RE: Is this gout?

KMurphy — Fri, 19 Aug 2016 17:06:26 GMT

Thanks Marie, that's really useful. He's booked to come back and see me on Monday so we'll see how we get on from there!

Thanks again :)

RE: Is this gout?

Marie Kubiak — Fri, 19 Aug 2016 16:49:23 GMT

It does look like gout- the pockets of pale material over foot joints is a typical presentation.

An aspirate will help a lot- you don't need to do the chemical tests to confirm, just rub material between two glass slides. Uric acid crystals will feel really gritty. Smooth exudate can then have cytology done to differentiate other causes- it could be bacterial abscessation (including Mycobacterium avium), lymphoma or other neoplasia or xanthomata.

The wing lesions are common as a secondary consequence- a bird with painful feet will struggle to ambulate and open the wings to balance. Repeated stumbles traumatise the leading edge of the wing, especially around metacarpi, and trauma and haemorrhage progresses to xanthomatous masses.

If gout then prognosis is poor as it is unlikely this bird will recover to a comfortable status. Patenteral fluids, allopurinol, uricase, opioid analgesia and sterile drainage of larger pockets can be used to improve the situation but I would also do bllodwork as a general health screen. Advanced renal damage and concurrent hepatopathy are not uncommon and may steer towards euthanasia rather than palliation.

Marie

RE: Is this gout?

MattB — Fri, 19 Aug 2016 16:12:14 GMT

If they're on the wings too, could they be xanthomata?