Minimizing Stress to Avian Patients During the Veterinary Visit


Lecture outline

conure on finger Why is it important to minimize stress associated with veterinary visits?

  • Fear is damaging to patients.
  • Fear is damaging to client-patient and client-veterinary relationships.
  • Clients are beginning to change their expectations of the veterinary visit.
  • Minimizing fear improves the quality of medicine provided.

Challenges that must be overcome include:

  • Underlying concurrent disease
  • Minimal prior training, poor socialization, and frightening past experiences
  • Owner cooperation (success is significantly influenced by client buy-in)

Practical tips for clinical implementation

  • Hospital design
  • Staff training
  • Client education

Working with patients in a clinical setting

  • Training in the exam room or hospital
  • Working with the untrained, frightened parrot (rethinking the use of force)
  • When to reach for sedation
    • Avian fatigue assessment score
    • Sedation protocols
    • Client communication
  • Use of wellness plans to improve compliance

The future of avian medicine



The impact of stress on physiologic and psychologic health is increasingly well known.  Many veterinarians strive to reduce stress during hospital visits for both their patients and clients in an attempt to minimize the harmful effects of stress.  Minimizing stress is more challenging to accomplish in avian patients compared to domestic species due to a variety of factors, including: frequent poor socialization, insufficient prior training, neophobic tendencies, aversive past experiences, and lack of routine veterinary care.  The pet owner, veterinarian, and veterinary staff all play different roles in either exacerbating or relieving patient stress during the hospital visit.  Sensitivity to avian body language, a clear understanding of behavior science, skillful use of desensitization and counterconditioning techniques, use of the minimal amount of force or restraint necessary to accomplish procedures, and use of conscious sedation as a management technique sooner rather than later can significantly improve the patient experience.

This webinar will provide a brief overview of concepts important to the Avian Fear Free™ veterinary visit, along with a number of practical case studies. A set of Fear Free ™ modules focusing on avian patients is currently in production and will be available as a hospital resource by the end of next year.  Interested practitioners can visit for more information on the Fear Free™ veterinary educational programs.


About the presenter

Alicia McLaughlin received her Doctorate of Veterinary Medicine from Oklahoma State University. She completed a veterinary internship in exotic animal medicine at the Center for Bird & Exotic Animal Medicine in Bothell, WA and is now an associate veterinarian at this practice. Dr. McLaughlin has been involved in veterinary research and leadership throughout her career, and has authored or co-authored articles in both professional journals and national conference proceedings. Dr. McLaughlin is passionate about providing low-stress veterinary visits for all of her patients.  She is a certified Fear Free™ veterinarian, and is spearheading the development of an avian-focused Fear Free™ course. [MORE]


Webinar recording


Client education

Download two client education handouts graciously shared by Dr. McLaughlin:  Stress and the Veterinary Visit and Training for the Veterinary Visit. You may also enjoy Reading Bird Body Language from LafeberVet’s client education library.



With a passing grade of 70% or higher, you will receive a continuing education certificate for 1 hour of continuing education credit in jurisdictions that recognize AAVSB R.A.C.E. approval.

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Evaluation form

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Expert Q+A

Although Dr. McLaughlin was able to answer most questions submitted during the live event, remaining questions were answered by email and are posted below:


Do you have experience with wild raptors and large birds, like pelicans, with intranasal (IN) sedation? Does it give the same results as [in] companion birds?

I have used the same doses of midazolam and butorphanol both IM and IN in falconry birds and waterfowl, but not pelicans. So far, all species have responded fairly similarly.

Was was the dose for flumazenil?

My flumazenil dose range is 0.025-0.1 mg/kg. I usually start at 0.05 mg/kg IN (sometimes they can react badly to IM administration, presumably from waking up too fast from sedation). I re-dose as necessary.

[D]osage for fatty acid supplementation?

0.1 mL/kg of VetOmega once daily

I work with a facility that houses two cockatoos and one macaw. [These] are rescue or surrendered birds and are used for public education.  They are very well taken care of and the trainers interact with them throughout the day. One of their rewards is the trainer petting or grooming the bird on its  head and back. They do seem to enjoy [this]. Can this reward be detrimental as in increase in plucking feathers if the bird is frustrated, wanting more or interpreting it as sexual and is petting below the head not advised for this reason?

I typically recommend touching birds only on the head or neck as touching the body tends to be interpreted in a sexual way by the bird. There are always exceptions to this rule but not, I think, for many cockatoos. There are many potentials for fallout with using this as a reward so it should only be used in rare occasions when other reinforcers are unavailable or ineffective. If desired the poster could send me a video of the behavior so that I could evaluate the birds’ body language and context and give a more informed opinion.


Fear Free® avian modules

Dr. McLaughlin shared the following update in June 2020:

Providing avian patients with comfortable, stress-free veterinary visits can be very challenging for a variety of reasons. To help practitioners navigate these obstacles, a team of veterinary professionals and behavior science experts have created the brand new Fear Free® avian modules.

This set of nine online modules covers the following topics:

  • Skillful use of behavioral science in the veterinary environment
  • Impact of the pet owner, veterinarian, and veterinary staff on avian behavior
  • Environmental sources of both stress and comfort for birds
  • Understanding and showing sensitivity to avian body language
  • Cross-species application of Fear Free® techniques
  • How to safely minimize the use of restraint while still providing appropriate patient care
  • Use of conscious sedation as a management tool
  • Options for reducing stress and providing training to hospitalized patients
  • Training plans for a variety of veterinary-related behaviors
  • Solutions for implementing a behavior-focused approach in a veterinary practice
  • Practical case studies

…and more!

Interested practitioners can visit to take advantage of this RACE-approved continuing education course.


RACE approval

This program 776-36829 is approved by the American Association of Veterinary State Boards (AAVSB) Registry of Continuing Education (R.A.C.E.) to offer a total of 1.00 CE credits to any one veterinarian and/or 1.00 veterinary technician CE credit. This RACE approval is for Category Two: Non-Scientific Clinical using the delivery method of Interactive-Distance/Non-Interactive Distance. This approval is valid in jurisdictions which recognize AAVSB RACE; however, participants are responsible for ascertaining each board’s CE requirements. RACE does not “accredit” or “endorse” or “certify” any program or person, nor does RACE approval validate the content of the program.

The program number for the non-interactive program is 776-36832.

To cite this page:

McLaughlin A. Minimizing stress to avian patients during the veterinary visit. LafeberVet Web site. Available at