Talk by Dr Stacey Gelis done in Bowral 15th June 2012

1. Stacey Gelis BVSc(Hons) MACVSc ( Avian Health)
Animal Referral Hospital
250 Parramatta Rd Homebush 2140

2. Patient Assessment
 To handle or not to handle…
…that is the question!

3. Ooops!!

4. Contraindications To Handling
 Extreme dyspnoea
 Prostration
 Unresponsive to stimuli

5. Beware of Small Patients

6. Stop a Clinical Examination when..
 Bird closes its eyes in your hand
 Sudden weakness
 Failure to grasp with both feet
 No pressure when item inserted in beak
 Immediately place into heated hospital cage +/-
oxygen
 Obtain a thorough history

7. Hospitalisation Facilities
 Heat 28-32 degrees C
 Humidity
 Oxygen
 Nebulisation
 Quiet
 Subdued Light
 Available food

8. Fluid Therapy
 Intravenous
 Jugular (right)
 Ulnar
 Medial tarsal
 Subcutaneous
 Inguinal ( bilaterally)
 interscapular
 Intraosseous
 Ulna
 tibiotarsus
 Oral
 Crop gavage

10. Calculating Fluid Requirements
 Daily maintenance: 5% BW/day
 Plus % dehydration
 Aim to replace 50% deficit first 24 hrs
 In acute fluid loss, 20-25% of deficit is replaced in first
4-6 hrs.
 Then the other 50% over next 24-48 hrs

11. Fluid Volumes
 IV fluid Rates
 Crystalloids: bolus 10 ml/kg or 10-25ml/kg over several mins
 Colloids: 3-5 ml/kg
 Transient bradycardia
 Decompensatory phase of shock (bradycardia, hypotension,
hypothermia)
 Slow IV/IO bolus over 10 mins of 7.5% hypertonic saline (3ml/kg) +
colloids (3ml/g)
 Fluid overload:
 Increased RR
 Cardiac dysrhythmia
 Agitation
 Collapse

12.  Subcutaneous Fluid Volumes
 5-10% bodyweight bid-tid
 Ensure all fluids are WARMED 37-39 DegC

13. Crop Volumes
 30ml/kg q 6-8 hrs or 3-5% bodyweight
 Initial to Max Crop Volumes
 Finch: 0.1-0.5 q 4hrs
 Budgie: 0.5-3.0 q 6 h
 Cockatiel: 1-8 q 6h
 Sun conure: 7-15 q 6h
 Cockatoo: 10-40 q 8-12 hrs

14. Oral Rehydration/Nutrition

15. Fluid Types
 Hartmann’s solution
 0.45% NaCl and 2.5% glucose
 0.9% NaCl
 Colloids eg Gelofusin (10-15 ml/kg IV q 8hrs)
 Fluids should be WARMED

16. Blood transfusions
 Indicated when PCV <15-20%**
 Circulating Blood volume= 7-10% BW
 Can easily tolerate 30% acute blood loss
 PCV can take 24 hrs to stabilise
 Transfusion volume: 10-20% blood volume
 Homologous vs Heterologouss
 Homologous: RBC survival 9-11 day
 Heterologous: 1-3 days
 Reactions rare

17. Medication Injection Sites
 Intravenous
 Intramuscular
 Pectoral muscles
 Start low, alternate sites
 Subcutaneous
 eg enrofloxacin diluted with saline for repeated
injections

18. Dyspnoeic Patients
 Upper Vs Lower Respiratory Disease
 Upper:
 Open beak breathing with high pitched squeak
 Forward leaning posture
 Acute- good body condition
 Lower:
 Poor body condition- chronic?
 Coelomic distension

19. Stabilising Dyspnoeic Patients
 Oxygen therapy
 Nebulisation
 Relieve upper respiratory obstruction
 Coelomocentesis
 Ovocentesis
 Air sac cannulation

20. Nebulisation Protocols
 F10 concentrate
 1ml to 250 ml tap water
 Nebulise 10-20 mls for 30 mins tid-qid
 Acetylcysteine 20% (Mucomyst)
 22mg/ml sterile water
 Piperacillin
10mg/ml saline 10-30 mins q 6-12 hrs
 Amphotericin B

21. Diagnostic Sampling
 Faecal Exam
 Wet prep, D-Q, Gram Stain
 Crop wash
 Blood Sampling
 Li Hep and blood smear
 Radiology
 Lat AND VD views
 Ultrasonography
 Endoscopy
 Coelomocentesis

22. Assessing Urofaeces

23. Cardiopulmonary Arrest
 Intubation , 100% oxygen; PPV q 4-5 sec
 Don’t overinflate bird
 Don’t blow into ET tube- zoonoses!!
 CPR
 Adrenaline 0.5- 1 mg/kg
 Atropine 0.5mg/kg
 Plus fluid bolus
 Doxapram 20 mg/kg
 NaHCo3: 5mmol/Kg IV once
 Prognosis is better for acute arrest eg Iso overdose than
with chronic illness

24. Other Emergency Medications
 Analgesics
 Butorphanol 1-2 mg/kg IM q 4-8 hrs
 Meloxicam 0.3-0.5 mg/kg PO, IM sid-bid
 Tramadol 4-5 mg/kg
 Antibiotics
 Enrofloxacin 15 mg/kg bid PO or diluted IM/SC
 Amox/Clav; ticarcillin- 100-150 mg/kg bid
 Trim/Sulph- 30 mg/kg bid
 Chelating agents
 CaEDTA 50-75 mg/kg IM BID

25. Thank You!