Transcript Restrain for PE, venipuncture sites nails and wing clipping,

Restrain, Physical Examination,
Venipuncture, Blood samples and
Medication routes
History
 Before
you approach any avian, ask all the
pertinent question writing in your book
Page 19-20
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During the initial encounter
between veterinarian
technician and patient, a
number of very important
dynamics occur.
First, the patient is
approached, captured, and
restrained.
Second, the patient is
examined by the
veterinarian so its condition
may be assessed.
 Capture
of the patient may be affected
through a few basic techniques. Rarely
does a pet bird surrender willingly to the
entrapment of the handler. Almost always,
some form of mechanical assistance, in
the form of a towel, net, etc. must be
utilized.
 NO GLOVES
Handling
 Watch
for hyperthermia. Open-mouthed
breathing means stress and this should
return to normal within 5 minutes
 Be careful no interfere with respiration.
Birds don't diaphragm
 Use a towel to cover your hand when
capturing psittacines (parrots)
The single most useful tool in a bird
capture arsenal is a towel
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As the towel is quickly but
smoothly draped over the
bird the handler takes hold of
the patient's neck from
behind
The handler's hand encircles
the neck somewhat
stretching apart the head and
shoulders
The bird's neck is held by
one hand while its torso and
legs are encircled through
the towel by the other hand
Macaw faces bruise very
easily. Be gentle here.
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A small bird or a
cooperative large bird
may be captured with
bare hands. Always,
the bird should first be
captured from the
rear and behind the
neck
 Be sure to watch for
sharp claws
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Physical Examination
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Head:
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Lack of symmetry, bruising, swelling
Eyes:
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Lack of symmetry, discharge, opaque lens,
blood, distruption of normal anatomy
Beak:
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Lack of symmetry, elongated, severe flaking,
fractures, pitting of the surface
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Note: some flaking of the beak is normal
Ears:
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Closed meatus, discharge, odor
Nares:
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Lack of symmetry, discharge, mass, debris, blood
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Note: it is normal for a structure to be present just inside the nares, called
the operculum
P.E.
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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
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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)
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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
 Cloaca
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or vent:
P.E
Masses, dilated, irritated
(hyperemic), prolapse of
tissue, accumulation of feces,
diarrhea on feathers
 Feet:
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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:
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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)
Grooming
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Wing clipping can be
done in psitacines as they
use their beaks as an
extra “hand” for climbing
Whether to clip one wing
or both is debated. Some
say one wing clip produce
unbalanced flight and the
bird will crash when
attempting to fly.
Wing Clipping
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Encourage most people,
especially new owners, to clip
their birds' flight feathers.
 Trim only his flight feathers,
the "primaries" at the ends of
his wings. Do not clip the
"secondary" feathers near to
his body. These do not affect
his ability to fly, only his ability
to land.
Wing Clipping
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Restrain in a towel. Grasp the wing at the
humeroradial joint and extend carefully.
 Trim with sharp scissors, leaving the first and the
last two or four primary feathers
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Watch for “Blood
feathers” If one is
clipped, remove it
with pliers or
hemostats and apply
gentle pressure to
stop any bleeding
Toenail Clipping
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There are blood vessels
and nerves in birds’
toenails. Clip them too
short and you’ll hurt your
bird and quite possibly
cause bleeding.
If you do hit a blood
vessel, use silver nitrate
(Quick Stop) you can also
dip the bleeding toenail in
flour, corn starch or
sugar.
More on Toenail Clipping
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Clipping toenails too
short can also cause
a bird to have balance
and gripping
problems.
 So, clip toenails just
short enough to blunt
them.
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A guillotine type dog
nail clipper or human
toenail clipper can be
used.
 An electrical dremel
tool can be used. It
cauterizes as it trims.
Training – Positive Reinforcement
Beak
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Some individual parrots maintain
their beak length and never need
a trim, while others require a trim
q6m
Some species of parrots possess
a longer beak than others, and
these differences need to be
learned before trimming
Beak trims are performed when
the bird is either awake or under a
light plane of isoflurane
anesthesia
A roto-tool or a nail file is utilized
If the bill tip organ becomes visible
(as a row of white dots on the
occlusal surface of the beak) then
the beak should be trimmed no
further or hemorrhage and pain
will occur
Blood collection
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Syringe (25 gauge needle), blood tubes red top (general
chemistry and serology procedures), green top (plasma
or whole blood – general haematology and certain
chemistry procedures), test alcohol
Blood Collection
 The
blood volume of birds is 10%of their
body weight.
 The amount of blood that can be collected
safely from healthy bird is approximately
1% of the body weight (1ml/100 grams of
body weight in a healthy bird). This
amount should be reduced with a sick
patient.
Avian Venipuncture
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Most birds can easily be bleed through the right
jugular vein.
 This vein is the preferred site for blood collection
as is easily accessed and yield large volumes of
blood.
 In species where a featherless tract over the
jugular and tracheal areas doesn’t exist,
alternative venipuncture site must be used.
 Other sites include the medial metatarsal vein,
cutaneous ulnar, and toenail
Jugular
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Easily accessed
Can obtain large volumes
of blood
Highly mobile
Difficult to immobilize
Hematomas easily
formed
The angle and direction
that the needle is inserted
will depend on personal
preference and restraint
technique
After venipuncture, hold
pressure on vessel to
ensure hemostasis
Medial Metatarsal
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Easily inmobilized
 Can obtain large
volumes of blood
 Minimal chance of
hematomas forming
Cutaneous Ulnar
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Easily accessed
Yields low volume of
blood
The wing should be
extended and held flat
against the surface of the
table.
Directs the need le
towards the body.
Maintain a very light
pressure on the syringe
plunge as this vein will
collapse easily
Toenail Clip
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Is painful
 Yields a low volume
of blood
 This technique is
used primarily on very
small birds
Avian Blood
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consists of plasma + formed elements
 plasma is largely water (~85%) plus lots of
protein (~9-11%); other constituents of blood
include glucose (blood glucose levels in birds
are greater than in mammals; about 200-400
mg/dl), amino acids, waste products, hormones,
antibodies, & electrolytes.
 the formed elements include red blood cells (or
erythrocytes), white blood cells (or leucocytes),
and thrombocytes
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Bird’s RBC (shown to the right),
unlike those of mammals, are
elliptical in shape and
nucleated. In most species, red
blood cells are about 6 x 12
microns in size (mammalian
RBC's are typically 5.5 - 7.5
microns in diameter).
Avian RBC have a lifespan of
28-45 days
Red blood cells contain
hemoglobin, the molecule
responsible for transporting
oxygen throughout the body,
and are produced in the bone
marrow, but in passerines (song
birds) are form in the liver and
spleen
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White blood cells play an important role in
protecting birds from infectious agents such as
viruses and bacteria. In adult birds WBC are
primarily produced by the spleen. Birds have
several types of white blood 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
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; Tlymphocytes attack infected
or abnormal cells.
More 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?
 Neutrophil
is the WBC type that is not
found in the an avian blood smear
 Basophils are rarely to observe and their
function is still unclear
Thrombocytes
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Thrombocytes are nucleated cells that act as a platelets.
They are smaller than RBC and have a large, round to
oval nucleus. They are important in blood clotting and
are produce by the bone marrow in adult birds
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A good review/access to avian
hematology can be found at:
 http://www.vet.uga.edu/vpp/ivcvm/1999/ph
illips/index.php
 www.texascollaborative.org/.../sec1_act.ph
p
Drug delivery to birds
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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
IO
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This is called an
intraosseus (IO) catheter.
It is used to give fluids,
especially during an
emergency. Birds have
very thin walled veins and
sometimes they do not
hold up when we need to
administer fluids. The IO
catheter remedies this
problem
Ulna or tibiotarsus