Bird 7 Flashcards
- Common signs of pain in birds
o Lethargy, fluffed up
o Anorexia
o Tachypnea, tachycardia
o Lameness
o Over-preening over-painful areas
o Alteration of species ethogram
is it hard or easy to for us to assess pain in birds? why? what should we keep in mind?
Harder to assess in birds because:
o Tends to hide signs of pain
o Minimal facial expression (no grimace scoring possible)
o Hard to extrapolate from mammals
- Why do we treat pain in birds?
oEthical reasons
oTo improve prognosis
- Pain is immunosuppressant
- Better appetite, less weight loss
- Better attitude, comfort
- Complete pain management plan
o Decrease stress
o Improve comfort
o Stabilize fractures
o Decrease handling
o Drugs
antiinflammatories that we should and should not use in birds:
Only NSAID
- NO corticosteroids in birds!
can we use the same analgesics for all birds?
A bird is not a bird is not a bird
o Every species is different
o Would you give the same drug plan to cows and dogs because they are both mammals?
use of opiods in birds? what should we use for parrots? raptors?
o Most parrots respond more to κ-agonists
- Butorphanol 1-5 mg/kg IM q2-4h
- Butorphanol 1-2 mg/kg/h CRI IV
o Most raptors respond more to μ-agonists
- Hydromorphone 0.1-0.3 mg/kg IM q2-4h
- Buprenorphine 0.1-0.6 mg/kg q6h IM
- Fentanyl 5-15 ug/kg/h CRI IV
analgesic of choice for birds?
NSAID
* Meloxicam
o Drug of choice
o Safe even at high dose and long term >Ensure bird is well hydrated
o Most birds: 1 mg/kg q12h PO
> 10 times higher than dogs!
- Alternatives
o Carprofen (cheaper, use in big birds)
o Celecoxib (more cox-2 specific but no data)
o Some NSAID toxicity reported in birds
Diclofenac in old world vultures
non NSAID options for analgesia in birds
- Tramadol
o Useful for chronic treatment at home when meloxicam is
not enough or contraindicated o Several studies in birds
o Can be combined with NSAID o 5-30 mg/kg PO q12h - Gabapentin
o Neuropathic pain
o Can cause sedation at high doses
o Great inter-individual variability
Start “low” and gradually increase dosage
local anesthetics used in birds? are epidurals used often?
- Lidocaine
o Block, splash
o 1-2 mg/kg total
Careful with small species - Epidural
o Very difficult in birds and risky
metabolic consideration for bird anesthesia
small size and much higher metabolism than mammals
pre anesthetic considerations for birds:
- Acclimation
- Pre-anesthetic work-up
o Ensure crop is empty
o CBC/Biochemistry/Physicalexamination
o May need to stabilize first - Major contraindications
how do we ensure clip is empty? for surgery? keep i nmind?
- If not, fast for 12h
- Standard fasting: 6-12h (until crop is empty)
- Do not fast passerines for too long
major contraindications for anesthetic in birds
o Crop distension
o Hypovolemic/severe dehydration
o Severe dyspnea
o Cardiovascular compromise
o Severe anemia
how to use premed / sedation in birds?
- Either use alone (sedation) or as pre- medication for long anesthesia/surgery
goals of premed / sedation in birds
o Sedation
o Pre-emptive analgesia
o Potentiate isoflurane
- Decreases MAC
- Decreases side-effects of isoflurane
combination for premed / sedation in parrots
midazolam & butorphanol
combination for premed / sedation in birds of prey
Midazolam & Fentanyl (or hydromorphone)
when do we place IV and monitoring for birds under anesthesia
- Typically the IV and monitoring are placed after induction
o Except in larger birds (chicken, ducks…)
mask induction methods in birds
- Mask induction with isoflurane 5% (less if very sedated or compromised)
o Fairly rapid, <5 minutes
o Different size/shape masks
o Mild differences with sevoflurane, equivalent in parrots
problem with mask induction in large birds, and solution
- Large birds may struggle with mask induction and have prolonged induction times (turkeys, ducks, swans)
- Solution
o IV propofol induction (5-10 mg/kg slow IV)
when will we want to keep on the mask for bird anesthetic? drawbacks?
o Very short anesthesia
o Tiny birds (see later)
o Repeated anesthesia (see later)
o Drawbacks
- Cannot support ventilation and monitor end- tidal CO2
- No glottal protection if regurgitation
- Will become hypercapnic over time
endotracheal intubation method for birds? materials? what to expect?
o Glottis easy to visualize
o Uncuffed tube
- Complete tracheal rings
- Various sizes / models
- Expect some leakage
- Drawbacks of intubation
o Small birds: increase in airway resistance
(varies with radius)
- 5 to 3 mmincrease resistance by 7
- 5 to 1 mmincrease resistance by 625!!
o Tube obstruction with mucus
- Especially ducks, needs to be changed
every hour
o Risks of post-intubation tracheal stenosis
- About 10-14 days after intubation
- Clean, atraumatic, (sterile), tubes
- Don’t intubate too deep (first line of tube)
- Avoid repeated intubations
- Be careful when moving head/neck
when will tracheal stenosis appear after intubation, sometimes? how do we avoid?
- About 10-14 days after intubation
- Clean, atraumatic, (sterile), tubes
- Don’t intubate too deep (first line of tube)
- Avoid repeated intubations
- Be careful when moving head/neck
when should we go with IV access for bird anesthesia?
- Only for long anesthesia
surgical rate of fluids for birds?
o 10 ml/kg/h crystalloids (Plasmalyte)
type of circuit for birds?
Use a non- rebreathing circuit
oBain circuit
MAC isofluorane for birds?
Differs by species, but:
-need about 1.3-1.5 MAC for surgical anesthesia (without balanced anesthesia)
o 2.5-3% frequently needed clinically
- Side-effects of isoflurane
o Respiratory depressant
- More marked in birds than in mammals
o Hypotension
- IV fluids surgical rate
- Balanced anesthetic protocol (reduces MAC as much as possible)
o Induces arrhythmias in some species
- Second-degree AV blocks
- Atropine, glycopyrrolate
purpose of balanced anesthesia in birds?
o Potentiates effects of isoflurane and provide
analgesia
o Reduce the isoflurane MAC
is anesthetic depth very stable in birds? what will they lose when too deep? what with they be missing under anesthesia?
o Changes quickly in birds
oLack of reflexes (leg, wing withdrawal), muscle relaxation
oLack of response to noxious stimulus
o Corneal reflex lost when too deep
(birds have the same general reflexes as mammals)
heart rate detection methods
stethoscope, doppler
monitor heart rate with what consistency?
- Monitor constantly if increased risk
o Dyspnea, etc. - Otherwise, monitor trend
o Concerning when <100 bpm
things that are not really measured for birds under anesthetic
- Blood pressure (can measure indirectly though)
- ECG
pulse oximetry use for bird anesthetic? limitations?
o Based on human hb
saturation curve
o Use for trends, not totally accurate
o May fail to diagnose hypoxemia
o Often does not work (scales, pigmented skin)
capnograph limitations in birds
- End-tidal CO2
o Capnographs overestimate PaCO2 in birds - Because respiratory system is so efficient at excreting CO2
end tidal CO2 levels we want to see in birds?
o Should maintain between 20-40 mmHg
type of capnograph we should use for birds????????
o Microstream capnograph
- Neonatal, pediatric
- Low sampling volume/rate
when will end-tidal CO2 be 0 in birds?
o Low or 0 if breach in air sacs
