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MSK2 > Exotics MSK diseases > Flashcards

Exotics MSK diseases Flashcards

1
Q

List your differentials for a falcon presented with swelling of the foot

A
  • Bumblefoot
  • Gout
  • Neoplasia
  • Foreign body
  • Abscess
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2
Q

What factors need to be investigated in a bird with a swelling of the foot?

A
  • Need to ask about the diet
  • Need to ask about the perch
  • Previous injury/illness
  • Any concurrent signs
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3
Q

List the investigations needed in a case of suspected bumblefoot and justify

A
  • Individual investigation of each individual toe
  • Radiography (assess presence/degree of damage to the bone)
  • Swab for culture, sensitivity and cytology (needed for treatment)
  • Surgical debridement samples (ensures demonstration of infective agent rather than just commensal skin microbes)
  • Blood tests (haematology, biochem - may be systemic disease, look for underlying cause that can be treated)
  • Palpate origins of tendons
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4
Q

What is the notarium of a bird?

A

The fused thoracic vertebrae

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5
Q

Explain why the great vessels of older parrots may be visible on radiography

A

Atherosclerosis, either as a cause or result of cardiovascular compromise

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6
Q

Which skeletal structures need to be assessed in particular in a case of bumblefoot and why?

A
  • Spine and HL

- May show evidence of abnormal weight bearing

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7
Q

What may be seen radiographically in severe cases of bumblefoot?

A

Progression of skin infection into the bone, which may be seen as lysis or fracture of the bone

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8
Q

How many phalanges are normal in the first, second, third and fourth digits of birds?

A
  • First and second: 2 phalanges + claw
  • Third: 3 phalanges + claw
  • Fourth: 4 phalanges+ claw
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9
Q

Discuss the prognosis for a case of bumblefoot

A
  • Guarded, with treatment ~80%
  • Poor outcome usually related to owner not revealing underlying cause, or not addressing underlying case
  • Commonly concurrent diseases
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10
Q

List concurrent diseases that are commonly identified in cases of bumblefoot

A
  • Obesity
  • Nutritional
  • Aspergillosis
  • Amyloidosis
  • Heart disease
  • Anything affecting circulation
  • Anything affecting the immune system
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11
Q

Outline the treatment for early stage bumblefoot

A
  • No surgery required
  • Improve husbandry
  • Meticulous cleaning of perches to prevent infection
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12
Q

Outline the treatment of bumblefoot if infection is present

A
  • Topical or systemic antibiotics based on C+S, 1 week minimum, but usually requires several weeks treatment
  • Amoxyclav, marbofloxacin can be used, avoid gentamycin systemically
  • Clindamycin good bone penetration
  • Fluoroquinolones can be used if needed, good penetration
  • Metronidazole if Clostridia
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13
Q

Outline the treatment of bumblefoot lesions with deep infection and granulomatous material

A
  • Surgical debridement
  • Protective dressings after surgery, regular changes
  • NSAIDs/analgesia
  • if unable to grasp food or perch, prognosis poor, consider euthanasia
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14
Q

Outline the general approach to a lameness case in an exotic species

A
  • Same as dog/cat
  • History, clinical examination, radiography, cytology, biopsy, joint fluid analysis
  • Endoscopy/arthroscopy possible in some, coelioscopy to look at internal organs esp. kidneys
  • Sedation/GA often needed
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15
Q

What are the categories of lameness in exotics?

A
  • Metabolic and nutritional
  • Traumatic
  • Degenerative
  • Infection
  • Neoplastic
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16
Q

Discuss traumatic causes of lameness in exotics

A
  • Common from cage mates, other pets, owners

- Most reptiles should be kept alone, owners commonly think should be in pairs

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17
Q

Outline pododermatitis in rabbits

A
  • No pads on feet, hair only
  • Overgrown claws, overweight, DJD increase risk
  • Most rabbits have degree of pododermatitis
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18
Q

Where does degenerative joint disease most commonly occur in rabbits?

A
  • Stifles and spine most common

- Cranial cruciate disease common

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19
Q

What spinal deformity commonly occurs in older rabbits?

A

Spondylosis

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20
Q

Which spinal deformities commonly occur in rabbits generally?

A
  • Spondylosis
  • Kyphosys
  • Lordosis
  • Scoliosis
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21
Q

What factors are risk factors for spinal deformities in rabbits?

A
  • Small cages

- Lack of exercise

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22
Q

What do spinal deformities commonly occur as a result of in younger rabbits?

A

Breeding/husbandry

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23
Q

Outline the potential consequences of spinal deformities in rabbits

A
  • May interfere with locomotion, caecotrophy, urination, grooming
  • May result in faecal soiling, urine scald, unkempt co, Cheyletiella, facial dermatitis
  • Pain may lead to aggression, depression, GI stasis
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24
Q

What is kyphosis?

A

Excessive curvature of the spine

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25
Q

What are the most common sites of fracture in rabbits?

A
  • Spine and limbs
  • Jaw also common
  • Tibia most common
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26
Q

Discuss the development of nutritional secondary hyperparathyroidism in rabbits

A
  • Common due to feeding of muesli mix, lack of UV-B
  • Cause of dental disease in rabbits
  • Indoor rabbits or outdoor rabbits shielded from sunlight
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27
Q

What are the most common sites of luxation in rabbits?

A

Hip, elbow and tarsus

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28
Q

What is the most common tumour that may cause metastatic musculoskeletal disease in rabbits?

A

Uterine adenocarcinoma

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29
Q

Explain the relationship between renal failure and musculoskeletal disease in rabbits

A

Leads to hypercalcaemia (normally excess excreted in urine), leading to soft tissue calcification and bone hypercalcification

30
Q

How is musculoskeletal disease secondary to renal failure diagnosed in rabbits?

A
  • Biochem and haematology may be normal

- If see hypercalcification and calcification of soft tissues on radiography is enough for diagnosis

31
Q

What are the 3 main causes of muscular weakness in rabbits?

A
  • Floppy bunny syndrome
  • Splayleg
  • Nutritional muscular dystrophy
32
Q

Describe floppy bunny syndrome (presentation, cause, treatment)

A
  • Generalised flaccid paralysis but rabbit often still very alert with good appetite
  • Exact cause unknown: hypokaalemia, hypoMg, plant toxicity, myasthenia gravis, E. cuniculi suggested
  • E. cuniculi most likely
  • Majority recover within 3-4 days with supportive care
33
Q

Describe splayleg in rabbits (presentation, cause, treatment)

A
  • HL or FL affected, usually one or two rather than all 4
  • Usually younger rabbits
  • Poor prognosis vs. floppy bunny, often will not resolve
  • Treatment: supportive +/- euthanasia
34
Q

Describe nutritional muscular dystrophy in rabbits (presentation, cause, treatment)

A
  • Mostly commercial units, unlikely to be seen in pets

- Similar to sheep/cattle (Se deficiency)

35
Q

Describe the general treatment of musculoskeletal disorders in rabbits

A
  • Analgesia essential (opioids/NSAIDs)
  • Ensure soft, clean bedding
  • Ensure clean wounds, perineum, face, ears
  • Casts and splints contraindicated generally
  • Cage rest and pain relief effective
36
Q

Why are casts/splints generally contraindicated in rabbits?

A
  • Bones are wide proximally, thin distally - difficult to place
  • Often exacerbate injury due to pendulum effect
37
Q

What is the preferred treatment for fractures in rabbits?

A

External fixation for most fractures

38
Q

What are the main risks associated with surgical fixation of fractures in rabbits?

A
  • Rabbit bone has thin cortices, shatters easily

- Osteomyelitis significant risk with open wound, poor surgical technique, difficult to manage

39
Q

What are the main complications of hindlimb amputation in rabbits?

A
  • Contralateral pododermatitis
  • Ipsilateral otitis
  • But usually do well if generally well
40
Q

Which species of rodent in particular are prone to pododermatitis?

A
  • Guinea pigs
  • Chincillas
  • Rats
41
Q

What commonly leads to degenerative joint disease in guinea pigs?

A
  • Metastatic calcification
  • Can occur in lung/joints
  • Older guinea pigs usually, cause poorly documented
42
Q

What are key differentials for a ferret presented with HL paresis?

A
  • MSK disease
  • Hypoglycaemia
  • Cardiomyopathy
  • Generalised lymphooma
  • Generalised disease
  • Abscessation of spine
43
Q

Identify the common MSK diseases of ferrets

A
  • Spinal abscesses
  • Trauma
  • Long bone fracture
  • Elbow luxation
  • Vertebral disc prolapse and spinal neoplasia reported
44
Q

What is the most common cause of lameness and fractures in many exotic mammal species?

A

Nutritional secondary hyperparathyroidism (NSHP)

45
Q

Outline the general treatment of MSK disorders in exotic mammals

A
  • Cage rest
  • Analgesia
  • Supplement calcium and vit-D
  • Correct diet
  • UV-B provision
46
Q

Describe the clinical signs of lameness disease in birds

A
  • Can be very subtle
  • Abnormal stance +/- reduced grip on perch
  • Using beak/ipsilateral wing for support
  • Affected leg may be warmer
  • Bumblefoot on contralateral limb
47
Q

List orthopaedic causes of lameness in birds

A
  • Fractures
  • Bumblefoot
  • Luxation
  • Spinal injury
  • Growth deformities
  • NSHP
  • Septic arthritis
  • Osteomyelitis
  • Osteoarthritis
  • Tendon injury
  • Tenosynovitis
48
Q

Describe state of fractures in birds

A

Commonly compound and contaminated, esp. wild birds

49
Q

Which cause of lameness are waterfowl, raptors and budgies especially prone to?

A

Bumblefoot

50
Q

Where do spinal injuries most commonly occur in birds? Why?

A

At the vertebral synsacral junction - this is the only moveable part of the spine

51
Q

Name 2 common orthopaedic growth deformities in birds

A
  • Luxated gastrocnemius tendon

- Juvenile osteodystrophy

52
Q

When does juvenile osteodystrophy most commonly occur in birds?

A
  • Hand rearing (too much space, move too much, excessive strain on bones too soon)
  • Parents with inappropriate diet
53
Q

How do tendon injuries most commonly occur in birds?

A
  • Bites from companions/prey
  • Equipment on legs e.g. rings
  • Extension of skin infection
54
Q

Name the causative agent of tenosynovitis in birds

A

Mycoplasma synoviae

55
Q

Identify the non-orthopaedic causes of lameness in birds

A
  • Nephritis
  • Renal and testicular neoplasia
  • Gout
  • Mass effect in cloaca e.g. egg binding
  • Lead poisoning
  • Viral
56
Q

Explain how nephritis can cause lameness in birds

A
  • May be bacterial, parasitic, coccidial, fungal
  • Kidney swells, presses on nerve, causes sciatica type pain
  • Presents as paresis of limb
57
Q

Describe the lameness that may occur with renal and testicular neoplasia in birds

A
  • Most common in budgie

- Unilateral lameness

58
Q

What does gout in birds often occur secondary to?

A

Renal disease

59
Q

Describe the common presentation of lameness as a result of a cloacal mass effect

A
  • Pushes against kidney, leading to pain or lameness
  • Budgie, cockatiel, ducks most common
  • May have regurgitation
60
Q

Explain how lead poisoning may lead to lameness in birds

A
  • Neuro and renotoxic
  • Leads to limb weakness
  • Raptors may be seen holding own feet i..e one on top of the other
61
Q

Outline viral disease as a cause of lameness in birds

A
  • Marek’s disease in chickens
  • Young birds presented with progressive lameness, death
  • No MSK injury, one leg and one wing outstretched
62
Q

What are the key considerations for fractures in birds?

A
  • Lifestyle: wild need perfect restoration, caged can cop with less aggressive treatment
  • Compound fractures or close to joints carry poor prognosis for return to normal function
  • Ocular damage in 80% of impact injuries, damage to pecton probably PTS
  • Surgical repair only once patient stable for at least a day
63
Q

What is the pecton and explain its significance in birds?

A
  • Black segmented patch in eye of bird
  • Provides nutritional supply to the retina
  • Must be visualised prior to release, minor damage can do well, significant damage means euthanasia
64
Q

When do tibiotarsal fractures of birds most commonly occur?

A

In newly-jessed falconry birds

65
Q

Discuss the tethering of falconry birds

A
  • Should be short tether

- Prevent bird getting up too much speed before being held back

66
Q

Describe the treatment of fractures in birds

A
  • Immobilisation of joints more than 3-5 days may lead to permanent disability
  • Casts and splints generally contraindicated
  • Supportive body sling if trouble standing
  • Ex-fix and IM pin most useful
  • Must anaesthetise for each bandage change
  • Need physiotherapy
67
Q

What fractures in birds can have casts/splints applied?

A
  • Distal tarsometatarsal

- Tibiotarsal in very small birds

68
Q

List the factors that predispose to the development of bumblefoot

A
  • Poor perching surfaces
  • Trauma
  • Excessive weight bearing
  • Hypovitaminosis A
69
Q

Describe the clinical signs of lameness in reptiles

A
  • Can be very subtle even with severe fractures
  • Abnormal stance/gait +/- reduced grip
  • Often may just seem lethargic
  • Deformity of spine/limbs +/- generalised limb swelling may indicate metabolic bone disease
70
Q

Identify the orthopaedic causes of lameness in reptiles

A
  • Fractures
  • Luxation
  • Tendon/ligament injury or infection
  • Spinal injury(trauma, NSHP, burns)
  • Septic arthritis/osteomyelitis (solid pus)
71
Q

Identify the non-orthopaedic causes of lameness in reptiles

A
  • Gout and pseudogout
  • Pre- and post-ovulatory oostasis (POOS)
  • Urolithiasis
  • Hypocalcaemia
  • Viral (herpes in tortoise)

MSK2 (29 decks)

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