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T. Hauke, M.S., Ph.D.

Clinical Director, Texas Tech University Health Sciences Center School of Medicine

Any factor that interferes with the homeostasis of the chick can alter growthure 30. The leading causes of stunting are suspected to be underfeeding, chronic microbial infections and polyomavirus. Collect samples for diagnostic blood work and microbiology if this will not compromise the patient. Dehydrated chicks will have sunken facial features, dry, reddened, wrinkled skin and feel sticky to the touch. The preferred route of fluid administration depends on the condition and size of the chick. Once the hypovolemia is corrected, subcutaneous fluids can be administered between the shoulder blades and into the groin. Oral fluids can be used in birds that are responsive and are not having problems with crop stasis or regurgitation. Jarred baby cereal containing oatmeal, applesauce and bananas diluted 50 percent with water, the juice of boiled rice or commercial human infant fluid replacers have been successfully used as oral fluids. Chicks that have not been fed and those suffering crop stasis may be marginally hypoglycemic. Psittacine birds rarely seizure because of hypoglycemia; the most common clinical sign is depression. Dextrose should not be added to the fluids of a dehydrated neonate to prevent the induction of metabolic acidosis and the movement of fluids out of the intracellular space causing more severe dehydraion. If suspected, treatment should begin immediately, because waiting for cultures may be fatal. The advanced generation penicillins (eg, piperacillin) and cephalosporins (eg, cefotaxime and ceftiofur) have excellent gram-negative activity and are relatively nontoxic. To avoid renal toxicity, the aminoglycosides should not be used in dehydrated patients. If the bird is capable of taking oral antibiotics, enrofloxacin or trimethoprim-sulfa provide good gram-negative bacterial activity. Enrofloxacin has been safely used in many nurseries but should still be used with caution in growing birds because joint abnormalities have been reported in mammals. Trimethoprim-sulfa combinations can cause regurgitation in some birds, especially macaws. Nystatin can be used to treat yeast infections of the alimentary tract (see Chapter 18). Currently, these species do best when fed high-fiber, high-fat formulated diets throughout development, with the addition of nuts at weaning. Malnourished birds can often be salvaged by correcting the underlying problems and gradually increasing their plane of nutrition. If the stunting is mild and the cause is corrected early, many birds will wean normally. Moderate stunting may result in a smaller bird with a globose head and slender beak. If the stunting is severe, the bird may survive for a long time without growing but will eventually die. Congenital Abnormalities Congenital abnormalities have been infrequently reported in psittacine chicks. The lack of documented congenital abnormalities could be a result of underreporting, rapid death in embryos with abnormalities or undiagnosed congenital abnormalities in dead neonates. Additionally, the fact that psittacine birds have been domesticated only recently (and thus show a relatively low level of inbreeding) may result in a reduced expression of genes responsible for congenital abnormalities. If the latter were true, one would expect a higher incidence of abnormalities in budgerigars and cockatiels, which have been domesticated longer than other psittacine birds. Reports in the literature would suggest that budgerigars, cockatiels and African Grey Parrots have a greater incidence of congenital deformities than do other psittacine species. Documented cases of congenital abnormalities in psittacine chicks include bilateral anophthalmia in a budgerigar,2 varying degrees of cryptophthalmus and ankyloblepharon in four cockatiels,5 congenital extra-hepatic biliary cysts in an African Grey Parrot26 and familial cataracts in Scarlet Macaws.

Blood Gases Arterial blood gases can be assessed directly by running arterial samples on a blood gas machine. This is not practical for most practitioners and it may involve taking multiple blood samples, a procedure that smaller patients cannot tolerate. An oximeter records the percentage of circulating oxygenated blood via a noninvasive probe. Oximeters are not as sensitive at direct determination of arterial blood gases, and oximeter readings at 98% saturation are common in birds that are actually 100% saturated. The probe is small and requires only one wire so it is easily used during surgery. Additionally, many oximeters are actually pulse oximeters that produce an audible beep, allowing the anesthetist to monitor heart rate as well as oxygen saturation levels. Most birds will maintain an oxygen saturation between 80 to 85% when self-ventilating. Respiratory Arrest If respiratory arrest occurs, the anesthetic system should be disconnected from the bird and the chest should be lightly pressed and released to induce air intake, or fresh air can be gently delivered into the tracheal tube. If the patient is not intubated, an air sac tube should be placed or the animal should be immediately intubated. The pulse rate should be carefully monitored and resuscitation should continue until the bird is breathing unassisted. Birds that show respiratory arrest should be rescheduled for the procedure; a second or third episode of apnea in these cases is often followed by cardiac arrest. If success is to be achieved and cardiac arrest truly does exist, the clinician should be aggressive and utilize open heart massage. The rate should be 60 or more compressions per minute and they should be accompanied by coordinated artificial ventilation. Hemorrhage If hemorrhage occurs during surgery, a significant portion of that loss can be replaced via fluid therapy using isotonic solutions. Postanesthetic Monitoring and Recovery Anesthetic recovery should occur in a pre-heated environment, preferably a pediatric or avian incubator. The safest approach to post-anesthetic monitoring of a patient is to leave all of the monitoring devices in place until the patient absolutely will not tolerate them. Recovery from injectable anesthetics will be much more prolonged and if ketamine has been used, potentially traumatic. Anesthetic recovery is best accomplished by wrapping the bird in a towel to prevent wing-flapping and self-inflicted trauma. The lights should be dimmed and the noise level kept to a minimum to prevent violent reactions. The patient should be rolled over every few minutes, and the pharynx should be monitored for the accumulation of mucus or vomit. Recovery from even long anesthetic episodes with isoflurane generally requires less than five minutes. Aguilar R, et al: Electrocardiographic changes in bald eagles (Haliateetus leucocphalus) subjected to isoflurane anesthesia. Korbel R, et al: Aerosacular perfusion with isoflurane - an anesthetic procedure for head surgery in birds. Lamberski N, Daniel G: Fluid dynamics of intraosseous fluid administration in birds. Seaman G, et al: Effects of inspired oxygen on ventilation in birds anesthetized with isoflurane. M any avian patients are small and delicate, increasing the risks associated with surgery. Seemingly minor hemorrhage can be life-threatening in patients with such a small blood volume. Their high metabolic rate, small body size, and high ratio of body surface area to body volume predispose them to intraoperative hypoglycemia and hypothermia, the risks of which increase as the duration of anesthesia and surgery increases. These factors make it crucial that the avian surgeon not only have the procedure well thought out, but also have any necessary equipment ready and accessible.

Syndromes

• Trouble urinating
• Receive intravenous (IV) fluids
• Blood chemistry results, such as electrolyte levels
• Seizures
• ANA titer
• Uneven position of the nipples
• Blood differential
• Medications, such as an overdose of acetaminophen, which can be deadly