Procedures: Therapeutics

Article Webinar

Save the date

Save the Date for a R.A.C.E.-approved continuing education webinar

Presenter: Charly Pignon, DVM, DECZM (Small Mammal)

Date: Wednesday, November 7, 2018

Time: 1 pm EST; What time is that in my time zone?

Registration opens October 23, 2018

Lecture outline

Lecture topics will include:

Emergency triage
Cardiopulmonary resuscitation
Analgesia
- Opioids
- Anti-inflammatories
- Co-analgesics
Fluid therapy
- Deficit correction
- Rehydration
- Maintenance
Critical care nutrition

Abstract

Intensive care in rabbits requires a thorough knowledge of rabbit […]

Article Case Study

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…

Article Case Study

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…

Article Case Study

An eleven year old male neutered rex rabbit presented with lethargy and inappetence of two days duration, and an acute episode of vestibular ataxia. Anemia and elevations in plasma alkaline phosphatase and alanine aminotransferase were evident. Abdominal ultrasound revealed questionable, diffuse hepatomegaly. Computed tomography revealed hepatic venous congestion, severe dilation of the pre-hepatic caudal vena cava, and bicavitary effusion, consistent with Budd-Chiari-like syndrome. Turbulent blood flow within the dilated segment of the caudal vena cava was present on spectral Doppler evaluation. Fine needle aspirate and cytology of the liver revealed necrosis with no evidence of infectious organisms…

Article Case Study

A female, spayed miniature lop rabbit presented 1-week post spay with marked subcutaneous swelling along the entire length of the surgical incision. Subsequent debridement of the abscess and closure of the incision site was somewhat unsuccessful, with the patient returning for another debridement procedure, after which the wound was left open for continued flushing and debridement. Culture and sensitivity of the purulent material grew a multi-drug resistant Coagulase-positive Staphylococcus.

Article Case Study

Two guinea pigs suspected of having hyperthyroidism based on weight loss, presence of a cervical mass, and elevated total thyroxine (TT4) levels were confirmed to have active thyroid masses via scintigraphy with Technetium-99 and treated with radioactive iodine therapy (I¹³¹). Both patients responded initially with weight gain and a decrease in the TT4. The purpose of this case series is to describe the use of scintigraphy to aid in confirming a diagnosis of hyperthyroidism, as well as to show the benefits and effectiveness of using radioactive iodine therapy (I¹³¹) to treat hyperthyroidism in guinea pigs in order to provide the best treatment protocol.

Article Case Study

A 1-year-old female intact lionhead rabbit was referred for a history of hematuria, bloody vaginal discharge, anorexia, and lethargy unresponsive to antibiotics and anti-inflammatory medications. Based upon physical examination, radiographs and abdominal ultrasonography a uterine mass was suspected. Severe regenerative anemia secondary to blood loss was diagnosed and the rabbit was administered a whole blood transfusion prior to surgical intervention. Abdominal exploratory with ovariohysterectomy revealed…

Article

Poisonings are relatively uncommon in companion bird emergency medicine, but these conditions do occur and can involve a wide assortment of toxins. In principal, treatment in birds is the same as for other animals. First, stabilize the patient presented with abnormal clinical signs. Establish an airway, initiate respiration, and address cardiovascular needs.

Article

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 …

Article

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.

Article

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.

Article

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.

Article Slideshow

Inland bearded dragons are native to Australia and are a popular companion animal. Private breeders often select for desirable temperaments and various color morphologies in an effort to provide an ever-increasing variety to the pet trade. They are also bred commercially and sold by large pet retailers making them a widely available pet reptile…

Article

Rabbit intubation can be accomplished using either an orotracheal or nasotracheal technique. Both intubation methods can be challenging in rabbit patients and require patience and practice. Nasotracheal intubation may be the preferred approach in situations where maximum access and maneuverability is required in the oral cavity. Nasotracheal intubation is also preferred where an extended recovery is expected.

Article Presenting Problem

This presenting problem article reviews the basic approach to the dyspneic ferret beginning with clinical signs of the dyspneic ferret, key points of urgent care, as well as case management. This latter section reviews tips on taking the history, performing the physical exam, important differential diagnoses, as well as the diagnostic/therapeutic approach.

Quiz

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…

Article Webinar

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.

Article

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…

Article Video Webinar

This live webinar event was presented by Javier Nevarez, DVM, PhD, DACZM, DECZM (Herpetology). View a recording of Dr. Nevarez’s web-based seminar and earn 1 hour of R.A.C.E.-approved continuing education credit. Lecture objectives include a review of the principles and concepts of reptile analgesia, recommended analgesics, signs of pain and pain recognition, and a review of analgesic protocols. The presentation also reviews principles and concepts of reptile anesthesia, popular anesthetic agents and anesthetic protocols, monitoring, as well as keys to success.

Article

The “Pigeon Disease Primer” explores important differential diagnoses for common clinical problems observed in pigeons and doves. Although the clinical approach to the columbiform relies on the same concepts of “One Medicine” used in all species, many of the infectious diseases of pigeons are relatively unique to this taxonomic group, or at least much more prevalent when compared to psittacine birds or songbirds.

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.

Article

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…

Article

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…

Form-Questionnaire

The Vets Now Surgical Safety Checklist includes a list of safety issues that should be read aloud, with both the veterinarian and veterinary nurse or veterinary technician present. This checklist is divided into three categories: induction of anesthesia, before the skin incision, and before the patient leaves the operating room…

Article Video Webinar

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.

Article Video Webinar

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.

Article Presenting Problem

Red leg syndrome, also known as “pink belly disease” or bacterial dermatosepticemia, is one of the most common clinical conditions of captive frogs. Associated with peracute to acute bacterial septicemia, red leg is generally a disease of captive animals although the condition has also been implicated in rare mass mortalities of wild amphibians. This presenting problem article reviews clinical findings in red leg syndrome, pathogenesis of disease, as well as key points of urgent care and prognosis. The basics of case management are then reviewed: differential diagnoses, diagnostics, treatment, prevention and control.

Article

The non-hyphal, zoosporic, chytrid fungus Batrachochytrium dendrobatidis (Bd) has caused widespread and dramatic population declines in both wild and captive amphibians worldwide. Use this table to review the basics of the infectious disease chytridiomycosis

Article Slideshow

Did you hear about the Palawan turtle crisis? In June 2015, Philippine authorities confiscated over 4,000 turtles, many of them critically endangered Philippine forest turtles (Siebenrockiella leytensis), intended for the illegal pet trade. Enjoy LafeberVet’s brief, fun slideshow that explores our Emeraid donation for the Palawan turtle crisis as well as care of many, many, many turtles. Although medical supplies are not currently required, financial contributions are still needed for this important conservation effort.

Gastric dilatation or “bloat” and gastrointestinal obstruction is an acute and life-threatening condition of pet rabbits commonly caused by an obstruction with pellets of compressed hair. The discussion portion of this Case Challenge reviews onset, clinical signs, and diagnostic test results of obstructive and non-obstructive gastrointestinal disease. This condition is considered a surgical emergency and key points of urgent care strive to stabilize the patient through analgesia, decompression when indicated, and supportive care. Surgery is discussed as well as recommendations for patients that cannot go to surgery due to clinical or financial constraints. Follow-up care as well as homecare recommendations, disease prevention, and prognosis are also explored.

Article

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.

Article

A variety of agents may be used in small mammals with ectoparasites. Download this easy-to-use table for a list of agents used to manage lice, flea infestation, mange or acariasis.

Article

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.

Client Education Handout

Should I have my pet rabbit “fixed”? In most cases, the answer is an unqualified YES. In this client education handout, the benefits to spay or neuter of the house rabbit are explored. Recommendations for pre-surgical preparation for companion animal castration as well as aftercare are also discussed.

Article

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.

Article Video

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.

Article

Proventricular dilatation disease or PDD is one of the most frustrating avian conditions encountered today. The recent discovery of a causal relationship between PDD and avian bornavirus has not simplified the challenges that are faced. The detection of avian bornavirus infection is common in birds with PDD but is also detected in birds with other chronic diseases that are not diagnosed with PDD. Proventricular dilatation disease was first reported in the late 1970s…

Article

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…

Article

Leg bands are sometimes used for identification of birds. Band removal is indicated as a medical treatment when the band is associated with tissue swelling due to trauma or a build up of keratin. Prophylactic band removal is recommended by some veterinarians because of the danger of the band catching on wire or toys. There is some controversy, however, as to whether bands truly pose a significant risk. Most clinicians agree that closed bands pose less risk of injury compared to…

Article

Reproductive emergencies are most commonly seen in small psittacine birds like the cockatiel, lovebird and budgerigar parakeet. This article reviews conditions commonly seen on an emergency basis such as dystocia, egg yolk peritonitis, cloacal or oviductal prolapse, and/or chronic egg laying. Pertinent anatomy and physiology as well as case management, including the reproductive history, physical examination, diagnostic imaging, and behavioral modification techniques are also discussed.

Article

Although the overall incidence of urethral obstruction is probably low, this condition is an important reason for emergency presentation of the male ferret. n the United States, urethral obstruction is most frequently caused by…

Article

Urolithiasis is characterized by single or multiple calculi throughout the urinary tract or by the presence of sandy material within the bladder and urethra. Uroliths are fortunately more of a historical disease in the ferret, while calculi are still an important problem in rabbits and rodents.

Article

Antibiotic therapy is a challenge in rabbits. The rabbit digestive system depends upon a healthy population of microbes to function properly. In normal circumstances, normal commensal bacteria completely overwhelm the small numbers of opportunistic pathogenic bacteria present and keep them safely in check. Certain antibiotics, particularly when given by the oral route, however, have the potential to disturb this crucial balance by killing off the commensal bacteria…

Article

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.

Article

Omega-3 fatty acids are polyunsaturated fatty acids (PUFAs) that comprise a small percentage of dietary lipids ingested by humans and animals. The name “omega-3” refers to the location of the double bond closest to the methyl end of the hydrocarbon chain, and may be alternatively referred to as “n-3” in the literature. Chief among the omega-3 fatty acids is…

Article

One of the most valuable items in avian practice is a reliable formulary. Although pharmacokinetic and pharmacodynamic data is slowly growing, the vast majority of drug doses in companion parrot medicine rely on extrapolation and/or clinical experience. It is crucial that the clinician have access to this wide range of information and experience.

Article

The gastrointestinal tract acquires and digests food, absorbs nutrients and water, and expels unabsorbed ingesta as feces. Nutritional support of the avian patient with gastrointestinal (GI) disease is challenging. In cats and dogs, it is easy to “rest” the gut, however with their relatively high metabolic rate, this is difficult, if not impossible, to achieve in many avian patients. Specific disease conditions increase the difficulty regulating gastrointestinal motility including ingluvitis (crop stasis). …

Article

The avian patient poses special challenges for delivery of injectable medications. Although the techniques involved are not unique to birds, special knowledge of avian anatomy as well as delicate, proficient technical skills are required. Depending on the species, the individual, and the clinical situation, injections can be delivered by intramuscular, intravenous, intraosseous, subcutaneous, intratracheal, or intracoelomic routes. Parenteral drug administration provides the advantage of delivering a precise dose when a rapid therapeutic response is necessary. Disadvantages include stress as well as the potential irritation or pathology that can occur at the injection site.

Article Product information

There are various approaches to provide food for the companion parrot. Each nutritional strategy has its own advantages and disadvantages including seed-only diets, pelleted diets, extruded diets, and/or foraging diets.

Article

There are a number of potential nutritional problems that can promote renal disease. Excess dietary protein, excess dietary calcium, hypovitaminosis A, or hypervitaminosis D may lead to nephritis or other degenerative renal changes…

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