Restrain, Physical Examination, Restrain, Physical Examination, Venipuncture, Blood samples and Venipuncture, Blood samples and

Medication routesMedication routes

HistoryHistory

Before you approach any avian, ask all the Before you approach any avian, ask all the pertinent question writing in your book pertinent question writing in your book Page 19-20Page 19-20

During the initial encounter During the initial encounter between veterinarian technician between veterinarian technician and patient, a number of very and patient, a number of very important dynamics occur. important dynamics occur.

1.1. First, the patient is approached, First, the patient is approached, captured, and restrained. captured, and restrained.

2.2. Second, the patient is examined Second, the patient is examined by the veterinarian so its by the veterinarian so its condition may be assessed. condition may be assessed.

Capture of the patient may be affected Capture of the patient may be affected through a few basic techniques. Rarely through a few basic techniques. Rarely does a pet bird surrender willingly to the does a pet bird surrender willingly to the entrapment of the handler. Almost always, entrapment of the handler. Almost always, some form of mechanical assistance, in some form of mechanical assistance, in the form of a towel, net, etc. must be the form of a towel, net, etc. must be utilized.utilized.

NO GLOVESNO GLOVES

Handling Handling

Watch for hyperthermia. Open-mouthed Watch for hyperthermia. Open-mouthed breathing means stress and this should breathing means stress and this should return to normal within 5 minutesreturn to normal within 5 minutes

Be careful no interfere with respiration. Be careful no interfere with respiration. Birds don't diaphragm Birds don't diaphragm

Use a towel to cover your hand when Use a towel to cover your hand when capturing psittacines (parrots)capturing psittacines (parrots)

The single most useful tool in a bird The single most useful tool in a bird capture arsenal is a towel capture arsenal is a towel

As the towel is quickly but As the towel is quickly but smoothly draped over the bird smoothly draped over the bird the handler takes hold of the the handler takes hold of the patient's neck from behind patient's neck from behind

The handler's hand encircles The handler's hand encircles the neck somewhat stretching the neck somewhat stretching apart the head and shoulders apart the head and shoulders

The bird's neck is held by one The bird's neck is held by one hand while its torso and legs hand while its torso and legs are encircled through the are encircled through the towel by the other hand towel by the other hand

Macaw faces bruise very Macaw faces bruise very easily. Be gentle here.easily. Be gentle here.

A small bird or a A small bird or a cooperative large bird cooperative large bird may be captured with may be captured with bare hands. Always, bare hands. Always, the bird should first be the bird should first be captured from the captured from the rear and behind the rear and behind the neck neck

Be sure to watch for Be sure to watch for sharp claws sharp claws

videovideo

Physical ExaminationPhysical Examination Head:Head:

Lack of symmetry, bruising, swellingLack of symmetry, bruising, swelling Eyes:Eyes:

Lack of symmetry, discharge, opaque lens, Lack of symmetry, discharge, opaque lens,

blood, distruption of normal anatomyblood, distruption of normal anatomy Beak:Beak:

Lack of symmetry, elongated, severe flaking, Lack of symmetry, elongated, severe flaking,

fractures, pitting of the surfacefractures, pitting of the surface Note: some flaking of the beak is normalNote: some flaking of the beak is normal

Ears:Ears: Closed meatus, discharge, odorClosed meatus, discharge, odor

Nares:Nares: Lack of symmetry, discharge, mass, debris, bloodLack of symmetry, discharge, mass, debris, blood Note: it is normal for a structure to be present just inside the nares, called the Note: it is normal for a structure to be present just inside the nares, called the

operculumoperculum It is important not to disturb this structure or it may bleedIt is important not to disturb this structure or it may bleed

P.E.P.E. Skin:

Excess flaking, pitting of the surface, blood, redness, swelling, masses

Note: it is normal for birds to bruise green, rather than purple, so it should not be mistaken for gangrene

Feathers: Unzipped barbules, dull, greasy, unkempt,

stained, plucked or shredded feathers, lack of powder down, stress bars (horizontal lines of malformation along the feather, suggesting the bird encountered a stressful incident during the formation of that (feather)

P.E.P.E. Crop:

No movement w/in one minute, fistula, distended, empty

Pectoral muscle mass (thin or obese): A body condition score is assessed by

determining pectoral muscle mass Normally the edge of the keel can be palpated

b/t the rounded pectoral muscles that slope slightly to either side

Wings: Feathers missing, damaged hemorrhaging

blood feathers, masses, fractures, dislocations, feathers trimmed, ulcers in skin, lice

P.EP.E Cloaca or vent: Masses, dilated, irritated

(hyperemic), prolapse of tissue, accumulation of feces, diarrhea on feathers

Feet: Plantar erosions (pink area on

bottom of feet), flaky skin, necrotic areas, scab, swelling (abscess or gout, which is an accumulation of white uric acid under the skin)

Assessing Hydration Status:Assessing Hydration Status:

A “vein refill time” can be performed on the basilic (cutaneous ulnar) vein of birds

Normally hydrated bird, the basilic vein should instantaneously refill, and by the time a finger is off the vein to see it, it should have refilled

If the basilic vein can be seen to refill, then it is estimated the bird is approximately 5% dehydrated

If the vein requires one second to refill, the bird is severely dehydrated (10%) or is in shock (low BP)

  

GroomingGrooming

Wing clipping can be Wing clipping can be done in psitacines as they done in psitacines as they use their beaks as an use their beaks as an extra “hand” for climbingextra “hand” for climbing

Whether to clip one wing Whether to clip one wing or both is debated. Some or both is debated. Some say one wing clip produce say one wing clip produce unbalanced flight and the unbalanced flight and the bird will crash when bird will crash when attempting to fly. attempting to fly.

Wing ClippingWing Clipping

Encourage most people, Encourage most people, especially new owners, to especially new owners, to clip their birds' flight clip their birds' flight feathers. feathers.

Trim only his flight Trim only his flight feathers, the "primaries" at feathers, the "primaries" at the ends of his wings. Do the ends of his wings. Do not clip the "secondary" not clip the "secondary" feathers near to his body. feathers near to his body. These do not affect his These do not affect his ability to fly, only his ability to fly, only his ability to ability to land.land.

Wing ClippingWing Clipping

Restrain in a towel. Grasp the wing at the Restrain in a towel. Grasp the wing at the humeroradial joint and extend carefully.humeroradial joint and extend carefully.

Trim with sharp scissors, leaving the first and the Trim with sharp scissors, leaving the first and the last two or four primary feathers last two or four primary feathers

Watch for “Blood Watch for “Blood feathers” If one is feathers” If one is clipped, remove it clipped, remove it with pliers or with pliers or hemostats and apply hemostats and apply gentle pressure to gentle pressure to stop any bleeding stop any bleeding

Toenail ClippingToenail Clipping

There are blood vessels There are blood vessels and nerves in birds’ and nerves in birds’ toenails. Clip them too toenails. Clip them too short and you’ll hurt your short and you’ll hurt your bird and quite possibly bird and quite possibly cause bleeding.cause bleeding.

If you do hit a blood If you do hit a blood vessel, use silver nitrate vessel, use silver nitrate (Quick Stop) you can also (Quick Stop) you can also dip the bleeding toenail dip the bleeding toenail in flour, corn starch or in flour, corn starch or sugar.sugar.

More on Toenail ClippingMore on Toenail Clipping

Clipping toenails Clipping toenails too short can also too short can also cause a bird to cause a bird to have balance and have balance and gripping problems.gripping problems.

So, clip toenails So, clip toenails just short enough just short enough to blunt them.to blunt them.

A guillotine type dog A guillotine type dog nail clipper or human nail clipper or human toenail clipper can be toenail clipper can be used.used.

An electrical dremel An electrical dremel tool can be used. It tool can be used. It cauterizes as it trims. cauterizes as it trims.

Training – Positive Reinforcement Training – Positive Reinforcement

BeakBeak Some individual parrots maintain Some individual parrots maintain

their beak length and never need a their beak length and never need a trim, while others require a trim q6mtrim, while others require a trim q6m

Some species of parrots possess a Some species of parrots possess a longer beak than others, and these longer beak than others, and these differences need to be learned differences need to be learned before trimmingbefore trimming

Beak trims are performed when the Beak trims are performed when the bird is either awake or under a light bird is either awake or under a light plane of isoflurane anesthesiaplane of isoflurane anesthesia

A roto-tool or a nail file is utilizedA roto-tool or a nail file is utilized If the bill tip organ becomes visible If the bill tip organ becomes visible

(as a row of white dots on the (as a row of white dots on the occlusal surface of the beak) then occlusal surface of the beak) then the beak should be trimmed no the beak should be trimmed no further or hemorrhage and pain will further or hemorrhage and pain will occuroccur

Blood collection Blood collection Syringe (25 gauge needle), blood tubes red top (general Syringe (25 gauge needle), blood tubes red top (general

chemistry and serology procedures), green top (plasma chemistry and serology procedures), green top (plasma or whole blood – general haematology and certain or whole blood – general haematology and certain

chemistry procedures), test alcoholchemistry procedures), test alcohol

Blood CollectionBlood Collection

The blood volume of birds is 10%of their The blood volume of birds is 10%of their body weight.body weight.

The amount of blood that can be collected The amount of blood that can be collected safely from healthy bird is approximately safely from healthy bird is approximately 1% of the body weight (1ml/100 grams of 1% of the body weight (1ml/100 grams of body weight in a healthy bird). This body weight in a healthy bird). This amount should be reduced with a sick amount should be reduced with a sick patient. patient.

Avian Venipuncture Avian Venipuncture

Most birds can easily be bleed through the right Most birds can easily be bleed through the right jugular vein. jugular vein.

This vein is the preferred site for blood collection This vein is the preferred site for blood collection as is easily accessed and yield large volumes of as is easily accessed and yield large volumes of blood.blood.

In species where a featherless tract over the In species where a featherless tract over the jugular and tracheal areas doesn’t exist, jugular and tracheal areas doesn’t exist, alternative venipuncture site must be used.alternative venipuncture site must be used.

Other sites include the medial metatarsal vein, Other sites include the medial metatarsal vein, cutaneous ulnar, and toenail cutaneous ulnar, and toenail

Jugular Jugular Easily accessedEasily accessed Can obtain large volumes Can obtain large volumes

of bloodof blood Highly mobileHighly mobile Difficult to immobilizeDifficult to immobilize Hematomas easily Hematomas easily

formed formed The angle and direction The angle and direction

that the needle is inserted that the needle is inserted will depend on personal will depend on personal preference and restraint preference and restraint technique technique

After venipuncture, hold After venipuncture, hold pressure on vessel to pressure on vessel to ensure hemostasis ensure hemostasis

Medial MetatarsalMedial Metatarsal

Easily inmobilizedEasily inmobilized Can obtain large Can obtain large

volumes of blood volumes of blood Minimal chance of Minimal chance of

hematomas forminghematomas forming

Cutaneous UlnarCutaneous Ulnar

Easily accessedEasily accessed Yields low volume of Yields low volume of

bloodblood The wing should be The wing should be

extended and held flat extended and held flat against the surface of the against the surface of the table.table.

Directs the need le Directs the need le towards the body.towards the body.

Maintain a very light Maintain a very light pressure on the syringe pressure on the syringe plunge as this vein will plunge as this vein will collapse easily collapse easily

Toenail ClipToenail Clip

Is painfulIs painful Yields a low volume Yields a low volume

of blood of blood This technique is This technique is

used primarily on very used primarily on very small birds small birds

Avian BloodAvian Blood

consists of plasma + formed elements consists of plasma + formed elements plasma is largely water (~85%) plus lots of plasma is largely water (~85%) plus lots of

protein (~9-11%); other constituents of blood protein (~9-11%); other constituents of blood include glucose (blood glucose levels in birds include glucose (blood glucose levels in birds are greater than in mammals; about 200-400 are greater than in mammals; about 200-400 mg/dl), amino acids, waste products, hormones, mg/dl), amino acids, waste products, hormones, antibodies, & electrolytes. antibodies, & electrolytes.

the formed elements include red blood cells (or the formed elements include red blood cells (or erythrocytes), white blood cells (or leucocytes), erythrocytes), white blood cells (or leucocytes), and thrombocytes and thrombocytes

Bird’s RBC (shown to the right), Bird’s RBC (shown to the right), unlike those of mammals, are unlike those of mammals, are elliptical in shape and elliptical in shape and nucleated. In most species, red nucleated. In most species, red blood cells are about blood cells are about 6 x 12 microns in size (mammalian RBC's are typically (mammalian RBC's are typically 5.5 - 7.5 microns in diameter). 5.5 - 7.5 microns in diameter).

Avian RBC have a lifespan of Avian RBC have a lifespan of 28-45 days 28-45 days

Red blood cells contain Red blood cells contain hemoglobin, the molecule hemoglobin, the molecule responsible for transporting responsible for transporting oxygen throughout the body, oxygen throughout the body, and are produced in the bone and are produced in the bone marrow, but in marrow, but in passerines (song passerines (song birds) birds) are form in the liver and are form in the liver and spleenspleen

White blood cells play an important role in White blood cells play an important role in protecting birds from infectious agents such as protecting birds from infectious agents such as viruses and bacteria. In adult birds WBC are viruses and bacteria. In adult birds WBC are primarily produced by the spleen. Birds have primarily produced by the spleen. Birds have several types of white blood cells: several types of white blood cells:

The lymphocyte is the second numerous white blood cell.  Lymphocytes are either T-lymphocytes (formed in the thymus) or B-lymphocytes (formed in the bursa of Fabricius). B-lymphocytes produce antibodies; T-lymphocytes attack infected or abnormal cells. 

The heterophil is the most numerous WBC in most birds. Heterophils are phagocytic and use their enzyme-containing granules to lyse ingested materials. Heterophils are motile and have bilobed nucleus. A rise in their number is usually seen in acute diseases

More Avian WBCMore Avian WBC

Monocytes are phagocytic cells that act as a second line of cellular defense. An increase production is often seen in cases of tuberculosis and aspergillosis

Eosinophils make up about 2 to 3 % of the WBC population of healthy birds. Their number increase in response to allergic reactions and heavy internal parasites

Where are the neutrophils?Where are the neutrophils?

Neutrophil is the WBC type that Neutrophil is the WBC type that is notis not found in the an avian blood smear found in the an avian blood smear

Basophils are rarely to observe and their Basophils are rarely to observe and their function is still unclear function is still unclear

Thrombocytes Thrombocytes

Thrombocytes are nucleated cells that act as a platelets. Thrombocytes are nucleated cells that act as a platelets. They are smaller than RBC and have a large, round to They are smaller than RBC and have a large, round to oval nucleus. They are important in blood clotting and oval nucleus. They are important in blood clotting and are produce by the bone marrow in adult birds are produce by the bone marrow in adult birds

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A good review/access to avian A good review/access to avian hematology can be found at:hematology can be found at:

http://www.vet.uga.edu/vpp/ivcvm/1999/phillips/index.php

www.texascollaborative.org/.../sec1_act.php

Drug delivery to birdsDrug delivery to birds Oral Medication Strategies

Per Os Administration Application of Medications in the Food

Application of Medications in the Drinking Water Routes of Alimentation

Tube Feeding (Over the tongue and to

the right size of the mouth)

Esophagostomy Routes of Fluid Therapy and Intravascular Drug

Delivery Subcutaneous Administration (inguinal area)

Intravenous Administration (metatarsal for fluids) jugular

Intraosseous Catheterization Respiratory Therapy

Nebulization Intramuscular Injection

Pectoral muscle

IOIO

This is called an This is called an intraosseus (IO) catheter. intraosseus (IO) catheter. It is used to give fluids, It is used to give fluids, especially during an especially during an emergency. Birds have emergency. Birds have very thin walled veins and very thin walled veins and sometimes they do not sometimes they do not hold up when we need to hold up when we need to administer fluids. The IO administer fluids. The IO catheter remedies this catheter remedies this problemproblem

Ulna or tibiotarsusUlna or tibiotarsus