Common Avian Emergencies
Emergencies are Common
Birds instincts are to hide symptoms
Owners often unaware bird is sick until critical
Flighted birds often injured
Roaming free in home use beaks to explore
Vulnerable to attack by other pets
Example: Bird with Mass
“Doc it just started yesterday”
“Long Overgrown beak”
Beak abnormalities are usually a sign that something else that is wrong with the
bird.
Cockatiel – puffed up, posture, hunched, wing droop, beak is overgrown –
Says beak trims are no part of the normal care –
Proper handling of case is key to success
Initial presentation: not to overly stress the bird by attempting too much on initial
presentation
Live bird and no diagnosis than dead bird and answers
Signalment and History
One of the most valuable parts of the evaluation
Helps establish a differential list with no stress to patient
Signalment (species / age / sex)
Historical Review (dig deep)
Captive / wild caught
How long owned
History prior to this owner
Known trauma
Exposure – toxins (free roam)
Sun Catcher – most common source for lead toxicity
Tiffany items – perch on tiffany lamp – NO NO NO
Is the bird flighted?
Exposure to new birds (groomed, boarded)
Exposure to pets / children
Anything new or different
Historical Review
Diet
Changes in Diet
Substrate
Cage Mate
History of egg laying
Corn Cob Bedding, Walnut Shells – aspergilosis – too much of a risk
Newspaper – don’t worry about aspergilosis
Hands Off Exam
Observe patient in cage / carrier
Note response to environmental stimuli
Respiratory Rate
Posture
Droppings / Cage condition (xmas)
Hands Off Exam
Sleeping in front of you
Important to warn owner how fragile bid is prior to handling
Critical Cases
Quickly check vital areas
- oral cavity
- Heart / lungs
- Coelom / cloaca
Ready to treat for shock after PE
Pre-oxygenation may be necessary
Sine cases require treatment of a specific problem prior to PE
Bleeding
Dyspnea
Shock
Birds that struggle with handling may need sedation for exam, diagnostics,
therapeutics
Medazalam (ask Rhoda)
As permitted by patient’s condition (prior to treatment)
HCT/TS
CBC
Chemistry
Chlamydia
C/S
Standing rads for heavy metal
Once patient is stabilized other diagnostics
Specific testing
Aspergillosis
PDD
Lead/Zinc
Radiographs
Ultrasound
Endoscopy
Critically ill birds
Treat cautiously to avoid stress / death
Each treatment weighed for benefit: danger ratio
Lead or zinc – pinkness to urate / chartreuss green / watery dropping – causes true
diarrhea
Most patients stabilized in a warm (85-90 F) humid, quiet environment
Patient with head trauma should be placed in cool 75 degree incubator
Initially WDQ – Warm Dark Quiet
Food and water placed on Floor of incubator
Oxygen
Observe
Maintenance fluid requirement
40-60 ml / kg/ day
5% of body weight
100g bird – 5 ml
Shock Fluids
90 ml / kg / hr
Fluid therapy
Subcutaneous fluids initially less stressful
Can then follow with IV or IO fluids after more stable
Caution with large boluses of IV or IO fluids
Hypervolemia
Cardiac overload
Can give – 1cc per 50 gm slow bolus
Steroids
Dexamethasone (1 mg / kg IM/IV)
Shock (single dose)
NSAIDS Instead (Meloxican, Metacam)
Antimicrobials
Antibiotics
Antifungals
Butorphanol (kappa receptors) very short acting
Torbugesic (?)
NSAIDS
Meloxican0.2 – 0.6 mg / kg
Tube feeding
Initiated once patient is stabilized and hydrated
Start w/ smarway via entotracheal tube or air sac cannulall volumes of diluted
easily digestible formulas
Benefit : risk ratio
Guidelines for gavage feeding
Should be warmed (100 – 1004 f)
Approximately 2-3% of body weight can be given at one time
100g m bird 2-3 cc
palpate crop before each feeding
Cardiopulmonary Resusitation CPR
Establish airway via entrotracheal tube or air sac cannula
Administer positive pressure ventilation every 3-5 seconds
Epinephrine may also be given IV , IC, OR IT
IF NO HEART BEAT OR PULSE, GIVE RAPID STERIOD
Avian Emergencies / Regurgitation / Vomiting
History
Presents for regurg / vomiting
Unusual neck movements
Owner not aware is regurg / vomiting presents for SBS
Syndromes
ADR – Aint Feelin’ right
SBI – something bad inside
Physical Exam:
Dried mucus present on top of head
Possible abdominial distention
PE may be normal
Behavioral
Infectious
- Bacterial
- Fungal
- Parasitic
- Viral (PDD)
Toxins
- Lead/Zinc
- Plants
- Insecticides
- Food
Metabolic
- Liver
- Kidney
Neoplasia
Foreign Body ingestion
Drugs
Diagnostics:
Based on good history
Standing radiographs
Crop wash – cytology / direct
Fecal evaluation (AGY, occult blood)
CBC / Chemistry
Other Dx once more stable
Survey radiographs
Infectious agents
Treatment:
Supportive – address fluid loss
Parenteral drugs initially (why? System is inflamed make sure drugs go where you
want them to go)
Specific therapy
- chelation
- antibiotics
Treatment:
GI protetants
- activated charcoal
- sucralfate
Fasting to rest GI tract initially
Slowly weaned back to normal food
Neurological Disease
History
Need detailed HX (many etiologies)
O may present for:
- inability to perch
- ataia
- head tilt
- paresis/ paralysys
Rule outs:
Trauma,
- Brain / Spinal coard
- Peripheral Nerves
Toxins
- heavy metal
- houserplants / drugs / etc.
-
metabolic disease
hypocalcemia
hypoglycemia
hepatic disease
Rule outs
Infectious
Bacterial
Chlamydia
Viral (PDD, PBFD)
Sarcocystis
Fungal (crypto)
Egg yolk stroke
Dystocia
Pituitary neoplasia
Neurological Disease
Initially:
Standing radiographs
CBC / Blood Chem
Once more stable:
Thorough neurological exam
More specific testing:
Survey radiographs
Viral testing (borna)
Heavy metal (lead/zinc)
Microbiology
Treatment
Initial supportive care followed by specific treatment
Chelating agents
Ca2+EDTA
Activated charcoal
Dextrose, calcium
Seizures – diazepam
.5-1.0 mg/kg IM/IV/vent
NSAIDS (PDD)
RESPIRATORY DISTRESS
History
Bird breathing w/ difficulty
Increased respiratory rate
Tail bob
Exercise intolerance
History for tracheal obstruction differs
Hear squeak / wheeze
Change in the birds voice ***
Change in posture
- leaning forward
- neck extended
Examination
- Brief and cautious
- Auscultate heart / lungs
- Assess tracheal noise / stridor
- Coelom palpation
- Differentiate upper from lower respiratory disease
- Open mouth to separate glottis from choana
- Listen for tracheal noise / stridor
Diagnostics
- Stabilize first
- Radiographs
- Endoscopy
- Ultraound (coelom +)
- CBC / chem
- Microbiology
Primary Disease
- Bacterial, Fungal
- Chlamydia
Sarcocystis
Respiratory toxins (PTFE)
Allergic pneumonitis
Seconary Disease
- Cardiac
Coelomic
- Ascites
- Organ enlargement
- Reproductive
- Neoplasia
Tracheal Disease
- seed hull / food aspiration
- aspergillosis
- bacterial
- squamous netaplasia
- toxin damage