Dr Luke Gregory explains the initial steps to assess the health of small to medium wildlife species when they are brought into the clinic.

Perhaps the most important step, and the one that gives us the most information, is to check what they can do while conscious.

Some of the things to watch for while the animal is conscious include:

Birds:

• Can they fly, if so how well?

• Can they fly up or just horizontally?

• Can they perch?

• Are there any signs of lameness?

• Are the wings droopy?

• Are they vocal?

• Are the eyes normal?

• Are the pupillary light reflexes normal and pupil size even?

Mammals:

• Can they move well?

• Is any lameness noted?

• Is the tail functional?

• Are the eyes normal?

• Can they see where they are going?

• Is any fur missing?

• Are there any wounds visible?

• Are the droppings normal?

Most of the time these observations can be done safely in a small room, away from other animals, with locked doors, closed windows and blinds shut.

Once that is done and if the animal is stable, a general anaesthetic can be performed so that a more detailed examination can take place.

Auscultating the lungs and heart, palpating the abdomen/coelom for any abnormalities, limbs for any swellings or asymmetries, a more detailed exam of the eyes, ears and inside the mouth, are all examples of things to look for when the patient is anaesthetised.

From there, imaging and laboratory diagnostics can be done to finish the assessment. This whole process should take no more than 15-20 minutes for uncomplicated cases.

Dr. Alex Kreiss describes the basic principles of avian anaesthesia.

Birds have a higher anaesthetic risk than mammals, as they lack a diaphragm. Additionally, birds have complete tracheal rings, so intubation must be done with uncuffed endotracheal (ET) tubes.

***All birds should be assessed prior to the anaesthesia consciously; birds that are unresponsive or in respiratory distress should be provided with emergency care before anaesthesia. Avoid making birds fly excessively prior to anaesthesia, as this can lead to a higher risk of failure during the anaesthetic process***

Once the bird is contained, a mask of appropriate size is placed over the beak/bill, with high flow of oxygen and 5% isoflurane. In a few minutes, once the bird is induced, an endotracheal tube can be placed in the trachea and the person monitoring the anaesthesia can begin performing intermittent positive pressure ventilation (IPPV) to the bird. This is not always necessary, but as a precaution it can be performed at four breaths per minute.

Take note of breathing and heart rate using a stethoscope at a minimum of every five minutes, or more frequently if necessary. A doppler or an oesophageal stethoscope can be adapted to monitor the heart rate more easily.

Provide warmth throughout the procedure, as birds can lose heat very quickly.

Upon recovery, provide oxygen and warmth until fully conscious.

In this video, Dr. Ruth Pye describes the correct positioning for avian radiographs. All birds should be anaesthetised to have X-rays taken appropriately. A minimum of two views, ventro-dorsal (VD) and latero-lateral (LL), should be taken all times. Additional positions might be needed, according to the case.

The main points of interest when taking X-rays of birds are:

• For the VD view, make sure the wings and legs are symmetrical and the keel aligns with the spine

• For the LL view, the limb closest to the plate should go forward

• Two LL views (left and right) should be taken in cases of fractured limbs

• Don’t X-ray only the limb with an obvious fracture, X-ray the whole animal, as other injuries might be present

Some common injuries that birds sustain, such as coracoid fractures, are diagnosed only with proper positioning of the animal, hence the importance of taking the time to produce good X-rays.

Dr Alex Kreiss demonstrates blood collection in avian species.

The three main vessels where a reliable blood sample can be collected are:

• Jugular vein – for larger volumes, eg., for biochemistry studies

• Medial tarsal vein – smaller volumes, eg., for PCV, TP, Glucose

• Ulnar vein – smaller volumes

Apply pressure to the site after blood collection, to avoid haematoma formation.

For seabirds with downy feather coverage, avoid plucking feathers for venous access as this can impair waterproofing.

For raptors, avoid the jugular vein if possible due to the risk of underlying rodenticide toxicity.

Dr. Alex Kreiss demonstrates how to take a swab sample from a bird’s crop.

Crop swabbing is an important diagnostic tool in the health assessment of avian patients. The crop can harbour pathogens, such as trichomonas and candida. These will create health issues for the bird if left untreated.

After the swab is taken, it can be immediately looked at under low power objective, as a wet preparation (use isotonic sodium chloride to wet the preparation). Trichomonas organisms are easily seen, as they move in a circular motion.

A stained slide can be prepared at the same time, for other organism identification (e.g., candida).

Crop swabbing is a simple procedure, which can be done with the patient restrained or anaesthetised.

Dr. Luke Gregory demonstrates the proper methods of housing and handling echidnas for medical examination.

When transporting an echidna, it is best to use a sturdy storage container with at least four snap locks, as echidnas have a tendency to try to escape by wedging themselves between the lid and the box.

*The box should be kept on the floor, as echidnas may move the box back and forth and could fall from a high surface.*

Make sure that the box has holes for ventilation and towels inside for bedding.

When picking up an echidna, keep your hands flat and slide them underneath the abdomen between the front and back legs, avoiding the spines.

When anaesthetising an echidna, it is most easily done with two people. One person should hold them upright with the legs abducted, while the other threads the mask onto the beak.

*Be aware that this can be very stressful for echidnas and they may urinate or defecate, which can be very projectile in this position.*

An anesthetic mask can be made for an echidna’s beak from a 60ml syringe.

When taking an X-ray of an echidna, there are four main views that are important to take:

• Full body dorsal-ventral view

• Full body lateral view

• Focused view of skull and beak (dorsal-ventral)

• Focused view of skull and beak (lateral)

For full body lateral X-rays, a foam wedge can be used to keep the legs separated and the body aligned.

For lateral X-rays of the skull and beak, a cotton tip can be used to keep the beak separated and easier to examine on the image.