Surgical procedures in birds

Question 1

What are the surgical problems of small patient size?

Answer 1

• Hypothermia
• Hypoglycaemia
• Hypovolaemia + blood loss
• Thin skin + delicate tissues
• Difficult anaesthesia monitoring

Question 2

How would you prep an avian patient for surgery?

Answer 2

• Pluck feathers - don’t clip
• Minimize heat loss - warm prep solutions
• Use transparent surgical drapes

Question 3

What is patient support during surgery?

Answer 3

• 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

Question 4

What are common avian procedures?

Answer 4

• 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

Question 5

How would beak corrections include?

Answer 5

• 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

Question 6

How would you remove leg rings?

Answer 6

• remove ring on healthy leg or a leg with trauma
• Ring cutters = TOO TRAUMATIC
• High speed burr

Question 7

How would you perform wound closure?

Answer 7

• 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

Question 8

What is ingluviotomy? When would you perform one?

Answer 8

• Crop incision
• indications = removal of FB, Crop wall biopsy, feeding tube placement

Question 9

What could cause crop fistula? How would you repair it?

Answer 9

• 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

Question 10

What may cause lumps? what should be done?

Answer 10

• Neoplasia
• Abscess
• Feather cyst
• Haematoma
• Always investigate first = FNA before removal
• consider cautery to minimise blood loss

Question 11

When would you perform a cloacopexy? What are potential causes?

Answer 11

• Cloacal prolapse
• Causes =
• reproduction - retained egg, hypersexuality
• enteritis - bacteria, parasites
• cloacal neoplasia, polyps
• systemic disease

Question 12

Why would you perform enucleation? Why should you be careful?

Answer 12

• Trauma
• Glaucoma
• Neoplasia
• Globe much larger than orbit, optic nerve = very short, very vascular

Question 13

How would you remove rhinoliths?

Answer 13

• Under sedation / GA + local anaesthesia
• Blunt dissection + removal of necrotic material
• Flush nasal cavities

Question 14

How would you stabilise fractures?

Answer 14

• First aid + supportive care
• Radiography under sedation / GA
• Referral - complex

Question 15

When would you perform external coaption / splinting?

Answer 15

• Temporary - prior to ortho surgery
• Sole treatment - only for closed, well aligned fractures

Question 16

What are main fracture surgical repair options?

Answer 16

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

Question 17

What are causes of egg binding?

Answer 17

◦ 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

Question 18

What is medical tx of egg binding?

Answer 18

• 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

Question 19

What is surgical tx of egg binding?

Answer 19

1. Egg manipulation
2. Ovocentesis + egg implosion - Transcloacal (ideal), Percutaneous
   ▪ Flush cloaca and try to remove egg shell pieces (all should be passed in 48h)
3. Midline incision and salpingetomy to remove egg

Question 20

How would you perform coeliotomy + salpingetomy?

Answer 20

1. Midline skin incision;
2. Midline muscle layer incision;
3. Expose oviduct and pack coelomic cavity with sterile swabs soaked in sterile saline;
4. Longitudinal incision of oviduct;
5. Remove egg
6. Close oviduct w/ monocryl 4/5-0 in a double invaginating continuous pattern;
7. Close muscle layer with PDS 3/4-0 in an interrupted pattern;
8. Close skin the same way