - UVB supplementation (MUST be a specific bird light) - dietary changes may take a significant amount of time and can be frustrating

Answer 208

``` Caused by metabolic changes -> excessive accumulation of triglycerides in liver -> cholestasis and hepatic dysfunction Risk factors: - high fat - high protein diet - overfeeding of neonates - multinutrient deficient diet - reduced exercise - hereditary factors - active egg-laying - diabetes mellitus stress (catecholamine release) - thyroid disease obesity Clinical signs: often non-specific related to: - liver size (eg dyspnoea) - poor liver function (hepatic encephalopathy, poor feather production) - general sick bird (anorexia, weakness) ```

Answer 209

Biochemistry: - hepatocellular damage - reduced hepatic function - cholestasis - serum will often be lipaemic Diagnosis: radiography or endoscopy will confirm and refine diagnosis Treatment: - improve nutritional status of patient - develop plan for weight loss - improve liver function (SAMe, ursodeoxycholate) - treat any secondary conditions identified - nutritional supplements eg vitamin B complex, E and K, choline and methionine (lipotrophic factors), L- carnitine

Answer 210

Pancreas no longer produces insulin or peripheral tissues become resistant - hyperglycaemia in raptors Psittacines - elevated blood glucose is related to overproduction of glucagon Signs: - glucosuria - hyperglycaemia - polydipsia/polyuria - weight loss despite good appetite - increased susceptibility to infections Diagnosis: - persistent hyperglycaemia - glucosuria - glucagon levels can be tested but challenging - ?fructosamine levels Treatment: - low carbohydrate diet - provide enough exogenous insulin to override the effects of the glucagon over-production (serious risk of hypoglycaemia however) - oral insulin dosing has been suggested - oral hypoglycaemics such as glipizide or metformin can be tried, and may be safer There are reports of spontaneous recovery.

Answer 211

Budgerigars Associated with iodine deficiency - treat with iodine supplementation May have palpable goitre

Answer 212

Increased drinking where no other cause is found and where water deprivation testing does not result in concentration of urine

Answer 213

Budgies | See brown hypertrophy of cere and may see lameness in leg on same side (sciatic nerve impingement)

Answer 214

Paired kidneys Uric acid is excretory product - not osmotically active so requires little fluid loss of excretion Poor ability to concentrate urine Partially reptilian and partially mammalian 2 types of nephron: with/without loop of Henle Water retention in tubules, colon and cecae Reflux of urine into colon No urinary bladder Salt glands: extra renal pathway for salt excretion when a bird consumes more NaCl than able to remove via kidneys

Answer 215

PD Increased fluid portion within droppings where there is normal formed faeces - owners may struggle to differentiate from diarrhoea Appetite often affected Weight loss Acute renal failure: suddenly very unwell Chronic renal failure: non specific lower level signs, although articular gout may be noted Diagnosis on clinical chemistries: - less reliable than in mammals: uric acid elevated when glomerular filtration reduced by >80% so uric acid may be normal - urea/creatinine not useful - NB uric acid maybe elevated post-prandially in carnivorous birds - imaging/endoscopy helpful - biopsy for definitive diagnosis Treatment: - fluid therapy - consider ACE-I or angiotensin receptor blockers - dietary modification in species that have a high protein intake - treatment for gout - antibiosis if bacterial infection implicated in acute renal failure

Answer 216

Causes: - period of acute dehydration - high protein diet - renal insufficiency Level of uric acid in blood exceeds solubility threshold -> uric acid crystals deposited on surface and within internal organs (visceral gout) or within joints (articular gout) Blood uric acid levels not always elevated at time of presentation, but with articular gout the lesions are fairly pathognomic Treatment: - initially aggressive fluid therapy and diuresis - dietary modification if necessary - treatment is aimed at slowing down uric acid deposits in articular gout (allopurinol, colchicine, vitamin A, omega 3&6 fatty acids) and treating organ compromise for visceral gout - anti-inflammatories (care with dehydration and renal compromise) and pain management

Answer 217

Single ovary or testis - usually left Ovary -> infundibulum -> magnum -> isthmus -> uterus -> vagina Intromittant organ - ratites, anseriformes Non-intromittnet phallus - domestic fowl Neither - psittaciformes

Answer 218

Secondary to ectopic ovulation (doesn’t always result in coelomitis) - infundibulum of salpinx is not anatomically attached to ovary so ovulated follicles can go astray Ectopic eggs without surrounding clinical signs may resolve without treatment Can become depressed, lethargic with coelomic distension Cystic ovarian disease (follicles are not normally ovulated and remain within the ovary) can also be associated with coelomitis

Answer 219

``` Obstructive dystocia: - egg/maternal disproportion - misshapen eggs - uterine torsion Non-obstructive dystocia: - uterine inertia - hypocalcaemia Often able to diagnose on examination but radiography needed to determine whether size and position of egg will allow oviposition Risk factors: - stress - environmental temperature - nutritional and endocrine abnormalities - disease external to reproductive tract Treatment: - consider manual delivery - ovocentesis - surgical delivery - medical treatment with calcium and oxytocin ```

Answer 220

One every 24-48h dependent on species

Answer 221

= Failure of ovulation Often non-specific presentation - anorexia, depression, perhaps nesting behaviour, caudal coelomic distension Differentials include ovarian neoplasia May be associated with hepatic lipidosis due to constant mobilisation of fat Often see polyostotic hyperostosis radiographically due to continual mobilisation of calcium Diagnosis often endoscopic Treatment: - deslorelin - leuprolide - tamoxifen - HCG - aspiration of follicles, and partial ovariectomy (advanced and complex surgery)

Answer 222

Often pet budgies and cockatiels (also chickens, waterfowl, finches, canaries, lovebirds) Hens lay repeated clutches or more than normal clutch size -> Calcium and energy requirements are high - may be more than hen can cope with Predisposes to egg yolk peritonitis, egg bonding/dystocia, nutritional depletion and osteoporosis/pathological fractures Risk factors: - high levels of nutrition - nesting boxes (areas where hens are comfortable laying eggs) - early removal of eggs (encourages ‘double clutching’) Management: - reduce nutritional levels - remove nesting areas - do not remove eggs once laid (use dummy eggs or cook the eggs) - reduce the day length - remove the ‘mate’ - deslorelin implant - leuprolide - tamoxifen (NB side effects) - HCG - salpingohysterectomy (very difficult surgery)

Answer 223

``` Common sequel to repro disease Causes: - hypocalcaemia - egg production - dystocia - testicular enlargement - constipation - enteritis - cloacal masses - intussusception Need to determine underlying cause, what structures have prolapsed, and whether the tissue is viable May prolapse oviduct, phallus, ureter, intestines, cloacal tissue or abnormal masses Treatment: - viable tissue replaced and anchored in place - bird must be prevented from interfering with the area - underlying causes must be addressed - antibiotics and analegsia/anti-inflammatories often indicated ```

Answer 224

``` Atherosclerosis in Amazon parrots Valvular disease in older birds Congenital defects in juveniles Vegetative endocarditis Pericarditis, pericardial effusion CHF Signs: - respiratory distress - oedema/ascites - syncope - reduced exercise tolerance - may have audible murmur, variable heart rates, pulse deficits, cyanosis Diagnosis: - ECG and chest radiography useful - echocardiography limited by airsacs ```

Answer 225

``` 2 cervical 1 interclavicular 2 cranial thoracic 2 caudal thoracic 2 abdominal ```

Answer 226

``` Facial/nares deformity Periocular swelling Oculonasal discharge Matted feathers around the face Dyspnoea ```

Answer 227

Often chronic and poorly responsive to treatment Nutritional deficiency (hypovitaminosis A), immunosuppression, poor environmental hygiene, chronic mucosal irritation and organisms that are poorly responsive to treatment are common factors Diagnosis on clinical signs, +/- imaging, culture, cytology Treatment can be challenging and long term medications are often required If purulent or granulomatous material present physical removal may be necessary Nebulisation may be helpful in addition to oral medication/flushing

Answer 228

Viral tracheitis Tracheal stenosis - iatrogenic Syringeal damage - leading to alterations in voice Pneumonia affecting lung parenchyma Asthma in macaws Air sacculitis related to fungal disease or irritant inhalation

Answer 229

Inhalation of spores More susceptible: gyr falcons, grey parrots, Pionus parrots, goshawks, red tailed hawks, golden eagles, swans and penguins Risk factors: - stress - immunosuppression - long term corticosteroid use - recent capture from the wild Often carry spores in lungs for prolonged periods - only cause problem when becomes immunosuppressed Often dyspnoea but may be non-specific inappetence, lethargy, reluctance to fly/perch Diagnosis - haematology: monocytosis with heterophilic leukocytosis, occasionally anaemia - biochemistry: usually increased AST, LDH, hypoalbuminaemia, hypergammaglobulinaemia - radiology: may indicate lesions in lungs and airsacs but not very se or sp - endoscopy much better option - serology confirms exposure to spores Treatment: - approx 50% will survive - most require intensive initial stabilisation (O2, fluids, nebulisation, supported feeding) - euthanasia should be discussed early on due to severity of disease and cost/length of treatment required - look for underlying causes and correct these - itraconazole, voriconazole, terbinafine - antibiosis for secondary bacterial infections

Answer 230

Inhalation of fluorinated gas produced when PTFE heated above 240C - cooking, ironing, heat lamps Sudden death a potential Usually present as weak and dyspnoeic Neurological signs are also possible Pulmonary oedema, haemorrhage and necrosis Treatment: - oxygenate and prevent secondary infection - consider diuretics (furosamide) - consider bronchodilators (terbutaline, theophylline) - NSAIDs may be helpful Prognosis depends on level of exposure, but generally poor

Answer 231

``` Signs: seizures, ataxia, paresis, paralysis, tremors, circling, torticollis, head tilt, nystagmus Causes: - hepatic disease - renal disease - hypoglycaemia - trauma - toxicity - nutritional deficiencies - neoplasia - parasitic infection - viral infection - bacterial infection - fungal infection - cardiac disease Stabilisation: - benzodiazepines - levetiracetam - gabapentin - phenobarbital sodium ```

Answer 232

``` Psittacosis Mycoplasmosis Irritants Excessive UV exposure Respiratory disease ```

Answer 233

Can cause squamous metaplasia of conjunctival tissue

Answer 234

Pituitary neoplasia

Answer 235

``` Control active bleeding Fluid therapy/transfusion Nutritional support Analgesia Care with handling - stress/flapping can worsen ```

Answer 236

Very thin skin and easily torn - care with tension of sutures Poor ability to produce granulation tissue to heal by secondary intention Distal appendages have poor soft tissue coverage and blood supply is easily compromised

Answer 237

Light and brittle bones - can make orthopaedics challenging Nutritional deficiency can predispose to pathological fracture Pneumatised bones - fractures of femur/humerus can leave air sacs open/compromised Long term dressings can compromise joint function

Answer 238

Seed diet without supplementation Hyperkeratosis Scaling

Answer 239

Medical vs environmental vs psychogenic aetiology DDX Psittacine Beak and Feather Disease (PBFD) - Circovirus, polyoma virus, PDD Flock birds Boredom Sexual frustration Enrichment essential

Answer 240

Full husbandry and dietary review Full clinical examination Dermatological: mapping skin lesions if present and categorise into primary and secondary lesions, map areas of feather loss Skin cytology/feather plucks Blood sampling- haematology/biochemistries, serology, PCR, heavy metal levels Radiography/endoscopy Decide on both medical and behavioural plans - identify and remove conflict causing the destructive behaviour - modify environment and alter the birds time budgets by providing enrichment - consider desensitisation and behaviour modification - drug therapy is last resort: dopamine antagonsists (haloperidol), opiate receptor blockers (naloxone), tricyclic antidepressants (doxepin, clomipramine), benzodiazepines, anxiolytics, hormone therapy (if associated with breeding birds) Prognosis for full recovery without future intervention is very poor

Answer 241

Wing clipping is psychologically cruel - option of last resort for aggression, NEVER in juvenile psittacines that can’t yet fly properly Collars can be part of a long term care plan for feather plucking Imping = replacing lost/damaged feathers with sterilised feathers moulted from another bird - designed to allow flight and more normal behaviour

Answer 242

``` Knemidocoptes mutans, K. pilae, K. gallinae - scaly leg: poultry, passerines - scaly face: budgies Treatment: - Ivermectin - Topical Petroleum Jelly, Fipronil - Analgesia Dermanyssus gallinae (Red mite) Ornithonyssus spp (Northern fowl mite) Quill mites ```

Answer 243

``` Commonly raptors Also Anseriforms, Psittacines, Galliformes Causes: - often husbandry related - inappropriate perch material/shape - overgrown talons - obesity/inactivity - ontralateral lameness - hypovitaminosis A Grading systems Treatment: - management changes - analgesia/anti-inflammatories/antibiosis - surgery/bandaging ```

Answer 244

Dry gangrene syndrome Affects metacarpus of raptors Typically birds normally found in warmer climates Occurs during winter - triggered by period of cold weather - husbandry related disease Typically birds in their first year - not fully trained and potentially less good blood supply to distal wing Wing - dropped and swollen, cold tip (pitting oedema) Can attempt gentle warming, encouraging wing exercise on the fist, fly bird if able After 1 week, swelling becomes hard and dry Eventually will be areas that slough -> loss of primary feathers and so loss of flight capability Treatment - medication causing vasodilation: isoxuprine, benazepril, topical preparation H - only effective if started BEFORE dry gangrene has set in

Answer 245

Gland present in many but not all species (Hyacinth macaws and Amazon parrots do NOT have preen glands) Usually dorsal pelvis area (pygostyle) Can become impacted with secretions, infected, neoplastic change in the ducts or glands Will usually present as a mass or an area of clumped feathers Bird may peck/pluck the area if there is pain Gland can be removed but has impact on feather and skin health subsequently (particularly waterfowl)

Answer 246

Polyfolliculitis - love birds, follicle resection Xanthomatosis - small Psittaciformes, variable yellow masses on wing & keel, high fat diet, trauma, lipid metabolism derangements, surgical resection Feather cysts - removal of feather follicle Gout tophi - not integumentary but may be confused

Answer 247

Scissor beak = abnormal beak occlusion - congenital or secondary to trauma/disease Traumatic damage/avascular necrosis where germinal tissue suffers direct damage and subsequent keratin production is abnormal Interlamellar necrosis in cockatiels - cause unknown PBFD - virus damages the germinal tissue leading to necrosis and abnormal production of keratin Hepatic disease - implicated in budgies and cockatiels but no pathophysiologic cause determined Brown hypertrophy of the cere - related to excess oestrogen production/reduced testosterone production in male budgies with testicular tumours

Answer 248

``` Trichomoniasis Candidiasis Capillariasis Diphtheritic pox Hypovitaminosis A ```

Answer 249

Crop stasis/sour crop - contents ferment -> toxaemia Crop impaction - crop content is inappropriate and cannot be emptied e.g. crop feeding formula made too thick, ingestion of grass/fibres etc Crop foreign bodies - can prevent emptying or cause pain and crop stasis Crop wounds - from self trauma to the area, if there is underlying disease or secondary to trauma Thermal burns - chicks being hand-reared where the formula is too hot

Answer 250

Evaluate causes and crop function Often crop requires emptying - often needs sedation and endotracheal intubation to prevent aspiration Surgical debridement of wounds/burns 2 layer closure - inverting suture pattern Fluid therapy, easily digestible feeds whilst function is returning Prokinetics in some cases Proventricular feeding

Answer 251

Very non-specific sign Can be behavioural/sexual in nature (mirrors!) In unweaned psittacines can be related to poor feeding practices Birds that regurgitate often shake their heads -> food matter sprays onto their faces/heads

Answer 252

``` Foreign body Parasite burden Torsions Adhesions Strictures Neoplasia Extra-intestinal disease Papillomatous lesions PDD Peritonitis Heavy metal toxicity ```

Answer 253

``` Campylobacter Chlamydophila E.coli Pseudomonas Salmonella Many viral diseases Heavy metal toxicity Dietary change Stress Anorexia Septicaemia ```

Answer 254

Macrorhabdus ornithogaster, Megabacteriosis Progressive wasting in budgies Difficult to treat Associated with stress and overcrowding

Answer 255

Zinc - new cage disease - galvanised metal - absorbed in gut - primary organ that is damaged is pancreas, but can be found in liver, kidney and repro tract Lead - environmental in wildlife - cage toys/furniture in pets - absorbed in gut and retained in soft tissues - causes anaemia, bone marrow suppression, liver damage and CNS oedema Occasionally copper Heavy metal must be in gut to be biologically active (lead shot in muscle doesn't cause toxicity) Birds are depressed, weak, may see vomiting/diarrhoea, PU/PD, anorexia, ataxia, seizures, haemoglobinuria (lead) Treatment: - chelation: Calcium EDTA, D-penicillamine (not if heavy metal still in gut) - supportive care - physical removal of particles - either surgically, by flushing or by use of bulk laxatives

Answer 256

Lactobacillus Corynebacterium Non-haemolytic Streptococci Staphylococcus epidermidis

Answer 257

``` Gram negative pathogens - Klebsiella - Pseudomonas - Enterobacter - Proteus - E.coli - Pasturella - Salmonella Gram positive: - Staph aureus - S.intermedius - Clostridium - Enterococcus - Streptococcus Mycoplasma, Mycobacteriosis and Chlamydophila also important ```

Answer 258

Chlamydophila (Chlamydia) psittaci - obligate intracellular gram positive bacterium Zoonotic (ornithosis in humans) Risk factors: - stress - improper environmental conditions/husbandry - high reproductive activity - exposure to new birds - immunosuppression 3 potential scenarios: - subclinical carriers - clinical disease - chronically infected birds showing neurological signs Often non-specific clinical signs - combo of resp signs with diarrhoea can be a clue Conjunctivitis and choanal slit inflammation may be present Spread by direct contact, respiratory secretions, faeces Enlarged spleen on radiography very suggestive Can attempt culture (3 days pooled faecal sample) but PCR on conjunctival/choanal/cloacal swabs more useful Serology available - only indicates exposure General supportive care will be required Doxycycline - long treatment length Azithromycin, fluroquinolones somewhat effective but may induce carrier state rather than clearing the organism

Answer 259

Mostly M.avium or M.genevense Oral or airborne transmission Clinical signs non-specific: - chronic illness - weight loss - diarrhoea - lameness - poor feathering - on examination may find hepatomegaly, intestinal thickening, subcutaneous or coelomic masses (granulomas) Diagnostics: - inflammatory leukogram, - acid-fast organisms seen within cytology or tissue samples - birds do not form classical tubercle. - PCR is available - culture can be challenging and time consuming Treatment controversial because of zoonotic risk but psittacines shown to pose low risk to humans Combined antibiotic therapy for 6-12 months is required (rifabutin, clarithromycin, ethambutamol, enrofloxacin) Birds with advanced disease have a poor prognosis

Answer 260

M.gallisepticum is economically important disease of poultry Emerging disease in finch populations Respiratory disease and septic arthritis in poultry, waterfowl and pet birds that have come into contact with wild birds/poultry Direct aerosol spread, or fomite spread are both possible Potential cause of chronic sinusitis in psittacines and conjunctivitis in passerines

Answer 261

``` Diarrhoea Multisystemic disease Septicaemia Osteomyelitis Dehydration Lethargy Ileus ```

Answer 262

Clostridium botulinum type C toxins 7 serotypes Primarily seen in waterfowl Causes progressive flaccid paralysis - loss of flight, loss of use of limbs, limberneck/respiratory muscle paralysis Death due to eventual respiratory failure or drowning Triage, removal of source of toxin, supportive care, adsorbents

Answer 263

Orthomyxovirus Most viruses cause subclinical infection with subtle signs such as reduced fertility or respiratory disease H5N1 form causes severe signs or death in wild bird populations Notilifiable

Answer 264

Progressive, often fatal disease affecting ANS relating to gut-myenteric plexus Avian Borna Virus - pathophysiology unclear Incubation 3 weeks to 3 months Many differentials for proventriculus dilatation - lead toxicity, GI foreign bodies, inflammation of gut Can be seen in any species - common in macaws, grey parrots, cockatoos, eclectus - budgies appear resistant Clinical signs: - dilation of proventriculus, generalised ileus, and non-specific neurological signs - undigested seed in faeces, regurgitationand - feather plucking particularly over flanks - may be very thin/cachectic Diagnosis: - PCR on cloacal/pharyngeal swabs - radiographic confirmation of proventricular dilatation (contrast helpful) - histopathology Treatment often unsuccessful - celecoxib - prokinetics (metoclopramide, ranitidine, erythromycin) - amantidine - recombinant interferon Prognosis guarded to poor NB husbandry if a flock, cage/bowl hygiene and biosecurity including proper quarantine procedures

Answer 265

Circovirus Most Psittacine species, passerines and columbiformes Immune suppressive virus - grey parrots get a pancytopenia from bone marrow suppression Virus shed in feathers, dander, faeces and saliva Transmission by ingestion or inhalation Australian psittacines seem to have severe beak and feather lesions Other species from different geographical areas show less severe feather signs (African greys) South American psittacines appear to be more resistant Classic PBFD - lack of powder/feather dander, beak becomes very shiny, abnormal feather formation- clubbed or constricted at the base, feathers easily epilated and grow back slowly or not at all Diagnosis from PCR on faeces, feather pulp, blood Treatment is supportive only, and many birds survive many years with this disease

Answer 266

Papovavirus, budgerigar fledgling disease 7-14d incubation Primarily affects young birds- often acute death of unweaned or recently weaned birds Seen more commonly in UK than USA Adult birds appear resistant but infected adults may seroconvert and shed virus for up to 90 days Chicks presented alive may have crop stasis, ecchymotic haemorrhages subcutaneously, coelomic distention and abnormal feather production Chicks that survive often have chronic feathering abnormalities/dystrophic feathers

Answer 267

Paramyxovirus group 1 (VVND or exotic Newcastle disease) Transmission by Clinical signs: - asymptomaiv -> acute death - non specific - depression, anorexia, weight loss, bright green diarrhoea - resp - sneezing, conjuncitivis, oculonasal discharge - neurological - Add from slides

Answer 268

Systemic Pachecos disease - peracute signs, high mortality Papillomas in birds that survive Epithelial hyperplasia Can arise from skin, mucous membranes and glandular ducts (liver, pancreas, intestines) Appearance is typical and MM papillomas will blanch if acetic acid is applied May be associated with development of squamous cell carcinomas as well as biliary, hepatic, intestinal and pancreatic carcinomas Diagnosis by histopathology, and lesions that are related e.g. to cloaca prolapse or affect normal function should be removed Birds with internal lesions have a poorer prognosis and a reduced life expectancy

Answer 269

Environmental factors - UV light exposure and melanoma, SCC Viruses - papillomatosis Diagnosis - clinical exam, imaging, cytology, histopathology of biopsy Treatment: - NSAIDs palliatively - intralesional chemotherapy - radiotherapy can be hard to access - radical excisions surgery most likely treatment to give good results

Answer 270

``` Dehydration Loss of muscle mass Nutritional deficiencies Crop/GI stasis Weakness Anaemia ```

Answer 271

Pain Systemic disease Poor sight Normal hormonal activity Neurological disease Frustration from inappropriate pair-bonding with human Inadvertant positive reinforcement of aggressive behaviours

Answer 272

Abnormal body/head position Suggests normal CNS function inhibited A symptom not a disease- e.g. Inclusion body disease, organophosphate toxicity, trauma, excessively high or low body temperature, bacterial meningitis May be associated with difficulty moving, disorientation, depression, tremors, seizures and lack of adequate righting reflex Diagnostics: bloods, and potentially advanced imaging

Answer 273

Suggests discontinuity of spinal cord's ability yo transmit neural impulses or an inability of the muscles to respond Trauma, spinal osteoarthropathy, spinal mycobacteriosis

Answer 274

Unable to raise head | Unable to constrict when stimulated

Answer 275

``` Improper light cycles Improper hibernation Improper temperature gradients Iodine toxicity/deficiency Intrinsic thyroid disease Signs of hyperthyroidism: - abnormally frequent sheds Signs of hypothyroidism: - weight ain - lethargy - poor appetite - depression - dysecdesis - goitre - myxoedema ```

Answer 276

4-6 times a year (dependent on age)

Answer 277

``` = Failure to shed full skin normally Poor humidity Low ambient temperatures Incorrect periodicity Hypovitaminosis A, Mites Thyroid disease Dermatitis Trauma Incorrect handling (especially when snake is about to shed) resulting in damage to fracture plane Bacterial, fungal and viral disease - systemic or dermal ```

Answer 278

Correct underlying problems Place snake in warm damp environment with something that is gently abrasive - warm/damp towel Apply topical antimicrobials to any areas of skin damage Parenteral treatment if deeper structures involved

Answer 279

Specialised scales over eyes often not fully shed even if rest of shed appears normal Eyes appear wrinkled and opaque Requires careful treatment as sensitive secondary spectacles/cornea underneath can easily become damaged Damage to spectacle can lead to infection and subspectacular abscesses, and this may be associated with bacterial stomatitis Use wetting solution (hypromellose/lacrilube) for few days to increase local humidity around these scales, then can usually gently encourage off by grasping edge with fine forceps

Answer 280

Poor dermal perception of heat - often don’t recognise they are at risk of burning until burns have occurred Often secondary to inadequate ambient temperatures - so th snake is generally cold, with provision of focal heat sources such as ‘Hot Rocks’ or unguarded lamps Animal is cold so its heat perception will be very poor, and it will also actively seek to increase its body temperature Burns may not become evident immediately and are often identified after a shed - areas are open, ooze serum and and can easily become infected Analgesia, potentially debridement of area, topical and systemic antibiosis Cling film, condoms and proprietary clear dressings can all be used to protect the areas while they heal

Answer 281

Dermatitis/bacterial skin infection - leads to blisters under scales NB fungal skin disease can also cause blisters Areas are discoloured and fluid filled - may rupture leaving ulceration Associated with poor environmental hygiene and immunosuppression Culture fluid from blisters, correct environment and provide appropriate antibiosis - often Pseudomonas, Aeromonas, Citrobacter Look for other causes of immunosuppression - underlying systemic disease or management related Topical treatment (eg silversulphadiazine) and systemic antibiotics

Answer 282

Ophionyssus natricis parasitic mites Blood feeders - puncture skin and engorge with blood Skin damage can lead to irritation/pain Can spread bacterial or viral infection- e.g. Pseudomonas or Inclusion body disease Environmental treatment - remove anything porous (e.g. wood, bark etc) and deep clean everything else, use newspaper for substrate until mites are controlled Bathing/submerging in water will kill mites, or Fipronil Predatory mites - Hypoapsis mites will eat the parasitic mites - much less potentially toxic Treatment needs to be prolonged due to length of mite life cycle - 40 days minimum

Answer 283

‘Mouth Rot’ Usually a symptom of systemic infection and immunosuppression Animal becomes unable to keep the bacteria normally present in mouth under control signs: loss of appetite, red, swollen oral tissues, pus within mouth, discharge from mouth and nose Infection often spreads to the GIT or lungs Risk factors: poor husbandry (hygiene/temperatures), oral injury Diagnosis on examination Physical cleaning/debridement of damaged tissues and parenteral antibiotics Correct underlying husbandry concerns

Answer 284

Can be behavioural: - preparing to hibernate - preparing to breed Can be secondary to improper environment: - lack of hide boxes - temperatures too high or too low - food presented poorly - wrong food presented Can be due to systemic disease Animals that are anorexic because of breeding or brumation will not lose very much weight (<7% BW) during expected time course of behavioural change Once the anorexia exceeds the expected timeline or the weight loss becomes significant then intervention is required

Answer 285

Secondary to handling/upset soon after feeding Inappropriate environmental temperatures Reaction to inappropriate food intake/spoiled food GI blockage - most likely rostral portions of gut Common sign of cryptosporidiosis Also associated with Chlamydophila, IBD, amoebiasis, metabolic disease such as renal or hepatic insufficiency May be associated with weight loss, but fluid balance and electrolyte abnormalities are less likely Correct husbandry, rehydration therapy if needed, diagnose and treat specific cause

Answer 286

Cryptosporidium serpentis Causes gastric hypertrophy -> visible abdominal swelling and regurgitation of typically mucus covered prey - may be sporadic Weight loss Oro-faecal transmission Can get subclinical shedders and non-ophidian reptiles can be carriers Oocysts very resistant in environment - 5% ammonia and formol saline are effective Diagnosis: - can visualise oocysts in faeces (acid fast) but shedding is intermittent - stomach washes may be more likely to demonstrate organisms - serology available but not specific for C.serpentis - histopathology is the gold standard Treatment and prevention of spread: - supportive care may be helpful in short term but few helpful medications - hyperimmune bovine serum (to C parvum) may help - euthanasia should be considered - good hygiene is key to stop spread within collection - euthanase positive snakes - maintain a closed collection - test food and water courses for presence of Cryptosporidia - quarantine and test any snakes being brought into collection

Answer 287

Entamoeba invadens -- commensal in herbivorous reptiles but can invade intestinal mucosa and cause disease in carnivorous reptiles High morbidity/mortality Mixed collections are risk factor - especially if poor husbandry and inadequate quarantine Direct lifecycle Poor body condition/muscle tone, anorexia, regurgitation, constipation/diarrhoea Can see neurological signs Diagnosis on cloacal wash cytology - but more usually histopathology Treatment - metronidazole every 2-3 days if clinically ill, every 10-14 days if just exposed

Answer 288

``` Commonly cultured bacteria: - Pseudomonas - Klebsiella - Proteus - E.coli - Aeromonas - Morganella morganii - Citrobacter freundii - Pasturella spp Chlamydophila, Mycobacteria, Mycoplasma, Salmonella IBD, paramyxovirus, Reovirus also cause pneumonia ```

Answer 289

Oral discharge, gaping, gular excursion and orthopnoea position, anorexia, weight loss Diagnosis: - culture and sensitivity of lung wash - culture of organisms from mouth is not diagnostic - endoscopic evaluation to visualise, clear discharge and biopsy lesions Oxygen therapy, warm towards POTZ, fluids, appropriate antibiosis, suction of excess secretions from oral cavity

Answer 290

Inability to retract phallus or hemipenes Seen commonly in ball pythons and boa constrictors, as well as many chelonians Risk factors: - spinal trauma - nutritional secondary hyperparathyroidism - excessive breeding (snakes) - hypovitaminosis A Trauma to protruded organ and abscessation are possible consequences - must confirm that protruding tissue is in fact phallus/hemipene and not cloacal tissue or gut Goal is to repair/replace the organs and allow to heal whilst kept in correct position - wound gels, hypertonic sugar solutions, local anaesthesia and replace and suture back into position as for cloacal prolapses

Answer 291

Primarily boas, pythons and related species (Henophidia) Increased risk in mixed species collections Often associated with mite infestations Retrovirus Characteristically signs of neurological disease Often fatal Inclusion bodies found in most tissues on histology Secondary infections due to immunosuppression - stomatitis, pneumonia, gastritis may be misleading Neurological signs - opisthotonus (star-gazing), poor righting reflex, reduced mentation Tissue biopsy (oesophageal tonsils, liver and pancreas are good sites) Eradication from collection is goal Eradication of mites - biosecurity and appropriate quarantine prior to introduction of a new specimen into the collection Avoid keeping geographically separate species in mixed species displays eg boas and pythons

Answer 292

Common in viperid snakes Highly contagious Infection is from respiratory secretions Risk factors: age, stress and immunosuppression Primarily causes respiratory signs: - pneumonia - potentially encephalitis Secondary infections are common Mortality rates can be high PCR on respiratory wash/choanal or pharyngeal swabs confirm diagnosis Treatment - supportive care only, provide an increased thermal gradient to allow animal to exhibit behavioural fever Biosecurity important for groups of snakes

Answer 293

New paramyxovirus identified in 2016 Discovered in Australian pythons Snakes display neurorespiratory disease - signs are non specific e.g regurgitation, lethargy, inappetance Mortality is variable and snakes may not show severe pathology

Answer 294

Non- enveloped RNA Orthoreovirus Many species other than snakes can also be affected (lizards, tortoises) Risk factors not well understood - virus very stable in environment- so hard to disinfect Presenting signs include pneumonia and encephalitis High death rates PCR available - pulmonary washes are sample of choice Supportive care is only option and prognosis for survival and recovery is guarded

Answer 295

Anomalous displacement or distortion of spinal column characterised by segmented fusion of affected vertebrae by foci of irregular proliferative bone (spinal osteodystrophy) Any reptile can be affected - snakes and green iguanas most commonly Risk factors: poor diet, inappropriate husbandry, chronic bacterial infection and trauma Affects spinal mobility and righting ability May be swellings noted on the spine Constipation, faecal/urinary incontinence, inability to strike Exact cause unknown - potentially hypovitaminosis A, hypervitaminosis D, septicaemia, immune mediated, neoplastic? Radiography or CT are diagnostic Euthanasia should be considered in severe cases Alternatively analgesia, attention to husbandry and diet, antimicrobials if bacterial infection suspected

Answer 296

Gram negative facultative anaerobes Reptiles are likely exposed soon after hatching Animals raised in high stocking densities are more likely to be infected Reptile associated salmonellosis is a major public health concern due to zoonotic potential Reptiles that are clinically normal should not be treated for Salmonellosis as part of normal microflora Animals presenting with signs of clinical disease should be treated with antibiotics Successful treatment confirmed by repeat faecal cultures - NB false negative cultures Salmonella can invade extra-intestinal tissues so treatment may not eliminate all organisms - chronic carriers Hygiene measures - hand washing, handling behaviour of owners

Answer 297

``` No diaphragm No loop of henle Internal gonads Hemipenes No urinary bladder ```

Answer 298

Scent glands in vent (squamates) Prefemoral glands/pores (geckos, bearded dragons, iguanas) Temporal glands (Chameleons) Salt glands in nares (marine iguanas, turtles)

Answer 299

Renewal phase - fragile skin, dull skin, behaviour changes Resting phase - between ecdysis Regulated by temperature, humidity and thyroid hormone

Answer 300

Snakes - in toto shed | Lizards and chelonia - flakes

Answer 301

``` Retained shed - rings of retained shed may act as tourniquets - digit loss - hemipene prolapse Causes: - husbandry (temperature, humidity, surfaces diet) - dermatitis, parasites, trauma, surgery, hormone imbalances Soak squamates to facilitate removal of retained shed Lubrication Antibiosis for secondary infection Injection of vitamin A to induce shed? Thyroxine supplementation in lizards? ```

Answer 302

Blister disease (ulcerative dermatitis) Bacterial - stomatitis, abscesses, septicaemia Viral - herpes, pox, papilloma Fungal - CAN-V Thermal burns Ticks - Ixodes, Ambylomma Mites - Trombicuild mites (Hirstiella spp)

Answer 303

= Yellow fungus disease (Chryosporium anamorphic of Nanniziopsis vriesii) Can be skin or systemic infection Risk factors unknown - skin damage, stress, poor husbandry, immunosuppression suggested Direct contact and airborne spread Skin disease - blisters, progresses to yellowish crusting, hyperkeratosis, epidermal necrosis Diagnosis - cytology (fungal hyphae) and culture Biosecurity to prevent spread - isolate cases Treatment: - debride skin lesions - topical and oral treatment required: terbinafine, voriconazole, itraconazole Guarded prognosis - often fatal

Answer 304

Acrodont = non rooted and directly attached to underlying bone Weak attachment, easily lost and not replaced

Answer 305

Pleurodont = regularly shed and replaced | Periodontal disease rare

Answer 306

Diet (food items that are too soft-bodied) Inappropriate lighting/heating Trauma Clinical signs: deformity of lips/mouth, anorexia, discharge from mouth, tooth loss Treatment: debride abnormal tissues, dental scaling/gels, provide appropriate antibiosis and analgesia, improve diet and address husbandry

Answer 307

Some (Oxyurids in particular) thought be beneficial and a natural part of multi biota so low burdens shouldn't be treated

Answer 308

Nutritional secondary hyperparathyroidism: - deficiency of calcium or vitamin D - imbalance of Ca:P - inadequate UV light provision for fit D activation Persistent hypocalcaemia increases activity of parathyroid gland -> increased PTH production -> resorption of calcium from bones -> clinical signs Juvenile or reproductively active females are most likely to show clinical sgns Clinical signs: - rubber jaw - pathological fractures -- swollen fibrous osteodystrophy of long bones - bloating/constipation - cloacal prolapse - follicular stasis/dystocia - paresis/paralysis if spinal damage Diagnosis - radiography - blood ionised calcium assay? Other metabolic bone disease causes: - renal secondary hyperparathyroidism - hypovitaminosis C (affects collagen production and bone growth)

Answer 309

Acute: - Stabilise fractures and treat seizures if occurring - Manage secondary ileus - Warm animal to POTZ - Fluid therapy if required Calcium gluconate IV/SQ if muscle fasciculations Chronic: - Correct husbandry/nutritional issues and client education - Consider underlying reproductive disease - Nutritional support - Oral calcium supplementation with calcium glubionate - Can give vitamin D injections - Can use calcitonin once normocalcaemic to shut off the parathyroid: improves rapidity of bone repair Prognosis: - Dependent on severity - Spinal lesions/carapace deformity has more guarded prognosis particularly if neurological involvement

Answer 310

Aetiology - inappropriate substrate/food presentation/inappropriate diet - pica?- renal disease or mineral deficiency, NSHP Clinical Signs: - acute anorexia - some have palpable mass in coelomic cavity - may also feel recognisably like substrate Diagnosis: radiography essential Treatment - bulk laxatives and fluids - calcium supplementation - prokinetics (as long as not obstructed) - surgical intervention may be necessary

Answer 311

Follicles are not stimulated to ovulate or do not respond to stimulation to ovulate Remain unovulated on the ovary -> resorption (a factor in hepatic lipidosis) -> necrosis -> systemic illness May be successfully stimulated to ovulate: - environmental: heat, humidity, provide nest sites, sight/access to male - medical interventions (hCG) Clinical Signs: - lethargy - inappetence - HL weakness - weight usually stable or increased Bloodwork may indicate reproductive activity Imaging required for diagnosis and comorbidities If follicles static then ovariectomy indicated before the lizard becomes too unwell