A 20-year-old, female saddle-billed stork (Ephippiorhynchus senegalensis) was diagnosed with grade III/VI heart murmur and mitral regurgitation after osteomyelitis and resultant toe amputation. Treatment was attempted with antibiotics and enalapril, but medicating was unsuccessful. Four years later the mitral regurgitation and heart murmur had worsened (grade IV/VI). Treatment with enalapril (0.5 mg/kg SID PO; Wockhardt Ltd., Mumbai, India) and furosemide (0.2 mg/kg SID PO; Vedco, Inc., St. Joseph, MO, USA) was again attempted, and medications were successfully delivered 60% of the time. The bird was clinically normal for 8 months, but then showed acute lethargy and anorexia. Cardiac consultation revealed atrial fibrillation, pulmonary edema, and hepatic congestion. Digitalization (15 µg/kg BID PO; Jerome Stevens Pharmaceuticals, Inc., Bohemia, NY, USA) and increased diuresis initially improved the bird’s condition, but the animal was found dead 10 days after first signs of decompensated heart failure. At necropsy dilation of the left ventricle and atrium and thickening of the mitral valve were noted. Histologic examination revealed myocardial degeneration and fibrosis.
Cardiac disease is not uncommon but infrequently diagnosed in birds.2 Several institutions holding this species have recently noted heart murmurs and cardiomegaly. Infection with the filarid Paronchocerca ciconarum has been previously reported1 but this individual did not appear to be infected. Full cardiac examination should be considered to screen individuals of this species and to help clarify findings and etiologies to enable early treatment of cardiac disease, since several cases such as this one have anecdotally responded to medical treatment.
1. Echols MS, Craig TM, Speer BL. Heartworm (Paronchocerca ciconarum) infection in 2 saddle-billed storks (Ephippiorhynchus senegalensis). J Avian Med Surg. 2000;14:42–47.
2. Pees M, Krautwald-Junghanns M-E, Straub J. Evaluating and treating the cardiovascular system. In: Harrison GJ, Lightfoot TL, eds. Clinical Avian Medicine. Palm Beach, FL: Spix Publishing, Inc.; 2006:386–389.