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Amitriptyline, a tricyclic antidepressant, is used clinically to treat feather-destructive behavior in psittacine birds at a recommended dosage of 1–5 mg/kg PO q12–24h, which has been extrapolated from human medicine and based on anecdotal reports. The purpose of this pilot study was to describe the individual and population pharmacokinetic parameters of amitriptyline after a single oral dose at 1.5 mg/kg, 4.5 mg/kg, and 9 mg/kg in healthy African grey parrots (Psittacus erithacus, n = 3) and cockatoos (Cacatua species, n = 3). Three birds received an initial 1.5 mg/kg oral dose, and blood samples were collected for 24 hours at fixed time intervals. Serum concentrations of amitriptyline and its metabolites were determined by polarized immunofluorescence. After determining the initial parameters and a 14-day washout period, 2 African grey parrots and 1 cockatoo received a single oral dose at 4.5 mg/kg, and 3 cockatoos and 1 African grey parrot received a single oral dose at 9 mg/kg. Concentrations reached the minimum therapeutic range reported in people (60 ng/mL) in 4 of 10 birds (4.5 and 9.0 mg/kg). Concentrations were within the toxic range in 1 African grey parrot (9 mg/kg), with regurgitation, ataxia, and dullness noted. Serum concentrations were nondetectable in 3 birds (1.5 and 4.5 mg/kg) and detectable but below the human therapeutic range in 3 birds (1.5 mg/kg and 9 mg/kg). Drug concentrations were continuing to increase at the end of the study (24 hours) in 1 bird. Elimination half-life varied from 1.6 to 91.2 hours. Population pharmacokinetics indicated significantly varied absorption, and elimination constants varied between species. Although amitriptyline appeared to be tolerated in most birds, disposition varies markedly among and within species, between the 2 genera, and within individual birds. The current recommended dosage of 1–5 mg/kg q12h in psittacine birds appears insufficient to achieve serum concentrations within the human therapeutic range and does not yield predictable concentrations. Results of this study suggest doses of up to 9 mg/kg may be necessary, although that dose may produce adverse events in some birds, and elimination half-life is sufficiently variable that dosing intervals are not predictable. Therapeutic drug monitoring combined with response to therapy is indicated to determine individual therapeutic ranges.
Currently available assay methods and reagents are not optimized for evaluating avian hemostasis; therefore, assessing avian coagulopathies is challenging. Recently, thromboelastography (TEG), which measures the viscoelastic properties of blood, has been used clinically in mammalian species to diagnose and characterize hemostatic disorders. To evaluate TEG in healthy individuals of 6 avian species, we modified existing mammalian TEG protocols to allow analysis of citrated, avian whole-blood samples collected from scarlet ibis (Eudocimus ruber) (n = 13), American flamingos (Phoenicopterus ruber) (n = 13), helmeted Guinea fowl (Numida meleagris) (n = 12), Amazon parrots (Amazona species) (n = 9), Humboldt penguins (Spheniscus humboldti) (n = 6), and domestic chickens (n = 16). Activated partial thromboplastin time, prothrombin time, and fibrinogen were measured as a means of comparison. Regardless of the mode of activation, clot formation in the species studied was markedly delayed compared with mammals. Because of prolonged reaction time (14.7–52.7 minutes) with kaolin and diluted tissue factor, undiluted human tissue factor was used in all avian samples because it provided the shortest reaction time. Species differed significantly in reaction time (P = .007), clotting rate (P < .001), rate of clot formation (α angle; P < .001), and maximum amplitude (P < .001) values, indicating that species-specific reference intervals are necessary. Based on these results, TEG with specific reference intervals could prove useful in evaluating avian hemostatic disorders.
Arterial and venous blood gas analysis is useful in the assessment of tissue oxygenation and ventilation and in diagnosis of metabolic and respiratory derangements. It can be performed with a relatively small volume of blood in avian patients under emergency situations. Arterial and venous blood gas analysis was performed in 30 healthy gyr falcons (Falco rusticolus) under anaesthesia to establish temperature-corrected reference intervals for arterial blood gas values and to compare them to temperature-corrected venous blood gas values with a portable point-of-care blood gas analyzer (i-STAT 1, Abbott Laboratories, Abbott Park, IL, USA). Statistically significant differences were observed between the temperature-corrected values of pH, partial pressure of carbon dioxide (Pco2), and partial pressure of oxygen (Po2) and the corresponding nontemperature-corrected values of these parameters in both arterial and venous blood. Values of temperature-corrected pH, temperature-corrected Pco2, bicarbonate concentrations, and base excess of extra cellular fluid did not differ significantly between arterial and venous blood, suggesting that, in anesthetized gyr falcons, venous blood gas analysis can be used in place of arterial blood gas analysis in clinical situations. Values for hematocrit, measured by the point-of-care analyzer, were significantly lower compared with those obtained by the microhematocrit method.
Both short- and long-acting formulations of oxytetracycline are commonly used in veterinary medicine to treat animals infected with gram-negative and gram-positive bacteria, rickettsiae, mycoplasma, and chlamydiae. To compare pharmacokinetics of short- and long-acting oxytetracycline in chickens, injectable formulations from the same pharmaceutical company were administered to healthy 6-week-old broiler chickens in accordance to the labeled instructions. Fourteen chickens were separated into 2 groups: chickens in group A (n = 7) were administered the short-acting formulation (10 mg/kg IM q24h) for 4 consecutive days, whereas those in group B (n = 7) were treated with a single dose (20 mg/kg IM) of the long-acting formulation. Blood samples were collected into heparinized tubes before and at 0.25, 0.5, 1, 1.5, 2, 4, 6, 8, 10, and 24 hours after initial treatment. Thereafter, blood samples were taken every 24 hours up to 120 hours. Plasma concentrations of oxytetracycline were determined by competitive enzyme-linked immunoabsorbent assay, and pharmacokinetic parameters were obtained. Both formulations delivered therapeutic plasma concentrations of oxytetracycline for approximately 100% of their respective dosing intervals as recommended. However, considering the additional labor, patient stress, and mortalities associated with handling, in addition to rejection of the carcass due to tissue necrosis resulting from multiple injections, we recommend use of the long-acting instead of the short-acting injectable formulation in broiler chickens.
In birds, blood samples are often collected from the jugular, medial metatarsal, and basilic vein. Samples are sometimes collected by toe nail clip, but concerns to avoid drawing blood from the nail include pain after nail clips for blood collection, potential differences in complete blood count (CBC) results, and potential contamination with uric acid values. To compare differences in biochemical and hematologic values in blood samples obtained by jugular venipuncture versus toenail clip, blood samples were collected from Moluccan cockatoos (Cacatua moluccensis) (N = 23) and sent to a commercial laboratory for routine CBCs and serum biochemical analysis. Results showed good agreement between venipuncture and nail clip blood samples in red blood cell count, packed cell volume, heterophil count and percentage, lymphocyte count and percentage, aspartate aminotransferase, chloride, creatine phosphokinase, glucose, lactate dehydrogenase, total protein, and uric acid values. Constant bias was found in values of bile acids, cholesterol, and hemoglobin. Proportional bias toward higher values in the jugular sample were found in total white blood cell (WBC) count and inorganic phosphorus. Serum calcium plots revealed a proportional bias toward higher values in the toe nail blood when values were increased. Results suggest some differences in WBC count, bile acids, calcium, cholesterol, hemoglobin, and phosphorus values between blood samples collected by jugular venipuncture and samples collected by toe nail clip, but the differences are mostly minor and, with the possible exception of inorganic phosphorus and marginally elevated or very low WBC counts, are unlikely to affect the use or interpretation of the avian blood panel.
The Puerto Rican parrot (Amazona vittata) has become an iconic and high-profile conservation species. The cornerstone of the recovery plan for this critically endangered species is an active captive breeding program, management of the wild population, and a long-term reintroduction program. In 2002, 40 adult Puerto Rican parrots that had not produced viable offspring were selected for reproductive assessment at 2 aviary populations in Puerto Rico (Iguaca and Río Abajo), which are the only sources of parrots for release. The goal was to enhance reproductive potential and produce productive pairings in an attempt to augment the population growth and provide ample individuals for reintroduction. Seven Hispanolian Amazon parrots (Amazona ventralis) that were used as surrogate parents for the Puerto Rican parrots were also included in the study. This assessment included physical examination, endoscopic evaluation, hematologic and plasma biochemical profiles, viral screening, and hormonal assays. Results of general physical examination and hematologic and plasma biochemical testing revealed overall good health and condition of this subset of the population of Puerto Rican parrots; no major infectious diseases were found. Endoscopic examination also revealed overall good health and condition, especially of females. The apparent low fertility of male birds warrants further investigation. The findings helped to define causes of reproductive failure in the selected pairs and individual birds. New pairings resulting from the assessment helped to augment reproduction of this critically endangered species.
Kristin M. Sinclair, Michelle G. Hawkins, Lewis Wright, Richard P. Chin, Sean D. Owens, David Sanchez-Migallon Guzman, Michael S. Kent, H. L. Shivaprasad BVSc
An asymptomatic 14-year old, male black swan (Cygnus atratus) housed at a zoological institution was presented for routine preshipment examination. Hematologic findings indicated that the bird had a severe lymphocytic leukocytosis, consistent with chronic lymphocytic leukemia. Radiographs showed the presence of multiple soft tissue masses within the caudal coelomic cavity; ultrasound showed one mass to be an enlarged spleen, a cystic mass near the gonads, and a mass suspected to be associated with the ventriculus. Results of further antemortem diagnostics, including bone marrow aspiration, fine-needle aspirate cytology of the coelomic masses, and immunohistochemical staining confirmed T-cell leukemia with infiltration of the bone marrow and the spleen. The bird showed partial response to treatment with chlorambucil, lomustine, prednisone, l-asparaginase, and whole-body radiation, with neither evidence of adverse effects nor clinical signs of disease. Although the leukemia showed response, there was no evidence of remission at any point. The swan died 433 days after initial evaluation and initiation of therapy. Necropsy, histopathologic findings, and immunohistochemistry results confirmed extensive infiltration of multiple organs, including the liver, spleen, heart, lungs, and kidneys with neoplastic T-cell lymphocytes.
Luigi Maria De Luca Bossa, Giuseppina Mennonna, Leonardo Meomartino, Orlando Paciello, Francesca Ciccarelli, Davide De Biase, Pasquale Raia, Vincenzo Caputo, Alessandro Fioretti, Ludovico Dipineto
We report a case of polyostotic chondroblastic osteosarcoma in a kestrel (Falco tinnunculus) admitted to the Wildlife Rehabilitation and Rescue Center (Naples, Italy). A consolidated fracture of the left tibiotarsus bone and a deviation of the limb were evident. After radiographic, cytologic, and histopathologic examinations, a diagnosis of polyostotic chondroblastic osteosarcoma was made. To our knowledge, this is the first report on polyostotic chondroblastic osteosarcoma in a kestrel.
The southern ground hornbill (Bucorvus leadbeateri) has been classified as globally vulnerable and, in South Africa, regionally endangered, with a negative population trend. Factors contributing to the population decline in South Africa are poisoning, electrocution, and illegal capture for trade, coupled with slow reproductive rates and extensive habitat requirements. Lead toxicosis is a previously undescribed threat for the population. An adult southern ground hornbill presented with acute lead toxicosis due to lead particles in the gizzard, which required intensive treatment. Two other hornbills were likely exposed. The source of the lead in these cases was likely a carcass of a porcupine that was killed with lead shot. This report highlights the importance of the use of lead-free ammunition within the habitat of the southern ground hornbill in South Africa.
From 2 exhibits in a zoological collection, 2 juvenile fairy bluebirds (Irena puella) and 1 adult blue-grey tanager (Thraupis episcopus) died within 3 months of one another. The cause of death was attributed to air sac trematodes, which were identified as Szidatitrema species based on morphology of adult trematodes and miracidia isolated from a snail intermediate host. To determine the extent of trematodiasis in the collection, individual exhibits within the same building as the original presenting cases were assessed, with birds representing 27 avian species from 9 orders. Sampling consisted of individual (n = 244) and pooled same-species group (n = 193) fecal examinations, and for some individuals, and tracheal swab (n = 106), resulting in a total of 543 samples. In addition, tracheal swabs were performed on 14 birds for comparative cytology, but no parasites were found. Flukes were positively identified in 4 tracheal swab samples (4%), 37 individual fecal samples (15%), and 52 of the group fecal samples (27%). When results of the swab method were compared with those of fecal examination, fecal testing was significantly associated (P < .001) with positive results. Based on these results, a screening process was instituted of 3- or 4-day combined fecal samples evaluated by both sedimentation and flotation techniques 2 weeks before outgoing shipments or intrazoo transfers of birds housed in exhibits known to have snail populations. Snail control methods also were initiated in all exhibits. Treatment with praziquantel was carried out on a case-by-case basis, and included oral, parenteral, and nebulized administration. Although control measures were expected to manage the infection and reduce distribution of the parasite to other collections, complete eradication of trematodes in the population is unlikely.
We would like to acknowledge and extend our sincere gratitude to the following people for contributions of their time, expertise, and guidance as reviewers of manuscripts for the Journal of Avian Medicine and Surgery from October 28, 2014 through December 1, 2015.
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