Whats Your Diagnosis

1
Whats Your Diagnosis?

• Mark A. Mitchell DVM, MS, PhD
• University of Illinois
• College of Veterinary Medicine

2
Eagle 1

• SIGNALMENT
• BALD EAGLE
• AGE?
• GENDER?
• (weight4.8 kg)

3
Eagle 1

• History
• Houma, LA
• Found down
• BAR and Aggressive
• Limited history typical

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Eagle 1

• Physical examination
• BAR
• Neurotic
• Palpation WNL
• HR 230
• RR panting
• Diagnostic plan?

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Eagle 1

• CBC
• PCV 38
• TS 3.7 mg/dl
• Leukocytes
• 19.8 x 103
• Differential
• Heterophils
• 85 (16,830)
• Lymphocytes
• 9 (1,782)
• Monocytes
• 6 (1,188)
• Differentials?

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Mitchells Clinical Pathology Rules

• WBC
• 5-15 x 103
• Identify predominant cell
• Heterophil/Neutrophil Lymphocyte ratio
• 11 to 31 (inverse if lymphocyte predominates)
• Lymphocytes
• 2.0 x 103
• Monocytes
• 0.5-1.0 x 103
• 1.5 x 103
• Eosinophils and Basophils

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Eagle 1

• Plasma biochemistries
• Sodium 153
• Potassium 3.8
• Chloride 112
• ALP 187
• CK 9,889
• AST 956
• TP 7.4
• Albumin 3.0
• Globulins 4.4
• Calcium 10.4
• Phosphorus 4.9
• Uric acid 2.6
• Differentials?

Sodium 145-160 Potassium 2.5-5.0 Chloride
90-120 ALP 3.0-6.0 (birds), 4.0-7.0 (others) Albumin
1.5-2.5 (birds), 2.0-3.5 (others) Globulins
1.5-3.5 (birds), 2.0-4.0 (others) Calcium
8-12 Phosphorus 2.5-6.0 Uric acid
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Eagle 1

• Fecal examination
• Saline smear
• Numerous motile bacteria and ciliates
• Fecal flotation
• Negative
• Gram stain
• Mixed population
• Gram rods (60) Gram rods (40)
• Differentials?

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Eagle 1
10
Eagle 1

• Left coracoid fracture
• Complete, mid-diaphyseal
• Closed
• Oblique
• Options?

11
Eagle 1

• Cage rest
• Surgery
• Techniques?

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Eagle 1
13
Eagle 1

• Recovery from anesthesia uneventful
• Duration of rehabilitation?
• Radiographs?

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Eagle 2

• Signalment
• Adult
• Female
• Bald eagle
• 4 kg

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Eagle 2

• Physical examination
• Bright, alert, responsive
• muscle atrophy
• dyspneic when stimulated
• 5 cm mass distal tarsometatarsus
• Diagnostic Plan?

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Eagle 2

• CBC
• PCV 30
• TS 6.7 mg/dl
• Leukocytes
• 73.3 x 103
• Differential
• Heterophils 52.0 (71)
• Lymphocytes 2.6 (3.5)
• Monocytes 18.0 (24.5)
• Eosinophils 0.7 (1)
• Differentials?

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Eagle 2
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Eagle 2

• Nodular masses within lung
• Hepatomegaly
• Intracondylar lysis

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Eagle 2

• Fine needle aspirate of mass/bone
• General anesthesia
• Mixed inflammatory cells

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Eagle 2

• Second CBC
• PCV 28
• TS 7.0 mg/dl
• Leukocytes
• 306.8 x 103
• Differential
• Heterophils 230.1 (75)
• Bands 0.6 (0.2)
• Lymphocytes 7.0 (2.3)
• Monocytes 66.0 (21.5)
• Eosinophils 3.1 (1)

22
Eagle 2

• Exploratory Laparoscopy
• Air sacs opaque
• Multiple cream colored mass throughout
• Biopsy
• Granulomatous mass
• No organisms observed
• Special stains pending

23
Eagle 2

• Eagle submitted for necropsy
• Hepatomegaly
• Multifocal 1 cm nodules replacing lung tissue,
• Small granulomas throughout lamina propria of
  intestine

Mycobacterium avium
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Brown pelican

• Signalment
• Brown pelican
• Adult
• Gender unknown

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Brown pelican

• History
• Found in Port Fouchon, LA
• Depressed and weak
• Would attempt to fight back when approached

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Brown pelican

• Physical examination
• Depressed, quiet and alert
• Palpation WNL
• HR 220
• RR 36
• Temperature 108oF
• Diagnostic plan?

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Brown pelican

• CBC
• PCV 44
• TS 3.5 mg/dl
• Leukocytes
• 46.7 x 103
• Differential
• Heterophils
• 74 (34,558)
• Lymphocytes
• 16 (7,472)
• Monocytes
• 10 (4,670)
• Purple structures?
• Differentials?

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Brown pelican

• Plasma biochemistries
• Sodium 149
• Potassium 3.1
• Chloride 107
• ALP 256
• CK 945
• AST 987
• TP 5.4
• Albumin 2.2
• Globulins 3.2
• Calcium 9.7
• Phosphorus 4.7
• Uric acid 1.3
• Differentials?

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Brown pelican
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Brown pelican

• Problem list?
• Additional diagnostics?

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Brown pelican
Bile acids value?
Chlamydophila testing??
Treatment?
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Great-Horned Owl

• Signalment
• Adult
• Male
• 1.4 kg
• History
• found down
• didnt put up a fight

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Great-Horned Owl

• Physical examination
• Lethargic
• Good muscle condition
• Estimated 5 dehydrated
• Oral plaques
• DIAGNOSTIC PLAN?

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Great-Horned Owl

• Complete Blood Count (estimate)
• PCV 38
• TS 6.8 mg/dl
• Leukocytes
• 26.8 x 103
• Differential
• Heterophils 43
• Lymphocytes 45
• Monocytes 10
• Eosinophils 2

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Great-Horned Owl
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Great-Horned Owl

• Biopsy of plaque
• Cytology
• Mixed inflammatory cells
• heterophils and monocytes
• Culture
• No growth

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Great-Horned Owl

• Bird found dead in cage 48 hours after
  presentation
• Necropsy ordered
• Differential list?

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Great-Horned Owl

• Gross
• Liver
• Pale and diffusely scattered with tiny 0.5 mm
  white foci on surface and parenchyma. Gall
  bladder distended.
• Spleen
• enlarged with white foci.
• Other tissues WNL

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Great-Horned Owl

• Microscopic examination
• Liver
• Most lobules contain random necrotic areas
• Infrequent, eosinophilic intranuclear inclusion
  bodies in hepatocytes and bile duct epithelium
• Spleen
• Multiple foci of necrosis
• Centrally positioned eosinophilic intranuclear
  inclusions bodies occur in mononuclear cells in
  red pulp.

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Great-Horned Owl

• Diagnosis
• Owl herpes virus (most probable)
• Owl herpes virus
• Distinct from other herpes viruses
• Owl host species
• Treatment
• High mortality
• Acyclovir?