Avian Oncology: Diseases, Diagnostics, and Therapeutics

Epitheliotropic T-cell lymphoma of non-viral origin with hypercalcemia of malignancy in a Roman goose (Anser anser domesticus)

A Roman goose (Anser anser domesticus) was presented with a large mass on the left lateral side of the neck with a smaller satellite mass on the right. Utilizing radiography, blood tests, and histological and immunohistochemical investigations, a diagnosis of cutaneous T-cell lymphoma associated with hypercalcemia of malignancy was established. The involvement of oncogenic viruses was ruled out through PCR and RT-PCRs. Due to the mass's considerable size, location, and post-treatment management challenges, the owner opted against surgery and chemotherapy. Glucocorticoids were administered upon the great enlargement of a second mass on the base of the right side of the neck and the worsening of clinical signs but proved entirely ineffective. Due to the disease progression, euthanasia was elected, and a post-mortem investigation ensued to clarify the extent and confirm the lesion's nature. Similar histological and immunohistochemical findings confirmed the final diagnosis of epitheliotropic T-cell lymphoma with cutaneous and esophageal involvement.

Prevalence, Anatomical Distribution, and Risk Factors of Adipocytic Tumors and Xanthomas in Psittaciformes: 1096 Cases (1998-2018)

Adipocytic tumors are mesenchymal tumors that are commonly reported in psittacine birds; however, large-scale studies evaluating their prevalence and associated risk factors are lacking. A retrospective study of adipocytic tumors in psittacine birds was performed by reviewing pathology submissions from the University of California, Davis-Drury Reavill Pathology Database, containing 26 013 submissions from psittacine birds (1998-2018). Age, sex, genus, anatomic distribution, and pathological diagnosis were collected for each case when available. The prevalence, risk factors, and association with other lipid-accumulation disorders were reported. A total of 450 cases of lipoma, 129 cases of myelolipoma, 35 cases of hemangiolipoma, 31 cases of liposarcoma, and 451 cases of xanthoma were identified. The prevalence of adipocytic tumors and xanthomas on necropsy was 1.3% (158/11 737, 95% confidence interval [CI]: 1.1-1.6). Adipocytic tumors were identified in 27 genera. Amazona (odds ratio [OR] = 1.93, 95% CI: 1.24-2.99, p = 0.004), Myiopsitta (OR = 2.3, 95% CI: 1.0-5.2, p = 0.041), Melopsittacus (OR = 3.4, 95% CI: 2.1-5.5, p < 0.001), and Agapornis (OR = 3.5, 95% CI: 2.0-6.1, p < 0.001) had significantly higher odds of developing adipocytic tumors compared with other genera, whereas Ara had significantly lower odds (OR = 0.5, 95% CI: 0.3-0.9, p = 0.030). Age was also a significant risk factor for many types of adipocytic tumors. There was no significant association between general adipocytic tumor formation and atherosclerosis or hepatic lipidosis. Xanthomas were associated with atherosclerosis (OR = 1.88, 95% CI: 1.01-3.51, p = 0.048), but not hepatic lipidosis (p = 0.503). On necropsy, the trunk and air sacs were the most common sites of xanthoma formation, whereas the trunk and liver were the most common sites of lipoma and myelolipoma formation, respectively.

Myxoid leiomyosarcoma of the oviduct and uterus in a Cockatiel (Nymphicus hollandicus)

An 11-year-old female cinnamon cockatiel (Nymphicus hollandicus) was presented with a coelomic distention. Dystocia was suspected, given its previous history of a calcium-deficient diet and multiple instances of nonobstructive dystocia. Exploratory coeliotomy revealed a large intraluminal mass extending through the magnum to the uterus (shell gland). Metastasis and multiorgan involvement were not seen. Histopathologically, malignant and invasive fascicles of spindle cells were associated with abundant myxoid matrix and hypocellular areas. Multinucleation, bizarre cells and atypical mitotic figures were prominent. Masson's trichrome staining verified the muscular origin, and the myxoid matrix was demonstrated utilizing Alcian blue. The neoplastic cells exhibited alpha-smooth muscle actin and desmin immunoreactivity and were negative for vimentin. Thus, the patient was diagnosed with oviductal and uterine myxoid leiomyosarcoma (LMS). The patient survived 34 days post-surgery before death associated with suspected enteritis. Myxoid LMS is an extremely rare neoplasm in animals. To our knowledge, myxoid LMS has not been reported previously in pet birds.

Laryngeal and oropharyngeal adenocarcinoma with pulmonary metastases in a common raven (Corvus corax)

A captive 15-year-old male common raven (Corvus corax) was presented for post-mortem examination. It had been previously presented to a local veterinarian due to a 3-4 weeks long history of abnormal respiratory sounds. Upon admission, the bird demonstrated severe dyspnea and a massive amount of mucous in the oropharynx. After symptomatic treatment, dyspnea deteriorated dramatically, and euthanasia was elicited because of poor prognosis. The necropsy revealed a 2.65 x 2.15 x 2.18 cm expansile and poorly delineated cauliflower-shaped mass around the glottis and extending inside the tracheal lumen. Additionally, a dilated salivary gland in the adjacent tissue and multifocal reddish-fleshy areas in the lung parenchyma were detected. Histopathological examination identified the mass as moderately differentiated, tubular adenocarcinoma with invasive growth and moderate to marked cellular atypia and numerous mitoses. The presumptive origin of the neoplasia was one of the salivary glands. Multiple metastases were identified in the lung both macroscopically and histologically. Bacterial culture and molecular testing for West Nile and Usutu viruses were negative. To the authors' knowledge, this is the first report of metastatic laryngeal and oropharyngeal adenocarcinoma in a common raven.

Beak fracture associated with leiomyosarcoma in a budgerigar (Melopsittacus undulatus): a case report and literature review

A 2-year-old male budgerigar (Melopsittacus undulatus) died after a 1-day history of fracture of the rostral rhinotheca with pale mucous membranes, dyspnea, dull mentation, and ataxia. Histopathology revealed an infiltrative neoplasm composed of interweaving streams of spindle cells effacing the dermis and bone of the rostral upper beak as well as a ganglion and two cranial nerves. No visceral metastasis was observed. Neoplastic cells exhibited strong cytoplasmic immunolabeling for alpha-smooth muscle actin (α-SMA) and lacked immunolabeling for S100, Melan-A, PNL2, and cytokeratin AE1/AE3. These findings were consistent with a locally invasive leiomyosarcoma Leiomyosarcomas arise from the smooth muscle and are locally invasive with rare metastases. In birds, leiomyosarcomas are mostly reported to arise from the spleen, gastrointestinal, and reproductive tracts. In the case report herein, we describe the histological and immunohistochemical features of a primary beak leiomyosarcoma in a budgerigar associated with a fracture located at the rostral rhinotheca. Leiomyosarcoma arising from the beak has not been described in the literature.

Survey of the Clinical, Cytological, and Histopathological Features Associated with Neoplasms in Captive Avian Species in Melbourne, Australia

Over a 3.5-year period, tissue samples from 141 companion and aviary birds with clinically suspected, naturally occurring solid neoplasms were collected via surgical biopsy (n = 53) or at necropsy examination (n = 88) from a population of birds presenting to an avian veterinary clinic in Melbourne, Australia. Neoplastic processes were identified in 73.7% (n = 104) of samples, with 83.7% (n = 87) being interpreted as malignant neoplasia and 16.3% (n = 17) being interpreted as benign neoplasia. The overall estimated prevalence of neoplasia in the study population (n = 5125) was 2.45% (95% confidence interval, 2-2.97%). The gastrointestinal and reproductive tracts were the most commonly affected systems. The most common presenting signs were nonspecific and included lethargy, coelomic distension, and inappetence. In 59 cases, fine-needle aspirates (FNAs) and impression smears were also obtained and evaluated cytologically. The accuracy of cytology for detecting neoplasia in birds and for determining whether a neoplastic process was benign or malignant was assessed by using histopathology as the "gold standard." There was complete agreement between the cytological and histopathological diagnoses in 72.8% (43/59) of cases. Cytology correctly identified 87.5% of these cases (35/40) as malignant neoplasms and 55.6% (5/9) as benign processes. There was no significant difference between the use of cytology and histopathology for the detection of malignant neoplasia in birds (P = 0.185). The accuracies of FNAs and impression smears for examining avian tumors were also compared. Overall, the best cell preservation was obtained by performing impression smears from tissues, with 62.2% (n = 28) returning high cellularity for cytological examination, compared to 53.8% (n = 14) when samples were obtained by FNA. This study provides an overview of the types and prevalence of neoplasms in a captive bird population from Australia, correlates physical examination findings with tumor types, and provides evidence that cytology is a reliable preliminary diagnostic tool for detecting neoplasia in birds.

Air Sac Cystadenoma in a Pet Chicken

A 2-yr-old female Brahma chicken was presented to the Poultry Mobile Clinic of the College of Veterinary Medicine at North Carolina State University with a 3-wk onset of a wet sneeze that progressed to wheezing with a whistle-type sound. Upon observation, a cyst was found above the left clavicle in the area around the crop. The bird was euthanatized due to the progressive and chronic nature of the symptoms. Postmortem examination revealed an ovoid, soft to fluctuant, smooth, pale brown mass (2 × 0.9 × 0.8 cm), encased within the cranial membrane of the left cervical air sac. Histologically, focally expanding the left cervical air sac was a pedunculated, nonencapsulated, well-demarcated, moderately cellular neoplasm that consisted of cuboidal cells predominantly arranged in variably sized cystic structures lined by a single layer of cells. Neoplastic cells have strong cytoplasmic immunolabeling against cytokeratin AE1/AE3. Gross and histologic findings were consistent with an air sac cystadenoma. Primary respiratory neoplasia in birds is infrequent. Air sac carcinomas, adenocarcinomas, and cystadenocarcinomas have been described in Psittaciformes, Columbiformes, Falconiformes, and Cuculiformes. Benign air sac tumors are poorly documented, and detailed descriptions of this neoplasm in poultry literature are lacking.

Bilateral Cubital Lymphoma and Mycobacteriosis in a Salmon-Crested Cockatoo (Cacatua moluccensis)

A 32-year-old male salmon-crested cockatoo (Cacatua moluccensis) was diagnosed by cytology with bilateral cubital lymphoma and mycobacteriosis. Polymerase chain reaction assay testing confirmed Mycobacterium genavense. This patient was subsequently humanely euthanized. Postmortem histopathology confirmed both diagnoses with findings of multicentric lymphoma, acid-fast bacilli, and severe degenerative changes in all synovial joints examined. Immunohistochemical staining for paired box protein 5 of the cubital mass was positive for a high percentage of B-cell lymphocytes, consistent with B-cell lymphoma. This unusual case of two major diseases presenting concurrently in one patient raises the question of whether the pathogenesis could have an interdependent relationship. Mycobacteriosis, severe degenerative joint changes, or both may have stimulated lymphocytes, eventually leading to lymphoma. Additional screening and monitoring for comorbidities may be advised if 1 of these diseases are diagnosed in companion avian species.

Fibrolipoma subcutáneo en Loro Amazónico (Amazona aestiva): Evaluación clínica, histopatológica y técnica quirúrgica

Los lipomas son neoplasias benignas conformadas por adipocitos bien diferenciados, delimitados por un delicado estroma fibroso reticular. Éstos constituyen el tumor cutáneo más frecuente en aves, siendo masas blandas que generalmente aparecen en el tejido subcutáneo. Se describe el caso de un loro amazónico (Amazona aestiva) en cautiverio, que fue llevado a consulta debido a una masa ulcerada en la región de la cadera. El diagnóstico citológico refirió que se trataba de un lipoma, y ante la ineficacia del tratamiento local, se procedió con la extirpación quirúrgica de la masa. El tratamiento posquirúrgico consistió en limpiezas con clorhexidina al 0,5 % por 15 días (d), e ibuprofeno por vía oral, por 3 d. La masa fue remitida para su estudio histopatológico, refiriendo como diagnóstico morfológico un fibrolipoma. Los puntos de sutura fueron retirados a los 18 d, observándose una cicatrización completa.

Lymphoma in Psittacine Birds: A Histological and Immunohistochemical Assessment

In psittacine birds, round cell neoplasms that originate from lymphocytes, plasma cells, histiocytes, or mast cells are sporadic and poorly described. The lack of morphological and immunohistochemical diagnostic criteria or grading schemes make specific diagnoses and prognoses challenging. We assessed cases of psittacine birds diagnosed with round cell neoplasia from 3 North American veterinary diagnostic laboratories to describe the diagnostic features of these tumors. For all cases, demographic data, anatomic distribution, histological features, and immunoreactivity for T (CD3) and B (Pax5 and MUM-1) cell markers were assessed using tissue microarrays and whole slide mounts. Thirty-eight psittacine birds representing 14 species were included. Tumors were mainly infiltrative and multicentric, were composed of homogenous sheets of round to polygonal cells, and commonly presented with a high mitotic count (average 21 mitoses per high-power field). Based on Pax5 immunoreactivity, B-cell lymphoma was most common (19/38 [50%]), and was significantly associated with involvement of the gastrointestinal and urogenital systems. Of the 38 cases, 6 (16%) were consistent with T-cell lymphoma, 3 (8%) with plasma cell tumor, and 3 (8%) were double-reactive for both B- and T-lymphocyte markers. This is the first study to describe morphologic and immunohistochemical features of round cell neoplasia in a large number of psittacine birds, and provides benchmark data for future studies aimed at elucidating the diagnosis and prognosis of these neoplasms. These data also provide useful information about reactivity of commercially available antibodies as lymphocyte markers in tissues of multiple psittacine species.

Alimentary squamous cell carcinoma in psittacines: 12 cases and review of the literature

Squamous cell carcinoma (SCC), which is a neoplasm that usually arises from the integument, is reported uncommonly in pet birds. Only a few reports of SCCs in the alimentary tract of birds, including psittacines, have been published, and a detailed description of the pathology is not available in the literature. We present here 12 cases of alimentary SCC in psittacines. The average age of the birds was 22.2 y (range: 15-29 y), and affected species included 4 Amazon parrots (Amazona sp.), 3 cockatiels (Nymphicus hollandicus), 3 macaws (Ara sp.), 1 conure (Eupsittula sp.), and 1 Senegal parrot (Poicephalus sp.). Frequent clinical complaints included regurgitation, dysphagia, dyspnea, lethargy, and/or weight loss. SCC primarily affected the oral cavity in 6 of 12 cases, the crop alone in 2 of 12 cases, the crop and esophagus in 1 of 12 cases, the proventriculus alone in 1 of 12 cases, and the crop, esophagus, and proventriculus in 2 of 12 cases. Histologically, alimentary SCCs were locally invasive and often resulted in mucosal ulceration. Although there were no metastases in any of our cases, poor clinical outcomes were frequent and associated most commonly with complete effacement of the alimentary segment and severe inflammation with opportunistic bacterial infection. Our review of the literature records commonly affected species, variability of gross presentations and clinical signs, plausible etiologies, and current diagnostic developments.

Modified Tail Amputation Technique in a Blue and Gold Macaw (Ara ararauna) With Uropygial Gland Adenocarcinoma

A 33-year-old male blue and gold macaw (Ara ararauna) presented with a 5-month history of an ulcerated lesion and feather loss at the tail base. Two 4-mm biopsies obtained by the primary care veterinarian were consistent with uropygial gland adenocarcinoma. The bird was examined at the Veterinary Medical Teaching Hospital, University of California, and on physical evaluation, the dorsal and ventral surface of the tail base were devoid of feathers, ulcerated and crusted without an identifiable uropygial gland. Complete blood count, plasma biochemistry panel, whole-body radiographs, and an echocardiogram were performed before surgery. The bird was anesthetized, and a complete amputation of the tail was performed. The skin was incised with a radiofrequency electrosurgical system approximately 2 mm circumferentially cranial to the diseased tissue. The musculature was transected to the level of the vertebral column, disarticulating between the second and third caudal vertebrae and transecting the spinal cord with a no. 15 blade. Lateral vertebral processes of the second vertebra were removed with a rongeur. Coccygeus lateralis muscles and tensor fasciae latae muscles and skin were closed laterolaterally with 2 layers and 3-0 polydioxanone suture. The bird recovered uneventfully and was discharged after 6 days of hospitalization. The histopathological diagnosis was adenocarcinoma with squamous differentiation, marked scirrhous response, and superficial epithelial ulceration. It was determined that narrow margins of unaffected tissue were achieved from the pathological examination of submitted material. The bird was evaluated 24 days after surgery and again 3.5 months after surgery, without evidence of complications or recurrence. Approximately 10 days after the last reexamination, the bird was euthanatized after being found minimally responsive at home. A postmortem examination was not performed.

A comprehensive diagnostic approach combining phylogenetic disease bracketing and CT imaging reveals osteomyelitis in a Tyrannosaurus rex

Traditional palaeontological techniques of disease characterisation are limited to the analysis of osseous fossils, requiring several lines of evidence to support diagnoses. This study presents a novel stepwise concept for comprehensive diagnosis of pathologies in fossils by computed tomography imaging for morphological assessment combined with likelihood estimation based on systematic phylogenetic disease bracketing. This approach was applied to characterise pathologies of the left fibula and fused caudal vertebrae of the non-avian dinosaur Tyrannosaurus rex. Initial morphological assessment narrowed the differential diagnosis to neoplasia or infection. Subsequent data review from phylogenetically closely related species at the clade level revealed neoplasia rates as low as 3.1% and 1.8%, while infectious-disease rates were 32.0% and 53.9% in extant dinosaurs (birds) and non-avian reptiles, respectively. Furthermore, the survey of literature revealed that within the phylogenetic disease bracket the oldest case of bone infection (osteomyelitis) was identified in the mandible of a 275-million-year-old captorhinid eureptile Labidosaurus. These findings demonstrate low probability of a neoplastic aetiology of the examined pathologies in the Tyrannosaurus rex and in turn, suggest that they correspond to multiple foci of osteomyelitis.

Gerontology of Psittacines

With recent improvements in the husbandry, nutrition, and veterinary care of captive psittacines, the avian clinician must be familiar with common medical condition seen in geriatric parrots. A review of the theory of evolution and avian senescence is provided. Five clinically relevant medical conditions are described: organ failure, atherosclerosis, neoplasia, cataracts, and osteoarthritis.

A retrospective analysis of mortality in captive Magellanic penguins (Spheniscus magellanicus) in the United States, 2008-2018

Mortality data for Magellanic penguins (Spheniscus magellanicus) housed in zoos and aquariums in the United States has not previously been published. Necropsy and histopathology records were examined for Magellanic penguins housed at 12 Association of Zoos and Aquariums institutions from 2008 through 2018. If birds lived through the first year, the mean longevity was found to be 18.9 years of age (standard deviation: 7.9). Prefledge chicks and geriatric penguins experienced the highest mortality rates. Aspergillosis was a major cause of death in this species. There was no significant difference in mortality between males and females. Based on these data, recommendations for the husbandry and veterinary care of captive Magellanic penguins can be made.

High occurrence rate of xanthomatosis and nephrocalcinosis in aquarium-housed Atlantic wolffish Anarhichas lupus and spotted wolffish A. minor

The Atlantic wolffish (AW) and the spotted wolffish (SW) are long-lived fish found in the North Atlantic and Arctic oceans and are respectively classified as special concern and threatened species, mainly due to fisheries bycatch. To better understand health issues associated with the care of these species in public aquaria, reports from all necropsies performed in 2 zoological institutions between 2009 and 2019 were reviewed (31 AW and 8 SW). These wolffish were fed with a similar fish-based diet and kept in multi-species exhibits with comparable environmental parameters. The most frequent necropsy findings were the presence of xanthomas (AW: 41.9%; SW: 75.0%), nephrocalcinosis (AW: 42.9%; SW: 75.0%) and urocystoliths (AW: 6.5%; SW: 62.5%). Xanthomas were mostly located at the base of pectoral fins and were characterized by extensive granulomatous inflammation centered on accumulations of partly mineralized degenerate fatty material, mainly composed of cholesterol crystals. Nephrocalcinosis was characterized by the deposition of calcium salts within the renal tubules and was commonly associated with tubular necrosis. The aquarium-housed wolffish were fed a coldwater fish-based diet. However, the natural diet of wolffish is composed mostly of invertebrates such as urchins and crustaceans. Differences in nutrient composition between these diets, such as lipid and mineral content, may have contributed to the development of xanthomatosis, nephrocalcinosis and urocystolithiasis in wolffish housed in these institutions.

Mandibular squamous cell carcinoma in 2 psittacines

A unilateral, malformed gnathotheca in a green-winged macaw (Ara chloropterus) was managed for 16 mo with periodic beak trims. Biopsy of the affected beak did not identify an underlying cause; however, at postmortem examination, a densely cellular neoplasm invaded the mandible from the beak, dissecting and effacing the cortex and trabecular bone and inciting periosteal proliferation. There was no evidence of metastasis. Neoplastic cells were strongly immunopositive for cytokeratin AE1/AE3, consistent with squamous cell carcinoma (SCC). A black-headed caique (Pionites melanocephalus) was presented with a similar clinical history, timeline, and gross appearance. Biopsy of the mandibular portion of the lesion resulted in a diagnosis of SCC. Medical management with toceranib at a palliative dose resulted in adverse side effects and was discontinued. Early diagnosis of mandibular SCC may allow for early intervention and development of treatment modalities. Our 2 cases suggest that the mandibular bone, not the beak, may be a preferred biopsy site in the diagnosis of mandibular SCC in psittacines.

Clinical Management of Avian Renal Disease

Treatment of avian renal disease relies on supportive care, such as fluid therapy and nutritional support. Analgesia and adaptations of the environment are indicated in cases of renal disease associated with painful joints. Other treatments vary with the underlying etiology and may include systemic antibiotics, antifungal therapy, vitamin A supplementation, or chelation therapy.

Bilateral Malignant Seminoma With Ventricular Metastasis in a Bald Eagle ( Haliaeetus leucocephalus)

A 30-year-old bald eagle ( Haliaeetus leucocephalus) was presented with a history of hyporexia and lethargy. Results of initial hematologic testing, biochemical analysis, and fecal examination were unremarkable, and clinical signs did not resolve with supportive care and management changes. Results of echocardiography, based on auscultation of a murmur, and coelomic endoscopy, based on the presence of a soft tissue opacity on radiographs, as well as an aspergillosis panel were largely unsuccessful in determining a definitive diagnosis. Euthanasia was performed after the eagle did not recover from anesthesia after endoscopy. Necropsy results demonstrated bilateral testicular seminomas with metastases to the ventriculus. This case demonstrates an abnormal metastasis of a common reproductive tumor in an avian species.

Subcutaneous Myxomas in Kelp Gulls ( Larus dominicanus) in Chile

Myxomas are an uncommon neoplasm in vertebrates, and are found at a low frequency in birds, both wild and domestic. We report myxomas in two Kelp Gulls ( Larus dominicanus) in Chile, identifying tumors in specimens that were received for necropsy.

Update on Cancer Treatment in Exotics

Treatment options for animals with cancer are rapidly expanding, including in exotic animal medicine. Limited information is available about treatment effects in exotic pet species beyond individual case reports. Most cancer treatment protocols in exotic animals are extrapolated from those described in humans, dogs, and cats. This review provides an update on cancer treatment in exotic animal species. The Exotic Species Cancer Research Alliance accumulates clinical cases in a central location with standardized clinical information, with resources to help clinicians find and enter their cases for the collective good of exotic clinicians and their patients.