Critical care management in birds

TREATMENT OF CASUALTY AND EMERGENCY IN BIRDS

Handling the Avian Emergency:

The avian practitioner will be presented with three classes of birds:

-       - The well-bird,

-       - The obviously sick bird

-       - The bird harbouring a sub-clinical infection. 

The first two classes of birds are very straight forward to deal with, but it is the sub-clinically ill bird that is most problematic for most avian practitioners

Birds are masters at hiding signs of illness as a protective mechanism. So, the ill bird will act as normal as it possibly can for as long as it can

DO see a sick bird as soon as possible:

It is very important to know about the differences between avian medicine and dog and cat medicine. Any delay in providing diagnosis and treatment may result in the death of the bird.

Sick birds:

Most sick birds require supplemental heat, which is easy to provide with an incubator, aqua brooder or heating pad. If the bird appears critical, provide the bird with heat and supplemental oxygen before you attempt to do anything else to it

DON'T handle a sick bird until a thorough history and visual evaluation have been performed:

A bird can be emaciated and weak, yet when it fluffs out its feathers, it may look normal. Have oxygen ready, warmed lactated ringers in a syringe, perhaps a syringe of warm hand-feeding formula and a stainless steel feeding tube, and any other equipment or medications that you feel might be necessary.

DO assess the avian patient's condition every moment during the time it is being handled:

In cases where the bird is very ill, it may be most important to stabilize the bird first, and procure tests later. With a critically ill bird, tests may need to be performed in stages, or sometimes, they must be forgone, so that all efforts are directed towards support care.

DON'T forget your sound medical background when dealing with the avian emergency:

Remember that birds have air sacs, and if there is serious damage to the beak, oropharynx or glottis, and establishing an airway is difficult, an air sac can be cannulated, and the bird can safely and easily breathe through the tube.

Fracture:

Birds also have some pneumatised bones, and a fracture may result in extensive SC emphysema. This is often puzzling to the beginning avian vet, who may suspect rib fractures. However, SQ emphysema is a common sequelae to a fractured pneumatised bone and will usually spontaneously resolve with 24 hours.

SHOCK:

Birds may be treated for "shock" although their physiological response to injury does not result in shock as occurs in mammals. We must always remember that steroid use in birds has potentially more serious and long-standing consequences than its use in mammals does.

One injection of a steroid in a critical bird is worth the risk, however, its use will increase the chance that the bird may develop aspergillosis, a serious fungal disease. Steroids have limited benefit in avian species, and topical preparations are also dangerous.

Thermoregulation:

Many sick birds also require supplemental heat, as they are not thermoregulating properly. Keeping a sick bird in a cage with a controlled temperature and humidity is very important. Birds will do well in an incubator set at between 87-92 degrees F. Humidity should be over 75%.

Sick baby birds often become ill from being kept at too low of a temperature. When this happens, the GI tract slows down dramatically. Therefore, giving any medications orally is usually not a great idea, as absorption will be erratic and slower than normal. Parenteral antibiotics and therapeutics are a better choice.

Supportive:

Many ill birds are dehydrated. Fluids may be given SC (over the back of the neck, where there is lots of loose skin, just beware of the jugular veins), intraosseously or intravenously. Hydrating a critical bird is very important.

When bandaging or splinting a bird, make sure that the sternum moves freely. Birds breathe like a bellows, in and out, not up and down, as mammals do. If the sternum's movement is restricted, the bird may asphyxiate

Stress:

DO plan to clip the wings of hospitalized birds. DO minimize stress in sick birds.

Keep critical birds in a stress-free environment. Don't put them in stainless steel cages where they can see their reflection. Keep them in a warm, quiet, dark environment. Don't keep a sick bird in a cage on the clinic floor. Birds are most comfortable up high, so take that into consideration when deciding where to put birdcages.

DO maintain total haemostasis when working on a bird:

Although it is not true that a bird will die from losing a few drops of blood, it is very important to minimize any bleeding. If a bird is bleeding badly, it is vital to stop the bleeding as quickly as possible. If a bird won't stop bleeding after venepuncture, a pressure bandage may be applied for 20 minutes or so, until clotting has occurred.

Liquid clotting agent, is safe and effective to use in birds. Use of a radio surgical unit (and NOT an electro cautery unit) is very helpful in stopping bleeding.

Emergency treatment for the ill bird at home:

•      Provide Warmth.

•      Give energy fluids by mouth.

•      Give sterile seed and remove all other foodstuffs.

•      Clean out the cage and disinfect with a Cage cleaner.

•      If possible give the appropriate medicines by mouth.