Externships

Question 1

age range for ferret heart disease

Answer 1

greater than 3.5 years

Question 2

signs of adrenal disease in ferrets

Answer 2

straining to urinate ir defecate
lethargy
alopecia
comedones of the tail
unexpressible bladder
vulur and mammary enlargement

Question 3

pattern of alopecia in ferrets with adrenal disease

Answer 3

tail, dorsum, ventrum, head, and legs. These signs are pathognomonic

Question 4

treatment of adrenal disease in ferrets

Answer 4

leuprolide acetate to amelioate sighns at 100 mcg. fetter in the semimenbranosis. This is repeated every 30 days

surgical excision in the best course of action.

Question 5

If a ferret with adrenal disease is blocked due to secondary prostamegaly, what is the specific drug to do?

Answer 5

casodex (bicaltamide). this blocks testosterone and will help faster than lupron, Dosage is 5 mg/Kg SID

Question 6

Supportive care for a bird thats sick

Fluid rate

Answer 6

25ml/KgSQ BID

Question 7

when gavage feeding a bird:

Answer 7

2.5- 3.0 cc per 100 grams of BW

Question 8

General care for a sick bird

Answer 8

fluids
gavage feeding
heated cage
perching should be kept low
oxygen cagerate is 2L/hr

Question 9

what are signs of dyspnea in a sick bird

Answer 9

open beaked breathing
increased abdominal effort
tail bob
tachypnea
cyanosis

Question 10

what are the minimum treatment options of a dysneicavian

Answer 10

get weight
oxygenate
terbutaline
Give IM abx

Question 11

teflon toxicosis

Answer 11

peracutepulmonary edema, hemorrhage

treat with terbutaling, NSAID, oxygen,supportive care, antibiotic prophylaxis

Question 12

avacado toxicosis

Answer 12

flush crop if its before 4 hrs
activated charcoal
oxygen
support

Question 13

broken blood feather

Answer 13

full gently in the direction of growth

can suture skin if needed

Question 14

broken beak tip

Answer 14

note blood in the oral cavity
apply pressure
AgNO3
analgesia

Question 15

treatment of dog and cat attacks

Answer 15

piperacillin (150 mg/Kg) TID
Baytril (15 mg/Kg) SQ in fluids BID
TMS (30 mg/Kg IM or PO BID

Question 16

assessment of head trauma

Answer 16

wet the feathers of the head
check aural openings (any blood is bad)
mannitol if there are CNS signs
supportive care with no heat

Question 17

lead toxicity

Answer 17

signs: lethargy, seizures, tremors, pelvic limb paresis,
chocolate milk droppings

Treatment with CaEDTA (35 mg/Kg IM BID for 5 days) then repeat PRN

this treatment is the same for Zinc Toxicity

Question 18

other causes of seizures

Answer 18

Hypocalcemia- african greys, diet issues. Treat with Ca gluconate 100 mg/Kg IM or SQ
idiopathic of cockatiels-treat with diazepam at 0.5 mg/Kg IV or IM

Question 19

ddx for pelvic limb paresis

Answer 19

trauma (wet the back to look at the spine)
Abdominomegaly-egg binding, renal or gonadal tumors
infectious- aspergillois, Avian Borna virus

Question 20

dystocias

Answer 20

Hx- strai2- ning, lethargy, weakness, poor diet
PE- dilated or flaccid cloaca. Palpable egg

Dx- radiographs

TX
1- Ca, Vit A/D/E, fluids, heat, humidity
2- oxytocin- dialate the vaginal sphicter first. 5IU/Kg IM
3- assist delivery with lots of lubricant/percloacal ovocentesis
4- hospitilize for 24 hours. ascess renal function, urates, bleeding, spesis

send home for antibiotics and observation

Question 21

cloacal prolapse

Answer 21

flush and clense
shrink edematous tissue using topical 50% dextrose
lubricate and gently remocve the edd and reduce prolapsed tissue. NO PURSE String.

Question 22

renal disease in avians

Answer 22

signs: tophi in joints. Uni or bilateral paresis, increased uric acids

treat with SQ diuresis at 75 mL/Kg/day

allopurinol to block uric acids at 8-10 mg/kg PO BID

colchicine at 0.04 mg/kg PO S-BID

Question 23

reguritation and crop stasis

Answer 23

crop swab

aspirate fluids back

Question 24

GI foreign body in avians spp

Answer 24

metamucin in water through a feeding tube
chelation
surgery

if Its in the crop then remove as soon as possible if lessthan 20 minutes. If there is fluid, aspirate back and milk the FB into the mouth and remove. This can be done under anesthesia if needed.

Question 25

early herbivore enterotoxemias

Answer 25

Fairly alert, normal, but with diarrhea and a temperature of less than 100F (chinchillas less than 99). High carb diet, lethargy. there may be very mild lethargy and pallor

CBC/CHEM- normal liver values can rule out liver torsion
radiographs

treatment with LRS at 100 to 150 mL/Kg per day divided TID, buprenex- 0.03 mg/Kg BID, 0.01-0.05 mg/Kg. Prokinetics like cisapride or metoclopramide0.5 mg/kg PO or SQ B-Syringe-feeding (Critical Care Herbivore- rabbits- 12-24cc QID, chin or GP 6-12cc QID)
*Antibiotics (metronidazole @ 10 mg/kg, chloramphenical at 50 mg/kg, or in rabbits only Procaine penicillin G- 70,000 IU/kg SQ q48 hr)
*Toxin chelation (cholestyramine- mix 1 packet to 40mL tap water, syringe-feed rabbits 12cc , chin or GP 6cc S-BID)
Heat therapy until T > 100. (Monitor closely, these species are susceptible to heat stress!)

prognosis is guarded as decompensation is fatal)

Question 26

enterotoxemic shock in small herbivores

Answer 26

Weak, lethargic, pale and/or increased respiratory effort with T < 100
Can be rapidly fatal

Signalment
Any small herbivore, any age, either sex

History
Same history as GI stasis and enterotoxemia

Physical Examination
Temperature <100 (axillary +1 degree is acceptable to avoid stress or injury)
Chinchillas <99
Abdominal palpation same as GI stasis
Lethargy or pallor may occur (adrenaline won’t mask for very long)
Incr. respiratory effort

Diagnostics- BP <40 mm Hg
No additional! Stabilize patient!

Treatment
IVC will be invaluable here. If IV access cannot be obtained without undue stress to patient, give warmed SQ fluids (LRS @ 100 mL/kg) and place on heat, +/- cover with warm blanket. As fluid is absorbed, consider reattempt IVC; intraosseus in femur is also acceptable (as in puppies)

1) Crystalloids- 10-15 mL/kg IV
Hetastarch- 15 mL/kg IV over 15 min.
Recheck BP. If <40 mm Hg, repeat. If still <40mm Hg, go to step 2.
If >40 mm Hg, go to step 3.

2) Hypertonic Saline- 3 mL/kg over 10 minutes
Hetastarch- 3 mL/kg IV over 15 min.
Crystalloids- 4 mL/kg/hr IV

Recheck BP.  	If <40 mm Hg, rule-out hypoglycemia or heart disease (rads)
		If >40 mm Hg, go to step 3. 

3) Warm aggressively including IV crystalloids until BP > 90 mm Hg
If BP drops below 40 mm Hg, return to step 1.

Once stable, administer treatments as per enterotoxemia. Treatments may need to be given slowly due to stress. **Therefore, first treatment should be toxin chelation (cholestyramine- mix 1 packet to 40mL tap water, syringe-feed 12cc S-BID, chin and GP 6cc S-BID) CBC/chem. and possibly rads may be warranted if patient is stable. Additional diagnostics should be deferred.

Prognosis
Guarded-grave unless recovers completely and quickly following above treatment.

Question 27

signalment and history for ferret diarrhea

Answer 27

Signalment: ferrets <1 year old more likely to be infectious (non-Helicobacter) or GI FB
ferrets > 1 year more likely to be Helicobacter or GI FB

diarrhea will be reported as being soft or seedy, green or malena, vomiting, nausea, gagging , pytalaism pawing and mouth, pain, anorexia, hsitory of eating something

Question 28

PE of a ferret with diarrhea

Answer 28

: +/- debilitated (dehydration by CRT, lethargy), abd. Palpation may have focal thickening/discomfort (incr. suspicion for GI FB), or just generalized SI thickening, gas, fluid. Abd. LN enlargement can occur (not pathognomonic for LSA).

Question 29

ddx for diarrhea in a ferret

Answer 29

Helicobacter gastroenteritis +/- ulcerative gastritis, GI FB (including trichobezoars), LSA, IBD, eosinophilic gastroenteritis, ECE (epizootic catarrhal enteritis)- usually older ferret exposed to new or young ferret, proliferative bowel disease (younger), metabolic derangement

Question 30

treatment of diarrhea in a ferret

Answer 30

ATH if debilitated, many times tx for Helicobacter with further work-up if young or poor response to tx.
Amoxicillin – 20 mg/kg PO BID
Metronidazole- 15-20 mg/kg PO BID
Sucralfate- 100 mg/kg PO B-TID 20 min. before meals or meds.
Famotidine- 0.5 mg/kg PO/SQ/IV S-BID

Question 31

gastrointestinal tract stasis is an emergency in small herbivores. What is the history?

Answer 31

Can be acute (<24 hours) or chronic (2-7 days)
Inappetance, anorexia, or normal appetite (usually early)
Small, dry, sparse droppings
May have dysphagia
Emotional stress (travel, owner away, construction or new pet or family member in home)
Physiological stress (underlying disease, typically dental, infectious, renal, hepatic, or cardiac, or heavy metal toxicity)
Dietary issues (low fiber or high protein or high carbohydrate diet)

Question 32

Physical examination of a colicky small herbivore

Answer 32

Temperature >100 (axillary +1 degree is acceptable to avoid stress or injury) Chinchilla >99
Abdominal palpation may or may not reveal:
Splint, vocalizations
Full firm stomach
Tympany (stomach or cecum)
Empty cecum
Liquidy or gassy cecum
Lack of feces in colon
Decreased borborygmus (almost always decreased or absent unless very early in process)

Question 33

diagnostics of a small herbivore thats colicky

Answer 33

CBC/chem.- normal liver enzymes can help rule-out life-threatening liver torsion

E. cuniculi titer- ideal to always check, but especially when nothing in history or PE suggests underlying problem

Lead level- particularly for known chewers allowed loose in homes >35 years old.
(Has been seen in pets from “certified lead free” homes in our area)

Imaging- Radiographs- ideal to always check, but especially important in severely debilitated (if not outweighed by risk of stress), severely painful, if PE is equivocal, or if looking for radiographic signs of underlying disease. U/S- recommended especially if liver torsion or FB suspected.

Question 34

treatment and prognosis of small herbivore enterotoxemia

Answer 34

Rehydration (SQ fluids- Maintenance is LRS @ 100-150 mL/kg per day, divided TID)
Analgesia (buprenex- 0.03 mg/kg BID) (range 0.01-0.05 mg/kg)
Prokinetics (cisapride when available, metoclopramide 0.5 mg/kg PO or SQ B-TID)
Syringe-feeding (Critical Care Herbivore- rabbits 12-24cc QID, chin or GP 6-12cc QID)

Prognosis
Good if not debilitated, not too painful and no underlying disease; unfortunately, decompensation due to any of these can be rapid and fatal.