Page 4 - Clinical Connections - Spring 2024

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Page 4 - Clinical Connections - Spring 2024
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RVC RESEARCH    STUDY    VETERINARY SERVICES       RVC.AC.UK
         Exotics
        EXOTICS ADVANCED IMAGING

        Vicki Baldrey, Lecturer in Exotic Species and Small Mammal Medicine and Surgery

              iagnostic imaging plays an essential                               Figure 5: Slinky the ferret, at the RVC
              role in exotic animal medicine, with
        D CT an increasingly used and hugely
        useful tool, to enable fast diagnosis and
        targeted interventions.
          CT is particularly useful to help us
        diagnose respiratory disease. For example,
        in tortoises. The lung fields can be assessed
        radiographically, where moderate to severe
        changes can be detected. For more subtle
        changes,  and  to  allow  more  specific
        localisation of lesions, CT  is superior and
        can be performed consciously in tortoises.

                                              Rabbits (lop eared breeds in particular)   CT imaging helps us to plan ear surgery, if
                                            commonly suffer from ear disease. Although   required, so we know whether just the ear
                                            severe  lesions  affecting  the  middle  ear   canal, or the tympanic bullae is/are affected.
                                            may be picked up on radiographs, mild to   We may then recommend a lateral wall
                                            moderate lesions are not usually visible and   resection, partial ear canal ablation, and/or
                                            a CT scan is required to fully understand the   bulla osteotomy to treat the problem.
                                            pathology present.
                                              Figure 3 shows the normal, aerated   Whole body CT scanning
                                            tympanic bullae of a rabbit. Figure 4 shows   Complex cases with multiple comorbidities
                                            a unilateral filling of the tympanic bulla with   can also benefit from CT. Given the small
         Figure 1: CT scan of a tortoise, showing
         healthy lungs                      soft tissue material, in this case otitis media.   size of many of our exotic patients, a whole-
                                                                                body CT scan is a rapid imaging modality
                                                                                and can be performed under sedation rather
                                                                                than full anaesthesia. The ferret in Figure
                                                                                5 presented with a history of ear disease,
                                                                                respiratory signs and an abnormal shape of
                                                                                the left kidney.
                                                                                 A whole-body CT scan enabled us to
                                                                                assess the tympanic bullae, the lungs
                                                                                and  the  abdominal contents in a single
                                                                                intervention.
                                                                                 Figure 6 shows a large cyst affecting the
                                                                                left  kidney.  Diagnosis  of  these  concurrent
                                                                                diseases enabled the ferret to be treated in
                                                                                the most appropriate way, with all problems
                                                                                and their possible interactions considered.
                                             Figure 3: Normal air-filled tympanic bullae of
         Figure 2: Unilateral pneumonia in a tortoise     a rabbit

          Figure 1 shows the normal CT appearance
        of tortoise lungs. Figure 2 shows a CT scan
        of a Hermann’s tortoise with unilateral
        pneumonia. By localising the lesion, we
        were able to drill a small hole through the
        carapace  (upper  shell),  with  the  tortoise                           Figure 6: Cyst in the left kidney of a ferret
        under general anaesthesia, to access the
        lung.                                                                    The CT scanner was funded by the RVC’s
          We then drained the infected fluid, taking                            registered charity, the Animal Care Trust.
        samples for culture and cytology. A catheter
        was secured in place, running through the
        hole in the carapace, to the lung, allowing
        us to instil small volumes of antibiotic to treat                              For the RVC Exotics and Small Mammals
        the  infection. Following several weeks  of                                  Service, please call: 020 7554 3528
        treatment, the tortoise made a full recovery.   Figure 4: CT scan of a rabbit showing right     Email:
                                             sided otitis media                      londonreferrals@rvc.ac.uk

        4   Spring 2024
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