Journal of Wildlife Diseases. 29(1). 1993. pp.

177-179
. Wildlife 1)isease Association 1993

Brachial Plexus Injury in Two Red-Tailed Hawks

(Buteo jamaicensis)
Linda Shell,’ Michael Richards,2 and Geoff Saunders, 1 Virginia-Maryland Regional College of Veterinary Me&
icine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; 2 Mathews Veterinary Services,
P0 Box 487, Cobbs Creek, Virginia 23035, USA

ABSTRACT: Two red-tailed hawks (Buteo ja- presumptive diagnosis of radial nerve pa-
niaicensis), found near Deltavibbe, Virginia nalysis was made. The rehabilitator was
(USA), were evaluated because of inability to
advised to flex and extend the wing reg-
use a wing. Results of needle electromyographic
studies of the affected wing muscles in both
ubarly to preserve the musculature and to
hawks were compatible with denervation. On keep the joints flexible.
euthanasia, one hawk had extensive axon and Hawk 2, also found near Deltaville, Vir-
myelmn loss with multifocal penivascular lym- ginia, was presented 5 January 1991, Un-
phocytic inflammation of its brachial plexus and
able to fly, but alert and eating. There were
radial nerve. Demyelmnation and axon loss in the
dorsal white matter of the spinal cord on the
no visible lesions except that the left wing
affected side also were found at the origin of drooped. Based on radiographs of the wing,
the brachial plexus. The other hawk’s wing had there was no fracture or luxation. The din-
not returned to functional status >2 yr after icab diagnosis was radial nerve paralysis
injury.
and the bird was referred to the Virginia-
Key words: Red-tailed hawk, nerve injury,
brachial plexus injury, electromyography, de-
Maryland Regional College of Veterinary
nervation, demyelmnation, Buteo jamaicensis. Medicine (Virginia Tech, Bbacksburg, Vir-
ginia) for evaluation of nerve function in
Traumatic wing injuries in raptors are the affected wing. Hawk 1 still was in the
a common problem in clinics that treat cane of the rehabilitator and also was re-
wildlife. We report brachiab plexus injury ferred for evaluation. Although a persis-
with radial nerve paralysis in two red-tailed tent effort had been made to exercise the
hawks (Buteo jarnaicensis). Hawk 1 was wing, it still drooped and was not func-
maintained for 2 yr after the problem ap- tional. The hawk could not hold the wing
peared, with marginal clinical improve- high enough to prevent damage unless the
ment. Hawk 2 was euthanized shortly after flight feathers were trimmed very short.
a presumptive diagnosis of radial nerve Neurobogic and needle electromyo-
paralysis was made. graphic (EMG) examinations were per-
A mature red-tailed hawk (Hawk 1) was formed on each hawk. Needle ebectro-
presented to a rehabilitation organization myography was performed according to a
in February 1989. The hawk had been previously described technique (Shell et
found near Deltavibbe, Virginia (USA) ab., 1988) using the Nicolet Compact Four
(37#{176}30’N, 76#{176}20’W) on the side of a road, Unit with a two-channel EMG amplifier
unable to fly. The left wing dropped no- (Nicolet Biomedical Instruments, Madi-
ticeably. The hawk was in good condition son, Wisconsin, USA).
otherwise and ate well at the rehabilitation Abnormalities of Hawk 1 were restrict-
center. ed to the left wing and included weakness,
Radiographs of the wing were normal, decreased muscle tone and mass, ankybosis
and the bird was returned to the rehabilita- of joints, and lack of voluntary movement.
tor for observation. It was reexamined 2 Based on the needle electromyography,
wk later, with no improvement. The wing there were many fibrillation potentials and
at this time seemed slightly atrophied and occasional bizarre high frequency dis-
was noticeably weaker when flexed or ex- charges in the muscles of the left wing,
tended, compared to the normal wing. A compatible with denervation (Chnisman,

177
178 JOURNAL OF WILDLIFE DISEASES. VOL 29, NO. 1, JANUARY 1993

ent within the nerves, and dense connec-

tive tissue proliferation surrounded the
nerve fiber bundles (Fig. 1). The radial
nerve also had extensive axon and myebin
boss.
Skeletal muscle of the antebrachium had
mild myofiber atrophy with no evidence
of angular atrophy as seen in neurogenic
muscle damage. However, muscle enzyme
histochemistry was not done; this preclud-
ed proper evaluation of the muscle. Nerve
fibers within the muscle had extensive my-
FIGURE 1. Brachial plexus from a red-tailed hawk
(Hawk 2) showing chronic inflammation, nerve fiber elm boss. Mubtifocal mild lymphocytic in-
damage, and fibrosis(*). H&E. flammation was present.
The spinal cord was normal except for
dernyebination and axon loss in the left don-
1975; Gniffiths and Duncan, 1978). A few sal white matter at the origin of the brachi-
motor unit action potentials were ob- al plexus. The final diagnosis was pre-
served, which suggested some intact nerve sumed trauma to the brachial plexus with
fibers were present. The affected wing of spinal cord and radial nerve degeneration.
Hawk 2 had very poor muscle tone and Both hawks presumably had traumatic
would not retract when it was pulled away injuries to the brachial plexus region, re-
from the bird’s body. There also were many sulting in radial nerve paralysis. Such in-
fibrillation potentials and a few motor unit juries have been reported in owls (Bubo
action potentials with the needle EMG. virginianus, Otus asio), a gull (Larus ar-
Based on these results, we diagnosed pe- gentatus), a crow (Corvus brachyrhyn-
ripheral nerve injury in both birds. Hawk chos), and a red-tailed hawk (Smibey et ab.,
1 was returned to the rehabilitation or- 1988; Moore et al., 1989). In dogs, auto-
ganization with a poor prognosis; return mobile accidents are the most common
of function to the limb after 2 yr was high- cause of brachiab plexus injuries; it is hy-
ly unlikely. Hawk 2 was euthanized (Beu- pothesized that the shoulder and scapula
thansia-D, 1 ml intravenously, Schening- are displaced caudably on abducted, put-
Plough, Animal Health Corp., Kenibworth, ting tension on the dorsal and ventral nerve
New Jersey, USA) and a complete necrop- rootlets on the nerves of the brachial plexus
sy performed. (Gniffiths et al., 1974). There was no avub-
At necropsy, lesions in Hawk 2 were sion of the ventral or dorsal nerve rootbets
limited to the left antebrachium which had evident, based on the histopathobogy of the
muscle atropy and some focal hemor- spinal cord in Hawk 2. However, the de-
rhage. Tissues were fixed in 10% neutral myebination and axon boss in the dorsal
buffered formalin, embedded in paraffin, white matter were compatible with trau-
sectioned at 5 s, and stained with hema- ma to at least the dorsal nerve rootlets (Gnif-
toxybin and eosin for examination by bight fiths, 1974). In another report (Smibey et
microscopy. Histologically, there was ex- ab., 1988) of brachial plexus injury in a red-
tensive fragmentation and loss of axons tailed hawk, trauma to the ventral nerve
throughout the brachial plexus nerves. De- nootlets was supported by obvious boss of
myelination was nearly complete as as- cell bodies in the ventral gray column.
sessed with the Luxol fast blue stain for Radial nerve injury in raptors can be
myelin (Pearse, 1960). Multifocal penivas- difficult to distinguish from muscle or ten-
cular bymphocytic inflammation was pres- don trauma. The natural tendency of hawks
 SHORT COMMUNICA’TlONS 179

to resist manipulation complicates diag- LITERATURE CITED

nosis by making it impossible to discern CHRISMAN, C. L. 1975. Electromyography in the
sensory deficits. A high degree of suspicion localization of spinal cord and nerve root neo-

for avulsion injuries should be maintained plasia in dogs and cats. The Journal of American
Veterinary Medical Association 166: 1074-1079.
for raptors unable to fly within 2 to 4 wk
GRIFFITHS, I. R. Avulsion
1974. of the brachial plex-
of injury. Needle ebectromyography can us-i. Neuropathology of the spinal cord and
provide diagnostic (Chnisman, 1975) and peripheral nerves. Journal of Small Animal Prac-
prognostic information (Gniffiths and Dun- tice 15: 165-176.
AND I. D. DUNCAN. 1978. The use of elec-
can, 1978). In these cases presented here,
tromyography and nerve conduction studies in
needle EMG confirmed damage to the
the evaluation of lower motor neurone disease or
muscles supplied by the brachial plexus injury. Journal of Small Animal Practice 19: 329-
nerves. Although the needle EMG changes 340.
were most compatible with nerve injury, AND D. D. LAWSON. 1974. Avul-
sion of the brachial plexus-2. Clinical aspects.
nerve conduction studies would have been
Journal of Small Animal Practice 15: 177-182.
helpful to more specifically localize the
MOORE, M. P., E. STAUBER, AND N. THOMAS. 1989.
injury (Moore et ab., 1989). Avulsion of the brachial plexus in a great horned
Dogs with radial nerve paralysis some- owl (Bubo virginianus). The Journal of Raptor
times can be managed with physical ther- Research 23: 3-9.

apy to allow the muscles to remain healthy PEARSE, A. G. E. 1960. Histochemistry, theoretitcal
and applied, 4th ed. Churchill Livingstone, Ed-
until the nerve can regenerate (Gniffiths et
inburgh, United Kingdom, 857 pp.
al., 1974). None of the birds with reported SHELL, L., B. S. JORTNER, AND M. EnRICH. 1988.
cases of brachial plexus injury have im- Assessment of organophosphorus-induced de-
proved. Because hawks are rather poor pa- layed neuropathy in chickens using needle elec-

tients for physical therapy and bong-term tromyography. Journal of Toxicology and En-
vironmental Health 24: 21-33.
maintenance can be difficult, a guarded to
SMILEY, L. E., M. BONDA, A. GAYNOR, R. B. JUSTIN,
poor prognosis must be considered if K. L. VAN DER EEMS, AND A. DE LAHUNTA.
brachiab plexus injury is suspected. Refer- 1988. Avulsion of the roots of the brachial plexus
ral to a facility capable of ebectrodiagnostic in five birds. Companion Animal Practice 2: 38-

40.
studies should be considered to confirm the
diagnosis. The authors thank Dr. Gouni
Received for publication 7 October 1991.
Krishna for her assistance with the cases.