Nursing Birds Flashcards

1
Q

What are the basics of parrot husbandry?

A
Suitable perches of varying diameters
Regular bathing/misting
12hr day/night cycle
UVB light
Enrichment and foraging
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2
Q

Why are seed-based diets inappropriate for birds?

A

High in fat and calories
Deficient in vitamins, minerals, essential amino acids
Have poor calcium : phosphorous ratio
Poor quality/stored incorrectly = contaminated with fungal spores e.g. Aspergillus sp.
Can be contaminated with aflatoxins - liver failure
Encourages selective feeding, cannot supplement as seeds dehusked before consumption

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3
Q

What can calcium/vitamin D deficiency cause?

A

Nutritional secondary hyperparathyroidism (metabolic bone disease)
Hypocalcaemia - seizures in African greys
Thin-shelled eggs, dystocia (egg binding)

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4
Q

How can we diagnose calcium/vitamin D deficiency?

A

Radiography - pathological fractures, long bone deformity

Serum ionised calcium

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5
Q

How can we treat calcium/vitamin D deficiency?

A

Calcium/vitamin D supplementation e.g. calcium borogluconate
Correct diet
UVB lighting

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6
Q

Describe obesity in pet birds.

A

Common especially in amazons/budgies/cockatiels
Hepatic lipidosis - respiratory compromise, diarrhoea
Atherosclerosis - lipid/cholesterol deposits and mineralisation of arterial walls (can cause aortic rupture and sudden death)
Lipomas - common in budgies

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7
Q

Describe hypovitaminosis A.

A

Leads to squamous metaplasia of epithelial surfaces - respiratory/urogenital/GI tract/skin
Secondary bacterial/fungal respiratory infections - sinusitis, rhinitis
Rhinoliths, blunted choanal papillae, salivary gland abscesses
Poor feather/skin quality, diarrhoea

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8
Q

What environmental improvements can we try to discourage feather-damaging behaviour?

A

Diet change to pellets
Increase humidity - spray daily, encourage to bathe, humidifier
Allow max. 12hrs light daily - cover cage at night
UVB provision - outdoor aviary, UV lamp
Improve ventilation, no smoking
Decrease stress - cage in secure location
Enrichment and foraging

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9
Q

What considerations should we have when admitting a bird patient?

A

Very good at hiding illness (masking phenomenon) - need to be seen immediately, often in critical condition
Need to know species, age, diet, history
Ideally bring in cage/pics of cage
Questionnaires can be completed before consult

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10
Q

What are some non-specific signs of illness in birds?

A

Fluffed, up, depressed, sleepy
Anorexia/polyphagia, vomiting/regurgitation
Change in behaviour/activity
Change of perching height e.g. sitting on floor
Tail bobbing, open-mouthed breathing
Sneezing, voice change, periocular swelling
Discharge - eyes/ears/nares/oral cavity/cloaca/uropygial gland
Wings hanging down, abnormal stance (e.g. wide-legged)
Straining, coelomic swelling
Change in droppings - quantity, colour, consistency

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11
Q

How do we handle birds during consults?

A

Make sure windows and doors closed and extractor fans off
Support body and keep wings under control
Do not restrict sternal movement - no diaphragm and could suffocate
Use separate towel/cloth for each bird and gloves for raptors

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12
Q

How do we carry out a clinical exam on a bird?

A

Systematic approach!
May need to be stabilised before thorough exam, e.g. oxygen for dyspnoeic birds
Consider exam under GA e.g. if wild/stressed/very ill
Diagnostics important
Get everything ready before bird is handled
Always get a weight
Assess body condition - palpate pectoral muscle mass, subcutaneous fat deposits?

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13
Q

What hospitalisation considerations should we have for birds?

A

Quiet and away from predators
More secure if high up - appropriate perches/substrate
Food/water dish easily accessed
Baths for waterfowl
Tail guards for raptors
Hygiene and biosecurity - infectious birds treated last
Zoonosis e.g. Chlamydia psittaci
Do not keep sick birds in same air space as other birds/wild birds with pet birds

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14
Q

How should we care for hospitalised birds?

A

Keep warm ~30 degrees C - radiant heat better than heat pads etc.
Offer normal/familiar diet
Will not eat in the dark
High metabolic rate - quickly use up energy reserves
Weigh daily (same time each day)
Record-keeping

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15
Q

What considerations should we have when treating birds?

A

Birds have high metabolic rates so require increased doses and frequency compared to mammals
Putting treatments in water not reliable and may stop bird drinking
May not voluntarily take meds in food - crop tubing/direct administration

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16
Q

What routes of admin do we have for meds?

A

Oral - crop tubing
Topical (avoid ointments on skin/feathers)
Flushing sinuses/nares useful for upper resp. tract infections
Nebulisation (very useful in resp. disease)
Injection

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17
Q

Describe crop tubing of birds.

A

Use largest diameter tube - metal in parrots
Extend neck and pass tube into left side of mouth, over tongue and into oesophagus
Palpate right side of base of neck to confirm tube in crop (feel separate trachea)
Frequency - every 2-8hrs depending on species
Food at 38-40 degrees C
Hand-rearing formula

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18
Q

What injection sites can we use on birds?

A

SC - inguinal fold / interscapular region
IM - distal third pectoral muscles
IV - jugular veins / basilic veins / metatarsal veins
IO - ulna or tibiotarsus

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19
Q

Describe fluid therapy for birds.

A

Maintenance = 50-100ml/kg/24hrs (higher for smaller e.g. passerines)
Lactated Ringer’s solution
Assume all sick birds 5-10% dehydrated
Give maintenance + 0.5 deficit on day 1, and maintenance plus rest of deficit over days 2-3

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20
Q

How can we admin fluid therapy to birds?

A

Oral fluids 10ml/kg
SC 20ml/kg inguinal fold
IV 10-20ml/kg bolus or 10ml/kg/hr infusion
IO - distal ulna/proximal tibia

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21
Q

What diagnostic procedures can we perform on birds?

A
Radiography
Biochemistry, haematology
PCR, serology
Culture
Cytology e.g. crop wash/aspirates, faecal
Faecal parasitology
Endoscopy, biopsy
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22
Q

How do we carry out radiography on birds?

A

Standard views = right lateral, ventrodorsal
Good positioning important - use GA
Take two views at 90 degrees
Radiograph normal side for comparison e.g. joints
Barium contrast radiographs useful for GI tract and investigation of coelomic masses (15-20ml/kg)

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23
Q

How can we collect a blood sample from a bird?

A

May be easier and safer under GA in small/wild/very sick birds
Right jugular vein (larger than left)
Basilic vein (medial elbow) - prone to bleeding/haematoma
Median metatarsal vein - larger birds
Can safely collect 1% bodyweight in healthy birds (less if sick)

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24
Q

What considerations should we have for haematology in birds?

A

Heparin or EDTA suitable in most species (but blood of penguins/hornbills/flamingos/crows/some cranes will lyse EDTA)
Avian erythrocytes nucleated - automated counts unreliable, manual method needed to determine white blood cell count and differential
Good quality blood smears very important

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25
Q

How can we use endoscopy in birds?

A

2.7mm rigid endoscope, 30 degree angle
Trachea, upper GI tract, cloaca
Caudal air sacs for sexing monomorphic species

26
Q

What can we biopsy in birds?

A

Lungs, air sacs, kidneys, gonads, GI tract, spleen, liver

27
Q

How can we flush sinuses in birds?

A

Infraorbital sinus
Flush for treatment or diagnostic samples (e.g. cytology +/- culture and sensitivity)
Via nares - can be done conscious
Via needle into sinus

28
Q

How do we microchip birds?

A

Distal third of pectoral muscles to avoid pectoral artery
Direct microchip downwards
Tissue glue to close skin

29
Q

How do we euthanise birds?

A

Best done under gaseous GA
Give IV into jugular, wing vein or median metatarsal
Can inject into liver if unable to access a vein

30
Q

What are the pre-GA fasting times for birds and why?

A

Short to decrease chance of regurgitation but minimise hypoglycaemia
2-4hrs parrots, 30mins budgies

31
Q

What is the anaesthesia technique of choice for most birds?

A

Inhalational - isoflurane/sevoflurane

Rapid induction and recovery

32
Q

Why would we ET intubate a bird?

A

Provides patent airway
Decreases dead space
Protects against aspiration
Allows IPPV

33
Q

Describe ET intubation of birds.

A

Use uncuffed ET tubes to prevent pressure necrosis
In birds < 100g may become blocked with mucus (increased respiratory effort)
Can rarely cause tracheal mucosal damage/strictures - esp. macaws/cockatoos/owls
Care with size, position and stability of tube
Keep neck straight

34
Q

How do we position birds during anaesthesia?

A

Lateral recumbency best
Ventilation may be decreased in dorsal/ventral recumbency (esp. larger birds)
Consider IPPV at 6-12bpm

35
Q

What complications can occur in waterfowl if anaesthesia is induced using a face mask?

A

Apnoea and bradycardia due to stimulation of trigeminal receptors around beak/nares (dive reflex)
Can use injectable agents for induction

36
Q

When might we use air sac perfusion anaesthesia in birds?

A

Useful for head surgery or as emergency procedure in tracheal obstruction

37
Q

How do we place an air sac tube for anaesthesia?

A

Quick prep
Into left caudal thoracic air sac - behind last rib
Secure through muscle and skin
Can maintain GA through tube to allow endoscopy
Leave 3-5 days if necessary - can become blocked

38
Q

What reflexes can we monitor during anaesthesia?

A

Withdrawal reflexes e.g. toe pinch
Corneal reflex - maintained at surgical anaesthesia (rate slows with depth)
Palpebral reflex - less useful

39
Q

Where can we place a Doppler probe for heart rate monitoring?

A

Peripheral artery - ulnar / metatarsal

40
Q

Describe the use of capnography for monitoring during anaesthesia.

A

Assessment of ventilation
Relies on ETCO2 reflecting gas concentration - not validated in birds
Sidestream units with low sampling rates best for small birds (min. 50ml/min)
Birds susceptible to hypercapnia - assisted ventilation advisable

41
Q

How can we use pulse oximetry in birds?

A

Non-pigmented MMs e.g. oral/cloacal mucosa
Thin areas of skin e.g. wing web/interdigital skin
Trends probably more useful than actual results

42
Q

Describe blood pressure monitoring during anaesthesia.

A

Indirect techniques most practical though may be not reliable in all species
Cuff on metatarsal region / distal humerus (width 40% bone circumference)
Psittacine systolic BP 90-100mmHg awake, 90-140mmHg under GA
If < 90mmHg give fluid bolus (crystalloid or colloid)

43
Q

What anaesthetic complications can occur in birds?

A

Hypoventilation, hypothermia, hypoglycaemia, apnoea - common
Apnoea = put on 100% O2 or reduce anaesthetic %, check ET tube patency
If respiratory rate < 4bpm, gentle IPPV at 10-12bpm

44
Q

How do we recover birds after anaesthesia?

A

Ventilate with 100% O2, maintain fluid support
Swab to remove mucus from oral cavity
Extubate when breathing well, evidence of glottal tone, swallowing/jaw tone
Wrap lightly in towel to avoid feather damage
Keep warm and monitor closely until standing
Must eat quickly (within 30mins if <100g)

45
Q

Why might a bird be slow to recover from anaesthesia?

A

Pre-anaesthetic medication
Hypothermia - decreased RR and slower elimination of volatile anaesthetics
Hypovolaemia - check BP/CRT/vein turgor, give fluids at shock rates
Hypoglycaemia - check with glucometer
Haemorrhage - give colloids/blood
Pain - often increased RR and HR

46
Q

What surgical nursing considerations should we have for bird patients?

A
Avoid hypothermia
Pluck (not cut) feathers - remove as few as possible
Bird skin very thin
Care with alcohol when prepping op site
Fluid therapy and analgesia important
47
Q

What zoonotic diseases should we be aware of?

A

Chlamydia psittaci
Salmonellosis, campylobacteriosis, mycobacteriosis
Aspergillosis
Avian influenza
Allergic alveolitis (sensitivity to feather dust)

48
Q

What are some common causes of GI disease in birds?

A
Infection - fungal/bacterial/viral
Parasites - nematodes/cestodes/protozoa
Heavy metal toxicity - lead/zinc
Malnutrition e.g. hypovitaminosis A
GI tract obstruction e.g. neoplasia/foreign bodies
Crop impaction/stasis/sour crop
Crop burns (hand-reared parrots)
49
Q

What are the clinical signs of GI disease in birds?

A

Weight/body condition
Dysphagia - head-flicking, yawning
Crop enlargement/impaction
Vomiting/regurgitation
Matting of feathers on head, head bobbing
Faeces - diarrhoea, presence of undigested seeds etc.
Soiling of tail feathers

50
Q

How can we diagnose GI disease in birds?

A

Faecal smears or crop/proventricular wash for cytology
Faecal floatation for endoparasites
Culture and sensitivity
PCR/serology e.g. for avian bornavirus, C. psittaci
Radiography - barium contrast studies
Endoscopy

51
Q

What are some causes of respiratory disease in birds?

A

Obstruction e.g. tracheal, foreign body aspiration/fungal granuloma (aspergillosis)
Inhaled toxins e.g. aerosols, cigarette smoke
Infectious - bacterial/fungal/viral
Parasitic
Allergic/pulmonary hypersensitivity - macaws
Dyspnoea compression of trachea or air sacs, e.g. hepatomegaly, ascites, obesity, egg binding

52
Q

What are the clinical signs of upper respiratory tract disease?

A

Nasal/ocular discharge
Swellings - palpate periorbital area (sinuses)
Conjunctivitis
Sneezing, rhinoliths

53
Q

What are some clinical signs of lower respiratory tract disease?

A
Dyspnoea
Voice change
Weight loss
Lethargy
Tail bob
Anorexia
Cyanosis
54
Q

How would we diagnose respiratory disease in birds?

A

Haematology - right jugular/ulnar/median metatarsal vein, 1% bodyweight
Radiography - lateral/ventrodorsal views
PCR, serology e.g. for C. psittaci
Culture and/or cytology e.g. nasal/sinus aspiration or flush
Endoscopy, biopsy
Post-mortem exam

55
Q

How do we treat respiratory disease in birds?

A
Always rule out C. psittaci
Nebulisation (<5um)
Adjunctive therapy
Antimicrobials
Mucolytics
Diluted F10 (1:250)
Air sac tube placement for obstructive dyspnoea
56
Q

What are some predisposing factors for egg binding in birds?

A

Malnutrition (hypocalcaemia)
Obesity
Excessive egg production

57
Q

What are the clinical signs of egg binding?

A
Depression, lethargy, weakness, reduced activity
Straining, wide-based stance
Dyspnoea
Leg paresis
Decreased frequency of defaecation
Coelomic distension
58
Q

How can we diagnose egg binding in birds?

A

History
Egg may be palpable
Radiography
Biochemistry - ionised calcium

59
Q

How can we treat egg binding in birds?

A

Fluid therapy, nutritional support, 10% calcium borogluconate SC/IM
Provide warmth, dark, quiet, oxygen-enriched environment
Lubrication and manual manipulation
Ovocentesis and egg collapse
Coeliotomy and surgical removal

60
Q

Describe egg yolk coelomitis.

A

Common in psittacines, chickens, ducks
Yolk released into coelomic cavity e.g. if yolk retropulsed from oviduct due to salpingitis
Causes inflammatory reaction +/- secondary infection

61
Q

How can we manage fractures in birds?

A

Must be immobilised to prevent further soft tissue damage
Wing fractures may require figure of eight bandage and/or body wrap
Leg fractures - difficult to stabilise femoral fractures, may be possible to splint tibiotarsus/tarsometatarsus/digits
Heal quicker than in mammals or reptiles
Maintain joint function - avoid prolonged immobilisation