Exam 2: GI, Endocrine, Hepatic Exotics

generally define adrenal disease in ferrets

• adrenocortical hyperplasia or adenoma or carcinoma

• excess secretion of ANDROGENS with minimal glucocorticoid, mineralcorticoid production

what layer of the adrenal is affected in ferrets

zone reticularis

signalment renal disease

• no sex predilection

• ferrets 3+

• 85% unilateral with L more common (R is much harder to treat)

• 15% bilatera

adrenal disease clinical signs 

• bilateral symmetrical alopecia 

• vulvarprostate enlargement ± urethral obstruction 

• pruritis

• recurrence of sexual behavior 

• comedones 

• thinning of skin 

• anemia uncommon 

diagnostics adrenal  disease 

• clinical presentation 

• CBC

• chemistry panel 

• ultrasound showing >3.9mm width 

• CT 

• sex steroid measurement definitive 

• urinary cortisol:creatinine 

surgical management of adrenal disease

• debulking

• excision

• cryosurgery

• left easier to opporate than right

• disease free perod 13.6mo

medical management adrenal disease

• GnRH agonist causing initial rise then fall of gonadotropins

• deslorelin implant lasts 8-12 months

• lupron

adrenal disease prognosis 

• medical management works well for hyperlasia and adenomas 

• may or may not work for carcinoma 

• prognosis highly variable 

generally define insulinoma

• pancreatic beta cell tumor

• inhibits response of glucagon, cortisol, epi, GH leading to decreases glycogenolysis and gluconeogenesis

• increased uptake of glucose in the tissue

clinical signs insulinoma

• decreased activity

• weakness

• lethargy

• star gazing

• sudden collapse

• excessive salivation

• glassy eyes

• weight loss with normal appetite

diagnosis insulinoma 

• history and signs 

• fasting glucose <70

• incidental via working up adrenal disease or during surgery 

treatment of insulinoma

• prednisone to inhibit glucose uptake by tissues and stimulate gluconeogenesis (avoid alcohol suspension)

• Diazoxide acts on pancreatic beta cells to inhibit release of insulin

• surgerical treatment

monitoring for insulinoma

• blood glucose

• clinical signs

• many ferrets will remain hypoglycemic with no clinical signs while on pred

• adjust dose as needed

insulinoma prognosis 

• depends on severity and age 

• will lead to problems with time 

generally define epizootic catarrhal enteritis

• ferret enteric coronavirus aka green slime disease

• villi blunting causes malabsorption and maldigestion

• transmission from asymptonmatic juvenile ferret

clinical signs ECE

• severe green diarrhea that persists for several days

• dehydration

• bruxism, ptyalism, pawing at the mouth

• vomiting

diagnostics ECE

• PCR on feces 

• ELISA

• rule out other conditions 

ECE treatment

• aggressive IV crystalloids

• antibiotics - clavamox, metro, tylosin

• prednisolone

• gastroprotectants/antinausea mediactions )famotidine, omeprazole, sucralfate

• easily absorbed bland diet

types of GI foreign bodies in ferrets

• <2yo foreign objects

  • >2yo trichobezoars

clinical signs of GI foreign bodies 

• lethargy 

• inappetance 

• diarrhea 

• nausea (bruxism, ptyalism , pawing at face, vomiting) 

GI foreign body diagnosis

• rads → whole body 3 view, may be false negative, ± barium contrast

• ultrasound under anesthesia

• diagnostic exploratory surgery

GI foreign body treatment

• surgery

• owner education

causes of gastric ulcers in ferrets 

• stress 

• NSAIDs and steroids 

• Helicobacter mstela → opportunistic organism, gastric MALT lymphoma 

signs of gastric ulcers

• anorexia

• bruxism, hypersalivation

• melena, vomiting

gastric ulcers diagnostics

• clinical signs

• CBC and chem

• definitive is scoping + biopsy

gastric ulcers treatment 

• amoxicillin and metronidazole 

• gastroprotectants including sucralfate, ranitidine, famotidine, omeprazole, pantoprazole, maropitant 

• bland foods

• fluids 

GI disease in rabbits

• iatrogenic dysbiosis

• ileus/stasis

• liver lobe torsion

generally define antibiotic induced dysbiosis

• loss of delicate balance between G+ and G- flora in the intestine

antibiotics you do NOT use in rabbits due to risk of dysbiosis 

• PLACE 

• penicillins 

• lincomycins 

• amoxicillin 

• cephalosporins

• erythromycin 

  • strong coverage for G+

history and physical exam for GI dysfunction in rabbits 

• anorexia/hyporexia, diarrhea or soft tissues, reduced pellets, lethargy, depressed, abdominal discomfort 

• dehydrated, painful, distended abdomen, matted fur, decreased borborygmi 

GI dysfunction diagnostics

• CBC

• chemistry

• radiographs

• THIS IS AN EMERGENCY

rabbit ielus differentials

• bloat

• trichobezoar

• dehydration

• underlying disease

• foreign body

• idiopathic or stress

4 pillars of treating gastrointestinal dysfunction 

• fluid therapy 

• nutritional support 

• pain management 

• heat support 

other treatment options for GI dysfunction

• antibiotics

• metoclopramide once confirmed no onstruction

• laxatone

prognosis and sequella of gastric dysfunction in rabbits

• temperature and glucose

• rapid deterioration, hepatic lipidosis, death

antibiotic related enteritis in rabbits 

• no PLACE , colibacillosis 

• often from e.coli 

• neonates 1-14 days 100% mortality 

• supportive care, enrofloxacin 

define liver lobe torsion in rabbits

• caudate lobe

• acute or chronic

• present with GI stasis ± pale MM

diagnosis liver lobe torsion

• PCV/TS, AFAST

• CBC chem with liver enzymes elevated with normal CK

• ultrasound

treatment liver lobe torsion

• surgical management ideal partial lobectomy + transfusion PRN + GI stasis management

• medical management 50% prognosis, long term GI management, metronidazole and enrofloxacin

define PDD or bornavirus 

• aka macaw wasting disease, neuropathic ganglioneuritis, lymphoplasmacytic ganglioneuritis 

• dilation of the proventriculus causing gastrointestinal dysfunction and damage to enteric nervous system 

clinical signs PDD/bornavirus

• cachexia

• crop stasis

• GI dilation

• regurgitation

• malgigestion

• starvation

• death

CNS signs of PPD/Bornavirus

• encephalitis

• myelitis

• depression

• seizures

• ataxia

• blindness

• tremors

definitive diagnosis PDD/bornavirus 

• problematic due to inconsistent distribution of lesions 

• antibody response using western blot 

• PCR antigen

bornavirus pathogenesis

• unknonw

• normal bird shows 18-20kDa brain protein

• sera from normal bird reaction

• transent autoimmune response to myelin?

• response to brain gangliosides following viral infection?

transmission of bornavirus

• common and widespread in captive psittacine species

• clinical disease and subclinical carriers

general treatment for bornavirus 

• antiviral → amantadine for 6 weeks (does not affect fecal shedding)

• cyclosporine as imunosuppressant 

• anti inflammatories maybe (celecoxib, meloxicam) 

• combination therapy 

• immunomodulating therapy using robenacoxib or M. bovis extract 

generally define mycobacteria spp

• human contact of M. tuberculosis, soil and water, infection

• affects all bird species

forms of mycobacteria spp

• atypical = enlarged organs

• lepromatous = SQ nodules

• tuberculous = nodules on internal organs

clinical signs mycobacteria 

• weight loss 

• polyphagia 

• depression 

• diarrhea, polyruria 

• poor feathering 

• lameness

PE presentation mycobaceria

• emaciation

• ceolomic distension

• dyspnea

• conjunctive and SQ masses

• bumblefot

• eczema

• darkened damaged feathers

diagnosis of mycobacteria

• RAD

• biopsy of liver and skin

• serology

  • culture or histopath

treatment mycobacteria 

• riphampin 

• isoniazide

• ethambutol 

• EUTHANASIA 

gram negative bacteria that affect birds

• E. coli

• Pseudomonas

• Aeromonas

• Pasteurella

• Salmonella

gram positive bacteria that affect birds

• streptococcus spp

• enterococcus spp

• staphylococcus spp

• mycobacteria spp

define avian chlamydiosis 

• Chlamydia psittaci also known as Ornthosis and Psittacosis in humans 

lesions of avian chlamydiosis

• conjunctivitis

• pneumonia/air sacculitis

• hepatomegaly and splenomegaly

• hemorrhages and exudate on the heart surface

clinical signs of avian chlamydiosis

• respiratory distress

• nasal and ocular discharge

• inflamed choana

• weight loss, chronic

• regurgitation and diarrhea

• neonatal death on second or third clutch

• incoordination, ataxia

diagnostic challenge of avian chlamidiosis 

• leukocytes >40,000

• large new world birds can see leukocytosis, monocytosis/basopholia, anemias 

• budgerigars show relative monocytosis/basophilia 

diagnostic tests for C. psittaci

• direct complement fiaxation test

• culture

• elementary-body agglutination test

• PCR

• histopathology

confirmed cases of avian chlamydiosis

• culture and isolation + flourescent antibody

• serum antibody titer 4x rise over 14 days

• stains of macrophages or tissues

antibiotics active for Chlamydia spp 

• tetracycline 

• erythromycine 

• rifampin 

• fluoroquinolones 

• azithromycin 

reporting of avian chlamydiosis

• vets and labs required to report a diagnosis

• state department of agiculture = case tracebacks, may impose bird quarantine, source of infection, assess human health risk

predisposing factors to nutritional secondary hyperparathyroidism

• decreased Ca and or vitamin D

• imbalance of Ca:P ratio

• lack of exposure to UVB

pathophysiology of NSHP

• increased PTH in response to decreased Ca

• Ca transfered to extracellular space 

• result is increased serum Ca and weak bones, rickets and osteomalacia 

• animals will only be hypocalcemia if very early or very late 

• seen in long bones, mandible, spine, skull 

• fibrous osteodystrophy 

diagnosis of NSHP

• history and clinical presentation

• radiographs

• ± Ca with normal P levels

treatment of NSHP

• correct diet and husbandry

• treat any fractures

• Ca and Mg supplementation

• ± supportive care

foreign bodies in reptiles 

• geophagia (Picca)

• plant based material like wood chips

• free roaming reptiles eat everythi ng 

• asymptomatic, painful, anorectic 

• rads of pylorus and colon 

treatment of GI foreign bodies in reptiles

• passage days to weeks, up to 4 weeks → metaclopramide suggested but potential dangers

• surgery if removal is necessary such as heavy metals

generally define gastric neirendocrine carcinoma

• bearded dragon disease

• somatostatinoma = excessive release of somatostatin from the tumor that inhibits insulin secretion

presentation of gastric neuroendocrine carcinoma 

• poor body condition 

• anorexia 

• depressed and not moving 

• vomiting 

• other signs if tumor has spread to othe rorgans such as the liver 

diagnosis of gastric neuroendocrine carcinoma

• biochem for increased glucose

• diagnostic imaging

• biopsy

prognosis and treatment of gastric neuroendocrine carcinoma

• grave

• surgery, chemo, radiations, supportive care