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AVIAN ANESTHESIA &
SURGERY
Kim HealyVETS 247 – Exotic Animal Medicine and NursingDr. MeckelSpring 2008
Anesthetic Procedures Surgical sexing
– Not as commonly done now
– DNA testing Abscess/Wound
repair Repair bone
fractures Foreign body
removal Growth removals
Anesthetic Procedures
Radiography Endoscopy Repair beak
abnormalities– Scissor beak
Reproductive problems– Egg-bound
Many more
Preanesthetic Period
Complete History Physical Exam Diagnostics
– CBC/Chem– +/- Radiographs or Ultrasound
Stabilization for critical patients Fasting: 0-2 hours prior to
procedure
Premedication Rarely used
– Stress from handling– Unpredictability of injectable drugs
Anticholinergics (Atropine,
Glycopyrrolate)– If history of bradycradia
Opioids (Butorphanol)– Reversible
Induction
Inhalants – preferred method Isoflurane or Sevoflurane
– Iso: less cardiac s/e
Benefits– Rapid induction and recovery– Rapid adjustments to anesthetic depths– Low organ toxicity
Induction Injectables
– Unpredictable effects– Side effects– Extended recovery times
Ketamine +/- Benzodiazepines– Long & stormy recovery
Propofol– Respiratory depression– Stormy recovery
Induction
Mask
Commercially made Home made
– Plastic bottles or syringe cases
Smaller patients– Whole head inside
mask
Intubation
Can use mask for very short procedures
Intubation provides:– Manual ventilation– Prevents aspiration
Non-rebreathing system– Less than 7kg
Intubation
Concentric (complete) tracheal rings– Less flexible
Don’t inflate cuff of endotracheal tube Or, use uncuffed tubes
– Cole
Inflated cuff can cause pressure necrosis of trachea and sloughing of mucosa
Intubation
Intubation
Air sac cannula– Head/beak procedures– Clearing tracheal
obstruction Caudal thoracic air sac
– Through lateral body wall
– Typically left side – larger air sac
Can be left in for several days– E-collar
Air Sac Cannulation
Local Anesthesia
Example – Lidocaine Not recommended
– Necessary dose higher than toxic dose, especially in smaller birds
– Restraint of an awake bird is difficult
Surgical Prep
Avoid heat loss!– High surface area to volume ratio = lose heat
quickly Pluck only necessary feathers
– Pluck in opposite direction Chlorexidine or Betadine scrub Saline
– Alcohol will cause heat loss Transparent sterile drape
– Retains heat– Easier to monitor patient
Transparent Drape
Monitoring
Manual Auscult heart rate
– Stethoscope, esophageal stethoscope Observe breathing
– Can be difficult to visualize– Lungs rigid, no diaphragm– Muscular movement of ribs/sternum
• Relaxed when anesthetized
Shivering = too light
Monitoring
ECG – Heart activity– Larger birds– Smaller birds
• Machine that can register rapid heart rate Doppler – Blood pressure
– Medial metatarsal artery– Radial artery
Pulse Oximeter – Oxygen saturation– Femur, foot, toe, radius– Can be difficult to get a reading
Cloacal or esophageal thermometer
Monitoring Blood Pressure
Catheterization
Replace fluids lost Maintain blood pressure Blood Transfusion IV Dextrose
Not often done– Difficult to monitor blood pressure– Avoid overhydration
Catheterization
Intravenous (IV)– Fragile veins: long-term is difficult– Jugular, basilic, medial metatarsal veins
Intraosseous (IO)– Bone– Distal ulna
Intraosseous Catheter
Anesthetized Patient
a/b- et tube c- IVC d- IVF e- pulse ox
Thermal Support
High surface area to volume ratio = lose heat quickly
Heated surgery table Water circulating blanket Forced air blankets (Bair hugger) NO Heat lamps/heating pads
– NOT RECOMMENDED! – thermal burns even on low setting
Heat Support
IPPV
Intermittent Partial Pressure Ventilation– “Bagging”– Mechanical Ventilator
Inflates and circulates air through air sacs
1-4 times per minute Do not exceed 15mm H2O
– Overinflation, rupture of air sacs
IPPV - Bagging
Recovery Incubator
– Stabilize temperature– Oxygen support
Wrapped in towel Remove endotracheal tube
– Chewing/swallowing, head shaking, flapping wings
Feed small amount of food or few drops 50% dextrose– hypoglycemia
Incubator
Instruments & Equipment
Small specialized surgical instruments
Ophthalmology instruments– Delicate and precise
Laser– Cauterizes for
hemostasis– Shorter
surgical/anesthesia times
Endoscope
Equipment
Optical Magnification– Binocular head sets– microscope
Suture
Fine suture for thin skin
4-0 to 8-0 Tapered needle Tissue glue
Suture
Sources Cited
Ballard, B., & Cheek, R. (2003). Exotic Animal Medicine for the Veterinary Technician. Iowa: Blackwell Publishing.
Tully, Jr., T.N., & Mitchell, MA. (2001). A Technician’s Guide to Exotic Animal Care. Colorado: AAHA Press.
Nielsen, L. (1999). Chemical Immobilization of Wild and Exotic Animals. Iowa: Iowa State University Press.
Tseng, F.S., & Kaufman, G. Avian Anesthesia and Surgery. Retrieved March 15, 2008, from Tufts University Open Courseware. Web site: http://ocw.tufts.edu/Content /5/ lecturenotes/215768
Gunkel, C., & Lafortune, M. (2005). Current Techniques in Avian Anesthesia. Seminars in Avian and Exotic Pet Medicine, 14,4, 263-276. Retrieved March 15, 2008, from Science Direct Database.
Avian Surgery: To Cut is to Cure. (2006). Exotic Pet Veterinarian. Retrieved March 15, 2008, from http://www.exoticpetvet.net/avian/surgery.html
Exotic Animal Anesthesia, Perioperative Support, and Surgical Instrumentation. Michigan Veterinary Medical Association. Retrieved March 15, 2008, from http://www.michvma.org/
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