Surgical procedures in birds Flashcards
What are the surgical problems of small patient size?
- Hypothermia
- Hypoglycaemia
- Hypovolaemia + blood loss
- Thin skin + delicate tissues
- Difficult anaesthesia monitoring
How would you prep an avian patient for surgery?
- Pluck feathers - don’t clip
- Minimize heat loss - warm prep solutions
- Use transparent surgical drapes
What is patient support during surgery?
- Thermal support = heat mats, warm fluids, monitor cloacal temp
- Respiratory support = place uncuffed ETTs, IPPV, monitor RR, SPO2, capnography
- Circulatory support = provide fluids SC, IV or IO, Monitor HR + BP
What are common avian procedures?
- Beak corrections
- Removing leg rings
- Suturing wounds
- Ingluviotomy
- Crop fistula repair
- Lump removal
- Cloacopexy + cloacal prolapse reduction
- Enucleation
- Removing rhinoliths
- Fracture stabilization
- Egg binding – surgical approaches
How would beak corrections include?
- Beak burr - not nail clippers
- Beak fractures / avulsion = Rhamphotheca (upper beak) / Gnatotheca (lower beak), Minor trauma might only require hemostasis but Severe trauma – prosthethics + referral
- Congenital problems = scissor beak - correct early as possible
How would you remove leg rings?
- remove ring on healthy leg or a leg with trauma
- Ring cutters = TOO TRAUMATIC
- High speed burr
How would you perform wound closure?
- Skin usually very thin
- SC layer reduced, frequently fatty and not holding sutures very well
- Avian pus is caseous and doesn’t drain
- Flush tissues with sterile saline
- PDS 4-0 to 6-0 can be used
- Whenever wound closure not possible, use 2nd intention healing techniques = Wet-to-dry dressings, Hydrocolloid gels and dressings
What is ingluviotomy? When would you perform one?
- Crop incision
- indications = removal of FB, Crop wall biopsy, feeding tube placement
What could cause crop fistula? How would you repair it?
- Thermal burns – common in fledglings being hand fed with warm formula
- Scab/granulation tissue on chest
- Sometimes SC abscesses
- Tx = WAIT – devitalized tissue can take 3-5 days to form until becomes apparent
- incise skin around scab, dissect edges from crop, remove necrotic tissue,
- Closure = crop wall in 2 layers (PDS 4-0 to 6-0), skin closure PDS 4-0 to 6-0 interrupted
What may cause lumps? what should be done?
- Neoplasia
- Abscess
- Feather cyst
- Haematoma
- Always investigate first = FNA before removal
- consider cautery to minimise blood loss
When would you perform a cloacopexy? What are potential causes?
- Cloacal prolapse
- Causes =
- reproduction - retained egg, hypersexuality
- enteritis - bacteria, parasites
- cloacal neoplasia, polyps
- systemic disease
Why would you perform enucleation? Why should you be careful?
- Trauma
- Glaucoma
- Neoplasia
- Globe much larger than orbit, optic nerve = very short, very vascular
How would you remove rhinoliths?
- Under sedation / GA + local anaesthesia
- Blunt dissection + removal of necrotic material
- Flush nasal cavities
How would you stabilise fractures?
- First aid + supportive care
- Radiography under sedation / GA
- Referral - complex
When would you perform external coaption / splinting?
- Temporary - prior to ortho surgery
- Sole treatment - only for closed, well aligned fractures
What are main fracture surgical repair options?
Main surgical options:
◦ IM pinning – might not provide the best stabilization
◦ Cerclage + IM pinning – slightly better but wires can damage periosteum
◦ External fixators – still allow some bone movements
◦ External fixators + IM pinning – ideal
◦ Plates usually not very well supported by avian bones
Wing/leg amputation is usually not a reasonable option
What are causes of egg binding?
◦ Very young/geriatric birds
◦ Sub nutrition (sp. Calcium)
◦ Obesity
◦ Frequent egg-laying
◦ Salpingitis/metritis
◦ Abnormally sized/shaped eggs
◦ Obstruction – e.g. masses, egg remnants from previous laying
◦ Other health conditions
EMERGENCY
What is medical tx of egg binding?
- Uncomplicated cases in +/- stable birds
- Incubator with suppl O2
- Warm fluids supplemented with glucose
- Meloxicam 1mg/kg SC BID
- Calcium gluconate 100mg/kg IM
- Tube feeding
What is surgical tx of egg binding?
- Egg manipulation
- Ovocentesis + egg implosion - Transcloacal (ideal), Percutaneous
▪ Flush cloaca and try to remove egg shell pieces (all should be passed in 48h) - Midline incision and salpingetomy to remove egg
How would you perform coeliotomy + salpingetomy?
- Midline skin incision;
- Midline muscle layer incision;
- Expose oviduct and pack coelomic cavity with sterile swabs soaked in sterile saline;
- Longitudinal incision of oviduct;
- Remove egg
- Close oviduct w/ monocryl 4/5-0 in a double invaginating continuous pattern;
- Close muscle layer with PDS 3/4-0 in an interrupted pattern;
- Close skin the same way
