Avian Critical Care and Supportive Care Techniques

Question 1

Triage

Answer 1

The process of identifying quickly those patients who have life-threatening conditions and require immediate attention, as opposed to those who can wait

Question 2

Birds to see ASAP

Answer 2

Fluffed and ruffled posture

Weakness and partially closed eyes

Respiratory signs: pronounced dyspnea, prolonged panting or gasping for air, change in breathing or abnormal respiratory sounds, tail bobbing

Bleeding or injury

Lack of normal response to stimuli and incoordination

Marked abdominal distention and prolapse

Anorexia

Question 3

Evalutation and Triage:

Keep hands off first

Answer 3

observe bird, cage, and contents before considering restraint

Oxygen nad heat

Obtain history

quick physical exam

Question 4

Dyspnea

Clinical Signs

Answer 4

Excessive sternal motion

Open-mouth breathing

Extended neck

Tachypnea

Head bob, tail bob

Wings extended away from the body

Question 5

What not to do with a dyspnic bird

Answer 5

do NOT restrain birds that appear dyspneic or extremely weak

Question 6

Dyspnea

Treatment

Answer 6

Oxygen cage

Air sac tube: alternative to endotracheal intubation, for emergencies, foreign body, granuloma, neoplasia

Question 7

Air Sac Tube Procedure

Answer 7

Make a skin insicion on the lateral aspect of the bird behind the last rib.

Will hear a pop sound and that is how you know you are in the air sac

Insert tube (Red rubber)

Suture to the bird so they do not remove it.

Can be used to give oxygen or anesthesia.

Question 8

Hemorrhage

Answer 8

Damaged Nails - break and wil bleed a lot.

Blood feathers

skin wounds

Other Trauma: fractures, shot

Question 9

Hemorrhage

Treatment

Answer 9

Silver nitrate sticks

Would powder, flour

Sustained pressure

Super glue (surgical)

Sutures

Pull the blood feather: Hemostats to clamp the base of the feather, pull straight out, should stop the bleeding

Bite wounds - antibiotics

Question 10

Seizures

Causes

Answer 10

Hypocalcemia - african grey parrots

Hypoglycemia - neonates, raptors

Epilepsy

Others - infectious, toxins)

Question 11

Physical Diagnosis

Restraint

Answer 11

When catching up a bird, the first goal is to restrain the talons and head

Method varies with species and conditions

Ensure safety of handlers, medical staff, and patient

Sternum must be unrestricted

The handler should monitir the bird’s status

Avoid laying the bird on its back

Body weight

Question 12

Diagnostics

Options

Answer 12

Blood work - CBC, Chemistry

Imaging - Radiographs, CT

Parasitology

Toxicology

Others

Question 13

General Supportive Care

Answer 13

Clean, quiet, dark environment

Minimize stress

Hospital cage

Oxygen

Heat (70% RH)

85-90 degrees for adults

94 degrees for babies

Low perches or no perches

Easily Accessible food

Question 14

Fluid Therapy

Assessing Dehydration

Answer 14

History

Turgor / refill of wing vein

Sunken eyes

Tacky mucous membranes

Skin tent and sliding

PCV, TP, BUN

Question 15

Estimating Fluid Requirements

Answer 15

Estimated dehydration % x body weight (g) = fluid deficit

5-10% dehydration = 50-100 ml/kg fluid deficit

Deficit is generally replaced over 12-24 horus with maintenance fluids

Maintenance fluid = 50ml/kg/day

Question 16

Fluid Therapy

Oral Administration

Answer 16

Mildly dehydrated birds

Maintenance

+/- in conjunction with SQ or IV/IO

Question 17

Fluid therapy

Subcutaneous (SQ)

Answer 17

The most common route

Mild to moderate dehydration

Maintenance

Question 18

Fluid Therapy

Intravenous (IV) / Intraosseous (IO)

Answer 18

Sever dehydration

Severe Hypovolemia / shock

Bolus or continuous infusion

Question 19

Fluid Therapy

Types of Fluids

Crystalliods

Answer 19

LRS
LRS + 5% dextrose (if hypoglyemia)

Question 20

Fluid therapy

Types of Fluids

Synthetic Colloids

Answer 20

Hetastarch

Oxyglobin

Question 21

Fluid therapy

Types of fluids

Blood

Answer 21

If PCV< 15%

Homologous preferable

IV or IO

Question 22

Antibiotic therapy

Answer 22

Preferably based on blood work or a culture.

Cultures can take days, bird needs treatment now

Prophylactic (broad spectrum) use may be indicated on the basis of clinical signs and history for birds that cannot undergo further testing

Question 23

Antibiotic therapy

Clamydia suspect

Answer 23

Doxycycline

Question 24

Other drugs

Answer 24

Anaglesics (butorphanol)

Calcium

Glucose

NSAIDS (meloxicam)

Vitamin B complex

Others ( antifungals)

Question 25

Nutritional support

Answer 25

Many birds present after several days of anorexia

Start tube feeding as soon as stable and the GI tract is functioning

Daily weighing (important)

Question 26

Nutritional Needs

Answer 26

generally 3-5% body weight (30-50ml/kg)

Ideal gavage food temp. 100-105

Question 27

Key Points

Answer 27

Success with the critical bird patient is founded on preparation and planning

DO provide birds 5-10minute acclimation period whenerver possible

DO NOT restrain birds for prolonged periods

DO NOT restrain birds with obvious respiratory distress unless is extremely necessary

DO provide quiet, calm, housing as well as supplemental heat as needed