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.
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.
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.
Fluid therapy is an important part of supportive care, and there are several routes available for fluid support in the reptile. Subcutaneous and/or oral fluids are appropriate for mild to moderate dehydration, while intracoelomic, intravenous, or intraosseous fluids are administered to critically ill reptiles or to patients with moderate to severe dehydration.
Reptile owners are routinely instructed on oral or intramuscular drug administration techniques for outpatient care. In many instances and in many species, parenteral injections are preferred over the oral route. Injectable medications can be delivered intramuscularly, subcutaneously, intracoelomically, intravenously, or…
Fluid therapy is indicated in critical patients including exotic animals. Vascular access can be extremely difficult or even impossible during shock, making intraosseous or IO catheterization necessary in the bird. Fortunately fluids and medications given through IO catheters are immediately taken up into the vasculature. The distal ulna is the site of choice for intraosseous catheter placement in the bird.
Fluid therapy is an important part of supportive care in the critical patient. When intravenous catheter placement fails or when veins are too small or too fragile, an intraosseous or IO catheter is an excellent option in exotic companion mammals. Use this video or text with still images to review equipment needed, potential complications, as well as the technique for intraosseous catheter placement in small mammals.
General anesthesia is generally required for placement unless the patient is extremely weak. A spinal needle or hypodermic needle may be selected.