pododermite em cisne negro (cygnus atratus) em moçambique · 2018-12-18 · pododermite em cisne...

ISSN 1679-9216

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CASE REPORTPub. 344

Acta Scientiae Veterinariae, 2018. 46(Suppl 1): 344.

Received: 24 July 2018 Accepted: 10 October 2018 Published: 28 November 2018

1Pós-doutorando em Cirurgia de Pequenos Animais, Departmento de Cirurgia e Anestesiologia Veterinária (DCAV); 2Programa de Pós-graduação em Biotec-nologia Animal; 3Programa de Pós-graduação em Animais Selvagens; 4Curso de Medicina Veterinária & 1Pós-doutorando em Cirurgia de Pequenos Animais, Departmento de Cirurgia e Anestesiologia Veterinária (DCAV); 2Programa de Pós-graduação em Biotecnologia Animal; 3Programa de Pós-graduação em Ani-mais Selvagens; 4Curso de Medicina Veterinária & 5Departmento de Cirurgia e Anestesiologia Veterinária (DCAV). Universidade Estadual Paulista(UNESP), Faculdade de Medicina Veterinária e Zootecnia (FMVZ), Botucatu, SP, Brazil. CORRESPONDENCE: I.F.C. Santos [[email protected] - Tel.: +55 (14) 3880-2022]. Setor de Cirurgia Animal, FMVZ – UNESP. Distrito de Rubião Junior, s/n. CEP 18618-681, Botucatu, SP, Brazil.

Pododermite em Cisne Negro (Cygnus atratus) em Moçambique

Bumblefoot in Free-Living Black Swan (Cygnus atratus) in Mozambique

Ivan Felismino Charas dos Santos1, Bruna Martins da Silva2, Barbara Sardela Ferro3, David José de Castro Martins2, Gustavo Manea Ferreira2, Marina Paiva Branco2, José Ivaldo de Siqueira Silva Júnior2,

Mayra de Fátima Solano Blazizza4, Thais Hamae Sato4 & Sheila Canevese Rahal5

ABSTRACT

Background: Black Swan (Cygnus atratus Linnaeus 1766) is an aquatic bird native to Australia and non-migratory birds. Bumblefoot is a chronic, progressive, degenerative and granulomatous disease that affects the plantar region and causes inflammation and degenerative changes in plantar tissues. Given that bumblefoot incidence in free-living wild birds is low and that the literature lacks publications about bumblefoot in free-living Black Swans, the aim of the current study is to describe the first bumblefoot case reported in a free-living Black Swan (Cygnus atratus) in Mozambique who was subjected to surgical procedure.Case: An adult intact Black Swan (Cygnus atratus) weighing 7.2 kg was presented to Veterinary Hospital of the Veterinary Medicine School, Mozambique with reluctance to support the left hind limb. Water intake was not unsettled and urine and feces were normal. A brown mass with 3 cm diameter approximately was identified in the footpad of the left hind limb; there were local bleeding and ulcers and pain. Footpad radiographic images of the left hind limb showed no abnormalities in the bone tissue. An incisional biopsy was performed with patient under sedation. The cytopathological examination was suggestive of bumblefoot. An excisional biopsy was performed with patient under anesthesia. The mass was excised with surgical margin of 1 cm and the local was subjected to debridement. The sample was sent to histopathological examina-tion. The histopathological examination confirmed a chronic Bumblefoot Type 2. The patient started to support the left hind limb three days after surgery and twenty days after surgery, the footpad sutures were removed. Fifty days after the surgical procedure the patient was released in the site it was rescued.Discussion: The present case report describes the clinical and diagnostic treatments, as well as the histopathological find-ings about a chronic bumblefoot type 2 diagnosed in a free-living Black Swan. Bumblefoot is uncommon in free-living wild birds, since they have the possibility of choosing a habitat that allows natural plantar desquamation. There are no reports in the literature describing bumblefoot in free-living Black Swan (Cygnus atratus) in Mozambique. Bumblefoot occurrence in birds can change depending on body mass and age. Older and heavier birds are the most affected by the condition, which is associated with immune defense decrease and with increased pressure on the footpad region. Toxins produced by microorgan-isms inhibit phagocytosis and coagulase stimulates the formation of a fibrin barrier that isolates them from the action of the animal’s immune defense in the acute phase of bumblefoot. The present reported case was classified as chronic bumblefoot type 2 given the lesion features: infection of the dermis without purulent content. Chronic bumblefoot reports highlight the animals’ reluctance to support the limb and pain, similar to the clinical signs of the present report. Radiographic examina-tions allowed assessing bone commitment and histopathological exams enabled the final diagnosis. Treatment modalities have already been implemented in bumblefoot in aquatic birds, including antibiotic therapy, surgical debridement and photodynamic therapy, however, surgical therapy was better than the clinical one. The literature recommends an excisional biopsy with debridement of the lesion in birds due to the reduction of the antigenic load and inflammatory debridement. In conclusion, bumblefoot was a rare condition in free-living wild birds; its clinical diagnosis must be made through cyto-pathological examination and confirmed through histopathological exams. Surgery is recommended as therapy of choice.

Keywords: bird, plantar tissue, surgery, Mozambique, Africa.

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I.F.C. Santos, B.M. Silva, B.S. Ferro, et al. 2018. Pododermite em Cisne Negro (Cygnus atratus) em Moçambique. Acta Scientiae Veterinariae. 46(Suppl 1): 344.

INTRODUCTION

Black Swan (Cygnus atratus Linnaeus 1766) is an aquatic bird native to Australia [15]. The species belongs to Family Anatidae, which also comprises ducks and geese [15]. Although Black Swans are non--migratory birds, they can travel long distances to find food [15]. The species lives in lakes at least one meter deep, but it can be found in places close to the water, including sea shores and, occasionally, in open sea [15].

Bumblefoot is a chronic, progressive, degene-rative and granulomatous disease that affects the plan-tar region and causes inflammation and degenerative changes in plantar tissues [21,22]. All bird species can present this condition; however, it is often identified and reported in domestic birds and rarely observed and reported in wild birds [5]. The following factors reduce bumblefoot incidence in free-living birds: their continuous physical activity, better control over the landing impact and the possibility of choosing a habi-tat presenting diameter and texture that allows natural plantar desquamation [21]. Prognosis is poor in birds with proliferative lesions [18].

Given that bumblefoot incidence in free-living wild birds is low and that the literature lacks publica-tions about bumblefoot in free-living Black Swans, the aim of the current study is to describe the first bumblefoot case reported in a free-living Black Swan (Cygnus atratus) in Mozambique who was attended at the Veterinary Hospital of the Veterinary Medicine School, and subjected to surgical procedure. Clinical presentation, diagnostic evaluation, treatment and his-tological diagnosis of bumblefoot are also described.

CASE

An adult intact Black Swan (Cygnus atratus) weighing 7.2 kg, and 1.1 m of body length was presen-ted to Veterinary Hospital of the Veterinary Medicine School, Mozambique (GPS: 25° 54’ 32.8’’ S; 32° 33’ 57.8’’ E), with reluctance to support the left hind limb. Water intake was not unsettled and urine and feces were normal. The patient was found by the National Forest Guard near the border with South Africa (GPS: S 25 ° 27 ‘22.3’ ‘, E 31 ° 59’ 33.3 ‘’). Sex determination was performed through DNA examination and subsequent Polymerase Chain Reaction (PCR) examination. On physical examination there was observed a rectal tem-perature of 43ºC (normal range: 40 - 41ºC). A brown mass with 3 cm diameter approximately was identified

in the footpad of the left hind limb; there were local bleeding and ulcers in 10% of the lesion (Figure 1). During palpation of the footpad committed was obser-ved pain. The remainder of the physical examination was within normal.

Plantodorsal radiographic images of the foo-tpad region of the left hind limb showed no abnorma-lities in the bone tissue and in the surrounding soft tissue. Based on results of physical and radiographic examinations, the decision was made to perform an incisional biopsy. The patient was sedated with 0.3 mg.kg-1 [intramuscular (IM)] of morphine (Dimorf®)1, and 1.5 mg.kg-1 [intranasal (IN)] of midazolam (Dor-monid®)2. In addition, 10 mg.kg-1 (IM) of enrofloxacin (Zelotril®)3 was administered.

The cytopathological examination revealed presence of neutrophils, tissue destruction, and absen-ce of cells with neoplastic characteristics, suggestive of bumblefoot. According to the clinical signs and cytopathological examination, an excisional biopsy was performed.

The patient was premedicated with 2 mg.kg-1 [subcutaneous (SC)] of carprofen (Rimadyl®)4. Anes-thetic induction was performed with a combination of

Figure 1. Photography showing a mass with 3 cm diameter with brown color on the footpad of the left hind limb of adult male Black Swan (Cygnus atratus), and local bleeding and ulcers in 10% of the lesion.

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6 mg.kg-1 (SC) of ketamine (Dopalen®)5 and 1 mg.kg-1 (SC) of xylazine (Anasedan®)5. Anesthesia was perfor-med with 3 mg.kg-1 (IM) of ketamine (Dopalen®)5. The surgical procedure took 32 minutes. Excisional biopsy was performed with patient in lateral recumbence, and the footpad was submitted to antisepsis with chlorhexi-dine (2%) (RioHex®)6. The surgical procedure took 32 minutes. The mass was excised with surgical margin of 1 cm and the local was subjected to debridement. The footpad was sutured with captonated single isolated suture patterns using surgical nylon 2.0 (Shalon®)7 [Figure 2A, 2B and 2C]. After the surgical procedure a compression bandage was performed (Figure 2D).

The sample was placed in sterile Petri dish for immediate histopathological examination, as well as for culture, bacterial and fungal isolation and antibio-gram. The patient recovered uneventfully from surgery. It was prescribed 10 mg.kg-1 BID orally for 7 days of enrofloxacine (Zelotril®)8 and 1 mg kg-1 SID orally for 5 days of carprofen (Rimadyl®)4. The surgical wound was treated daily with diluted iodine povidone (1:10), and the bandage was changed every 24 hours until sutures were removed.

The histopathological examination of the foo-tpad mass revealed presence of massive, multifocal

and diffuse infiltration of lymphoplasmacytic inflam-matory cells, tissue destruction, and epithelial necrosis (Figure 3).

The histopathological diagnosis confirmed chronic Bumblefoot Type 2. The fungal exam was negative and microbiological examination showed presence of Staphylococcus aureus with high sensi-tivity for enrofloxacin and cephalexin. The patient remained hospitalized in the Veterinary Hospital for 20 days on a grassy field. Diet was based on chicken remains and vegetables. The patient started to support the left hind limb three days after surgery. Twenty days after surgery, the footpad sutures were removed. The animal presented no physiological alteration fifty days after the surgical procedure (Figure 4); therefore, was released in the site it was rescued.

DISCUSSION

This case report describes the clinical and diagnostic treatments, as well as the histopathological findings about a bumblefoot diagnosed in a free-living Black Swan. Bumblefoot is uncommon in free-living wild birds, since they have the possibility of choosing a habitat that allows natural plantar desquamation [21]. To the best of the author’s knowledge, there are no reports in the literature describing bumblefoot in free--living Black Swan (Cygnus atratus) in Mozambique.

Figure 2. Photography of the excisional mass biopsy. A- Footpad of the left hind limb after mass excision and wound debridement. B- Temporary hemostasis with Halsted hemostatic clamps. C- Footpad was sutured with captonated single isolated suture patterns using surgical nylon 2.0. D- Compression bandage.

Figure 3. Photomicrography of footpad mass of adult male Black Swan (Cygnus atratus) diagnosed with chronic pododermatitis type 2 showing an infiltration of lymphoplasmacytic inflammatory cells (white arrows), tissue destruction, and epithelial necrosis [HE 10x & 40x]. [Bar= 100 µm].

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Black Swan (Cygnus atratus) is a water bird species native to Australia, although it is also identified as self-sufficient populations in Great Britain, Iceland, Poland and in the Netherlands [15]. In Mozambique, they are classified as exotic birds who were introduced in the region. Black Swan individuals spend their lives in the places where they are born, but they have the ability to adapt to the local flora, since they can nest in large embankments [15].

The body weight and body length of the patient was similar to that reported in the literature which mentioned body weight and body length of 6.3 kg - 8.7 kg and 1.2 e 1.4 m, respectively [15]. It is not possible to identify phenotypic differences between male and female from the age of two on [15]; there-fore, sex determination was performed through DNA and PCR examination.

Bumblefoot occurrence in birds can change depending on body mass and age [2,14]. Older and heavier birds are the most affected by the condition, which is associated with immune defense decrease and with increased pressure on the footpad region [2,14]. Disease pathogenesis is associated with direct inoculation of microorganisms in the wound and with their proliferation in subcutaneous tissues [21]. Toxins produced by microorganisms inhibit phagocytosis and coagulase stimulates the formation of a fibrin barrier that isolates them from the action of the animal’s

immune defense in the acute phase of bumblefoot [21]. It is possible to observe presence of fibrosis [21] and of histological skin changes in the chronic phase of the disease [3].

The herein reported case was classified as chronic bumblefoot type 2 given the lesion features: infection of the dermis without purulent content [18]. Assumingly, the primary cause of bumblefoot was a trauma penetrating the footpad region, similar to the literature [24].

Clinical signs are associated with swelling of footpad region, changes of the corneal extract of plantar epithelium [16], abscesses, pressure ulcer and secondary infection [1,7,10]. The presence of pain on the committed footpad has already been reported and it is an animal welfare issue [4,13]. Although the basal layer of the epidermis remains intact in animals suffering from the condition, acute bumblefoot cases showed epidermis crust [8]. Chronic bumblefoot reports highlight the animals’ reluctance to support the limb and pain [12,13], similar to the clinical signs observed in our report. The ulceration observed on the footpad was associated with changes in local vascularization [5,7,10], and pain was related to local inflammation [4,21].

The diagnosis was based on information available in the literature [11] and through physical examination and palpation over the affected region. Radiographic examinations allowed assessing bone commitment and histopathological exams enabled the final diagnosis [11]. Incisional biopsy was important to assure the presence, or not, of neoplasia and to set a previous diagnosis.

Treatment modalities have already been imple-mented in bumblefoot in aquatic birds, including anti-biotic therapy, surgical debridement and photodynamic therapy [6,17,20,24]. The surgical therapy was better than the clinical one [9]. The effects of Whole-Body Vibration were assessed by using a vibrating platform as alternative treatment for bumblefoot in penguins [23]. The superficial temperature of the footpad region was measured in healthy penguins and with bumblefoot type 2 during the use of the vibrating platform [23].

The surgical procedure must be performed as soon as possible in order to avoid tissue mineralization and osteomyelitis in birds [24]. The herein reported swan did not present osteomyelitis in the radiographic examination. The literature recommends an excisional

Figure 4. Photography of the footpad of the left hind limb 50 days after surgery (white arrow).

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biopsy with debridement of the lesion in birds due to the reduction of the antigenic load and inflammatory debridement [9,10]. This procedure enables faster postoperative period than the clinical therapy [9,10]. Excisional biopsy with surgical margin of 1 cm was used as therapy option in the present case, similar from the literature [10].

Staphylococcus aureus was identified in the sample sent to the microbiological examination, simi-lar from the study performed with 100 penguins with bumblefoot [19]. Staphylococcus spp. and Corynebac-terium spp. were permanent or transient microbial bac-teria in bumblefoot cases reported for penguins [19].

Thus, in conclusion, bumblefoot is a rare con-dition in free-living wild birds, its clinical diagnosis must be made through cytopathological examination and confirmed through histopathological exams.

Surgery is recommended as therapy of choice. To the best of the authors’ knowledge, this is the first report of a bumblefoot case observed in a free-living Black Swan (Cygnus atratus) in Mozambique.

MANUFACTURERS1Cristália Produtos Químicos e Farmacêuticos Ltda. Itapira, SP, Brazil.2Produtos Roche Químicos e Farmacêuticos S.A. Rio de Janeiro, RJ, Brazil.3Agroline Comércio De Produtos Veterinários Ltda. Campo Grande, MS, Brazil.4Zoetis Brasil - Saúde Animal. Campinas, SP, Brazil.5Ceva Saúde Animal. Paulínia, SP, Brazil.6Indústria Farmacêutica Rioquimica Ltda. São José do Rio Preto, SP, Brazil.7Shalon Medical - Shalon-Fios Cirurgicos Ltda. Goiânia, GO, Brazil.8Agener União - Saúde Animal. Osasco, SP, Brazil.

Declaration of interest. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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http://seer.ufrgs.br/ActaScientiaeVeterinariaeCR344

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pododermite em cisne negro (cygnus atratus) em moçambique · 2018-12-18 · pododermite em cisne...

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