Case Study

Egg Related Peritonitis in a 30 year old F macaw bird

The patient, a 30 year old female macaw, was presented for dyspnea and a distended abdomen. The patient is being treated with Baytril and Lasix. Abnormalities on blood work include: low AST, high creatinine kinase, elevated WBCs, and elevated protein.

Sonographic Differential Diagnosis

Differentials include egg yolk peritonitis, carcinomatosis or +/- hepatic cirrhosis.

Image Interpretation

The kidneys appeared unremarkable.
The liver appeared excessively small and coarse in architecture. Echogenic bile duct was noted.
The gastrointestinal tract appeared unremarkable with ingesta in the gizzard.
The abdomen in this patient presented a large amount of echogenic free fluid with echogenic, irregular tissues. Large structures in the midabdomen are likely eggs.
The caudal abdomen revealed cystic structures with echogenic irregular tissue. This is strongly suggestive for chronic inflammation and likely progressive egg formation and rupture.

DX

Septic peritonitis

Comments

Immediate cytospin of the abdominal fluid would be recommended with assessment of the sediment for any carcinoma type cells or similar neoplastic cells. If strict peritonitis type sediment is noted then exploratory surgery and lavage would be recommended. Abdominal exploratory is the best option unless overt cancer cells are noted on the sediment. Very guarded prognosis.