Medical Updates from September 1 2008
Medical Updates from July and August
Statement from Ed Clark, President and Co-Founder of the Wildlife Center of Virginia
Cause of Growth on Norfolk Botanical Garden Eaglet Confirmed as Avian Pox [5/28/08]
WVEC Chat Room Transcript – WCV President Ed Clark answers questions [5/30/08]
Background paper on Avian Pox

Support the Wildlife Center’s care of the Bald Eaglet

UPDATE: June 30 2008, 6pm

by Dr. Dave McRuer, Director of Veterinary Medicine at the Wildlife Center of Virginia

No big news today with regard to the eagle’s health, other than to report that the latest blood work is completely within normal limits for the species. Clinically, this means that no secondary infections exist and that the eagle’s immune system is in full swing. The eagle has been off all antibiotics (enrofloxicin and clindamycin) for one week and we don’t anticipate this to occur again unless other issues, such as post-surgical stress, arise.

The bird continues to perch and move around its enclosure; due to his growing body, however, he often bumps into the walls. We hope to have a larger cage in the isolation area within the next several weeks. In the meantime, we’ll likely attach a tail guard (a sheath made of a waterproof material) to the bird’s tail to prevent the feathers from becoming broken or frayed. This is standard procedure for many captive birds of prey.

Two questions have arisen recently that I’d like to address:

Question: Is the eaglet now fighting this pox on his own or is he still receiving the interferon?

Answer: Both. We are still keeping the eaglet on interferon as the mass is continuing to shrink and the surface becomes more and more dry. In all likelihood the disease is running its course and the eagle’s immune system has become sensitized to the virus. While the interferon helps boost one arm of the body’s immune system into action, all other arms are becoming more and more effective at combating the infection. At this point, we might be able to remove interferon; however, as there is no harm in giving it, it only adds to the supportive care.

Question: Once the pox is gone, is there any possibility of his developing pox in other areas?

Answer: I never like to say “never”, especially when it comes to biological systems, but the chance of the viral infection becoming clinical again (in any part of his body) is very small. Once the body’s immune system is sensitized to the antigens on the virus’s surface, it will recognize them in future infections and prevent the virus from establishing itself. From what we know in the avian system, long-lasting immunity is gained if the bird survives the initial infection. A second outbreak may occur if [1]the bird becomes immunosuppressed to the extent that major immune cell lines responsible for foreign antigen memory recognition are lost (for example, some forms of leukemia), [2] the bird is exposed to another strain of pox which the body doesn’t recognize; or [3] the current immune system “forgets” the first infection and becomes susceptible once again. All of these cases would be very rare.

UPDATE: June 26 2008, 12noon

by Dr. Dave McRuer, Director of Veterinary Medicine at the Wildlife Center of Virginia

Great news today. We decided to start exercising the eaglet’s tendons by providing a perch in the enclosure. As you can see by the picture, the bird thought this was a fantastic idea and now spends many hours of the day perching and grasping the new furniture.

We are continuing to provide supportive care and the patient continues to gain weight. From a surgical standpoint, the stars are aligning and I feel comfortable to report that we should have the mass debulked within the next two weeks. This has been a long process – longer than we had intended. However, in the interest of doing the very best for this bird, we’ve been consulting with the very best avian surgeons. The spring/summer is a very busy time for everyone and arranging schedules and the necessary equipment to perform the surgery (laser and radio surgical instruments) has been a challenge. The downfall of waiting is that the beak may be more deviated than if the surgery took place two to three weeks ago. On the other hand, the surgery would have been more risky as the mass was still in the growth phase and the immune system was not as effective.

[+] enlarge		[+] enlarge

UPDATE: June 19 2008, 6pm

by Dr. Dave McRuer, Director of Veterinary Medicine at the Wildlife Center of Virginia
There are no big medical changes in the Norfolk eaglet to report. We are still waiting to schedule surgery to debride the main mass. However, as we wait, the mass is becoming smaller, making the procedure less risky.

The eagle is being housed in our isolation room, along with other wildlife patients that need to be quarantined to prevent the spread of transmissible diseases. In addition to the baby Bald Eagle, we are currently housing in our isolation suite two Eastern Box Turtles with Mycoplasma conjunctivitis (an eye infection), a Virginia Opossum with sarcoptic mange, and a Mourning Dove with avian pox (not a concern for the eaglet). Staff members wear latex or vinyl gloves while handling patients; these gloves are disposed of between patients. The cage furniture (hide boxes, perches, food dishes, etc) are all assigned to individual patients and disinfected on a regular basis. All items in isolation stay in isolation. Before staff members can enter or leave the isolation room, they must also step through a disinfectant bath. With these protocols in place, we hope to protect all of the Center’s patients from potentially infectious disease agents.

UPDATE: June 12 2008, 3pm

by Dr. Dave McRuer, Director of Veterinary Medicine at the Wildlife Center of Virginia

The mass appears even drier today compared to yesterday. The eaglet ate well this morning and, although not taking food off the forceps, will readily eat the food when placed in his mouth.

The eaglet is still hock-sitting and will soon need branches within its enclosure in order to strengthen the tendons in his legs and feet. We hope to install a larger pen in our isolation room later this week so that the eaglet can easily begin to perch without feeling confined by the roof.

The bird keeps the nest incredibly clean by defecating through the cage door onto the window and wall two feet away. The bird’s projectile power does not seem to be hampered by the pox infection.

[+] enlarge		[+] enlarge

UPDATE: June 10 2008, 5pm

by Dr. Dave McRuer, Director of Veterinary Medicine at the Wildlife Center of Virginia

As the mass on the beak is shrinking in size and the eaglet’s white blood cell count was lowered into the range of “normal” for an eagle, Wildlife Center veterinarians decided to remove the antibiotics from the eaglet’s treatment regime. After four days, the white blood cells were rechecked; unfortunately, there was again a significant increase in the heterophils – the cells in birds that are involved in the initial defenses against bacteria. For this reason, we believe that a secondary bacterial infection is ongoing, and we have resumed our antibiotic treatment.

The eaglet continues to thrive, although it was extremely hot this past weekend with the unseasonable heat here in Waynesboro [highs in the mid to upper 90s.] To help cool the bird, we’ve placed a fan near the enclosure that ensures air circulation.

The patient has also gone back to not eating on his own. If the food (mice these days) is placed in his mouth, he has no issues with swallowing. However, the bird lacks initiative to open his mouth and actually take the food. Daily weight continues to increase, and a new dosage of pain medications is being considered.

We are close to finalizing surgery for the patient and we are hoping to nail down the date by the end of the week. There have been lots of consults with some of the best avian surgeons in the country, and we feel privileged that the veterinary community has responded favorably. While waiting for surgery, the mass continues to shrink, and this will make the operation less risky.

UPDATE: June 6 2008, 10am

by Dr. Dave McRuer, Director of Veterinary Medicine at the Wildlife Center of Virginia

The eaglet is back in good spirits again. After starting the patient on a course of butorphanol (an opioid pain medication offering the best known pain relief for birds), the eaglet is now accepting food off the forceps, making force-feeding unnecessary.

The bird continues to be active in its enclosure. Just as if it were in the nest, the eaglet defecates out the cage door, thus keeping the nest clean.

We have taken the eaglet off its antibiotics and will be repeating blood work today to assess the white blood cell count – an indication of infection status. The bird continues to grow and presently weighs 2.24kg – certainly up from the admitting weight of 1.02kg. The downy feathers have also been mostly replaced with the first layer of contour feathers.

With regard to the pox lesion… it continues to shrink! The nostril is still open and the surface of the mass is much drier and not as raised on the most forward surface. Most encouraging is the fact that the area within the mouth has receded and almost appears normal. We are still planning on surgically removing the mass and are waiting to hear back from potential surgeons.

Finally, we have received the results of our heavy metal and organophosphate panels and I’m happy to report that all were within “normal” limits. This likely indicates that these factors are not a contributing cause to the bird’s infection.

[+] enlarge		[+] enlarge

UPDATE: June 2 2008, 6pm

by Dr. Dave McRuer, Director of Veterinary Services at the Wildlife Center of Virginia:

Bald Eagle 08-0887 continues to have ups and downs. The eaglet has begun to resist feeding and no longer takes food off the forceps. At the present time, we have to physically open the bird’s mouth and place the food in the back. The upper beak has continued to deviate laterally in the direction of the lesion and the main mass has invaded the tissue over the cutting surface of the upper beak. Due to this expansion, we speculate that the bird feels pain when manipulating food and hence is hesitant to eat. In response, we have increased the dose of anti-pain medication that we administer.

On a positive note, the mass appears to have decreased in size. The left nostril, which has been pressed firmly shut by the mass since the eaglet was admitted to the Wildlife Center, is now open and functioning. This is good news.

On the surgery front, we have consulted four separate veterinary surgeons/avian veterinarians regarding potential surgical techniques. We hope to have a surgery date locked down within the next few days but it really depends on surgeon availability and scheduling.

UPDATE: May 31 2008, 6pm

by Dr. Mark Ruder at the Wildlife Center of Virginia

The Bald Eaglet was originally eating well off of a chopped plate and took bits of mice from the forceps. On Thursday and Friday, however, the bird began to occasionally refuse to eat. Today, the bird refused to eat anything off of a chopped plate OR from the forceps and was force-fed at each meal. These force-feedings are not going to help in our attempt to minimize stress for the eaglet. The bird also dropped a small amount of weight, from 2.26 kg to 2.15 kg. Our goal is to increase the bird’s body mass to help it withstand anesthesia.

No big change in the lesion, although it is difficult to objectively evaluate its growth. If anything, it is slightly larger than yesterday, especially on the underside of the beak (within the oral cavity). Today was the first full day of interferon therapy, which we hope will stop the growth of the lesion.

Dr. Ruder has completed his one-year internship as a valued member of the Wildlife Center’s veterinary team. Mark will be starting a new position as a Post-Doctoral Research Associate at the Southeastern Cooperative Wildlife Disease Study at the University of Georgia and will be concurrently working on a PhD in wildlife pathology. Thank you, Dr. Mark!

UPDATE: May 30 2008, 12 noon

by Dr. Mark Ruder at the Wildlife Center of Virginia

The eaglet continues to gain weight and enjoys both mice and fish. Unfortunately, the pox lesion is continuing to grow and is now involving the hard palate. We think that this is causing some discomfort, as the bird occasionally refuses to eat and must be force-fed. Furthermore, the mass is causing a mal-alignment of the beak, meaning that the upper and lower beak do not line up perfectly. We have started the bird on a pain medication and will monitor it closely. We are beginning another medication today – interferon – to help stimulate the bird’s immune response. As recovery from avian pox is dependent on the individual bird’s immune system, a healthy and vibrant immune response by the eagle is needed.

UPDATE: May 28 2008, 3:00pm

by Dr. Dave McRuer, Director of Veterinary Services at the Wildlife Center of Virginia

We performed an in-house test of the eaglet’s blood for lead (a common contaminant that brings Bald Eagles to our Center). The levels were below detection, indicating that this is not a contributing factor causing the mass on the beak. Blood was taken today for several other tests aimed at ruling out an environmental source. These tests include a panel looking for heavy-metal contamination and organophosphates, a common group of chemicals used in pesticides. Results should be in by the end of the week.

The mass itself continues to grow. A swelling has recently developed on the roof of the mouth, directly under the soft tissue mass. This swelling was not present when the bird arrived at Wildlife Center and is not encouraging. In addition, the top beak has begun to deviate in the direction of the mass leaving the tip of the beak at least 1/4 inch to the left of the same point on the bottom beak. Our theory is that with the disruption in the bone under the mass, the growth of the beak has slowed down compared to the same bone on the right side of the beak. As a result, the healthy right side is literally pushing/curving the upper beak to the left.

Our current treatment plan includes antibiotics to help fight secondary bacterial infections, antifungal drugs to prevent the occurrence of aspergillosis (a common fungal disease in raptors that are enduring stress), and medications to help boost the immune system. The mass is also being scrubbed daily with iodine to slow its growth and help keep any open wounds clean. We are still awaiting authorization to release biopsy results from the Virginia Department of Game and Inland Fisheries.

UPDATE: May 26 2008, 12:00pm

by Dr. Dave McRuer, Director of Veterinary Services at the Wildlife Center of Virginia

The young eagle was examined first thing this morning and appears to be in normal chatty spirits. The bird is gaining weight dramatically and takes food without hesitation.

The mass has again increased in size since Saturday and now protrudes below the cutting surface of the upper beak.

There have been a number of questions about determining the eaglet’s gender. This morning, I researched sexing Bald Eagle nestlings by measuring various aspects of the bird’s feet and beak. Based on a study by Bortolotti, 1984, I measured the eagle’s beak depth and the length of the footpad, and both measurements indicate the eaglet is a male. However, the original measurements in the Bortolotti paper were performed on a population of Saskatchewan eagles, and those eagles may be larger in overall size than Virginia birds. In addition, until an eagle is 60 days old, I cannot tell for sure based on this paper.

Statement of Ed Clark

President, Wildlife Center of Virginia
May 26, 2008

The Bald Eagle hatchling the Wildlife Center of Virginia recently received from the Norfolk Botanical Gardens is a heartrending case. It is a beautiful little creature, just under one month old. It came to us with a rapidly growing mass on its beak. The mass appears to be extremely serious.

The Wildlife Center will do absolutely everything in our power for this beautiful little bird. I have already instructed our veterinary team to go to the wall for this patient. At the same time, we will not let the celebrity status of this patient sway or influence our decisions; our first and foremost concern will be the welfare and well-being of the eaglet.

The prognosis for this little guy is not promising. I would be less than honest to imply otherwise. Nevertheless, we will use every test and treatment available to us to save its life and give it a future. I am pleased that so many people have shown such interest in this case. We will continue to update you on the eaglet’s health and any developments in its condition.

Ed Clark is the President and Co-Founder of the Wildlife Center of Virginia. He has worked with Bald Eagles for more than 20 years, both as director of the Wildlife Center’s hospital and as an advocate for threatened and endangered species. He currently serves as a steering committee member of the Endangered Species Coalition.

UPDATE: May 25 2008, 5:00pm

by Dr. Mark Ruder of the Wildlife Center of Virginia:

Not much has changed in the past 24 hours. The bird is resting comfortably and continues to have a great appetite. The young eagle gobbled down 14 mice today. The artificial nest constructed for the bird was moved near a window so that it has some natural lighting. The bird has nearly doubled its body weight since arrival just four days ago, weighing in at just over 4 1/2 pounds.

UPDATE: May 25 2008

by Dr. Dave McRuer, Director of Veterinary Services at the Wildlife Center of Virginia

The Bald Eagle nestling was taken to the Augusta Medical Center in Fishersville on Saturday afternoon [May 24] to undergo an MRI on the soft-tissue mass located on the upper beak. The purpose of this diagnostic test was to allow the veterinarians to better evaluate the extent of the mass and to better estimate how invasive it had become. The eagle was intubated and placed under general anesthesia in order to keep it perfectly still for the MRI scan. The scan took approximately 20 minutes, with the bird asleep for approximately 25 minutes. Speed was of utmost importance in order to avoid complications.

The MRI indicated that the mass had not only grown out and away from the beak, but also internally into the nasal sinus. Thus far, the mass is localized to just the front aspect of the sinus and has not crossed the septum into the front right sinus. Nonetheless, the mass has invaded both the keratin surface of the beak and the associated underlying bone. This information will be used, along with the biopsy results expected on May 28 or 29, to determine prognosis and potential treatment options.

The eagle was returned to the Wildlife Center following the MRI and was heartily eating within one hour of the trip.

UPDATE: May 24 2008, 4:00pm

On Saturday afternoon [May 24], the veterinary team from the Wildlife Center took the baby Bald Eagle to the Augusta Medical Center in Fishersville for an MRI. The Wildlife Center gratefully acknowledges AMC’s help with this case.

[+] Dr. Dave McRuer, Wildlife Center Dir. of Veternary Services and the Norfolk Botanical Garden Eaglet enter Augusta Medical Center		[+] Dr. Dave McRuer, Wildlife Center Dir. of Veternary Services, and Dr. Mark Ruder, Veterinary Intern at the Wildlife Center, with the Norfolk Botanical Garden Eaglet		[+] Dr. Dave McRuer, Wildlife Center Dir. Veternary Services watches as the Norfolk Botanical Garden Eaglet at Augusta Medical Center undergoes an MRI scan

UPDATE: May 24 2008, 12:00pm

by Dr. Mark Ruder, a member of the Center’s veterinary team:

The eagle is doing well, with no significant changes from Friday. The bird continues to eat very well; on Friday the eagle ate six large mice (two mice at each of three feedings). We plan to introduce fish to his diet today.

The bird was anesthetized on Friday for radiographs, which were unremarkable other than the mass on the beak. Bloodwork (complete blood count) was performed to make sure that there was no underlying infection. We plan to perform another blood test (serum biochemistry) in the next couple of days to better evaluate organ function. [This is just routine bloodwork; we do not anticipate any abnormalities]. Based on the radiographs, the soft-tissue mass does not appear to involve the sinuses; however, it has distorted the wall of the beak.

We are taking the eagle to Augusta Medical Center in Fishersville on Saturday afternoon for an MRI. This form of imaging will give us more information regarding just how invasive and destructive this mass is to the underlying tissue.

Coverage by the News Virginian

UPDATE: May 23 2008, 6:00pm

On Friday the Wildlife Center’s veterinary staff took radiographs [x-rays] of the young Bald Eagle taken from the nest at the Norfolk Botanical Garden. Dr. Dave McRuer, the Center’s Director of Veterinary Services, notes that the head shots “show the mass nicely. Although there are some small deviations in the underlying bone, the sinus cavities appear unaffected. Tomorrow [Saturday, May 24], we have plans to take the bird to the Augusta Medical Center hospital in Fishersville for an MRI. Hopefully this will give us further information as to the invasiveness of this growth.”

[+] Norfolk Botanical Garden Eaglet – Lateral head view radiograph		[+] Norfolk Botanical Garden Eaglet – VD head view radiograph

Support the Wildlife Center’s care of the Bald Eaglet