nwra symposium march 5-9 2019 st. louis, mo · 2019-02-24 · #19007 – admitted 2015-08-11 keel...
TRANSCRIPT
Carolina Raptor Center
NWRA Symposium
March 5-9 2019
St. Louis, MO
Neurologic signs • Ataxia/paresis
• Lethargy
• Tremors/seizures
• Disorientation
• Torticollis
Systemic signs • Lethargy
• Emaciation
• Feather issues?
Carolina Raptor Center
Carolina Raptor Center
Trauma
Toxin
Infectious
Must consider the
cost/benefit/speed of
each diagnostic test
Do inexpensive/fast tests
first ( exam, lead, CBC,
rad)
Follow up with more
expensive/slower tests
(PCR, toxicology,
histopathology)
Vehicular trauma/window strikes
Physical exam • Usually not more obvious problems
like fractures.
• Look for blood in eyes, ears, mouth
• Bruises and wounds can be hidden underneath the feathers
• Fundic exam – anterior chamber is usually normal even with severe head trauma. Especially important with referrals
from home rehabbers.
Carolina Raptor Center
Raptor Ophthalmology Powerpoint - Mark Mitchell,
Univ of Illinois CVM
Necropsy • Intracranial hemorrhage • Hemorrhagic lungs • Free blood in coelomic
cavity
Carolina Raptor Center
Did the trauma happen
secondary to another cause?
19873 - RSHA
Sometimes not visible
thru the skin.
Lead • Affects many tissue but particularly the brain • From metal fragments ingested in carcasses
More likely during deer hunting season
Absorbed vis GI tract
• Acute vs chronic form • Scavengers such as eagles and vultures. But what
about osprey swallowing (lead sinkers)? Mercury bio-accumulation in fish (flat-head
catfish) so osprey and bald eagles are at risk.
Carolina Raptor Center
Blood lead level – ante mortem • In house LeadCare unit • Results in 3 minutes • > 20 ug/dl for most species
Mercury requires outside lab.
Radiographs are often negative (TRC 10%??)
Carolina Raptor Center
Carolina Raptor Center
BAEA 16152 2012-06-08
Lead toxicity not typically from gunshot fragments embedded in tissue
In 1992 in the US, 500,000 tons of 600
different types of chemicals were used!
Carolina Raptor Center
Carolina Raptor Center
Pesticide intoxication • Species that hunt grubs/insects in yards like red-
shouldered hawks or juvenile red-tailed hawks.
• Multiple cases from same street/block
• Many bio-accumulate in environment and can be
absorbed via inhalation of dust.
Carolina Raptor Center
Pesticide Screen on liver, stomach contents, brain – post mortem • Avitrol (4-aminopyridine) – Affects K+ channels
and induces seizures/convulsions • Organophosphates (Malathion, Parathion,
Dichlorvos) are irreversible acetylcholinesterase (ACHE) inhibitors Whole blood acetylcholinesterase levels
• Carbamates reversibly inhibit ACHE • Metaldehyde is used in snail bait. • Organochlorine pesticides are DDT-like. Work on
Na+ channels in PNS (Aldrin/Dieldrin, Chlordane for termite control, Heptachlor)
Carolina Raptor Center
Flavivirus transmitted by mosquitoes
First seen in Western Hemisphere in 1999
Most avian species affected but can also be non-clinical carriers • Corvids, great-horned owls, Cooper’s
hawks • Several recent cases in Buteo spp. • Humans also affected
Carolina Raptor Center
2006
Birds can become viremic and serve as a reservoir host
Non-avian species do not typically develop viremia and are thus “dead-end” hosts.
Carolina Raptor Center
www.ci.greenfield.ca.us/Public_Health_Info.htm
Neurologic signs • Ataxia • Lethargy • Tremors/seizures
• Disorientation • Torticollis
Vision loss from retinal damage
Abnormal feather growth with “pinched off” shaft
Sudden death – birds “falling from the sky”
Carolina Raptor Center
Species – corvid, GHOW, COHA Clinical signs – neuro +/- feather anomalies Seasonality – when mosquitoes are present. PCR
• Blood vs choanal/chloacal swab –more likely to get positive test result with blood?
Serology – a single sample is not useful. Need to observe trends
Feather shafts • PCR – low detection rates?
Histopathology of brain tissue – post mortem • Immunohistochemical stains
Note: PCR/serology can be NEG depending on timing and phase of the infection. May
be viremic early and shedding later. Note: a POS result does not necessarily imply disease.
Carolina Raptor Center
Carolina Raptor Center
http://www.annals.org/cgi/content /full/140/7/545
PCR may be negative
What about shedding detectable via swab?
Not practical
Paramyxovirus PMV-1/Newcastle’s disease • Primarily a poultry disease but raptors infected after
consuming affected birds
• Few published case reports (mostly pigeons and poultry)
• Most reports from falcons in the Middle East
Avian Influenza (LPAI vs HPAI)
• Almost any clinical signs including lethargy and neurologic signs
• Mostly poultry but many species can been infected.
• Several raptor species affected in 2015 outbreak
Carolina Raptor Center
Avian vacuolar myelinopathy (AVM) • Affects mostly water birds (Coots) or those
that feed on water birds (Bald eagles) • Mostly in southeastern states • Causative agent is a cyanobacteria that grows
on aquatic plants (Hydrilla spp.) which are ingested by waterfowl. Bald eagles and American coots.
Carolina Raptor Center
http://www.nwhc.usgs.gov/publications/fact_sheets/pdfs/avm091002.pdf
PCR • Avian & Exotic Lab
• Veterinary Molecular Diagnostics Serology – HI, ELISA For AI, check with USDA/APHIS
• www.usda.gov/documents/usda-avian-influenza-diagnostics-testing-factsheet.pdf
• Rapid screening test
• Confirmatory tests (VI, etc).
• Many different subtypes with variable pathogenicity (LPAI vs HPAI) What is LP in one species may be HP in another.
• Need to have an emergency response plan ready to go.
Carolina Raptor Center
Adult red-shouldered hawk (Buteo lineatus) #19805 – Admitted 2016-07-03 Recent history of vehicular trauma Lethargic. Tremors -> seizures Midazolam worked well to calm bird and
stop seizures Exam – deep wound at base of skull behind
right ear. Euthanized Cost: $0
Adult bald eagle (Haliaeetus
leucocephalus)
#18525 – Admitted 2015-01-13
Keel score 3/5
Moderate to severe flaccid paralysis of
both legs
Radiograph negative for metallic FBs.
Lead level checked using LeadCare unit.
Cost: $10
May need to dilute samples to get reading.
Initial level was > 180 ug/dl!
Chelation with CaEDTA and DMSA worked well.
Be on the lookout for rebound.
Hatch-year red-shouldered hawk (Buteo lineatus) #19007 – Admitted 2015-08-11 Keel score 2/5 Severe neuro signs (ataxia, tremors) No signs of severe/acute trauma (i.e. - blood in
mouth, eyes) Treatment
• Supportive care with fluids, meloxicam (1 mg/kg) and midazolam
• Suspected toxin due to habit of insect hunting in yards
Condition deteriorated and bird was euthanized within 24 hours
Necropsy: • WNL – rarely anything visible on gross necropsy
• Brain WNL – usually WNL with WNV
Toxin highly suspected so stomach contents and liver submitted for toxicology. • Toxicology negative
Brain submitted for histopathology and IHC
Total cost: $220
Perivascular lymphoplasmacytic encephalitis. Suspected WNV or EEE.
IHC POS for WNV
Hatch-year red-tailed hawk (Buteo jamaicensis) #19779 – Admitted 2016-06-26 Keel score 1/5 Subtle neuro signs developed over 3 weeks. Dropped all tail feathers with 8 days Began meloxicam at 1 mg/kg while waiting for
bloodwork CBC – 39,000 with 4700 monocytes (Asper?). TS = 5.2
g/dl Has been on antifungals since admission WNV PCR POS Began dropping all main flight feathers. Otherwise doing well, gaining weight and molting. Cost: $50
Hatch-year red-shouldered hawk (Buteo lineatus)
#19460 – Admitted 2016-03-23 Extremely neurologic with violent
vocalizations during transport. Dead on arrival.
Severe extensor rigidity within minutes of death.
Exam did not reveal any signs of trauma. Gross necropsy and histopathology WNL
Toxicology (liver and stomach contents): • DDE 0.7 ppm Metabolite of DDT.
Consistent with chronic background exposure.
Banned in 1972
• Heptachlor 4.1 ppm Metabolite of Chlordane.
Outlawed in 1988. Was used for treating termites.
Bio-accumulates in fatty tissue.
“One of the most potent carcinogens ever tested in animal models”
5 ppm in brain considered lethal in birds
Cost: $180
Carolina Raptor Center
Trauma
?
YES
NO
Lead?
NO
YES
Supportive
Care
(mannitol)
Begin
chelation
Begin
meloxicam
(1 mg/kg
BID)
WNV
PMV-1, AI
PCR
POS NEG
Supportive
care
Euthanasia
Improvement
?
NO
Histopatholog
y
Toxicology
Response to
Atropine?
YES
NO
Histopathology - NC State Vet Diagnostic Lab (NCVDL) • $40 + 45 for IHC
PCR/serology • Avian and Exotic Lab - $35
Lead • In-house with Lead Care unit - $9
Toxicology • Penn Animal Diagnostic Lab System (PADLS) – New
Bolton Center – Pesticide screen - $75
• Mercury $28
• Lead $22 Don’t forget shipping fees
Carolina Raptor Center
Cost for complete workup: $204
13 RSHA in last 12 months
All presented with neuro signs/seizures/tremors
All dead with 24 hours
Cause of death • WNV – 1
• Not worked up – 3
• Pesticide – 6
• Pending – 2
• Other - 1
Carolina Raptor Center
Carolina Raptor Center
19460 3/23/2016 RSHA Chlordane - 4.1 ppm in liver (5 ppm lethal in brain)
19577 5/8/2016 RSHA Chlordane - 0.88 ppm in liver, 4.3 ppm in stomach
DDE - 0.6 ppm in stomach (chronic exposure)
PCB - 1.8 ppm in stomach, ND in liver
19581 5/9/2016 RSHA Chlordane - 0.6 ppm in liver, 3.7 ppm in stomach
DDE - 0.8 ppm in stomach (chronic exposure)
PCB - 2.3 ppm in stomach, ND in liver
19753 6/20/2016 RSHA Dieldrin - 59.2 ppm in brain ( 4 ppm lethal in brain)
Heptachlor/oxychlordane - 6.2 ppm in brain
DDE - 1.7 ppm in brain PCB - 9.5 ppm in brain
19677 5/29/2016 RSHA Dieldrin - 705 ppm in liver Heptachlor/oxychlordane - 17.1 ppm in liver
Alpha chlordane - 13.3 ppm in liver
19676 5/29/2016 RSHA Dieldrin - 101 ppm in liver Heptachlor/oxychlordane - 6.3 ppm in liver
Alpha chlordane - 3.3 ppm in liver
Toxicology on
brain is best.
No chance for
recovery.
COLLABORATION?
Carolina Raptor Center
Dave Scott
Carolina Raptor Center
704-875-6521 x105
dscott@carolinaraptorce
nter.org
Carolina Raptor Center