Diagnosis and treatment of congestive heart failure secondary to dilated cardiomyopathy in a hedgehog

A one‐year‐old African pygmy hedgehog (Atelerix albiventris) was evaluated for severe respiratory distress. Physical examination findings included marked dyspnoea, cyanosis and tachypnoea. Radiographic findings included an enlarged heart and pulmonary oedema, and dilated cardiomyopathy was confirmed via echocardiogram. The patient was treated for congestive heart failure because of dilated cardiomyopathy with furosemide, enalapril, pimobendan and l‐carnitine. Within 24 hours of treatment, the pulmonary oedema and cyanosis had resolved. Following discharge, clinical improvement was noted by the owner and echocardiogram confirmed improved fractional shortening. Cardiomyopathy has been reported at post‐mortem examination in hedgehogs, but there are no reports of ante‐mortem diagnosis and treatment. Performing baseline cardiac assessment in hedgehogs is recommended, and treatment with l‐carnitine and pimobendan may improve outcome, as carnitine deficiency is a possible cause of cardiomyopathy in hedgehogs. Successful emergency treatment of congestive heart failure in the hedgehog of this report may be effective for other hedgehogs presented with similar clinical signs .     

Unilateral proptosis and orbital cellulitis in eight African hedgehogs (Atelerix albiventris).

Eight African hedgehogs (Atelerix albiventris) were presented with unilateral proptosis. Six animals presented specifically for an ocular problem, whereas two had concurrent neurologic disease. Enucleation and light microscopic examination of tissues was performed in five animals, and euthanasia followed by complete postmortem examination was performed in three animals. Histopathologic findings in all hedgehogs included orbital cellulitis, panophthalmitis, and corneal ulceration, with perforation in seven of eight eyes. The etiology of the orbital cellulitis was not determined, but it appeared to precede proptosis. Orbits in hedgehogs are shallow and the palpebral fissures are large, which may predispose them to proptosis, similar to brachycephalic dogs. This clinical presentation was seen in 15% (8/54) of African hedgehogs presented to the Western College of Veterinary Medicine over a 2-yr period from January 1995 to December 1996 and warrants further investigation.     

Cytologic diagnosis of diseases of hedgehogs.

This article focuses on neoplastic diseases because they may be the most frequent disease processes in captive hedgehogs according to the literature and authors' case files and the most common cases submitted for cytologic diagnosis in these species, particularly the African hedgehog (Atelerix albiventris).     

Radiographic evaluation of cardiac size in flying fox species (Pteropus rodricensis, P. hypomelanus, and P. vampyrus).

Dilated cardiomyopathy is a relatively common pathology in captive flying foxes (Pteropus spp.). The goal of this study was to establish quantitative reference range measurements that could be used to support a diagnosis of cardiac disease in these animals. Lateral and ventrodorsal thoracic radiographs from apparently healthy flying foxes (n = 66) of three species (Rodriguez island flying fox, P. rodricensis, n = 18; small island flying fox, P. hypomelanus, n = 16; and Malaysian flying fox, P. vampyrus, n = 32) were evaluated objectively to describe the cardiac appearance. Absolute and relative cardiac dimensions also were measured. The same methods were used to evaluate radiographs from flying foxes (n = 9) with known dilated or acute cardiomyopathy. The following ratios were most appropriate for categorizing normal cardiac silhouette size. In the ventrodorsal projection, heart width to thoracic width and heart width to clavicle length were the preferred measurements. In the lateral projection, heart width compared with thoracic height was the preferred measurement. From radiographs of the bats with known dilated and acute cardiomyopathy, the apicobasilar heart length compared with thoracic height and heart width compared with thoracic height on lateral films were the most sensitive ratios for diagnosing cardiomegaly.     

Cardiomyopathy in captive African hedgehogs (Atelerix albiventris).

From 1994 to 1999, 16 captive African hedgehogs (Atelerix albiventris), from among 42 necropsy cases, were diagnosed with cardiomyopathy. The incidence of cardiomyopathy in this study population was 38%. Fourteen of 16 hedgehogs with cardiomyopathy were males and all hedgehogs were adult (>1 year old). Nine hedgehogs exhibited 1 or more of the following clinical signs before death: heart murmur, lethargy, icterus, moist rales, anorexia, dyspnea, dehydration, and weight loss. The remaining 7 hedgehogs died without premonitory clinical signs. Gross findings were cardiomegaly (6 cases), hepatomegaly (5 cases), pulmonary edema (5 cases), pulmonary congestion (4 cases), hydrothorax (3 cases), pulmonary infarct (1 case), renal infarcts (1 case), ascites (1 case), and 5 cases showed no changes. Histologic lesions were found mainly within the left ventricular myocardium and consisted primarily of myodegeneration, myonecrosis, atrophy, hypertrophy, and disarray of myofibers. All hedgehogs with cardiomyopathy had myocardial fibrosis, myocardial edema, or both. Other common histopathologic findings were acute and chronic passive congestion of the lungs, acute passive congestion of the liver, renal tubular necrosis, vascular thrombosis, splenic extramedullary hematopoiesis, and hepatic lipidosis. This is the first report of cardiomyopathy in African hedgehogs.     

Spontaneous proliferative lesions and tumors of the uterus of captive African hedgehogs (Atelerix albiventris).

Fifteen captive female African hedgehogs (Atelerix albiventris), 3- to 5-yr-old, were diagnosed with proliferative uterine lesions (n = 28). Lesions were associated with vaginal bleeding in all cases, hematuria in 11 of 13 cases, and weight loss in 7 of 12 cases. Lesions were multiple in eight cases and single in seven cases. The lesions identified were 13 adenosarcomas, 7 endometrial stromal sarcomas, 6 endometrial polyps, 1 adenoleiomyosarcoma, and 1 adenoleiomyoma. In one animal with adenosarcoma, peritoneal seeding was detected at the time of hysterectomy. Mean survival time was 303 days (n = 10). Ovariohysterectomy allows prolonged survival of hedgehogs with uterine tumors.     

Echocardiographic and electrocardiographic examination of clinically healthy, conscious ferrets

Objectives : To assess the feasibility of performing electrocardiography (ECG) and echocardiography on conscious ferrets and to establish reference values for this species under these conditions. Methods : End‐systolic and end‐diastolic left ventricular (LV) diameters, LV and interventricular septal thicknesses were measured by M‐mode echocardiography, while left atrial, aortic and pulmonary trunk diameters were determined by two‐dimensional echocardiography in 46 ferrets. In some animals the maximum velocities of blood flow in the aorta and the pulmonary trunk were also measured by spectral Doppler. ECG examinations were performed by using limb leads both in right lateral recumbency and in the so‐called “hanging” position. In the course of the ECG examinations (n=43), the occurrences, directions, durations and amplitudes of the P, QRS and T waves and the duration of the PR‐ and QT intervals were recorded for all six leads. Results : ECG and echocardiography were successfully performed on non‐sedated ferrets in 90 and 96% of the cases, respectively. Males were significantly heavier and had larger cardiac dimensions compared to females. Clinical Significance : Performance of both echocardiography and ECG are feasible techniques in conscious ferrets, and reference values are now available for future comparisons.     

Plasma biochemical reference values in clinically healthy captive bearded dragons (Pogona vitticeps) and the effects of sex and season

Background: Bearded dragons are one of the most popular pet lizard species, and biochemical reference values are useful for health management of these reptiles. Objectives: The objectives of this study were to measure plasma biochemical values in healthy captive bearded dragons, determine reference values, and evaluate the effects of sex and season on the results. Methods: Blood samples were collected from 100 captive healthy bearded dragons in Tokyo during the summer and winter. Plasma biochemical measurements were performed using a dry‐slide automated biochemical analyzer. The data were then compared based on sex and season using 2‐way ANOVA. Results: Globulin, cholesterol, and calcium concentrations of females were higher in both summer and winter compared with the values obtained for males. Both males and females had higher uric acid concentrations in winter than in summer. When compared with males, females had a higher chloride concentration in summer and a higher total protein concentration and aspartate aminotransferase activity in winter. Potassium concentration in males was lower in winter than in summer, whereas in females cholesterol concentration was lower in winter than in summer. Conclusions: Biochemical values that differed based on sex and season in bearded dragons were similar to those in other lizards. These differences reflect physiologic differences in reproductive status in females and seasonal changes in temperature and hydration status. Plasma biochemical values established for bearded dragons in this study will be useful in the diagnostic assessment of captive animals.     

Evaluation of supraglottic airway device use during inhalation anesthesia in healthy African pygmy hedgehogs (Atelerix albiventris)

ObjectiveTo evaluate a supraglottic airway device (SGAD) designed for rabbits in African pygmy hedgehogs (Atelerix albiventris) during inhalation anesthesia.Study designProspective, randomized, blinded experimental study.AnimalsA total of 12 adult African pygmy hedgehogs (seven male, five female).MethodsHedgehogs were placed in a chamber and anesthesia was induced using isoflurane in oxygen. Oropharyngeal endoscopy was performed and video recorded. The SGAD (v-gel R1) was inserted and connected to a Mapleson D circuit. Capnography, pulse oximetry and physiologic variables were measured during anesthesia, and lung inflation was tested at 10 and 20 cmH₂O. With the SGAD temporarily disconnected, anesthetized hedgehogs were randomly positioned into right and left lateral, dorsal and sternal recumbency to evaluate the effect of a change in body position on SGAD placement. Oropharyngeal endoscopy was repeated at the end of anesthesia, and recovery time was recorded. Pre- and post-SGAD placement endoscopy videos were retrospectively reviewed and scored for gross trauma.ResultsThe median [interquartile range (IQR)] time to successful SGAD placement was 38 (16–68) seconds. The time to SGAD placement decreased as the study progressed. SGAD required repositioning in six hedgehogs, median 2.5 (IQR, 1–3.5) adjustments each, to successfully perform lung inflation or maintain capnography readings. Lung inflation at 10 cmH₂O was successfully performed without leakage in nine animals, and in the other three animals after adjusting the SGAD at 1–2 time points. Inflation at 20 cmH₂O was rarely achieved without an air leak. Changes in heart and respiratory rates during anesthesia were not clinically relevant. Median endoscopic scores were 0 (no lesions) for both pre-and postplacement.Conclusions and clinical relevanceThe SGAD was relatively quickly and easily placed, permitted lung inflation and caused no significant oropharyngeal damage. The SGAD is a practical option for airway management in African pygmy hedgehogs.     

Mycobacterium bovis infection in New Zealand hedgehogs (Erinaceus europaeus)

Seventy-nine wild hedgehogs from the Wairarapa, an area of New Zealand in which bovine tuberculosis is endemic, were examined for lesions suggestive of tuberculosis. Sixteen animals with suspicious lesions had samples submitted for culture. Mycobacterium bovis was recovered from four animals with gross pulmonary lesions. The gross and histopathological appearance of the lesions are described and the significance discussed in the light of previously reported experimental and captive animal infections. It is likely that infection arose from the scavenging behaviour of hedgehogs. The moderate prevalence (5%) of tuberculosis in these animals combined with their small home ranges may allow them to be used in wildlife surveys to pinpoint the locality in which tuberculous possums have died.     

Echocardiography: principles of interpretation

Doppler echocardiography allows the serial, noninvasive collection of quantitative hemodynamic information. When coupled with the results of physical examination, thoracic radiographs, ECG, and routine cross-sectional and M-mode echocardiogram, DE helps identify the nature as well as the severity of cardiac disease. As more experience is gained with DE, more applications will be discovered and the indications for more invasive diagnostic tests including cardiac catheterization will diminish.     

Accuracy of the modified vertebral heart score and the cardio-vertebral ratio for radiographic evaluation of cardiomegaly in ferrets

Thoracic radiography is commonly used to assess the size of the heart and diagnose cardiac disease in ferrets. Several standardized radiographic heart size indicators have been introduced in this species and values in healthy ferrets have been reported. To date, none of these indicators has been tested in ferrets with cardiac disease. The aim of this prospective and retrospective, analytical observational design study was to assess the accuracy of the modified vertebral heart score (mVHS) and the cardio-vertebral ratio (CVR) in the radiographic detection of cardiomegaly in ferrets. Thoracic radiographs of 24 ferrets with confirmed heart diseases, 22 ferrets with non-cardiac diseases and normal-sized hearts on echocardiogram, and 24 healthy ferrets were mixed and examined by three independent and blinded radiologists who measured mVHS and CVR in right lateral (RL) and ventrodorsal (VD) radiographs. For all readers, ferrets with cardiac disease had significantly higher mVHS and CVR than ferrets without cardiac disease on echocardiography. Optimal cut-points for predicting cardiac enlargement were 6.25 vertebrae and 7.25 vertebrae for RL-mVHS and VD-mVHS, and 1.58 and 1.80 for RL-CVR and VD-CVR, respectively. Using these cut-points, the accuracy was good for indicators measured in RL radiographs (92.9% for RL-mVHS; 91.4% for RL-CVR) and moderate for indicators measured in VD radiographs (88.6% for VD-mVHS; 85.7% for VD-CVR). Findings supported the use of mVHS and CVR for evaluating the size of the heart in diseased ferrets, with caution in values interpretation when pericardial fat prevents precise delineation of the cardiac silhouette contour especially on VD radiographs.     

Urinalysis in three species of captive rhinoceros (Rhinoceros unicornis, Dicerorhinus sumatrensis, and Diceros bicornis)

This study reports urinalysis values for three species of captive rhinoceros (Rhinoceros unicornis, Dicerorhinus sumatrensis, and Diceros bicornis) and evaluates individual and species differences. Repeated urinalysis was conducted on 11 individuals to establish normal reference ranges. Although no individual or species differences existed in urinary values for pH, all species differed in specific gravity. Rhinoceros urine demonstrated many physical and chemical properties similar to that of the horse, but reliability of this comparison was limited. Urinary pH in the rhinoceros was within range of that established for the horse and other large herbivores. However, all rhinoceros species exhibited urinary specific gravities below the lower limit of the normal equine reference range. Comparative urinalysis using an outside laboratory source confirmed the results of this study and illustrated the value of conducting in-house analysis. These results are the first data available on reference ranges for urine parameters in the greater one-horned, Sumatran, and African black rhinoceros and provide a useful diagnostic tool for the veterinary care of individuals in captivity.     

Forelimb amputation for the treatment of distal radius osteosarcoma in an African pygmy hedgehog (Atelerix albiventris)

Neoplasia is a common finding in African pygmy hedgehogs. Both skeletal and extraskeletal osteosarcomas have been previously reported in this species, but the only reported case of appendicular osteosarcoma was diagnosed postmortem. A 3-year-old intact female African pygmy hedgehog presented with a 10-day history of left foreleg swelling and lameness. Radiographs performed by the referring veterinarian confirmed the presence of a lytic lesion affecting the distal radius. A whole-body computed tomography scan was performed and confirmed a marked osteolytic lesion affecting the distal radius, which was consistent with bone neoplasia, however osteomyelitis could not be excluded. There was no evidence of thoracic or abdominal metastasis. Ultrasound-guided fine needle aspiration of the lesion yielded a nondiagnostic sample. The affected forelimb was amputated and along with the axillary lymph node, was submitted for histological analysis which confirmed a well differentiated osteosarcoma within the distal radius. The patient made a full recovery with no complications and remained disease free at the time of writing, 12 months after presentation. Osteosarcoma is rarely diagnosed antemortem in African pygmy hedgehogs. This case describes the management, diagnostic techniques, and successful treatment of an osteosarcoma affecting the distal radius by forelimb amputation.     

Endometrial polyps in 2 African pygmy hedgehogs

Reports of spontaneously occurring endometrial polyps in animals are rare and have only involved a few species. This report is intended to advise veterinarians that older African pygmy hedgehogs may develop endometrial polyps and that these lesions can be a cause of bloody vaginal discharge, sometimes interpreted as hematuria.     

Cardiac troponin I concentrations following medetomidine‐butorphanol sedation in dogs

ObjectiveTo evaluate the effect of medetomidine–butorphanol sedation on serum cardiac troponin I (cTnI) concentration, a marker of myocardial ischemia and injury, in healthy dogs undergoing pre–surgical radiographs for orthopedic procedures.Study designProspective clinical study.AnimalsTwenty client–owned dogs with no history of cardiac disease.MethodsDogs were evaluated for pre–existing cardiac disease with electrocardiogram (ECG), noninvasive blood pressure and echocardiogram. Sedation was achieved using a combination of medetomidine (10 μg kg^?1) and butorphanol (0.2 mg kg^?1) intravenously. Blood pressure, heart rate and ECG were serially recorded throughout the duration of sedation. Serum cTnI concentration was measured at baseline and 6, 18, and 24–hours post–sedation.ResultsFollowing administration of medetomidine and butorphanol, all dogs were adequately sedated for radiographs and had a decreased heart rate and increased diastolic blood pressure. Arrhythmias associated with increased parasympathetic tone occurred, including a sinus arrhythmia further characterized as a sinus bigeminy in 17 of the dogs. Serum cTnI was undetectable at all time points in all but three dogs. Two of the three dogs had a detectable concentration of cTnI at all time points measured, including prior to sedation. Only one of the two dogs had a cTnI concentration above the normal reference interval. The dogs that exhibited detectable cTnI had no significant difference in signalment, heart rate, blood pressure, or lactate concentration as compared to those with undetectable cTnI.Conclusions and clinical relevanceSedation with medetomidine and butorphanol had predictable cardiovascular effects including bradycardia, an increase in arterial blood pressure, and arrhythmias in apparently healthy dogs requiring radiographs for orthopedic injuries, but did not induce significant increases in serum cTnI concentration following the drug doses used in this study.     

Forelimb amputation for treatment of a peripheral nerve sheath tumor in an African pygmy hedgehog

CASE DESCRIPTION: A 6-year-old female African pygmy hedgehog was evaluated because of a mass of unknown duration on the lateral aspect of the right shoulder region. CLINICAL FINDINGS: A fine-needle aspirate of the mass was collected for cytologic examination; findings were consistent with a spindle cell tumor. A CBC, plasma biochemical analyses, and whole-body radiography revealed no other abnormalities. TREATMENT AND OUTCOME: An initial surgery performed in an attempt to remove the mass with preservation of the limb failed in that tumor-free surgical margins were not obtained. Histologically, the mass was identified as a peripheral nerve sheath tumor (neurofibrosarcoma). A second surgery to amputate the forelimb was successful. After 1 year, there had been no further development of peripheral nerve sheath tumor at this or other sites. CLINICAL RELEVANCE: In African pygmy hedgehogs, potential differential diagnoses for a subcutaneous mass should include peripheral nerve sheath tumor. If necessary, forelimb amputation can be performed successfully in this species with procedures modified from those used in dogs. Information gathered during the treatment and recovery of the hedgehog of this report may assist practicing veterinarians in counseling owners of hedgehogs that are undergoing forelimb amputation with regard to the course of recovery that may be expected following this procedure.     

Postanesthetic effects of two durations of isoflurane anesthesia in African pygmy hedgehogs (Atelerix albiventris)

Background: African pygmy hedgehogs (Atelerix albiventris) are popular companion animals that require chemical immobilization to facilitate examination. The objective of this study was to evaluate effects of isoflurane anesthetic duration on recovery time, food intake, and body weight following anesthesia in African pygmy hedgehogs. Methods: Eight healthy, adult hedgehogs (4 male, 4 female) were used in this randomized, blinded, complete cross-over study. Two different isoflurane anesthetic durations of 15 minutes (ISO15) and 45 minutes (ISO45) were evaluated with a 2-week wash-out period between treatments. Physiologic parameters, reflexes, and behaviors were monitored to assess anesthesia quality. Food intake (grams of food per kg of body weight) and body weight were measured both before and after anesthesia to assess postsedation effects. Result: There was no statistically significant difference in body weight between or within treatments following the anesthetic events. A decrease in postanesthetic food intake from baseline values was noted with both treatments (ISO15: −16% [−40% to 167%]); (ISO45: −13% [−38% to 43%]), but these fluctuations were not statistically significant between or within treatments. The total amount of food consumed per hedgehog over the 6 days following anesthesia was 99 ± 23 g/kg (ISO15) and 108 ± 28 g/kg (ISO45, P = 0.15). Conclusions and clinical relevance: Differences in duration of isoflurane anesthesia of either 15 or 45 minutes does not have a clinically relevant effect on recovery time or postanesthetic food intake in hedgehogs.     

Subcutaneous tiletamine-zolazepam immobilization and effect of flumazenil reversal in African pygmy hedgehogs (Atelerix albiventris)

African pygmy hedgehogs (Atelerix albiventris) are popular zoological companion animals that routinely require chemical immobilization for veterinary care. The objective of this randomized, blinded, cross-over study was to evaluate the efficacy of low and high dosages of subcutaneous (SC) tiletamine-zolazepam for sedation and the efficacy of flumazenil for recovery in African pygmy hedgehogs. Twelve adult hedgehogs (7 males, 5 females) were administered tiletamine-zolazepam at 10 mg/kg (T10) or 30 mg/kg (T30) SC. Physiologic variables, reflexes and behaviors were monitored to evaluate quality of immobilization. Forty-five minutes after tiletamine-zolazepam injection, hedgehogs were administered flumazenil or an equivalent volume of saline SC. Baseline daily food intake was measured and then recorded daily for 6 days following sedation trials. Median (interquartile range [IQR]) time to onset of first effects for T10 and T30 was 2.9 minutes (2.5–5.3 minutes) and 2 minutes (1.4–2.9 minutes), respectively. Eighty-three percent of T10 and 100% of T30 hedgehogs lost righting reflex. The median (IQR) duration righting reflex was lost for T10 was 32.5 minutes (23.8–37.5 minutes) and it was lost for 47.5 minutes (36.25–63.75 minutes) for T30. Jaw tone was reduced in the majority of animals for both dosages but never lost. Heart and respiratory rate for both treatments remained within normal limits. Hedgehogs became rapidly hypothermic after induction. Flumazenil administration did not have a statistically significant effect on recovery time, but mean recovery times were 18 minutes faster for T10 hedgehogs administered flumazenil. There were no statistically significant differences in food intake within or between dosages of tiletamine-zolazepam at any time point for hedgehogs administered saline or flumazenil; however, mean food intake over the 6 days following T10 administration was 16 g/kg more for hedgehogs administered flumazenil. SC tiletamine-zolazepam at 10 and 30 mg/kg produces dose-dependent heavy sedation to light anesthesia in hedgehogs. Subjectively, while both dosages provided a sufficient depth of immobilization to permit a physical examination and noninvasive procedures like blood collection or diagnostic imaging, some jaw tone was maintained precluding endotracheal intubation. T30 provided a deeper level of immobilization than T10 but longer recovery times. Flumazenil administration did not have a statistically significant effect on recovery but recovery times were noticeably faster following SC flumazenil in hedgehogs sedated with T10. For hedgehogs immobilized with T10, mean food intake was greater when flumazenil was administered. Tiletamine-zolazepam provides an injectable option for immobilization of hedgehogs.     

Plasma and erythrocyte fatty acids in captive Asian (Elephas maximus) and African (Loxodonta africana) elephants

The fatty acid components of the plasma triglycerides and the phospholipid fractions of the red blood cells of a captive group of two African (Loxodonta africana) and four Asian (Elephas maximus) elephants were investigated. All the animals received the same diet of hay, fruits and vegetables, and concentrates. A comparison with data from free-ranging African elephants or Asian work-camp elephants showed that the captive elephants had lower proportions of polyunsaturated fatty acids (PUFAs), and for several lipid fractions a higher n-6:n-3 ratio, than their counterparts in the wild or under the more natural, in terms of diet, work-camp conditions. The difference in PUFA content was smaller in the African than in the Asian elephants. The captive Asian elephants tended to have lower levels of n-3 and total unsaturated fatty acids in their red blood cells than the captive African elephants.