TREATMENT OF MYCOTIC RHINOSINUSITIS IN A BENNETT'S WALLABY ( MACROPUS RUFOGRISEUS) USING TOPICAL VORICONAZOLE SUSPENDED IN A REVERSE THERMODYNAMIC PLURONIC GEL.

An approximately 4-yr-old female Bennett's wallaby ( Macropus rufogriseus) was evaluated for chronic left-sided facial swelling and nasal discharge. Computed tomography, endoscopy, biopsy, mycologic culture, and panfungal polymerase chain reaction were consistent with destructive mycotic rhinosinusitis. The patient's infection was treated with a long-term injectable antibiotic, oral antifungal therapy, and multiple intranasal infusions of voriconazole suspended in a reverse thermodynamic pluronic gel. This case represents the first documented case of mycotic rhinosinusitis in a macropod and underlines the importance of advanced cross-sectional imaging in the diagnosis, monitoring, and management of nasal cavity disease in zoo animals.

CALVARIAL OSTEOSARCOMA WITH CEREBRAL COMPRESSION IN A FREE-RANGING POWERFUL OWL (NINOX STRENUA).

A free-ranging powerful owl (Ninox strenua) presented in a dull state with extensive bruising of the skin overlying the skull, due to suspected trauma. Supportive care was provided, which resulted in the return to a normal state, although intermittent subtle neurologic abnormalities remained. One month from original presentation, intermittent episodes of head turning and a possible seizure were noted, but behavior and appetite were otherwise normal. The owl was referred to Taronga Wildlife Hospital for evaluation. On presentation, the owl exhibited severe neurologic abnormalities, prompting euthanasia. At necropsy the dorsum of the skull exhibited marked osseous proliferation, extending ventrally and compressing the cerebrum. The skull was radiographed and submitted for histopathology. A diagnosis of osteoblastic osteosarcoma was made. This is the first report of a calvarial osteosarcoma in a powerful owl.

Utilization of Health Care Coalitions and Resiliency Forums in the United States and United Kingdom: Different Approaches to Strengthen Emergency Preparedness.

The process for developing national emergency management strategies for both the United States and the United Kingdom has led to the formulation of differing approaches to meet similar desired outcomes. Historically, the pathways for each are the result of the enactment of legislation in response to a significant event or a series of events. The resulting laws attempt to revise practices and policies leading to more effective and efficient management in preparing, responding, and mitigating all types of natural, manmade, and technological hazards. Following the turn of the 21st century, each country has experienced significant advancements in emergency management including the formation and utilization of 2 distinct models: health care coalitions in the United States and resiliency forums in the United Kingdom. Both models have evolved from circumstances and governance unique to each country. Further in-depth study of both approaches will identify strengths, weaknesses, and existing gaps to meet continued and future challenges of our respective disaster health care systems.

CT findings in two cats with broncholithiasis.

CASE SERIES SUMMARY: Chronic inflammatory airway disease with secondary broncholithiasis was diagnosed in two cats from CT and bronchoalveolar lavage cytological findings. In one cat with progressively worsening lower respiratory tract signs, more than 80 discrete, highly attenuating endobronchial opacities were detected on thoracic CT. The broncholiths were distributed throughout the right middle, and left and right caudal lung lobes, and the caudal part of the left cranial and accessory lobes. In the other cat broncholithiasis was an incidental finding on thoracic radiographs taken during diagnostic investigation of inappetence. On thoracic CT, 25 calcified endobronchial opacities were detected in the left caudal lung lobe in secondary and tertiary bronchi. CT features of chronic inflammatory airway disease were present in both cases, including bronchiectasis, atelectasis, flattening of the diaphragm and bronchial wall thickening. RELEVANCE AND NOVEL INFORMATION: This is the first report to document CT features of broncholithiasis in cats. Feline broncholithiasis should be considered as a differential diagnosis in any case where calcified endobronchial material is evident on thoracic radiographs or CT.

Polyostotic hyperostosis in a domestic shorthair cat.

CLINICAL PRESENTATION: An 11-year-old male neutered domestic shorthair cat was presented for investigation of weight loss and inappetence. On physical examination there was palpable enlargement and thickening of many bones, and this finding was confirmed radiographically. PROPOSED DIAGNOSIS: Based on clinical, radiological and histopathological findings, a polyostotic bone disease, best described as generalised idiopathic hyperostosis, was diagnosed. This condition has not been reported in cats previously. Canine and human diseases with similarities to this presentation are discussed.

Dilated cardiomyopathy in a De Brazza's monkey (Cercopithecus neglectus).

BACKGROUND: Cardiomyopathies have been reported in many primates. They may result from an inflammatory response to an infectious agent, nutritional deficiency, familial-genetic inheritance or toxic agents, but in many cases they are idiopathic. METHODS: A De Brazza's monkey (Cercopithecus neglectus) presented with weight loss and inappetence. Physical examination, blood collection and diagnostic imaging and an electrocardiogram were performed. RESULTS: Radiographs and echocardiogram revealed pleural effusion with partially collapsed lungs, cardiomegaly, and reduced myocardial contractility from myocardial failure. CONCLUSIONS: Necropsy revealed pulmonary infarction, subsequent to heart failure from dilated cardiomyopathy.

Stifle osteochondritis dissecans in snow leopards (Uncia uncia).

Three snow leopard (Uncia uncia) cubs, female and male siblings and an unrelated female, had lameness attributed to osteochondritis dissecans (OCD) lesions noted at 6, 8, and 10 mo of age, respectively. All cubs were diagnosed with OCD via radiographs. The sibling cubs both had lesions of the right lateral femoral condyles, while the unrelated cub had bilateral lesions of the lateral femoral condyles. Subsequently, OCD was confirmed in all three cases during surgical correction of the lateral femoral condyle lesions via lateral stifle arthrotomies, flap removal, and debridement of the defect sites. Histopathology also supported the diagnosis of OCD. Postoperatively, the sibling cubs developed seromas at the incision sites and mild lameness, which resolved within a month. To date, two cubs have been orthopedically sound, while one of the sibling cubs has developed mild osteoarthritis. OCD has rarely been reported in domestic felids, and to the authors' knowledge these are the first reported cases of OCD in nondomestic felids.

Concurrent infection with Cryptococcus neoformans/gattii species complex and Mycobacterium avium affecting the subcutis and bone of a pelvic limb in a cat.

This paper describes a cat with severe localised infections with Cryptococcus neoformans/gattii species complex and Mycobacterium avium affecting the subcutis and underlying fascia and bone of the right pelvic limb. The simultaneous isolation of both pathogens in this patient was unexpected and posed unique issues concerning both diagnosis and clinical management. The aetiopathogenesis of this infection is discussed in relation to aspects of diagnosis and therapy.

Vitamin D-dependent non-type 1, non-type 2 rickets in a 3-month-old Cornish Rex kitten.

UNLABELLED: CASE PRESENTATION AND ASSESSMENT: A 3-month-old female Cornish Rex kitten was found to have non-painful swelling of the carpal and tarsal regions when presented for routine neutering. The kitten was smaller in stature and less active than its siblings and, according to the owner, had a bunny-hopping gait, was reluctant to climb stairs and strained during defecation. Radiography of the affected limbs and a subsequent radiographic survey of the entire skeleton demonstrated features consistent with rickets. The three littermates were clinically and radiographically normal. As a nutritionally complete diet was being fed, it seemed most likely that the kitten had an inborn error related to vitamin D metabolism. Serum biochemistry demonstrated reduced total alkaline phosphatase activity and increased concentrations of parathyroid hormone. Concentrations of 1,25- and 25-hydroxycholecalciferol were markedly reduced, confirming the diagnosis of rickets. TREATMENT: The kitten was treated with calcitriol, administered orally once daily, and improved rapidly both clinically and radiologically. Serial laboratory studies suggested that the error in vitamin D metabolism was transient, and, at the time of writing, as an adult, the cat appears to require no ongoing replacement calcitriol therapy. CLINICAL RELEVANCE: This case emphasises the value of examining a full 'calcium profile' via a human or veterinary reference laboratory, and a favourable prognosis in some kittens with rickets makes such investigations worthwhile. Even when finances preclude detailed investigation, trial therapy using a nutritionally complete diet and physiological doses of calcitriol or cholecalciferol is inexpensive and can produce a good response.

Synovial osteochondroma involving the elbow of a cat.

CLINICAL PRESENTATION: A 12-year-old spayed domestic crossbred cat presented because she would not walk down stairs. A firm swelling on the medial aspect of the elbow was detected during physical examination. The lesion was not hot or painful on palpation and the lameness was mild, but the elbow had a reduced range of motion compared with the contralateral limb. DIAGNOSIS AND TREATMENT: Plain radiographs, physical findings, the appearance of the lesion at surgery and histopathological examination of biopsy specimens suggested the mass was a synovial osteochondroma arising from synovial membrane near the medial portion of the elbow joint. Resection of the lesion improved the cat's mobility and overall clinical status. At the time of writing, the cat continued to do well 18 months following surgery and was receiving standard doses of meloxicam for the concurrent elbow osteoarthritis. PRACTICAL RELEVANCE: Practitioners should be alert to the possibility of this benign entity. Misdiagnosis as a chondrosarcoma, for example, might conceivably lead to radical and unnecessary amputation.

Surgical management of vertebral malformation in a Manx cat.

A 15-week-old Manx kitten was presented for evaluation of progressive hind limb paresis and ataxia. Spinal radiographs and computed tomography revealed a malformation of T3 causing thoracic spinal cord compression. Decompressive surgery consisting of dorsal laminectomy, without vertebral stabilisation, resulted in improvement of clinical signs.

Ulnar metaphyseal osteochondrosis in seven captive bred cheetahs (Acinonyx jubatus).

Distal ulna metaphyseal osteochondrosis was identified in seven captive bred cheetahs raised in Australia between 1984 and 2005. The disorder was characterized by bilateral carpal valgus conformation. In the metaphyseal region of the distal ulnae, an osteolucent defect that appeared as a proximal extension of the lucent physis was identified radiographically between 6 and 10 months of age. Ulna ostectomy was done to correct the angular limb deformity. Histologically, changes were identified in the osteolucent lesion that resembled osteochondrosis. We propose that the condition is probably familial and/or dietary in origin.

Feline pyothorax: a retrospective study of 27 cases in Australia.

Pyothorax was diagnosed in 27 cats between 1983 and 2002. In 21 (78%) of the cases, pleural fluid culture and/or cytology was consistent with a mixed anaerobic bacterial infection of oropharyngeal origin. In six cases (22%), infection was caused by unusual pathogens or pathogens of non-oropharyngeal origin, including a Mycoplasma species, Cryptococcus gattii, Escherichia coli, Salmonella typhimurium and Staphylococcus aureus. The overall mortality rate was 22%. Treatment was successful in 18 of 19 cases (95%) where closed thoracostomy tubes were inserted. One case resolved only after thoracotomy. Actinomyces species were isolated in three cases and in contrast to dogs where thoracotomy is recommended, they were resolved with tube thoracostomy. Mechanical complications occurred in 58% of the cats with indwelling chest tubes. Probable mechanisms of pleural space infection were identified in 18 cats (67%) including haematogenous infection (n=1), direct inoculation of bacteria into the pleural space (n=1), intrathoracic oesophageal rupture (n=1) and parapneumonic extension of infection (n=15; 56%). Of the latter, perioperative aspiration was suspected in two cats, parasitic migration in two and antecedent upper respiratory tract infection was implicated in seven. Parapneumonic spread of infection after colonisation and invasion of lung tissue by oropharyngeal flora appears to be the most frequent cause of feline anaerobic polymicrobial pyothorax and contests the widespread belief that direct inoculation of pleural cavity by bite wounds is more common.