Hydrocephalus in a Red Panda Cub
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A one month old, female red panda presented to Cornell’s Exotics Service for a soft area on her head and erratic head movements. The patient was one of two cubs in a litter born in captivity. The other cub was healthy and nursing, and the dam was healthy, up to date on vaccinations, and has been on a nutritionally complete diet. The dam had a previous litter in 2013 with another sire and had two cubs, one of which died at a few days old from traumatic wounds, and the other died at two years of age due to cardiac issues. After the patient was born she was not nursing well, so the facility staff decided to hand rear her. Overall she was doing well, and her eyes opened within the last two days. At 2.5 weeks of age, a soft area on her head was noted, and radiographs and a skull ultrasound were performed. These revealed fluid in the calvarium, and a referring neurologist diagnosed hydrocephalus. No treatment had been initiated prior to presentation to Cornell. A physical exam and ophthalmologic exam revealed frequent erratic head movements, significant soft, fluctuant areas bilaterally on the rostral cranium, and reduced palpebral fissure and mild discharge in the right eye. A computerized tomography (CT) scan was performed which revealed severe congenital hydrocephalus and multiple large persistent fontanelles. Our diagnosis was severe, non-obstructive congenital hydrocephalus with open fontanelles and hydrancephaly. It is likely that the microphthalmia and the abnormal head movements are the result of concurrent congenital malformations, or may have been secondary to hydrocephalus and hydrancephaly. There was no evidence of obstruction in the ventricles or elevated intracranial pressure, so treatment consisted of constructing a helmet to protect her brain. We were unable to determine the extent that the lack of cerebrum would have on her mentation and behavior due to her age, and recommended waiting until she completes her development (9-12 months of age) to further assess her prognosis. We expected she would likely have a decreased lifespan compared to other red pandas maintained in human care, but we believed she had good quality of life at this time. Sadly, this patient was euthanized two weeks later at another facility due to respiratory distress unrelated to her previously diagnosed neurologic disease.