Trauma is a common presentation for avian patients. Cat or dog bite wounds or large birds attacking smaller birds all occur frequently. Pet birds allowed to roam or fly freely in the house can become injured flying into walls, windows, or ceiling fans, or falling off shoulders, play gyms, or the top of their cage. Birds can also be injured in their cage. A foot or band may get caught in a toy or in the bars. Other common traumatic injuries include puncture wounds, lacerations, fractures, limb amputations, and crushing injuries.
Stabilization is paramount; birds presenting with trauma are often cold and stressed and have suffered blood loss. The bird should be placed in a warm, oxygenated incubator immediately after presentation and observed from a distance for respiratory distress (tail bobbing), open-mouth breathing, active bleeding, ability to perch, use of both legs, and presence of a wing droop.
After the initial assessment, the clinician must decide whether to maintain the bird in the incubator or oxygen, perform a brief physical examination and begin immediate supportive treatments, or perform a more thorough physical examination with or without diagnostic tests. Before handling the bird, a detailed plan must be determined, and all items set up ahead of time for anticipated treatments and diagnostics.
Examination and treatments may need to be done in steps, placing the bird back in the oxygenated incubator to recover if it becomes stressed or weak at any point during handling or treatments. Emergency treatments include warm fluids (subcutaneous, intravenous, or intraosseous), analgesics, anti-inflammatories, and antimicrobials. Maintenance fluids are estimated at 50–100 mL/kg/day. In dehydrated birds, 50% of the total daily maintenance can be administered subcutaneously and repeated every 6–8 hours until hydration is reestablished. In traumatized birds with excessive blood loss, an intravenous or intraosseous catheter may be placed for fluid therapy, which may include hetastarch and or a blood transfusion. Often, birds are stressed and in pain and may benefit from sedation for diagnostic testing and treatments. In stressed birds, midazolam (0.5–1 mg/kg, IM, or 1–2 mg/kg, intranasally), with or without butorphanol (0.5–2 mg/kg, IM or intranasally) can be used.
Often with trauma cases, diagnostic tests or extensive treatments or surgery should be postponed until the bird is stable, which may take 12–48 hours. All birds with trauma should be treated with the goal of the bird's survival first and treatment of traumatized tissue second. For example, a bird that has been struggling for hours with its leg band caught, with possibly a fractured tibiotarsal bone, is in more danger of dying from stress related to the prolonged struggling than from the fracture.
Diagnostic tests should be based on physical examination findings and may include radiographs to determine whether fractures or luxations are present.
With predator bite wounds, antimicrobial therapy consisting of treatment for both anaerobic and aerobic bacteria is crucial to increase the chances of a successful case outcome.
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