Retrospective evaluation of voriconazole treatment in psittacines: 14 cases (2012-2023).

OBJECTIVE: To retrospectively evaluate the clinical use of voriconazole in psittacine patients for the treatment of suspected respiratory fungal infections. ANIMALS: 14 client-owned psittacine birds. METHODS: Medical records were searched from 2012 to 2023 for voriconazole use in psittacines. Species, age, clinical signs, physical examination findings, CT reports, bloodwork results, treatment, and outcome were obtained from the records or client follow-up. RESULTS: African grey parrots were the most prevalent species (8/14). Dyspnea (9/14) and abnormal respiratory auscultation (11/14) were the most common examination abnormalities. An initial CT was performed in all cases, and pneumonia (10/14) and air sac disease (9/14) were the most common findings, with 8 cases having both pulmonary and air sac disease. Voriconazole doses ranged from 10 to 21 mg/kg (median, 16 mg/kg), with most cases prescribed as every-12-hour frequency (12/14). Three of 14 (21%) cases died or were euthanized within 24 days of diagnosis. One case was euthanized at 311 days, and 6 cases were lost to follow-up. Four of 14 (29%) cases lived > 12 months from diagnosis. Two of these cases cleared clinical infection after receiving voriconazole at 17 to 18 mg/kg (q 12 h). No adverse effects attributable to voriconazole were reported. CLINICAL RELEVANCE: Voriconazole can be safely used for the treatment of suspected fungal respiratory infection in psittacines. However, the prognosis for resolution is guarded, and prolonged treatment and repeated diagnostic imaging are necessary in many cases.

Calculation of body surface area of corn snakes (Pantherophis guttatus) utilizing computed tomography.

OBJECTIVE: To determine the K-constant for body surface area calculation from body weight in corn snakes (Pantherophis guttatus) through the use of computed tomography (CT) measurements. ANIMALS: 12 adult corn snakes held by North Carolina State University for research purposes underwent CT between November 2022 and January 2023. METHODS: Each snake had a CT scan, physical examination, and body weight measurement. CT images were uploaded into software able to perform 3-D reconstruction and measure body surface area. The species-specific K-constant was determined using nonlinear regression analysis between body surface area and (body weight in grams)2/3. RESULTS: The mean body weight of the 12 adult corn snakes was 228 g, with a mean body surface area of 505.1 cm2. The calculated K-constant was 13.6 (P < .001). The resulting formula for body surface area in corn snakes is BSA in cm2 = 13.6 X (body weight in grams)2/3. CLINICAL RELEVANCE: The body surface area formula developed for corn snakes will allow for improved dosing accuracy for medications with low therapeutic safety margins. Additional pharmacokinetic and pharmacodynamic studies are necessary to determine the safety and efficacy of individual medications.

African Pygmy Hedgehog Pediatrics.

African pygmy hedgehogs have become a popular pet and are commonly available through breeders and pet stores. Responsible breeding, proper husbandry, and close monitoring of the dam and pups are important for neonatal health. The risk of abandonment or cannibalism is high in this species especially in stressed dams unfamiliar to frequent handling. Hand-rearing hedgehog pups is difficult and cross-fostering is a preferable alternative for abandoned pups when possible. If intervention becomes necessary, heat support, frequent feedings, and physical stimulation to eliminate must be provided.

Surgical management of dystocia in a colobus monkey (Colobus guereza).

A 14-year-old female black and white colobus monkey (Colobus guereza) presented in labor with fetal arms visible protruding from the vulva. Manual manipulation for assisted delivery of the fetus was unsuccessful. Radiographs identified a large fetal skull and hysterotomy was required with ovariohysterectomy elected to follow. The fetus was confirmed to be deceased during hysterotomy, but the dam recovered from the procedure uneventfully. The detailed description of the anesthesia and surgical procedure in this case may aid other clinicians when presented with similar dystocia cases in this species.

Successful radiation treatment of undertail fibrosarcoma in a Major Mitchell's cockatoo (Lophochroa leadbeateri).

CASE DESCRIPTION: A male Major Mitchell's cockatoo (Lophochroa leadbeateri) of unknown age presented with an ulcerated mass on the ventral tail caudodorsal to the cloaca. CLINICAL FINDINGS: An impression smear of the mass showed spindle cell atypia. Multiple biopsies were submitted for histopathology with inconclusive results. A CT scan revealed a soft tissue mass causing compression of the cloacal lumen. The patient underwent surgical debulking, and a core of the mass was submitted again for histopathology, which reported it as fibrosarcoma. TREATMENT AND OUTCOME: Under repeated general isoflurane gas anesthesia, the patient received a course of definitive radiation therapy totaling 60 Gy and divided in 3 Gy X 20 fractions. By treatment completion, the lesion had decreased in size with necrotic debris on the surface. Surrounding tissues appeared healthy and no adverse effects were observed. As of 1.5 years post-treatment, the mass appears completely healed with no signs of reoccurrence. CLINICAL RELEVANCE: This case suggests that radiation therapy with this protocol could be an effective treatment option for fibrosarcoma in avian species.