bacterial sinusitis in a common hill myna

1. BACTERIAL SINUSITIS IN
a Gracula religiosa
Muhammad Aqmal Hakim Bin Mazlan (160702)
Supervisor: Dr Jalila Abu
Co-Supervisor: Dr Abraham Gabriel

2. Introduction
Case report
Discussion
Conclusion

3. INTRODUCTION

4. COMMON HILL MYNA
Common hill myna or ‘Tiong Mas’
Green-glossed black plumage body colour
The wattles, bill and legs are bright yellow
Range from the southern part of Thailand to Malaysia and
Indonesia
It is known for its ability to mimic noises including human speech.
Order: Passeriformes
Family: Sturnidae
Genus: Gracula
Species: Gracula religiosa
(Birdlife.org)

5. • Sinusitis is an inflammation of one or more of the paranasal
sinuses, often occurring during an upper respiratory infection, by
extension from the nasal cavity.
(Blood, Studdert & Gay, 2007)
• Sinus is any of various air-
filled cavities in the bones of
the skull, especially one
communicating with the
nostrils.
(Dictionary.com)
(Doneley,B. 2011)

6. CASE REPORT

7. PATIENT SIGNALMENT
• ID: Tiong
• Age: Adult
• Sex: Female
• Common name: Hill Myna
• Scientific name: Gracula religiosa
• Weight: 0.26kg
• Management: Pet bird

8. HISTORY
Owner noticed
swelling left
eyelid with fluid
filled mass
Visit UVH after
the mass
became firm
upon palpation
27 October 2015
2 weeks before

9. PHYSICAL EXAMINATION
• Bright and alert
• Body Condition Score: 3/3
• Ulcerated mass at the
upper eyelid about 3cm X
2cm in diameter of the left
upper eyelid.
• The eye is still functioning
and responded to light.

10. Problem list Differential
diagnosis
Plan
#1 Ulcerated mass of
the left upper eyelid
1. Sinusitis
2. Neoplasia
(Papilloma,
Lipoma)
3. Hypovitaminosis A
1. Fine needle
aspiration (FNA)
2. Complete blood
count
3. Surgery of mass
removal
4. Swab for
bacteriology lab

11. FNA RESULT
Presence of cocci-shaped
bacteria
INCONCLUSIVE!

12. COMPLETE BLOOD COUNT
Haemogram Result Reference value Interpretation
Erythrocyte Insufficient blood 2.08-4.02
Hemoglobin Insufficient blood 36-204
Leucocytes 45.0 1.75-16.44 Marked
heterophilia with
left shift,
monocytosis,
eosinophilia;
indicating infection
or inflammation
Seg. Heterophils 29.25 0.26-7.67
Monocytes 10.35 0.06-2.38
Eosinophils 1.35 0.05-0.61
Thrombocytes Insufficient blood
Plasma protein 68
Icterus index Lysed

13. SURGICAL procedure for MASS REMOVAL
OF LEFT UPPER EYELID

14. ANESTHETIC PROTOCOL
• Induction: Isoflurane 5 % + 0.5 litre Oxygen per minute
• Maintenance: Isoflurane 2.5 % + 0.5 litre Oxygen per minute

15. Close up view of the
mass (approximately
3cm x 2 cm)
CranialCaudal

16. Elliptical skin incision
was made on the
mass by using blade
#15
CranialCaudal

17. The mass was
curetted by using
Volkmann's spoon
CranialCaudal

18. The excess skin was
incised and removed by
using Mayo scissors.
Any bleeding was
observed and dabbed
with sterile gauze.
CranialCaudal

19. 5 mL of normal saline and
5 mL of Metrogyl was
flushed into the cavity
CranialCaudal

20. Subcutaneous
closure was done
using Vicryl 5-0
absorbable suture
material with
modified cushing
pattern
CranialCaudal

21. Skin closure:
Skin closure was
done using Vicryl
5-0 absorbable
suture material
with intradermal
suture pattern.
CranialCaudal

22. Terramycin
was applied
on the suture
site

23. Casseous
material: firm
and yellow
colour

24. POST-OPERATIVE MANAGEMENT &
TREATMENT
• Monitor suture site
• Monitor appetite
• Antibiotics-Enrofloxacin, 10 mg/kg, 0.52mL,
PO, BID for 10 days
• NSAIDS- Carprofen, 4 mg/kg, 0.16 mL, PO,
SID for 5 days
• Supplements- Multivitamin, 0.2 mL, PO,
SID, for 5 days

25. PROGRESSION DAY 1 POST SURGERY
Bright and alert & good appetite
Suture site was dry and intact
No discharge was observed from suture site

26. BACTERIOLOGY RESULT
Pure culture of E. coli

27. ESCHERICHIA COLI
• Facultative (aerobic and anaerobic growth) gram-negative, rod shaped
bacteria that can be commonly found in animal feces, lower intestines of
mammals and in the environment.
(MicrobeWiki.kenyon.edu)

28. FINAL DIAGNOSIS
Bacterial sinusitis due to Escherichia coli

29. PROGNOSIS
GOOD

30. DISCUSSION

31. Common organisms
Predisposing factors
Treatment modalities
Choice of anesthetics

32. COMMON ORGANISM
Pseudomonas sp.
E. coli
Lactobacillus sp
Micrococcus sp
Mycoplasma sp
(Phalen, 2000)
(Tully & Harrison 1994)

33. PREDISPOSING FACTORS
• Complex anatomy of
the infraorbital sinuses
• Hypovitaminosis A
• Irritation to the sinuses
• Extreme humidity
• Choanal atresia
(Tully & Harrison 1994)

34. TREATMENT MODALITIES
Nasal flushing
Surgical Resection
Aerosol therapy
(Tully & Harrison 1994)

35. CHOICE OF ANESTHETICS
• Inhalants
• Rapid induction & recovery
• Rapid and frequent adjustments in
anaesthetics depth
• Minimal biotransformation
• Minimal cardiorespiratory side
effects or toxicity
• Isoflurane, Sevoflurane
(Gunkel & Lafortune 2005)

36. • Injectables
• Do not require special equipments and
machines
• Can be administered through many
different routes (IV,IM,SQ & IP)
• Potential for prolonged and/or rough
recoveries
• Need for an accurate weight for
appropriate dosing
• Propofol, Ketamine etc
(Furtado & Andrade, n,d.)

37. CONCLUSION

38. CONCLUSION
• This is a case report of a common hill myna that was
diagnosed with bacterial sinusitis, where it was
surgically resected and managed with good clinical
outcome.
• Treatment combination of antibiotics, aerosol therapy,
and surgical resection often produce successful
outcomes.
• A good management of pet birds in captivity could
reduce the risk of occurrence of the disease.

39. ACKNOWLEDGEMENT
• Allah SWT
• Dr Jalila
• Dr Abraham, Dr Shafiq, Dr Wan
• DVM5 Rotation group 3, Siti Noor Fadhilah Azihi
• Nur Arina Binti Ahmad Jelani
• DVM class 2016
• Audience

40. REFERENCES
•
• BirdLife International. 2012. Gracula religiosa. The IUCN Red List of Threatened Species 2012:
e.T22710993A39682701. http://dx.doi.org/10.2305/IUCN.UK.2012-1.RLTS.T22710993A39682701.en. Downloaded
on 26 November 2015.
• Blood, D., Studdert, V., & Gay, C. (2007). Sinusitis. Saunders Comprehensive Veterinary Dictionary. Edinburgh:
Elsevier.
• Curro TG: Anesthesia of pet birds. Sem Avian Exot Pet Med 7:10-21, 1998
• Furtado, KS, and FO Andrade. 'Comparison Of The Beneficial And Adverse Effects Of Inhaled And Injectable
Anaesthetics: A Mini-Review.OA Anaesthetics'. Oapublishinglondon.com. N.p., 2015. Web. 29 Nov. 2015.
• Gunkel, C., & Lafortune, M. (2005). Current Techniques in Avian Anesthesia. Seminars In Avian And Exotic Pet
Medicine, 14(4), 263-276. http://dx.doi.org/10.1053/j.saep.2005.09.006
• Microbewiki.kenyon.edu,. (2015). Escherichia coli - MicrobeWiki. Retrieved 23 November 2015, from
https://microbewiki.kenyon.edu/index.php/Escherichia_coli
• Phalen DN: Respiratory medicine of cage and aviary birds, Vet Clin North Am Exot Anim Pract 3: 423-452, 2000
• Sinus. (n.d.) American Heritage® Dictionary of the English Language, Fifth Edition. (2011). Retrieved December 2
2015 from http://www.thefreedictionary.com/sinus
• Tully TN, Harrison GJ (1994). Pneumology. In: Avian Medicine: Principles and application. BW Ritchie, GJ Harrison,
LR Harrison (eds). Wingers Publishing, Lake Worth, pp. 556-606.

41. THANK YOU