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Joanna Hedley (Senior Lecturer in Exotic Species and Small Mammal Medicine and Surgery) and Vicki Baldrey (Senior Lecturer in Exotic Species and Small Mammal Medicine and Surgery)

The Exotics Service is primarily based at RVC’s Beaumont Sainsbury Animal Hospital but the team also provides a weekly clinic at the Queen Mother Hospital for Animals (QMHA).

The clinic allows collaboration with specialists across other disciplines and enables patients to benefit from advanced diagnostic imaging modalities. This combination of transdisciplinary expertise and cutting-edge medical technology has been of great value to a broad range of species.

An Amazon parrot with cardiac disease and a yellow-bellied slider with a complex pulmonary problem both recently attended the clinic.

Rodney, the orange-winged Amazon parrot

Rodney came to see the Exotics Service with a history of falling over, clenching and unclenching his feet and appearing uncomfortable. His owners reported lethargy, and he had stopped playing with his toys. Rodney’s exact age was unknown, but he had been with the family for 30 years. Amazon parrots can live for over 50 years in captivity, so Rodney was at least middle-aged in parrot terms.

Following Rodney’s initial assessment, further investigations were performed by our avian specialist (Dr Vicki Baldrey). These included bloods and radiographs, obtained under a brief gaseous anaesthetic. The radiographs showed increased opacity of the great vessels of the heart and a tortuous appearance to the aorta, consistent with atherosclerosis – which is seen quite commonly in older parrots.

Biochemistry showed a mildly elevated cholesterol, which further supported the concern for peripheral arterial disease. Rodney’s diet consisted predominantly of seed, and his owners reported he loved human foods, especially less healthy options, a common inclination of Amazon parrots.

Treatment was started with pentoxifylline and enalapril, alongside supplementation with omega-3 fatty acids and an altered diet.

Echocardiography was scheduled with the Cardiology Service at the QMHA two weeks later. By this time, Rodney’s owner reported a significant improvement in his activity levels and no further foot clenching, which we suspect had been related to claudication, due to reduced blood flow to his legs.

The team echocardiogram was performed without sedation and thankfully it revealed good cardiac function with no evidence of cardiomyopathy. Treatment is continuing with the vasodilators and dietary changes and Rodney continues to do well.

George, the yellow-bellied slider   

George was presented to the Exotics Service for assessment and treatment of chronic abnormal buoyancy. Her owners reported that she had been swimming at an angle tilted to the right side since they obtained her two years before but were concerned that her signs were worsening. She could still climb out of the water to bask and was spending most of her time on dry land.

George was bright and alert on examination and moved around the consult room normally. However videos of her swimming behaviour at home were markedly abnormal. Auscultation is always limited in chelonian species but no obvious respiratory noise or effort was noted. CT was recommended for further investigation, and this was performed the same day. CT is an invaluable diagnostic tool in chelonians, where the shell limits what can be visualised with traditional radiography.

In George’s case, CT revealed significantly abnormal lung parenchyma. On the left side, the airways appeared expanded and emphysematous. The remaining lung parenchyma had an uneven attenuation, suggestive of pulmonary fibrosis. In contrast, on the right side the lung was replaced with a cavitated gas-filled structure, suspected to represent an end-stage emphysematous lung or changes secondary to chronic pneumonia. The changes are likely permanent but further investigations, such as endoscopy, can be helpful in some cases to ascertain if there is active disease that treatment could help.

Multiple round structures were also visualised within George’s coelomic cavity, consistent with ovarian follicles. While these were not currently of a size or number to be causing a problem, George is at risk of follicular stasis in future if they do not progress (either to ovulate and form eggs or to regress and be resorbed).

Changes to her feeding regime and adaptations to her enclosure were recommended in view of her compromised lungs so that she could easily access a nesting site and follow up imaging is planned to track the follicles and identify any problems at an early stage.