Hemorrhage resulting from traumatic injury may quickly become life-threatening. Although birds can tolerate substantial blood
loss over longer periods of time and appear to be more tolerant of acute blood loss compared with other companion animals,
the loss of 20% to 25% of the total blood volume in a few moments can be fatal.7 The total blood volume in birds is generally estimated to be about 10% of their body weight. Common causes of potentially
lethal hemorrhage include lacerations, long bone fractures, contusions in the region of the pectoral muscles, and beak fractures.
Contrary to a long-held belief, broken pinfeathers or toenails in healthy birds rarely result in fatal hemorrhage. However,
broken pinfeathers or toenails in subclinically ill or malnourished birds have a greater potential for continued bleeding.
Hemorrhage from toenails and beaks may be controlled with chemical or electric cautery. Do not use chemical cautery agents
in soft tissue wounds, including pinfeathers, as these substances may cause severe tissue irritation and necrosis.
As mentioned above, birds appear to be more tolerant of acute blood loss than mammals are. After hemorrhage, baroreceptor
and catecholamine-induced arteriolar vasoconstriction appear to rapidly shift extracellular fluid to the vascular space.5 Birds also appear to rapidly mobilize large numbers of immature red blood cells and lack many autonomic responses to hemorrhage
that contribute to shock.8,9 According to one report, healthy birds seem to be able to lose as much as 30% of their blood volume (3% body weight) without
any deleterious effects.10 In one study in pigeons, blood removal of up to 9% of body weight (equal to 90% of blood volume) was performed before significant
mortality occurred.11 In another study, pigeons that lost 70% of blood volume had a normal packed cell volume within six days.12
One study indicates that transfusions may be of limited benefit in treating birds with acute blood loss. Raptors transfused
with heterologous pigeon red blood cells had a red blood cell survival time of only 12 hours, and homologous transfusions
of pigeon red blood cells into other pigeons had a survival time of only 7.1 days.13 In this study, pigeons losing 70% of their blood volume recovered from anemia after receiving fluid replacement with lactated
Ringer's solution as quickly as or more rapidly than did birds receiving heterologous or homologous blood transfusions. This
study suggests that, if needed, a homologous transfusion from the same species of bird would be most appropriate. Volume replacement
with colloid or crystalloid solutions appears to be sufficient in treating many cases of acute blood loss. Using products
such as polymerized bovine hemoglobin solution (Oxyglobin—Biopure) may also be helpful in avian patients with severe and acute
Lacerations may usually be sutured closed if the patient is presented within six to 12 hours after injury. Older wounds may
require more cleaning and débridement before closure. Most lacerations should be repaired while the patient is anesthetized.
Pluck, clean, and débride the area, and prepare the smallest surgical site possible to minimize heat loss. Most of the common
products used for wound care in domestic mammals can be used in birds. Popular products include chlorhexidine or dilute povidone-iodine.
Carefully maintain thermal support while cleaning and repairing lacerations, as hypothermia is easy to induce in an anesthetized
and wet patient. Use taper needles and small suture materials (3-0 to 6-0). Polydioxanone (PDS) is commonly used for wound
closure, as a recent study has demonstrated that it provides strong closure with the least amount of tissue reaction.15 I and many other clinicians use polyglactin 910 (Vicryl) for skin sutures. In my experience, antibacterial treatment of
lacerations in many avian species seems to be required less often than in dogs or cats with similar lacerations.