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.

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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 …

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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.

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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.

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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.

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…

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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.

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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…

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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…

Article  Webinar 

Five Common Reptile Emergencies

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  Video  Webinar 

Medical Management of Psittacines with Bornavirus Ganglioneuritis (PDD)

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.

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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.

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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.

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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.

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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.

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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…

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Feeding the Hospitalized Small Mammal

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…

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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.

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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.

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Fluid Administration in 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…

Article 

Feeding the Hospitalized Turtle or Tortoise

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.

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Abdominocentesis in Birds

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.

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Pain Management in Small Mammals

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.

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Feeding the Hospitalized Lizard

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…

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Fluid Administration in Reptiles

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.

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Emergency Equipment Checklist for Avian Practice

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…

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Crop Stasis in Birds

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…

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Normal Body Weights in Birds

“Normal Body Weights in Birds” is a collection of normal reported weights in common companion birds and birds of prey presented in table format. Keep in mind that reported normal body weights for a given species can vary significantly…

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Intravenous Catheter Placement in Rabbits

Intravenous catheters are commonly placed in rabbits to administer fluids, medications, induce anesthesia, and for delivery of analgesic drugs during the perioperative and postoperative periods. Catheterization techniques used in dogs and cats can also be used for rabbits. To reduce the time in handling and reduce stress, supplies needed for catheterization should be set out and ready to go, prior to removing the patient from the cage.

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Fluid Administration in Amphibians

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.

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Top Ten Fluid Therapy Facts

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.

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Evaluating Hydration Status in Birds

Physical examination parameters used to assess hydration are essentially the same in birds and mammals. Reduced elasticity of the skin or decreased skin turgor is seen with dehydration however normal bird skin is relatively inelastic and checking skin turgor is not as straightforward as in mammals. To check skin turgor in birds, tent the skin on the on the…

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Basic Husbandry: Hospitalizing Non-Traditional Pets

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.

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Vascular Cutdown Techniques

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.

Client Education Handout 

Medicating Your Bird

Keeping your pet healthy is everyone’s goal. However if your bird becomes ill, effective treatment will require that medications are given at the right dose and frequency for the…

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Exotic ICU: Nursing Care for Reptiles

Due to their unique anatomy, physiology, and behavior, critically ill reptiles pose special challenges. Fortunately there are a host of tips and tricks that can increase clinical success in an intensive care setting.

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The Snapping Turtle – Tips for the Practitioner

At the Ontario Turtle Conservation Centre, previously the Kawartha Turtle Trauma Centre, we encourage private practices, emergency clinics, and rehabilitation centers to aid in the initial treatment of these injured turtles. We admit turtles from across the province, and it is extremely beneficial to the turtle to get immediate care locally before transfer. Snapping turtles are incredible in their ability to heal (albeit slowly!) and we cannot stress enough that the injuries can appear horrific, and yet can go on to heal, with subsequent release of the turtle back into the wild…

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Basic Husbandry: Hospitalizing the Sea Turtle

Debilitated sea turtles are often too weak to be housed in water upon presentation to a veterinary medicine or wildlife rehabilitation setting. Instead these patients are maintained on a padded surface or waterbed. Once the turtle is stronger, it should ideally be transferred to a rehabilitation tank. LOGIN to view references.

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In My Experience: Living With a PDD Bird

In My Experience: Living with a PDD Bird was authored by a diligent parrot owner and reviewed by her avian veterinarian. This commentary includes suggestions on diet as well as management tips that improved the quality of life, and possibly the life span, of this owner’s birds.

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Catheters in Reptiles

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.

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Esophagostomy Tube Placement in the Ferret

Esophagostomy tube placement is an excellent choice for nutritional support of the debilitated small mammal patient requiring long-term feeding or for individuals that have suffered major orofacial trauma. Use this video clip or text with still images to review this important technique in the ferret.

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Intravenous Catheter Placement in Small Mammals

Intravenous catheters are commonly placed in ferrets and rabbits to administer fluids and medications, induce anesthesia, and for delivery of analgesic drugs during and after surgery. Intravenous catheters are also placed with growing frequency in chinchillas, guinea pigs and other small exotic companion mammals. Use this video clip or text with still images to review patient selection, potential complications, equipment needed and step-by-step instructions for this technique, as well as daily fluid requirements, catheter maintenance, and patient monitoring.

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Nasogastric Tube Placement in the Rabbit

Nasogastric tube placement in the rabbit is an excellent choice for the weak, dehydrated patient that requires enteral nutritional support. Use of a nasogastric tube can be less stressful and more successful than syringe feeding. Nasogastric intubation is also indicated in rabbits that will undergo surgery involving the oral cavity, esophagus, stomach, or biliary tract. Use this video clip or text with still images to review contraindications and potential complications, equipment needed as well as the technique involved.