Effect of different injection rates and doses of contrast medium on the image quality of computed tomographic angiography in African grey parrots (Psittacus erithacus)

BACKGROUND

Atherosclerosis is a common cardiovascular disease in parrots but the antemortem diagnosis is challenging. In human medicine, computed tomography angiography (CTA) has been used widely for the diagnosis of atherosclerosis. By adjusting the injection rate and total dose of contrast medium, the image quality can be improved. To test the effects of different injection conditions on the image quality of major arteries, 10 African grey parrots (Psittacus erithacus) were used. Three injection rates (0.3, 0.4, 0.5 mL/s) and three doses (740, 370, 222 mg of iodine/bird) were tested while the other variables of the studies were fixed.

RESULT

A higher injection dose led to a significantly higher attenuation, image noise and diameter, with a lower signal-to-noise ratio and contrast-to-noise ratio of the six major arteries. The 370 mg of iodine/bird group showed significantly better subjective image quality. Furthermore, with increasing injection rates, the prevalence of heterogeneity decreased. However, we found an increased risk of injection failure for the 0.5 mL/s groups.

CONCLUSION

We recommend a combination of 370 mg of iodine/bird with 0.4 mL/s for clinical use to achieve better image quality for CTA.

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.

Cardiovascular Diseases in Pet Birds: Therapeutic Options and Challenges

Cardiovascular disease, including congestive heart failure, pericardial disease, and atherosclerosis, is becoming increasingly better recognized in companion birds. A wide range of medications is available to treat these conditions, including diuretics, vasodilators, positive and negative inotropes, antiarrhythmic agents, and pentoxifylline. This review systematically discusses each of these drug classes and their potential applications in avian species. Although treatment approaches remain largely empirical and extrapolated from small animal and human medicine, the management strategies presented here have the potential to both maintain quality of life and extend survival time for the avian cardiac patient.

Heart Disease in Pet Birds - Diagnostic Options

Cardiovascular diseases are common in pet birds. Diagnosis is often made postmortem only. In any case, suspicious for cardiac disease, a full diagnostic work up should be applied. First indications are given by the anamnestic data. Relative predisposition to cardiovascular diseases is associated with the species, breed, age, gender, lifestyle, and diet. Clinical signs and examination can reveal further indications of cardiovascular diseases, but may be unspecific or even without any pathologic finding. Diagnostic imaging, at least radiography, and echocardiography are always recommended. Advanced imaging methods, especially angiocardiography, can be valuable but is also more invasive and expensive.

Pharmacokinetics of zonisamide after oral single dosing and multiple-dose escalation administration in domestic chickens (Gallus gallus)

Background

There are few effective drugs for treatment of seizures in avian species.

Objectives

To investigate the pharmacokinetics and safety of zonisamide in chickens.

Methods

Phase 1: chickens (n = 4) received a single oral dose of zonisamide at 20 mg/kg. Blood samples were collected intermittently for 36 hr after dosing. Phase 2: chickens (n = 8) received zonisamide in a dose escalation protocol (20, 30, 60 and 80 mg/kg orally every 12 hr). The dose was increased weekly, and peak and trough blood samples were collected on Days 1, 3, and 7 each week. Two birds were randomly euthanized at the end of each week. Plasma zonisamide concentrations were analysed using a commercial immunoassay. Drug concentration vs. time data were subjected to non‐compartmental pharmacokinetic analysis.

Results

For Phase 1, peak plasma zonisamide (C_max) was 15 ± 3 µg/ml at 2 ± 1 hr (T_max). The disappearance half‐life was 6.5 ± 1 hr. Mean plasma concentrations remained within the (human) therapeutic range (10–40 µg/ml) for 6 hr. For Phase 2 of the study, plasma concentrations of zonisamide remained within or close to the recommended mammalian therapeutic range for birds in the 20 and 30 mg/kg dose. Area under the curve (AUC) and C_max were dose dependent. Two birds developed immune‐mediated haemolytic anaemia.

Conclusions

Zonisamide appears to be a viable drug for use in chickens at a dose of 20 mg/kg orally every 12 hr.

Diagnosis and long-term management of post-traumatic seizures in a white-crowned pionus (Pionus senilis)

CASE DESCRIPTION

A 13-year-old female white-crowned pionus (Pionus senilis) was examined because of seizures 22 months after it was treated for a traumatic brain injury (TBI) characterized by vision loss, hemiparesis, nystagmus, circling, and head tilt.

CLINICAL FINDINGS

Bloodwork performed during the initial seizure workup revealed hypercalcemia and hypercholesterolemia, which were attributed to vitellogenesis given the bird's previous egg-laying history and recent onset of reproductive behavior. Magnetic resonance imaging of the brain revealed diffuse right pallium atrophy with multifocal hydrocephalus ex vacuo, which were believed to be the result of the previous TBI. Findings were most consistent with post-traumatic seizures (PTS).

TREATMENT AND OUTCOME

Levetiracetam (100 mg/kg [45 mg/lb], PO, q 12 h) was initiated for PTS management. A 4.7-mg deslorelin implant was injected SC to suppress reproductive behavior. The bird was reexamined for presumed status epilepticus 5 times over 22 months. Seizure episodes coincided with onset of reproductive behavior. The levetiracetam dosage was increased (150 mg/kg [68 mg/lb], PO, q 8 h), and zonisamide (20 mg/kg [9.1 mg/lb], PO, q 12 h) was added to the treatment regimen. Additional deslorelin implants were administered every 2 to 6 months to suppress reproductive behavior. The owner was trained to administer midazolam intranasally or IM as needed at home. The treatment regimen helped control but did not eliminate seizure activity. The bird was euthanized 22 months after PTS diagnosis for reasons unrelated to the TBI or PTS.

CLINICAL RELEVANCE

Long-term management of PTS in a pionus was achieved with levetiracetam and zonisamide administration.

Medication for Behavior Modification in Birds

The use of behavior modifying drugs may be considered in birds with behavior problems, especially those refractory to behavior modification therapy and environmental management. To accomplish behavior change, a variety of drugs can be used, including psychoactive drugs, hormones, antihistamines, analgesics, and anticonvulsants. Because their prescription to birds is off-label, these drugs are considered appropriate only when a sound rationale can be provided for their use. This requires a (correct) behavioral diagnosis to be established. In addition, regular monitoring and follow-up are warranted to determine the efficacy of the treatment and evaluate the occurrence of potential adverse side effects.

Cardiovascular Drugs in Avian, Small Mammal, and Reptile Medicine

Cardiovascular disease, including congestive heart failure, pericardial disease, and atherosclerosis, is becoming increasingly better recognized in companion birds, small mammals, and reptiles. A wide range of medications is available to treat these conditions, including diuretics, vasodilators, positive and negative inotropes, antiarrhythmic agents, and pentoxifylline. This review systematically discusses each of these drug classes and their potential applications in exotic species. Although treatment approaches remain largely empirical and extrapolated from small animal and human medicine, the management strategies presented here have the potential to both maintain quality of life and extend survival time for the exotic cardiac patient.

Central vestibular disease in a blue and gold macaw (Ara ararauna) with cerebral infarction and hemorrhage

A 24-year-old female blue and gold macaw (Ara ararauna) was presented for an acute onset of left head tilt. On examination, the macaw was dehydrated and had a 120-degree left head tilt, decreased proprioception of the left pelvic limb, and intermittent vertical nystagmus. Results of hematologic testing and biochemical analysis revealed severe leukocytosis with lymphopenia and heterophilia and a high uric acid concentration. Radiographs showed bilateral intertarsal joint osteoarthritis and a healed ulnar fracture. Magnetic resonance imaging of the brain revealed focal T2 and fluid-attenuated inversion recovery hyperintense lesions in the right cerebral hemisphere and in the midbrain. The midbrain lesion showed susceptibility artifact on the T2* sequence, suggesting hemorrhage. In the T2* sequence, iron accumulation (as seen with hemorrhage) distorts the magnetic signal, resulting in the production of a susceptibility artifact, which can then be visualized as a region of hypointensity. The bird was hospitalized but died despite intensive care. Necropsy revealed multiple cerebral vascular lesions including an acute cerebral infarct, a ruptured midbrain aneurysm, and multifocal systemic atherosclerosis. To our knowledge, this is the first report of a cerebral aneurysm in a bird. This report correlates the clinical presentation, imaging, and histopathologic findings in a macaw with central vestibular disease and demonstrates how advanced imaging techniques can identify hemorrhagic lesions through the T2* sequence.

Experimental diet-induced atherosclerosis in Quaker parrots (Myiopsitta monachus)

Spontaneous atherosclerosis is common in psittaciformes, and clinical signs associated with flow-limiting stenosis are encountered in pet birds. Nevertheless, a psittacine model of atherosclerosis has not been developed for research investigations. Sixteen captive-bred Quaker parrots (Myiopsitta monachus) were used in this study. While 4 control birds were fed a maintenance diet, 12 other birds were fed an atherogenic diet composed of 1% cholesterol controlling for a calorie-to-protein ratio for periods ranging from 2 to 8 months. The birds were euthanized at the end of their respective food trial period. Histopathology, transmission electron microscopy, and cholesterol measurement were performed on the ascending aorta and brachiocephalic and pulmonary arteries. Plasma lipoproteins, cholesterol, and triglycerides were also measured on a monthly basis. Significant atherosclerotic lesions were induced within 2 months and advanced atherosclerotic lesions within 4 to 6 months. The advanced lesions were histologically similar to naturally occurring lesions identified in the same parrot species with a lipid core and a fibrous cap. Ultrastructurally, there were extracellular lipid, foam cell, and endothelial changes. Arterial cholesterol content increased linearly over time. Plasma cholesterol and low-density lipoprotein (LDL) significantly increased over time by an average of 5- and 15-fold, respectively, with a shift from high-density lipoprotein to LDL as the main plasma lipoprotein. Quaker parrots also exhibited high plasma cholesteryl ester transfer protein activity that increased, although not significantly, over time. This experiment demonstrates that in Quaker parrots fed 1% cholesterol, advanced atherosclerosis can be induced relatively quickly, and lesions resemble those found in other avian models and humans.