Surgical preparation, post-operative care important considerations for avian patients - DVM
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Surgical preparation, post-operative care important considerations for avian patients


DVM360 MAGAZINE


Diode lasers (Sharplan 810 and 980, ESC/Sharplan) produces a beam of light energy in the 635nm to 980nm wavelength range. The main advantage of using Diode lasers over CO2 lasers is that they can be used through an endoscope. Additional uses of diode lasers include chromophore enhanced tissue ablation or coagulation, laser welding (tissue fusion) and photodynamic therapy. The diode laser has deeper penetration than the CO2 laser and is less precise for delicate procedures such as debriding a cornea and ablating an adrenal gland.

Lasers are to be used only after operators have received proper training to avoid injury.

Magnification Magnification, although not absolutely necessary in all procedures, is highly recommended due to the small size of most exotic patients. Magnification may be provided by surgical scopes or loupes/telescopes such as those produced by Surgitel (General Scientific Corp., Ann Arbor, MI, http://www.surgitel.com/). Binocular magnification loupes or telescopes of 1.5X to 3.5X provide excellent magnification for most procedures. Surgical scopes should have a lens objective of approximately 150mm with a 12.5mm ocular lens.

One of the least expensive options for surgical magnification are hobby loupes that can be obtained from hobby stores or other specialty shops. No matter what type of magnification system is used the surgeon should strongly consider the ergonomics of the chosen system. The ergonomically correct system will allow the surgeon to perform the procedure with the head in an erect position. It is also recommended that the magnification system have a focal range rather than a set focal distance. This will allow the surgeon a large depth of field as well as a large view of the patient.

Patient monitoring There are numerous methods of monitoring the patient in addition to the use of a stethoscope while it is under anesthesia and undergoing a surgical procedure.

Electrocardiography (ECG) is commonly used for most procedures and affords the anesthetist a reliable indication of the patient's pulse rate as well as clues toward impending changes in the patient's cardiovascular system. The ECG should be capable of recording speeds of 100 mm/s and amplify the signal to at least 1mV equal to 1 cm. Standard lead positions described for dogs and cat are used for birds; however, many small avian patients are difficult to monitor with an ECG due to their rapid heart rates or the small electrical potential produced.

Ultrasonic Doppler detects pulsatile blood flow and are based on the principle that the frequency of transmitted sound waves are altered when reflected off moving red blood cells. Dopplers are considered to be very accurate as long as they are placed in close proximity to an artery or the heart. Unfortunately, they do not give information regarding changes in the patient's physiological status. I personally use Doppler flow detection for all avian patients. One of the best sites to use for placement of the Doppler probe is over the superficial ulnar artery or the deep radial artery just inside the elbow.

Pulse oximetry involves the use of a noninvasive technique to measure pulse and oxygenation during anesthesia and surgery. Pulse oximeters estimate arterial hemoglobin O2 saturation (SaO2 or SpO2) by measuring pulsatile signals across (transmission) or by reflectance (reflection) from perfused tissue at two discrete wavelengths (660 nm, red; 940nm infrared) using the constant component of absorption at each wavelength to normalize the signals. Pulse oximetry should be used to evaluate trends in oxygenation as values may be unsatisfactory for routine use in some exotic patients; in particular avian species.

Post-operative considerations The immediate postoperative period is another critical time to pay special attention to avian patients recovering from anesthesia and surgery. Patients should be placed in a quiet (away from dogs, cats, high traffic), visually secure, warm recovery cage or incubator as they awaken from anesthesia. During this period, fluid balance should be addressed as well as postoperative pain. Signs of pain may include abnormal body positions, tucked abdomen/coelomic cavity, aggression (biting, attacking), vocalization, reluctance to move or stand, pronounced fear, self mutilation and inability to perform "normal" everyday activities. Unfortunately, few studies have been performed in exotic species; however, many of the same analgesics used in dogs and cats can all be used in exotic species.

Dr. Jones is associate professor of avian and zoological medicine at the University of Tennessee’s College of Veterinary Medicine. He is a diplomate of the American Board of Veterinary Practitioners—Avian Specialty. Dr. Jones’ clinical interests include raptor medicine, orthopedic and soft tissue surgery, avian nutrition and avian infectious diseases. He is also a master falconer with 15 years experience.


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Source: DVM360 MAGAZINE,
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