ABSTRACT
Pododermatitis is an important cause of morbidity and mortality in flamingos under human care; management and treatment options vary widely based on subjective assessment from veterinarians or animal care staff (ACS). The objective of this study was to evaluate the agreement of pododermatitis severity scores assigned by veterinarians, ACS, and veterinary students when given a standardized rubric. Twenty-four greater flamingos (Phoenicopterus roseus) from a single zoo-managed flock were evaluated over time for pododermatitis. The individual feet of each bird were imaged, blinded, randomized, and scored for hyperkeratosis, fissures, nodules, papillomatous growth, and overall subjective score by seven evaluators (three veterinary specialists, two ACS, and two veterinary students) using a previously established flamingo pododermatitis scoring rubric. Interindividual reliability between evaluators and intraindividual agreement among specialists was determined. Reliable interindividual agreement was seen for fissures (Krippendorff's α [KA] = 0.807) between all seven evaluators, whereas the other individual lesions had very low reliability. Between the specialists, fissures had low interindividual reliability (KA = 0.782). Two specialists had strong intraindividual agreement for fissure score and one specialist had strong intraindividual agreement for overall subjective score (Cohen's κ [CK] 0.8-0.9, P < 0.01). Hyperkeratosis, papillomatous growth, nodules, and overall subjective score had low to moderate inter- and intraindividual reliability or agreement (KA, 0.06-0.49; CK, 0.02-0.8). In conclusion, the current scoring method for flamingo pododermatitis does not supply a reliable method for tracking foot health based on images alone across timepoints, except for fissures. Further analysis of the scoring system being used during a physical examination is warranted.
