Rabbit Pediatrics.

Rabbits encompass roles spanning from companion animals, wildlife species to laboratory animal models. Pediatric care of these species therefore may extend to various disciplines of veterinary medicine. Rabbits are born altricial but have a unique perinatal relationship between kit and doe with infrequent nursing. Nursing is immunologically protective to the kit and close contact with the doe allows for colonization of their gastrointestinal tract with bacterial flora. The most common diseases that pediatric rabbits are faced with are gastrointestinal in nature with orphaned and hand-reared rabbits at higher risk due to the aforementioned effects on their immune system.

Splenic Small Cell Lymphoma with Presumed Secondary Immune-Mediated Hemolytic Anemia in an African Penguin (Spheniscus demersus).

A 2-year-old male African penguin (Spheniscus demersus) was presented to a veterinary teaching hospital for evaluation of a previously diagnosed subclinical, marked regenerative anemia. Physical examination at the zoological institution demonstrated biliverdinuria and pale oral mucous membranes. Diagnostic tests performed on the penguin since the diagnosis and prior to presentation to the veterinary teaching hospital included serial complete blood counts, plasma biochemistry panels, radiographic imaging, blood and plasma heavy metal testing, and infectious disease testing. The abnormal diagnostic test results were consistent with marked regenerative anemia and splenomegaly. At the veterinary teaching hospital, further diagnostic testing was ordered in an attempt to determine the cause of the biliverdinuria and pale oral mucous membranes. The diagnostic tests performed included a full-body contrast computed tomographic scan, upper gastrointestinal endoscopic procedure, bone marrow aspiration and evaluation, saline agglutination testing, blood Plasmodium species polymerase chain reaction screening, a vitamin profile panel, and repeat blood heavy metal testing. The complete blood count demonstrated a marked, regenerative anemia with the presence of dysplastic erythrocytes, and splenomegaly was found on the computed tomographic images without identifying a definitive cause. Primary disease differentials for the diagnosed regenerative anemia included a myelodysplastic syndrome and primary or secondary immune-mediated hemolytic anemia. The penguin was treated with oral prednisolone as an immunomodulatory agent; however, it did not result in a positive treatment response. The patient developed hyporexia, weight loss, and lethargy 2 months post presentation to the veterinary teaching hospital. Additional therapy with cyclophosphamide was initiated, and the penguin improved clinically, but then declined. The patient was euthanized due to a poor quality of life and prognosis 4 months after initial presentation and 1.5 years after the first complete blood count revealed the penguin to be anemic. Microscopic review of submitted postmortem tissue samples demonstrated a monomorphic population of neoplastic small lymphocytes infiltrating the spleen, consistent with splenic small cell lymphoma. The neoplastic cells did not label with the T-cell marker CD3 or B-cell markers CD20, CD79a, and Pax-5.

Successful treatment of ivermectin overdose in a bearded dragon (Pogona vitticeps) using gastric lavage and intravenous lipid emulsion.

OBJECTIVE: To describe the clinical signs and outcome following ivermectin overdose in a bearded dragon. This case also describes the novel use of intravenous lipid emulsion (ILE) as a rescue therapy in reptiles, as well as the use of aggressive gastrointestinal decontamination. CASE SUMMARY: A 4-year-old female intact bearded dragon (Pogona vitticeps) (0.6 kg) was admitted to the ICU at a specialty hospital following accidental overdose of 40 mg (66.7 mg/kg) of ivermectin enterally. The patient was physically inverted to allow passive reflux of the medication, then sedated for gastric lavage. A 20% ILE was administered intravenously due to the high risk for fatality. Additional treatments included 2 doses of activated charcoal, as well as SC fluids, enteral nutrition, and sucralfate. The patient was profoundly sedate until day 4 when mild improvements in mentation were noted. The patient started ambulating on its own on day 6 and was discharged from the hospital on day 13. The patient was alive 720 days postdischarge. NEW OR UNIQUE INFORMATION PROVIDED: This is the first case report describing the events following ivermectin overdose and the use of ILE therapy and activated charcoal in a bearded dragon. These therapies were tolerated with no adverse effects noted in this patient. This report provides evidence that complete recovery from ivermectin overdose is possible.

Emerging Infectious Diseases of Rabbits.

Recently, multiple infectious organisms have been identified as the cause of emerging diseases in lagomorphs. The most important of these emerging diseases is rabbit hemorrhagic disease virus (RHDV) type 2, a new variant with differences in pathogenicity to classical RHDV. Hepatitis E is considered an emerging zoonotic infectious disease, with widespread prevalence in many different rabbit populations. Mycobacteriosis has been recently reported in other captive domestic rabbit populations. This article provides a recent review of the published literature on emerging infectious diseases in rabbits, including farmed, laboratory, and pet rabbits, some of which have zoonotic potential.

Acremonium and trichosporon fungal keratoconjunctivitis in a Leopard Gecko (Eublepharis macularius).

A 6-year-old male leopard gecko (Eublepharis macularius) was presented with a 2-year history of recurrent dysecdysis involving the ocular surface of both eyes. Ophthalmic examination revealed ocular surface desiccation and multifocal superficial ulcerative keratitis with patchy remnants of retained shed. Other abnormalities included stomatitis and mandibular and maxillary osteomyelitis. Topical and systemic antibiotic therapy, oral vitamin A, and improved husbandry conditions resolved the stomatitis and osteomyelitis but did not improve the ocular surface. Corneal cytology collected with a cytobrush revealed branching hyphae and budding yeast consistent with fungal keratitis. Fungal culture grew Acremonium sp. and Trichosporon sp. The addition of topical antifungal therapy improved the ocular surface health, but the patient was euthanized 7 weeks after initial presentation for persistent vomiting and dyspnea. Necropsy was declined. This case describes the first case of fungal keratitis caused by Acremonium sp. and Trichosporon sp. in a reptile.

Clinical and pathological findings for rabbits with dystocia: 10 cases (1996-2016).

OBJECTIVE: To characterize clinical and pathological findings of rabbits evaluated at a veterinary teaching hospital because of dystocia. DESIGN: Retrospective case series. ANIMALS: 9 client-owned rabbits and 1 wild rabbit with signs of dystocia evaluated at a veterinary teaching hospital from 1996 through 2016. PROCEDURES: Medical records of rabbits were reviewed to collect data on signalment; medical history; physical examination, laboratory, diagnostic imaging, and procedural findings; treatment; final diagnosis; and outcome. Data were summarized. RESULTS: Dystocia in 7 rabbits was successfully managed through medical treatment, assisted vaginal delivery, or both (n = 6) or surgery alone (1); 3 rabbits were euthanized. Primiparous does, does ≤ 4 years old, and does of small breeds (< 2 kg [4.4 lb]) were most common. All client-owned rabbits had clinical signs of abnormal second-stage parturition, whereas the wild rabbit had only hemorrhagic vulvar discharge. Imaging was used to identify the number, size, and state of fetuses in most rabbits. Overall, 35 fetuses were accounted for, 25 of which were dead or later died. The cause of dystocia was determined for 8 rabbits and included fetal-maternal mismatch (n = 4), uterine inertia (2), fetal death or mummification (1), and stress-induced abortion (1). CONCLUSIONS AND CLINICAL RELEVANCE: Obstructive dystocia from fetal macrosomia with or without secondary uterine inertia was the most common cause of dystocia in the evaluated rabbits. Although medical management was successful for many rabbits with dystocia in this study, surgery could still be required in other affected rabbits, particularly when fetal-maternal mismatch is involved.

A novel herpesvirus associated with chronic superficial keratitis and proliferative conjunctivitis in a great horned owl (Bubo virginianus).

An adult great-horned owl (Bubo virginianus; GHOW) presented with a history of recurrent corneal ulceration of the right eye (OD). Findings included ulcerative superficial keratitis, proliferative conjunctivitis, and iris pigmentary changes. The ulcer was initially nonresponsive to medical therapy, but showed rapid and appropriate healing following diamond burr debridement. Proliferative conjunctivitis markedly improved following topical antiviral therapy with cidofovir 1%, interferon alpha 2B ophthalmic solutions, and oral l-lysine. Histopathologic evaluation of a conjunctival biopsy revealed epithelial features suspicious for viral cytopathic changes and intranuclear structures suspicious for viral inclusions, suggestive of a possible viral-induced papillomatous conjunctivitis. A novel alphaherpesvirus, referred to as Strigid Herpesvirus 1 (StrHV1), was identified using PCR and gene sequencing. This case represents a new clinical manifestation of a previously unreported herpesvirus in the GHOW. Identification of the herpes virus was critical to administration of appropriate therapy and resolution of the conjunctivitis, and corneal epithelial debridement promoted resolution of the chronic corneal epithelial defect.

Pharmacokinetics of a concentrated buprenorphine formulation in red-tailed hawks (Buteo jamaicensis).

OBJECTIVE To determine the pharmacokinetics and sedative effects of 2 doses of a concentrated buprenorphine formulation after SC administration to red-tailed hawks (Buteo jamaicensis). ANIMALS 6 adult red-tailed hawks. PROCEDURES Concentrated buprenorphine (0.3 mg/kg, SC) was administered to all birds. Blood samples were collected at 10 time points over 24 hours after drug administration to determine plasma buprenorphine concentrations. After a 4-week washout period, the same birds received the same formulation at a higher dose (1.8 mg/kg, SC), and blood samples were collected at 13 time points over 96 hours. Hawks were monitored for adverse effects and assigned agitation-sedation scores at each sample collection time. Plasma buprenorphine concentrations were quantified by liquid chromatography-tandem mass spectrometry. RESULTS Mean time to maximum plasma buprenorphine concentration was 7.2 minutes and 26.1 minutes after administration of the 0.3-mg/kg and 1.8-mg/kg doses, respectively. Plasma buprenorphine concentrations were > 1 ng/mL for mean durations of 24 and 48 hours after low- and high-dose administration, respectively. Mean elimination half-life was 6.23 hours for the low dose and 7.84 hours for the high dose. Mean agitation-sedation scores were higher (indicating some degree of sedation) than the baseline values for 24 hours at both doses. No clinically important adverse effects were observed. CONCLUSIONS AND CLINICAL RELEVANCE Concentrated buprenorphine was rapidly absorbed, and plasma drug concentrations considered to have analgesic effects in other raptor species were maintained for extended periods. Most birds had mild to moderate sedation. Additional studies are needed to evaluate the pharmacodynamics of these doses of concentrated buprenorphine in red-tailed hawks.

PUM I Revisited: Tradeoffs in Preservation and Discovery.

An Egyptian mummy designated PUM I (Pennsylvania University Museum) was subjected to a complete autopsy in 1972. Forty-one years later, the senior author (MZ) was invited back to the Penn Museum to identify several packages of material that had been preserved with the mummy joining the project conservator (MG) in the evaluation of these remains. A summary of the 1972 examination reviews the dating of the mummy, about 3,000 years ago. The mummy was poorly preserved and the only significant pathology was a rare skin disease, subcorneal pustular dermatosis, which was not identified by modern medicine until 1956. The review of PUM 1, as the mummy is stabilized during conservation at the Penn Museum (previously called the Pennsylvania University Museum), generates a discussion for researchers who embark on the study of mummified remains. There have been major advances in the study of mummies since 1972, including computed tomography (CT) scanning, with much less invasive endoscopically guided biopsies, analysis for ancient DNA (aDNA), nuclear magnetic resonance technology, chemical analysis, and paleoserology. The value of complete autopsy must now be balanced against preservation of a complete mummy by less invasive techniques that are tissue sampled through guided technology. Indeed it is unlikely that these regions of the skin of PUM 1 would have been sampled and studied if these new tools of analysis had been available and applied.