1
Q
What is the chinchilla gestation length?
A
111 days
2
Q
What blood parameter reflects the native habitat of chinchillas?
A
High-altitude oxygen binding is a niche adaptation of the chinchilla. Living at elevations 3,000–4,900 m (10,000–16,600 ft) above sea level, chinchillas have a greater hemoglobin oxygen affinity than other rodents.
3
Q
Which leg bone is extremely reduced in chinchillas?
A
Fibula
4
Q
How many hairs emerge from each chinchilla hair follicle?
A
50-75
5
Q
Describe the female chinchilla reproductive cycle.
A
females living in the Northern Hemisphere are seasonally polyestrus between November and May and experience estrus once every 30–50 days if not pregnant. Gestation is 105–118 days, averaging 111 days. Wild chinchillas usually produce two litters a season. Although there may be up to six offspring—referred to as kits—litters include one or two kits each on average.
6
Q
How long do female chinchillas nurse their young?
A
Female chinchillas nurse their young for approximately 6–8 weeks; kit survival requires a minimum suckling period of 25 days.
7
Q
How soon after birth do chinchillas start eating solid foods?
A
Kits begin to take solid foods at about 1 week of age
8
Q
How many pairs of mammary glands do chinchillas have?
A
3 - two thoracic pairs, and one inguinal pair.
9
Q
Do male chinchillas aid in rearing young?
A
Yes - males often assist in cleansing the kits after birth. Both parents engage in kit grooming and play as the young develop, and family units often sleep huddled as a group. Adults discipline the young with a chirping or grunting vocalization if the kit pesters while the adult is sleeping or eating.
10
Q
What is appropriate nutrition for chinchilla pellets?
A
16–20% protein, 2–5% fat, and 15–35% bulk fiber.
11
Q
What is a possible medically relevant sequela to offering new types of food (particularly fresh greens) to chinchillas suddenly?
A
Gastric tympany has been associated with sudden changes in diet or the addition of fresh greens and fruit.
12
Q
What is the scientific name of pet chinchillas?
A
Chinchilla lanigera (long tailed chinchillas)
13
Q
Are male or female chinchillas more aggressive?
A
Females
14
Q
When selecting wood for chinchillas to chew on, what should be considered?
A
the wood of stone-bearing fruit trees (plum, apricot, peach, etc.) is generally safe, but many species produce cyanogenetic glycosides in their seeds and leaves. The leaves of some conifers, as well as those of mahogany trees may also be a problem. All yew plants are considered toxic, so use of wood from the Taxus sp. should be avoided. Walnut shavings induce lethargy in some laboratory animals, so should be avoided for chinchillas. The wood from many aromatic plants contain enzyme-inducing chemicals that may lead to rapid breakdown of pharmaceuticals used for therapy and can be a source of gastrointestinal irritation and diarrhea. Safe woods include bamboo, apple, pear, poplar, willow, aspen, ash, birch, elm, sycamore and dogwood, and grape vines. Any and all woods treated with insecticides, fungicides, or preservatives must be avoided.
15
Q
What is the most commonly diagnosed type of ringworm in chinchillas?
A
Trichophyton mentagrophytes
16
Q
What is the most common endocrine disorder of chinchillas?
A
Diabetes mellitus is the most common endocrine condition reported in chinchillas and is highly correlated with obesity. Clinical signs include inappetence, progressive weight loss, depression, polyuria, polydipsia, and bilateral cataracts. Ante-mortem diagnostic testing demonstrates hyperglycemia, glycosuria, and ketonuria. At necropsy, the pancreas may be atrophic and wispy with microscopic evidence of pancreatic islet vacuolation as well as hepatic lipidosis. Differential diagnoses include urinary disease, cystitis, stress or pain, inappetence, hepatic lipidosis, and hyperthyroidism.
17
Q
A chinchilla presents for necropsy after a 4 week history of weight loss. The gross necropsy findings include multinodular granulomatous pneumonia with bullous emphysema and multifocal necrohemorrhagic hepatitis. What infectious disease should be on your differential list?
A) Bordetella bronchiseptica
B) Streptococcus pneumoniae
C) Mycobacterium genavense
A
C) Mycobacterium genavense
A single chinchilla housed with ten others and reported to be smaller than others in the group, was diagnosed with Mycobacterium genavense-associated multinodular granulomatous pneumonia with bullous emphysema and multifocal necrohemorrhagic hepatitis following a 4-week history of progressive weight loss. The animal had received medical treatment for paraphimosis and had been castrated three months prior. Mortality from this small colony was investigated over the next two years and further mycobacterial lesions were not identified. The source of the infection was not discovered. M. genavense infections pose a zoonotic risk, especially for immunocompromised humans.
18
Q
In one case, 17 chinchillas from a group of 130 died within a 1-month period with clinical signs including anorexia and weight loss, constipation, and tachypnea. No oculonasal discharge was noted. Deaths occurred within 2–4 days following the development of respiratory signs. Of this group, one chinchilla evaluated had emphysematous lungs with multifocal hemorrhages and a marked bronchopneumonia. The spleen was enlarged with generalized prominent white nodules, the liver had extensive areas of focal necrosis, and the gastrointestinal tract was empty. Histologically, the lungs demonstrated extensive proliferation of type II pneumocytes with focal areas of consolidation and a fibrinous pleuritis. Organisms consistent with _______ were observed in multinucleated giant cells, macrophages, and endothelial cells. Multifocal granulomatous hepatitis, splenitis, lymphadenitis, and nephritis were also noted.
A
Histoplasma capsulatum
19
Q
Farm-raised chinchillas presented with dyspnea, lethargy, gradual weight loss, anorexia, rhinitis, conjunctivitis, and loss of facial fur. The disease had an insidious onset and animals were ill for 1–6 weeks prior to euthanasia. On gross examination, chinchillas were in poor body condition with poor quality pelts. Pinpoint white foci were noted throughout the pulmonary parenchyma and livers were normal in size but sometimes had an orange tinge. What was the final diagnosis and why did this occur?
A
Pulmonary adenomatosis. Histologically, multifocal alveoli were lined by uniformly arranged cuboidal to columnar epithelial cells with papillary formations and these cells were continuous with the bronchiolar epithelium. There was a concurrent nonsuppurative, interstitial pneumonia sometimes with marked pulmonary edema. It was hypothesized that chronic irritation of the bronchiolar and alveolar epithelial cells from irritants from the dust bath resulted in proliferative changes with eventual development of adenomatosis.
20
Q
How do you diagnose Toxoplasma gondii?
A
Histopath with immunohistochemistry,
Clinical signs include sudden death, depression, hunched posture with drooping of the ears and head, tachypnea, ataxia, and convulsions. Upon gross examination, lesions include pleural effusion, patchy pulmonary consolidation, miliary white hepatic foci, and mild splenomegaly. Microscopically, interstitial pneumonitis is seen with numerous T. gondii trophozoites contained within macrophages as well as free within alveoli. In addition, pyogranulomatous hepatitis with numerous T. gondii pseudocysts and multifocal granulomatous encephalitis with variable numbers of pseudocysts are seen.
21
Q
What parasite has been documented to encryst in the mandibular ramus, axillary connective tissue, and the subscapularis fascia of chinchillas?
A) Taenia serialis
B) Echinococcus lanigaster
C) Eimeria steidae
A
A) Taenia serialis
Cysts of the second larval stage of Taenia serialis have been identified in subcutaneous tissues and fascia in multiple chinchillas housed in laboratory settings as well as in commercial fur operations. The significance of this infestation depends primarily on location of the cysts. In one case, multiple coenuri were present on the mandibular ramus and interfered with food consumption. Lameness was the presenting clinical sign in two other animals with cysts in the axillary connective tissue and the subscapularis fascia, respectively. Coenuri were identified morphologically via characterization of the protoscolices. Cystic structures should be differentiated from abscesses.
22
Q
What is the definitive host of Taenia serialis? How can chinchillas become infected with this parasite?
A
The definitive host of T. serialis includes dogs, foxes, and coyotes. It was presumed, in all cases, that the chinchilla feed or, possibly, the bedding material was contaminated with feces from dogs infected with T. serialis. Historically, fresh grass cuttings have been fed in some research facilities for enrichment and were considered to be the most likely source of T. serialis contamination. Pet chinchillas allowed access to the outside or fed diets supplemented with grass clippings, hay, and other roughage, may be at increased risk for this condition.
23
Q
What is the most common fracture location in chinchillas?
A
The tibia
the bone is long and slender and attached to a vestigial fibula.
24
Q
Microscopically, abundant intensely basophilic mineral matrix is deposited on the surface of bone trabeculae and is pathognomonic for ______ intoxication in chinchillas. Other possible bony lesions include osteocyte necrosis within both cortical and trabecular bone resulting in empty lacunae, resorption of cortical bone, new periosteal bone production, and mineralization of soft tissues.
A
Vitamin D intoxication.
25
________ intoxication of farmed chinchillas has occurred following an inadvertent feed mill mixing error. Affected animals were depressed, off their feed, recumbent, and found dead 8 days after being presented with the contaminated feed. Skeletal muscle myofiber swelling, degeneration, and necrosis were noted microscopically.
Salinomycin
26
What musculoskeletal neoplasia has been diagnosed in a chinchilla? What were the clinical characteristics?
Lumbar osteosarcoma has been reported in a mature male chinchilla presenting with a chronic history of progressive weight loss, depression, anorexia, and tail tip alopecia. On examination, the chinchilla was reluctant to move and demonstrated hind leg stiffness that quickly progressed to paralysis. The animal also demonstrated self-trauma to the tail tip. A 3-cm diameter fixed, firm mass was palpated in the ventral region of the last lumbar vertebra and the inguinal lymph nodes were enlarged. Survey radiographs identified an irregular opaque mass attached to the ventral border of the seventh lumbar vertebra that also extended into the subtending vertebral canal. Microscopically, the mass was confirmed to be an osteosarcoma with intravascular invasion but no evidence of distant metastasis. Other musculoskeletal tumors have not been reported in chinchillas.
27
What percentage of chinchillas presenting for vet care have abnormal dentition?
50%+
Dental abnormalities are observed in over 50% of chinchillas presenting for veterinary care. In the majority of these cases, lesions are secondary to coronal elongation of the cheek teeth or to the absence of an opposing tooth somewhere along the dental arcade. A congenital absence or pathologic loss of teeth and malocclusion secondary to skeletal abnormalities are infrequently observed in chinchillas.
28
How do wild caught chinchilla teeth differ from captive bred chinchilla teeth?
Skulls from wild-caught chinchillas generally only demonstrate mild dental disease and they have shorter cheek teeth compared with skulls from domesticated chinchillas. Cheek tooth elongation is thought to be associated with insufficient tooth wear highlighting the critical requirement of fiber for captive chinchillas. Appropriate diets that are high in fiber encourage more normal chewing movements and increase tooth wear, thereby improving the dental health of captive chinchillas.
29
Which demographic of chinchilla is most likely to develop bloat?
Nursing females
30
How can you differentiate infection with Yersinia enterocolitica and Yersinia pseudotuberculosis infections?
The clinical signs and pathologic lesions of Y. enterocolitica and Y. pseudotuberculosis infections are similar and require bacterial culture for differentiation.
31
Describe the clinical etiology and progression of infection with Yersinia species in chinchillas.
Bacteria are thought to enter via contaminated feed or through the introduction of infected animals. Chinchillas may present with listlessness, anorexia, progressive weight loss, slimy or mucus-coated soft fecal pellets, diarrhea, weakness, and death. The liver, spleen, and less frequently, the kidney, may contain multifocal, pale necrotic foci throughout the parenchyma. The intestinal tract is usually severely inflamed with small mucosal erosions and ulcers extending into the intestinal muscularis. Mesenteric lymph nodes are enlarged and congested, and lung lesions are rare. Laboratory Diagnostics Yersinia spp. can be recovered from samples of heart blood or affected tissues using selective media, such as cefsulodin-irgasan-novobiocin (CIN) agar. Colony/Herd Management Yersinia enterocolitica biogroup 3, serogroups O:1, 2, and 3 are associated with chinchilla infections and can also cause infections in humans. Infected animals should be quarantined from healthy, unexposed animals and should be handled after all other husbandry tasks have been completed. Humans infected with Y. enterocolitica usually present with gastrointestinal signs, but in cases of immunosuppression or iron overload, septicemia can occur.
32
Clinical signs in ________-infected chinchillas include sudden death, depression, torticollis, anorexia, progressive weight loss, constipation, and tenesmus, which may result in intestinal intussusception or rectal prolapse. Less frequently, diarrhea, abortion, and vaginal discharge are seen. Post-mortem findings include multifocal, pale, miliary foci on the hepatic capsular surface and throughout the parenchyma as well as within mesenteric lymph nodes.
Listeria monocytogenes
Listeria monocytogenes, a Gram-positive, rod-shaped bacillus, is a common disease agent in chinchilla breeding operations. Three clinical forms of listeriosis are recognized in domestic animals, including septicemia, which occurs principally in monogastric animals, encephalitis or abortion, which occur principally in adult ruminants, and a visceral form. Chinchillas are highly susceptible to visceral septicemia and acquire the infection by ingestion of feed, such as pellets, meal, or hay contaminated with infected rodent, chicken or ruminant feces. L. monocytogenes can also be introduced into a herd through infected chinchillas. Transmission occurs by orofecal contamination with subsequent hepatic dissemination, causing multifocal necrosis and abscessation. From the liver, there is hematogenous spread to other organs, including lymph nodes, lung, spleen, kidney, adrenal glands, uterus, and placenta. Involvement of the brain also occurs but the actual route of cerebral infection is debated. Clinical signs in infected chinchillas include sudden death, depression, torticollis, anorexia, progressive weight loss, constipation, and tenesmus, which may result in intestinal intussusception or rectal prolapse. Less frequently, diarrhea, abortion, and vaginal discharge are seen. Post-mortem findings include multifocal, pale, miliary foci on the hepatic capsular surface and throughout the parenchyma as well as within mesenteric lymph nodes. Similar foci are also seen on the serosal surfaces of the small and large intestines, particularly on the cecum. Microscopically, foci of necrosis and microabscessation are present throughout the liver, mesenteric lymph nodes, and Peyer's patches, as well as on the intestinal serosa. Similar lesions are seen less frequently within the spleen, lung, uterus, placenta, and brain of affected animals. Intralesional Gram-positive bacteria are abundant.
Listeria monocytogenes can be cultured readily from affected tissues. Differential diagnoses for listeriosis in chinchillas include pseudomoniasis, yersiniosis, and salmonellosis. With pseudomoniasis, the primary lesions are found in the cecum and colon and the liver is less frequently involved. Following infection with Listeria, bacteria are passed in the feces. Thus, equipment, cages, feed, water, and dust baths contaminated with infected feces are important means by which the infection is spread to other chinchillas. Not all animals respond to treatment with antimicrobials and apparently recovered animals may remain carriers and shed Listeria for extended periods. Listeriosis is a zoonotic condition with transmission of bacteria from infected animals as well as from contaminated equipment and the environment. Human caregivers should wash their hands carefully after handling known infected equipment or animals.
33
What clinical signs may be seen associated with Pseudomonas aeruginosa outbreaks in chinchilla colonies?
In acute outbreaks, otitis media and interna may occur as well as conjunctivitis, uveitis, rhinitis, and septicemia. Septicemia is common in neonates and post-parturient or pregnant females. Localized Pseudomonas sp. infections can also occur in the skin, resulting in subcutaneous abscesses, as well as in other sites, such as the gastrointestinal tract, liver, lungs or urogenital tract. When the upper respiratory system is involved, clinical signs include purulent oculonasal discharge, otitis externa, facial paralysis, torticollis, circling, and rolling. With gastrointestinal disease, animals may present with lethargy, inappetence, depression, diarrhea, weight loss, intestinal intussusception, rectal prolapse, and sudden death with no premonitory signs. Inguinal dermal pustules with dermatitis, cellulitis, and acute mesenteric lymphadenitis were seen in a laboratory-reared chinchilla following apparent recovery from initial signs of conjunctivitis, corneal and oral ulcers, mild diarrhea, anorexia, and weight loss. Urogenital infections include purulent vaginal discharge, and preputial and penile ulceration. Pregnant females may abort prior to death.
34
Name some necropsy lesions that may be seen in chinchillas diagnosed with Pseudomonas aeruginosa postmortem.
At necropsy, lesions are extensive and often involve multiple systems, including mucopurulent to purulent rhinitis and conjunctivitis, uveitis, caseous yellow exudate in external ear canals, and purulent exudate in tympanic bullae. Lungs from affected animals may be wet, and mottled red and white, with frothy to serosanginous fluid in the trachea. Enteritis presents as gas- or fluid-filled loops of bowel with microabscesses within the cecal and colonic walls. The liver is less frequently affected. Secondary intestinal intussusception and rectal prolapse may be seen as well as fibrinous peritonitis, suppurative vaginitis, and ulcerative or suppurative balanoposthitis. Microscopically, lesions include fibrinosuppurative otitis media and interna, and meningitis. Pulmonary lesions are often reflective of septicemia or acute hemorrhagic pneumonia in the case of chinchilla kits. Cecal and colonic lesions include multifocal areas of mucosal to transmural necrosis.
35
What disease presents with necropsy findings very similar to P. aeruginosa in chinchillas, and how can you tell the disorders apart?
1) listeriosis
In chinchillas, pseudomoniasis also affects the intestinal tract with microabscesses visible through the serosal surface of the cecum and colon.
2) Culture of affected organs is necessary to differentiate between the two conditions. However, in contrast to listerosis, the liver is less frequently involved in Pseudomonas cases.
36
How is listeria shed in infected animals and what are the implications for biosecurity?
Following infection with Listeria, bacteria are passed in the feces. Thus, equipment, cages, feed, water, and dust baths contaminated with infected feces are important means by which the infection is spread to other chinchillas. Not all animals respond to treatment with antimicrobials and apparently recovered animals may remain carriers and shed Listeria for extended periods. Listeriosis is a zoonotic condition with transmission of bacteria from infected animals as well as from contaminated equipment and the environment. Human caregivers should wash their hands carefully after handling known infected equipment or animals.
37
What chinchilla disease may cause lesions in the skin, eyes, ears, gastrointestinal tract, liver, lungs, and urogenital tract?
Pseudomonas aeruginosa
38
What histopath lesions may be seen with Pseudomonas infections in chinchillas?
Microscopically, lesions include fibrinosuppurative otitis media and interna, and meningitis. Pulmonary lesions are often reflective of septicemia or acute hemorrhagic pneumonia in the case of chinchilla kits. Cecal and colonic lesions include multifocal areas of mucosal to transmural necrosis.
39
What are differential diagnoses for Pseudomonas infections in chinchillas?
Listeriosis, yersiniosis, and salmonellosis.
40
What percentage of pet chinchilla water bottles contain Pseudomonas?
P. aeruginosa has been recovered from 20% of swabs taken from water bottles of clinically normal pet and laboratory chinchillas. Acidification of the water supply and regular flushing and disinfection of water bottles and automatic water lines are important preventive measures.
41
An established chinchilla breeding operation introduced a new male of unknown health status that became ill soon after arrival. All of the females co-housed with this new animal died, as well as the male. Clinical signs in these animals included intermittent diarrhea with emaciation, followed by rapid clinical decline and death. At necropsy, acute enteritis was the predominant finding with some animals also demonstrating cecal mucosal ulceration. What was the cause of death in these animals?
Salmonella Dublin was isolated from liver, small intestine, and fecal samples, and the newly introduced breeding male was suspected to be the source of the infection as there was no evidence of food contamination.
42
What clinical signs are expected with Salmonella infections in chinchillas?
Sudden death with no obvious clinical signs is the typical history, and post-mortem findings include catarrhal gastroenteritis, splenomegaly, multifocal splenic and hepatic necrosis, and hemorrhagic metritis in some females. One case series documented reduced feed intake for the week prior to death. Another reported a few animals showing anorexia and diarrhea 1 or 2 days before death. A chinchilla farm experienced an outbreak of S. Typhimurum that lasted for a week, resulting in the loss of 35% of animals. At post-mortem examination, animals were in poor body condition with nodular gastritis and duodenitis, multifocal hepatic necrosis, splenomegaly, and hemorrhagic pneumonia.
43
Young, farmed chinchillas approximately 6 months-old presented with acute mortality and upon post-mortem examination, the small intestine fluid content was (increased?) whereas the cecal content was dry. A proportion of the animals also had rectal prolapse. What was the diagnosis?
Escherichia coli was isolated from the small intestines, and were positive for Pool 1 N, O, and K isolates, which are most commonly associated with neonatal diarrhea of piglets and calves.
44
What are reported microscopic signs of colibacillosis in chinchillas?
Attaching and effacing eae adhesin-positive E. coli enteritis and septicemia were reported in one of a group of three laboratory-housed chinchillas. The histologic ileal and colonic lesions demonstrated carpeting of enterocytes with mats of Gram-negative bacilli and moderate numbers of neutrophils within the lamina propria. Additional lesions included suppurative nephritis, neutrophilic interstitial pneumonia with microvascular fibrinous thrombosis, erosive gastritis, and hepatic lipidosis.
45
If certain antibiotics are administered to chinchillas (penicillins, lincosamides, cephalosporins, clindamycin, etc.), what is the documented outcome and why?
Enterotoxemia and hemorrhagic typhlitis. This is thought to occur as a result of increased populations of Gram-negative bacteria and overgrowth of clostridial organisms in the hind gut, including Clostridium difficile.
46
In addition to antibiotic exposure, what can cause Clostridial disease in chinchillas?
Clostridial spores may be found in contaminated feed and may induce disease. A chinchilla farm experienced severe diarrhea with rectal prolapse and subsequent death within 24–48 hours, resulting in 20% morbidity and mortality. Necropsy findings in affected animals included large intestinal mucosal erosion and inflammation, and hepatosplenomegaly. Microscopic lesions included centrilobular hepatic necrosis, proliferation of the splenic white pulp, and large intestinal mucosal edema, congestion, and necrosis. Clostridium perfringens A enterotoxin was detected by ELISA in the gastric content and the bacterium was isolated from the feed, producing large amounts of enterotoxin in vitro.
47
What is a differential diagnosis for diarrhea, sudden death, and typhocolitis in chinchillas, other than Salmonella and Clostridium?
Bacillus cereus and associated enterotoxin (an outbreak has been reported on a farm)
Also, coccidiosis
48
What is the causative agent of coccidiosis in chinchillas and what makes it unique to other coccidia species?
Eimera chinchillae The agent can infect other rodents, contradicting generally accepted principles of host specificity of Eimeria spp.
49
What are the presenting clinical signs of coccidiosis in chinchillas?
Presenting clinical signs include diarrhea, rectal prolapse, and sudden death. In affected chinchillas, post-mortem examination demonstrated cecal and colonic distension with semi-solid ingesta and gas, erythema and thickening of the cecal and anterior colonic mucosa, and mucosal speckling with miliary pale foci. The rectum contained small numbers of mucus-coated fecal pellets and coccidial oocysts were identified in the droppings.
50
What do Eimera chinchillae oocysts look like and how soon do they sporulate after being produced?
Oocysts are oval, subspherical or spherical, and measure 13–22 µm by 11–18 µm with a single-layered light brown wall that is 0.7–1μm thick. The oocysts sporulate within three days of being produced.
51
Is Giardia chinchillae a primary pathogen of chinchillas?
Recent investigations support the concept that G. chinchillae is an opportunistic pathogen.
Historically, Giardia chinchillae was considered to be a primary pathogen of chinchillas, as infected animals presented with diarrhea and increased mortality, however, Giardia chinchillae organisms have also been found in apparently healthy animals. Given that chinchillas with giardiasis commonly have concomitant bacterial infections, such as pseudomoniasis, the significance of this organism as a primary pathogen has been unclear.
52
Where are Giardia chinchillae organisms found in infected animals? What other species of Giardia has been found in chinchillas?
G. chinchillae trophoblasts most commonly reside in the upper small intestine and were seen in intestinal scrapings of >82% of normal, healthy chinchillas in one study, and in fecal smears from >64% of culled chinchillas in another study. Only one of these animals had abnormal fecal pellets. No other parasitic or bacterial pathogens were detected in this animal and there was no evidence of abdominal discomfort. Pet chinchillas have also been tested for the presence of Giardia duodenalis using a sedimentation flotation technique and a subset of the Giardia isolates were characterized. Multiple isolates were identified, including A and B forms, which are considered zoonotic. Juvenile and show chinchillas were more likely to be positive for G. duodenalis.
53
Are intestinal nematodes important pathogens in chinchillas? Which nematodes have been diagnosed in this species?
Intestinal nematodes are not thought to be important pathogens in chinchillas. In one report, chinchillas had lost weight and were dull and listless with no change in fecal consistency. Nematode eggs were subsequently identified on fecal flotation and female Ostertagia worms were found in the stomach as well as one male Trichostrongylus colubriformis worm in the small intestine. These chinchillas responded well to treatment with parasiticides and the source of the infections was thought to be alfalfa hay cut from pastures grazed occasionally by sheep and goats.
54
Which age group of chinchillas is most likely to be affected by cestodes? Which species of cestode is the cause of disease?
Cestodes can cause rare problems in young chinchillas. Post-mortem examinations conducted on a group of young, emaciated chinchillas identified numerous Rodentolepis sp. tapeworms within the small intestines. A farm visit indicated that the recently weaned chinchillas were in very poor condition but were eating well and passing normal fecal droppings. Unweaned and adult chinchillas appeared normal. Tapeworm segments were not being excreted but eggs were identified by fecal flotation.
55
What feature of chinchilla behavior predisposes to cestode infections?
The direct life cycle is perpetuated by coprophagy.
R. nana has three life cycle variations. With the direct life cycle, ova bearing proglottids are passed in the feces by one definitive host and ingested by another. Because chinchillas are coprophagic, they may reinfect themselves. The second type of life cycle is an internal autoinfection cycle in which the ova release hexacanth larvae into the intestinal lumen without ever leaving the intestine. The third type of life cycle is indirect, in which ova bearing proglottids are passed in the feces from a definitive host to an intermediate host, such as beetles, cockroaches, or fleas and then the intermediate host bearing cysticeroids is ingested by the next definitive host. In the case mentioned above, fleas or grain beetles were considered as potential intermediate hosts or feed contaminated with droppings from infested rats or mice.
56
An 8 month-old chinchilla developed severe diarrhea shortly after being purchased from a pet store and died despite aggressive antibiotic and fluid treatment. The stomach, small intestine, and colon were distended with gas and yellow fluid. Histologically, large numbers of 2–5 µm spherical bodies were seen on the luminal surface of the stomach, duodenum, jejunum, ileum, and colon. There was mild to moderate villus atrophy with irregular foci of epithelial necrosis, and lamina proprial infiltrates of neutrophils, lymphocytes, and macrophages. Sinus histiocytosis was noted in mesenteric lymph nodes as well as lesser numbers of neutrophils. Coliform bacteria were also isolated from the small intestine, lungs, and liver. What was the diagnosis for the causative agent of gastroenteritis?
Cryptosporidia sp., confirmed by transmission electron microscopy. Colibacillosis was likely a secondary disease.
57
A history of scant, hard fecal pellet production with or without frank blood in a chinchilla may be indicative of ______.
cecal or colonic impaction.
Impaction may be caused by insufficient dietary fiber. Other causes of constipation include dehydration, lack of exercise, obesity, intestinal obstruction, chronic bacterial enteritis, and intestinal compression and ischemia secondary to a large gravid uterus. Differential diagnoses for colonic impaction include gastric foreign bodies and intestinal accidents, such as torsion and intussusception.
58
Name 3 causes of constipation in chinchillas.
dehydration, lack of exercise, obesity, intestinal obstruction, chronic bacterial enteritis, and intestinal compression and ischemia secondary to a large gravid uterus.
59
Name differential diagnoses for colonic impaction.
Differential diagnoses for colonic impaction include gastric foreign bodies and intestinal accidents, such as torsion and intussusception.
60
Intestinal intussusception can occur following outbreaks of bacterial gastroenteritis or intestinal parasitism in chinchillas, and typically, the _____ is affected.
Colon
Animals with an intussusception may be hypothermic, have a distended abdomen, and refuse to eat or use a dustbath, and they may demonstrate abnormal postures because of the acutely painful abdomen. Tenesmus is not usually present unless the intussuscepted intestine prolapses rectally.
61
In a report of intestinal torsion in a chinchilla, where did the intestines torse?
There was 360° rotation of the distal 20 cm of the small intestine through a rent in the mesocolon.
62
What toxin caused the following clinical signs on a chinchilla farm?
“…animals became lethargic with reduced feed intake and exhibited exaggerated responses to stimulation. With longer-term consumption, progressive hair loss and fur chewing were seen as well as discoloration of the teeth, abortions, vaginal hemorrhage, polyuria, production of feces containing undigested content and mucus, and sudden death. Post-mortem lesions included highly alkaline abdominal fluid, marked mesenteric congestion, and gastric erosion, ulceration and hemorrhage with occasional gastric perforation. The small and large intestines were largely empty, livers were enlarged and dotted with subcapsular petechial hemorrhages, and the kidneys and adrenal glands were enlarged. There was alkaline pleural effusion and lungs were wet and congested.”
Chronic sodium carbonate intoxication from accidental replacement of sodium bicarbonate with sodium carbonate in the feed - eventually resulted in depopulation of a chinchilla farm.
63
What pathology did Listeria ivanovii cause in a chinchilla case report?
Hepatitis.
A pet female chinchilla of unknown age and in poor body condition died shortly after purchase. At necropsy, generalized, miliary pale foci were seen throughout the liver, and the intestinal content was scant and mucoid in nature. Abundant Saccharomyces-like yeast cells were seen in cecal smears. Microscopically, acute multifocal hepatic necrosis was noted together with infiltrating neutrophils. Vacuolated hepatocytes contained Gram-positive, intracytoplasmic rod-shaped bacteria and there was activation of the splenic white pulp. Listeria ivanovii was cultured from the liver.
64
A 7 month-old pet chinchilla, one of a group of seven, died unexpectedly. Microscopically, acute interstitial pneumonitis and multifocal hepatitis were seen with numerous protozoa in various stages of development, including schizonts and merozoites. What is your diagnosis?
Sarcocystis cruzi.
Schizonts were positively labeled via immunohistochemistry for antibodies against Sarcocytis cruzi but were negative for Toxoplasma gondii and Neospora caninum. Protozoal organisms were antigenically and structurally identical to S. canis from dogs. The source of infection was not identified and it was unlikely that the chinchilla was exposed to food or water contaminated with feces from an infected carnivore. The possibility that the chinchilla became subclinically infected at an early age could not be discounted. The other six chinchillas remained healthy.
65
What zoonotic tapeworm with canid definitive hosts and rodent intermediate hosts has been documented to cause hepatitis in chinchillas?
Echinococcus multilocularis
(Caused hepatic aleveolar echinococcosis)
Hydatid cysts have been reported sporadically in both farmed and pet chinchillas and may be an incidental finding at post-mortem or may induce clinical disease. The significance to the animal depends primarily on the location that is affected. In a recent European case, a 6-year-old pet chinchilla presented with clinical signs of anorexia, tachypnea, and an enlarged, firm, and painful abdomen. The animal was euthanized and a post-mortem examination was conducted. The liver capsule had numerous 1–5 vesicles 5-mm in diameter, which upon microscopic examination were noted to have outer laminated walls, an inner germinal epithelium, and internal protoscolices. An immunofluorescence assay using an E. multilocularis-specific monoclonal antibody labeled the outer walls positive. PCR testing confirmed the diagnosis of the larval stage (hydatid cyst) of the tapeworm E. multilocularis. Definitive hosts for E. multilocularis include foxes, coyotes, and domestic dogs. Rodents are intermediate hosts and must be eaten by a carnivore to transmit the infection. Infections of intermediate and aberrant hosts occur through ingestion of eggs in feces-contaminated feed. The chinchilla in this case was fed pellets and hay, but on occasion, also received branches from trees and shrubs, which may have been contaminated. Humans are considered aberrant hosts but may develop potentially serious and even life-endangering hydatid cysts following ingestion of infective eggs from a definitive canid host.
66
A chinchilla producer experienced catastrophic on-farm mortality losing all 200 animals following consumption of an oat-based commercial pelleted feed. At necropsy, livers were markedly enlarged by up to 71%, friable, and pale yellow with multiple grey foci. Histologically, marked diffuse hepatic lipidosis and necrosis were seen. Thin layer chromatography analysis of the feed revealed approximately 212 ppb of _______.
aflatoxin B1.
The safe limit of AFB1 in chinchilla feed is estimated to be 10 ppb.
67
What are features of pancreatitis in chinchillas?
Pancreatitis occurs sporadically in obese pet chinchillas receiving excessive fatty or high carbohydrate treats. Affected animals may be found dead. At necropsy, findings include abundant subcutaneous and abdominal fat stores often with multifocal hemorrhages and acute fat necrosis, and an enlarged pale, friable liver. Histologically, acute necrotizing and hemorrhagic pancreatitis, peripancreatic and subcutaneous fat necrosis, and marked hepatic lipidosis may be seen.
68
A 12 year-old female chinchilla presented with a slow-growing nonpainful fluctuant mass in the right submandibular region. The animal had lost some weight, but was still bright and alert with intermittent dysphagia, facial pruritus, and mild peripheral lymph node enlargement. The animal's condition deteriorated quickly and it was euthanized. The submandibular mass was approximately 6 x 4 x 2.5 cm, mottled pale yellow with numerous fluid-filled cysts, and involved the submandibular lymph nodes with additional metastases to liver, lung, and spleen. Microscopically, the mass was composed of nodular, unencapsulated populations of spindloid to polygonal cells contiguous with salivary gland epithelium and surrounded by moderate amounts of fibrous tissue with large pseudocytic spaces containing abundant pale eosinophilic fluid that stained mildly positive with PAS and Alcian blue. Neoplastic emboli were present within lymphatic vessels and populations of similar cells formed streams, bundles, and small pseudocysts in the submandibular lymph node, liver, lungs, and spleen. Immunohistochemistry demonstrated strong positive cytoplasmic labeling of neoplastic cells for vimentin and pan-cytokeratin. What was the diagnosis?
Co-expression of vimentin and cytokeratin, lack of α-SMA, S100, and myosin labeling, and close contact with the salivary gland were the basis for diagnosing this mass as an undifferentiated salivary gland carcinoma.
69
A 5 year-old female chinchilla was reported to be anorectic and lethargic for a short period of time before dying. Gastric adenocarcinoma was diagnosed. What concurrent diagnosis was made on PCR?
A PCR assay for Helicobacter pylori was positive on the gastric tissue but the organism was not identified in the tissues by immunohistochemistry or with silver stains.
70
What artery is the primary supply of blood to cardiac tissue of chinchillas?
A) right coronary artery
B) left coronary artery
C) accessory coronary artery
B) The left coronary artery is the primary supply of blood to cardiac tissue in chinchillas as the right coronary artery is absent.
71
Which of the following is not a reported cause of vegetative valvular endocarditis in chinchillas?
A) Staphylococcus species
B) Streptococcus species
C) Bordetella bronchiseptica
C) Bordetella bronchiseptica
This organism is not associated with valvular endocarditis, but it IS associated with pericarditis in chinchillas.
Pericarditis can be a sequela to severe bacterial conjunctivitis, rhinitis, bronchopneumonia, and septicemia. B. bronchiseptica, K. pneumoniae, Staphylococcus sp., S. pneumoniae, and other Streptococcus spp., may be cultured from infected animals.
Vegetative valvular endocarditis has been associated with S. pneumoniae, S. pyogenes, and S. zooepidemicus infections in chinchillas.
72
What is the pathognomonic lesion of vitamin d toxicosis?
An abundant intensely basophilic matrix is deposited on the surface of bone trabeculae - this is considered to be pathognomonic for vitamin D intoxication.
Other clinical signs:
At post-mortem examination, great vessels are rigid with chalky white streaking of the walls, and there may be fine pale stippling of the diaphragm, trachea, lung, heart, and gastric muscularis (Figure 4.13). Mineralization may also be seen in the renal cortices, contributing to a gritty feel upon sectioning. Microscopically, lesions include mineralization of arterial walls and soft tissues including the endocardium and myocardium, pulmonary alveolar basement membranes, gastric and intestinal mucosa, and renal glomerular and tubular basement membranes. Other bony lesions include osteocyte necrosis, resorption of cortical bone, and new periosteal bone production.
73
Name 3 ddx for suspected vitamin d toxicosis.
Other potential intoxications or conditions that may result in metastatic calcification include accidental poisoning with cholecalciferol rodenticides, dietary imbalances of calcium and phosphorus, chronic renal disease, and hyperparathyroidism.
74
Name clinical signs of heat stroke.
Clinical signs include panting with excessive salivation, recumbency, hyperthermia, bloody diarrhea, and engorgement of ear veins and mucosa with blood. At post-mortem, lesions include marked pulmonary congestion, distension of blood vessels with dark blood, pale straw-colored fluid in the pericardial sac, and subcutaneous edema along the lateral sides of the body wall seen upon reflection of the skin.
75
What anatomical renal feature helps chinchillas concentrate their urine?
Chinchillas have an elongated renal papilla, which is thought to assist with the production of concentrated urine. In the wild, chinchillas ingest daily water indirectly through consumption of a variety of herbs and grasses. Domesticated chinchillas consume 25–50 mL of water per day.
76
Sanitation of chinchilla water bottles and waterers is critical as they can be a source of _________.
Pseudomonas aeruginosa colonization.
77
When does a chinchilla’s vaginal closure membrane open?
Only at estrus and during parturition.
78
A male chinchilla presents with stranguria and over grooming of the inguinal region. What should be the first diagnostic step?
Thorough PE to screen for a penile fur ring that may be causing balanoposthitis
79
A group of commercial female chinchillas with a history of progressive weakness all died. Microscopically, lesions were confined to the renal cortex, with moderate to marked tubular deposits of pale yellow, variably-shaped crystals that are birefringent under polarized light, moderate hydropic degeneration and regeneration of tubular epithelial cells, protein casts, and interstitial inflammatory cell infiltrates. What is your diagnosis?
Oxalate nephrosis.
Oxalate crystals can be identified by their distinctive microscopic appearance, as they are pale yellow, variably-shaped crystals that are birefringent under polarized light. Common dietary sources are plants containing high levels of oxalic acid include chard, kale, rhubarb, spinach, and beetroot.
80
What is a cause of acute pyelonephritis in chinchillas?
Acute pyelonephritis has been associated with Streptococcus zooepidemicus vaginitis.
81
Name 3 causes of abortion in chinchillas.
Rough handling during palpation, jumping, falling, fighting or shipping, startling or frightening the female, especially in latter part of gestation, poor body condition due to disease or inadequate nutrition, unbalanced diets, heat stress, and pyrexia or illness from septicemia. Bacterial agents associated with fetal loss include Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus pyogenes, S. pneumoniae, Salmonella spp., Pasteurella multocida, and Listeria monocytogenes. Aborted fetuses may not be found as they are ingested by the dam.
82
Name 3 agents isolated from cases of metritis in chinchillas.
Streptococcus spp., Staphylococcus aureus, Pseudomonas aeruginosa, Listeria monocytogenes, and Proteus vulgaris or P. mirabilis.
- Retained placentas or fetuses, trauma during parturition or an unsanitary environment may lead to vaginitis, pyometra or metritis in chinchillas. Affected animals are usually depressed, anorectic, and agalactic, and the vulva is swollen and hyperemic with mucopurulent to purulent malodorous vaginal discharge that may soil the perianal region. Secondary septicemia may occur. Mucoid vaginal discharge with secondary mucometra and chronic endometritis and cystic endometrial hyperplasia are also reported.
83
What disease is shown in this picture of the endometrium of a chinchilla?
84
What is the clinical significance of Pulmonary trophoblastic emboli in chinchillas?
Incidental finding in pregnant and post parturient chinchillas. The trophoblastic cells are large, 100 µm to > 400 µm with multiple large nuclei, and they are found in clusters of 1–6 cells within alveolar septal capillaries. Sometimes groups of cells can be so large that they are visible as small, raised pulmonary nodules. Rodents, like humans, have hemochorial placentation, such that the maternal blood is in direct contact with the fetal chorionic epithelium. This circumstance allows migration of trophoblastic cells directly into the maternal bloodstream. Trophoblastic cells are also seen in the myometrium. These cells migrate from the developing placenta and can persist long after the pregnancy has completed.
85
What disease is shown in this picture of the endometrium of a chinchilla?
Mucometra
86
What 3 uterine neoplasms have been diagnosed in chinchillas?
Uterine lymphoma, leiomyoma, and leiomyosarcoma
87
What is an appropriate ddx list and diagnostic testing plan for a chinchilla with neurologic signs?
bacterial, fungal and parasitic otitis media and interna, meningitis, encephalitis, nutritional deficiencies, and lead toxicity.
For all cases, the diagnostic plan is similar and includes gross examination, histology, and potentially bacterial and fungal culture, virus isolation, and toxicology.
Many neurologic conditions of chinchillas present with similar clinical signs, including torticollis.
88
Chinchillas are _____susceptible to the _______, ________ form of listeria. Route of infection is usually through the ______ and spreading to the ______.
Highly, visceral, septicemic, intestines, liver
Chinchillas are highly susceptible to the visceral septicemic form of listeria and the route of infection is typically via the intestine with later dissemination to the liver and a resultant septicemia. Involvement of the brain also occurs as a sequela to septicemia. When the brain is involved, neural lesions include fibrinosuppurative meningitis, and foci of parenchymal necrosis and microabscessation with intralesional Gram-positive bacilli. The more characteristic hepatic and intestinal lesions of listerosis may also be seen in these animals or in other affected animals from the same group, which will assist in selecting relevant diagnostic tests and differential diagnoses.
89
Otitis media and interna are frequently seen in young chinchillas secondary to infection with which organisms
Potential bacterial agents include Bordetella bronchiseptica, Streptococcus pneumoniae, S. pyogenes, S. zooepidemicus, Klebsiella pneumoniae, Pasteurella multocida, Pseudomonas aeruginosa, and Staphylococcus aureus. Mucopurulent or caseous exudate can be found within the external ear canal if the tympanic membrane has ruptured as well as within the tympanic bulla. Inflammation can progress to involve the inner ear, meninges and brain, and affected animals will present with ataxia, torticollis, circling, and rolling. Microscopically, fibrinosuppurative exudate and bacteria can be seen within the tympanic bullae and meninges with extension into the cerebral parenchyma.
90
What disease is shown in this picture of the endometrium of a chinchilla?
Mucometra
91
An aged chinchilla presented with a short history of lethargy, anorexia, and mild, intermittent rear leg tremors. Granulomatous meningitis and optic neuritis were noted with large numbers of ______ organisms typical of ______ spp.
Yeast, Cryptococcosis
92
How was cerebral nematodiasis transmitted in a chinchilla farm?
Ingestion of bedding and feed contaminated with raccoon feces.
Affected animals developed acute progressive ataxia, torticollis, paralysis, incoordination, and tumbling. The clinical signs progressed and animals became recumbent, comatose, and died or were euthanized. At necropsy, no gross lesions were seen. Microscopically, foci and tracks of malacia with swollen and degenerating axons and neurons were seen in midbrain, medulla, and cerebellar peduncles with varying amounts of eosinophilic and lymphohistiocytic meningeal and perivascular infiltrates. Cross-sections of ascarid larvae with prominent lateral alae were present in close proximity to areas of parenchymal necrosis. A presumptive diagnosis of B. procyonis larval migration and encephalitis was based on the fact that the hay for the three farms was stored at one location where raccoons were known to reside and the ranch owner had noticed raccoon feces on the hay. Sourcing and maintaining bedding and feed ingredients in biosecure facilities will reduce the risk of contamination with raccoon feces containing B. procyonis eggs.
93
What is the definitive host of Frenkelia microti? Where has this organism been found in a chinchilla? What were the reported clinical and pathologic signs?
Raptors; a large Frenkelia microti tissue cyst with no associated inflammatory response was identified in the cerebrum of a retired breeding female chinchilla; This animal exhibited no clinical signs and at necropsy, no lesions were observed.
Coccidia of the genus Frenkelia have an obligatory two-host life cycle, which includes a rodent intermediate host and a raptor definitive host. The chinchilla likely became infected by ingesting food contaminated with feces from an infected hawk.
94
What are typical clinical exam/microscopic findings of a chinchilla with neurologic signs secondary to toxoplasmosis?
When the cerebrum is involved, clinical signs include sudden death, depression, hunched posture, tachypnea, ataxia, and inability to stand. Typical microscopic lesions include a granulomatous encephalitis with intralesional Toxoplasma sp. bradyzoites.
95
A chinchilla presents with uveitis and sudden death. Histopath findings include neuronal necrosis, microgliosis and lymphocytic perivascular cuffing with numerous intranuclear inclusions, both eosinophilic Cowdry Type A and large, amphophilic, homogeneous viral inclusions in neurons and astroglia. What is your suspected diagnosis?
A) toxoplasmosis
B) human herpesvirus-1
C) chinchilla herpesvirus
B) human herpesvirus-1
Systemic disease, uveitis, and sudden death with nonsuppurative encephalitis were reported in pet chinchillas infected with human herpesvirus-1. Microscopic cerebral lesions included neuronal necrosis, microgliosis and lymphocytic perivascular cuffing with numerous intranuclear inclusions, both eosinophilic Cowdry Type A and large, amphophilic, homogeneous viral inclusions in neurons and astroglia. Herpesvirus was confirmed by transmission electron microscopy and the virus was recovered and shown to have near 100% sequence homology with human herpes simplex virus Type 1 (HHV-1). Ocular infection was considered to be the originating site of the infection with subsequent spread to the brain. The source of infection was not determined but close contact with a human shedding HHV-1 was considered the most likely.
96
What ocular clinical signs may be seen with lead intoxication in chinchillas?
Blindness
97
What is a potential cause of fatalities during air shipment of chinchillas and what are the reported pathologic signs?
Cabin pressurization problems during air transport resulted in a group of chinchillas dying during transit. At necropsy, the lungs were edematous and mottled red-black, and the tympanic bullae contained blood. Microscopically, the tympanic membranes were congested and frank blood filled the tympanic bullae. The lungs from affected animals were edematous and congested.
98
According to one retrospective study, what part of the eye is most commonly affected by pathology?
The lens; cataracts are very common.
99
What is the 3rd most common ophthalmic abnormality reported in chinchillas?
In a retrospective study of clinical ocular disorders, conjunctival disease was the third most common condition reported. Foreign body conjunctivitis in both nursing and adult chinchillas can develop secondary to excessive exposure to dust baths. Catarrhal conjunctivitis can be seen in environments with dirty or poor quality bedding, inadequate cage ventilation, and elevated ammonia levels. Conjunctivitis in chinchillas can also have a primary bacterial etiology and agents include S. aureus, Streptococcus spp., and P. aeruginosa cultured from affected animals, and is also seen in conjunction with respiratory disease. Infected conjunctivae are hyperemic and swollen with serous to purulent ocular discharge (Figure 4.26). Where the ocular discharge is serous and no other ophthalmic clinical signs are present, underlying dental disease should be considered.
100
What is the second most common anatomic location of eye pathology in chinchillas?
Corneal disease, with corneal erosions and ulcerations most frequently diagnosed possibly from trauma or irritation from unsuitable dust bathing material.
101
Which infectious agent may induce keratitis, mild lymphohistiocytic uveitis, lymphocytic retinitis with partial to complete retinal detachment, and mild lymphocytic optic neuritis in chinchillas?
Human herpesvirus-1
102
What parasitic disease (dogs are the definitive host) has been documented to cause exophthalmos in a chinchilla?
Intraorbital Taenia serialis (coenuris) resulted in slowly progressive exophthalmos in an adult male chinchilla. This chinchilla had been kept indoors, but was provided with dandelions from the backyard. Microscopically, a single cyst with multiple invaginated protoscolices, each bearing a prominent scolex with refractile hooks, suckers and numerous calcareous corpuscles, consistent with Taenia coenurus, was identified within the orbit. Dogs are definitive hosts of T. serialis and it is likely that either the hay or the dandelions fed to the chinchilla were contaminated with feces infected with T. serialis.
NOTE: The infection with the metacestode larval form (coenurus) of T. serialis is called coenurosis.
103
What infectious organism has been reported to cause hypopyon in chinchillas?
Pseudomonas aeruginosa
104
Where do chinchillas excrete excess dietary calcium?
In the colon (not the bladder)
105
What is the prevalence of heart disease in chinchillas?
23%, mostly innocent murmurs
Echos recommended for chinchillas with grade 3-6 heart murmurs only
106
What percentage of chinchillas on fur farms develop fur chewing?
15-20%
107
What causes cotton fur syndrome in chinchillas?
Ingestion of dietary protein >28%
108
What dietary deficiencies are associated with skin disorders in chinchillas?
Fatty acids, panthotenic acid, and zinc
109
Ulcerative keratitis and retinitis have been reported in chinchillas infected with which anthropozoonosis?
Human herpesvirus type 1
110
Aged chinchillas are prone to what type of cataract?
Posterior cortical cataracts
Also prone to asteroid hyalosis (mobile calcium-lipid opacities in the vitreous humor)
111
When do chinchillas eat?
70% of diet consumed at night along with fecal ingestion.
112
How much of the gi content does the chinchilla cecum hold?
23% (rabbits hold 57-65% in cecum and guinea pigs cecums, 44-65%)
113
What type of uterus do chinchillas have?
Uterus duplex bicollis vagina simplex
Two uteri, two cervices, single vagina
(Separate cervical openings cannot be discerned macroscopically)
ABVP ARM Study Qs
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