Emergency + critical care of exotics Flashcards
What are poor prognosis indicators in birds?
Birds often mask their clinical signs = advance stage when noticed
* Species sensitivity
* Small patient size
* Duration of disease / problem
* Dyspnoea
What is your general approach to the sick bird?
- Visual exam while inside carrier - mental state, lesions/trauma, breathing (open mouth breathing), Droppings
What is approach to the collapsed bird?
- Supplemental O2 - face mask / ETT / air sac intubation
- Supplemental heat - heat mat, incubation, warm fluids
- Fluids - IV / IO access
- Emergency drugs
Where would you get IV / IO access in birds?
- IV = ulnar / medial metatarsal vein
- IO = distal ulna / proximal tibiotarsus
What are emergency drugs in birds?
- Atropine
- Adrenaline
- Dextrose
NOT STEROIDS
How would you monitor critical avian patients?
- Mentation / behaviour
- HR
- RR
- BP
- Temp
How would you approach a dyspnoeic bird?
- Limit handling
- Supplemental O2 in incubator;
- Sedation – Midazolam 0.5mg/kg + Butorphanol 0.5mg/kg intranasal, IM
- Meloxicam 1mg/kg SC
- Terbutaline 0.01-0.1mg/kg IM
- Nebulization
How would you approach an ‘unwell bird’?
- Incubator With heat + O2
- Fluid therapy
- Supplemental feeding by crop tube
What analgesia can be used in birds?
- NSAIDs - meloxicam
- Gabapentin
- Opioids - butorphanol
- Local anaesthesia - bupivicaine + lidocaine
What are common emergency presentations in birds?
- Dyspnea
- Non-specific illness
- Trauma/bleeding
- Reproductive – e.g. egg binding, egg yolk coelomitis, etc
- Neurological – seizures, paresis/paralysis, etc.
- GI – regurgitation
- Prolapses
What is step by step approach to critical birds?
- initial assessment - collapse, dyspnoea
- Is patient going to crash
- Stabilization - heat, O2, fluids, analgesia
- Reassess - when more stable
- Further investigation - depending on presentation - start from least to more risky tests (radiographs, bloods, coelomic US scan, Radiographs under sedation)
- Adjust Tx accordingly
- Consider advising euthanasia if keeps deteriorating
What are proper emergencies in reptiles?
- Trauma
- Prolapses
- Reproductive - retained eggs, follicular stasis
- Neurologic - seizures, muscle fasciculations
- Most ‘emergencies’ = chronic cases recently decompensated, unnoticed disease
What is approach to the collapsed reptile?
- ETT placement
- IPPV with ambu bag - Room air, 4-6bpm
- IV access - Jugular (chelonia), Difficult in other species
- IO access on proximal tibia
- Warm fluids IV, IO bolus:
- Emergency drugs: Adrenaline, Atropine
What is approach to the unwell reptile?
- Warm them - gradual 4-6hrs
- Fluid therapy
- Assisted feeding - oesophageal tube
- Antibiotics depending on case - Ceftazidime
What analgesia can be used for emergencies?
- NSAIDs = Meloxicam
- Lidocaine / Bupivicaine
- Opioids =
- Tramadol (lizards + chelonia)
- Morphine (bearded dragons
- Methadone
What is step by step approach to reptile emergencies?
- Initial assessment – collapsed? Unwell? Any obvious problems/conditions?
- Warm patient – 4-6h; use incubator, heat bulb;
- Start supportive care – fluids, analgesia, ABs, other specific medication or treatment?
- Start further investigations – depending on case:
- Radiography, US scan, Bloods - Review case and adjust therapy accordingly
Atropine isn’t effective in 50% of rabbits, what should be used instead?
- Glycopyrrolate
What does blood glucose in rabbits indicate?
- Stress / pain
- NOT diagnostic of GI obstruction
How should gut stasis be managed in rabbits / rodents?
- Gut stasis NOT a disease + is secondary to something else
- Key points of Tx =
- Fluids (IV, SC)
- Analgesia
- Prokinetics
- Supplemental feeding
- Supportive Tx
What are common emergencies in rabbits?
- Gut stasis
- Trauma - fractures, bite wounds …
- Respiratory - URT, pneumonia, Heart disease, neoplasia
- Neuro - seizures, paresis/paralysis, sudden + progressive head tilt
- Urogenital - haematuria
- Ophthalm - sudden blepharospasm, bupthalmia / exophthalmia
- Flystrike
What are common emergencies in ferrets?
- Trauma
- Vomiting if frequent and > 24h duration
- Non-specific illness w/ anorexia >24h
- Neuro – seizures, ataxia, collapse, paralysis
- Dyspnoea
What are common emergencies in hystricomorph rodents?
- Gut stasis
- Dyspnea (sp. Guinea pigs)
- Trauma
- Neuro – seizures, collapse, paralysis
- Non-specific illness
- Urogenital =
- Bleeding + straining/vocalizing
- Dystocia
What are common emergencies on other rodents? (myomorphs)
- Non-specific illness
- Trauma
- Dyspnoea
- Neuro – seizures, paralysis, head tilt
- Abnormal perineal discharge = “wet tail”
