Figure 3A. & 3B. The excessively short clipped wings of this young Umbrella cockatoo (3A) were likely responsible for its uncontrolled fall, which resulted in the split skin of the ventral tail base (3B). Unfortunately, these types of wing-clip-associated injuries are common. The wound was surgically repaired, but the follow-up was key in the ultimate resolution and prevention of the problem. The bird was trained to perch only on the hand, where a fall was easiest to prevent, and owners were made aware of the risks associated with excessive wing clipping. The bird began its juvenile molt at about 10 months of age and ultimately replaced all of those feathers successfully.

EMERGENCY CARE PRINCIPLES

As in any emergency, the ABCs—airway, breathing, and circulation—must be addressed in pet birds before you initiate diagnostic testing and further treatment. Samples for pretreatment laboratory tests may be collected in many cases, but in most emergency situations, stabilization is the primary goal. Although radiography may be helpful in some cases, in inexperienced hands, an effort to obtain a detailed radiographic diagnosis can sometimes be as life-threatening as the patient's medical condition. Take time to learn proper avian handling and restraint techniques before you're faced with an emergency. Avoid causing excessive fear, pain, or discomfort and be efficient with your technique. Frequently, a towel is used to help restrain companion birds, but this is not mandatory. Avoid, if possible, pouncing on your patient, similar to the way a predator may attack, and try to be respectful of the patient's instinctual predator or prey behavioral differences.

Quickly assess the adequacy and pattern of respiration, and auscultate the chest and air sacs. If a bird is not breathing adequately, place an endotracheal tube. The glottis of birds, located at the base of the tongue, is not covered by an epiglottis. This anatomical feature makes endotracheal intubation much easier than in mammalian patients of similar size. Hold the beak open and pull the tongue rostrally to easily see the glottis. Most of the common pet bird species have complete tracheal rings, so be careful when inflating the cuff of an endotracheal tube or use an uncuffed endotracheal tube.

To bypass the trachea in patients with a tracheal obstruction, cannulate the abdominal or caudal thoracic air sacs. Place the bird in right (preferred) or left lateral recumbency, incise the skin caudal to the last rib, and use a curved or right-angled hemostat to penetrate the body wall. Choose a tube that is nearly equal to the size of the trachea, and place the tube through the hemostat jaws and into the caudal thoracic or abdominal air sac. Cut the tube to a comfortable length for the bird, and then tape and suture it into place just as you would suture a tomcat catheter. Ventilate intubated birds with slow, deep respirations (10 to 20 breaths/min for birds weighing less than 100 g [3.5 oz]). ²

Breathing

If airway patency is adequate, observe the rate, depth, and quality of respiration. Rapid, shallow respirations may be due to pain from rib trauma. Birds with head trauma may have slow, shallow respirations. Hypoventilation commonly occurs with hypovolemic shock and acid-base disturbances. A tail bob is commonly observed when there is a marked abdominal component to expiration, often seen with pulmonary disease or obstructive tracheal disease. If the patient is conscious and breathing, oxygen may be delivered through a face mask or by placing the bird in an oxygen-rich environment.