Zocor
By N. Fadi. United Theological Seminar.
Injuries Chicks receiving adequate parental care will have Nestlings may be injured by their parents order zocor 20 mg overnight delivery cholesterol levels beef, other food in their crops and yellowish-pink skin (Color nestlings or improper nest box construction (eg buy zocor 20 mg lowest price cholesterol levels video, ex- 30. Chicks that have empty crops, act listless and posed nails, slippery nest material). Poor nutrition are cool to the touch are receiving inadequate care can cause metabolic bone disease and make the and should receive immediate attention. Many of the chicks may be hypothermic, hypoglycemic, dehy- larger psittacines are territorial and may traumatize drated or have bacterial or yeast infections. To prevent lution to many of the problems associated with par- these injuries, the nest box can be equipped with a ent-raised neonates is to remove them for sliding door over the entrance hole to exclude the hand-raising. Care of the critically ill neonate is parents from the nest box while chicks are being described in the section on hand-raising. Chicks may also traumatize each other, most frequently injuring the beak, face and wing tips. Parental Problems Parenting is a learned process and captive birds do Infectious Diseases not always make ideal parents, especially with the Microbial infections (gram-negative bacteria, first few clutches. Parents may eat, traumatize or chlamydia, viruses and yeast) and internal parasites abandon the eggs or the chicks. Some parents never (eg, giardia and trichomoniasis) are frequent causes learn to provide adequate care; others may learn to of mortality in nestling birds (Figure 30. Most psit- tacine birds lay eggs every two to three days and start incubation when the first egg is laid. Highly pro- ductive species such as cockatiels may lay an additional clutch before fledging chicks from the previous lay. These adults may remove the feath- ers from the chicks in an attempt to encourage them to leave the nest. Any factor that decreases the for food, or if the nest box is cold, hot, damp or infested with vermin. Chicks that are being raised by the parents should be observed daily, if the parents will allow it, to ensure they vigor of the chicks (disease, cold, are receiving proper care. Neonatal mortalities may indicate disease or management-re- lated problems within the collection that can be identified by postmortem examination. If cockroaches enter the nest box and die from the insecticide, they may be eaten by either the parents or nestlings and sub- sequently transmit Sarcocystis sp. These deaths may indicate underlying bacterial Husbandry and Preventive Medicine or viral infections in the flock. Note the egg tooth and membrane covering the ear in this 28-day-old Moluccan Cockatoo embryo. Psittacine chicks are altricial, and as neonates they are unable to thermoregulate, unable to feed them- matic carriers) and contaminated food, water or nest selves and have a poorly developed immune system. Ill nestlings should be pulled for hand-feed- Consequently, diet and environmental conditions ing and appropriate treatment. When faced with be raised separately from other neonates and should a neonatal health problem, it is essential for the not be fed by the same person who cares for the other clinician to carefully evaluate the environmental birds in the nursery. If this is not possible, some conditions, hygiene practices and feeding methods in microbial infections can be treated by offering medi- the nursery. Books are available on hand-feeding cated food to the parents who will then feed it to the practices and it is beyond the scope of this chapter to nestlings. Fortunately, adult birds are often less se- completely discuss all aspects of hand-raising. The lective of their diet while feeding offspring and may purpose of this section is to introduce the avian vet- accept foods that they would ordinarily refuse. Par- erinarian to the most important factors to consider ents preferentially feed nestlings soft, moist food, when investigating neonatal health problems (Table which should be offered fresh two to three times 30. Only highly susceptible microbial infections raising healthy psittacine chicks is providing them can be treated by offering medicated food to the with ample rest periods in which they are not dis- parents, because it is difficult to achieve adequate turbed between feedings.
In one study zocor 10mg with visa bon cholesterol definition, supplementing the diet of postmenopausal women with 3 mg boron per day reduced urinary calcium excretion by 44% and dramatically increased levels of 17-beta-estradiol purchase 10 mg zocor visa how much cholesterol in eggs benedict, the most biologically active estrogen. A boron deficiency may contribute greatly to osteoporosis and to menopausal symptoms. Because fruits and vegetables are the main dietary sources of boron, diets low in these foods may be deficient in boron. In order to guarantee adequate boron levels, supplement with 3 to 5 mg boron per day. Prunes may also be able to help offset women’s significantly increased risk for accelerated bone loss during the first three to five years after menopause. When 58 postmenopausal women ate about 12 prunes each day for three months, they were found to have higher blood levels of enzymes and growth factors that indicate bone formation than women who did not consume prunes. Prunes’ beneficial effects on bone formation may be due to their high concentration of phenolic compounds that act as antioxidants and help curb bone loss. Prunes also provide a good supply of boron, a trace mineral integral to bone metabolism that is thought to play an important role in the prevention of osteoporosis. The binding of soy isoflavones to estrogen receptors is preferential for the estrogen receptor beta and thus indicates that soy isoflavones act as selective estrogen modulators similar to Evista, but seemingly without the side effects. Soy foods or soy isoflavone supplements have the potential to favorably affect bone metabolism, yet they remain a bit controversial in the medical literature due to the inconsistencies in the studies that have been done to date. Nonetheless, there is considerable evidence that soy has a bone-building effect, as many studies have shown that soy or soy isoflavones can slow bone turnover and increase bone density in women. Menopausal women taking 55 to 90 mg soy isoflavones for six months had an increase in mineral levels and density in the lumbar spine. In addition, the benefits of soy in bone health may be more apparent in postmenopausal women than in premenopausal women. A diet that includes greater amounts of soy products can account for a meaningful amount of calcium, and some soy foods can offer at least as much calcium as a serving of dairy products. However, calcium alone provides very little benefit in protecting against osteoporosis; vitamin D, vitamin K, and other nutrients are required as well). In postmenopausal women, calcium supplementation has been shown to decrease bone loss by as much as 50% at nonvertebral sites. The effects were greatest in women whose baseline calcium intake was low, in older women, and in women with established osteoporosis. Studies are clear that the benefits seen at 2,000 mg per day are not greater than those seen with 1,000 mg. Taking large doses of calcium can impair the absorption of magnesium and other minerals. Avoid oyster-shell calcium, dolomite, and bonemeal products because these forms tend to have higher lead levels. We prefer easily ionized forms of calcium such as calcium citrate, but the reality is that if taken with meals even calcium carbonate is effectively absorbed in most people. We also like tricalcium phosphate, for the following reasons: 101,102 • Tricalcium phosphate provides three molecules of calcium for every molecule of phosphorus, so it is a highly efficient source of both calcium and phosphorus. While too much phosphorus is not a good thing, especially when it is not accompanied by calcium (as in soft drinks and animal meats), so too is not enough, especially in regard to the absorption of calcium. While numerous clinical studies have demonstrated that calcium and vitamin D supplementation can help prevent bone loss, the data are inconclusive in regard to any link between a high dietary calcium intake from milk and prevention of osteoporosis and bone fractures. In fact, the current available data indicate that frequent milk consumption actually increases the risk for osteoporosis. When reviewing the data from the Nurses’ Health Study, a study involving 77,761 women, researchers found that women who drank two or more glasses of milk per day had a 45% increased risk for hip fracture compared with women consuming 1 glass or less per week. This negative effect may turn out to be due to the vitamin A added to milk (at higher levels, vitamin A, but not beta- carotene, may interfere with bone formation). Interestingly, the rate of osteoporosis is considerably higher in countries where milk intake is highest. Vitamin D As discussed above under “Diagnostic Considerations,” vitamin D plays a major role in bone health.
This bird was a fecal antigen test zocor 20mg with visa qrisk cholesterol ratio, and the bird responded housed in an area that contained a water- to doxycycline therapy buy zocor 10 mg with mastercard cholesterol i eggs. Peri- plasia, either primary or secondary, can cause similar orbital papilloma-like virus infection in an African clinical changes. Periorbital abscesses generally re- Grey Parrot resulted in hyperplastic parakeratotic epithelial proliferations. They are most often seen in cockatiels, lomas have been described without viral isolation. Surgical debridement of the Any dermatosis (eg, allergic, bacterial, fungal) can abscesses with concomitant systemic antibiotics is potentially affect the periorbital skin and occur in the the only effective treatment. Early dacryocystitis can sometimes be treated Congenital Deformities by expressing the inflammatory debris through the Although rare in birds, congenital eyelid abnormali- lacrimal punctum. More severe cases with firm, ne- ties do occur and are a surgical challenge to correct. Surgical removal is not the point at which normal upper eyelid would be recommended because of the potential for scarring found, has been reported in a raptor. Cryptophthalmos (fusion of the eyelid margins) has Periorbital Swelling of Neoplastic Origin been reported in four cockatiels11 in which dramati- Any primary tumor arising in the periorbital or cally reduced or absent palpebral fissures were de- retrobulbar area can cause swelling with or without 7 scribed without other ocular abnormalities (Color globe displacement. Reconstructive surgery was uniformly unsuc- appears to be a particularly common area for cutane- 13 cessful. Behaviorally, the birds appeared normal be- ous manifestations of lymphoreticular neoplasia, cause some vision was possible through one or both represented clinically by periorbital swelling, globe 61,65 eyes. Exophthalmia or goose, in which feathers grew out of the aberrant posteriorly directed strabismus may be noted. Exophthalmos and globe deviation have been re- Microphthalmia and maldevelopment of ciliary body, ported secondary to optic nerve glioma, orbital round retina and pecten, as well as retinal dysplasias and cell sarcoma,2,26 and some advanced cases of pituitary congenital cataracts have been described in rap- 69 tors. Other less common causes of retrobulbar masses include Myco- Umbrella Cockatoo with choanal atresia, resulting in bacterium spp. This lesion can be resolved with a lateral Hyperplastic Periocular Lesions canthoplasty (see Chapter 41). Proliferative and hyperplastic periorbital lesions are most commonly seen in budgerigars and canaries in response to Knemidokoptes spp. In another study, 41% of ocular samples were sterile and 50% of the isolates were gram-positive cocci. Physical examination indi- fungal organisms was determined in a group of 117 cated the lack of a choanal slit and an abnormally formed in- birds by swabbing the conjunctiva. The pled were clinically asymptomatic and were housed periorbital tissue was moistened with a serous ocular and nasal discharge. The first are those caused by strictly local ducklings, suggesting that neonatal conjunctival factors, such as localized conjunctival infection or flora are derived from intestinal flora (Color 26. The second are those in which con- The isolation of gram-negative bacteria from the eye junctivitis is a manifestation of periorbital or orbital or conjunctiva should be considered abnormal except disease. These are mainly related to sinusitis (see in Anseriformes and Rheiformes, where gram-nega- Chapter 22). The third group are those in which tive bacteria are considered autochthonous flora. Haemophilus-like bacteria have been reported to Almost any organism causing systemic infection can cause conjunctivitis in cockatiels. A careful examination of the bird for upper respiratory disease is mandatory in Chlamydia psittaci is a frequent cause of keratocon- determining the cause of ocular discharge or conjunc- 23 junctivitis in Australian parakeets and of conjunc- tival hyperemia (Color 26. In smoke, chemical fumes and other aerosolized envi- these cases, treatment with topical oxytetracycline is ronmental toxins should always be considered in the effective. Clinical chlamydiosis in Psittaciformes is differential diagnosis of conjunctivitis, with or with- generally associated with conjunctivitis, diarrhea out signs of upper respiratory disease. The conjunctival flora of captive exotic birds conjunctivitis may be the only presenting signs. This nematode can the third eyelid, may be a cause of conjunctival irri- enter the lacrimal duct and may cause transient tation and should be suspected in cases of unilateral epiphora if present in large numbers. Heavy parasite Hawks had grass florets lodged behind the third burdens must be treated with a single topical dose of eyelid. When a bird eats the cockroach, the mature Cockatiels are frequently presented with a conjunc- nematode larvae escape into the crop, move up the tivitis from which no infectious agent can be isolated. Companion birds maintained in indoor envi- discharge, progressing to conjunctival chemosis and ronments are less likely to be infected.
