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Special Species > Avian Exam Pt. 2 > Flashcards

Avian Exam Pt. 2 Flashcards

1
Q

Examples of avian emergencies (6)

A

1) Hemorrhage
2) Trauma
3) Neurologic signs (seizures, tremors, ataxia)
4) Fluffed bird on the bottom of the cage
5) Egg binding, cloacal prolapse

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2
Q

What should you instruct a client to do before bringing in an avian emergency?

A

1) Stop any bleeding - direct pressure, styptic, corn starch
2) Provide heat
3) Reduce stress on the bird - quiet and dark room
4) Bring bird in a carrier (never allow loose birds in your waiting room)

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3
Q

What does fluffing at the bottom of a cage indicate?

A

Birds response to loss of body heat - need to keep them warm

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4
Q

Initial assessment of avian ER cases

A

Visual exam in cage - respiratory rate (tail bob), mentation, ambulation, posture, droppings

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5
Q

Things in the history you want to think about with avian emergencies

A

> Improper husbandry = common cause of illness

  • Diet
  • Droppings, equal amount of urine, feces, urate
  • Any new pets in the household
  • Exposure to toxins - lead paint
  • Cage type and location
  • Perches, substrates, or toys
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6
Q

What to keep in mind with PE’s of avian emergencies

A
  • KNOW THE PATIENT’s LIMITATIONS AND STRESS LEVEL
  • Establish priorities
  • May need to pre-oxygenate or stage PE’s = have O2 or sedation ready
  • MONITOR stress level during restraint (open mouth breathing?)
  • Only perform PE if the bird is stable
  • Careful not to compress the keel during restraint
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7
Q

What sedation can be used in avian emergencies?

A
  • Intranasal or IM midazolam +/- butorphanol (for deeper sedation)
  • Reversed with flumazenil (IM, IN, IV)
  • Decreases the acute stress response
  • Anamnestic = makes them forget the stress
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8
Q

How much blood should you take from a normal or severly compromised bird?

A
  • Safely take 1% of body weight
  • Compromised birds = aim for <1% of BW = already anemic? hypoproteinemic?

*Blood volume = 10% of body weight

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9
Q

Where do we take veinpuncture from in birds?

A
  • Best choice = RIGHT jugular
  • IV catheter = ulnar in small birds (hematomas common, difficult to hold off)
  • Median metatarsal vein in bigger birds
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10
Q

Basic emergency avian PE

A
  • Auscultate heart, air sacs, lungs
  • Palpate coelomic cavity
  • BCS from keel (thin = more chronic disease)
  • Examine nares, oral cavity
  • Examine neck, crop
  • Palpate wings, legs
  • WEIGH

+/- Cloacal inversion
+/- Skin and feather exam
+/- Feet
+/- Back or uropygial gland if present

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11
Q

Reliable and non-reliable ways to assess hydration in birds

A
  • Assume any sick bird is dehydrated and will need fluids
  • Move upper eyelid upward = should spring back normally
  • Sternal skin test over the keel = skin should normally be freely moveable
  • Ulnar vein refill time
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12
Q

Preferred and other routes of fluid administration (and where?)

A
  • Preferred = SQ in the inguinal region (large volumes, non-invasive), small gauge (23-25g)
  • IV (+ sedation) = R jugular, metatarsal, ulnar
  • IO (+ anesthesia) = ulnar, tibiotarsal (NOT humerus, femur)
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13
Q

Why can’t you do IO fluids in the humerus or femur?

A

Pneumatic bones that connect to air sac, will drown the bird

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14
Q

What is a good choice for fluid therapy?

A
  • Warmed fluids
  • Crystalloids
    > 40-60 ml/kg/day + dehydration or fluid deficits
  • Colloids for IV use in volume depleted cases
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15
Q

Why do we make sure we can see a bleb when we give fluids SQ?

A

To ensure we’re not enstilling it in an air sac

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16
Q

Materials to use and things to remember when placing IO catheters/fluids

A
  • Site = distal ulna, proximal tibiotarsus
  • Usually requires anesthesia or analgesia
  • Can stay in place for several days if needed
  • Materials = 22-g spinal needle, figure-8 bandage, suture into place
  • Aspirate to ensure placement
    +/- Flush to observe ulnar vein fill more proximal on the wing
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17
Q

Things to remember when hospitalizing sick birds

A
  • House them in a room separate from cats and dogs
  • Incubate 80-90 degree F
  • Use cages and perches that are easy to disinfect
  • Use oxygen/nebulization cages
  • Be conscious of infectious agents with other cases in the hospital
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18
Q

Further diagnostics you can do if the bird is stable (3)

A

1) Imaging = rads, U/S = take TWO views of the entire body, line up keel with spine in VD, requires anesthesia/sedation
2) Cytology and culture from coelomic fluid, choana, fecal or nasal flushes, crop samples
3) Endoscopy - has to be very stable

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19
Q

Order of treatment in stable birds (first to last)

A

1) Know the bird’s weight
2) O2 if necessary
3) SC fluids or injections
4) Meds SC, PO, IM
5) Monitor patient stress levels at all times
6) LAST = tube or force feeding - put them in the incubate immediately after feeding (reduces aspiration risk, can shake head and cough)

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20
Q

Why do we place birds in their cage/incubator quickly after force feeding?

A

To avoid aspiration - allows them to clear their airways and/or cought

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21
Q

What/where is the most common route for injectable medications?

A

IM in the pectoral muscle

22
Q

What IM medication can cause muscle necrosis? What can you do to avoid it?

A

Enrofloaxacin - pH = 11, dilute it out and give it SQ to avoid (buffers and absorbs)

23
Q

What nutritional support do we offer for avian patients?

A

> Critical care hand feeding formulas, mixed with warm water as directed
- Tube fed with feeding needles or red rubber feeding tubes

24
Q

Do’s and don’ts of crop lavage

A
  • Metal tubes = good for parrots
  • Red rubber catheters for raptors or large birds (goes farther)
  • Assistant retrains, enter the oral cavity with feeding needle from the commissure, advancing slowly
  • Palpate the instrument as it passes into the crop
  • Should feel TWO tubes = feeding tube and trachea
  • Administer food and watch for it coming back into the mouth from the crop
  • Put down the bird immediately so it can clear it’s airway
25
Q

What crop lavage volume do you generally shoot for?

A

3-5% BW - start low and increase volume if the bird tolerates it

26
Q

Problem and treatment of blood feather hemorrhage

A
  • Blood feather = new, actively growing feather with a large nutrient artery in shaft, can cause life threatening hemorrhage if broken
  • Tx = remove using hemostats or needle-nosed pliers
  • Pull in the same direction as the feather is growing
  • Should see the bulbous end when you pull it out = means the shaft has been completely removed from the follicle
27
Q

Treatment of fractures

A
  • Assume most are open = bones are sharp, poke through skin easily
  • Open fracture = clean, debride, administer antibiotics
  • Analgesia = NSAID’s +/- butorphanol
  • Stabilize the fracture = temporary with bandage (figure-8, robert jones), surgical if the bird is stable
28
Q

When do we use figure 8 bandages?

A

Stabilizes most wing fractures (keeps it in a fixed position) - add body wrap if it includes humerus or coracoid fracture

29
Q

When do we use Robert jones or tape splint bandages?

A

For fractures distal to the femur with sedation/anesthesia, based on the size of the bird

Tape splint = smaller birds, wrap tape and krimp with hemostat to add rigidity

30
Q

What is important to remember about fracture immobilization?

A

Need to immobilize the affected limb to the extent of a joint above and below the fracture

31
Q

Treatment of avian bite wounds

A
  • Analgesia
  • Anti-inflammatories
  • Fluids
  • Cleaning and surgical debridement (CAUTION with air sacs and flushing cavities)
  • Use of antibiotics = depends on the circumstance of the bite (bird on bird vs. cat/ferret bite wounds)
32
Q

Clinical signs of avian dyspnea

A

+ Open mouth breathing
+ Tail bobbing
+ Increased thoracic excursions

33
Q

Handling of dyspneic birds (do’s and dont’s)

A
  • Minimal handling of the bird = already stressed and unstable
  • Place in warmed incubator with supplemental O2
  • SEDATE
  • Observe and characterize breathing, gather the supplies while the bird is resting in oxygen chamber
  • Delay diagnostics until the bird is more stable
34
Q

ER treatments for a dyspneic bird

A

*Based on suspected etiology
- O2
- Empirical antibiotics or anti-fungals
+/- Furosemide
- Nebulization for URI’s
+/- Air sac cannula placement

35
Q

Diagnostics for a dyspneic bird

A
  • Radiographs = differentiate between lungs, air sacs, heart, coelom
  • CBC = leukocytosis may indicate Chylamdophila, Mycoplasma, Aspergillosis
    +/- Chem panel to check liver and renal values
  • Specific disease testing = tracheal or choanal cultures, Chlamydophila PCR/serology
    +/- CT if stable
    +/- Laparoscopy of trachea or air sacs
36
Q

What should you do with a bird that is in severe respiratory distress and will likely die without assistance?

A

Place an air sac tube (ONLY if it’s an upper airway obstruction)

37
Q

Do’s and dont’s for air sac tube placements

A
  • ONLY for upper airway obstructions
  • Target = caudal thoracic or abdominal air sacs
  • Animal is in RIGHT lateral recumbency
  • Insert the tube caudal to the last rib, in the flank region
  • Use short ET tubes or sterilized red rubber tubing
  • Suture in place
38
Q

DDx? Abdominal distension, dyspnea, +/- straining, weakness

A

Egg binding - unshelled, soft-shelled, or broken egg shell in oviduct

*Whole egg stuck in cloaca = can block urine and feces

39
Q

Pre-disposing factors to egg binding (2)

A

1) Obesity

2) Low Ca++ diet

40
Q

Diagnostics for egg binding

A
  • PE
  • Palpation
  • Radiographs
41
Q

Prognostic indicators for egg binding

A
  • How long has it been going on? LONGER = worse
  • Overall health status of the bird?
  • Location of the egg
  • Invasiveness of the procedures

+ Bird may bright, alert, responsive, or extremely sick

42
Q

Medical and surgical of egg binding

A

> Med = support and stabilization = fluids, analgesia
+/- Antibiotics if coelomitis is present
- Ca++ IM = to restore depleted body stores
- Oxytocin = ONLY for suspected uterine inertia
- EGG REMOVAL w/ heavy sedation or anesthesia, can try lubrication/manual manipulation, also transvaginal or percutaneous egg implosion/collapse

> Surgical = if needed, after stabilization

43
Q

Prevention of egg binding (2)

A
  • Discuss behavior cues with owner (avoid mirrors, nest boxes, etc)
  • Administer hormone therapy
44
Q

Differentials for avian neural disease (5)

A
  • Lead/zinc toxicity
  • Avian bornavirus
  • Hepatopathy = lipidosis, Chlamydophila psittaci
  • WNV
  • Trauma
45
Q

Diagnostics for avian neural diseases

A
  • Radiographs for foreign bodies (i.e. metal)
  • Blood lead or zinc levels
  • Avian bornavirus serology
  • Chlamydophila psittaci PCR
46
Q

Treatment for avian neurologic disease

A
  • Supportive fluids and/or tube feeding
  • Anti-microbials
  • Chelation therapy (Ca++ EDTA), even without blood Pb results
    +/- Anti-convulsant meds
    +/- NSAID’s
    +/- Remove metal from GI tract
47
Q

What is fun with bird PLR reflexes?

A

Birds have striated muscle in their iris, allows them to control their response to a PLR, makes the PLR difficult to interpret

48
Q

True or false - you can retrieve objects, from the ventriculus, with an endoscope

A

FALSE - too far distal

49
Q

Dx? Inappetence, weakness, vomiting/regurgitation, green diarrhea, PU/PD, +/- CNS signs, anemia, +/- pancreatic damage

A

Lead or zinc toxicity

CNS signs = Pb toxicity
Pancreatic damage = Zn toxicity

50
Q

Treatment of Pb or Zn toxicosis

A
  • Ca++ EDTA chelation
  • Fluid therapy
  • Gavage feeding when ileus has resolved
    +/- Antibiotics if you suspect GI damage

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