Search

Avian anesthesia can be challenging due to birds' anatomical and physiological peculiarities. Also, most drug doses and combinations used are empirical. The objective of this study was to evaluate the anesthetic quality and physiological changes after dexmedetomidine-ketamine sedation and isoflurane anesthesia in the saker falcon (Falco cherrug). Twelve falcons weighing (mean±standard deviation) 915±175g were included in the study. Pre-sedation heart rate (HR) and respiratory rate (RR) were assessed. A combination of ketamine (3mg/kg) and dexmedetomidine (25µg/kg) was administered intramuscularly. Sedation times were recorded, physiological variables assessed, and various blood parameters measured. Induction was performed with isoflurane at 2% for 2 minutes and anesthesia was maintained at 1%. During maintenance, physiological variables were assessed at 5-minute intervals and blood parameters were re-evaluated before reversal administration. Recovery times were documented. Quality of sedation, maintenance, and recovery were assessed. Sedation was achieved within 2.9±1.0 minutes and quality of sedation and maintenance were deemed «excellent» in all falcons. HR values decreased during sedation (137±38 versus 99±13 beats per minute; p =0.001) and remained constant during maintenance. No significant differences were seen in RR from pre-sedation values. Mean arterial blood pressure (203±14 versus 168±22mmHg; p <0.001) and cloacal temperature (40.3±0.8 versus 38.9±1.0°C; p <0.001) decreased after induction. Hypoxemia (65.9±6.1mmHg) was observed at sedation but resolved during maintenance, while hypercarbia (54.2±11.5mmHg) and acidemia (7.28±0.036) developed. Full recovery was quick (12.3±3.9minutes). The proposed drug combination provided for high quality sedation, maintenance, and a satisfactory recovery. Nevertheless, alterations in the falcons' physiology were documented. [ABSTRACT FROM AUTHOR]

Feather damaging behavior (feather picking) is a common malady of captive parrots. Diagnosis is challenging as a primary disadvantage to clinicians faced with diagnosis of parrot skin disease remains the lack of normative data for the healthy parrot epidermal microbiology. The objective of this pilot study was to establish bacterial and fungal cutaneous microbiota baselines for quaker parrots with and without feather loss. Healthy quaker parrots (Myiopsitta monachus n = 12) with intact feathers were compared to 12 quaker parrots with evidence of feather loss via next-generation DNA sequencing of bacteria and fungus swabbed from skin. Of 351 bacterial and 97 fungal species identified, no statistical differences occurred in bacteria or fungal alpha-diversity or beta-diversity based on age, sex, or feather loss. However, enclosure affected bacterial beta-diversity. The most abundant bacterial species for fully feathered quaker parrots were Exiguobacterium indicum, Sphingomonas yabuuchiae , and Corynebacterium spp.,. Fragaria/Populus euphratica, S. yabuuchiae, and E. indicum for quaker parrots with feather loss. Lactobacillales, Acinetobacter, Kocuria sp., and Streptococcus epidermidis were significantly enriched in fully feathered quaker parrots, while Streptococcaceae, Methylobacterium, Clostridiales, Nocardioidaceae, Nesterenkonia, and Actinomycetospora were significantly enriched in quaker parrots with feather loss. Both groups had Cladosporium halotolerans/sphaerospermum as the predominant fungus, while Capnodiales was significantly enriched in quaker parrots with feather loss. Use of next generation microbial sequencing as a preliminary diagnostic tool of bacterial and fungal communities of captive birds allows veterinarians to confirm cytologic diagnoses and circumvent the limitations of culture testing. Diagnostic implications include the potential transmission of pathogenic bacteria and/or fungi and pathogen resistance between cohoused birds. [ABSTRACT FROM AUTHOR]

The American Society of Anesthesiologists physical status classification system is commonly used in all fields of veterinary medicine, with higher grades correlated with increased mortality in non-avian companion animals, but little evidence is available for avian species. This study aims to investigate whether prospective ASA grade is a reliable predictor of mortality in avian species undergoing general anesthesia. Anesthetic records for avian patients undergoing inhalational isoflurane anesthesia were retrospectively examined to assess mortality outcomes during and up to 48 hours after cessation of anesthesia. Prospective ASA grade assigned at the time of anesthesia was used to categorize anesthetized patients. A total of 1820 anesthetic records were included over a 3-year period. A total of 81 patients (4.45%) died during anesthesia or within 48 hours of cessation of anesthesia. Patients assigned an ASA grade of 1 had a mortality rate of 0% (95% confidence interval [CI] 0.0–0.2), and patients assigned an ASA grade of 2 had a mortality rate of 0.6% (CI 0.2–1.3%). Patients assigned ASA grades 3, 4, and 5 had mortality rates of 5.9% (CI 4.3–8.0), 18.8% (CI 13.4–25.7) and 50.0% (CI 29.9–70.1) respectively. Patients assigned an ASA grade of 3 were found to have 11.5 times the odds of a mortality event (95% CI 5.0–31.8) compared to ASA grades 1 and 2. A further increase in odds of 40.0 times (CI 16.9–113.8) was identified in patients assigned an ASA grade of 4, and 185.2 (CI 57.6–668.1) identified in patients assigned an ASA grade of 5. Age, sex and weight were shown to have no statistically significant impact on odds of death. Investigation into timing of death showed that the majority of patients died following cessation of general anesthesia (81.48%), with the highest mortality rate occurring between 0 and 3 hours postgeneral anesthesia. This study indicates that patients assigned ASA grades of 3 or greater are at higher odds of death compared to those assigned ASA grades 1 or 2. The odds of death increased with increasing ASA grades. The highest mortality rate was identified within 0–3 hours of cessation of general anesthesia. [ABSTRACT FROM AUTHOR]

Caudal duplication syndrome is a rare developmental anomaly thought to be a result of incomplete twinning. A 6-week-old female broiler chicken (Gallus gallus domesticus) presented to a private specialty exotic animal hospital, for evaluation of accessory hindlimbs due to one of the limbs becoming soiled with feces causing localized dermatitis. The bird had been rescued from culling at an undisclosed private poultry farm. Diagnostic evaluation included whole body radiographs and computed tomography. Radiographic and CT images confirmed an accessory malformed pelvis and fused femur, left lateral deviation of the coccygeal spine and pygostyle. CT images further revealed a paired proctodeum exiting through a single fused vent also deviated to the left. Surgical removal of the accessory limbs was successful and the chicken was healthy on follow up examination 12 months following initial presentation. This case documents polymelus anomalies and caudal duplication syndrome in an avian patient and shows a long-term positive surgical outcome for a chicken treated for these conditions. [ABSTRACT FROM AUTHOR]

Squamous cell carcinoma is a commonly reported neoplasm in avian species. Often locally invasive, it rarely distantly metastasizes. Superficial chronic ulcerative dermatitis (SCUD) is a commonly observed dermatologic condition in companion psittacine birds. This report describes a case of metastatic squamous cell carcinoma in an African gray parrot (Psittacus erithacus) caused by malignant transformation of an initial SCUD lesion that developed over a 2.5-year period. The right humerus was previously amputated to treat a squamous cell carcinoma, but it recurred in the skin 4 months prior to presentation. The bird presented on referral with pelvic limb paresis, and computed tomography showed a large, more right sided, paraspinal mass involving the right caudal coelom and effacing the lungs, ribs, and vertebral canal, resulting in the presenting neurologic signs. The patient was euthanized, and limited necropsy diagnosed the coelomic mass as a squamous cell carcinoma effacing the liver. Though uncommonly reported, squamous cell carcinoma may distantly metastasize to other parts of the body even with partial or seemingly complete excision. SCUD is still a poorly understood condition and should be further researched to determine etiology and find more effective therapies. This is the first report of a metastatic squamous cell carcinoma invading the vertebral canal and spinal cord resulting in upper motor neuron signs in the pelvic limbs. Chronic inflammation may lead to malignant transformation, and once squamous cell carcinoma has developed, the goal of therapy should be complete surgical excision where possible. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate topical medications, lavage solutions and laser therapy for treating open clean wounds induced in captive blue-fronted Amazon parrots. Twenty-four blue-fronted Amazon parrots (Amazona aestiva) were divided into 6 groups according to the wound treatment: Group DEX—dexpanthenol 5% ointment; Group RIC—ointment of Ricinus communis oil; Group CHL—chlorhexidine digluconate solution 1%; Group SSS—0.9% sterile saline solution; Group LLL—low-level laser therapy and Group CON—no treatment, control. Four full-thickness wounds were induced in the front part of the chest area with the aid of an 8-mm punch. In each parrot, the 4 wounds received the same treatment, every 48 hours until healing, according to the group. In all groups, on postoperative days 5, 14 and 21, biopsies were taken for histological examination. One of the 4 wounds was not submitted to biopsy but rather was used for wound size measurements. Group CON presented the longest healing time and differed statistically from the other groups. Excluding Group CON, groups CHL and SSS showed no significant difference. Microscopically, groups DEX and CHL showed higher fibroplasia and epithelialization compared to the other groups on day 21. In conclusion, the best results were achieved macroscopically through lavage solutions, chlorhexidine digluconate solution or sterile saline solution; however, chlorhexidine digluconate was superior microscopically. The laser therapy and dexpanthenol ointment showed intermediate results, whereas the Ricinus communis oil showed the worst results. It is unclear the exact amount of energy received from the tissue since laser was administered in non-contact mode, and further studies at different laser settings are warranted. [ABSTRACT FROM AUTHOR]

Alfaxalone is a neurosteroid anesthestic drug. In 2001, alfaxalone (Alfaxan) was released and since then there have been reports of it use in a large spectrum of veterinary species, including some avian species. Alfaxalone's rapid onset, short duration of action and multiple routes of administration (intravenous, intramuscular, subcutaneous, and intraosseos) make it a versatile induction agent. The following case report describes the use of intravenous alfaxalone in two pet domestic chickens (Gallus gallus domesticus). Alfaxalone was administered intravenously to effect. The quality of induction in both cases were poor, with a period of excitement occurring after administration of 5 mg/kg, before muscle relaxation following continued administration to a total dose of 10 mg/kg in the first case and 15 mg/kg for the second case. [ABSTRACT FROM AUTHOR]

Background: Ventral abdominal herniation (with or without oviduct involvement) in avian species is most commonly seen in reproductively active females. Case Description: A 2.5-year-old female budgerigar (Melopsittacus undulatus) presented for a ventral tail, 2.0 cm in diameter, mass extending between the cloaca and the tail base. Upon surgical evaluation, the mass was determined to be a herniation of the oviduct and later confirmed with histopathology. A salpingohysterectomy and closure of the body wall defect was performed, and the patient recovered well. Postoperative radiography revealed no evidence of retained egg or other obvious pathology to determine an underlying cause. Conclusions and Case Relevance: Lateral body wall herniations with involvement of the oviduct has been reported, but an undertail body wall herniation involving the oviduct has not been previously reported based on the literature search, and should be considered in birds presented with similar lesions in this anatomical location. [ABSTRACT FROM AUTHOR]

Thermophilic Campylobacter spp. and Salmonella spp. are zoonotic bacteria, commonly harbored in the enteric tract of avian species. This survey aimed at verifying the presence of these microorganisms in a heterogeneous Italian population of pet birds and captive birds of prey (e.g ., Passeriformes, Psittaciformes, Accipitriformes, Falconiformes, and Strigiformes) that live in close contact with humans. A total of 151 individuals were tested for thermophilic Campylobacter spp. and 444 for Salmonella spp. Six C . jejuni and one S . Livingstone were isolated from birds of prey: 4 Accipitriformes (2 Buteo regalis , 2 Parabuteo unicinctus ), 1 Falconiformes ( Falco peregrinus ) and 1 Strigiformes ( Strix aluco ) were positive for C . jejuni , and 1 Falconiformes ( Falco peregrinus ) for S . Livingstone. Five C . jejuni strains were genotyped by Multilocus Sequence Typing (MLST) and identified as ST 2116, assigned to ST-353 CC. Results of this study suggest that these microorganisms are not common inhabitants of the digestive tract of pet birds and captive birds of prey, but occasional findings. However, as potential reservoirs of zoonotic bacteria, pet birds should be monitored in order to preserve human health. [ABSTRACT FROM AUTHOR]

Aspergillosis is a common and life-threatening disease in birds affecting single individuals and flocks. Acute and chronic forms of this mycotic disease have been known for centuries; however, antemortem diagnosis remains difficult. Reliable, rapid, and noninvasive diagnostic testing is desirable, especially for chronic aspergillosis cases, when other disease conditions may be present. Therefore, research has focused on the development and improvement of clinical diagnostic procedures and techniques. At present, a definitive diagnosis for aspergillosis is based on cumulative evidence from several diagnostic tests. Potential sources of fungal infection, predisposing factors, and management conditions may be identified during anamnesis. Suspect cases can be confirmed by clinical examination, radiology, or computed tomography. Additionally, results from a blood biochemistry panel, complete blood count, acute phase protein analysis, and protein electrophoresis may be used as ancillary tests to determine a patientʼs condition. Aspergillus antigen, toxin, and Aspergillus -specific antibody detections from blood samples may aid in determining a diagnosis, but are currently not considered reliable for all avian species. For most aspergillosis cases pathological and histopathological lesions are diagnostic and molecular biological assays are available to identify the fungal agent from biopsy or necropsy specimens. A definitive diagnosis is based on fungal identification with histopathological evidence demonstrating the fungal agent inside the affected tissue. However, endoscopic or laparoscopic samples submitted for fungal culture and subsequent identification are still regarded as valid for a clinical diagnosis of aspergillosis in birds. The current status, benefits, and disadvantages of diagnostic procedures and techniques for avian aspergillosis are provided to aid the avian practitioner in selecting a test protocol to determine a definitive diagnosis. [ABSTRACT FROM AUTHOR]

Neurological dysfunction is a frequently presenting sign in avian and reptile patients. Clinical neurological signs are rarely pathognomonic, often requiring the attending veterinary surgeon to perform more involved diagnostic tests to achieve a diagnosis. Variations in patient anatomy, physiology and demeanour present unique challenges to the veterinarian evaluating the bird or reptile that has neurological disease signs. Despite these challenges, a well-structured physical and neurological examination can often be accomplished with minimal equipment. A structured neurological examination is essential to formulate an appropriate investigative plan and therapeutic regime for these difficult cases and to provide the owner with an accurate prognosis. [ABSTRACT FROM AUTHOR]

Abstract: Blood pressure monitoring of patients has become increasingly common in companion animal veterinary hospitals, especially during anesthesia, surgical procedures, critical care, and general health assessments. Determining an animal’s blood pressure has become a standard part of the routine diagnostic evaluation for monitoring hypertension in geriatric patients or patients affected with renal insufficiency, cardiac disease, vision loss, or endocrine disorders. To increase the standard of care in exotic and zoological medicine, new diagnostic techniques must be identified and implemented. Blood pressure measurements in avian species are more challenging because only direct blood pressure techniques have been reported to be accurate. Arterial catheterization and interpretation can be daunting without the knowledge of avian physiology and anatomy; however, techniques for placing arterial catheters are not difficult once clinicians have gained sufficient experience. This article describes the techniques, anatomy, and appropriate interpretation of blood pressure results obtained through arterial catheterization in birds. [Copyright &y& Elsevier]

Abstract: To evaluate potential factors related to avian atherosclerosis, plasma cholesterol and triglyceride values were measured in 35 apparently healthy captive monk parakeets (Myiopsitta monachus). Birds were categorized as healthy or at risk based on body condition score and weight and were also evaluated based on their aviary environmental conditions. Plasma cholesterol mean was 8.008mmol/L (range: 4.655 to 20.33mmol/L) or 309.65mg/dl (range: 180 to 786mg/dl) for all birds sampled. Plasma triglyceride mean for all birds sampled was 4.364mmol/L (range: 0.960 to 44.62mmol/L) or 386.54mg/dl (range: 85 to 3952mg/dl). Thirty plasma samples were evaluated through density gradient ultracentrifugation lipid profiling techniques used to examine risk of cardiovascular disease in humans. The resultant lipid density profile graph was determined from the hydrated densities of the following lipids: triglyceride-rich lipoproteins, low-density lipoproteins (LDL) and subfractions, and high-density lipoproteins and subfractions. When analyzed using linear discriminant analysis, lipid profiles of triglyceride-rich lipoproteins, LDL1, LDL2, and high-density lipoprotein 2b subfractions were increased (P < 0.05) in at-risk monk parakeets when compared with healthy cohorts. Gender and diet had no apparent effect on plasma cholesterol or triglyceride concentrations. Cholesterol and triglyceride concentrations and lipoprotein density profiles from captive monk parakeets, a species known to be affected by atherosclerosis, may prove useful as markers for use in future investigation of atherosclerosis in birds. However, the consequence of increased plasma lipid concentrations and changes of lipoprotein profiles on avian health requires additional investigation. [Copyright &y& Elsevier]

Abstract: Negative pressure wound therapy (NPWT) is an adjunctive wound management modality that has been shown to augment the treatment of acute and chronic dermal and subdermal wounds in human and veterinary medicine. The proposed effects of NPWT are multifactorial and include improvement of wound perfusion, reduction of interstitial edema and substances inhibitory to wound healing, enhancement of granulation tissue formation, and reduction in bacterial contamination from a wound bed. Together, the proposed benefits of NWPT can lead to enhanced efficiency of wound healing when this treatment modality is applied to a wound. In this article, the authors provide an overview of the mechanism of action of NPWT. Case selection, system application and management, as well as contraindications to NPWT therapy are presented. Potential uses, practical application, and limitations of use of NPWT in avian species are discussed. [Copyright &y& Elsevier]

Abstract: Atherosclerosis is a disease that occurs in many avian species commonly presented to veterinarians. Many risk factors for atherosclerosis are well defined in mammals but not in avian species. Dietary nutrients can play a large role in reducing the severity and prevalence of atherosclerosis in both avian and mammalian species. Information on the effect of dietary nutrients on atherosclerosis in Falconiformes and other birds of prey is extremely limited as no studies were identified by the authors. Dietary cholesterol can be fed to induce the development of atherosclerosis in avian species that consume nonanimal protein. Diets containing high levels of omega-3 fatty acids reduce the prevalence and severity of atherosclerosis, with fish oil being more effective than α-linolenic acid. The presence of dietary cholesterol results in higher levels of dietary protein, increasing the prevalence and severity of atherosclerosis, but if dietary cholesterol is absent, there is a subsequent decrease in atherosclerosis. Pectin in the diet decreased the occurrence of atherosclerosis but also decreased the availability of nutrients owing to faster ingesta passage rates. Feed restriction has also been found to decrease the prevalence of atherosclerosis in birds. It should be noted that many studies have found nutrient interaction effects on the development of atherosclerosis, with some being “neutralizing” or negative, so caution should be observed when manipulating avian diets. The objective of this article is to review the effects of dietary nutrients on atherosclerosis. [Copyright &y& Elsevier]

Abstract: Atherosclerotic lesions are prevalent in companion psittacine species. Parrots account for much of the veterinary scientific information on avian atherosclerosis, but the lesions have been described in virtually all avian orders. This review presents a synthesis of the epidemiologic, clinical, diagnostic, and therapeutic information known in psittaciformes, at this time, which may help in the veterinary management of atherosclerotic diseases. The article further expands on nondomestic avian species for which information is restricted to pathologic and prevalence studies. A thorough knowledge of atherosclerosis is of the upmost importance for avian clinicians as the disease is common, affects most species of birds, and seems to be associated with captive lifestyles characterized by decreased activity and nonnative diets. Therefore, avian veterinarians are expected to be largely exposed to this chronic medical condition through patient presentation and should be prepared to properly manage this disease. [Copyright &y& Elsevier]

Abstract: Computed tomography (CT) is an increasingly available and valuable imaging modality for the diagnosis of companion avian pets. Previously, CT studies of birds required general anesthesia with inhalant anesthetics. Owing to the risks associated with general anesthesia, the authors of this article investigated the effect of sedation on birds during a CT examination. In this study, 10 psittacine birds were imaged using a 40-slice helical CT scanner. Birds were sedated with midazolam and butorphanol and placed in a positioning device. Following the initial study, birds were removed from the device and placed under general anesthesia with isoflurane. A second study was then performed. Two radiologists, blinded to the identity of the birds and partially blinded to the conditions of the study, reviewed the images. Studies were evaluated using a questionnaire consisting of 18 questions. Each question was scored on a Likert scale. A Wilcoxon signed rank test compared scores of sedated and anesthetized birds. A significant difference (P = 0.05) between sedated and anesthetized studies was found for 2 of 18 (11.1%) questions for radiologist 1 and 1 of 18 (5.5%) questions for radiologist 2, with differences identified in the scleral ossicles and the femoral heads. Interrater agreement for all questions using a linearly weighted κ was 0.334 and 0.311 for sedated and anesthetized birds, respectively, indicating fair agreement. The interrater agreement, excluding the head and musculoskeletal system, was 0.381 for sedated animals, indicating fair agreement, and 0.404 for anesthetized birds, indicating moderate agreement. Based on our results, performing CT studies in birds with sedation is a viable alternative to studies performed under general anesthesia. [Copyright &y& Elsevier]

Abstract: A female juvenile peahen (Pavo cristatus) presented with acute respiratory distress after the owner observed the bird apparently “choking” the night before presentation. A swelling at the base of the throat was also noted by the owner approximately 2 days prior to the “choking” incident. An air sac breathing tube was placed immediately following presentation and the respiratory rate and effort returned to normal. While performing a physical examination on the patient, a string foreign body was identified and removed from the oral cavity. The string had been wrapped around the base of the tongue, initially resulting in a laceration at the base of the tongue and displacing the glottis caudally, but eventually retroflexed the tongue resulting in occlusion of the glottis. Once the string was transected, the tongue was replaced into normal anatomic position. Three days after presentation, the bird was able to breathe normally with the air sac tube occluded, thus the air sac tube was removed. The lesions under the tongue completely resolved 8 weeks following the initial presentation. Although there have been reports of string foreign bodies in avian species, there are no reports of these foreign bodies causing entrapment of the tongue with subsequent obstruction of the glottis. [Copyright &y& Elsevier]

Abstract: The anatomy of the avian gastrointestinal (GI) tract is unique and significantly different from that of other animals. The characteristics of the avian GI tract allow the different species to adapt and thrive in their habitats. Infectious diseases of bacterial, viral, fungal, and parasitic origin commonly affect avian species. The significance and the nature of these pathologies vary with species and if they live in the wild or a captive environment. This review compiles information available in the literature on specific infectious processes that were considered relevant and clinically significant by the authors. Clinicians should be knowledgeable and aware of the infectious agents, clinical signs associated with disease, diagnostic techniques, and treatment methodologies currently available regarding diseases that affect the avian GI tract. Recent information that provides new insight to these infectious processes is the focus of this article. [Copyright &y& Elsevier]

Abstract: Veterinarians face many challenges when an avian patient is hospitalized for a prolonged period of time. Debilitated birds are often anorexic, which can quickly lead to severe weight loss and further deterioration of their clinical condition. For these patients, tube feeding becomes an essential part of a complete treatment plan. However, prolonged handling can amplify stress in these birds and a rapid delivery of nutrients is required as part of a treatment plan. To maximize the success of this treatment, a thorough knowledge of general avian restraint and the tube feeding process is necessary for the medical team responsible for treating the patient. [Copyright &y& Elsevier]

Abstract: Avian reproductive disorders are commonly diagnosed in pet birds, backyard flocks, and commercial aviaries. Birds that are diagnosed with reproductive disorders can present with a variety of clinical signs that range from benign disorders to life-threatening emergencies. In many cases there are underlying husbandry and management issues that need to be addressed. This article will address the presenting signs of common reproductive disorders in avian species and the best approaches to determine appropriate diagnostic and treatment plans. [Copyright &y& Elsevier]

Abstract: Surgical intervention and painful conditions often apply to avian patients that are presented to veterinary hospitals. Therefore, anesthesia and analgesia are an important part of the daily routine associated with avian veterinary practice. These procedures differ from mammal medicine primarily because of different physiologic composition and different anatomical structures, which are described when relevant to anesthetic management. This article describes the most common anesthetic and analgesic procedures for birds and provides recommendations for veterinarians who treat these species. Moreover, there are detailed descriptions of preanesthetic and postanesthetic patient care and how to monitor anesthetized birds. Advantages and disadvantages of the different anesthetic techniques and analgesic protocols are also reviewed. If one treats birds in a veterinary hospital, it is important to have inhalation anesthesia equipment readily available so that it can be used when needed. [Copyright &y& Elsevier]

Abstract: Standards of care in avian medicine are a source of discussion and review any time 2 or more veterinarians who treat birds congregate. In selecting the topics that veterinarians need to know regarding avian medicine, it was important to cover those issues that some veterinarians may perform on a daily basis and to include others that may seem less common but still represent critical information. Avian patients may enter the hospital for routine care and evaluation, for evaluation of disease and follow-up care, or for emergency care. Birds from each group listed above undergo certain evaluations, diagnostic testing, and treatment. This article discusses procedures and treatments associated with avian veterinary medical care along with a review of some commonly diagnosed disease processes, toxicoses, and fracture stabilization techniques. [Copyright &y& Elsevier]

Abstract: Obtaining tissue samples for histopathologic examination is an important part of avian medicine. Harvesting biopsy samples from the crop, although a relatively simple procedure, can be a useful diagnostic tool (e.g., diagnosing proventricular dilation disease). As with all surgical patients, the bird must be properly assessed before the procedure, thereby determining its ability to withstand the stresses associated with general anesthesia, collection of the biopsy samples, and recovery. Careful tissue handling and proper instrumentation are essential for optimum pathological evaluation of the samples. Generally, 2 to 3 tissue samples of the affected area of the crop are submitted for diagnostic purposes. When testing for proventricular dilation disease, at least 1 blood vessel should be included within the tissue specimen. Rarely are there complications noted when obtaining crop biopsy samples if the proper surgical protocol is followed. [Copyright &y& Elsevier]

Abstract: Anatomic differences necessitate the modification of venipuncture techniques between avian species and selection of appropriate blood collection sites. Moreover, a venipuncture site in an individual patient should only be selected after considering a number of important clinical and anatomic factors. The volume of blood required for collection dictates whether a relatively small or large blood vessel is sampled. The patient''s physical status, ranging from healthy to critical, influences how the patient is restrained for blood collection, and thereby determines which vein is selected. History of recent venipuncture in a particular vessel may preclude the clinician from sampling that same vessel again. Risk of hematoma formation should be considered by the phlebotomist because there is variation of this iatrogenic trauma between blood collection sites. Coagulopathies may be associated with certain diseases, including liver failure and aflatoxicosis, and may influence the location of blood collection from an avian patient. Furthermore, for veterinarians who perform phlebotomies in an examination room with the bird''s owner present, the client''s perception and acceptance of the venipuncture site must be considered. Finally, the clinician''s experience also plays a role in the site selected. Several common and uncommon blood collection sites are described. [Copyright &y& Elsevier]

Abstract: Evidence-based veterinary medicine is a process used to guide clinical decision making, thereby allowing veterinarians to find, appraise, and integrate current best evidence with individual clinical expertise, client wishes, and patient needs. Although the concept of using research evidence to guide clinical decisions is not new, a structured approach to integrating these aspects of veterinary practice opens the door to allow the overwhelming amount of available published evidence to flow into the veterinary examination room. The goal of this article is to demystify evidence-based veterinary medicine and explain how the techniques are used in exotic animal practice. [Copyright &y& Elsevier]

Abstract: Computed tomography images generate multiple views of a target site of a patient, resulting in 2-dimensional scans of the area. This form of imaging provides visualization of internal anatomy without interference of adjacent and overlying structures, contributing to our knowledge of normal anatomy and allowing us to more accurately assess changes in clinically ill patients. Computed tomography has proven to be beneficial in establishing diagnoses, prognoses, and treatment plans in numerous zoological species when used in conjunction with other imaging modalities, and with the involvement of a dedicated radiologist. Additional studies are needed to establish protocols for image collection and criteria for evaluating the images. [Copyright &y& Elsevier]

Abstract: Enucleation is often the final option when considering ocular treatment for an exotic pet patient. There are many considerations when performing the surgical procedure to remove the eye. It is incumbent on the surgeon to be familiar with the anatomy of the individual species’ globe and orbit to reduce hemorrhage, optic nerve trauma, and postsurgical complications. This review of enucleation procedures will focus on ocular anatomical differences and techniques that should be used to maximize surgical success. [Copyright &y& Elsevier]

Abstract: More so than any other terrestrial vertebrate, birds rely most heavily on their ability to assess their visual environment. High visual acuity is not only necessary to find and acquire food, but also to navigate surroundings, to identify conspecifics and potential mates, and to quickly identify and escape from predators. This article aims to help the reader understand how birds, particularly birds of prey, see by reviewing pertinent anatomy and physiology of the eye, color vision, visual fields, visual acuity, accommodation, and flicker-fusion frequency. For more information on specific disease conditions of the avian eye, the reader is encouraged to review any number of avian medical and surgical texts. [Copyright &y& Elsevier]

Abstract: The effective use of psychoactive medications in avian patients is limited by the lack of controlled studies. Appropriate dosages, predictable therapeutic effects, pharmacokinetic data, and information about toxicity are often lacking. A variety of psychoactive agents have been used in avian patients to treat disorders such as feather chewing or picking, self-mutilation of soft tissue, and anxiety, but larger clinical trials and placebo-controlled trials are needed to determine efficacy and safety of these agents. The decision to use psychoactive medication in an avian patient and the choice of medication should be based on existing data for the particular species and an understanding of the drug’s mechanisms and indications. For any behavioral disorder, the need for pharmaceutical intervention requires the following: a thorough physical examination and baseline pretreatment laboratory testing, as indicated by physical examination findings and symptoms; an established diagnosis based on complete behavioral and medical histories; a signed owner consent statement; a behavior modification plan with appropriate environmental modifications; knowledge of the drug, side effects, indications, and mechanisms of action; and realistic expectations about treatment outcomes. Use of antipsychotic agents, serotonin reuptake inhibitors, tricyclic antidepressants, opioid antagonists, benzodiazepines, and hormonal therapies are described. [Copyright &y& Elsevier]

Abstract: Exotic pet practice is an exciting but demanding field in veterinary medicine. The decision to enter this field should be made only after careful consideration of some of the unique challenges and responsibilities of this type of practice. This article covers the considerations to be made when choosing species to see as patients, specific challenges for the exotic pet practitioner, legal and ethical issues regarding exotic species, sources of patients, development of a network for referral veterinarians, and a discussion of education for the veterinarian, staff, and clients. Also covered are suggestions for additions to the physical plant as well as recommendations for surgical, anesthetic, treatment, and examination equipment. There is an extensive list of additional recommended sources of information in the forms of texts, publications, organizations, and internet sites included at the end of the article. [Copyright &y& Elsevier]

Abstract: Psittacine birds are challenging to medicate, because they can deliver a painful bite and can learn to resist drug administration. Some drug delivery systems require restraint or sedation for placement, which may not be tolerated by critically ill birds. In this article, drug-delivery strategies will be discussed regarding psittacine species, including the benefits and risks of each method as well as practical guidance based on the experience of this and other authors. [Copyright &y& Elsevier]

Abstract: Exotic animal veterinarians have been prescribing analgesics for their patients for many years, but recently the recognition and alleviation of pain in these patients have become widely recognized as an essential component of clinical veterinary care. Misconceptions about the nature and significance of pain, difficulties in recognizing its severity, uncertainty as to the most appropriate therapies in clinical settings, and a fundamental lack of scientific data in exotic animals have hampered our understanding of pain management in these patients. To manage pain effectively in exotic animal patients, we must first be able to define and recognize pain in these animals. This article addresses some of these obstacles by discussing current knowledge concerning the recognition and management of pain in common pet exotic animal patients and by providing information regarding analgesic medications determined in other species, with the hopes of applying these fundamental understandings to our exotic animal patients. [Copyright &y& Elsevier]

Abstract: A variety of antibiotics are available for treating companion birds. Drug selection should consider pathogen susceptibility, the severity of illness, conditions at the site of infection, pharmacokinetics and pharmacodynamics of selected drugs, potential drug toxicity, and the cost of treatment. The ability of the bird owner to comply with the recommended treatment regimen and the potential impact on the bird-owner bond must also be assessed. This article will review rational selection of an antibiotic and dosage regimen for treatment of common bacterial infections in companion birds. [Copyright &y& Elsevier]

Subcutaneous emphysema is a common presentation affecting avian species. This condition occurs when tissue overlying an air sac is compromised and allows for direct communication to the subcutaneous space. Although not life-threatening in most cases, it can cause discomfort to the avian patient and affect the bird’s quality of life, immune status, and, in the case of wildlife, to prevent disease. A Teflon stent has been advocated as a means to reduce the buildup of air under the skin of chronic avian subcutaneous emphysema cases. In the case presented here, a Teflon stent was used as a temporary treatment modality until the underlying muscle layers healed. One month after placement, the stent was removed. The bird recovered with no evidence of subcutaneous emphysema and was eventually released. [Copyright &y& Elsevier]

Abstract: An oiled bird response involves 6 basic steps: recovery and transportation, processing and intake, stabilization, cleaning, prerelease conditioning, and release. Oiled birds are often emaciated and dehydrated when they are captured. These deficiencies and any problems associated with oil exposure must be addressed before birds can be washed to remove the oil from contaminated feathers. Restoring waterproofing is paramount to recovery. For this to occur, normal feather structure must be restored. [Copyright &y& Elsevier]