Long-term vascular access is difficult to obtain and maintain in chelonians. Fortunately, central venous catheters provide flexibility and length to avoid catheter dislodgement. Central lines are an effective tool that allow serial blood measurements and can be used for anesthesia administration, intravenous drug delivery, blood product transfusions, and continuous fluid therapy or continuous rate infusions.This photo tutorial article describes this simple technique step-by-step.
Save the Date for a RACE-approved webinar by Royal Veterinary College reptile #veterinarian, Joanna Hedley: February 27, 2019.
Save the date for this free R.A.C.E.-approved continuing education webinar, Emergency and Critical Care of Rabbits, presented by Charly Pignon, DVM, DECZM (Small Mammal) on November 7, 2018. Lecture topics will include emergency triage, cardiopulmonary resuscitation, analgesia, fluid therapy, and critical care nutrition. Register today and join us for this interactive event.
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A 3-year old intact male guinea pig was presented on emergency for suspected bloat and with a history of chronic hair loss. Clinical examination revealed non-pruritic symmetric truncal alopecia, thin skin, severe cachexia, and an abdominal fluid wave. Alkaline phosphatase, alanine transaminase, aspartate aminotransferase, gamma-glutamyl transferase, leukocytes (neutrophils), bilirubin, and serum cortisol were markedly elevated. Abdominal ultrasonography revealed peritoneal effusion, cholestasis, and cholelithiasis. Hyperadrenocorticism was diagnosed based on…
An adult intact female guinea pig was presented with dysorexia, exhaustion and weight loss. Radiographic and ultrasound findings demonstrated a severe gas dilatation of the stomach, severe gallbladder distension, and abnormalities on the organ topography. On laparotomy, a 180-degree gastric dilatation and volvulus was noticed with a gallbladder obstruction, hepatic lipidosis, and adhesions between the bowels…
Reptiles lack an epiglottis and the glottis is ready visualized, making intubation readily accomplished in most species. If the glottal folds are closed, apply topical lidocaine to facilitate intubation. The tracheal rings are complete in reptiles. Use of an inflated, cuffed endotracheal tube can lead to pressure necrosis because there is no elastic ligament to accommodate tracheal expansion. Always select an uncuffed endotracheal tube in small reptiles and never inflate a cuff in large reptiles …
Although the principles of emergency medicine critical care are universal for all species, this approach must be balanced with an understanding of the unique aspects of small mammal medicine. Use this summary page to review the basic approach to the exotic companion mammal patient and select additional links to supplement your knowledge base.
Although the principles of emergency medicine critical care are universal for all species, this approach must be balanced with an understanding of the unique aspects of avian medicine. Use this summary page to review the basic approach to the avian patient and select additional links to supplement your knowledge base.
The approach to analgesia and sedation in exotic companion mammals faces special challenges, including small patient size and unique features of the prey species mentality. Recognition of pain is more difficult in rabbits and rodents because many small mammals are very good at hiding the signs of pain commonly observed in predator species. Instead pain in a rabbit or rodent is often inferred from the patient’s clinical condition as well as the absence of normal behaviors. The diagnostic and therapeutic plan frequently requires some form of chemical restraint in exotic mammal medicine. When compared to general anesthesia, sedation is a safer option for the debilitated or critically ill small mammal.
The Five Common Reptile Emergencies webinar was reviewed and approved by the American Association of Veterinary State Boards (AAVSB) Registry of Approved Continuing Education (R.A.C.E.) program for 1 hour of continuing education, in jurisdictions which recognize AAVSB R.A.C.E. approval…
View a recording of this AAVSB R.A.C.E.-approved web-based seminar presented by Eric Klaphake, DVM, DACZM, DABVP (Avian Practice), DABVP (Reptile & Amphibian), then take the brief post-test to earn 1 hour of continuing education credit. This webinar explores five common reptile clinical presentations in detail: trauma, gastrointestinal foreign body, neurological deficits, respiratory difficulty, and reproductive problems.
Placement of an enteral feeding tube is a recognized method of supportive care, and the esophagostomy tube is an accepted route that is generally well tolerated by avian patients and relatively easy to place. In clinical patients, esophagostomy tube placement has been described in psittacine birds, raptors, and ostriches.
Esophagostomy tube placement is indicated in cases of severe beak trauma or disease, as well as diseases of the oral cavity or proximal esophagus, such as abscesses and neoplasia. Esophagostomy tubes may also be used to…
Many people have been curious about the way we at International Bird Rescue were able to clean the birds affected by the San Francisco Bay Mystery Goo Spill in January 2015.
Traumatic orthopedic injuries are relatively common in the avian patient. Although bird bones are strong when intact, they tend to shatter on impact as the cortices are thin and brittle. A lack of abundant soft tissue coverage often leads to open fractures…
All raptors consume a meat-based diet ranging from the specialist diet of the fish-eating osprey (Pandion haliaetus) to a generalist diet that can include insects, mammals, birds, reptiles, amphibians, and even carrion. Other than poultry, the exact nutritional requirements of birds are unknown, however the natural raptor diet is always relatively high in protein and fat and low in carbohydrates. Whole prey diets have a calcium/phosphorus ratio of 1.5:1 as the bird actually consumes the bones as well as the meat…
Did you attend the Lafeber Symposium at the 2015 International Conference on Avian heRpetological and Exotic mammal medicine in Paris? View a recording of this encore, web-based seminar: “Medical Management of Psittacines with Bornavirus Ganglioneuritis (PDD)” by Susan Orosz, DVM, DABVP (Avian Practice), DECZM (Avian). This presentation on avian borna virus contains medium to advanced level content. The novice is encouraged to view the first hour of Dr. Orosz’s presentation “Anatomy & Physiology of the Avian Gastrointestinal Tract: Clinical Applications”, which includes a helpful review of avian gastrointestinal anatomy and physiology.
View the recording of this free, interactive webinar, presented by Neil Forbes, BVetMed DECZM (Avian) FRCVS. Many sick or injured exotic animals are presented in critical condition. More of these patients can be saved by appropriate fluids and nutritional support, than by any single medical or surgical procedure. In practical terms, providing this support is often easier said than done. Dr. Forbes’ presentation serves to demystify some of the challenges encountered; practical solutions for all exotic patients are described and discussed.
The use of esophagostomy tubes (E-tubes) allows administration of oral medications and critical care nutrition to turtles and tortoises while minimizing stress and the risk of esophageal trauma associated with repeated rigid gavage tube feeding. Esophagostomy tubes are very well tolerated in chelonians and the patient can even eat normally with the tube in place. Patients can be medicated and fed on an outpatient basis, and once fully recovered, the E-tube is easily removed in the veterinary clinic.
Released for National Veterinary Technician Week 2014, Nursing Care for Exotic Companion Mammals is part of an Exotic ICU series providing advice on the management of small exotic companion mammals in a critical care setting. Specific recommendations on caging, medicating, feeding, and monitoring the critical small mammal are explored as well as important potential sequelae to the stress of hospitalization.
It is 10 p.m. in your veterinary emergency hospital and a dreaded call comes in. A panicked owner is in tears because their beloved pet is in crisis. In most cases, your team will quickly gather supplies and move swiftly to prepare for the emergent patient. This patient may strike fear in many veterinary professionals, however, because it is the dreaded avian patient presenting to a general veterinary practice.
Released for National Veterinary Technician Week 2014, Tips and Tricks for the Avian Patient is part of an Exotic ICU series that provides advice on the management of birds in a critical care setting.
Wing injuries may present as a wing droop or an inability to fly. The figure-of-eight bandage, or wing wrap, is the standard method for stabilizing the wing short-term. See the NEW and improved version of LafeberVet’s wing wrap placement video clip.
Because of a lack of identified blood groups in companion bird species, compatibility for transfusion is based on the use of major and minor cross matches. A major cross match is performed by mixing donor red cells with recipient plasma and a minor cross match uses recipient cells and donor plasma. The appearance of agglutination or cell lysis indicates incompatibility.
Unlike mammals, a single transfusion between different bird species can be safe and efficacious. Transfusions will be most effective if the donor is…
If the gut works, use it. The preferred route for providing nutrition is enteral feeding since this preserves intestinal structure and function. Parenteral nutrition is indicated to prevent malnutrition when patients cannot consume adequate nutrients by oral feeding or tube feeding or when the respiratory tract cannot be protected. Parenteral nutrition is 100% bioavailable since nutrients reach tissue without the variations associated with gastrointestinal digestion.
As in other species, to manage pain successfully, one must know when pain might occur. Several common medical disorders can result in acute pain such as otitis, conjunctivitis, and acute gastrointestinal disease. Chronic pain can arise from conditions such as arthritis, which commonly develops in older…
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Lethargy, total or partial anorexia, a reduction in fecal output, or scant fecal size can all indicate critical illness in rabbits. Problems that slow the gut are often uncomfortable, however rabbits tend to mask pain and discomfort, especially when frightened. Signs of fear and pain in the rabbit can include…
Providing nutrition to the hospitalized small mammal is a fairly straightforward process. Encourage owners to bring their pet’s “regular” diet to minimize the risk of food refusal or gastrointestinal upset. Also consider keeping the following food items available…
Depending on their age and size, snakes may be fed multiple times in one week or every 2 to 4 weeks. If nutritional support is truly needed, then assisted feeding is indicated in the hospitalized snake. Tube feeding is commonly performed in critically ill snakes after fluid therapy and supplemental heat is provided.
This brief article was created to serve as a synopsis of LafeberVet’s longer, more detailed “Avian Analgesia” authored by avian veterinarian, Dr. Michelle Hawkins.
When Kara Burns, veterinary technician specialist in nutrition, visited Tuskegee University School of Veterinary Medicine during the fall of 2014, her lecture on critical care nutrition made a big impression on the veterinary medical students. This 48-minute presentation explores the basics of nutritional supportive care appropriate for all species before concluding with information on nutritional support of special species like birds, reptiles and exotic companion mammals.
The principles of fluid therapy are basically the same in exotic companion mammals as in other species. The biggest difference is that changes can occur very rapidly in these tiny patients. For instance, fluids should almost always be warmed or your patient will cool down quickly. Intraosseous or intravenous fluids can be heated with…
Turtles and tortoises display a variety of dietary strategies ranging from the complete herbivory seen in many tortoises to the strict carnivory displayed in aquatic species like the snapping turtle. There are also many chelonians, such as the Eastern box turtle, that may be considered opportunistic omnivores. This review article, critiqued by reptile nutritionist, Susan Donoghue, discusses clinical concerns related to feeding the hospitalized turtle or tortoise. Topics covered range from recognizing true anorexia to food items to avoid. Practical technical concerns related to nutritional support such as tube feeding and daily caloric requirements are also discussed.
Abdominocentesis or coelomocentesis may be indicated for the accumulation of fluid within one or more of the peritoneal cavities. Peritoneal fluid can accumulate with a variety of diseases, including chronic liver disease, amyloidosis in waterfowl, iron storage disease in mynah birds and toucans, coelomic tumors in budgerigar parakeets, viral infections like Marek’s disease (resulting in cardiac tumors), peritonitis, congestive heart failure, ovarian cysts, and trauma. This article reviews the potential complications of this clinical technique, the equipment needed, sample handling, and cytodiagnosis.
This brief article was created to serve as a synopsis of LafeberVet’s longer, more detailed “Analgesia in Small Mammals” authored by veterinary anesthesiologist, Dr. Paul Flecknell.
Fasting may be expected in lizards during certain times of the year. Many gravid females eat less or go off feed entirely due to the large number of eggs filling the coelom. Some species also fast for weeks or months as an adaptation to excess heat or cold, drought, or lack of food. This dormancy in reptiles is called…
It is critical to approach the dyspneic rabbit quietly, carefully, and gently. Many rabbits with respiratory disease are unstable upon presentation, given the stress of their condition compounded by the stress of transport and the strange smells, sights and sounds of the veterinary clinic. In many cases, it is prudent to delay handling the patient. Transfer the rabbit to…
The basic principles of fluid therapy are the same in the reptile as seen in birds and mammals, however reptile anatomy and physiology make some features of this crucial supportive care procedure unique. This article reviews fluid resuscitation with the use of crystalloid fluids and colloids, indications for replacement fluids including signs of dehydration and osmolarity values reported in reptiles. Routes of fluid administration in reptiles are described include subcutaneous, oral, soaking, intracoelomic, intraosseous, and intravenous via the cephalic vein, jugular vein, and in rare instances intracardiac catheter placement. Patient monitoring, including blood pressure measurement and signs of overhydration, are also explored.
Unfortunately, neurologic disease is a common presenting problem in the ferret. Neurologic deficits may include an altered level of consciousness, paresis, ataxia, or even pelvic limb paralysis or collapse.
When planning to accept avian patients, prepare yourself and your staff, prepare your hospital including hospital caging and exam rooms, and consider the equipment necessary for proper care…
The crop or ingluvies is a diverticulum of the esophagus present in many but not all, bird species. The crop serves as a food storage organ, regulating the flow of food through the gastrointestinal tract. Food within the crop is also softened by mucus glands. Crop stasis is a common clinical sign in which the crop fails to empty in a timely manner…
Most amphibians do not drink water. Fluid instead diffuses across semipermeable skin, and sometimes gills, directly from water or moist substrates. Excess fluid is excreted primarily by the kidneys, while conserving electrolyte levels. In some amphibians, skin is also involved in osmoregulation and respiration.
Water is the single most important medium for sustaining life. Although there are unique considerations for avian, exotic companion mammal, and reptile patients, the basic principles of fluid therapy hold true for all animals. This brief article reviews 10 important facts related to water and organ homeostasis.
No single hospital environment can meet the needs of every exotic animal and caging systems must be tailored to meet the specific needs of each patient. Read about those caging requirements that remain constant among exotic animals as well as the species-specific needs of each taxa from birds and small mammals to fish, amphibians, and reptiles.
Among exotic animals, venous cutdown is most commonly employed in reptiles like lizards and snakes although intraosseous catheters are also placed in lizards. Similarly, when an exotic companion mammal like a ferret or rabbit suffers from severe hypovolemia, dehydration, hypotension, and vascular collapse, intraosseous catheters have largely replaced venous cutdowns but this technique is occasionally employed.
The sugar glider is a small, nocturnal marsupial native to New Guinea and Australia. Sugar gliders are omnivores that eat arthropods and plant products, such as eucalyptus phloem sap, manna, honeydew, nectar, and pollen in the wild. Although there is little medical information available on sugar gliders in captivity, nutritional secondary hyperparathyroidism or metabolic bone disease is recognized as a common problem in this species.
Exotic animal veterinarians are well aware of the differences between energy expenditure in small and large species. Larger animals use more energy overall, however when energy expenditure is divided by body weight (kcal/kg/day), large animals use relatively less energy than small animals
Nebulization is used in avian medicine to deliver certain medications, usually antibiotics or antifungals, directly to the respiratory tract. Nebulization can provide hydration to the mucous membranes as well as provide an expectorant effect to help clear debris from the respiratory tract.
First aid is the initial treatment given to an injured or ill bird during an emergency. The goal of first aid is to stabilize the bird until veterinary medical care can be provided. Donated by Dr. Greg Burkett, this client educational handout helps owners prepare for emergencies. Topics covered include the creation of a home hospital cage, stocking a first aid kit, the basics of owner supportive care as well as specific advice for emergencies like bite wounds, bleeding, and head trauma.
Why syringe fed? A cornerstone of treatment is delivery of food containing high dietary fiber. Proper syringe-feeding technique is essential..