Welcome to this, webinar vet webinar. Today, we're going to be considering common disorders and some emerging diseases in pet African pygmy hedgehogs. My name's Emma Keeble, and I work at Edinburgh Vet School.
And I'm particularly interested in African pygmy hedgehogs, as I quite enjoy them, really, in terms of the, the character and how quite lovable they are, really, when you get to see these animals up close. So I thought it would be helpful just to have a little recap on African pygmy hedgehogs. And we are seeing a lot more of these, very strange little animals coming into veterinary practise.
And I really feel it's important for us to be as vets aware of the common things that we might see in hedgehogs. And interestingly, there have been quite a few fairly recent new reports of some emerging conditions in this particular animal. So this is something that we'll look at and consider today.
I thought it's interesting to, when you look on Instagram, there are, African pygmy hedgehogs with considerable numbers of, followers. So these animals are really making quite great waves, in, in the, the pet industry. So what we're going to do is revise some of the common problems that you might see in these little pets.
And then look at these new emerging conditions, which are three primary things. One is, mite infestations, the nectar. Analysis, and then also neurological disease and a sort of review of of the signs we might see associated with that, but also some new cases that have actually described tumours of the brain causing these sort of wobbly hedgehogs.
What we'll also be looking at is what are the clinical signs, how do we diagnose these conditions, and actually how we're gonna go ahead and treat and look after these individuals. So I'm hoping by the end of the webinar, you will have learned quite a few things, but the main things being what are our common problems in this species? How do we recognise and treat mite infestations?
How do we recognise central nervous system disease? What are the key sort of signs that we see, and what are our differentials for these? And also, hopefully be able to diagnose and treat salmonellosis in pet hedgehogs.
So looking back really again at these little animals and what their sort of background, biology and natural habitat is, this is really key when we're thinking about treating these individuals. These guys originate from Africa, and they typically live in sort of grassland and scrub, and they do burrow. They're nocturnal, so we're likely to see these in, in pet animals as well.
They're more likely to be out during the night. And they do seem to be very territorial and, and sort of live singly. There is a, a, quite a discrepancy between the weight of males and females of males usually weighing a lot more.
And one thing that we need to remember is if they get very cold, they can go into a state of torpor. And so this could apply if you had a pet hedgehog that was being kept in a very cold house, perhaps without supplementary heating. I think also it's really important to have a think about what their sort of background data is when we're examining these animals.
What are we expecting body weight wise, because it's quite common for them to be overweight or if there is systemic disease, perhaps underweight. And something really important to note, and hopefully, an important point that you'll learn from this webinar, is that their body temperatures a lot lower than we'd normally expect for a typical mammal. So 36.1 to 37.2 is much, much lower than, than a dog or cat.
So, obviously, if you had a temperature of 35, the animal's likely to be hypothermic, but if you get 36.5, this could be a normal value for this individual. And we've got fairly typical respiratory rates and heart rates as well.
They are quite unique in their behaviour because their defence mechanism obviously is to curl up. So they've got all these spines that cover most of the body, and they curl up via a muscular ring called the orbicularis muscle. If they're really upset, they start hissing and, and they actually jump.
And this is something that can often give you a bit of a start when you're examining them. I, I quite like it, really. I mean, they've got real attitude, but, you know, a hedgehog that's constantly hissing and jumping is obviously a little bit distressed by being examined.
And sometimes we have to actually use a general anaesthetic, to help us see what's going on for our clinical exam. Sometimes also, these animals can self-anoint. So you can see in the picture at the bottom, this individual salivating, and it's basically licking its spines.
And this is a, a, a, a, but often a, a behaviour that you see in on induction if you're using a chamber for, for gaseous induction. And it's a, a fairly normal behaviour. We don't know why these animals do it, but it's not something to worry about.
Also, worth thinking about their long snout. They have a very well-developed sense of smell. So I've just got a few slides here that recap and go over the common sort of things we're likely to see in our little pet hedgehog patients.
It's quite a long list, but this is something hopefully that, you know, you can use as a resource. And obviously, if you get the animal. Coming in, and you're looking at a particular body system, then knowing that that perhaps, you know, oral masses are common in these animals is quite important.
So we might miss things like that on, a clinical exam because they often curl up and don't let you have a really good look at the mouth area. Other things we commonly see are respiratory problems. So you might see the individual having really quite sort of, abdominal effort to its breathing, and the respiratory rate could be elevated as well.
And then perhaps these, these other conditions which we're going to really have to anaesthetize the animal and do some further diagnostics to investigate further. And we'll come on to discuss gastrointestinal disease in more detail, because this is something that's quite a common presentation in pet hedgehogs. Also thinking about urinary tract disease, we do see cystitis quite regularly and hematuria.
Something very commonly that, that I've had quite a few cases very recently of, are uterine tumours or pyometers in females, and they often do present, according to the owner as hematuria. So Any sort of blood from the vulval area could be urinary or could be reproductive tracts, especially in females. So do you, do you consider that as an underlying possibility?
And also, as these animals get older, we do see issues with arthritis and spondylosis of the spine, which in an animal that curls right up, obviously, anything that's affecting the flexibility of the spine, could be quite significant and could show some signs of perhaps inability to fully curl. The same would be true also for any disc disease. And they can get limb fractures and nail disorders, really just similarly to other species, particularly as they're getting older.
With the neurological disease, we will come on to talk about this in a bit more detail, but one of the really common signs we see is, is sort of tremor and ataxia. And there are many different reasons why these little guys might present with this. I say, I've got a list there for you, but we'll come to discuss this in a bit more detail later.
But there are many things that we need to be considering, and sometimes it's quite difficult to get to the bottom, of these neurological cases, partly because perhaps funding, is limited and partly because these guys are so little and anything you have to do generally have to anaesthetize them for. We also do occasionally see head tilts, this little pet African pig pig pygmy hedgehog in the picture here has a slight head tilt to the left, and was circling as well. So just again, things that might get presented to you in practise.
And then a final slide of recapping our common problems. Skin disease, again, is a really common thing that we see in these little individuals. I've come on to discuss the Cainia tripli infections and mite infections.
But on top of that, We do see ringworm, and sometimes we quite commonly see skin nearoplasia as well. I had a little animal with a fibrosarcoma, fairly recently diagnosed that presented initially as a swelling near the base of the ear. So, you know, our differentials are, are fairly extensive and a diagnostic workup is appropriate in these cases.
Unfortunately, these little animals are not particularly long lived in in captivity. And, you know, anything from the age of sort of 3 onwards is fairly elderly. Certainly, it seems that there is a high instance of neoplasia.
And certainly, you can see from, from the statistics there, it talks about, at least 53% of samples submitted histopathology were near plastic. And of those, the vast majority are nasties and malignant. So this is something that unfortunately, little African pygmy hedgehogs seem to be very prone to.
That can be quite frustrating, and quite difficult to treat. And then finally, you can see the picture there at the bottom of your screen with a really obese animal. Unfortunately, people love their African pygmy hedgehogs and quite often, overlove them and feed them far too much.
And, they become quite sedentary and, and overweight. So this is something we as vets can hopefully discuss with our, our clients and, and hopefully come up with an appropriate, diet and feeding regime. So that was a fairly quick recap on the things that we commonly see in practise.
What I then wanted to talk about really is these new studies that have sort of come, fairly recently, into being looking at a series of groups of animals, and what sort of common problems or themes have been seen in this particular species, because they are really commonly kept as pets and, and really this is now a worldwide, distribution. What we're seeing in, in North America and Europe is commonly skin disease problems, and more specifically, mite infections. So this is something that's really come about fairly recently.
It's not a new thing. We, we know that hedgehogs do get mites, but it just seems to be, being diagnosed with more frequency in these little pet hedgehogs. The next sort of commonest thing was gastrointestinal disease, and with that, we're also including dental disease and oral tumours.
And then skeletal disease also was very common with joint issues, constricted, limbs and spondylosis of the spine. So interestingly, there was another study performed over an eight-year period in Taiwan, and they found that actually neoplasia was the most common cause of death. And then secondary to that, it was respiratory issues.
So they were seeing things like pneumonia, pulmon edemia, and pulmonary haemorrhage. And then third to that was digestive disorders, either foreign bodies, gastritis, gastric ulceration. They did report that a lot of these were caused by tumours.
So over 50% of respiratory cases had underlying systemic disease. And the most common tumour reported was a squamous cell carcinoma in the mouth. And as I sort of said earlier, although my data that I showed earlier said, you know, average lifespan of 5 to 7 years, actually, our pet hedgehogs are not living as long as that.
And age 3 is a pretty good age for, for a pet hedgehog, 3 to 4 on average. We also have a study that looked at histology. So rather than actually looking at, you know, presenting signs or in diagnosis.
This was really just looking at samples that have been submitted. And what most commonly was submitted, were female reproductive tracts, and then skin and then oral mucosa. And this is probably reflecting, as we talked about earlier, the fact that we do see, unfortunately, neoplasia of the reproductive tract in females and that can present with hematuria.
But fortunately, benign neutron neoplasia was most commonly seen. So even if you do have a tumour of the reproductive tract, it may be that you can perform a hysterectomy, remove it, send it off histology, and hopefully, it may come back as a benign cause. Unfortunately, for the skin samples that, that we looked at, most of these were, were quite nasty fibrosarcomas.
And oral mucosal samples, interestingly, I would have thought that neoplasia would, would focus, would feature very clearly there, but they were actually finding that more of these cases were just hyperplasia and sort of chronic inflammatory disease of the gingiva. Again, we've got an overwhelming number of neoplastic cases and high, high rates of malignancy in this particular species. So just really summarising that, it really does seem to, differ geographically what diseases are seen.
But an overall sort of theme for, certainly worldwide is skin disease, GI disease, and neoplasia. But in the Far East, they're seeing more reproductive and respiratory disease. And this begs the question really that, An increase in life span in captivity could lead to an increase in neoplasia being seen.
And that's one thought. But, I guess also there may be set, breeding lines or, not much diversity within the pet population genetically, and maybe that has a factor to play as well. Interesting though, there aren't many studies that look at different species of hedgehog, and hopefully we're all aware we've got our lovely European hedgehog, wild hedgehog.
There was one study that looked at dental disease in African pygmy hedgehogs that pets versus rehabilitated European hedgehogs, and It did find that actually there were similar numbers of periodontal disease, and it was common in both, but perhaps slightly different clinical presentations and signs were noticed. I'm sure this is probably due to one being a wild species that sort of hides signs of illness, and the other perhaps being more domesticated, and perhaps, you know, more likely to show clinical signs associated with the sore mouth. So this leads us on to the, these sort of new emerging diseases, which, you might turn around and say, well, salmonella, it's, it's been around for a long time.
It has, but we, we've fairly recently become much more aware of this in the pet pygmy hedgehog population, majorly because of its zoonotic potential and the fact that, there have been outbreaks in America in, in people, and these have been linked to, pet hedgehogs. So, This is quite important and certainly as vets in practise, we need to be very aware of it and need to be aware that there's the potential with any pet hedgehog that we see or treat for the zoonotic condition. So just a real, a real quick sort of recap on salmonella.
It is found pretty much everywhere in the environment. It's fairly resistant to, to dehydration. But it doesn't survive really high temperatures, so 70 degrees plus.
Many, many different types of animals, have naturally occurring salmonella in their intestinal tract. And certainly there's been a lot of, interest, in live poultry, reptiles, amphibians, and small non-traditional pets, in terms of the potential for zoonotic spread. So there, there's quite a lot of talk about, salmonella in those particular groups of animals.
But, you know, salmonellosis has been described in many, many different mammals and reptiles and birds, and pretty much all ver vertebrates are susceptible. It interests me, the most common worldwide occurring zoonosis. And as I mentioned, we've had some fairly recent outbreaks, in America, which has brought it to the forefront, associated with pet hedgehogs.
We need to be worried, particularly if animals are debilitated for other reasons, then they can be much more predisposed to picking up this infection. So it's quite commonly seen in very young animals, and they seem to be at the highest risk of mortality. It should be assumed that it's everywhere in the environment, cause hedgehogs are not particularly clean animals, unfortunately.
And they have quite soft droppings. So they pass their droppings, and then they walk through them, and then that contaminates the, the spines, the feet, Coats and anything that they've walked over as well. So it's quite easy for fecal-oral transmission, to occur between animals.
And if we're not really, good with our hygiene as people, then again, into human owners as well. What then happens is the bacteria is very good at invading the intestine. Spreading to local lymph nodes, and then it can actually disseminate the liver and the spleen, and more systemically to affect heart, kidneys, and the central nervous system and joints.
So once you get systemic infection, it can be pretty widespread and very debilitating. What is also important is for us to remember that, many of these animals that have salmonella are actually asymptomatic carriers. So they might not be actually showing clinical signs.
Because of this, we need to be considering any direct or even indirect contact with a pet hedgehog as a potential source for infection. So if you see little hedgehogs in practise, always bear in mind that they could become carrying salmonella. And we do know that this is quite widespread and endemic in wild European hedgehogs in the UK.
So we have a little hedgehog presenting with diarrhoea. What are our other potential differentials? Well, it might not just be salmonella, it could be a mixed infection or we could actually have other bacterial infections which I've, I've listed there.
Interestingly, with your sinia infection, often there is also weight loss. You can sometimes palpate enlarged lymph nodes in the mesentery, and the animal often becomes quite weak and, and this can manifest as a hind limb weakness. With salmonella, you can also get enlargement of mesenteric lymph nodes.
So it isn't actually pathognoma for yoursinia, but it's a differential to consider. If we've got diarrhoea, we probably should do culture of those faeces, perhaps a pool sample, but we should also look for parasites because that's our sort of second most likely differential diagnosis. So I've listed the types of parasites that you might see in hedgehogs there.
Some of these are Less likely in pet hedgehogs because they require an intermediate host. So snails and slugs, for example. So they're not really seen in pet animals, but only in wild animals.
And they too can cause a bloody diarrhoea, which is very similar to, what you see with salmonella infection. Also popped in there, Candidiis. This has been described in pet hedgehogs and also has fairly similar clinical signs associated with it.
And we should also ask whether there's been any dietary indiscretion or dietary change recently that perhaps could have predisposed this, this bout of diarrhoea. So hopefully, in that case, it's gonna be something that's quite easily corrected with the correct diet change. I also wanted just to recap how this manifests in people.
And I actually found this, this little picture at the bottom there is my, my son, who, is now a lot older than that. This was a, a petting exhibition that we went to where a little African pygmy hedgehog's been handed around. And as you can see, I'm, I sort of cringe slightly now looking at it because we're not wearing gloves.
And, I'm very hopeful that we did wash hands after that episode. So unfortunately, it is very common salmonellosis in people, often from contaminated food sources, but contact with pets or wild animals is also potential source. And interestingly, it is highest in its instance in very young children.
And what people have thought about this is because young children are probably on, on balance, less hygienic, and more likely to sort of play outside and, and come in contact with wildlife sources and perhaps not wash their hands and put their hands in their mouth. So, this is something that has definitely been highlighted in the America cases that have been reported quite recently. And interestingly, 90% of the human cases in America, recent human cases have been shown to be directly through contact with a pet hedgehog.
As with any of these sort of things, you know, we need to be more careful in people who are immunocompromised. And, and people quite often, you see a di diarrhoea, but you can also get high temperature. It can be quite nasty and give you headaches and, and nausea and vomiting.
Usually it lasts only about 2 to 4 days and recovery is spontaneous. But there are some, inevitably some case reports where actually systemic illness has, has developed and, fortunately, mortality is extremely rare. And most of these cases are picked up and diagnosed in people, and appropriate treatment instigated.
In our little pygmy hedgehogs, the signs, are, are quite variable actually, because, as I mentioned, they can be totally asympymptomatic and basically just, just a carrier. We can also have, you know, these subclinical infections with, with latent, the, the hidden infections in the lymph nodes, and at certain times, they can become more stressed and start shedding. And this can be sort of persistently or it can be intermittently or just for a very short period of time.
So this makes diagnosing it more difficult. In fact, it can quite easily be missed, because the animal might not actually be actively shedding at the time of the sample. What we might see in a, an animal that's actually succumbed to salmonellosis is this really sort of green muoid, or bloody diarrhoea.
And it's really quite nasty. And associated with that, the animal's often not really eating. It becomes dehydrated because of the diarrhoea.
It loses weight and becomes quite lethargic. And obviously, this can progress to, to, mortality. You might see vomiting and regurgitation, but that's less common.
And in cases which have irritation of the of the colon or rectum, you might see tinesmus and rectal prolapse occurring. I think that's much more common in the very young hedgehogs, especially. So how are we gonna diagnose salmonellosis in, in these little hedgehogs?
Sadly, some of these cases might end up being diagnosed, basically on postmortem. And, and unfortunately, when I worked with wild hedgehogs, for the RSPCA, this is how we really, got our diagnosis. Little individuals would, would pass away and we'd, we'd send them off for postmortem and be isolated there.
Quite commonly you see these sort of classic histological signs that I've, detailed there, and especially if it's such a systemic disease, then infection can really spread and you can get other organs infected, like the lungs, the spleen, the kidneys. So obviously, if we've got a pet animal, we, we may well not wish for it to progress to that sort of end-stage diagnosis. And if we've got suspicious clinical signs or if we want to really screen an individual, then really faecal culture is the mainstay for diagnosis.
And I think, cause I mentioned about the fact that this is intermittently shared, we usually do our, pooled 5 day sample to try and increase that sort of, chance of picking up the infection, if it's being intermittently shared. And we do have to use salmonella enriching media for culture of this particular organism. What I would say is we want to rule out any parasites, and it might be that you actually have con concurrent infection.
So you might have an animal with, with salmonella, but also, parasites. So, so do always do that as well. There are some other tests that we can look at.
There's Eliza antibody test, PCR tests as well. So this is something perhaps, if your culture isn't, isn't successful, you could investigate further. And sometimes, we do have to base it really on our sort of, postmortem and histopathological signs.
So if we get a case, a positive case, how are we going to manage this particular animal? We want to bar barry us any hedgehog with diarrhoea. And obviously, that's quite key.
And at the time, we don't know whether this is salmonella, but because it's such a common thing, we want to really, be as cautious as we possibly can right from the very start of seeing this animal. It's really important to talk to clients about a negative result, because obviously, they'll be quite relieved if that comes through. But that doesn't mean that the individual isn't still a carrier and doesn't still have it.
And what we should be doing in vet practise is having risk assessments, really for, for hedgehogs being in coming in to be seen and for our staff to cover them. So if we get a salmonella positive animal, we should have a risk assessment. But I think it's worth having.
Standard operating procedures in place for pet hedgehogs anyhow. So, for instance, at the vet school, we would always wear latex gloves. At the moment, obviously, we're wearing masks anyhow, but also disposable aprons, I think is quite important, so we don't get any cloth contamination.
When these animals are actually brought in, then also barrow nursing and quarantine is quite important. And just reinforcing to those people who are cleaning out and looking after the animal, the risk of zoonotic infections, just be really, really careful with our hygiene. How are we going to treat these cases?
So we've, we've diagnosed it on our pool sample. The animal's been brought in and we're starting some supportive care. You know, mild cases might be fairly self-limiting and might just only last a few days.
But most of the cases that I've seen, come in and a Pretty debilitated and do need, you know, to be hospitalised and start fluid therapy because they're losing, obviously, a lot of fluid through the diarrhoea. On top of that, they're often quite painful. It's difficult with the hedgehogs because they tend to curl up, you know, to try and appreciate abdominal pain.
But certainly, you know, you may get an individual that's very weak, that tenses when you feel in the abdominal area. I think we're probably all fairly happy that we need to avoid nonsteroidals, in these individuals just because of the gastrointestinal side effects. So quite often we'll give analgesia with something like buprenorphine, and I've given some dose rates there for you, which hopefully will be helpful if you're having an animal in and hospitalising it.
If it's going home and we don't want to use non-steroidals, then perhaps using tramadol, and again, a dose rate is given there. We can give that orally as a liquid preparation. Which might, might be helpful if, if an owner is desperate to take that little individual animal home.
Remember that, these animals are losing fluids and they will become hypothermic very quickly. And I've popped up that temperature range, which is normal for our pet hedgehogs. So we need to warm them until they're normothermic.
Don't wait to get them up to 38 because they'll be, you know, overheated at that temperature. If they are very, very poorly, then hospitalising them and perhaps popping them into a warm incubator is a really good idea. If they are severely affected, it's important to have a discussion with the owner about this and whether really it's the right thing to treat or not.
And it's very hard cause owners are very, very, dedicated and, Very attached to their pet hedgehogs. And this can be quite a difficult conversation to have. But I think it's important.
Salmonellosis is not a nice disease, and we have all the worry about ongoing zoonotic potential. So it is a conversation I think that needs to be had with the owner carefully. If we are going to cheat, there's a lot of controversy surrounding whether we should give systemic antimicrobials.
And this again is something that I would encourage you to try and read up about if you do have a clinical case, and come to your own, opinions on this. Obviously, most often, this is a discussion to be had with the owner as well. Owners are often very keen to try and treat.
Usually we have to give a fairly prolonged course of treatment. So we put on there a three-week course. And traditionally, these antibiotics I've listed are sensitive to salmonella is sensitive to these antibiotics.
We have to be a little bit careful with using ampicillin and gentamicin, because, they're best avoided really in hedgehogs. The worry, I, I guess, is, it, it's controversial giving this, treatment because you do actually, you risk, developing a carrier status with long-term shedding. And ideally, antibiotic choice should always be based on culture and sensitivity.
And that's so important now with more, resistances being seen, particularly commonly with salmonella. So if you are considering treating, always do culture and get sensitivity as well. And the worry I guess is, as I mentioned before that that.
Cases that are actually treated often have prolonged bacterial shedding into the environment following treatment. So this animal could be a source of infection for a long time, and that has to be discussed with the owner and the owner's situation needs to be assessed as well. And obviously, if they're in contact, even express people or young children, that's not ideal.
If it's an individual person who can wear gloves, who's very meticulous with hygiene, that may be more acceptable. But it is a really important discussion we have, especially, as I said earlier, these little guys are not the cleanest of animals and do tend to walk through, their own droppings very commonly. So what are we going to advise a client who has a potential salmonellosis case and wants to go ahead and give it supportive care and treatment?
Well, this is a sort of list of points that that I've come up with really. Hopefully, if you are seeing cases like this in practise, you can, you're welcome to use. It's all very sort of basic sensible.
Advice, really sort of, looking at trying to reduce transmission to people. So washing hands, making sure that any food or water dishes are away from, any human food preparation areas. A lot of owners will be very, very cuddly with their pet hedgehogs, sometimes having them.
In the evening sitting on, on, on their, their chest or, cuddling them in their arm, whilst watching telly. So things like that. And, and probably if you've got, well, definitely if you've got a positive animal, you need to try and reduce that sort of contact.
And also, obviously, clothing could become contaminators as well. If we are disinfecting the enclosure, we need to be using a really good appropriate disinfectant and bagging and disposing of the waste perhaps separate to any other waste. And we need to be cleaning this area perhaps away from any kitchen areas in the house.
Food and water bowls should always be disinfected and if there's toys, they should also be cleanable as well. And obviously do not do any of this around kitchen sinks or in bathrooms where people use those water sources. Excuse me.
So how are we going to control salmonella can be difficult in a group situation. This is where we've most commonly got a breeding colony that's been set up or perhaps a group of, of hedgehogs, in a pet shop or, as a breeders that are that are waiting to be sold. The problem is we've got these asymptomatic carriers, so You really, if you have got owners that they're breeding, it, it's a discussion with the vet and the owner to come up with a a preventative control programme that is easy to implement in that particular situation.
So it's obviously Going to be, geared to how that individual breeder, is working and what sort of practises they have. But most are generally based on, good hygiene, and the fact that we need to be wearing protective clothing and gloves and disinfecting. The other thing to point out, perhaps is, is the underlying disease can also predispose to salmonellosis.
So any ill animal may be shedding salmonella. So if you have a pet hedgehog that's hospitalised, I really would just assume that it's likely to be shedding salmonella and barry and acid. But also, animals that are affected by salmonella may have underlying disease that we need to investigate, and find out about.
If we have got a group and we need the breed is very determined to try and find out the salmon status of the group, then you could consider a pooled faecal sample. But as you mentioned before, if it's negative, it doesn't absolutely exclude salmonella. We could also decide to screen any new animals and quarantine them prior to results, if they're coming into an existing population that hasn't really had many clinical signs.
And we could also talk to the owner about perhaps regular screening. So perhaps 3 or 4 times a year, we send a sample off and that will reduce the likelihood of this infection being present. If we do get a positive but no clinical signs, then this animal's most likely to be a carrier.
And as I mentioned, it's really stress induced, so, underlying disease or any stressful situation is much more likely to result in shedding. So, a discussion with the owner about, how to balance the sort of social groups, reduce the stocking densities, introduce new. Animals very carefully to a social group.
These sorts of things, optimising husbandry and diet and providing good enrichment are all really, really important to try and prevent extra stress to those animals and therefore reduce any potential shedding. So hopefully that's quite a helpful review of salmonellosis in, in these little pet hedgehogs. The second, emerging disease that we were going to discuss today, is actually one that perhaps you're, you're already very aware of in European.
Wild hedgehogs, this, mite infection caused by Cainia trippolis. It's always been known that hedgehogs can carry us, but it seems to have become much more of a, a big health problem in pets, pygmy hedgehogs worldwide. And this is something that's obviously quite concerning.
And of the disease reviews that we've looked at just earlier, this skin disease was one of the most common things that these animals are presenting with. And of those skin diseases, mite infestation was the sort of top culprit. And I, I think probably most pet hedgehogs, carry these mites anyhow.
And once you start looking, you will, will find them. There's some very classic, clinical signs that you'll see that will come on to discuss. So the most common species of mite is called Cainia.
It's a non-burrowing seroptid mite, but you might occasionally see coropsis or sarcoptid mites as well. They have been reported in pet hedgehogs. In healthy animals, you could consider a very small number to be normal, but what becomes a problem very quickly is if the animal is ill or immunocompromised, and it can really suddenly become a major infestation of mites in those situations.
Something else that we really commonly see with mites is, secondary fungal infections. And this is something that has been posted that perhaps, as the mites are feeding off debris, they, they help spread fungal spores and fungal, elements, as they move around the, the, the animal's bodies. So they can perhaps facilitate a fungal infection as well.
So, is this a normal commensal and then stress or hormones or your immune system, or disease, you know, predisposed for this to become a problem. We don't know for sure, but certainly, if you do have a pet animal presenting with lots of spine loss, and alopecia, then do think about any underlying potential problems. Have a chat about stresses, have a chat about, husbandry and diet.
And also consider that there could be some underlying issues going on. Just gonna show you this video which is One that we took, using a dermoscope and magnification. You can see these mites moving at the very base of the, hair follicles, the spine follicles, and and feeding off that detritus and debris and dry skin there.
So really quite a lot of these being able to be seen. I'll play that again as, as it's quite exciting to see that. They do have a very direct life cycle.
Usually about 3 weeks. And the adults, as I say, feed off the debris, at the base of the, at the base of the hair follicles. The good news is it's not a zoonotic infection.
So that's, that's nice to not to be too worried about picking up the infection yourself, having handled the animal. Although, obviously, if the animal has ringworm, then we should be wearing gloves because that is zoonotic. And often the two go hand in hand.
Clinical signs can be very, very mild. So some of these animals, I, I get just the owner saying, oh, it just looks a little bit red, a little bit, you know, inflamed on the underside of the tummy, and that can be a very common sign. But in severe infections, you see this really dry, flaky skin.
The spines are very easily lost. You can almost gently pull them off, which you shouldn't normally. And it generally can affect the whole body.
But one of the most common places to find these mites is behind the ears. Often they are quite itchy as well. So an owner might report they've been rubbing against things.
And it has been reported that self-trauma can occur in really extreme cases, when they're really, really itchy. Most of the pet cases you will see fairly early on, but certainly in wild hedgehogs, these, this infestation has been associated with severe weight loss and, eventual death, actually. But in the pet situation, it's, it's much less common for it to be seen in such an advanced state.
So any hedgehog that comes in, I would definitely recommend examining for mites because it's so common. So you could look at this little picture here, this little hedgehog and think, oh, that's fairly normal. It's just a little bit sparsely coated over the sort of, dorsal area there.
And this did have mite infestation. So just start thinking when you see them if if you Not that there are quite a few quills in the environment where the animal's been brought in, perhaps in a, in a cage or carrier, and you see lots of quills that have been shared, then that could also ring some alarm bells with you that it could be a mite infestation. So always wear gloves.
I think we've hopefully emphasised that quite clearly, particularly also with our salmonella potential as well. So we're going to base our diagnosis on, on the, the sort of quite classic clinical signs, but also, actually looking and seeing mites is quite important. So we can look with a dermoscope or magnification, and we can take skin scrapes or hair spine samples, plucks.
We can do sellotape tests as well. And then we can look under the microscope and see these, little tiny mites moving around quite, quite easily. I would definitely recommend taking multiple samples from different sites.
They've done quite a few studies in wild animals and found that the highest density tends to be behind the sort of ears, with less over the back and and the the least numbers on the The ventrum. If you're trying to get a little sellotape sample in a conscious animal, you're unlikely to be able to get the ventrum anyhow. Some individuals, you might have to give a very brief gas anaesthetic to get your, your appropriate samples from and to do a full clinical exam.
I do think it's worth doing, dermatify cultures as well, because often this goes hand in hand, and we could have multiple etiologies for the pruritus and, and the quilt loss. Sometimes we don't find mites, and that can be really frustrating, but we've got really obvious clinical signs. Then I would say in those cases, I usually do consider a trial treatment, obviously discuss it with the owner first.
But, you know, I think, I think we don't always get a sample that's positive. And, it has been positive that there might be individuals that are hypersensitive to, mites and, and it's more an allergic type reaction. So I think it's worth considering a trial treatment in those cases anyhow.
Like any of these little exotic pets, unfortunately, we don't really have much information about safety data or toxicology studies for the medications that we're giving. And most of these are going to be given, off licence, and need owner signed consent to, to be given. But what is good news is there are quite a few different treatments that have been discussed in the literature, and most of them don't seem to cause many side effects.
So they're quite uncommon to see side effects. It is quite confusing because there are lots of different papers about this because it's such a sort of, hot topic at the moment. Everyone's out there trying to, you know, publish, what, what the best treatment is for them, but Some of these have got variable efficacy, and I, I've had some issues, particularly with actually ivermectin, which is in the, in the literature often described as a very useful and effective drug.
I've had a few cases that haven't responded to this well, and particularly if it's been given topically rather than injected. So that's something just to bear in mind. But I've listed the most, Common types of, of treatments for mites that are given and I've actually got an extra slide in a minute that has dose rates for you as well.
So all of these have been described as being used in pet hedgehogs. And here are the actual sort of treatment doses, that you can use. Most of these have actually been taken from the exotic formerary by Carpenter, which is a really good little book.
I use it all the time. It's a really good reference for exotic animal, pet animal dose rates, and they've got actually a whole hedgehog chapter that's referenced as well. So that's really just for your your reference and, and, you know, obviously, what you'd probably use depends very much on the individual animal, how easy it is to administer, and how amenable perhaps the owner is to trying treatments in food.
So perhaps the forema, once-off dose by mouth, hidden in a bit of a treat might be easiest. Or you might want to see that animal back regularly, so you could instigate subcut injections and do 3 treatments and get the animal back regularly to check that your, your treatments are working. In terms of advice to the owner, we want to be as clean as possible at home to sort of prevent any sort of transmission, changing something like newspaper regularly, perhaps housing them on newspaper rather than sawdust or anything, like that.
If there are any other in contact animals, we need to treat them, we want to disinfect and treat at the same time so we don't put the animal back into a contaminated environment. If the animal's not responding, do you think about underlying ringworm? We should ideally repeat our samples and get at least 2 negative results, before we stop treatment and deem that it's effective.
I think sometimes that's the reason why treatments, you know, aren't effective or, or they relapse because of that. I think it's worth us all always wearing gloves, not because Cariia zoonotic, but because of the fungal potential. And we do need to be considering, you know, obviously, the environment that the animals in and disinfecting any bedding.
So you might need to clean out that whole enclosure and sort of really start from scratch. And that's a really important conversation to, have with the owner as well. And, and I mentioned treating in contact animals and, and usually these animals are kept on their own, so that doesn't often apply.
Obviously, it's a much different situation for a breeder or for pet shop owners. So hopefully, that's given you a, a, a good review of how to treat, capri infection in pet hedgehogs and how to diagnose it and what the signs are. I just really wanted to finish up the webinar, with a little bit about, wobbly hedgehog syndrome, but also another key differential that is, has been emerging for this sort of wobbly hedgehog clinical sign.
And this is central brain neoplasms. We've had quite a few case reports recently described, that present very much as a wobbly hedgehog, but actually have, quite significant brain tumours. So, wobbly hedgehog syndrome, just to recap, we talked about it in a previous webinar.
Hasn't really been reported much outside of the UFA, however, we definitely do see it, and I've got some videos that I'll show you, of wobbly hedgehogs in a minute. But there is this sort of 10% incidence, and it seems to occur from about 2 years onwards. And there's been a question as to whether this is potentially, a familial genetic disease.
They haven't identified any viral or autoimmune, etiologies. What they do know is it's a neurodegenerative myelopathy, and it may have a genetic aetiology. So, interestingly, there is such a high incidence of neoplasias we've discussed in African pygmy hedgehogs that perhaps central brain neoplasms are underreported.
I think a lot of these may be diagnosed as, as wobbly hedgehog syndrome. But there are a couple of differences, so I'll come on to discuss those in a minute. Looking at these, these brain neoplasms, we have a couple of reports that have been published on it.
And one of these in particular, quite recently found that of these wobbly hedgehogs, a small percentage were actually brain tumours. And since then, a lot more reports have been published, just to, to To actually emphasise that this is the case. What are the sort of brain tumours that are being diagnosed?
Most of these unfortunately being diagnosed at postmortem. So we have a histological diagnosis. There are very small numbers, but more and more cases have been published.
But these are the sorts of things that, that, we're seeing. And as I say, these are postmortem. Diagnosis.
So this is a little hedgehog, just looking a little bit ataxic. You can see the wobbliness. It's normal for them to, snuffle and sniff like that, but perhaps a little bit more exaggerated with its head.
Movements and very unsteady. It's pivoting around on its back legs, and just using its for legs to try and sort of balance itself. So you could say this is a wobbly hedgehog, and we'll come on to discuss what might be causing that in, in a little bit.
I think what's very difficult with these wobbly hedgehogs is that they often have lots of, they have other underlying disease and illnesses, and this is something we need to obviously consider. Unfortunately, in one of the studies, they were trying to look at an association, with where the, the tumour was with the clinical signs that were seen. But they were, they didn't actually find any obvious clear association.
So doing a full sort of neurological exam and trying to pinpoint lesion may not always be possible. What they did find though, is that for the exception was for cerebellar lesions. So, in these cases, the lesions match the expected, cerebellar and, and vestibular deficits that were seen in the animal.
The sort of clinical signs we'll see with any neurological disease and pet head choices often still is ataxia, this loss of balance, sometimes they stumble, sometimes they trip, and they can have weakness and they can be paralysed, and they often do lose weight as well. One thing though, with the brain tumours that was different to just a generally sort of wobbly hedgehog, these did present also with issues with urination and bladder retention. So, just showing a picture there of the underside of a little African hedgehog with a very distended bladder.
This is something that could be, a sort of key thing that is associated with brain tumours rather than just wobbly hedgehog disease. So I just wanted to show you another little animal here. That has ataxia.
So you'll see that he's doing that shaking of the head and sniffing. That's normal. But as we try and make, placing our feet there with very unsteady.
And we've actually got one of our students putting their hands up because they're worried the animal might tip up and over the, the edge of the table there. So very, very, attaxic and, and finding it very difficult to place, the feet appropriately. So what could be causing these wobbly conditions?
Well, we talked about this, this degenerative myelopathy, wobbly hedgehog syndrome. There could be another, a few other things ongoing as well. So I've, I've put a wee list there for you really to sort of consider.
Any sort of systemic disease that's causing a weakness and a lethargy, particularly cardiac disease, perhaps, we might have liver or kidney disease, we might have issues, with the ears, both external and internal. And then obviously you could have just encephalitis or encephalopathies that are actually affecting the nervous system. I've got a picture, a, a video again, just to show you, of an individual here, who's quite reluctant to walk, just place them down on the, consulting room floor.
And again, it's that trying to place the very wobbly, very staggery, really not normal movement at all for this individual. Another thing that we have actually seen on CT is intervertebral disc disease and this has been reported to cause ataxia. So that's something to think about if you've got a fairly elderly individual.
And then it's possible, that we might have some infectious causes. And Bali aspis is something that, that is seen more in, United States, but it has been described in pet hedgehogs, and there could be these other, neurological, infections such as paramyxovirus that, that could cause this sort of, clinical signs. I think less common, obviously, and, and quite difficult to actually diagnose.
So we have a wobbly hedgehog. Is this true wobbly hedgehog disease or is this a brain tumour? Most of these were initially just diagnosed as wobbly hedgehogs.
There were some key differences. So, one thing that was quite interesting is that With the wobbly hedgehog syndrome, it's seen in younger animals. So usually under 2 years of age, and then quite a long survival time post presentation.
So this is a degenerative condition, but it takes quite a long time for the animal to, to progress. With the, brain tumours, these typically present in older animals, usually older than the age of 3, and the progression is much, much more rapid than that. So really weeks to a few months.
And then on top of that with the brain tumours, we, we were seeing things, signs of urinary bladder retention as well. And that's definitely been seen associated with brain tumours in pet hedgehogs, but not with wobbly hedgehog syndrome. In, in terms of diagnosis, you might be saying, well, you know, you know, we've got these obvious clinical signs.
Is it really important to get a diagnosis? I mean, I think that's a very good question to, to ask and an important discussion to have with the owner. The fact that we can potentially now perform things like CTs and MRIs and tiny pet hedgehogs, you know, is, is amazing.
But whether we should be doing that and whether it affects our treatment or the prognosis for the animal, is a big question to ask. So, yes, it's, it's nice for us as vets to know what our end diagnosis is, but actually, does it, benefit the animal directly? And will it change anything?
We do, it probably won't. So, slides there just to say, well, look, you know, these things can be done. But in reality, talking to owners, what we're really going to do is probably start some palliative treatment just to make sure that that animal's quality of life, is reasonable, but this is emphasising that it's palliative care.
This is not going to be a cure. And unfortunately, you know, the signs will progress. We have had some, papers that are reported use of non-steroidal and steroidal therapies, but not really making any difference in terms of the, the quality of life or the lifespan.
I guess in theory, with, dogs and cats, we, we can think about radiotherapy for brain tumours and do get owners asking about this, in, in small pet species. But obviously, there, there can be side effects, and this is going to be quite a, a difficult undertaking in such a small animal. But maybe that's a conversation that, that is important to, to be had with the owner.
But logistically, I think it's quite difficult, in such small species at this time. I think in reality, thinking about the prognosis, unfortunately, both, these differentials are fatal diagnosis. So having that discussion is important with the owner, and, and having realistic expectations.
Right from the start. This is going to be a nursing situation and at some point, the animal is, is likely to have poor quality of life and then a discussion of euthanasia needs to be had. But I think by understanding, you know, that there could be underlying factors and looking at the different disease presentation and progression.
And we can give our owners of pet hedgehogs more information than perhaps we could 5 years ago, so that they can sort of understand what's going to happen, better and, and look after their pets palliatively better as well. And who knows, in the future, maybe, we may have advances in, in oncology, and that we might be able to understand wobbly hedgehog syndrome in more detail, and then be able to advise our pet hedgehog owners even further in this matter. So that really sort of sums up our emerging diseases in in pet hedgehogs.
I've got a reading list here just to show you, in case you were interested and wants to, investigate some more, these amazing little pets. And there's quite a few really good references out there, and, and useful texts if you're interested in learning a little bit more about, African pygmy hedgehogs. So thank you so much for listening.
And I really do hope that this has been enjoyable and inspired you, to go out and, do lots of further diagnostics, and treatment options for your pet hedgehogs. Thank you very much.