Evaluation of a Human Virtual-Reality Endoscopy Trainer for Teaching Early Endoscopy Skills to Veterinarians.

Competency in flexible endoscopy is a major goal of small animal internal medicine residency training programs. Hands-on laboratories to teach entry-level skills have traditionally used anesthetized laboratory dogs (live dog laboratory [LDL]). Virtual-reality endoscopy trainers (VRET) are used for this purpose in human medicine with the clear benefits of avoiding live animal use, decreasing trainee stress, and allowing repeated, independent training sessions. However, there are currently no commercially available veterinary endoscopy simulators. The purpose of the study was to determine whether a human VRET can be a reasonable alternative to a LDL for teaching early veterinary endoscopy skills. Twelve veterinarians with limited or no endoscopy experience underwent training with a VRET (n = 6) or a LDL (n = 6), performed two recorded esophagogastroduodenoscopies (EGD) on anesthetized dogs for evaluation purposes (outcomes laboratory), and then underwent training with the alternative method. Participants completed questionnaires before any training and following each training session. No significant differences were found between training methods based on: measured parameters from the outcomes laboratory, including duration of time to perform EGD; evaluators' assessment of skills; and, assessment of skills through blinded review of the esophageal portion of EGD recordings. The VRET was less stressful for participants than the LDL (p = .02). All participants found that the VRET was a useful and acceptable alternative to the LDL for training of early endoscopy skills. Based on this limited study, VRET can serve as a reasonable alternative to LDL for teaching endoscopy skills to veterinarians.

Evaluation of Goniometry and Electrogoniometry of Carpus and Elbow Joints in the Barred Owl (Strix varia).

The motion of wing joints is a critical factor for successful flight in avian patients, but little information is available about goniometry in birds. Elbow and carpus joints in flexed and extended positions from 10 orthopedically normal wings of 6 adult wild barred owls (Strix varia) were evaluated with the animals under general anesthesia using a modified universal plastic goniometer and an electrogoniometer. These measurements were compared to those obtained using radiographic assessment. Intra- and interobserver reliability was calculated. Measurements in live animals were compared to those obtained from frozen-thawed carcasses. Results showed that the modified universal plastic goniometer can be used to obtain accurate results for elbow flexion and extension and for carpal flexion with good to excellent reliability compared to measurements collected from radiographic assessment. Measurements obtained using an electrogoniometer were less accurate and less reliable than those obtained with a plastic goniometer, possibly because of the size and configuration of the model used. Comparison of measurements from live animals and carcasses revealed no significant differences between mean measurements and suggested that further evaluation of carcasses as a model for study of goniometry measurements in avian wing joints should be considered.

Management and Case Outcome of Gastric Impaction in Four Raptors: A Case Series.

Four captive raptors, an American kestrel ( Falco sparverius ), peregrine falcon ( Falco peregrinus ), golden eagle ( Aquila chrysaetos ), and barn owl ( Tyto alba ), were diagnosed with ventricular and/or proventricular foreign material impactions consisting of artificial turf substrate, paper and plastic substrate, grass, and newspaper. Partial or total anorexia was reported in all birds and decreased casting in 2 birds. Survey radiographs confirmed presence of gastric enlargement in all 4 birds. The kestrel and eagle were treated unsuccessfully with gastroscopy and gastric lavage, respectively, followed by surgical intervention to remove the ventricular impactions. Both birds died of undetermined causes after surgery. The peregrine falcon died before medical or surgical intervention was started, and the owl was managed successfully with oral mineral oil and liquid diet to facilitate egestion of the foreign material as a pellet. Lead poisoning was suspected as the predisposing cause for foreign body ingestion in the eagle, but underlying causes for pica in the other birds were not determined. Radiographs can provide useful diagnostic information in sick raptors that exhibit vomiting or changes in appetite or casting frequency, and may help guide treatment decisions of impacted birds. Careful consideration of substrate, enrichment items, and access to potential foreign material that could be ingested may be the best pre-emptive management strategy in captive raptors.

Hematologic parameters and hemoparasites of nonmigratory Canada geese (Branta canadensis) from Greensboro, North Carolina, USA.

Large flocks of wild, nonmigratory Canada geese (Branta canadensis) have established permanent residence throughout the eastern United States and have become a public concern. Few studies have assessed the hematologic parameters for these populations, which could provide useful information for monitoring individual and population health of Canada geese. This study measured the hematologic parameters and detected the presence of hemoparasites from 146 wild, nonmigratory Canada geese in central North Carolina, USA, during their annual molt. The age class, sex, and weight of each bird were recorded at capture. Values for packed cell volume (PCV), estimated white blood cell count, white blood cell differentials, and heterophil: lymphocyte ratios were calculated for each bird. Adults and female geese had higher estimated white blood cell counts compared with juveniles and males, respectively. The PCV increased with weight and age class. Adult geese had higher percentages of heterophils and heterophil: lymphocyte ratios, whereas juvenile geese had higher percentages of lymphocytes. Relative eosinophil counts in adults increased with decreasing bird weight, and relative monocyte counts in juveniles increased with increasing weight. Three percent of geese were infected with species of Hemoproteus blood parasites. Atypical lymphocyte morphology, including pseudopods, split nuclei, and cytoplasmic granules, was observed in 5% of the birds. The hematologic values reported for adult and juvenile nonmigratory Canada geese in this study may serve as reference intervals for ecological studies and veterinary care of wild and captive Canada geese.

Characterization of Campylobacter from resident Canada geese in an urban environment.

Waterfowl are natural reservoirs for zoonotic pathogens, and abundant resident (nonmigratory) Canada Geese (Branta canadensis) in urban and suburban environments pose the potential for transmission of Campylobacter through human contact with fecal deposits and contaminated water. In June 2008 and July 2009, we collected 318 fecal samples from resident Canada Geese at 21 locations in and around Greensboro, North Carolina, to test for Campylobacter. All campylobacter species detected were C. jejuni isolates, and prevalences in 2008 and 2009 were 5.0% and 16.0%, respectively. Prevalence of C. jejuni-positive sampling sites was 21% (3/14) and 40% (6/15) in 2008 and 2009, respectively. All C. jejuni isolates were susceptible to a panel of six antimicrobial agents (tetracycline, streptomycin, erythromycin, kanamycin, nalidixic acid, and ciprofloxacin). We used pulsed-field gel electrophoresis and fla-typing to identify several strain types among these isolates. Multilocus sequence typing of representative isolates revealed six sequence types, of which two (ST-3708 and ST-4368) were new, two (ST-702 and ST-4080) had been detected previously among C. jejuni from geese, and two (ST-991 and ST-4071) were first reported in C. jejuni from an environmental water source and a human illness, respectively. These results indicate a diverse population of antibiotic-susceptible C. jejuni in resident Canada Geese in and around Greensboro, North Carolina, and suggest a need for additional assessment of the public health risk associated with resident Canada Geese in urban and suburban areas.

Ventricular diverticula formation in captive parakeet auklets (Aethia psittacula) secondary to foreign body ingestion.

A captive parakeet auklet at the North Carolina Zoo evaluated for weight loss, lethargy, and dyspnea had radiographic evidence of a distended, stone-filled ventriculus (bird 1). Multiple stones (n = 76) were removed surgically, but the bird died and a large ventricular diverticulum was diagnosed at necropsy. This bird and seven other parakeet auklets had been transferred 3 yr earlier from a zoo in Ohio. Radiographic investigation revealed that 6 of 7 Ohio birds had stones in their ventriculus (n= 2-26), but only 1 of 7 radiographed North Carolina Zoo auklets had one small stone. Further diagnostic imaging (survey and contrast radiographs, fluoroscopy, CT scans [n = 2]) of six Ohio and two North Carolina birds was conducted to determine if other birds had ventricular abnormalities (birds 2-9). No ventricular diverticula were diagnosed using imaging techniques, although two Ohio birds (birds 6 and 7) required surgical intervention to remove 12-26 stones. A small ventricular diverticulum was identified in bird 6 during surgery. That bird died of unrelated causes 11 mo after surgery, but bird 7 remains clinically normal more than 4 yr later, along with four other auklets with stones (n = 2-15; birds 2-5). It is possible that without surgical intervention, these birds may develop ventricular disease, presumably due to chronic mechanical trauma to the thin-walled ventriculus. It was hypothesized that the Ohio birds ingested stones in their previous exhibit, with a loose stone substrate, and retained them for at least 3 yr. Possible causes for stone ingestion include trituration (for grinding, mixing coarse ingesta), gastric parasite reduction, hunger suppression, accidental ingestion while feeding, or behavioral causes, but the underlying cause in these birds was not determined. Based on these results, parakeet auklets and other alcids should not be housed, or at least fed, on a loose stone substrate.

Risk factors and outcome of bougienage for treatment of benign esophageal strictures in dogs and cats: 28 cases (1995-2004).

OBJECTIVE: To determine outcome of bougienage for treatment of benign esophageal stricture (BES) in dogs and cats and identify risk factors for the condition. DESIGN: Retrospective case series. ANIMALS: 20 dogs and 8 cats with BES. PROCEDURES: Medical records were reviewed for information on signalment, clinical features, and outcome. Long-term outcome information was obtained with a questionnaire. RESULTS: Esophageal bougienage was performed with dilators ranging from 5 to 15 mm in diameter; median numbers of bougienage procedures were 3 (dogs) and 4.5 (cats). A good outcome, defined as tolerance of solid food with regurgitation less than once a week, was achieved in 14 dogs and 6 cats. Complications were minimal, with nonfatal esophageal perforation occurring in 1 cat. Four dogs and 1 cat were euthanized or died because of esophageal disease. Dogs with BES were more likely to be female, have a recent history of general anesthesia, have received an antimicrobial orally, or have a history of vomiting than were dogs in a reference population. Cats with BES were more likely to have a recent history of general anesthesia, vomiting, or gastrointestinal tract trichobezoars than were cats in a reference population. Doxycycline-induced esophagitis was the suspected cause of BES in 3 cats. Although general anesthesia was associated with development of BES in 18 dogs and 5 cats, concurrent potential causes of esophageal injury were common. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that esophageal bougienage was a safe and effective treatment for most dogs and cats with BES, with outcomes similar to those reported for balloon dilation.

Waterfowl toxicology: a review.

Waterfowl populations may serve as sentinel species for natural and anthropogenic toxicologic problems in the environment. Unfortunately, many toxins cause nonspecific clinical signs, acute mortality, and subtle or no pathologic changes, making toxicologic investigations extremely difficult. The purpose of this article is to review important waterfowl toxins, including heavy metals, pesticides, botulism, mycotoxins, algal toxins, and petroleum oil. When applicable, clinical signs, diagnosis, pathologic findings, and treatment are discussed. Although most of the information in the literature is based on wild waterfowl populations or experimental toxicologic investigations, the information is also applicable to captive waterfowl populations.

Veterinary contributions to wildlife biology: participation in avian field studies in Alaska.

This report describes the author's experiences in participating in avian research during 3 field seasons in remote areas in Prince William Sound (PWS), located in south-central Alaska. Veterinary support was needed to biopsy the livers of nestling and adult pigeon guillemots (Cepphus columba) and adult black oystercatchers (Haematopus bachmani). These surgeries were part of larger research studies investigating guillemot and oystercatcher populations and possible continued exposure to residual crude oil in the marine environment after the Exxon Valdez oil spill in PWS in 1989.

Prevalence, clinical features, and causes of epistaxis in dogs: 176 cases (1996-2001).

OBJECTIVE: To determine prevalence, clinical features, and causes of epistaxis in dogs. DESIGN: Retrospective case series. ANIMALS: 176 dogs with epistaxis. PROCEDURES: Medical records were reviewed for information related to signalment, clinical features, diagnosis, and outcome. RESULTS: 132 (75%) dogs were initially examined by the hospital's emergency service; prevalence of epistaxis was 0.3%. Dogs with epistaxis were more likely to be old (> or = 6 years), male, and large (> or = 26 kg [58.5 lb]) than were dogs in a reference population. In 109 (62%) dogs with epistaxis, an underlying cause was identified; 115 underlying disorders were identified, with 90 classified as local and 25 classified as systemic. Local causes of epistaxis included nasal neoplasia (n = 35), trauma (33), idiopathic rhinitis (20), and periapical abscess (2). Systemic causes included thrombocytopenia (12), thrombocytopathia (7), coagulopathy (3), hypertension (2), and vasculitis (1). Dogs with local causes were more likely to have unilateral than bilateral epistaxis, but 11 of 21 (52%) dogs with systemic disorders also had unilateral epistaxis. Dogs with systemic disorders were more likely to have clinical signs of systemic disease. Duration of epistaxis (acute vs chronic), severity, and duration of hospitalization were similar for dogs with local versus systemic disorders. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that epistaxis was a common disorder in dogs and frequently regarded as an emergency. Local causes of epistaxis were predominant, but clinical features traditionally thought to be helpful in distinguishing local versus systemic causes could not be reliably used for this purpose.

A model for teaching raptor medicine in the veterinary curriculum.

Injured or sick wild avian species, especially raptors (birds of prey, including hawks, owls, falcons, and eagles), can present different challenges to veterinary students and veterinarians who are trained in companion avian medicine (e.g., parrot medicine). Proper capture and restraint, feeding, housing, and certain diagnostic and treatment techniques involving raptors require different skills, knowledge, and resources than working with parrots. We developed an innovative raptor medicine program that enables students to acquire proficiency in safe capture, restraint, and examination techniques and in common diagnostic and treatment procedures. A self-assessment survey was developed to determine students' confidence and proficiency in 10 procedures taught in the lab. Groups were compared by class status (Year 1 vs. Year 2 and 3) and level of prior raptor experience (non-experienced or experienced). In surveys conducted before and after teaching two sets of raptor training labs, students rated themselves significantly more proficient in all 10 diagnostic and treatment procedures after completing the two raptor laboratories. The greatest improvements were observed in technical skill procedures such as fluid administration, intramuscular injections, cloacal swabs, venipuncture, and bandaging. Our approach to incorporating elective wildlife learning experiences into the veterinary curriculum may be replicable in other veterinary schools, with or without a wildlife rehabilitation program.