Managing cloacal papillomatosis

July 5, 2018

Axel is a very handsome blue and gold macaw who had been having trouble with intermittent cloacal or vent irritations/infections from the age of two. Initially he responded well to medical management with antibiotics and anti-inflammatories but things progressed to the point where the bouts were more frequent, he was becoming uncomfortable on defaecation and was starting to prolapse ulcerated tissue from his vent. Biopsies of this tissue confirmed the presence of ‘papillomatous disease’ which is warty type growths of the cloacal tissue (and on occasion liver and oral cavity) caused by a herpes virus.

Prolapse tissue

Prolapsed tissue

Due to the risks of scar tissue formation and vent obstruction surgery is always deemed a last resort. In Axel’s case, due to the advanced nature of the disease, failure to respond to long term medical / nutritional management and obvious discomfort with bleeding on defaecation, we felt there was no other option.

Microsurgery insturments

Microsurgery instruments

Due to the small size and delicate nature of the cloaca, surgery was performed using 3.5x magnification and radiosurgery (essentially an electric scalpel that as well as cutting, cauterizes any small blood vessels within the affected tissue) which enabled us to excise the affected tissue. However, despite a lot of pain medication, Axel was extremely uncomfortable and looking very sorry for himself following surgery and we were actually beginning to wonder whether it had been fair to put him through such a procedure. Thankfully within a few days the inflammation subsided and he improved day by day especially once he was home with his family.

Post op. vent

Post op. vent

In cattle ‘autogenous’ vaccines have been used with success to treat warty ‘papillomatous’ growths on their udders. Autogenous vaccines are made by processing the affected tissue into a vaccine with the aim of stimulating the animals own immune system to ‘attack’ any such abnormal tissue. Following discussion with our pathologists at IZVG Pathology we wondered whether this may be applicable to Axel’s situation and so the surgically removed tissue was submitted to the lab and a vaccine created. We administered this by injection once weekly for 4 weeks and then repeated 6 months later.

Axel at home

Axel at home

Happily there appeared to be no negative effects of the vaccine and Axel is fighting fit and papilloma free two years down the line!!

Axel at home

Axel at home