Emergency and critical care of pet birds

Point of Care Ultrasound in Exotic Animal Emergency and Critical Care

Exotic pets are presented to veterinary clinics with increasing frequency for routine, urgent, and emergency needs. With these increased visits, owners' expectations for high-quality veterinary care are also increasing. Many presenting complaints of reptiles, birds, and small mammals can benefit from the use of point of care ultrasound (POCUS) to establish a minimum database, aid in triage, and help guide further diagnostics, treatment, and prognostic discussions with the owner. Hospitalized exotic patients can also have their progress tracked and better assessed with the aid of POCUS.

Glucose and Lactate Reference Intervals for White Sturgeon and Evaluation of Two Point-of-Care Devices in Sturgeon Infected with Veronaea botryosa

White Sturgeon Acipenser transmontanus are cultured for human consumption as well as for conservation purposes. In this study, two commercially available portable devices for measuring glucose and lactate were compared to a benchtop analyzer and blood reference intervals were generated using heparin plasma collected from 43 healthy White Sturgeon yearlings. The generated normal ranges were used to compare plasma values collected from Veronaea botryosa-infected White Sturgeon at 10, 20, and 30 d postchallenge (dpc). In the 43 healthy yearlings, significantly different glucose and lactate values were obtained when comparing the portable devices to the benchtop analyzer. In the portable devices, blood glucose showed a consistent bias of 12.3 mg/dL and blood lactate showed a proportional bias. The detected blood glucose values in infected sturgeon were significantly different from those in noninfected controls when using the benchtop analyzer at 20 and 30 dpc and when using the portable device at 20 dpc. However, blood glucose in infected individuals and controls was within the reference interval on either device. No significant difference was noted for lactate measurements in infected sturgeon. The results of this study indicate that portable devices for blood glucose and blood lactate evaluation in White Sturgeon may be useful in a setting where relative values are an acceptable approximation of absolute values.

Diagnosis and long-term management of post-traumatic seizures in a white-crowned pionus (Pionus senilis)

CASE DESCRIPTION

A 13-year-old female white-crowned pionus (Pionus senilis) was examined because of seizures 22 months after it was treated for a traumatic brain injury (TBI) characterized by vision loss, hemiparesis, nystagmus, circling, and head tilt.

CLINICAL FINDINGS

Bloodwork performed during the initial seizure workup revealed hypercalcemia and hypercholesterolemia, which were attributed to vitellogenesis given the bird's previous egg-laying history and recent onset of reproductive behavior. Magnetic resonance imaging of the brain revealed diffuse right pallium atrophy with multifocal hydrocephalus ex vacuo, which were believed to be the result of the previous TBI. Findings were most consistent with post-traumatic seizures (PTS).

TREATMENT AND OUTCOME

Levetiracetam (100 mg/kg [45 mg/lb], PO, q 12 h) was initiated for PTS management. A 4.7-mg deslorelin implant was injected SC to suppress reproductive behavior. The bird was reexamined for presumed status epilepticus 5 times over 22 months. Seizure episodes coincided with onset of reproductive behavior. The levetiracetam dosage was increased (150 mg/kg [68 mg/lb], PO, q 8 h), and zonisamide (20 mg/kg [9.1 mg/lb], PO, q 12 h) was added to the treatment regimen. Additional deslorelin implants were administered every 2 to 6 months to suppress reproductive behavior. The owner was trained to administer midazolam intranasally or IM as needed at home. The treatment regimen helped control but did not eliminate seizure activity. The bird was euthanized 22 months after PTS diagnosis for reasons unrelated to the TBI or PTS.

CLINICAL RELEVANCE

Long-term management of PTS in a pionus was achieved with levetiracetam and zonisamide administration.

Outcomes of Conservatively Managed Coracoid Fractures in Wild Birds in the United Kingdom

Coracoid fractures are a frequent presentation in wild birds, commonly caused by collisions with motor vehicles, windows, or other obstacles such as pylons. Despite this, there are few reports of outcomes, and those published consist of small numbers of birds with conflicting results when comparing conservative management with surgical intervention. To determine outcome success of conservative management in a larger population of wild birds, records of 232 adult wild birds in the United Kingdom (UK) with closed unilateral coracoid fractures confirmed on radiography and surviving more than 48 hours after admission were retrospectively analyzed. Conservative management had a high success rate, with 75% (n = 174/232; 95% confidence limits [CL]: 69%, 80%) of all birds successfully released back to the wild. The proportion of raptors successfully returned to the wild was even higher at 97% (n = 34/35; 95% CL: 85%, 99%). A significant difference of 26% (95% CL: 18%, 34%, Fisher exact test, P < .001) was demonstrated when comparing the outcome success of raptors (97%, n = 34/35) to nonraptors (71%, n = 140/198). The median time in captive care until released back to the wild was 30 days (95% CL: 27, 33). Conservative management of coracoid fractures in wild birds in the UK, and in particular in raptors, appears to result in good outcomes. The approach is low cost and noninvasive, in contrast to surgery, and is recommended as the first-line approach of choice in these cases.

Systemic Clinical and Metabolic Diseases

Like other animals pet and companion birds are also prone to systemic illness. This is presented in the form of certain clinical signs and symptoms which is known as “ sick-bird syndrome.”

Emergencies and Critical Care of Commonly Kept Fowl

Fowl are birds belonging to one of the 2 biological orders, the game fowl or land fowl (Galliformes) and the waterfowl (Anseriformes). Studies of anatomic and molecular similarities suggest these two groups are close evolutionary relatives. Multiple fowl species have a long history of domestication. Fowl are considered food-producing animals in most countries and clinicians should follow legislation regarding reportable diseases and antibiotic use, even if they are pets. This article reviews aspects of emergency care for most commonly kept fowl, including triage, patient assessment, diagnostic procedures, supportive care, short-term hospitalization, and common emergency presentations.

Coracoid fractures in wild birds: a comparison of surgical repair versus conservative treatment

Medical records of wild bird admissions to the Australian Wildlife Health Centre at Healesville Sanctuary were analyzed for cases of unilateral coracoid fractures with known final outcomes. Forty-seven birds, comprising 13 species, fit these criteria. Of those birds, 18 were treated conservatively with analgesia and cage rest without coaptation bandaging, and 29 were treated with surgical correction of the fracture. Of the conservatively managed birds, 89% (16 of 18) were released back into the wild. Conversely, 34% (10 of 29) of the surgically managed birds were released. Treatment success for release differed significantly between treatment groups (P < .001). Intraoperative death from concurrent trauma was the major reason that surgically treated birds were not released. Given the high risks associated with surgical treatment and the high success rate of conservative management, cage rest without surgery appears prudent when managing coracoid injuries in birds.

Comparison of intraosseous and peripheral venous fluid dynamics in the desert tortoise (Gopherus agassizii)

The efficacy of intraosseous catheterization has not been described previously in the desert tortoise (Gopherus agassizii). The goal of this study was to describe and compare the efficacy of four intraosseous catheter sites (humerus, femur, plastocarapacial junction [bridge], and gular region of the plastron) to jugular catheterization. Five adult tortoises were catheterized in each of the sites at least once. The distribution of a bolus injection of radiopharmaceutical (technetium-99m-diethylenetriaminepentaacidic acid [99mTc -DTPA]) was monitored via gamma camera over 2-min periods at five time intervals over 24 min. Compared to jugular catheterization, the humerus and femur sites provided the next best vascular access, with 84.4 and 61.8% of activity reaching the systemic circulation by 7 min, respectively. The bridge and gular catheter sites were less effective with only 41.9 and 40.8% systemic activity, respectively. Intraosseous catheters were no more technically difficult to place than jugular catheters and were less commonly dislodged, making them a viable option for vascular access in tortoises.

Management of common psittacine reproductive disorders in clinical practice

The reproductive organs play a key role in the maintenance of normal homeostasis in psittacine birds. For this reason, sex determination should be part of the baseline data collected on every avian patient. Disorders of the psittacine reproductive tract can have a negative effect on the function of other organ systems in the body. Reproductive organs may be plagued by a multitude of problems ranging from infection and neoplasia to inflammation and idiopathic issues that affect fertility. Detection of reproductive problems may require the use of a variety of modalities. The ability to treat these problems often depends on the presenting complaint as well as the clinical condition of the avian patient. Different reproductive disorders of male and female psittacine birds, with their detection and treatment are discussed in this article.