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Limited activity against gram-positive or- ganic arsenic and chemotherapeutic agents) from the gastrointes- ganisms order levitra professional 20 mg without prescription. Can be mixed with sodium to treat gram-negative bacteria (Pseudomonas generic 20 mg levitra professional otc, Klebsiella spp. Sodium sulfate can cause osmotic diarrhea when used in combination with synthetic penicillins. Can be mixed with hemicellulose to function as a bulk period to decrease the possibility of nephrotoxicity. Appears to be most effective if treat- ment is initiated in an individual bird before clinical signs occur. Should induce complete Acyclovir is preferentially absorbed by herpesvirus-infected cells molt within 2 months of administration. Tricyclic antidepressant with a sedative effect that has been results in a high therapeutic index. Appears to be treatment of poxvirus, but there is no conclusive evidence to rarely effective. May cause depression, arrhyth- The injectable product may cause severe muscle necrosis if admin- mias, tachycardia, vomiting or muscle rigidity. Acyclovir has been shown to interfere with spermatogenesis Available as an ointment for topical application. Used as a topical and is mutagenic when administered at high doses in some mam- analgesic or antipuritic (see Aloe Vera). Palatable and easy to administer but rarely with variable activity for viruses and fungi. Will cause a dramatic effective against the bacterial organisms that affect birds. Ab- decrease in core body temperature when applied to large areas of sorbed from the gut more effectively than ampicillin, resulting in the skin as a presurgical dressing. Consumption of alcoholic bev- higher blood levels than are achieved with oral ampicillin. Inject- erages or absorption of ethanol through open wounds can result in able solution stable one year after reconstitution if refrigerated. Should be administered on an membrane of fungi, causing alterations in permeability. Indicated for gastrointestinal irritation, ulcers or to aid sac administration does not result in systemic absorption and is in the removal of some ingested toxins. Oral administration is recom- tion for treatment of “cat bite” injuries in which pasteurella septi- mended for long-term therapy of calcium deficiencies and for cemia is common. Ampicillin administered orally is poorly ab- supplementation during bone healing, bone development and egg sorbed and the drug that is absorbed is rapidly excreted by the laying. Oral administration is limited to highly sensitive patho- ment of hypocalcemia, hypocalcemic tetany, egg binding and soft- gens restricted to the gastrointestinal tract. Oral calcium will chelate some tetracycline prepara- treating salmonella arthritis in gallinaceous birds. Toucans being treated with tetracyclines should receive tive against some L-form bacteria when used in conjunction with parenteral calcium supplementation to prevent bone deformities. The strains that infect mynahs and toucans prevent lead or zinc from being absorbed from the gastrointestinal appear to be particularly resistant. Long-term treatment (over two weeks) can result in unac- lowing repeated use in an aviary. Not as effective in Galliformes ceptable chelation of normal cations from the blood. Must be used in conjunction with thor- renal tubular necrosis and its use should be discontinued if ough aviary cleaning to prevent reinfection following treatment. May be beneficial support for avian patients with infectious Available as a capsule containing 325 mg of calcium, magnesium or debilitating metabolic diseases. Does not cause pupil dilation mites and ants (one tsp is effective for a small nest box; two tsp as occurs in mammals. Mixture of bacteria, enzymes, electrolytes and vitamins that may be an effective adjunct therapy in debilitated birds. Also available as an ointment or trum activity for many gram-negative and gram-positive avian cream for topical administration. Cannot be thawed and cases of candidiasis in a flock while hygiene problems that caused refrozen (see Chapter 17). The less concentrated rations contain alcohol that may cause local skin irritation. Reconstituted As a disinfectant, mix six tablespoons (3 oz or 90 ml)/gallon of solution is stable for ten days refrigerated or six months frozen. May also be used as a disinfectant Cannot be thawed and refrozen (see Chapter 17). The longer the chlorine is in contact with an organism the more efficient it is as a disinfectant. Varied efficacy for like most disinfectants, is not effective if organic debris is present. Frequent dosing makes treatment Exposure to fumes may cause epiphora, coughing, sneezing, rhin- in all but hand-feeding neonates impractical. Reconstituted sus- orrhea and dyspnea in most avian species, particularly neonates. May react with some of staphylococcus dermatitis where long-term therapy is necessary basic cleaners. This drug is not absorbed from the gastroin- completely absorbed from the intestinal tract. May cause retinal damage, vomiting, Similar in activity and spectrum to cephalexin. Should be used with extreme caution in patients with mashes containing rice, beans, chick starter ration and ground renal or liver disease. Rapidly excreted by pigeons, necessitating a monkey biscuit for the flock control of chlamydiosis. May be useful in suppressing bacterial replication in flocks of large psittacine birds. Suspension or powder from capsules can be used to lace Impregnated millet seeds may be helpful in treating chlamydiosis favorite foods or to mix into a mash for flock treatment of some in flocks of budgerigars and cockatiels. Particularly effective in the flock for the treatment of chlamydiosis should be considered inferior to treatment of salmonella. Has been associated with temporary the use of doxycycline and enrofloxacin (see Chapter 17 and 34). Anti-inflammatory that may be useful in debili- Available as tablets (200, 300, 400, 800 mg) or liquid (60 mg/ml) tated animals. Inhibits gastric acid treatment of shock and to reduce the effects of gram-negative secretion by inhibiting the effects of histamine at the H2 receptor endotoxemia that may occur when patients with bacteremia are of the parietal cells. Higher dose may be immunosuppressive decrease gastric acidity if the cloacal pH is low, a common problem and a lower dose should be used for repeated therapy. May cause increased levels of liver administration, as an injectable solution (200 or 400 mg/ml) for enzymes, polydipsia, polyuria and diarrhea. Doses of three drops/gallon of water were crushed and added to liquid but must be shaken well before found to be immunosuppressive in pigeons. Primarily indicated in cases of osteomyeli- be used to control some seizures and feather picking (0. Clinical impres- Available as a solution for oral administration: Cardoxin = 15 sions suggest that this drug is rarely effective in controlling muti- mg/ml; Lanoxin = 0. Toxic reactions include depression, probenecid) for oral administration or as an injectable solution (0. Injectable solution used as an inhibitor of Intramuscular injection has been associated with paralysis and collagen production and may stimulate collagenase activity. Calcium and zinc have little effect on Available as a liquid or gel (90% - 900 mg/ml) for topical applica- the absorption of doxycycline. Calcium and zinc may reduce the half-life of doxycycline by a vehicle for carrying some antibiotics into difficult-to-reach sites binding excreted doxycycline and thereby preventing enterohepa- of infection (joints, cellulitis, bumblefoot).

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The re- fistula should be given as much time as possible to moval procedure should be accomplished in stages if heal before surgery purchase levitra professional 20 mg visa, and the scab should be left in the bird becomes overly stressed levitra professional 20mg visa. Most birds with crop stasis are dehydrated and require parenteral fluid administration. A Gram’s stain of a crop swab can be used to determine the microbial agents that are present. If a generalized microbial infection is suspected, start treat- ment with a broad-spectrum antibiotic and antifungal drug. Cephalosporins and penicillins are the safest drugs to use; aminoglycosides and sulfas should be avoided due to poten- tial dehydration and renal toxicity. Injectable antibiotics should be used if there is severe stasis because oral antibi- otics would not be properly absorbed. Oral antifungals (nys- tatin) should be used because the parenteral antifungal drugs (eg, amphotericin B) may be toxic. If the bird has generalized ileus, a motility stimulant such as metoclopramide or D-panthenol can be administered. Once the crop starts to partially empty and the bird is stabi- hangs over the thoracic inlet where food cannot enter the thoracic lized, limited feeding should resume. A crop bra can be used to elevate the crop a liquid, complex carbohydrate, medium-fiber-content diet and increase the gravitational forces that encourage food to pass until the crop is emptying normally (see Chapter 15). Gerber’s through the thoracic portion of the esophagus and into the proven- oatmeal with applesauce and bananas baby cereal mixed triculus (courtesy of Kim Joyner). As the crop starts to empty normally, the diet that is normally fed should be gradually results in a reduced crop capacity. It is impor- the bird should be fed small amounts of food fre- tant to restore normal feeding as quickly as possible because dilute baby food diets do not provide sufficient nutrition for quently to prevent reflux and aspiration. Subcutaneous fluid administration and antibiotics amount of food offered can be gradually increased to should continue until the bird is clinically normal. If the crop is overstretched or atonic it is beneficial to apply a pharyngotomy tube may be necessary to allow feed- “bra” to elevate the crop and facilitate emptying (Figure ing yet protect the wound during healing. The bra can be constructed from elastic bandage material or baby tube socks and should be applied while the tive to a pharyngotomy tube is to place a mushroom- crop is full to make sure it is not too tight. The neonate should tipped jejunal catheter in the crop and tunnel it be confined to a small container for a few days if it objects to subcutaneously up the side of the neck. Parenteral nutrition would be beneficial in cases of crop should be covered with a permeable dressing and stasis; however, at the time of this publication this is still a allowed to heal as an open wound. Regurgitation Hand-fed birds (especially macaws and African Grey Parrots) commonly regurgitate at weaning, and it is 30. If surgery is attempted before the tissues important to differentiate this relatively normal phe- surrounding the burn have healed, it is difficult to nomena from a pathologic condition. Causes of regur- accurately assess the extent of devitalized tissue that gitation include overfeeding, crop stasis, alimentary must be debrided. Surgical adhesives can be used to tract infections (especially candidiasis), alimentary close the crop and allow feeding or a pharyngotomy tract foreign bodies, blockage of the alimentary tract tube can be passed (see Chapter 41). It has been and use of some drugs such as trimethoprim-sulfa estimated that it takes seven to ten days following a compounds and doxycycline. Large crop defects (greater than one-third the size of the crop) can be difficult to repair. Preventing neonates from consuming foreign Intestinal Intussusception bodies is far easier than treating them. The feeder should be very selective about the objects the birds This condition is occasionally reported in macaws are allowed to contact (Color 30. Mild cases are diagnosed radiographically object from entering the proventriculus. It is much and may respond to antimicrobial and supportive easier to retrieve objects from the crop than the therapy. Severe cases with a visible cloacal prolapse proventriculus, and birds have a remarkable capac- are usually fatal. Some ob- jects can be “milked” up the esophagus and retrieved Disorders of the Respiratory Tract from the caudal oral cavity with forceps. Forceps can also be introduced into the crop to retrieve foreign Upper Respiratory Infections bodies, with or without the aid of endoscopy. Objects Nestling birds can pass food through the choanal slit, can also be retrieved via an ingluviotomy incision resulting in clogged nostrils and upper respiratory (see Chapter 41). These can be treated by removing the food plug with a feathered wooden applicator (see Chap- Objects in the proventriculus or ventriculus can be 8 ter 8) or dull needle, and gently flushing the nares tolerated for long periods but should be retrieved if with saline until clear. Microbial infections of the they have the potential to erode the stomach wall or upper respiratory tract are treated in the same man- can be digested, resulting in toxicity. Aspiration occurs most often in birds doscope must be carefully passed to prevent rupture that are reluctant to feed or if the aviculturist intro- of the thoracic esophagus or proventricular wall. If large proventriculus and ventriculus can also be opened sur- amounts of food are inhaled, the bird will die from gically as described for adult birds (see Chapter 41). Rapid placement of an air sac cannula and aggressive antimicrobial (eg, Proventricular or ventricular impactions caused by trimethoprim-sulfa, ketoconazole) and steroid ther- grit or bedding material are serious and require ur- 8 apy may save the patient, but the prognosis is poor. Mild accumulation of material in the Some birds respond to such aggressive treatment ventriculus (that does not impede passage of ingesta) and die months later due to a chronic fungal infec- can be treated by hydrating the patient and admin- tion. If small amounts of food are aspirated, the event istering laxatives (dioctyl sodium sulfosuccinate or may not be noted at the time but the bird may later psyllium or digestive enzymes). An affected bird limited to no more than one percent of the dry weight will show poor weight gain, a persistently elevated of the tubed formula to prevent it from causing an white blood cell count and may or may not show impaction. Often, the pneumonia may be be administered into the crop, followed 30 minutes noted only by radiology or at necropsy. Serial ra- Hepatic Lipidosis diographs can be used to evaluate the success of the In most cases, hand-fed birds gain weight slower therapy. If this treatment fails, proventriculotomy than parent-fed birds, and the hand-feeder should be (see Chapter 41) or gastric lavage (see Chapters instructed to maintain the maximum weight gain possible. This condition can be prevented others, it is possible to overfeed (especially in the by feeding a proven diet and comparing the bird’s later development stages) and cause massive weight weight gain to established growth charts. It has been suggested is normal in body size but substantially heavier than that multiple deficiencies of fiber, vitamins and min- the upper limit on the chart, the possibility of hepatic erals and nutritional excesses combine to cause this lipidosis should be considered. Affected birds are usually dyspneic, especially when food in the Hepatomas digestive tract places additional pressure on the res- Hepatic hepatoma has been described primarily in piratory system following feeding (Figure 30. The macaws, and may occur when blunt trauma ruptures abdomen is usually protuberant and the pale, en- the liver and causes hemorrhage. In these occur when the bird is lifted with pressure over the cases, the amount of food fed should be gradually liver or it may simply be idiopathic. Affected birds are reduced and small meals should be fed more often to pale with extremely low hematocrits and may be avoid respiratory distress. Hyperthermia will aggra- saved by repeated blood transfusions within the first vate the respiratory distress and should be avoided. If identified early, the birds may wean normally, but Gout Deposition of uric acid crystals in the tissues is called visceral gout and is usually due to end-stage renal disease. Excess vitamin D3 results in dystrophic calcification of numerous organs includ- ing the kidney, which then may result in gout (see Chapters 3, 21). Macaws seem to be particularly sensitive to excessive dietary consumption of vitamin D3 and calcium (see Color 21). It occurs sporadi- cally with several hand-feeding formulas, and the pigment may be more pronounced on some bedding materials, especially certain brands of paper towels. Musculoskeletal Disorders Leg Deformities Orthopedic problems in nestling birds are poorly un- derstood and the causes are believed to be multifac- torial. Nutritional deficiencies (especially of vitamin D3 and calcium), trauma and housing the birds on slippery surfaces are the most common causes. The bird was netic and incubation abnormalities probably also oc- 30% heavier than normal when compared to standard weight cur. In general, leg consisted of a peanut butter base supplemented with numerous herbs and vitamins.

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Effect of weight reduction on resting energy expenditure buy 20 mg levitra professional otc, substrate utilization purchase levitra professional 20mg on-line, and the thermic effect of food in moderately obese women. Children at familial risk for obesity: an examination of dietary intake, physical activity, and weight status. Exercise training prevents regain of visceral fat for 1 year following weight loss. Diets with high or low protein content and glycemic index for weight-loss maintenance. Water consumption increases weight loss during a hypocaloric diet intervention in middle-aged and older adults. Effects of an ad libitum low-fat, high-carbohydrate diet on body weight, body composition, and fat distribution in older men and women. The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia. Mild overweight treated with energy restriction and a dietary fiber supplement: a 6- month randomized, double-blind, placebo-controlled trial. An analytical ultracentrifuge study on ternary mixtures of konjac glucomannan supplemented with sodium alginate and xanthan gum. Studies on macromolecular interactions in ternary mixtures of konjac glucomannan, xanthan gum and sodium alginate. Beneficial effects of viscous dietary fiber from konjac-mannan in subjects with the insulin resistance syndrome: results of a controlled metabolic trial. The effect of a novel viscous polysaccharide along with lifestyle changes on short-term weight loss and associated risk factors in overweight and obese adults: an observational retrospective clinical program analysis. Meal replacements are as effective as structured weight-loss diets for treating obesity in adults with features of metabolic syndrome. Value of structured meals for weight management: risk factors and long-term weight maintenance. A novel soy-based meal replacement formula for weight loss among obese individuals: a randomized controlled clinical trial. A controlled trial of protein enrichment of meal replacements for weight reduction with retention of lean body mass. Efficacy of a meal replacement diet plan compared to a food-based diet plan after a period of weight loss and weight maintenance: a randomized controlled trial. Effects of supplemental chromium on patients with symptoms of reactive hypoglycemia. Hypothesis: sensitization of insulin-dependent hypothalamic glucoreceptors may account for the fat-reducing effects of chromium picolinate. Effects of resistive training and chromium picolinate on body composition and skeletal muscle size in older women. International Journal of Sport Nutrition and Exercise Metabolism 2002; 12: 125–135. Effect of chromium supplementation and exercise on body composition, resting metabolic rate and selected biochemical parameters in moderately obese women following an exercise program. The effects of oral 5-hydroxytryptophan administration on feeding behavior in obese adult female subjects. Effects of 5-hydroxytryptophan on eating behavior and adherence to dietary prescriptions in obese adult subjects. Eating behavior and adherence to dietary prescriptions in obese adult subjects treated with 5-hydroxytryptophan. Efficacy of a novel calcium/potassium salt of (-)-hydroxycitric acid in weight control. Enhanced thermogenesis and diminished deposition of fat in response to overfeeding with diet containing medium chain triglyceride. Greater rise in fat oxidation with medium-chain triglyceride consumption relative to long-chain triglyceride is associated with lower initial body weight and greater loss of subcutaneous adipose tissue. International Journal of Obesity and Related Metabolic Disorders 2003; 27: 1565–1571. Medium-chain triglycerides increase energy expenditure and decrease adiposity in overweight men. Differential rates of conversion of testosterone to dihydrotestosterone in acne and normal human skin—a possible pathogenic factor in acne. The familial risk of adult acne: a comparison between first-degree relatives of affected and unaffected individuals. Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris. Some observations on the sugar metabolism in acne vulgaris, and its treatment by insulin. Nutrition-endocrine interactions: induction of reciprocal changes in the delta 4–5 alpha-reduction of testosterone and the cytochrome P-450-dependent oxidation of estradiol by dietary macronutrients in man. Proceedings of the National Academy of Sciences of the United States of America 1983; 80: 7646–7649. Beneficial effect of chromium-rich yeast on glucose tolerance and blood lipids in elderly patients. Efficacy and safety study of two zinc gluconate regimens in the treatment of inflammatory acne. The effect of zinc on the 5-alpha-reduction of testosterone by the hyperplastic human prostate gland. Erythrocyte glutathione peroxidase activity in acne vulgaris and the effect of selenium and vitamin E treatment. A comparative study of tea-tree oil versus benzoyl peroxide in the treatment of acne. Pharmacokinetic and pharmacodynamic properties and its therapeutic role in hyperpigmentary disorders and acne. Exocrine pancreatic function and fat malabsorption in human immunodeficiency virus-infected patients. Study of the role of vitamin B12 and folinic acid supplementation in preventing hemologic toxicity of zidovudine. Thiamine disulfide as a potent inhibitor of human immunodeficiency virus (type-1) production. Low serum cobalamin levels occur frequently in the acquired immune deficiency syndrome and related disorders. Severe deficiency of 1,25-dihydroxyvitamin D3 in human immunodeficiency virus infection: association with immunological hyperactivity and only minor changes in calcium homeostasis. Suppression of human immunodeficiency virus type 1 viral load with selenium supplementation: a randomized controlled trial. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology 1997; 15: 370–374. Therapeutic application of zinc in human immunodeficiency virus against opportunistic infections. Studies on lipoate effects on blood redox state in human immunodeficiency virus infected patients. Carnitine in human immunodeficiency virus type 1 infection/acquired immune deficiency syndrome. Protective actions of L-carnitine and acetyl-L-carnitine on the neurotoxicity evoked by mitochondrial uncoupling or inhibitors. Detecting life-threatening lactic acidosis related to nucleoside-analog treatment of human immunodeficiency virus-infected patients, and treatment with L-carnitine. Three inhibitors of human type 1 immunodeficiency virus: long terminal repeat, directed gene expression, and virus replication. Proceedings of the National Academy of Sciences of the United States of America 1993; 90: 1839–1841. Comparison of systemic availability of curcumin with that of curcumin formulated with phosphatidylcholine. Journal of the American Academy of Child and Adolescent Psychiatry 2001; 40: 83–90. The severity of liver fibrosis is associated with high leptin levels in chronic hepatitis C.

Histologically effective 20mg levitra professional, tissue architecture is a Uropygial gland neoplasms occur sporadically in cap- differentiating feature of the lesion wherein blood tive birds discount 20mg levitra professional mastercard, especially budgerigars and canaries. Neoplasia must be distinguished from adeni- plasia with granuloma formation also may be ob- tis, which usually requires histologic examination. In such instances, nematode-induced reac- tive fibroplasia may be difficult to distinguish from Feather Folliculoma: Feather folliculomas occur pri- 57,62 marily in canaries and budgerigars. Microscopically, these lesions appear eous papillomas are observed occasionally in domes- multilobulated and are lined with irregular, hyperplas- tic, captive and free ranging birds. Basal ple papillomas most frequently originate from the skin cells are arranged in barb ridges and undergo abrupt of the eyelids, at the junction of the beak and face, and squamous differentiation in the center of the mass, forming laminations of free keratin. The anatomic location of these benign neoplasms may interfere with vision, prehen- Miscellaneous Basal Cell Tumors and Cutaneous sion of food or perching if the lesions are severe (Color Cysts: All of these neoplasms present as discrete skin 25. Basal cell tumors are composed of sheets, hyperplastic stratified squamous epithelium over a fi- nests or cords of basaloid epithelial cells. Cutaneouspapillomas are viral-in- population does not exhibit terminal cellular or struc- duced, at leastin African Grey Parrots, Chaffinchesand 5,25,108 73,87,96 tural differentiation. Intradermal cystic lesions occasionally are observed Squamous Cell Carcinoma: Squamous cell carci- in captive and free-ranging birds. Histologically, noma is observed most frequently in chickens but has these lesions often appear cystic as a result of glan- also been described in captive and free-ranging birds dular differentiation or keratin production. Those in the skin of the head, eyelids, neck, chest, wings or 6,7,15,29,49,59,108,135,142 benign neoplasms that exhibit glandular differentia- around the beak (Color 25. Gradual keratinization is ob- Multiple neoplasms usually are present, involving served with epidermal inclusion cysts, follicular cysts both feathered and unfeathered areas of the skin. On physical examination, a large mass was mangiosarcomas of chickens also noted in the area of the uropygial gland and dried excrement had accumulated around the vent. Radiographs indicated a large may originate in the pulmonary pa- mass that had invaded the synsacrum and was displacing the cloaca ventrally. In psittacine birds, cutaneous neoplasms may develop laryngeal papillomas may cause dyspnea. These le- under the skin of the face or neck, often in association sions may be surgically excised, but will recur if 9 excision is incomplete. Mast Cell Tumor: Mast cell tumors have been re- Bronchiolar Adenoma and Adenocarcinoma: A 99,124,139 bronchiolar adenoma has been reported in a parrot. In owls, mast cell neoplasms usually are associated with the The neoplasm appeared as a large, lobulated, ade- skin of the eyelid or auditory meatus, but may also nomatous nodule within a major bronchus. Mast cell tumors Fibrosarcoma: A solitary pulmonary fibrosarcoma appear grossly as raised-to-spherical, pink-to-red, has been described in a cockatiel. In some instances, of other neoplastic nodules, primary pulmonary ori- neoplastic margins may be indistinct or the neoplasm 27 gin was suggested. This subject is discussed below (bone proliferation resembling neoplasia; mus- culoskeletal system). Histologically, the neoplasm was lined by squamous epithelium and contained laminated keratin material and desquamated cells within the cyst lumen. These neoplasms may form wherever endothelium exists; however, pre- ferred sites of origin are apparent. Vasoformative neoplasms are classified as benign (hemangioma, lymphangioma) or malignant (hemangiosarcoma, lymphangiosarcoma). Vasoformative neoplasms must be distinguished from non-neoplastic conditions such as vascular mal- formations (arteriovenous fistulas and aneurysms), hematomas, excessively vascularized granulation tissue or other neoplasms with a rich blood sup- ply. In chickens, vasoformative neoplasms may arise as a sequela to avian leukosis virus, subgroup F infection. These virus- induced neoplasms may progress from benign growths to fibrosar- coma-like neoplasms, analogous to Kaposi’s sarcoma in human be- ings. Histopathology revealed a renal tubular adenocarci- noma with metastasis to the lung, liver and myocardium (see Color 25. These endothe- tion from tumor mass or secondary abdominal dis- lial cells usually appear polyhedral-to-spindle- tention from hemorrhage (hemoperitoneum). Vaso- shaped with round-to-oval nuclei and dark-blue, oc- f o r mat ive n e o p las ms may he mor rhage casionally finely vacuolated, cytoplasm. Aspiration spontaneously or following minor trauma (palpation) sites may hemorrhage profusely. These lat- ter neoplasms may cause abdominal distention by Lymphangioma: Birds possess lymphatic channels tumor mass or hemorrhage (hemoperitoneum). These neoplasms are extremely rare Cytologic aspirates of hemangiomas are of limited in all species, especially birds. En- been reported in the mesentery and spleen of a rhea dothelial cells are rarely observed. This pig- Histologically, these neoplasms consist of vascular ment appears globular and blue, golden-brown or channels lined by flattened epithelium and filled greenish-black in Romanowsky-stained cytology with lymph. He- matoma, hemangioma and hemangiosarcoma may be difficult or impossible to distinguish cytologically. Musculoskeletal System Histologically, hemangiomas are composed of vari- ably-sized vascular spaces and channels that are lined by flattened endothelium. Occasional solid ar- Neoplasms of Smooth and Striated Muscle eas of plump endothelial cells also may be observed. Neoplasms originating from striated or smooth mus- Vascular spaces typically contain blood, plasma or cle that are benign or malignant are observed occa- fibrin thrombi. Muscle matopoietic precursor cells may be adherent to the neoplasms presumably arise from embryonic rem- endothelium. Generally, smooth muscle neoplasms are often arise in the skin, liver, lungs, spleen, muscle, reported about twice as frequently as striated muscle mesentery, kidney, heart, oviduct, bone or 19,49,74,102,108,127,128,129,143 tumors. Grossly, excised neoplasms appear firm, pink, poorly delineated and unencapsulated. Microscopically, leiomyosarcomas are hypercellular with spindle cells arranged in sheets, interlacing bundles or whorls. Neoplastic myocytes have plump often pleomorphic nuclei, occasional nucleoli and variable amounts of eosinophilic cytoplasm. Rhabdomyoma: Rhabdomyomas are benign neo- plasms of striated muscle and are the rarest muscle neoplasm reported in captive birds. Cytologic aspirates are unrewarding except for pos- sible fragments of striated muscle cells. Histologi- cally, rhabdomyomas are composed of cells ranging from a fibroblast appearance to multinucleated cells. The histologic diagnosis was hemangiosarcoma (courtesy Rhabdomyosarcoma: Rhabdomyosarcomas are of of Jane Turrel). Less fre- quently, neoplasms will arise from other sites such Cytologic aspirates and imprints are sparsely cellu- as the dorsal lumbar musculature. These cells have Cytologic studies of rhabdomyosarcomas have not cigar-shaped nuclei and eosinophilic cytoplasm. Anisokaryosis may be prominent Leiomyosarcoma: Leiomyosarcomas are the most with plump oval-to-elongated nuclei. Some elongated common muscle neoplasm reported in captive and or “strap cells” will retain cross striations typical of free-ranging birds. Osseous neoplasms usually arise quent event, but has been documented to involve the from the long bones, while cartilaginous neoplasms liver, spleen, thoracic cavity and bone marrow. Osteomas may and possible matrix material; however, histopathology originate from the cranium, scapula, tarsometatar- is required to determine whether the neoplasm origi- sus, plantar foot pad and elbow joint. They often arise on the plantar frequently than osteomas and usually originate from surface of the foot pad where they may be subjected the proximal or distal portion of long bones including to trauma with subsequent hemorrhage and ulcera- the radius, humerus, femur, tibiotarsus and tar- tion of the overlying epidermis. Variable amounts of sulfated mucopolysaccharide matrix and lacunae Histologically, osteosarcomas are composed of poly- may be observed. Bony trabeculae may be present but disor- Chondrosarcoma: Chondrosarcomas are very rare in ganized. A chondrosarcoma has nective tissue, and myxomatous matrix also may be been reported involving the metatarsal-phalangeal present. The differential diagnosis for in- creased medullary opacity of long bones includes osteopetrosis, polyostotic hyperostosis, metastatic neoplasia, hypertrophic osteopathy and metabolic bone disease. Osteopetrosis: Osteopetrosis is defined as marked subperiosteal proliferation of bone resulting in loss of medullary space, increased bone thickness and de- formity. Osteopetrosis in chickens occurs sporadi- cally and is caused by leukosis/sarcoma virus infec- tion.

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