Common Injuries and Diseases

For initial treatment of injuries, refer to the section on First Aid.

Diagnosis of injuries includes:

• History
• Where from - place & situation
• When found
• Anything noticed by finder
• Any treatment carried out
• Any other relevant information

Observation

• Posture
• Frightened or calm
• Bright, alert - sleepy, listless, lethargic
• How does it stand
• Limbs hanging “loose”
• Huddled down
• Head position - ear position
• Uncoordinated or stumbling
• Fitting or convulsions
• General conformity
• Condition of fur e.g. dirty, bloody, wet soiled or contaminated
• Coughing, sneezing, vomiting, frothing
• Blood in box or on animal
• Condition of faeces - consistency, colour, smell 

 Examination

• Initial Aim - treat or euthanase.
• Perform in a safe location
• Keep noise to a minimum.
• Have examination aids to hand (pouches etc).
• Must be systematic.
• Should follow a sequence - proximal to distal (top to bottom) except for Macropods – distal to proximal (the majority of injuries in Macropods are in the hind legs, lower spine or base of tail. Most of these injuries will not be treatable).
• Compare sides
• Stop examination if animal is too stressed or goes into shock

Palpation

General

• Body temperature
• Body condition - feel - weigh
• Ectoparasites
• Muscle tone
• Dehydration

Head

• Fur loss, blood, matting, oedema
• Ear - discharge / debris
• Eyes - clear & bright or lack lustre, vision, blood, discharge, opacities, nictitating membrane
• Pupils - equal, reaction to light, very rapid movement
• Nostrils / nares - cracked, bleeding, discharge
• Mouth - mucosa colour, blood, discharge, palate condition, airway, smell

Body

• Fur loss, blood (where?)
• Crepitus over chest
• Air under skin
• Spine
• Pelvis
• Cloaca - matted, stained, diarrhoea, blood, discharge, raw skin, smelly
• Ectoparasites and maggots
• Tail

Upper limbs

• Proximal to distal- compare sides
• Asymmetry
• Palpate bones and joints for deformity, crepitus, abnormal movement, oedema, blood, bruising
• Check digits, pads and claws

Legs

• Know your anatomy (quadrupedal or bipedal)
• Repeat the same process
• Check, digits, pads and claws - knuckling on toes 

* REMEMBER: CEASE EXAMINATION IF ANIMAL IS TOO STRESSED OR

GOES INTO SHOCK.

Signs of Stress

The management of any wild animal during all stages of rescue, recovery, rehabilitation and release, should be geared towards minimizing stress.  Whilst wild animals can and will arouse curiosity in children, they are definitely not playthings and children should not be involved in early stages of care.  Keep in mind your own domesticated pets. Their noise and smell can play a big part in stressing a wild animal that has come into your care. 

Stress can create physical changes in the body - lowered immune response, lack of resistance to disease, protein breakdown resulting in weight loss, poor wound healing and an inhibition of the inflammatory response which is designed to help the body fight infection and recovery from surgery. 

Signs include:

• Hyper or hypo activity
• Escape attempted
• Thumping ground
• Barking or hissing, teeth grinding (joeys are usually quiet.  Their call when lost or insecure needs answering quickly.)
• Head shaking and / or ear flicking (sometimes mistaken for foreign body in the ear.)
• Body temperature
• Pale mucous membranes
• Licking of forearms, shoulders, chest, hind legs
• Hiding head
• Outstretched hands
• Clawing at itself, usually face
• Myopathy (see diseases)
• Decreased food intake, decreased body weight.  Failure to thrive
• Alopecia (bilaterally symmetrical) or rough coat
• Diarrhoea especially in joeys
• Stress in Echidnas may be shown by snuffling or nasal discharge 

Injuries 

The most common injuries are fractures, lacerations, arterial lacerations, puncture wounds, burns and internal injuries. 

Fractures 

All animals will require veterinary attention for diagnostic confirmation and an anaesthetic to allow handling and/or to relax the muscles around the fracture and permit realignment. The vet in consultation with the carer will decide whether a fractured bone is worth treating. The time span for immobilization will depend on the nature of the fracture and the size and age of the animal, and could vary from 2 to 8 weeks. As rehabilitation is the objective, the final decision will depend on: 

• The position and type of fracture.
• The animal species.
• The animal’s ability to tolerate the required treatment and nursing, and still be viable for release. 

Temporary splinting can be used until the animal can be transported to the veterinarian: 

• All compound fractures should be covered with clean gauze before splinting.

• In macropods, a fractured arm can be strapped temporarily to the body, preferably with a crepe bandage or Vetwrap. The position is similar to a human arm held across the chest in a sling.
• Quadrapedal species can have fractured forelimbs firmly (not too tightly) splinted with cotton wool and a bandage.
• Fractured hind legs in macropods can be temporarily immobilized with appropriate size splints, eg rolled up newspapers, towels, all well padded and wrapped with bandages. Otherwise placing the animal in a very strong bag will suffice.
• In smaller quadrupedal animals, eg possums, fractured hind legs can be splinted as for forelimbs.
• If a spinal or pelvic fracture is suspected, place the animal on a board for transportation to the vet.

The following could be a general rule of thumb when assessing the course of action with a view to rehabilitation:

All large wild kangaroos with any hind leg or spinal fracture should be euthanased.

The only joint fractures in the hind limb of a macropod which may be viable are those involving the metatarsus and digits.

• Fractures involving the calcaneal process of the hock in macropods are extremely common and often overlooked, especially in joeys. Displacement often occurs and the strong leg tendon contracts causing permanent deformity.
• All tails must be checked for fractures and are very common in pouch young. If not treated or if splinted incorrectly, the tails become permanently deformed.
• In macropods, joint fractures in the upper limbs may seriously impede getting up or down, grooming and holding food and the animal may be unsuitable for release.
• Joint fractures in quadrupedal marsupials — most animals with these injuries are best euthanased, as they will probably not be good candidates for release.
• Fractures of the humerus in macropods are generally not suitable for pinning. The arm may be strapped to the body. Forearm fractures may heal themselves.
• Fractures of the radius and ulna can be pinned. This may be difficult in Red Kangaroos due to the curvature of these bones, making external fixation preferable. A Robert Jones bandage is often used for fractures of the radius and ulna. The hand should also be included, placing soft packing between the digits.

• Fractures of the femur may require pinning and further stabilization to prevent rotation. In Macropods the healing fracture may break down at a later date.
• In all marsupials, except the larger macropods, fractures of the tibia may be immobilized with plates or external fixators. Immobilizing with pins does not always stabilize against rotation.
• Many fractures in the foot region are usually extensive and euthanasia may be the only option. Assess each animal on an individual basis.
• In all macropods avoid plaster casts and similar hard casts as the skin has very little underlying tissue layers and extensive pressure areas often occur.

• Fractured pelvis — In pouch young, some hairline and well aligned fractures of the pelvis have a good prognosis. Total rest and minimal handling for 3-6 weeks will be necessary. For more extensive fractures, and for pelvic fractures in older animals, euthanasia should be considered. Nursing will be intensive, debilitating and stressful for all concerned and the result is often disappointing.
• Femoral head dislocations in macropods are not treatable. These often result from animals caught in fences and are often overlooked.
• Fractured ribs - fragments may damage internal organs and ultimately lead to death. If there is no internal damage, the ribs may heal themselves. Total rest is imperative.
• Occasionally, minor fractures of the head (jaw, nose, skull) will heal adequately. Only someone experienced in this field should decide the prognosis.

• The commonest injury in Echidnas is damage to their beak. These injuries are generally not repairable and render the animal non viable. Veterinary assessment is imperative.

In all cases — consider the species and its requirements on release. 

Lacerations 

Up to 6 hours after a wound has been inflicted there is little multiplication of bacteria, so washing and cleansing with a mild bacterial solution is usually adequate. 

After 6 hours and up to 12 hours, the bacteria multiply, so an antibiotic cover should be given.

After 12 hours the wound should be considered to be infected. 

Flush the wound well with an antibacterial irrigation fluid to remove debris, eg betadine solution or chlorhexadine. Do not use surgical soap or detergents on exposed tissues. 

The wound may require suturing and draining by a veterinarian. 

Old wounds that are grossly contaminated and not good candidates for surgery should be cleaned as above, the infection controlled and granulation tissue allowed to develop. Dressings should be kept as light as possible, placing a non-adherent sterile material, such as Vaseline gauze over the wound. Use plain gauze swabs and dermaclens to debride and promote new tissue growth. Dressings may need to be changed every day or so in severe cases. 

Arterial Lacerations 

Control haemorrhage by pressure bandage and/or tourniquet to an extremity proximal to the injury. 

Once bleeding has stopped, treat for shock and seek veterinary attention. 

Puncture Wounds 

These include bite wounds from cats and dogs and gunshot wounds. 

Small wounds that look minor should always be opened to examine the underlying tissue for damage or infection. There can be extensive damage and the wound will usually need flushing out with chlorhexidine (0.05% solution) or betadine (10% solution). An antibiotic and tetanus injection should also be administered.

Burns 

When a burn victim is presented evaluate and make a decision quickly whether to treat or euthanase. It is recommended that any animal with severe burns should be euthanased and only animals with small areas of superficial burns should be treated.   

Superficial burns usually only affect the epidermis and possibly the underlying dermis. The hair may be singed but is still firmly attached. These burns are initially very painful, but healing is rapid. 

Treatment for burns includes:

• Analgesics (Pethadine)
• Ice or cold water compresses for 20 minutes (for recent burns)
• Clip and cleanse very gently
• Apply topical antimicrobial ointments (silver sulphadiazine (1%), or gentamycin cream)
• Apply topical burns dressing and tape in place. 

Housing for recovery should not be heated, but at ambient room temperature. Thick soft bedding should be used to relieve pressure. 

Internal Injuries 

If internal injuries are suspected (eg bleeding from the mouth, nose or cloaca, laboured breathing, pale to blue gum colour), seek veterinary advice.  

Diseases

Following is a list of diseases / medical problems commonly seen in marsupials. 

Pneumonia 

This can occur in all species. 

Inhalation pneumonia can be caused when attempting to tube feed and the fluid goes into the lungs and not the stomach.  Tube feeding should be left to experts and then only if there is no other option. 

Using too large a hole in a joey’s teat can cause it to drink too fast, causing milk to be aspirated into the lungs.  If choking occurs hold the joey upside down and clear any milk away form the nose immediately.  

Any animal suffering milk inhalation should not be left untreated, as secondary infection may set in and then the prognosis is poor. Treatment includes electrolyte fluids to replace milk feeds for 24 hours and antibiotic cover. 

Pneumonia can also be caused if an animal’s body temperature is not maintained correctly or if the animal is stressed. 

Signs of pneumonia include:

• The animal is lethargic and loses appetite. 
• The mucous membranes are pale and in severe cases may be blue.
• Breathing may be laboured, rapid or noisy and sometimes wheezing or rales can be heard during respiration. 
• Bubbles or fluid may be present in the mouth and nasal passages. 
• The body may feel cold or hot to the touch. 

Treatment includes warmth, quiet, fluids and antibiotics.  In severe cases fluids may have to be given intravenously or subcutaneously.  Changing the animal’s lying position regularly will help as this prevents the fluids from setting in one part of the lung.  Veterinary advice is imperative. 

Candidiasis (Thrush) 

This is caused by the fungus, Candida Albicans, and affects the digestive tract.  It is usually only seen in milk dependent young. Prolonged diarrhoea from either diet or stress results in an over population of the Candida fungus in the gut, which in severe cases may infect the entire digestive system.  Poor hygiene and diet or the use of antibiotics predispose this condition.  It is not usually a serious disease, unless allowed to go untreated.

Signs include persistent, greenish, yeasty smelling diarrhoea.  A white milky

substance may be seen around the teeth and gums.  The cloaca may be red and inflamed.

Treatment - Nystatin oral drops, obtained from a veterinarian / chemist.

Coccidiosis

Caused by an intestinal protozoan parasite.  It is believed that the majority of kangaroos carry the coccidian parasite in their gut lining.  It is only when there are sufficient numbers of the parasite, or the animal is under stress, that there is any evidence of the disease. It seems to occur mainly at weaning in Western Grey Kangaroos.  Adult kangaroos are usually immune. 

Signs - Coccidiosis can present in several different forms.  In the less severe chronic form, the animal may be lethargic and usually has very dark to black soft faeces.  If treated immediately, the animal may recover.  Unfortunately, in the acute form, the first sign may be severe haemorrhaging followed very shortly by death. 

Treatment - Diagnosis is made by microscopic examination of faecal sample.

Appropriate treatment for marsupials will be administered by your veterinarian.  Fluid replacement will be necessary. 

Nasal Coccidiosis 

Nasal coccidiosis or besmoides is a similar parasite to the intestinal form but occurring only deep in the nasal passage of marsupials. 

Signs - The discharge from the nose may vary at first and may be mistaken for a foreign body. If it becomes persistent and blood stained, the discharge should be examined under a microscope by a veterinarian.

Treatment - Although long term antibiotic drugs are needed, treatment is usually successful. 

Bloat 

Most cases occur in marsupials which habitually chew or pick on fabrics such as

blankets, pouches, carpet or wool.  It is occasionally seen in animals that over - groom, whereupon the ingested fur forms large hard balls in the intestine causing a blockage, leading to bloat.  It is most commonly seen in red kangaroo joeys. 

Signs - The animal will initially refuse food.  There will be almost no bowel movement and the pellets, if any, may be very small and hard.  There will then be varying signs of colic, e.g. lying down and getting up immediately, rolling, stretching, twisting and teeth grinding.  The stomach area will feel swollen and tight becoming larger as the condition worsens.  The gum colour is usually pale. 

Treatment - If a blockage is suspected, a dose of liquid paraffm should be given.

Depending on the size of the animal, up to a cupful of oil can be given at any one time.  Stimulation of the cloaca may encourage bowel movement. If nothing is passed and the signs do not abate, veterinary help must be sought immediately. By this time, the situation is very serious and major surgery is usually unsuccessful. 

Tetanus 

Occasionally seen in macropods. The tetanus bacteria, which can lie dormant in the soil for years, enters the animal through a deep puncture wound.  The wound often goes undetected, as it usually occurs on the bottom of the foot or in the mouth.  The toxin then attacks the nervous system and muscles. 

Signs - The animal may at first appear to be slightly stiff, walking with difficulty.  It may have problems with breathing and will start salivating.  It may appear to want to eat, but as the disease progresses it will become increasingly more difficult for it to do so.  The ears will be stiffened and upright and the facial expression will be worried.  The muscles will then start to twitch, and as it worsens, this develops into spasms, especially noticeable when the animal is stressed or stimulated by any loud noises.  By this time the salivating is more pronounced, and the animal will not be able to open its mouth. 

Treatment - By the time the disease is noticeable it is highly unlikely that treatment will be successful and it is probably kinder to euthanize.  In captive situations, tetanus can be prevented by vaccination. 

All carers, because they are susceptible to bites and scratches, should have regular tetanus vaccinations. 

Lumpy Jaw 

Lumpy jaw is a particularly nasty bacterial infection of the tissue and bone usually affecting the area around the jaw and teeth.  It can be associated with a tooth root abscess.  This condition is more common in the red kangaroo and some wallaby species. 

Signs - A hard swelling occurs usually along the lower jaw bone.  The animal becomes very depressed and refuses to eat. 

Treatment - The disease can occur in a chronic form which can be controlled by

antibiotics, but quite commonly reoccurs.  In the more serious form the infection rapidly spreads through the body, infecting the lungs etc.  The animal’s condition deteriorates rapidly and death will be swift. 

Kangaroo Pox 

This is a viral problem occurring in macropods. 

Signs - Irregular nodules appear with a roughened surface initially with hair, but as the lesions increase in size the hair is lost.  Larger lesions are always black and firm, but are not tender.  They are usually found on the legs and tail. 

Treatment- Usually excision is only warranted if the lesions are causing problems.  Antibiotics have no effect as the cause is viral.  The lesions are self- limiting and usually disappear after 2-3 months. 

Myopathy 

This is caused by stress of capture or confinement 

Signs - Lethargy, depression, inability to stand and loss of muscle tone in neck and hind limbs, caused by a break down of the muscle tissue. 

Treatment - Corticosteroids, antibiotics, sedatives, vitamin E and fluids can be tried.  The prognosis is poor for severe cases. Mild disease may be self limiting.  Prevention is improved by making capture quick, thus minimizing stress.  Nervous macropods being introduced into unfamiliar enclosures should be sedated by a veterinarian. 

Ringworm 

Caused by a fungus, this is usually only seen in captive animals which have come into contact with other infected animals / humans (zoonotic)

Signs - Multiple and roughly circular areas of alopecia.  The skin may be rough and thickened.

Treatment - Diagnosis is confirmed by microscopic examination of fur taken from

around the lesion.  It is treated by antifungal creams or washes and / or tablets, both being administered by a veterinarian.

Antibiotics

Antibiotics should never be given indiscriminately to any wildlife.  Often they are not necessary, and in some cases can actually cause bacteria to build up a resistance to the drug.  With herbivorous marsupials, all antibiotics should be injectable where possible. If given orally they can destroy the natural gut flora in the animal’s stomach, leading to further complications.