Susan E. Orosz

Pharmacokinetic Disposition of Itraconazole in Red-Tailed Hawks (Buteo jamaicensis)

Abstract The pharmacokinetic disposition of itraconazole in plasma and tissues was evaluated in a multiple dose study using 11 nonreleasable red-tailed hawks (Buteo jamaicensis). An itraconazole solution was administered by gavage at a dosage of 5 mg/kg in 4 hawks and 10 mg/kg in 7 hawks once daily for 15 days. On days 1 and 14, blood samples were obtained at 1, 8, 16, and 24 hours after itraconazole administration. The hawks were killed on day 15, and samples of air sac, brain, kidney, liver, lung, and small intestine were retrieved. High-pressure liquid chromatography was used to measure the concentration of the parent drug, itraconazole, and its active metabolite, hydroxyitraconazole, in plasma and tissues of each hawk. Concentrations represent point-in-time values. Results suggest that hawks gavaged with itraconazole at 10 mg/kg once daily will reach steady state plasma concentrations of itraconazole and hydroxyitraconazole within 2 weeks. Although plasma concentrations were lower than those reported in parrots and pigeons, concentrations of both itraconazole and hydroxyitraconazole in organs other than the brain were comparable among species of birds.

Pulmonary Carcinoma with Metastases in a Moluccan Cockatoo (Cacatua moluccensis)

Abstract Pulmonary carcinoma was diagnosed in a 14-year-old male Moluccan cockatoo (Cacatua moluccensis) presented for sudden onset of ataxia of the pelvic limbs lasting several hours. On physical examination, the cockatoo had paraparesis of both legs and a reduction in pectoral muscle mass. The bird responded to initial supportive therapy; however, its clinical condition deteriorated over a 3-week period. Histopathologic examination revealed pulmonary carcinoma with intrapulmonary metastases as well as metastases to the vertebral column and right humerus.

Sedative Effects of Medetomidine in Pigeons (Columba livia)

Abstract The sedative effects of medetomidine administered alone or in combination with ketamine or midazolam were evaluated in 20 adult pigeons (Columba livia). Six to 12 pigeons were randomly assigned to each of 5 treatment groups. Medetomidine administered alone (80, 150, or 200 μg/kg IM) caused effects ranging from ataxia to sternal recumbency, but the righting reflex was always retained. The level of sedation resulting from medetomidine (80 μg/kg IM) in combination with either ketamine (5 mg/kg IM) or midazolam (0.5 mg/kg IM) was variable; birds exhibited signs ranging from mild to heavy sedation. Heavy sedation was defined as loss of the righting reflex and profound muscle relaxation. Medetomidine-ketamine resulted in heavy sedation in 3 of 9 birds, whereas 5 of 12 birds were heavily sedated with medetomidine-midazolam. Atipamizole (0.5 mg/kg IM) was administered to reverse the effects of medetomidine. The length of time (mean ± SD) from atipamizole injection until loss of ataxia and return of full responsiveness ranged from 10 ± 4.0 to 17 ± 5.0 minutes with medetomidine alone. Birds sedated with medetomidine-ketamine recovered within 20 ± 12.0 minutes, and those sedated with medetomidine-midazolam recovered within 38 ± 11.0 minutes. Atipamizole was given 30 minutes after administration of medetomidine alone and medetomidine-ketamine, whereas birds given medetomidine-midazolam received atipamizole 50 minutes after administration. Medetomidine used alone or in combination with ketamine or midazolam cannot be recommended for sedation of pigeons at the dosages described in this study. Used alone, medetomidine was inadequate for restraint, and when administered with ketamine or midazolam, sedative effects were unpredictable.

Hiatal hernia and diaphragmatic eventration in a leopard ( Panthera pardus).

Abstract A 1-yr-old male leopard (Panthera pardus) presented for intermittent anorexia, emaciation, and generalized muscle wasting. Plain radiographs, ultrasonography, and esophageal endoscopy led to a diagnosis of diaphragmatic eventration with probable concurrent hiatal hernia. An exploratory laparotomy confirmed both diagnoses, and surgical repair and stabilization were performed. After surgery, the leopard was maintained on small liquid meals for 4 days, with a gradual return to normal diet over 2 wk. By 4 wk after surgery, the leopard was eating well and gaining weight, and it showed no recurrence of clinical signs for 2 yr subsequently, becoming mildly obese.

Mineral Content of Food Items Commonly Ingested by Keel-Billed Toucans (Ramphastos sulfuratus)

Abstract This study reports the content of iron and selected minerals from food items commonly ingested by keel-billed toucans (Ramphastos sulfuratus) in their native habitat in Belize, Central America. These same minerals were analyzed and compared with those found in a commercially prepared diet that was formulated to be low in iron. Seven of the food items collected from the wild had a total iron content ≤ 50 μg/g, whereas the remaining food items were ≤150 μg/g (except for 1 plant item). In contrast, the low-iron diet contained 210 μg/g of iron on a dry-matter basis. This study suggests that iron overload from feeding a commercial diet may contribute to the development of iron storage (disease) in captive toucans and other iron-sensitive species.

Cardiopulmonary and anesthetic effects of medetomidine-ketamine-butorphanol and antagonism with atipamezole in servals (Felis serval).

Abstract Seven (three male and four female) 4–7-yr old captive servals (Felis serval) weighing 13.7 ± 2.3 kg were used to evaluate the cardiopulmonary and anesthetic effects of combined intramuscular injections of medetomidine (47.4 ± 10.3 µg/kg), ketamine (1.0 ± 0.2 mg/kg), and butorphanol (0.2 ± 0.03 mg/kg). Inductions were smooth and rapid (11.7 ± 4.3 min) and resulted in good muscle relaxation. Significant decreases in heart rate (85 ± 12 beats/min) at 10 min after injection and respiratory rate (27 ± 10 breaths/min) at 5 min after injection continued throughout the immobilization period. Rectal temperature and arterial blood pressure did not change significantly. The Pao2 decreased significantly, and Paco2 increased significantly during immobilization but remained within clinically acceptable limits. Hypoxemia (Pao2 < 60 mm Hg) was not noted, and arterial blood oxygen saturation (Sao2) was greater than 90% at all times. Relative arterial oxygen saturation (Spo2) values, indicated by pulse oximetry, were lower than Sao2 values. All animals could be safely handled while sedated. Administration of atipamezole (236.8 ± 51.2 µg/kg half i.v. and half s.c.), an α2 antagonist, resulted in rapid (4.1 ± 3 min to standing) and smooth recoveries.

Pharmacokinetics of amoxicillin plus clavulanic acid in blue-fronted Amazon parrots (Amazona aestiva aestiva).

Abstract In the face of increasing bacterial drug resistance because of β-lactamase production, many microbial infections can be treated effectively by combining clavulanic acid with amoxicillin. Judicious drug use that includes defining the optimum dosage is important to control development of resistance to this drug combination. In this study, amoxicillin and clavulanic acid were administered to blue-fronted Amazon parrots (Amazona aestiva aestiva) in a multiple dosing trial. Birds were gavaged with 125 mg/kg of the drug combination at 0800, 1600, and 2200 hours on days 1–5. The half-lives of amoxicillin and clavulanic acid were similar to those in humans; however, the area under the curve was increased in the parrots compared with humans. These results suggest that this drug combination, at this dosing interval, achieves levels that may be effective against many bacterial species.

Veterinary Challenges With the Human–Companion Bird Bond

It seems not long ago that many veterinarians attending the AAV annual conference were discussing a new idea to hand-raise psittacine birds to create the companion bird of the future. Along with this discussion came a recognition of the importance of the human–companion bird bond. One issue brought forth was the positive impact companion birds could play with elders and with children. Despite enthusiasm, concerns about zoonotic diseases and other pressing issues put this new role on the back burner—except for 2 wildly disparate advocates. Dr Ted Lafeber, Jr, just kept talking about it to others while placing budgies and canaries in care facilities near his retirement home. He thought about how to make cages easier to clean for nursing staff or the elderly and how to provide food and water more efficiently for the birds so that staff could spend time caring for their human patients. If birds were to be in such facilities, care would need to be straightforward. There was also a gerontologist who wanted to revolutionize the nursing home industry—to deinstitutionalize it by introducing a variety of animals, plants, and—oh, yes—children into an environment that once was considered sterile. I had the pleasure of spending part of a day with Bill Thomas, MD, at the AVMA meeting where he spoke on the Eden Alternative and his vision of elders, their rightful place in society, and appropriate care. It was a fascinating opportunity, and I was happy to learn that birds have had and continue to have an important role in care facilities. As many as 100 companion birds, including budgies, cockatiels, finches, canaries, and others, can be found in each Eden home. Dr Thomas remarked that the song of the canary wafting down the hall of a care facility on a cold, dreary winter day lifts the soul like no other means. He also noted that drug costs were reduced significantly when birds were added to the Eden homes— more than compensating for the costs of the birds. Staff turnover was greatly reduced as well. The psychosocial benefits of companion birds are just beginning to be explored scientifically. Budgies in individual cages have been shown to reduce depression significantly for elders admitted to skilled rehabilitation units. They have also been shown to provide a variety of benefits to elders confined to their homes, including acting as companions and as a social lubricant to conversations. One researcher remarked that the bond between the elder and the budgie placed a special onus on the veterinary community to provide sympathetic and expert care. And that is where each of us should play a role. The avian veterinary community needs to be in the forefront of decisions about companion birds in care facilities. Reducing zoonotic disease risks by developing more meaningful diagnostic tests, flock management plans, and behavioral assessment plans for birds and humans for therapeutic interventions is a challenge facing the avian profession. As advocates of birds, we need to provide care and expert advice and to serve as veterinarians of record for care facilities in our communities. As we and our parents age, we need to address veterinary challenges to allow the special bond between humans and birds to flourish. In this way, perhaps even we will benefit in years to come.

In this Issue: New Sections, New Opportunities

As many of you know, I care very deeply about the continual advancement of the field of avian medicine and surgery. All of us who consider ourselves to be avian veterinarians should, for it is a direct reflection on each of us. What we do and say, particularly in print, reflects on us as a professional group. These actions and words shape and provide our career identity within the larger community, which includes aviculturists, veterinarians in other professional roles, and the lay public. So it is with great honor and humbleness that I step into the role of Scientific Editor for the Journal of Avian Medicine and Surgery. It carries with it a great responsibility to continually reflect the expanding role of avian medicine and surgery. I look at the journal as the flagship publication that represents us, and also advances and promotes avian medicine and stewardship. But we at the journal cannot do this without ALL of your help! It is not a journal of one but of many. It requires putting in that extra effort in finishing that paper, getting the review done in a timely manner, stepping up to the plate with writing a manuscript, and, of course, all of your reading and learning. For all those who have put forth that effort to make YOUR journal great, we thank you! Your effort demonstrates the increasing quality that reflects on all of us. One of the new tasks as Scientific Editor was to meet with the folks at Allen Press. That was a terrific experience—discussing publication procedures, looking at other journals, gathering new ideas—all things that help develop a new vision for our journal. So here is our vision—we want to continually expand the scientific publications from bench research to prospective and retrospective clinical trials. We have added Research Briefs, as well. Clear documentation of clinical cases helps our profession take those observations to clinical trials and/or research efforts. Although we solicit Case Reports, we want to go to the next rung—to clinical series reports—documenting multiple cases with similar conditions. We will also include Clinical Briefs. If you have questions whether your clinical/research observations fit into that category, give Cheryl Greenacre a call or you can contact me. We want you to publish in this journal. You will see that we have added other new sections. Although each of the new Associate Editors has written a manuscript for these new sections, they all want you to give them a jingle or e-mail a manuscript to them! Take a look at the new sections and see if your interest and experience could fit. Current Topics is being edited by Teresa Lightfoot—someone we all know and love for her wit and humor. But she wants YOU to provide timely (as best the journal can do) topics—things that are happening now! In the next issue, Teresa will share her concern about the effects of various chemicals long after their original use. She will describe how migratory birds suffered tremendous losses in one such environmental disaster. This concern is anticipated in the new section written by Christal Pollock—Historical Perspectives. Christal starts with the voice of Rachel Carson and fast-forwards us to current times. The medical history buffs in the crowd need to provide us with those lessons from history and compare them with how we view things now. In the next issue, Glenn Olsen will provide a journal of his trek across the middle of the country to Florida with the sandhill cranes. His new section—Notes from the Field—is an exciting opportunity to share experiences—from disease outbreaks to death-defying acts to help those winged creatures that we care so deeply about! We appreciate all of our new Associate Editors, reviewers, writers, and those who have continually helped us in the past. Hats off to the sustained efforts of Kathy Quesenberry and her many years of service. Happy reading (and don’t forget to write)!