Cardiopulmonary Resuscitation in Exotic Animals

There is little empirical information available on cardiopulmonary resuscitation in most exotic animals. Fortunately, the basic principles of CPR are the same for all species, however there are important species-specific considerations. This review article explores techniques for establishing airway control, ventilation and cardiac compression recommendations as well as considerations for emergency drug selection.

Video 

Reptile Emergency & Critical Care Summary Page

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 …

Exotic Companion Mammal Emergency & Critical Care Summary Page

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.

Avian Emergency & Critical Care Summary Page

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  Teaching Module 

Emergency and Critical Care Teaching Module

This learning aid is designed to assist the participant in meeting the needs of VECCS-certified facility. The basics of emergency medicine and critical care universal, however veterinarians face a unique set of challenges when caring for birds, exotic companion mammals, and reptiles. Level 1 of this teaching module reviews the basics of exotic animal critical care. To learn more in Level 2, review the key points on critical care or supportive care for each taxonomic group: birds, exotic companion mammals, and reptiles. Each summary page includes a brief quiz that tests your knowledge and reinforces fundamental principles. Delve deeper into critical care of exotic animal patients in Level 3 by browsing pertinent exotic animal content on LafeberVet.

Article 

Analgesia and Sedation in Exotic Companion Mammals

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 

Recognizing Signs of Illness in Birds

Signs of illness in birds are often quite subtle until disease is advanced. Fortunately, quite a bit of information can be gleaned from a detailed history and careful observation. View this brief slideshow for tips on the visual examination.

Article  Video  Webinar 

Avian Respiratory Anatomy, Physiology & Diseases: An Overview

The avian respiratory system has several unique and fascinating adaptations for flight that are important to clinicians. This web-based seminar will give an overview of the anatomical features of the avian respiratory tract and discuss the physiology of the respiratory system. Clinical correlates will be pointed out as we go through anatomy and physiology. We will then discuss clinical signs of respiratory disease in birds and how we can use these signs to help us anatomically locate the origin of the problem to the upper respiratory tract, the major airways, the pulmonary parenchyma and coelomic cavity…

Article  Presenting Problem 

Presenting Problem: Dyspnea in Ferrets

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 

Five Common Reptile Emergencies Post Test

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 

Esophagostomy Tube Placement in Birds

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…

How Did We Get Off the Goo?

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 

External Coaptation in Birds: Bandages and Splints

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 

Feeding the Hospitalized Bird of Prey

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…

Behavior Basics: Clinical Approach to the Rabbit

The approach to a prey species like the rabbit often calls for a profound paradigm shift for clinicians used to dealing only with cats and dogs. Rabbits can stress very easily in a clinical setting and the challenge of managing a small mammal like the rabbit increases exponentially when they are presented for illness or injury.

Article  Webinar 

Quality Exotic Small Mammal Anesthesia

Exotic small mammals can be challenging to safely induce, maintain and recover from general anesthesia. View the recording of this AAVSB R.A.C.E.-approved webinar, which explores clinical anesthesia in exotic companion mammals from patient assessment and anesthetic induction to monitoring and recovery. The use of common premedications, induction agents, maintenance drugs, and post-operative analgesics will be compared and contrasted in exotic companion mammals. Multimodal anesthetic techniques, such as epidural anesthesia and constant rate infusions, will also be discussed. After reviewing the recording, take the brief post-test to earn 1 hour of continuing education credit.

Article  Webinar 

Five Common Reptile Emergencies

View the recording of this webinar presented by Eric Klaphake, DVM, DACZM, DABVP (Avian Practice), DABVP (Reptile & Amphibian), then take the post-test to earn 1 hour of continuing education credit. This web-based seminar explores five common reptile clinical presentations in detail: trauma, gastrointestinal foreign body, neurological deficits, respiratory difficulty, and reproductive problems.

Form-Questionnaire 

Surgical Safety Checklist

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  Webinar 

Nutritional Support to the Critical Exotic Patient

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 

Presenting problem: “Red Leg” in Frogs

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.

Rabbit GI Case Challenge Discussion

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.

Client Education Handout 

Bloat and Gastrointestinal Blockage in Rabbits Client Handout

Gastrointestinal obstruction and a stomach distended with gas and fluid or “bloat” is a serious health problem of pet rabbits. Use this client educational handout to answer owner questions: What causes bloat and obstruction? Why is bloat a serious condition? What does bloat look like in the rabbit? This handout also explains the basics of a diagnostic workup, treatment, follow-up care, and prevention for this critical condition.

Article  Case Study  Slideshow 

Case Challenge: A 5-Year-Old Rabbit With Anorexia and Lethargy

A 5-year old female spayed lop rabbit presents with a history of acute anorexia (<24 hours) and lethargy. Use history, physical examination findings, laboratory results and survey radiographs to solve this case challenge.

Article 

A Guide to Esophagostomy Tube Placement in Chelonians

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  Video  Webinar 

Critical Care Nutrition

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.

Article 

Exotic ICU: Nursing Care for Exotic Companion Mammals

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.

Form-Questionnaire 

Procedure Equipment Checklists

Do you have everything? Shared by registered veterinary technician and veterinary technician specialist, Jill Murray of Oklahoma State University, review our collection of procedure equipment checklists. Checklists are used in clinical practice to make preparation for procedures more efficient and more consistent, thereby improving the quality of care. Use these equipment checklists to train students and staff, or simply to jog your memory for procedures performed only sporadically.

Article 

Exotic ICU: Nursing Care For the Avian Patient

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 Wrap Placement in Birds

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 

Transfusion Medicine in Birds

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 

Reproductive Emergencies in Birds

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 

Urethral Obstruction in the Ferret

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 

Parenteral Nutrition in Birds

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 

Emergency Drug Therapy in Birds

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 

Burns in the Avian Patient

Burns are common in avian medicine. Many burns result from contact with hot liquids such as scalding water or cooking oil. Electrical burns arise from chewing on electrical wires and burns may also occur when pre-weaning birds are fed hot formula. Burns resulting from entrapment in burning buildings or inside containers, such as chick incubators with burning bedding, are not as common but are much more difficult to treat due to the complication of smoke inhalation.

Article 

Supplemental Heat for the Avian Patient

Small birds face an enormous task in maintaining their body temperature, especially in a cold environment, but fortunately plumage provides an effective barrier to heat loss. Down feathers trap air and allow little convective movement of heat to occur. Fluffing feathers increases insulation and…

Article 

Fluid Therapy in the Avian Patient

Crystalloids, also called replacement fluids, are the mainstay of rehydration and maintenance fluid therapy, and they can be used together with colloids during resuscitation. Crystalloids are fluids containing sodium chloride and other solutes that are capable of distributing to all body fluid compartments. Replacement fluids have electrolyte concentrations that resemble extracellular fluid, whereas maintenance fluids contain less sodium (40-60 mEq/L) and more potassium (15-30 mEq/L). The most commonly used replacement fluids are 0.9% saline, lactated Ringer’s solution, Normosol-R, or…

Article 

Diagnosing and Treating Avian Neurologic Disease

The cranial nerve exam differs little from that of mammals, however there are differences in innervation. As in mammals, menace and pupillary light response (PLR) require use of cranial nerves II (optic) and III (oculomotor), however menace is difficult to interpret in birds. Also, PLR may be overridden in birds due to the presence of striated iridal muscle. Evaluate PLR early in the exam using a sudden, bright light directed toward the medial canthus. Consensual PLR is absent due to…

Article 

Emergency Equipment Checklist

Looking for an emergency equipment checklist? Review general recommendations for preparing yourself, your staff, and your practice to special species.

Article 

Assessing the Sick Guinea Pig

Guinea pigs tend to be shy, sweet-natured creatures. Guinea pigs are prey species. Their survival depends on the ability to be alert and respond quickly, and they possess acute senses of smell and hearing. Approach guinea pigs in a calm, quiet manner…

Article 

Assessing the Sick Rabbit

Rabbits are prey species. Their survival depends on the ability to be alert and respond quickly, and they possess acute senses of smell and hearing. Approach rabbits in a calm, quiet manner. Stressed or critically ill rabbits may not tolerate prolonged handling. Evaluation and treatment may need to proceed slowly in stages.

Article  Presenting Problem 

Presenting problem: Anorexia, Lethargy, and/or Scant Feces in Rabbits

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…

Article 

Feeding the Hospitalized Snake

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.

Article 

Online Resources: Emergency and Critical Care

A collection of online resources related to emergency medicine and critical care. This list of links come from a variety of academic institutions and professional organizations.

Article 

Pain Management in Birds

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.

Article 

Pancreatic Beta Cell Tumors in the Ferret

There is no cure for insulinoma. If the ferret lives long enough, eventually it will reach a point where clinical signs cannot be controlled and euthanasia will need to be selected to address quality of life issues.