Hello, everyone. My name is Catherine Quesnberry. I am the, the Avian Exotic Pet Service at the Animal Medical centre in New York, New York.
I am also the chief medical officer at the Animal Medical centre and today I'm gonna talk to you about advanced diagnostic imaging and exotic pets. So first we want to talk about why is advanced imaging important exotic pets? And I wanna go back to this quote from the seminars in avian exotic pet medicine in 2001.
And this pretty much sums up why we use advanced imaging in exotic pets. Avian and reptilian species usually show poor clinical signs for differentiation of various diseases. In most cases, physical examination does not give sufficient information.
Diagnostic imaging techniques like radiography, ultrasonography, computed tomography, or magnetic resonance imaging are useful tools for the examination of exotic species. And we all know that it's very, very difficult sometimes to arrive at a diagnosis in a small bird or a reptile just because we don't have the same tools. That we do in other species, small animal species, dogs and cats.
So, when we talk about imaging techniques and exotic pets, we want to talk about the the standard ones that we've been using for a long time such as radiology, ultrasound, fluoroscopy, computed tomography, magnetic resonance imaging is one that we don't use very often, and interventional radiology and endoscopy. Is one that we are starting to use more recently. So first we'll talk about radiography, and this is standard in every veterinary practise and how we use it in exotics has changed through the years.
So, radiography, of course, is the most common imaging modality. It's a very low cost for the most part in most areas. It's easy to obtain whole body assessments.
And you can or cannot use anaesthesia depending on the species and the demeanour and as well as the risk factor of what you're dealing with and what animal you're dealing with. In 10 years ago, most people use a high detailed mammography film, and that allowed much, much more detail in our radiographs. Now, most people have switched to digital radiography.
The advantage of digital radiography are the rapid dissemination of images to colleagues and emergency clinics, etc. Archiving with quick retrieval and now most many, I shouldn't say most, but many electronic medical records are actually connecting to digital radiography storages, diom images. The disadvantages are that you have less spatial resolution than with slow speed, high detailed radiographs such as mammography film and the increased cost of the digital radiography units.
This is an example of a, a standard digital radiograph that most people are using. With these images, of course, this bird is under anaesthesia. So some birds you have to use with anaesthesia, other birds you, don't, and again, with small mammals, some mammals you can do with anaesthesia, some mammals you can do without.
So it really depends on the species and what you're trying to achieve. One thing that we use now use our radiographs for is what we call the box shot or the standing dorsal ventral radiograph. And this is something that we use for quick survey films to screen for metal foreign bodies.
Eggs, bone quality or abdominal masses, and you can see in this radiograph, there is a large amount of metal density foreign material in this bird's gastrointestinal tract. So it's a quick way of screening for, for certain things. It does not give you an evaluation of organs, heart size, lung quality, but it's a good quick screening technique, especially if you have a very stressed animal.
And with this, we use primarily in birds but also in reptiles as well. Contrast radiographs are something that many people have used through the years. Contrast is used primarily for the GI tract to distinguish gastrointestinal abnormalities as well as extra GI masses.
And we use barium, we use iodine, and of course, what we use this for is for extra abdominal masses, what you're looking for is that the intestinal tract will be pushed out of their normal position. On this radiograph, you can see this is a normal barium study in a bird, you can see the proventriculus, you can see the isthmus of the proventriculus, and you can see here, let me see if I can get the pointer going here. This is the isthmus of the proventriculous, this is the ventriculous, and then the normal intestinal tract here.
The disadvantage of this is that there's a time factor of 1 to 4 hours. So you have to do usually multiple radiographs and sometimes multiple anaesthetic episodes to do this contrast study. So this was something that we relied on a lot before we started using CT units, .
Ultrasound is very safe. Usually you can do it with manual restraint. The, the reason we do ultrasound, of course, is to get real time time information.
We look at cardiac motility. We also look at tissue structure so we can look at the the opacity of the liver, the opacity of an abdominal mass, and that will tell us a lot about the structure, and what those, those organs, the organ function, the possible organ function. We also use it for fine needle aspiration of masses, of tumours, and various species.
Fluoroscopy is another technique that's not available to a lot of people, but it has really good advantages. It's again like like ultrasound. It provides real-time imaging, so you can see the actual movement of an organ.
It's very useful for motility studies, so we use it. For instance, we use the barium GI to give us some ideas, but now we can use it to give barium and watch the actual movement and, and motility of the GI tract. Most of the time it's CR and fluoroscopy, and fluoroscopy is a mainstay of interventional imaging.
So this is, let me see if I can go off this. This is a bird. Standing, we usually have them stand on a perch for a fluoroscopy study, and this is where we gave it some barium and you can see how we can watch not only the bird's respiration, the normal respiration was, but you can also see up in here, there is some barium.
Sort of hanging out in the oesophagus that should be there. You can see the motility of the ventriculous and the proventriculous, the normal motility there. So, again, it really gives us a good idea of, of normal versus abnormal in these birds, or in other animals.
CT is a is a modality that has become really much more available to us as exotic animal practitioners or zoo animal practitioners. The costs are decreasing. We use both helical and multi-detector CT technology in some of these in most referral centres in most universities, they have very, high detail, helical CT, in small animal practises, there are increasingly more commercial CTs that can be bought or leased that are, are less.
They're like 15 slice or 8 slice CTs, but it will still give you information. It, it has an extremely rapid image time depending on the CT detector that you have. It allows much greater contrast resolution.
You get many shades of grey, whereas in, in conventional radiographs, you only get 5 shades of grey. And when we use IV contrast, that increases the visibility of tissues with greater blood flow and capillary permeability. So this is our CT with two different rabbits here undergoing CT examination.
These are sedated, which we will talk about. So, CT imaging and exotic pets, you have to look at the cost, the personnel, the procedure, and the time. The cost, again, some, in some places, it may be outside of the grasp of, of pet owners or in, in, in other facilities that people can't afford it.
In other places, the cost has come down or or separate costs can be set up. For imaging of exotic pets to make it much more accessible. Personnel, of course, you can't just send an exotic animal to a CT imaging facility.
You have to have personnel that know how to deal with the exotic pets. The procedure itself, how long it takes much, most of these are very, very quick, so, and then you have to think about whether you're gonna do it. With a sedated animal versus an awake animal which I'll talk about.
And the time involved. Again, some of these are very, very quick. This is a, several examples of different reptiles undergoing CTs.
Many of these reptiles, can just, they're very stoic. They'll stand there. You can just, for, for instance, in this bearded dragon, didn't move, you can, you can just do the CT.
Other animals, we do anaesthesia. This is, on the left is a turtle that is in a a, a type of positioning, that has air compression to position the animal. This animal was undergoing CT for, later on radiation oncology, so we have to have the positioning very, very exact.
On the right is a sulcada with a vet cat, which I'll talk about. So again, we talk about sedation versus full anaesthesia versus no sedation. And it depends again on the animal.
There's different ways you can do the CT in the upper left, we have a a little sort of a round, container that you put a lot of padding around and you try to keep the animal as immobile as possible. On the right is again a vet cat study where the animals under sedated and this allows us CT of the head. The lower right is an animal, rabbit that's under sedation with oxygen flow by, and the lower left is a little mouse with some isofluoran.
Now, you can do standing CTs. These are some papers that have been written about standing CTs. We first started doing these in in a bird that had adenocarcinoma and a scarlet macaw, and then we've gone on and many more people are doing them now.
This was a study that we did with the wildlife Conservation Society where they brought in penguins. We put them in these little plexiglas boxes and we were able to do CTs of them without any sort of sedation or anaesthesia. We turn out the lights, we keep it dark, and the animals are still enough.
You don't get a good image of their head, but you usually go to get a get a good image of their body. Now, if you want to do contrast with CT you, of course, have to have venous access, and this does require sedation or anaesthesia for this. So we use pretty much the standard contrast dose for most animals, the 2 mL per kilo.
Birds and reptiles, remember, they do have a renal portal system, so you wanna try to avoid using the back legs or the caudal half of the body and those species if you can. Doctor Scott Eccles, who's given many talks on diagnostic imaging in exotics, uses an IOU 370, and he gives 4 to 6 mLs per kilo IV over a 2 minute. We don't do that.
We use a lower dose because we have to, in our machine, we have to inject it and then be out of the room. So it depends on the setup that you have, and, how you're gonna do this, but For many things, it's really nice to have a CT. It really shows a CT with contrast, it really shows what you're trying to see.
What you, again, you try, you try to avoid using IV catheter in, in the back leg in a bird or in a reptile. This is the vetA CT. This is a, came from the human dental world, and it's been adapted for veterinary medicine.
Several places throughout the US now have these units. Our dentistry unit has it and we use this machine a lot. So what this does is gives you, it has a very smaller window, so you can only do, for instance, a very small reptile or the head of an animal.
It's great for rabbit dental studies, it's great for small birds, and it allows you with the programmes to reconstruct 3D, images, so we use this quite often. MRI's are not used very commonly yet in exotics, advantages of MRIs or brain and spinal cord imaging. It allows differentiation of soft tissues.
The disadvantages and the reason that we don't use it that often primarily is the cost and the prolonged anaesthesia time. It can take up to 3 hours. Many times you can do an exotics for 1 to 1.5 hours, but still, that's a long time.
For a bird, a reptile, or a small mammal to, to be under anaesthesia. So that's one of the main reasons we don't use it. So I'm not gonna talk too much about that.
I have a few examples of that. Interventional radiography is what is basically the, the idea behind interventional radiography is it's used to open what is closed or close what is open. It's increasingly more available at universities and referral centres.
This is, this photo is from a paper that came out of the University of Georgia where a tracheal stent was placed in a in a bird, and, you can see it here. This bird, unfortunately didn't, didn't do very well. We've used interventional radiography in many, many cases.
We've used it for removing stones in in guinea pigs. We've used it for putting tracheal stents in rabbits. Recently, the wildlife Conservation came to our centre and use it for opening up venous, .
A blood vessel in the back leg of an aardvark that had a clot. So, it can be used and it, it, it's increasingly available. So, we're gonna talk about some common clinical presentations.
We're gonna go through some cases just to illustrate basically how we use some of this advanced imaging. So in rabbits, we primarily use it for neurologic disease for head tilt, otitis versus encephalitozoonosis. We use it routinely for dental disease, thymomas, birds, we use it for reproductive disease.
It's really great. For respiratory disease in birds, salomic disease. Small mammals again, for rep for reproductive disease, for dental disease, reptiles, turtles, and tortoises, for salomic disease, respiratory disease, and lizards again, for primarily salomic disease.
So reptiles, of course, we have a very limited physical exam. So that is why we use it a lot in these species. This was what you would see on a radiograph, In this area, we can see that there's a mass here.
On this view, we can see exactly where the mass is, what it looks like. So, again, in turtles and tortoises, it's very, very handy to have something like this to be able to tell you exactly what you're dealing with, where it's at in relation to other organs. This was a turtle that had an insicated egg in the CT.
This is the silcata I showed you a photo of earlier where we use the CT to show us what was going on. This animal came in, it couldn't defecate, wasn't defecating, and we can see it had a huge oops, let me go back. It has a huge eurolith here that you will see.
Showing up. All right. There you can see it.
And we went in with laser and we're able to break down the urolith and remove it and the, the tortoise did well. So we're gonna go through some case studies so I can show you how we've used this in clinical practise. So this is Oscar.
This is a 34 year old Amazon parrot first presented with anorexia for several days. No previous illness. The diet was seeds, bread, cheese, corn, no vitamins.
On blood chemistry, the AST was 9,746, which is of course very high. The bile acids were 600, which is also very high, had a normal CBC and a normal protein electrophoresis. So we did an ultrasound and what we found was that the liver was hyperchoic and on ultrasound, we did a liver aspirate which came back on cytology as lymphoplasmaytic infiltrate.
So the next step was we did a CT scan of Oscar. And you can see, this is, sorry about the bumps in here, but you can see in here, massively enlarged liver, very, very asymmetric hyperechoic areas, hypoechoic areas of the liver. Just really huge, very abnormal liver in this bird.
So this is a, a still shot of that. Again, you can see the liver enlarged. This is the side view going down, but again, it's a very, very abnormal liver.
So the bird ultimately was euthanized and what we found was marked diffuse hepatitis, nodular hepatocellular hyperplasia, megalocytosis with severe portal fibrosis, biliary hyperplasia which was compatible. With cirrhosis. The bird, I didn't show you the lung view, but the bird also had pneumonia with necrotizing pyogranulomatous disease with intralesional degenerated plant material, so it had aspiration.
It had erseculitis with fungal hyphae and advanced atheroscle sclerosis. So the lesions in the liver were suggested of a toxicosis. This is Pogo.
Pogo was a 20 plus year old. We didn't know exactly how old Pogo was. Blue and gold macaw with a history of ascites of several months' duration.
Multiple abdominal taps showed, cytology, on the cytology showed a transuddate. So the, it was referred in for suspect liver disease versus reproductive disease. So in Pogo, What you can see here on the CT and this is kind of a quick one, but again, let me show that to you and we can go through it.
So you can see here, this is the liver, this is the heart. This is a contrast study, and you can see how massively enlarged that heart is. This is all fluid in the abdomen.
This is the liver. Again, on this view, you can see that, but let me go back and show you a little something else. So, if we go back here, see if I can go back.
This structure right here between the heart and the liver, that's the caudal vena cava, massive, massively enlarged. So, what we also found this bird had Congestion of its pulmonary vessels. So it was in right heart failure, also going into left heart failure.
So, again, CT was done and it really allowed us to see what was going on with this bird. This is another bird. This bird, is a macaw came in with a history of, of, having difficulty walking, and you can see in this bird a difference in Perception.
So you see on the left side of this bird, it's not perceiving. Kinda knows something's going on there, but it's not really visual. It's not, whereas on the right side you can see on it immediately reacts.
So this bird was not visual in the left eye, which in birds they decasate completely. So that led us to believe there was a right-sided lesion in this bird. You can see also in this video a little bit that the bird is knuckling on the left side.
So this is a bird that we did do an MRI on, one of the few, and we did find hyperattenuating lesions in the right side. So this bird we believe had a stroke. The bird went on to do pretty well and lived to recovered, did, did well for a while after that, and then it died of another lesion.
This is a bird that we're actually dealing with right now in the hospital. This is another macaw that we believe had a hemorrhagic stroke, and on this bird, we did the CT. And you can see this hyperattenuating lesion at the tip of the arrow here, and, right here.
And again right here. So we believe the bird had to believe the bird is, this is on the left side of the brain. The bird is a visual on the right side of the brain and is also hemmipoietic on the right side and it's exhibiting an attentiveness on the right side of its face.
So the bird is still in the process of recovery and we're hoping it will do OK, but time will tell. This is Pickle. This is a 10 year old whitecap Pionis parrot.
Presented to the referring veterinarian for increased Respiratory rate and a change in vocalisation. On the referring radiographs from the, the veterinarian, they suspected cardiomegaly. They started the bird on Lasix.
The results of the blood tests were OK. The white cell count was normal, so it was referred basically for a cardiac workup. This is the radiographs taken by the referring veterinarian.
You can see just increased, opacity in the cranial selum here. Here's the liver, but again, this is abnormal here, this is So again, this is a radiograph and you can see what that shows. It, it doesn't really give us a whole lot of information other than something is abnormal there.
We can't tell if it's the heart, or, you know, what this is. So, an echo was done and we did find there was a dilated left ventricle with some mitral valve regurgitation. It started on immobendin and continued with Lasix.
Now, most of you know in birds, echocardiograms are difficult to obtain. You go through a window in the abdomen. You go through the liver, so you can't usually see cranial to the heart.
A lot of times you're lucky if you get the heart in the echo. So this bird was followed by the referring veterinarian for the next 8 months. And then it presented with increased wheezing and tail bobbing, and the white cell count was increasing.
So it was referred for a repeat echo. The repeat echo showed right heart enlargement and a decreased left ventricular contraction. And at that point, we did, did see evidence of a large mass which was adjacent to the heart.
So at that point, we decided to do a standing CT. Again, this is without contrast because we're concerned about anaesthesia in this bird with something a mass in its cranial thorax. So, this is the CT.
So you can see here, without contrast, there's a huge mass in the heart, in the area of the heart. It's also going up into the lungs, so mass effect that's penetrating into the lungs in this bird. On the lateral view.
Again, the mass going up into the lungs, penetrating into the lungs, you can see there. So, this was not heart disease. It was very obvious it was not heart disease in this bird.
Something was, else was going on that would affect the lungs in this bird, . So the bird ended up being euthanized and this is what we found on necropsy for orientation. The crop is on the right side up here, the arrow is pointing into this large mass and you can see the liver to the left.
And the heart you can see peeking out from out right between the liver, the mass is cranial to the heart. So on pathology, again, this is looking at the mass. You can see how enlarged it is.
And here you can see an impression smear. This turned out to be a mycobacterium case. This was mycobacterium gents.
So, very unusual presentation, but again, with, with the CT we were able to determine that this was really bad disease and that the birds should be euthanized. Ruby, is a 15 year old clectus female parrot that presented with the right lateral neck mass that was present for about a month. On cytology, had cystic fluid with moderate granulomatous inflammatory response, evidence of previous haemorrhage on bloods, we had an increased bile acid, and the uric acid was up mildly at 10.2.
So, repeat uric acid came back down to the normal range. Bile acids were still a bit elevated on repeat. So this is what a radiograph looked like and we can see this large mass on the, the right side of the neck here and to right to the adjacent to the trachea.
So the question was, is this something that could be surgically removed? This was ultrasound showing the, the mass, very large mass. And here we could see that there was some blood vessel involvement on the side of the mass, so we were concerned about whether or not this would be something that would be resectable.
So we did do a CT exam. And here we can see on this image, on the CT that the, this is with contrast and you can see the jugular vein right adjacent to the mass. So this we knew was going to be a very risky type of surgery because it was so closely involved with the blood vessel.
So, we did try surgical excision of the mass. It appeared to be comprised of chronic hematoma. The jugular vein was teased off and smaller vascular branches were ligated.
The bird unfortunately had a drop in heart rate during the recovery. We did CPR but it didn't have cardiac arrest. This is switching over to mammals, Freddie.
Freddie was a 2 year old male rat that presented for onset of neurologic signs, had no previous problems, normal diet, and caging. So this is Freddie, how Freddie presented on examination, very, very ataxic. He knew where he where he was, but he couldn't quite get there very, very well.
Kind of like a drunken sailor type of, of mobility. So for Freddie, again, doing a CT this is without contrast, but you can see very clearly here the mass here and the The base of the brain and this was anterior pituitary mass in this rat, which is fairly common development in ageing rats. So again, this is where CT helped us come to a diagnosis fairly quickly in this animal.
So, as I mentioned in the beginning, one of the uses of CT that, we use it for a lot is in skull imaging. It's useful to differentiate middle ear bullet and bola disease from CNS lesions. It's also useful in the diagnosis and prognosis of dental disease in small mammals.
So there is a lot of information out there on the use of CT and dental disease and rabbits, guinea pigs, and chinchillas. this is from Vittorio Capello book on use of CT imaging and reconstruction of the CT. Here's a 3D reconstruction in a rabbit just to look at.
Dental disease. So it's very, it's used very commonly for dental disease. There's a lot of papers written about the use of CT in small mammals and exotics, in rabbits primarily, but in also guinea pigs, chinchillas.
There's papers on the use of combbean CT, so a lot of information out there. Where we find it very useful, not, not in the common dental disease problems, but more in the more complicated dental disease problems. Dental abscesses are fairly common in rabbits, for many reasons, which I'll talk about in another lecture.
So, we use it quite commonly. In these animals to to diagnose dental disease, you can see in this one. Here, we're going through the maxilla and then we get into the mandible and you can see this here is abnormal.
Normal. I go to this one. There's the normal nasal passage, incisors, lower incisors here.
Here you can see some points on those teeth and then if you look down here, you can see this huge abscess there. And then just go back a little bit. And one thing I want to show you, you can see there that there is a bright spot which is a retained tooth root, and that's what you have to find in these abscesses because most of them do have a retained tooth root and that's why they abscess.
So CT is very, very useful to find those, those retained tooth roots and remove them to resolve the abscess. This is a reconstruction from a chinchilla. I'm sorry, this is a guinea pig, but you can see here there's molar root elongation.
So again, tooth root abscesses, diagnosing them with CT in guinea pigs and chinchillas. So lots of information out there about the use of CT in these small mammals. Another useful used for CT is to diagnosing thymomas in rabbits.
This is, an orthogonal radiograph of this rabbit, and you can see there's a mass here, but you can't really tell if this is an enlarged heart, if this is. The mass, so that's where CT would become very, very useful. Again, many studies now out on using CT to look at rabbits.
This is a study that was published in 2017 from Europe, and here they really go through the anatomy, the CT anatomy, pre and post contrast of the heart of the normal thorax and show what a normal, here's a normal, . Thymoma or thymus in an animal here. So again, it gives you what to, to look for.
Here's a normal thymus here in a rabbit. And this is a thymoma. So, what we look for is, We want to see where the thymoma is.
Here we can see in this animal, the thymoma is all the way on the right. It's pushing the heart all the way to the left. Again, this is a contrast study.
So this is where you do have to use contrast in these animals to be able to tell clearly the thymoma where it's at in relation to the heart, but you can see a large part of this thymoma is cystic, and that gives us information. Also about responsiveness to radiation therapy. This is another view.
Here's the same animal, and here you can see the huge cystic component to this. So what we can do with these animals, if we identify a cystic component, one way to give them palliative care is to try to remove some of this fluid to take the pressure off. The heart, and we've done that in multiple cases of thymomas.
In other cases, you'll find that these are very, very solid masses and that's not something that can be done. So, it, it really is useful to use a CT to diagnose these animals. This shows in an animal, a rabbit with a thymoma, we we know that most of them present with thalamus, bilateral buthalmus, and that's because the, the thymoma presses on the in the jugular veins of the rabbit and inhibit the venous return from the head.
So the sinuses behind the eye, the postorbital sinuses get very, very enlarged. This is another type of thymoma here you can see this one is very solid as opposed to the other one was very cystic. And again, this one's pushed the heart up and over.
So the other reason you wanna do this is to determine whether or not these are something that you can remove surgically. In my experience, very rarely do you catch them early enough that they are small enough that you can remove them surgically. A big reason we use CT in rabbits especially is to differentiate middle ear disease andbola disease from central nervous system disease.
So everyone has seen these rabbits that come in with torticolis like this and the question is, are these euniculi cases, are these cerebral vascular events or strokes, or are these Rabbits that have ear disease. And there's been numerous studies on these, This was one that was published in 2015, and this was rabbits with CT diseases with that had CTs that detected middle ear changes and what they found is that that 50%, more than 50% of the rabbits that present with clinical disease. Do have evidence of ear disease and I think our probably statistics are a little bit higher than that.
I would say ours usually more probably 60 to 70% of rabbits that present with, with CNS and torticollos have evidence of ear disease. So what does that look like? It look like a lot of different things, but you wanna see these nice clear bulla in this animal you see, that's not the case.
This bulla is, got soft tissue opacity in it, so that indicates that there is bula disease in this animal. So this is another type of rabbit. This, this rabbit you can see has evidence here of a, of a abscess on the outside, and these are often palpable, and it's actually pushing in.
There's still a membrane here cause you can see this demarcation here, but it's pushing into the middle ear from the external ear. These are usually lops. They end up getting these extra These oral abscesses and that can lead to middle and then certainly in your disease.
Another example. Many of these rabbits present with signs of facial nerve paralysis. So in these animals, the normal size, unlike people with palsy, people with palsy, facial palsy usually droop.
Rabbits, the ones with facial nerve paralysis, there's a contraction. So this animal would be show exhibit neurologic deficits on this side. If you touch this, the bray it's not gonna respond.
If you touch the lip, it's not gonna respond. Usually, they don't blink very well, so any animal that presents this way, you know, it's got evidence of ear disease. This is an animal that I'm still working with today.
This was actually from 3 years ago, but, or 4 years ago, and you can see this one had really, really severe ear disease there. Here you can see. Complete destruction of Ebola.
This animal surprisingly never showed neurologic signs. Completely normal, acts completely normal. We did multiple surgeries on this animal, used beads, still maintaining it, 3 to 4 years later now.
This is a rabbit that presented with chronic left nasal discharge, treated multiple times with oral antibiotics and nasolacrimal flushes, and then we noticed this tooth, this incisor tooth was discoloured. So we ended up doing a CT scan and you can see here on the CT scan that there is evidence of soft tissue opacity in the nasal passages and you can see the difference in the opacity. The normal incisor tooth would be lucent in the middle.
The, the abnormal tooth is opaque. So what we did for this animal was to go in and remove that tooth. Rodney was an eight year old male neutered rabbit with presented with chronic upper respiratory infection that was mentally responsive to antibiotics, underwent multiple treatments.
And here we use the CT to tell us the extent of the uro the upper respiratory sounds and you can see in this rabbit, very, very small amount of normal nasal passage left in this rabbit, could barely breathe. All his, his nasal turbinates were destroyed. This was fluffy.
This is a 10 year old female spayed rabbit that presented with a neck mass. This rabbit, oops, let me go back. .
This rabbit was referred to us for surgery and on a biopsy, they diagnosed a spindle cell sarcoma. So in this rabbit, we wanted to do the CT just to see what the risk of surgery would be and we determined from this that here you can see, sorry about that, that It was very, very close to the jugular vein, and we determined that probably the risk of removing this was too great. It was an older rabbit, so at that point, it was decided not to pursue surgery.
This was Emmett, a lop rabbit that had been adopted 6 months previously. It was a young male neutered, had increased episodes of urinating outside of the litter box in the last month, and one episode of chewing on electrical cord, no known trauma. So when we took the radiograph to see what was going on with Emmett, we noticed this, which looked, of course, very abnormal.
We weren't quite sure what was going on. Many of you probably already know. We ended up doing the CT and on this, you can see on one side of the thorax, it's complete black.
The other side of the thorax is normal lung tissue and here you can see in the middle, a little Area here. So what, what happened in this rabbit is that he had a ruptured lung lobe and this was all pneumothorax here. So again, normal lung and the ruptured lung.
Normal and ruptured. This animal underwent surgery to try to find the rupture, did well during surgery, did well for 23 days post-op but then took a radical turn and we ended up having to euthanize. So, that's the end of my cases, but I just wanted to show these to show you that advanced imaging provides really important options for the diagnosis of disease problems in avian and exotic pets.
Zoo animals, the optimum imaging modality and common disease presentations really depends on the species and the risk factors involved. So hopefully you gained some from something from this lecture, and I appreciate your attention.