Exotics: Emergencies and Critical Care Flashcards
What are poor prognosis indicators for birds?
- Species sensitivity
- Small patient size
- Duation of disease/problem
- Dyspnoea
What is the general approach to the sick bird?
Visual exam while inside carrier/cage
* mental status
* Obvious lesions or truama
* Breathing- open mouth
* Droppings
Main groups of ECC presentations- collapsed, dyspnoeic, unwell but stable
Describe the approach to the collapsed bird?
Supplement O2- facemask, ETT, air sac intubation
Supplement heat- heat mat, incubator, warm fluids
Fluids- IV, IO
Emergency drugs
Describe the process with breathing and airways in ECC of birds?
- Deliver O2 via facemask
- Check for any obstruction on mouth/glottus
- Place appropriate uncuffed ETT in trachea
- Start thoracic compressions (40-50bpm)
- If suspect UAO consider abdominal air sac canula
Describe resuscitation fluid therapy of birds
- IV access- ulnar or medial metatarsal vein
- IO access: distal ulna or proximal tibiotarsus
- Warm fluids
- Hypertonic saline
- Crystalloids- hartmanns or ringers lactate
- Colloids- mixed with crystalloids
What emergency drugs can be used in birds?
What cannot be used??
Atropine
Adrenaline
Dextrose
DO NOT USE STEROIDS IN BIRDS
How should critical avian patients be monitored?
Reduce handling to minimum
Assess
* Mentation/behaviour
* HR
* RR
* BP > 90mmHg
* Temperature
Describe the approach to the dyspneic bird?
- Limit handling
- Supptlemental O2 in incubator
- Sedation- midazolam and butorphanol- intransal, IM
- Meloxicam
- Terbutaline
- Nebulization- hypertonic saline, ABs, antifungals
- ABs?
Approach the the ‘unwell bird’
Incubator with suppl heat ± o2
Fluid therapy- maintenance + losses, hartmanns
Supplemental feeding by crop tube- appropriate formula
ABs?
What is used for analgesia in birds?
NSAIDS- meloxicam
Gabapentine
Opioids- butorphanol
Local anaesthetic- bupivicaine and lidocaine
Descibe step by step approach to critical birds?
- Initial assesment- collapse, dyspnea, unwell, specific
- In this patient likely to crash need CPR
- Stabilization- suppl heat, O2 fluids, analgesia, feeding
- Reassess- when more stable
- Further investigations- depending on presentation, start from least to more risky tests
- Adjust treatment accordingly
- Euthanise if deterioration
What are emergencies can happen in reptiles?
Proper emergencies are rare
* Trauma
* Prolapses
* Reproductive
* Neurologic
Describe the approach to the collapsed reptile?
- ETT placement
- IPPV with with ambubag- room air, 4-6bpm
- IV access- jugular (chelonia), difficult in other species
- IO access on proximal tibia
- Warm fluids- IV, IO bolus, care with osmolarity, hartmanns
- Emergency drugs- adrenaline, atropine
Describe the approach to an unwell reptile
Warm them
* Gradual 4-6h
* If POTZ unknown 25-30
* Create temp gradient
* Before any medications
Fluid therapy- hartmanns, glucose saline
Assisted feeding with OT
* day 1 0.5% weight glusoce saline
* day 2 0.5% weight formula
* day 3 1% weight formula
* day 4 2% weight formula
ABs depending on case
What analgesia can be used for reptiles?
Meloxicam
Local- lido, bupivi
Opioids- tramadol (lizards and chelonia), morphine (bearded dragons), methadone
Butorphanol/buprenorphine- no effect
What are common emergencies in reptiles?
- Trauma
- Non-specific illness
- Prolapses
- Repro- retained eggs, follicular stasis
- Neurological- seizures, muscle fasiculations
- Respiratory- not as frequent, most presentations are chronic/progressive
Describe the step by step approach to reptile emergencies?
- Initial assessment- collapsed, unwell, conditions
- Warm- 4-6 hours
- Start supportive care- fluids, analgesia, ABs
- Start further investigations- radiography, US scan, bloods
- Review case and adjust therapy accordingly
What are the key points for resuscutation of exotic mammals?
Same principles as small animal
* IV access- rabbit (maginal ear, cephalic), ferret (cephalic, jugular)
* IO access: proximal femur
* ETT placement dificult except ferret (face mask)
* Atropine not effective in rabbit patients (glycopyrrolate)
* Do not use steroids in rabbits/rodents
Describe how to manage dyspneic mammals?
Supplement O2
Sedation: midazolam, butorphanol
Meloxicam
Nebulization: hypertonic saline, acetylcysteine, aminophylline
Furosemide- cardiac cases
ABs
How should exotic mammals be generally cared for?
- Provide stress-free environment
- Monitor temp closely- hypo/hyperthermia
- Blood glucose in rabbits indicated stress/pain
- Maintenance fluid therapy- IV, SC hartmanns ± glucose
- Assisted feeding- syringe, nasogastric intubation
What can be used for analgesia of exotic mammals?
NSAIDs- meloxicam
Others- Gabapentine, maropitant, ketamine, local anaesthetic (lidocaine/bupivicaine)
Opioids
Buprenorphine
Methadone
How is gut stasis managed in rabbits/rodents?
Rabbits and hystricomorph rodents
Gut stasis not a disease- secondary
Treat but find cause
* Fluids- IV
* Analgesia
* Prokinetics- metoclopramide, cisapride, domperidone, ranitidine
* Supplemental feeding- oxbow, emeraid
* Supportive care- stress free, supplement heatq
What are common emergencies in rabbits?
- Gut stasis
- Trauama- fractures, bite wounds
- Respiratory- URT, pneumonia, heart disease
- Neuro- seizures, paresis/paralysis
- Urogenital- hematuria
- Opthalm
- Flystrike
What are common emergencies in ferrets?
- Trauma
- Vomiting if frequent >24h
- Non-specific with anorexia >24h
- Neuro- seizures, ataxia, collapse, paralysis
- Dyspnea
What are common emergencies in hystricomorph rodents?
- Gut stasis
- Dyspnea- guinea pigs
- Trauma
- Neuro
- Non-specific illness
- urogenital: bleeding + straining/vocalising, dystocia
What are common emergencies in other rodents?
- Non-specific illness
- Trauma
- Dyspnea
- Neuro- seizures, paralysis, head tilt
- Abnormal perineal discharge- wet tail
What are common emergencies in other rodents?
- Non-specific illness
- Trauma
- Dyspnea
- Neuro- seizures, paralysis, head tilt
- Abnormal perineal discharge- wet tail
