Common Emergencies in Pet Birds

Retrospective evaluation of cardiopulmonary arrest and resuscitation in hospitalized birds: 41 cases (2006-2019)

OBJECTIVE

To describe circumstances and outcomes following cardiopulmonary arrest (CPA) in hospitalized birds.

DESIGN

Retrospective case study.

SETTING

Academic medical center.

METHODS

The hospital medical records system was searched for avian cases that underwent CPR. Medical records were reviewed; data retrieved included association of CPA with anesthesia or handling, use of external compressions and intubation, drug administration, rates of return of spontaneous circulation (ROSC), and outcome. Cases with incomplete medical records were excluded.

RESULTS

Forty-one cases of avian CPR were identified. Anesthesia-related arrest was reported in 26 of 41 cases. The remainder of CPA events occurred during an examination (6/41) or were observed during hospitalization for treatment of disease or injury (11/41). Compressions were performed in 14 birds and manual ventilation performed in 21 of 41 cases via intubation (19/21), tight-fitting face mask (1/21), or air sac cannulation (1/21). Vascular access was achieved in 24 of 41 cases. Emergency drug administration was documented in 22 of 41 cases and included epinephrine (20/22), atropine (19/22), glycopyrrolate (3/22), doxapram (2/22), dextrose (3/22), mannitol (1/22), and furosemide (1/22). Fluid therapy was administered in 24 of 41 cases. There were 3 documented cases of ROSC (7%), all in patients under general anesthesia, and 1 (2%) CPA survivor.

CONCLUSIONS

There was no standardized approach to avian CPR in this study, and ROSC was rare. When ROSC was achieved, birds were under general anesthesia with direct monitoring by a clinician, were ventilated, and were administered anesthetic reversals and anticholinergic or catecholamine emergency medications. These poor outcomes suggest that further research and an updated standardized approach to avian CPR, with special consideration of the physiological differences from mammals, are needed.

Pharmacokinetic Behaviour of Enrofloxacin after Single Intramuscular Dosage in American Black Vultures (Coragyps atratus)

The aim of the study was to investigate the intramuscular pharmacokinetics of enrofloxacin in black vultures (Coragyps atratus). The pharmacokinetics of a single intramuscular dose (10 mg/kg) of enrofloxacin was studied in six vultures. Plasma concentrations of enrofloxacin and its active metabolite, ciprofloxacin, were determined by high-performance liquid chromatography (HPLCuv). Pharmacokinetic parameters were estimated using non-compartmental and compartmental analysis. After intramuscular administration, enrofloxacin showed a rapid and complete absorption, reaching a Cmax value of 3.26 ± 0.23 μg/mL at 1.75 ± 0.53 h. A long terminal half-life of 19.58 h has been observed. Using previously published MIC values to perform a PK/PD analysis, cumulative fraction responses obtained after Monte Carlo simulation for AUC/MIC > 30, 50 and 125 were 72.93%, 72.34% and 30.86% for E. coli and 89.29%, 88.89% and 58.57% for Mycoplasma synoviae, respectively. Cumulative fraction responses obtained for Cmax/MIC index were 33.93% and 40.18% for E. coli and M. synoviae, respectively. The intramuscular administration of 10 mg/kg could be appropriate to treat infectious diseases caused by gram-positive bacteria with MIC value lower than 1 µg/mL; however, although enrofloxacin showed a slow elimination in black vultures, plasma concentrations were insufficient to reach the gram-negative stablished breakpoints.

Development and evaluation of a technique for spinal anaesthesia in broiler chickens

AIMS

To develop a technique for the injection of local anaesthetic into the spinal canal of broiler chickens by first determining the ideal location for needle placement based on anatomy and histology, and then using the developed technique to assess the onset and duration of action of three doses of lidocaine.

METHODS

Two-month-old Ross broiler chickens (n = 30) were used in this study. Computed tomography imaging followed by anatomical examination of fresh cadavers (n = 6) were used to identify a suitable intervertebral space for injection of local anaesthetic, and landmarks to locate this space. Histological evaluation of the microanatomy of the caudal vertebral column in another six birds was used to examine the position of the spinal cord within the canal. Spinal anaesthesia was attempted using injection of lidocaine at 0.5 mg/kg (n = 6), 1 mg/kg (n = 6), and 2 mg/kg (n = 6) via the selected intervertebral space. Analgesia was tested by pinching the skin of the pericloacal area with thumb forceps to determine the onset and duration of analgesia. Respiratory rate, and cloacal temperature were measured at 0 minutes and every 10 minutes after injection until sensation returned.

RESULTS

The space between synsacrum and first free coccygeal vertebra (synsacrococcygeal space) was selected as the most suitable site for spinal injection. In this region, the dura mater adhered to the internal wall of the spinal canal, and the subarachnoid space was large indicating that injection would be into the subarachnoid rather than the epidural space. The interval to onset of analgesia was similar for all doses of lidocaine (1.5 (SD 0.7), 2 (SD 1) and 1.3 (SD 0.5) minutes for 0.5, 1 and 2 mg/kg, respectively; p = 0.604). Duration of analgesia was longer following injection with 2 than 0.5 or 1 mg/kg lidocaine (21.3 (SD 2.5) vs. 4.5 (SD 3.5) vs. 11.3 (SD 2) minutes, respectively; p = 0.002). Mean cloacal temperature decreased between 0 and 20 minutes after injection with all doses of lidocaine (p = 0.021).

CONCLUSIONS AND CLINICAL RELEVANCE

Spinal anaesthesia in chickens is feasible and is a practical, inexpensive and simple technique for regional anaesthesia of the pericloacal area.

Fracture Management in Avian Species

In treating avian species with fractures, the clinician must be prepared to think laterally and assess each case individually, taking into account the unique characteristics of the fracture, the temperament of the species and the individual, its lifestyle, and the desired outcome. All this should be considered during the decision making process, which should involve the owner or career of the patient. The clinician should aim for a result as close as possible to the original functional anatomy. The degree of perfection required for postoperative return to normal function is dictated by the species and the lifestyle of the patient.

Ambulatory Emergency Medicine

While practicing exotic animal medicine as an ambulatory practitioner, veterinarians need to be prepared for the inevitable emergency call. Emergencies in exotic animal medicine come in all shapes and sizes and the veterinarian must be prepared for a variety of situations. With the proper training, equipment, and managing client expectations, an ambulatory exotics animal practitioner can successfully address emergencies. This article provides a brief overview in managing emergency cases in an ambulatory exotics animal practice.

Overview of Drug Delivery Methods in Exotics, Including Their Anatomic and Physiologic Considerations

Drug delivery to exotic animals may be extrapolated from domestic animals, but some physiologic and anatomic differences complicate treatment administration. Knowing these differences enables one to choose optimal routes for drug delivery. This review provides practitioners with a detailed review of the currently reported methods used for drug delivery of various medications in the most common exotic animal species. Exotic animal peculiarities that are relevant for drug administration are discussed in the text and outlined in tables and boxes to help the reader easily find targeted information.