Vicki Baldrey, Exotics Clinician

A recent case referred to the RVC Exotics Service at the Beaumont Sainsbury Animal Hospital (BSAH) demonstrated again the considerable collaboration between our services - in this case with the Diagnostic Imaging Service and our Diagnostic Laboratory, both based at the Queen Mother Hospital for Animals (QMHA).

Riki, a six-year-old female grey parrot, was referred to the exotics team at the BSAH for further investigation of chronic weight loss and inappetence. She had undergone extensive investigation with her local vet, who suspected a problem with her proventriculus (the first part of the avian stomach).

To further investigate the problem, Dr Jo Hedley, head of the RVC Exotics Service, arranged for Riki to go to our QMHA for fluoroscopy. This is a specialised type of imaging allowing a real-time ‘continuous x-ray’ which can be used to demonstrate the anatomy and function of the gastrointestinal tract.

A special carry box was created for Riki by exotics intern Matthew Williams. This allowed her to stand comfortably on a perch in an enclosed space, preventing her from moving around excessively during the procedure, removing the need for general anaesthesia.

Riki was given barium by crop tube and the fluoroscopy procedure immediately performed. The imaging showed a real-time picture of the barium moving through Riki’s crop into the proventriculus and on into the gizzard and intestine. The barium highlighted a mass in the cranial proventriculus, consistent with a granuloma (most likely fungal in origin) or possibly neoplasia.

Rigid endoscopy of Riki’s proventriculus was performed 24 hours later. Riki was anaesthetised and via a small incision in her crop, a 2.7mm rigid endoscope was passed into her proventriculus, visualising the mass identified on fluoroscopy. Cytological samples were taken, alongside a blood sample, to investigate further. Results were quickly available from our diagnostic laboratory and showed an inflammatory response on haematology (heterophilia and monocytosis), consistent with a suspected fungal granuloma. Riki is so far responding well to treatment with an antifungal drug voriconazole, alongside supportive treatments to improve her body condition.

Time is a critical factor with avian species, as they can deteriorate very rapidly. It is therefore fantastic that in Riki’s case a collaboration between colleagues in multiple departments to very quickly perform advanced diagnostics, enabled specific, appropriate treatment to be initiated as soon as possible.

The RVC Exotics Service provides referral clients with 40-minute consults to discuss husbandry, diet and health concerns. There is a separate waiting area away from cats and dogs and dedicated hospitalisation facilities to separate prey and predator species.

Avian Diagnostic tests

• Blood testing for haematology and biochemistry
• Radiography
• Endoscopy Crop washes for cytology
• Faecal testing, especially for psittacosis
• Serological testing for common infectious diseases such as PBFD, Bornavirus
• Ultrasound or advanced imaging, such as CT or MRI as required

For exotic referrals call 020 75543528 or email exoticscamden@rvc.ac.uk