Comparison of transcoelomic, contrast transcoelomic, and transesophageal echocardiography in anesthetized red-tailed hawks (Buteo jamaicensis)

MITRAL REGURGITATION IN SADDLE-BILLED STORKS (EPHIPPIORHYNCHUS SENEGALENSIS) IN HUMAN CARE: DIAGNOSIS, ECHOCARDIOGRAPHIC MEASUREMENTS, AND MANAGEMENT

The asymptomatic and slow progressive nature of cardiopathies represents a risk to the welfare of avian species in human care. Diagnosis and treatment of cardiac disease in birds pose a challenge due to unique anatomic and physiologic characteristics. Comprehensive cardiac assessments with diagnostic tools such as echocardiography, color-Doppler, the biomarker cardiac troponin I (cTn1), and cholesterol serum concentrations have been utilized in different bird species with varying success. Saddle-billed storks (Ephippiorhynchus senegalensis) have been maintained in human care for over 80 yrs and several institutions have noted heart murmurs and cardiomegaly. Despite these findings, peer-reviewed literature describing cardiopathies is lacking for this species. This case series documents the identification of mitral valve regurgitation in saddle-billed storks in a breeding center. Transcoelomic echocardiography using a ventromedial approach with a two-chambered view and color Doppler was utilized. Echocardiographic measurements were taken and compared 1 yr later in most of the birds. There was left atrial enlargement and worsened mitral regurgitation in one geriatric patient, and no progression of the disease in two young birds. Serum samples showed that cTn1 had different concentrations depending on the severity of the disease, whereas cholesterol was within reference range for all birds. Treatment with digoxin and pimobendan was recommended in one bird, serum concentrations of digoxin were tested in a 6-mon span, results were within therapeutic range, and there were no overt adverse effects. There was a suspected genetic component in this population, as four of the five birds with confirmed mitral regurgitation were related.

Evaluation of diagnostic criteria in grey parrots (Psittacus erithacus) with suspected atherosclerosis

Ziel Atherosklerose ist eine häufige Erkrankung älterer Papageienvögel, die in Gefangenschaft mit unzureichenden Haltungsbedingungen leben. Die Diagnose beim lebenden Vogel bleibt jedoch schwierig und die Krankheit wird oft erst post mortem erkannt. In diesem Zusammenhang sollte der diagnostische Wert beschriebener Methoden bei lebenden Graupapageien (Psittacus erithacus) untersucht werden.

Material und Methoden Es wurden 7 klinisch gesunde Graupapageien und 32 Graupapageien mit Verdacht auf Atherosklerose evaluiert. Ein Gesamtbewertungssystem wurde auf der Grundlage klinischer Symptome, der Messung des Cholesterin- und Triglyceridspiegels im Blut, einer radiologischen Untersuchung und eines Echokardiogramms in B-Mode bestimmt. Darüber hinaus wurden Messungen der Blutflussgeschwindigkeit in der Aortenwurzel, der Herzfrequenz und des Geschwindigkeits-Zeit-Integrals unter Verwendung der spektralen Doppler-Ultraschallfunktion durchgeführt.

Ergebnisse Die Gesamtscoring- und Einzelmesswerte korrelierten mit radiologischen Zeichen. Messungen der Blutflussgeschwindigkeit in der Aortenwurzel zeigten hochsignifikante Unterschiede zwischen den klinisch gesunden Tieren und der Patientengruppe. Signifikante Unterschiede zwischen den Gruppen wurden des Weiteren im Vergleich der Gesamtbewertung und den Voruntersuchungen gefunden.

Schlussfolgerung Die Ergebnisse belegen, dass die Kombination der spektralen Doppler-Ultraschalluntersuchung mit anderen diagnostischen Möglichkeiten genutzt werden kann, um den Verdacht auf Atherosklerose zu erhärten und mehr Informationen über den Kreislaufstatus des Patienten zu geben.

Klinische Relevanz Die so gewonnenen Informationen ermöglichen es dem Tierarzt, eine frühe intra vitam Verdachtsdiagnose Atherosklerose zu stellen und früher mit der Behandlung zu beginnen.

Evidence-Based Advances in Avian Medicine

This article presents relevant advances in avian medicine and surgery over the past 5 years. New information has been published to improve clinical diagnosis in avian diseases. This article also describes new pharmacokinetic studies. Advances in the understanding and treatment of common avian disorders are presented in this article, as well. Although important progress has been made over the past years, there is still much research that needs to be done regarding the etiology, pathophysiology, diagnosis, and treatment of avian diseases and evidence-based information is still sparse in the literature.

Cardiomyopathy in a Harris hawk (Parabuteo unicinctus)

CASE DESCRIPTION An adult sexually intact female Harris hawk (Parabuteo unicinctus) housed at a wildlife hospital was evaluated because of acute collapse during an educational exhibition. CLINICAL FINDINGS Physical examination and hematologic analysis revealed no abnormalities; radiography revealed findings consistent with a previous tibiotarsal fracture. Coelioscopy with histologic examination and fungal culture of lung and air sac samples revealed anthracosis but no fungal infection. The hawk was discharged and temporarily removed from the education program; 1 month later, upon reintroduction into the program, it collapsed again. Physical examination and hematologic findings were similar to those after the first episode. Transcoelomic and transesophageal echocardiography and CT angiocardiography findings were consistent with cardiomyopathy. TREATMENT AND OUTCOME Initial cardiac treatment included furosemide (0.5 mg/kg [0.23 mg/lb], PO, q 24 h) and pimobendan (10 mg/kg [4.5 mg/lb], PO, q 12 h). After 10 days of treatment, peak and trough plasma concentrations of pimobendan were measured at 25, 196 and 715.97 ng/mL, respectively; the dosage was decreased to 0.25 mg/kg (0.11 mg/lb), PO, every 12 hours. No overt signs of toxicosis were detected. A sample was collected to reevaluate plasma pimobendan concentration after 30 days of treatment; results were not obtained prior to the patient's death but revealed a peak concentration of 16.8 ng/mL, with an undetectable trough concentration. The hawk was found dead 6 months after initial evaluation. Necropsy revealed cardiomegaly, but histologic examination did not reveal an inciting cause of cardiac dysfunction. CLINICAL RELEVANCE Cardiac disease in raptors may be underreported. Transcoelomic and transesophageal echocardiography and CT angiography provided useful information for the diagnosis of cardiac disease in the hawk of this report.

Echocardiographic and radiographic findings in a cohort of healthy adult green iguanas (Iguana iguana)

OBJECTIVES

To describe characteristics of echocardiography and cranial coelomic radiography in a cohort of iguanas.

ANIMALS

Twenty apparently healthy adult green iguanas (Iguana iguana) from a reptile sanctuary.

METHODS

Physical examination, radiography, two-dimensional and color Doppler echocardiography were performed to assess cardiac structures and function, and any related normal or abnormal findings were recorded.

RESULTS

Echocardiographic examination was possible without sedation and allowed visualization of the great vessels, atria, and ventricle. Some structures could not be evaluated in a minority of the iguanas due to individual differences in bony conformation and imaging quality. Suspected abnormal echocardiographic findings in 3 iguanas included pericardial effusion (n = 1) and enlarged caudal vena cava and/or sinus venosus (n = 2). Objective measurements were repeatable as assessed by within-subject coefficient of variation, and reliable as assessed by intra-observer intraclass correlation coefficient. Left atrial and ventricular measurements were significantly correlated with body weight. Valve regurgitation was common, with atrioventricular valve regurgitation present in 53% (9/17) and aortic or pulmonic valve regurgitation in 71% (12/17) of otherwise normal iguanas. A heart murmur was not appreciated during examination of any of the iguanas. Heart size cannot be measured radiographically due to superimposition and silhouetting of other coelomic structures. Echocardiographic or radiographic findings consistent with mineralization of the great vessels were present in 76% of iguanas (13/17).

CONCLUSIONS

Echocardiography in iguanas is well tolerated without sedation and allowed both subjective evaluation and structural measurements. Valve regurgitation and great vessel mineralization were commonly observed in this cohort of apparently healthy adult iguanas.