Critical care and management in wild species is a potential and fast growing discipline in wildlife medicine posing a challenge despite advancement in wildlife, zoo, and exotic animal medicine in recent years. This is due to availability of limited information on physiological aspect of the majority of wild species that may be presented for examination and treatment. Wild animals may be presented in a variety of situations that require emergent interventions. These situations may arise during animal capture, accidents or severe injuries, disease outbreak or natural disaster

1. Wild life Emergency Rescue
&
Veterinary critical care
Speaker:-
Dr. Sonu Shekhawat
M.V.Sc.

2.  Critical care and management in wild species is a
potential and fast growing discipline in wildlife
medicine posing a challenge despite advancement in
wildlife, zoo, and exotic animal medicine in recent
years.
 This is due to availability of limited information on
physiological aspect of the majority of wild species
that may be presented for examination and treatment.
 Wild animals may be presented in a variety of
situations that require emergent interventions. These
situations may arise during animal capture, accidents
or severe injuries, disease outbreak or natural disaster.
Introduction

3.  Critical care is usually described as the period of time that follows the
urgent actions taken to preserve life until the patient is physiologically
stable.
 This period of time is perhaps the most important in the critical care
process, during which improper clinical decisions may lead to
disastrous results.
1. Planning and preparedness
2. Practicality of intervention and thoughts
3. Prioritizing individuals need and procedures
4. Proper evaluation of patient and monitoring of physiological
parameters
5. Positioning and handling of patient
6. Prompt diagnosis and recognition of life threatening situations
7. Proper diagnosis
8. Patience
9. Ethics
Steps in critical care of wild patients

4. Planning and preparedness
 Emergencies being life threatening do not give much time to
prepare.
 It is important that the essential required (medical supplies
including life saving drugs, anaesthetics, cardiac and
respiratory stimulants, antidotes for poisons, anti snake venom,
fluid and electrolytes, plasma and plasma extenders and blood)
are in place.
 Need for setting out a clear check-list of procedures that need to
be performed on the animal and ensuring appropriate
equipment or medications is important.
 Appropriate facilities for treatment and housing of critically ill
wild patients requiring longer treatment/therapy should be
apriori.

5. Practicality of intervention and thoughts
 Practicality of using a technological tool for a specific species
is of prime concern.
 In a situation requiring management of compound
fracture/broken pelvis in elephant could question the
practicality of interventions.
 The questions would include whether facilitates are available
for managing such patients.
 What skills and capacities are available to handle such case.
 What is the prognosis of the intervention.
 Do the interventions compromise welfare and well being of
the animal.
 Is it worth to subject animal to radiography.
 How would the animal be hoisted to ensure healing.
 Is the intervention worth, if prognosis is grave.
 Is euthanasia a better choice.

6. Prioritizing individuals need and procedures
 It is important to prioritize individual needs based on
extent of the problem.
 This is relevant when a number of animals needs to be
managed that may happen during natural disaster,
accident or disease outbreaks.
 An animal in unstable condition needs to be treated on
priority.
 The initial therapy in the critical care should be generally
aimed at stabilizing the patient.
 Once stabilized, further interventions may be undertaken
based on severity and extent.

7. Proper evaluation of patient and monitoring of
physiological parameters
 Critical care monitoring techniques help in evaluation of
patients and aid in detecting early homeostatic instability
before damage becomes irreversible.
 Monitoring of physiological parameters provides valuable
information on animals health status, aids in diagnosis and
helps in evaluating the efficacy of treatment provided to the
animal.
 The cardiovascular system, respiratory system, and central
nervous system (CNS) from the essential body systems that
require monitoring.
 Failure of one usually results in failure of the others and the
subsequent death of the patient.

8. A)Cardiovascular functions:
 Estimating perfusion parameters are important to understand
the functioning of the cardiovascular system. The perfusion
parameters are:-
1) Heart rate:
 The basic perfusion parameter is the heart rate which provides
clues to the cardiac rhythm.
 The resting heart rate for mammals is calculated from the
allometric equation;
 Heart rate = 241×Mb-0.25, where Mb is the body weight in
kilograms.
 A heart rate 20% greater than or less than the calculated rate
for an individual is considered tachycardic or bradycardic
respectively.
 Variations may be due to shock, disease, trauma, excitement,
fever etc.

9. 2) Mucus membrane colour:
 Colour of nasal, oral and conjunctival mucous membrane is
the basic criteria to assess the peripheral tissue perfusion and
is dependent on the blood haemoglobin concentration, tissue
oxygen tension and peripheral capillary blood flow.
 The mucous membranes appear pink and moist in normal
healthy individual marked variations are noticed in diseased
condition.
 Colour may appear pale (anaemia, shock), bright red
(inflammatory process), yellowish/icteric (hepatic/biliary
disorder, haemolysis),brownish (acetaminophen toxicity),
Bluish (hypoxemia, toxaemia) or may show
petechia/echymosis (coagulation disorders, platelet disorder).
 The membrane may appear dry (dehydration, uraemia and
fever) or may appear moist (stomatitis, poisoning, acute viral
and bacterial infection).

10. 3) Capillary refill time (CRT):
 It indicates the peripheral tissue perfusion and involves
digitally compressing the gingival mucous membrane until
blanched, and determining the time it takes to return to its
original colour.
 Healthy animals and birds have a CRT of less than 2 seconds.
 A prolonged CRT is indicative of poor perfusion of the tissue.
4) Blood pressure:
 Blood pressure can be assessed by employing a direct method
(placing catheter in an artery and connecting it to a monitor by
means of a pressure transducer) or using indirect
methods(oscillometric, doppler).

11. 5) Body temperature:
 Severe shock, administration of certain drugs (anaesthetics),
trauma, hypovolemia, anaphylaxis, prolonged exposure to cold
environment, decreased heat production or increased heat loss
may result in hypothermic state.
 It can be controlled by using warm blanket on the animal,
avoiding unnecessary wetting of skin and hair and also by fluid
infusion.
 On the contrary, hyperthermic patient may be suffering from an
inflammatory process, drug reaction, infection, increased heat
production, exposure to high environmental temperatures and
loss of normal cooling mechanism.
 It can be managed by cold application including spraying, rectal
enemas and cold packs, administration of intravenous fluids and
provision of adequate protein and drinking water.

12. B) Monitoring respiration:
 Respiratory rate, depth, character, rhythm and sounds provide
critical information on pulmonary functions.
 These may be altered due to obstructions/blockages in airways,
pulmonary diseases, pleurisy, pulmonary oedema, emphysema,
neoplasm, toxaemia etc.
 If airway obstruction is suspected and animal can be safely
handled, the mouth should be examined for foreign bodies and
if possible the obstruction removed.
 In case respiration is compromised, it is advisable to
assist/provide emergency ventilation by intubation and
supplementation of oxygen.

13. C) Monitoring neurological functions:
 Evaluation of the patient through physical findings is
important in determining the patients neurological status.
 The various level of consciousness range from alert and
responsive to depressed, uncontrolled hyper excitability,
stupor and coma.
 Metabolic problems, hypoxia, hypotension, drug reactions,
trauma, toxins and brain pathology may result in these
neurological alterations.

14. Signs exhibited by stable/ unstable patient and in life threatening conditions
Parameter Signs exhibited by stable
patients
Signs exhibited by unstable
patient
Signs exhibited by
patient during life
threatening condition
Rectal
Temperature
Normal or slightly deviated Subnormal or greatly elevated Temperature is high enough
to cause convulsions (10-
150F above normal)
Respiration Normal Shallow quick respiration and
open mouth breathing
Irregular breathing, shallow
quick
respirations or open
breathing
Heart rate Regular rate and rhythm Irregular rate and rhythm No heartbeat, irregular
heartbeat or rhythm
Capillary refill time < 2 seconds > 2 second Mucous membranes too pale
to evaluate, more than 2
seconds,
or non-existent
Blood parameters Normal Packed cell volume
(PCV), Total Protein (TP) and
blood glucose
Low PCV (less than 15%) i.e.
anaemic (less than 1g/dl in birds,
higher in mammals), Low blood
glucose
Extremely low PCV (less
than 15%),
low blood glucose
(avian<100g/dl;
mammals<40g/dl) and TP
is 0 or close to it.
Palpebral reflex
and pedal reflex
Quick Slow No reflex
Blood parameters Normal packed cell volume
(PCV), total protein (TP) and
blood glucose (BG)
Low PCV (less than 15%), low TP
(less than 1g/dl in birds, higher in
mammals), low BG
Extremely low PCV (less
than 15%), TP 0 or close to
it, low BG (avian <100g/dl,
mammal<40g/dl )

15. Positioning and handling of patient
 Different taxonomic groups have different requirements and
limitations to preclude cardiovascular or respiratory
compromise, and to prevent bloat, aspiration, neuropraxia or
compartmental syndromes.
 The animals may be positioned on sternal, semi-sternal, left
lateral, right lateral etc. depending on need of the species.
Prompt diagnosis and recognition of life threatening
situations
 Critical care requires recognition of subtle clinical changes in
the animals, and the ability to take corrective action before
severe systemic changes become irreversible.

16. A)Shock:
 Shock due to trauma or from electrocution is common in wild
animals. Common manifestations include weakness, subdued or
comatose animal; rapid and weak pulse and subnormal body
temperature with the expectation of shock secondary to
bacterial infection.
 Gum colour, capillary refilling time, heart rate, mental status (
alert, sluggish, comatose), and body temperature are all
important reflections of the state of shock.
 Management of shock includes resuscitative and restorative
phase to provide adequate ventilation and normalisation of acid
base electrolyte alterations, prevention of overwhelming sepsis
besides corticosteroid therapy and latter including nutritional
therapy to meet the requirements of the tissue repairs.

17. Type of Shock
Type of shock Causative factor Basic indicators
Hypovolemic External and internal haemorrhage,
dehydration resulting from
diarrhoea,
intestinal obstruction, persistent
vomition
Gums and other members
pale and cool.
Cardiogenic Low blood pressure, secondary to
CNS disorders, trauma, anaphylaxis
and drug reactions
Unusually pink and warm
gums.
Septic Primarily bacterial, viral or fungal
infections
Gums blanched and may
appear
muddy.
Vasogenic Severe trauma, burn injury, excessive
surgery, rough handling of viscera
during
surgical intervention
Gums blanched and appear
pale

18. B) Dehydration:
 Majority of wild animals presented for emergency management have some
level of dehydration due to prolonged deprivation of food and water.
 Skin turgor can help in assessing the state of hydration Skin should return
back to normal in one second after pulling up.
Variables to be Percent Dehydration
assessed <5% 5-7% 7-10% 10-12% 12-15%
Dry mucous none mild moderate severe severe
membranes
Sunken eyes no no mild severe severe
Skin turgor <1 1-2 2-5 >5 no
return (seconds to
normal skin
return)

19. C) Physical trauma:
 Haemorrhage, laceration and wound are the common situations
encountered in wild patients.
 All efforts should be initially aimed to stop the bleeding followed
by treatment of injuries.
 Digital pressure is extremely useful for control of haemorrhage.
 The important consideration while treating wounds is
positioning of the animal and proper handling.

20. D) Emergencies during wild animals capture:
Physical capture: Physical restraint methods include various systems
and devices(nets, snares, traps, cages etc.).
Chemical capture: Chemical immobilization includes any method that
primarily uses a chemical agent or drug for restricting animal freedom so
that they are easily manageable.
Emergencies encountered during physical restraint:
Injuries Fractures, dislocations, wounds
Excessive Capture myopathy, hyperthermia, respiratory collapse
excitement
Shock Cardiogenic shock
Confinement Hyperthermia, shock, respiratory distress,
strangulation

21. Proper diagnosis
 Emergency and critically ill patients require rapid high yielding
and low risk procedures.
 Definitive diagnosis will lead to a specific treatment that will
help in increasing the probability of arresting the disease.
 Major consideration while performing diagnostic tests include
establishing the most probable cause, based on through history
and physical examination and the clinician’s experience.
Patience
 It is important to have patience while managing critically ill
patients as many a times the animals may not respond
immediately to therapy.

22. Conclusion
 Critical care and emergency management of wild animals
presents many challenges owing to differences in biology,
physiology, ecology and veterinary needs as compared to
domestic animals.
 The need of the hour is to assess and evaluate the situation
and carryout professional scientific, humane and ethical
handling and management of such patients.
Ethics
 The primary aim of emergency care and management is to
ensure that animal regains stability and becomes fit for
rehabilitation back in its natural habitat or from the place it
has come from.