Page 4 - Clinical Connections- Summer 2021

RVC RESEARCH STUDY VETERINARY SERVICES RVC.AC.UK
Exotics

REMARKABLE RHEA’S RVC REFERRAL

Vicki Baldrey, Lecturer in Exotic Species and Small Mammal Medicine and Surgery and Jo Hedley,
Senior Lecturer in Exotic Species and Small Mammal Medicine and Surgery
eorge the pet rhea was presented Jo Hedley performs an ophthalmic examination of Geeorge's left eye
to the RVC Exotics Service at the
G Queen Mother Hospital for Animals
(QMHA) for assessment and treatment of
left-sided periocular swelling. The Exotics
Service runs weekly clinics at QMHA and
often collaborates with the Ophthalmology
and Imaging services on cases.
George was brought by trailer to the
QMHA and was examined in a padded
equine knock-down box. Her owner
reported reduced vision and swelling
around her left eye. A brief conscious
ophthalmic examination revealed the
menace response was present in the
right eye and intermittent in the left eye.
Dazzle reflexes were intact bilaterally.
Further examination was limited by her
temperament, so the team proceeded
directly to anaesthesia for a full ophthalmic
examination and further investigation. This
allowed minimal stress to George, which is
important, as rhea can suffer from capture
myopathy with prolonged manual restraint.
After an initial ‘quad’ protocol comprising
intramuscular butorphanol, medetomidine,
ketamine and midazolam, George was
anaesthetised with IV propofol via her
basilic vein and then intubated and
maintained on sevoflurane in oxygen.
Ophthalmic examination of the left eye
revealed marked conjunctival hyperaemia.
There was a soft mass in the medial aspect aqueous humour flare. The pupil was round the medetomidine was antagonised with an
of the orbit, compressing the globe. The and mobile, and the lens was transparent. equal volume of atipamezole IM. George
corneal examination was unremarkable. The fundic examination was unremarkable made a smooth, rapid recovery and was
The anterior chamber was formed without and the ophthalmic examination of the right standing within 15 minutes.
eye was unremarkable. The intraocular Samples from the sinus were submitted
EXOTICS AND SMALL pressure readings were 12 mmHg and 22 to the RVC laboratory for culture and
MAMMALS SERVICE mmHg in the right and left eye, respectively. sensitivity, cytology and histology. Cytology
and histology revealed pyogranulomatous
The RVC’s Exotics and Small Advanced Imaging inflammation and thankfully no evidence
Mammals Service is the only specialist A CT was performed with IV contrast and of neoplasia. Culture grew two species
exotics service in central London revealed multiple pockets of fluid in the of E. coli and an unidentified anaerobe.
and the only full-time exotics service left periorbital sinus, with concretions of George was treated with oral marbofloxacin
at an English veterinary school. The solid material with areas of mineralisation and metronidazole based on the bacterial
team treats a wide variety of species, compressing the left globe. Ultrasound- sensitivity results.
including rabbits and other small guided fine needle aspiration was After discharge George continued to
mammals, reptiles, birds, amphibians, performed but yielded a limited amount of improve. Antibiotics were continued for
ornamental fish and invertebrates. The fluid. Following surgical preparation and six weeks and she was very compliant in
service has been steadily growing since instillation of 2mg/kg lidocaine, an incision taking these in her favourite egg sandwich.
being established in 2014 and will soon was made over the swelling, into the The swelling has so far not recurred so we
expand further and comprise of six vets dorsal aspect of the periorbital sinus and hope George will continue to do well.
– including one new intern and one new a large amount of caseous/mineralised
resident – and six registered veterinary material curetted out. The pocket was
nurses. The team’s presence at the at then copiously lavaged with sterile saline. For the RVC Exotics and Small Mammals
Service, please call: 020 7554 3528
the QMHA will be increasing from one Further pain relief was administered with Email:
to two days a week for referrals. IM meloxicam. At the end of the procedure, londonreferrals@rvc.ac.uk

4 Summer 2021