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Y4 exotics > MSK Disease > Flashcards

MSK Disease Flashcards

1
Q

Small mammal husbandry q’s

A
  • inside or outside?
  • any recent changes?
  • trauma?
  • diet?
  • flooring?
  • space?
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2
Q

Reptile husbandry q’s

A
  • viv, draw or table?
  • temperatures?
  • diet & supplements?
  • any recent changes?
  • trauma?
  • bathing?
  • substrate?
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3
Q

Bird husbandry q’s

A
  • where is the cage?
  • diet?
  • UV?
  • recent changes?
  • trauma?
  • space/flying?
  • flooring?
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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)
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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
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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
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7
Q

MSK dz categories

A
  • MSK (similar to other app e.g. degenerative joint dz, infection & neoplasia)
  • metabolic & nutritional causes of dz
  • trauma
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8
Q

Diagnostic tools for MSK dz

A
  • imaging
  • bloods
  • joint fluid analysis
  • cytology
  • culture and sensitivity
  • biopsy histopathology
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9
Q

Imaging

A
  • 1st line: radiographs, US
  • referral: arthroscopy, CT & MRI
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10
Q

Blood work

A
  • biochem for underlying causes (include ionised calcium)
  • haem for dehydration, infection or blood loss
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11
Q

What can joint fluid analysis show/indicate?

A
  • infection or gout, etc
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12
Q

What tissues can you biopsy?

A
  • bone
  • soft tissue
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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)
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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
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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
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16
Q

Fractures secondary to dz in rabbits

A
  • osteosarcoma of tarsus
  • metastatic dz (e.g. uterine adenocarcinoma)
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17
Q

Spinal deformities in rabbits

A
  • spondylosis
  • kyphosis
  • lordosis
  • scoliosis
  • ^ all occur quite commonly
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18
Q

Risk factors for spinal deformities in rabbits

A
  • small cages
  • lack of exercise
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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
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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
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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
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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

Y4 exotics (9 decks)

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