COMMON PRESENTATIONS

Table 15.3 provides a guide to the most common paediat­ric presentations. Further detail on diseases and common presentations can be found in the various chapters in Vogelnest and Woods (2008).

4.1 Metabolic bone disease

Metabolic bone disease can occur in any species, par­ticularly during the growth phase. Generalised osteope­nia and multiple pathological fractures are common (Fig. 15.7). Nutritional and environmental factors and the degree of load bearing on the developing skeleton are key factors in the development of metabolic bone disease. Pye et al. (2013) describe metabolic bone disease associated with hip and shoulder dysplasia in young koalas housed exclusively indoors. The lack of exposure to ultraviolet light was considered a significant contrib­utory factor.

Inadequate dietary calcium and/or vitamin D has been associated with metabolic bone disease in several species. Suspected nutritional deficiencies can be investigated by detailed dietary history and analysis of foodstuffs.

Managing animals carefully through the initial phases of weight-bearing (e.g. when beginning to emerge from the pouch) is an important preventative measure. Load­bearing must be increased gradually and always on an appropriate substrate to encourage normal bone develop­ment. Insufficient load-bearing may be just as detrimen­tal as excessive activity.

4.2 Infectious diseases

Infectious diseases may be acquired from the environ­ment, in-contact animals or human carers. Vertical transmission of pathogens such as Toxoplasma gondii is also possible (Parameswaran et al. 2009). Neonates and juveniles are particularly susceptible to infections because of the reduced capacity of the developing immune system to respond to exposure to pathogens.

Hand-reared mammals are considered at increased risk of infectious disease because they are removed from the protective factors present in the mother’s milk, colostrum intake may not be assured and in the case of marsupials, the protective mechanisms of the natural pouch environment are impossible to replicate in a care situation.

The pathology associated with a particular infection may present atypically in young animals. For example, a diagnosis of chlamydial pneumonia in a juvenile koala (Mackie et al. 2016).

4.3 Congenital defects

Congenital defects are rarely seen in Australian mam­mals. Portosystemic shunts, palatine defects and imper­forate anus have been reported in bats (Olsson and Woods 2008). Bilateral polydactyly has been diagnosed in grey kangaroos (De Paz et al. 2007; Warburton et al. 2021). Genetic and environmental factors do influence the development of wild animals of all species and should be considered in circumstances where other causes of illness have been excluded (Hamlin and Guillette 2010).

5.