MSK Disease Flashcards
1
Q
Small mammal husbandry q’s
A
- inside or outside?
- any recent changes?
- trauma?
- diet?
- flooring?
- space?
2
Q
Reptile husbandry q’s
A
- viv, draw or table?
- temperatures?
- diet & supplements?
- any recent changes?
- trauma?
- bathing?
- substrate?
3
Q
Bird husbandry q’s
A
- where is the cage?
- diet?
- UV?
- recent changes?
- trauma?
- space/flying?
- flooring?
4
Q
Clinical signs of MSK dz in small mammals
A
- anorexia, lethargy, hiding
- wound +/- fly strike
- gut stasis (hind gut fermenter)
- not eating caecotrophs/cleaning back end
- hunched stance
- urine staining
- bruxism/teeth grinding
- aggression or being bullied
- weakness or limping on 1(+) legs
- weight loss (more associated with chronic problems)
5
Q
Clinical signs of MSK dz in reptiles
A
- can be very subtle
- less active
- anorexia
- abnormal stance or gait
- deformity of spine & limb +/- generalised limb swelling (indicative of MBD)
- wounds
- swollen joints
- weakness or limping on 1(+) legs
6
Q
Clinical signs of MSK dz in birds
A
- can be very subtle -> often just anorexia and lethargic
- abnormal or wide stance +/- reduced grip
- may use beak or ipsilateral wing for support
- affected leg may be warmer
- bumble foot on contralateral limb
- weakness or limping on 1(+) legs
7
Q
MSK dz categories
A
- MSK (similar to other app e.g. degenerative joint dz, infection & neoplasia)
- metabolic & nutritional causes of dz
- trauma
8
Q
Diagnostic tools for MSK dz
A
- imaging
- bloods
- joint fluid analysis
- cytology
- culture and sensitivity
- biopsy histopathology
9
Q
Imaging
A
- 1st line: radiographs, US
- referral: arthroscopy, CT & MRI
10
Q
Blood work
A
- biochem for underlying causes (include ionised calcium)
- haem for dehydration, infection or blood loss
11
Q
What can joint fluid analysis show/indicate?
A
- infection or gout, etc
12
Q
What tissues can you biopsy?
A
- bone
- soft tissue
13
Q
Common primary MSK problems of rabbits
A
- pododermatitis/bumblefoot
- degenerative joint dz (e.g. stifles, spine)
- spinal deformities & injuries
- fractures (e.g. spine, limbs)
- osteomyelitis
- luxation (e.g. hip, elbow, tarsus)
- primary neoplasia (e.g. osteosarcoma)
- splay leg (e.g. genetic or trauma)
14
Q
Common secondary MSK problems of rabbits
A
- abscesses: bite wounds -> systemic spread to joints
- metastatic neoplasia (e.g. uterine adenocarcinoma)
- nutritional secondary hyperparathyroidism (NSHP): muesli mix, lack of UVB
- renal failure -> hypercalcaemia -> soft-tissue calcification and bone hypercalcification
- encephalitozoon funiculi (parasitic) -> hindlimb paresis
15
Q
Fractures caused by trauma in rabbits
A
- often occur when rabbit is dropped or jumps from height
- rabbits tend to make sudden, surprise escape attempts
- jaw fractures common but easily overlooked
16
Q
Fractures secondary to dz in rabbits
A
- osteosarcoma of tarsus
- metastatic dz (e.g. uterine adenocarcinoma)
17
Q
Spinal deformities in rabbits
A
- spondylosis
- kyphosis
- lordosis
- scoliosis
- ^ all occur quite commonly
18
Q
Risk factors for spinal deformities in rabbits
A
- small cages
- lack of exercise
19
Q
Consequences of spinal deformities in rabbits
A
- may interfere with locomotion, caecotrophy, urination, grooming
- may result in faecal soiling, urine scald, unkempt coat, Cheyletiella, facial dermatitis and gut stasis due to pain
20
Q
Common primary MSK problems of rodents
A
- podomeratitis is common in GPs, chinchillas and rats
- overgrown claws and keratin horns in GPs -> lameness
- metastatic calcification -> degenerative joint dz in GPs
- fractures are relatively common in chinchillas and hamsters, e.g. dropped or entrapped in cage bars and exercise wheel
- trauma
21
Q
Common primary MSK problems of ferrets
A
- hindlimb paresis common, often due to non-MSK dz e.g. hypoglycaemia or cardiomyopathy
- trauma e.g. long bone fractures
- luxation e.g. elbow
- abscessation of the spine
22
Q
Is walking with an arched spine normal or abnormal in the ferret?
A
- normal
23
Q
Common MSK problems in ferrets
A
- pelvic fracture and pneumothorax following fall from height
- femoral head and neck necrosis
24
Q
Common primary MSK problems of birds
A
- trauma (e.g. long bone fractures [often compound/open]), coracoid fractures and spinal injury)
- pododermatits/bumblefoot
- nutritional secondary hyperparathyroidism (NSHP)
- osteomyelitis & septic arthritis
- osteoarthritis, often in older birds +/- injury
- tenosynovitis & tendon injury (e.g. infection, bites, equipment rubbing)
- growth deformities (e.g. osteodystrophy, luxated gastrocnemius tendon)
25
Q
Common secondary MSK problems of birds
A
- kidney dz & gout
- viral (e.g. Marek’s dz in chickens)
- egg binding
- lead poisoning
26
Q
What is osteodystrophy?
A
- abnormal changes in the growth and formation of bone
27
Q
What can be caused when removing leg rings from birds?
A
- iatrogenic fractures
- so GA is required
28
Q
Trauma in birds
A
- falconry birds are often kept tethered to a perch during training, etc
- fractures to the tibiotarsus can occur when the bird ‘bates’ with a tether that is too long
29
Q
Causes of / risk factors for pododermatitis in birds and small mammals
A
- poor perching surfaces (birds)
- poor substrates/flooring (small mammals)
- trauma
- poor hygiene
- obesity
- hypovitaminosis A
- lack of exercise
29
Q
Pododermatitis in birds and small mammals
A
- pressure-sore on the plantar surface of foot often due to poor blood circulation
- allows entry of infection, can progress to osteomyelitis
- important to examine and radiograph both limbs
30
Q
Grade I bumblefoot in chickens
A
- small, shiny pink areas and/or peeling or flaking on the chickens leg and/or feet
31
Q
Grade II bumblefoot in chickens
A
- smooth, shiny surfaced, circumscribed areas on the pads of 1 or both feet
32
Q
Grade III bumblefoot in chickens
A
- ulcerations on footpads
- peripheral callus may form
33
Q
Grade IV bumblefoot in chickens
A
- necrotic plug of tissue present in ulcers
- will be painful and cause mild lameness
34
Q
Grade V bumblefoot in chickens
A
- swelling and oedema of the tissues surrounding the necrotic debris
- severe lameness is usually present
35
Q
Common primary MSK problems in reptiles
A
- luxation
- tendon/ligament injury or infection
- spinal injury (e.g. trauma, NSHP, burns)
- septic arthritis/osteomyelitis (note- they have solid pus)
36
Q
Common secondary MSK problems in reptiles
A
- fractures (commonly due to NSHP/RSHP (MBD))
- gout
- pre- and post-ovulatory oostasis -> space occupying
- urolithiasis (if they have bladder, e.g. tortoises) -> space occupying
37
Q
How can you treat simple fractures in reptiles?
A
- splinting the affected limb against the body, tail, or with the shell
38
Q
Gout in birds and reptiles
A
- birds excrete nitrogenous wastes as urates
- renal dysfunction decreases the clearance of uric acid from the blood -> hyperuricaemia
- hyperuricaemia -> precipitation of insoluble products within the body (irate deposition or urolithalisis)
- urate deposits are white and semi-solid
39
Q
2 types of gout in birds & reptiles
A
- visceral urate deposition -> urate deposits in soft tissues
- articular urate deposition -> urate deposits on synovial membranes -> chronic granulomatous reaction -> lameness
40
Q
Treatment for MBD (NSHP or RSHP)
A
- heavy external computation and/or surgical fixation are contraindicated with NSHP
- cage rest, analgesia, supplement calcium and vitamin D, provide UVB and start to correct diet
- diet changes slow and gradual in birds
41
Q
General principles for MSK dz treatment
A
- most tx same as cats & dogs
- clean, dry, comfortable bedding (e.g. cover perches in vet wrap)
- clean wounds and in rabbits clean perineum (fly strike risk)
- surgical fixation of fractures is often preferred but not if MBD
- osteomyelitis is a significant risk with exotics and small mammals with open wounds or with poor surgical technique
- antibiotics may be needed (e.g. open wounds, joint infections)
42
Q
Supportive care
A
- pain relief (e.g. NSAID (meloxicam) and opioids (reptiles: morphine [buprenorphine?], birds: butorphanol, small mammals: buprenorphine)
- fluids (oral, sc, ic, iv, io)
- warmth for all species (specific POTZ if reptile)
- tube feeding birds and reptiles (high protein recovery diet)
43
Q
Fracture repair methods
A
- cage rest only (pelvic or clavicle)
- external stabilisation (if bone is too small for internal stabilisation)
- internal fixation (IM pins work well in avian bones)
- ‘hybrid’ fixation (IM pins with external skeletal fixators)
44
Q
Small mammal fracture considerations
A
- casts and splints are generally contraindicated
- external fixation is useful for most fractures
- rabbit bone has thin cortices -> shatters easily
- fractures heal quickly with appropriate fixation (6-8w)
- hindlimb amputation increases risk of contralateral pododermatitis
- forelimb amputation increases risk of ipsilateral otitis
45
Q
Bird fracture considerations
A
- lifestyle of the bird should be considered when assessing prognosis and treatment (cage vs wild)
- main aim is to restore limb function asap
- hybrid fixator îs able to oppose axial, shear, bending, torsional and compressive forces acting on fractures - in falconry birds or bird of prey wildlife casualties this is necessary
- higher bone mineral content, so high risk of open, comminuted fractures
- vertebral, pelvic, sternal and costal bone contain the diverticula of the air sac system
- avian bones heal very fast (3-4w)
- surgical repair only once pt is stabilised
- immobilisation of joints for more than 3-5d may lead to permanent disability so casts and splints are generally contraindicated
- ^ exceptions are distal tarsometatarsal fractures and tibiotarsal fractures in very small birds
- supportive body sling if trouble standing
- external skeletal fixator + IM pin most useful
46
Q
When to consider euthanasia for bird fractures?
A
- fractures which are compound and/or close to joints carry a poor prognosis for return to normal function/release
- ocular damage occurs in 80% of impact injuries
47
Q
Surgical equipment for all species
A
- basically same as dog/cat
- basic fine surgical kit + mini chuck & pin cutters for most surgeries
- weight and size of implants can be a problem in exotic pts
- consider ordering in other equipment, such as bird collars to stop pts interfering with the wound
48
Q
Grade 1-3 pododermatitis tx
A
- non-surgical
- husbandry changes
- topical or systemic ABs if needed
- pain relief, such as an NSAIDG
49
Q
Grade 4-5 pododermatitis tx
A
- surgery needed to debride, remove the core and flush
- radiographs to assess bone involvement
- send swab/material away for C&ST
- dressing in birds (ball bandage/shoe bandage)
- can’t use collars in hindgut fermenters
- pain relief, e.g. opioids
50
Q
Causes of trauma
A
- incorrect or dangerous environment, e.g. wire cage
- incorrect or dangerous handling e.g. rabbits
- tethering and using equipment incorrectly
- poor protection from other animals e.g. wildlife or other pets
- unbalanced flight e.g. 1 sided wing clipping
- escaping an enclosure e.g. falling out of viv or flying out of cage
51
Q
Causes of MBD
A
- incorrect diet +/- supplements
- low environmental temperatures
- lack of UVB light
52
Q
Potential limitations in exotic species
A
- tendency to hide dz well
- normal gait varies across species
- pt size and demeanour can make a full clinical exam difficult or impossible
- sedation or general anaesthesia often required
- subtle lesions and even some fractures can be difficult to diagnose, esp in smaller pts
- equipment hard to find due to sizes and requirements
