The avian respiratory system has several unique and fascinating adaptations for flight that are important to clinicians. This lecture provides an overview of the anatomical features of the avian respiratory tract and discusses the physiology of the respiratory system. Clinical signs of respiratory disease in birds and how we can use these signs to anatomically locate the origin of the problem to the upper respiratory tract, the major airways, the pulmonary parenchyma, and coelomic cavity are also discussed. The ability to locate the problem can better shape our diagnostic and therapeutic approach to our patients. Emergency management of birds in respiratory distress, with reference to these anatomic locations, is also discussed. The presentation concludes with a review of some important diseases, including diagnosis and treatment, that affect each region of the respiratory tract.
Lecture Objectives include:
- Normal anatomy/physiology
- Upper respiratory tract
- Lower respiratory tract
- Clinical signs of respiratory disease
- Emergency treatment of respiratory disease
- Diseases of the respiratory tract
- Nares, nasal cavity
- Lungs and air sacs
- Coelomic disease
About the Presenter
Dr. James Morrisey has served as Service Chief of the Companion Exotic Animal Medical Service at Cornell University College of Veterinary Medicine since 2002. Dr. Morrisey is a 1992 graduate of Cornell University. Dr. Morrisey completed an internship in zoo, wildlife, and exotic animal medicine at Kansas State University College of Veterinary Medicine, and a residency in avian and exotic animal medicine and surgery at the Animal Medical Center in New York City, New York. [MORE]
The following video clips were shared by Dr. Morrisey
Slide 26. Dyspneic cockatiel
Slide 38. Air sac cannula placement
Although many chatbox questions were answered during the live webinar session, the remaining questions were answered by email and are summarized below:
Q: Oscine and Suboscine are different in relation to muscle insertions in [the] syrinx, right?
A: Yes, the Oscines (songbirds) are thought to have the most advanced and intricate songs because of the anatomy of their syrinx, which separates them from the Suboscines (Tyranni) within the passerine group.
Q: What is actually causing the respiratory “click” (i.e. the anatomy involved) we hear in stressed birds or respiratory disease patients?
A: I believe some of the sounds can come from foreign bodies or mucus/discharge within the trachea. We also hear and feel a clicking sound when holding birds that are breathing hard because of a popping of the sternal-coracoid joint from over-extension of the joint with excessively deep breathing.
Q: Do you see abdominal fluid in any wildlife species or generally in companion birds?
A: It appears to be more common in pet birds, probably because the ease of getting food allows for more chronic problems than wild birds that have to work hard to get food.
Q: Is voice change always a sign of aspergillosis? My male goshawk has a hoarse, high pitched voice and his breath is slightly louder than usual after bating a lot but he breathes with his beak closed. He never breathes through his mouth unless he’s hot or scared. He shows no other signs of illness and is parasite free.
A: That does not sound like respiratory disease at all, changes in voice can happen with increased respiratory rate or effort from breathing. There are a lot of things that can cause voice change other than aspergillosis so I wouldn’t worry about your bird.
Q: Better to flush or nebulize?
A: It depends on your goal and what part of the respiratory system you wish to treat. Flushing will only work with the nasal passages while nebulization can reach the entire respiratory tract.
Q: Any idea [on the use of] ampho[tericin] B in [nasal] flushing?
A: I have used 0.05 mg/ml in nasal flushes.
Q: Would you recommend teaching an owner to flush at home with chronic sneezing?
A: I would use topical nasal drops (saline, anti-inflammatories, antibiotics) at home but not have owners flush the nasal passages. Showers and steam can also help loosen material in the upper respiratory system.
Q: Do you nebulize with enrofloxacin. if yes, what dilution do you use?
A: I have used 0.5 ml of enrofloxacin in 9-10 ml of saline for this.
Q: Do you recommend DMSO in nebulization?
A: No, I have not used this or seen it used for nebulization.
Q: Do you ever nebulize with bicarbonate for aspergillosis?
A: No I have not heard of or used that treatment.
Q: What’s the best way to flush infraorbital sinuses? [Note: There was another question about treating IOS, not sure if you ever actually do flushes]
A: I don’t usually flush the infraorbital sinus unless there is an abscess or infection. I would make an incision between the medial canthus of the eye and the naris on that side to open the sinus to then flush the material from it.
Q: Pre-oxygenation, beneficial? Yes or no for birds?
A: Oxygen will automatically cause a respiratory suppression because part of the stimulus for birds to breath is decreasing oxygen tension. So I do not pre-oxygenate birds but I do start the inhalant anesthetic very low (0.2 for isoflurane) and allow the birds to get used to the smell of the gas for about 20 seconds, then turn up slowly every 15 seconds to control depth of anesthesia.
Q: Do you prefer to oxygenate in a chamber or by mask?
A: I use the chamber if the bird is overly stressed by handling, otherwise I use a mask.
Q: We’re wondering how diphenhydramine is helpful for treating asthma? (Perhaps this was partially answered because you talked about its sedative effects)
A: The asthma is birds often has an allergic component to the feather dander or allergen and the antihistamines will reduce this allergic response.
Q: Recommended antibiotics and dosages?
A: BSAVA and the Exotic Animal Formulary are great sources for a wide range of systemic and topical (nebulized) medications. Unfortunately, there are too many to list and their use depends on several factors.
Q: Would the doctor comment about sinus bleeding during debridement – the need to have epinephrine at hand?
A: I have not seen that unless there is already bleeding from the nares or choana from a tumor or foreign body. I have done many flushes and have rarely seen bleeding as a sequela. A small amount of bleeding could occur if there is considerable inflammation but would not usually require epinephrine.
Q: Treatment for rupture of diverticula due to head trauma?
A: I usually numb the skin and then make a hole with a pen-light cautery. This will stay open for a few days while the rent to the diverticulum heal.
You mentioned you’ve seen people use oregano essential oil. What did they use this for? And what dilution?
A: I have had clients use a small amount of undiluted oregano oil on surface wounds or diluted 1:10 or 1:20 for flushing open wounds.
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