Subcutaneous Fluids in Birds

Introduction

The subcutaneous route is the most common method of fluid administration in the bird. Subcutaneous fluids in birds are an excellent way to provide maintenance fluids or to correct mild dehydration. Subcutaneous fluids may also be the safest route initially for extremely debilitated patients as well as those with respiratory distress or abdominal distension.

 

Subcutaneous fluids in bird video


Video produced by Dr. M. Scott Echols and narrated by Susan Orosz, DVM, DABVP (Avian Practice), DECZM. Video script adapted from Dr. Ford’s article by Christal Pollock, DVM, DABVP (Avian Practice). Video script reviewed by Drs. M.S. Echols and S. Orosz.

 

Equipment needed

  • Syringe
  • Needle of appropriate size:  22 to 25-ga needles for larger birds and 25 to 27-ga for small patients
  • Rubbing alcohol, or soapy water if no alcohol is available, to part feathers
  • Fluids warmed to 100-102°F (38-39°C)
  • +/- Butterfly catheters make fluid administration much easier when a large syringe (35-60 ml) is used

Administer subcutaneous fluids using an intravenous drip set (10-15 drops/ml) attached to a bag of fluids for large raptors. A syringe attached to a needle or butterfly catheter is used for smaller birds. The gauge size listed above are for companion parrots, use a 18 to 23 gauge needle for raptors.

Subcutaneous fluid administration

Subcutaneous fluid administration using a small gauge needle and syringe to a small avian patient. Photograph provided by Dr. Isabelle Langlois. Click image to enlarge.

Potential complications

  • If the needle is inserted too deeply, fluids can be inserted directly into the abdominal air sac. From here they can quickly flow to the lungs.
  • Although the inguinal region has a relatively large subcutaneous space, over-distention of the space with fluids can disrupt the blood flow thereby reducing the rate of fluid absorption.

Step-by-step instructions

  • Provide warmed fluids by storing fluid bags in a fluid warming cabinet or placing the syringe in warm water.
  • Fluids are most commonly given in the inguinal region. While an assistant holds the bird upright, extend and slightly abduct one of the legs.

Subcutaneous fluids inguinal region

  • Part the feathers over the ventral or inner thigh where the leg meets the abdominal wall.  Use alcohol only sparingly to keep the feathers out of the way as alcohol will cool the bird.
  • Insert the needle, bevel up, at a shallow angle slightly away from the body wall. It is generally easy to avoid blood vessels since the needle is visible underneath the skin.

Subcutaneous fluids needle insertion

  • As you begin to infuse fluid, the subcutaneous space will expand substantially to form a bubble. Stop and redirect the needle if you do not see a bubble form.
  • Keep the needle in the middle of this bubble so that you do not inadvertently slip out of the subcutaneous space.
  • If the subcutaneous space is overfilled, fluid will begin to leak out around the needle or the bird may begin to show signs of discomfort.
  • If fluids do not flow freely, the needle is either in muscle or the tip of the needle is pressed against tissue. Try rotating the needle slightly or pulling back and readjusting your position.
  • If previously administered fluids have not be absorbed, consider adjusting frequency and dosage or, in the case of hypoproteinemic birds, consider cautious intravenous or intraosseous fluid administration.
Subcutaneous fluid diagram

Diagram provided by Dr. Scott Ford.

Tips for fluid administration in large avian patients

Fluids are most commonly given into the inguinal space (crural patagium). With the bird secured by an assistant, have them extend one of the bird’s legs out and to one side. Wet down the area on the inner thigh to see the skin better at a point about halfway between the body and knee.

 

Subcutaneous fluids administered to a large raptor

Subcutaneous fluids may be administered to a large raptor with a butterfly catheter and syringe or an intravenous administration set as shown below. This space can expand substantially to hold fluids. To aid in visualization, wet the feathers using rubbing alcohol and part them. Most species will actually have a bare patch in this region. Diagram provided by Dr. Scott Ford. Click image to enlarge.