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Initial therapy may be given simultaneously
with carrying out the initial examination (see section above: Initial
Examination), for example mucous membranes may be
cleaned of oil, allowing assessment of their colour (perfusion status) and
consistency of mucus, as well as any injuries, and treatment of
life-threatening conditions should begin before the examination is
completed.
BIRDS
Removal of excess oil:
- Excess oil should be removed from the eyes, nostrils (nares), mouth and vent if
this has not been carried out in the field. (B188,
D60.7.w7,
D133.3.w3,
P14.5.w6, D32.3.w3,
D135.5.w5,
D139,
D159.III.w3,
D160.5.w5,
P24.327.w4,
P24.335.w12)
- Clean gauze swabs and cotton buds are suitable for this purpose.
(P24.327.w4,
P24.335.w12)
- Eyes should be flushed with warm ophthalmic irrigation fluid
such as 0.9% sterile saline. (P14.5.w6,
P24.327.w4,
P24.335.w12,
B23.38.w2,
D32.3.w3,
D135.5.w5,
D160.5.w5)
- Water based antibiotic/anti-inflammatory drops should be
applied if the eyes are inflamed. (P24.327.w4,
P24.335.w12)
- Excess oil should be wiped from the body, wings and legs. (D135.9.w9)
- Excess oil may be wiped from feathers using an absorbent cloth such
as a clean towel, or absorbent paper, applied in the direction of feather
growth. On the head a cotton ball may be used. (B188,
P24.327.w4,
D32.3.w3,
D135.5.w5,
D139, P24.335.w12)
- Oil, droppings, or any other foreign material should
be removed from around the vent. (B23.38.w2,
D32.3.w3,
D135.5.w5)
Activated Charcoal/Enteric coating agent:
In order to reduce damage caused to the gastro-intestinal tract by oil, and
absorption of toxic oil from the gastro-intestinal tract, admission
protocols often include administration of activated charcoal and/or an
enteric coating agent, to block toxin absorption and/or adsorb toxins so
they pass through the gastro-intestinal tract. (D159.III.w3)
Suggested treatments include:
- Activated charcoal:
- Administer by gavage 50 mL per kg body weight of a mixture of
activated charcoal (75 mg/mL) in isotonic fluids. (D133.4.w4,
J29.8.w1)
- This gives 3.75 g activated charcoal per kilogram bodyweight. (J29.8.w1)
- To make the activated charcoal slurry of 75 mg/mL, three bottles
of Toxiban (Vat-A-Mix, Lloyd Inc., Shenandoah, Iowa, USA) are mixed with 250 mL of electrolyte solution. (J29.8.w1)
- This should be warmed (in a container of warm water) before
being administered. (D133.4.w4)
- If a bird regurgitates when first gavaged, check the fluid
mixture is at the right temperature and gavage again, slower and
using a smaller volume (D133.4.w4)
- For a full description of gavage in birds see: Gavage - Tubing of Birds (Techniques)
- Activated charcoal at 52 mg/kg after the first dose
of fluids. (P24.327.w4,
B23.38.w2, P4.1990.w1)
- In the UK, BCK granules (Fort Dodge Animal Health,
containing bismuth subnitrate 3.92%, light kaolin 42.16%, activated
charcoal 40.2%, calcium phosphate BP 4.9%, acacia 4.9% and sucrose
3.92% (B266))
may be used, at about 36 g granules per litre of rehydration fluid. (P14.5.w6);
1 teaspoon of BCK granules per 100 mL rehydration fluid. (D60.7.w7)
- OR enteric coating agents:
- Enteric coating agents, e.g. bismuth subsalicylate
(Pepto-Bismol®) may be given at 2.0 to 5.0 mL/kg, after
the first
dose of oral fluids, to reduce mucosal irritation and toxin absorption. (B23.38.w2,
P24.327.w4,
D32.3.w3,
D135.5.w5)
- CAUTION: Any bird
which is unable to hold its head up (maintain head carriage) or which
may not be able to swallow should NOT be given oral fluids. (B23.38.w2)
Correction of body temperature:
Birds which have been oiled have lost their main insulation and are likely
to become hypothermic. Hyperthermia may occur in some circumstances, such
as oiled birds left in boxes in direct sunlight.
- Birds should initially be housed at 80-85°F (27-29°C). (D135.5.w5)
- NOTE:
- Gradual changes in body temperature may be less
stressful than rapid changes. (B23.38.w2)
- Careful monitoring is required while correcting body
temperature. (D135.5.w5,
J29.8.w1)
- The cloacal temperature should be monitored closely while warming or
cooling a bird. (D133.4.w4)
To correct hypothermia:
- Supplementary warmth may be required for any bird with a body
temperature below 100°F (38°C). (D135.5.w5)
below 101°F (D159.III.w3)
- Birds may be warmed rapidly using
heat sources such as latex gloves filled with warm water, hot water
bottles, heat lamps, warm air pet driers or incubators. (D133.4.w4,
J29.8.w1)
See also: Chilling - Hypothermia
- General Nursing & Surgical
- Heat lamps are recommended, positioned to provide a temperature gradient, so that
birds can move away from the heat to avoid overheating.
(P24.327.w4,
P24.335.w12,
B23.38.w2, D135.5.w5)
- Heat lamps should be positioned to be effective, but also with
due consideration for safety of both birds and handlers. They
should always be mounted securely and placed safely away from all
flammable materials. (D135.7.w7)
-
Heat pads and hot water bottles are alternative heat sources. (P24.327.w4)
Placed under part of the cage these may be very useful for smaller
birds. (B23.38.w2)
-
Hot water bottles at 105-115°F (41-46°C), wrapped in light towels,
may be placed between the wings and the body of hypothermic recumbent
birds. Such bottles need to be changed frequently. (D135.5.w5)
-
In the absence of another heat source, placing the oiled bird in its
box near a radiator may be sufficient. (D139)
- Fluids (see Dehydration, below) should be given warm
(at or near body temperature) which will aid in increasing core body temperature. (P24.327.w4,
P24.335.w12)
- Glucose in administered fluids will provide an energy
source for the increased metabolic rate as the bird warms up. (P24.327.w4,
P24.335.w12)
- N.B. careful monitoring of the bird's body temperature is
important during warming. (J29.8.w1)
- Signs of overheating such as panting or open-mouth breathing
should be watched for while birds are being warmed. (D135.5.w5)
- Birds should also be monitored for their ability to move
relative to the heat source. (D135.5.w5)
- Slow warming is less stressful than very rapid warming. (P24.335.w12)
- N.B. it is essential that adequate ventilation is provided
during warming, as volatile oil components will start to evaporate as
the bird (and the oil) warms up. (P24.335.w12)
To prevent hyperthermia in dry birds, regular monitoring is
important. Open mouth breathing suggests overheating or stress. (D133.4.w4)
To correct hyperthermia:
- Hyperthermic birds should be placed in a well-ventilated area. (D135.5.w5)
- Birds with a core body temperature above 106°F require cooling. (D159.III.w3)
- If a bird becomes hyperthermic while being handled, a period of
time left quietly in a box may be sufficient. (D133.4.w4)
- For faster cooling the bird may be misted with water,
alcohol pads may be applied to the feet or the bird may be immersed in
cool water. (D133.4.w4,
J29.8.w1)
-
See also: Sunstroke - Heatstroke
- N.B. careful monitoring of the bird's body temperature is
important during cooling. (J29.8.w1)
Respiratory distress or wheezing:
- Check for any mechanical obstruction and remove this if possible. (D133.4.w4)
- NOTE: extra care is required when looking down the bill
of aggressive birds such as herons, gannets and divers (loons). (D133.4.w4)
- Place in an oxygen cage if available prior to further examination. (D133.4.w4,
J29.8.w1)
- Full veterinary evaluation will be required if the cause has not
been identified and treated. (D133.4.w4)
- Birds with dyspnoea, tachypnoea, abnormal lung sounds and signs of
liquid infiltration or bullae on radiography (i.e. with inhalation
pneumonia or emphysema) should be housed in oxygen cages if possible
and given good general supportive care including prophylactic
antibiotics and antifungal medication. (J29.8.w1)
Dehydration - Fluid Therapy:
If possible, fluid therapy should be given based on the calculated
deficit for each bird. In large oiling events a herd health approach may
be required, with all incoming birds assumed to be 8% to 10% dehydrated
and treated accordingly. (J29.8.w1)
Fluid therapy should be given as necessary to treat dehydration;
oiled
birds may be considered to be 10% dehydrated unless clinical signs indicate
otherwise (B23.38.w2,
P24.327.w4,
P24.335.w12).
Aim
to replace this 10% over 72 hours, plus 5% body weight maintenance, plus losses due to
e.g. diarrhoea. (B23.38.w2)
- For mild dehydration (less than 5%), oral fluid therapy should be
adequate. (D133.4.w4)
- For 5-8% dehydration, oral rehydration can be used (unless the bird
is regurgitating). (J29.8.w1)
- For severe dehydration (greater than 8%) intravenous or intraosseous
fluid therapy will probably be required. (D133.4.w4,
J29.8.w1)
Fluid therapy is most commonly administered orally by gavage (stomach
tubing). Oral fluid therapy is NOT suitable for any individual which is
having seizures, is extremely weak, depressed or hypothermic and cannot
maintain proper head carriage or may not be able to swallow properly.
(D32.3.w3, B23.38.w2,
D135.5.w5)
-
Fluids should generally be warmed to body temperature
i.e. 101-104°F before being administered. (D32.3.w3,
D135.5.w5)
- However, for individuals which are hyperthermic or showing
seizures, fluids at room temperature should be used. (D32.3.w3,
D135.5.w5)
- Oral fluids are preferable to parenteral fluids; oral fluids not
only treat dehydration but also assist in flushing any oil from the
gastrointestinal tract. (P24.335.w12)
- Parenteral fluids are required for individuals which:
- Are showing seizures. (D32.3.w3,
D135.5.w5)
- Are unable to maintain head carriage. (D32.3.w3,
D135.5.w5)
- Are extremely depressed or debilitated. (D32.3.w3,
D135.5.w5)
- Show clinical signs of shock or kidney failure. (D32.3.w3,
D135.5.w5)
- Show clinical signs of dehydration. (D32.3.w3,
D135.5.w5)
- Are hypothermic or hyperthermic. (D32.3.w3,
D135.5.w5)
- Show signs of exposure to toxic substances. (D32.3.w3,
D135.5.w5)
- Regurgitate fluids. (J29.8.w1)
Oral fluid therapy:
- Suggested suitable oral rehydration fluids (given by gavage (stomach tube)
include:
- Liquid Lectade (Pfizer) (P14.5.w6), Pedialyte
(a human pediatric rehydration solution, Abbott Laboratories) or lactated Ringer's solution
(LRS, Hartmann's) and 2.5% dextrose (B23.38.w2);
- Oral rehydration solutions such as Lectade can be
used, made up to half the strength recommended by the manufacturers.
Alternatively a 50:50 mixture of lactated Ringers solution (LRS,
Hartmann's) and 2.5% dextrose in 0.45% NaCl can be used. Fluids should
be warmed to 39-40°C prior to administration. (P24.327.w4)
- Lectade should be made up to half the
strength recommended by the manufacturers. (P24.327.w4)
- A basic oral rehydration solution can be made up
by dissolving one tablespoon of sugar and one teaspoon of salt in
one litre of water.(B203)
-
Give 20 to 40 mL/kg bodyweight at least three times in the first 24
hours. (P24.335.w12)
-
While birds may be able to take 50 mL/kg by gavage at one time, it is
best to use smaller volumes initially and increase the volume given
gradually. (D133.5.w5,
J29.7.w1)
- For further information on gavage see: Gavage - Tubing of Birds (Techniques)
Parenteral fluids:
- If necessary, parenteral fluids may be given (D160.5.w5,
P4.1990.w1);
(subcutaneously,
intravenously or
intraosseously), e.g.
at 3-5% of body weight intravenously plus approximately 5% body weight
subcutaneously. (P4.1990.w1)
- Note: give parenteral fluids as aseptically as possible,
cleaning the skin before introducing a needle, in order to avoid
introducing oil, bacteria or other contaminants into the bird. (B23.38.w2,
V.w5, V.w73)
- For correction of 5-8% dehydration, parenteral fluids may be required. These may
be given by the subcutaneous, intravenous or intraosseous route. (D133.4.w4)
- For correction of severe dehydration (greater than 8%
dehydration), intravenous or intraosseous
fluid therapy will probably be required. (D133.4.w4,
J29.8.w1)
- For correction of severe dehydration, fluids are required at a minimum rate of 50
mL/kg body weight over 24 hours, either by continuous infusion or
divided into two or three boluses for slow injection. (D133.4.w4)
- 15-35 mL/kg three times a day by bolus injection into the medial
tarsal or cutaneous ulnar vein. (B23.38.w2)
- For severely dehydrated hypoproteinaemic birds, intravenous colloid
solutions may be required (e.g. Hetastarch, Abbot Laboratories), 10 to
15 mL/kg three times daily. (J29.8.w1)
- Routes:
- The medial metatarsal vein on the leg or the brachial
vein on the wing can generally be used for intravenous injection. For
intraosseous injection a catheter may be placed in the distal ulna or
proximal tibiotarsus. (D32.3.w3,
D135.5.w5)
- Use of intravenous (medial tarsal vein) or intraosseous (distal
ulna or proximal tibiotarsus) catheters should be avoided unless
absolutely necessary: the individual generally needs to be
isolated from conspecifics and washing delayed until the catheter
has been removed and the site of insertion has healed. (B23.38.w2)
- If neither intravenous nor intraosseous routes are
available, fluids may be given subcutaneously in the inguinal region or
intrascapular region and avoiding the cervical air sacs. (D32.3.w3,
D135.5.w5)
- Limitations of the subcutaneous route:
- Fluids given subcutaneously are not well absorbed by
hypothermic birds due to peripheral vasoconstriction. (D133.4.w4)
- Fluids should not be given subcutaneously in birds with large
subcutaneous air sacs (e.g. pelicans). (J29.8.w1,
D133.4.w4)
- For a full description of intravenous and intraosseous
injection in birds see:
- Caution:
- Birds with a total protein level of less than 2.0 g/dL (i.e.
hypoproteinaemic) are at risk of developing pulmonary oedema if
given fluids. (D133.4.w4)
- Birds with moderate to severe anaemia
are at risk if given fluids. (D133.4.w4)
Therapy for regurgitation:
- Risk of regurgitation can be minimised by avoiding
handling for 20-30 minutes after gavage. (D32.3.w3,
D135.5.w5)
- If a bird regurgitates repeatedly:
- Check for hypothermia
or hyperthermia and treat as
necessary. (D133.4.w4)
- Discontinue attempts at oral feeding. (D133.4.w4)
- Examine for any problem which may be causing regurgitation, such
as gastrointestinal obstruction, hypothermia, infection. Any
problem found must be treated appropriately. (D133.4.w4)
- Give subcutaneous fluids: isotonic 2.5% dextrose or lactated
Ringers solution (LRS), total 5% of body weight, divided between
two sites. (D133.4.w4)
- Note: pelicans have large areas of subcutaneous air and
should not be given subcutaneous fluids as fluids are not well
absorbed from the subcutaneous space. (D133.4.w4,
J29.8.w1)
- For a full description of subcutaneous injection in
birds see: Subcutaneous Injection of Birds (Techniques)
Lethargy and hypoglycaemia:
- A bird which is obviously lethargic may be hypothermic,
hyperthermic or have a low blood glucose.
- For correction of body temperature see above (normal cloacal temperature for birds is about 39-41°C
(102-105°F)). (D133.4.w4)
- Normal blood glucose is in the approximate range 200-365 mg/dL. (D133.4.w4)
- Birds with a blood glucose below 80 mg/dL are at risk of
seizures. (D133.4.w4)
- Up to 10% dextrose can be given by gavage at 50 mL/kg body
weight. (D133.4.w4)(See:
Gavage - Tubing of Birds (Techniques))
- Alternatively, for example if the bird is regurgitating,
2.5% dextrose can be given subcutaneously at 5% of body weight. (D133.4.w4)(See:
Subcutaneous Injection of Birds (Techniques))
- Caution: Giving hypertonic fluids may increase
dehydration. (D133.4.w4)
- A bolus of 50% dextrose can be given intravenously, at 2 mL/kg
body weight, together with fluids. (B13.28.w29)
- Lethargy may be seen also in association with central nervous
system problems. (D133.4.w4)
Wounds and fractures:
- All wounds, fractures and luxations should be treated at this time. (B188)
- Examination by a veterinarian is required. (D133.4.w4)
- Wounds should be cleaned, bleeding stopped and fractures stabilised.
(D159.III.w3)
- If a veterinarian is not available basic treatment should be given:
(D133.4.w4)
- Basic cleaning including removing large pieces of debris and
flushing the wound, for example with sterile saline. (D133.4.w4)
- A fractured wing may be stabilised temporarily by wrapping it to
the body using a bandage such as Vetrap®. (D133.4.w4)
- A fractured leg may be stabilised temporarily by wrapping it to
the body in a flexed position using a tape such as micropore which
will not damage feathers. (D133.4.w4)
- Following basic cleaning and/or stabilisation the bird should be
placed in a well ventilated box and left in a dark, quiet area to
await further examination and treatment. (D133.4.w4)
- Note: Cleaning and successful treatment of oil-contaminated large
wounds and compound fractures may be difficult or impossible. The
possibility of euthanasia for animals with such injuries should be
considered at an early stage. (B23.38.w2)
See: Triage and Euthanasia of Oiled Wildlife
- Information on emergency care is available in:
Wildlife Casualty Assessment
- FIRST AID: Emergency Care
- Further information is available in: Bandages, Slings, Splints & Casts in Birds (Technique)
- See also: Lacerations & Punctures, including bite wounds (with special reference to Waterfowl and UK Wildlife )
- Further information on fracture treatment is available in:
Ocular lesions:
- Non-steroidal antibiotic ophthalmic drops (solutions) may be used if
ocular lesions are present. (D32.3.w3)
- Corneal ulceration due to physical trauma or chemical irritation
may be treated with chloramphenicol eye drops; fungal eye
infections may be treated with appropriate antifungal medication
such as flucytosine. (P4.1990.w1)
- Use of ointments should be avoided; these may trap oil
hydrocarbons against the cornea. (B363.App3.w16,
D32.3.w3)
- Prophylactic use of ocular ointments, in the absence of clinical
signs indicating they are required, is not appropriate. (D160.5.w5)
Shock:
- Intravenous fluids are recommended for birds with signs of shock. (D135.5.w5)
- A single injection of dexamethasone, 2-4 mg/kg, may be given to individuals with
signs of shock. This should be given intravenously if possible,
otherwise intramuscularly into the pectoral muscles, no more than 1.0 mL
per intramuscular injection site. (D135.5.w5)
Seizures:
- Birds showing seizures should be kept in a comfortable,
well-ventilated area. (D135.5.w5)
Antibiotic therapy:
- In individuals with lacerations, fractures or signs of respiratory
disease broad spectrum antibiotics should be given. A suggested choice
is enrofloxacin, twice daily for 5-7 days at 10-15 mg/kg,
orally if possible, otherwise intramuscularly (but remembering that
this drug is highly irritating to muscle), diluted 1:1 with saline
for injection to reduce the irritant effect on muscle tissue. (D135.5.w5)
- [Oral administration of antibiotics may not be appropriate
initially while there is concern about damage to the
gastro-intestinal tract.]
- Prophylactic use of antibiotics, in the absence of clinical signs
indicating that they are required, is not appropriate. (D160.5.w5)
Antifungal prophylaxis:
- This may be started in susceptible species. (D160.5.w5)
Anthelmintic therapy:
- This should not be given on a routine basis as part of
initial treatment. However, it may be necessary later in
rehabilitation e.g. for birds which are failing to gain weight. Some
species are more likely to suffer from excess parasite burdens than
are others. (V.w78)
Minor skin injuries:
- Non-steroidal antibiotic ointments may be used. (D135.5.w5)
- Note: Petroleum jelly (Vaseline, Cheseborough-Pond's Limited) smeared on the feet may be
useful to prevent desiccation and cracking of skin while waterfowl are confined in cages
off water prior to washing (P14.5.w6),
although careful consideration should be given to the potential advantages and
disadvantages before using any petroleum products.
Chemical burns:
- Areas of skin with chemical burns should be cleaned thoroughly using
dilute chlorhexidine solution, followed by application of a
water-soluble antibiotic ointment. (J29.8.w1)
- Petroleum-based ointments may further contaminate feathers and
disrupt waterproofing, thus should not be used. (J29.8.w1)
- Note: serous exudation and loss of feathers disrupt
waterproofing. (J29.8.w1)
Infection:
- Birds showing overt clinical disease should be isolated and
treatment initiated as appropriate. (D160.5.w5)
MAMMALS:
- Excess oil may be wiped from fur using an absorbent cloth such
as a towel, or absorbent paper, applied in the direction of fur
growth. (D32.3.w3)
Correction of body temperature:
- Mild hypothermia may be treated by placing the animal in a well
ventilated warm room (20°C/68°F for Enhydra lutris - Sea
otters), and drying the fur
vigorously using a towel and a pet drier (set to room temperature for
sea otters). (B335.4.w4)
- Hyperthermia in Enhydra lutris - Sea
otters may be treated initially by placing chips
of ice in the cage with the otter. (B335.4.w4)
Fluids:
- Note: Blood samples should be obtained before
rehydration is started. (D208.4.w4)
- Assume that all incoming mammals are at least 5% dehydrated. (D208.4.w4)
- Give isotonic fluids orally or subcutaneously at 10 to 20 mL/kg
once. (D208.4.w4)
- If giving by stomach tube:
- Preferably use a stomach tube of greater diameter than the
trachea; this minimises the risk of the tube entering the
trachea rather than the oesophagus. (D208.4.w4)
- Measure the tube length, from the nose tip to the base of
the ribs. (D208.4.w4)
- Lubricate the end of the tube. (D208.4.w4)
- Gently introduce the tube, taking care to enter the
oesophagus not the trachea. (D208.4.w4)
- Check the tube is in the stomach: listen for gastric sounds,
sniff the tube for the smell of gastric contents, place a hand
in front of the end of the tube and feel for air movement as
the animal breaths out. (D208.4.w4)
Blow air into the tube and listed for bubbling sounds. (B335.5.w5)
- If in doubt, pull the tube back and replace it again,
carefully. (D208.4.w4)
- Individuals which are weak, or are anaesthetised for examination
and treatment, should not be given oral fluids. Fluids such
as lactated Ringer's solution may be given subcutaneously at 20 to
40 mL/kg. (D208.4.w4)
- For Enhydra lutris - Sea
otters, normal saline or a 50/50 mixture of normal
saline and 5% dextrose solution, at 20 mL/kg/day subcutaneously or
intravenously, is suggested. (B335.4.w4)
- Some sea lions Galapagos sea lions Zalophus wollebaeki
(Otariidae - Sea lions (Family))
oiled during the Jessica oil spill in 2001were
hydrated by subcutaneous administration of physiological
saline plus vitamin B (J313.47.w1)
- Intravenous fluids may be required for severely depressed
individuals. (D208.4.w4)
- Additional fluids may be required, to meet maintenance needs
plus replace calculated fluid deficits. (D208.4.w4)
- Maintenance requirement is at least 40 mL/kg/day. Deficit
can be calculated: mass (kg) x 100 mL /kg x percentage
dehydration. (D208.4.w4)
- If possible, give maintenance plus deficit within the first
24 hours. (D208.4.w4)
Correction of hypoglycaemia:
- Hypoglycaemia is most likely to be seen in animals with a high
metabolic rate (e.g. Enhydra lutris - Sea
otters) and/or low energy stores (e.g. sea
otters, neonates). (D208.5.w5)
- Subcutaneous fluids may be given, containing 2.5% dextrose as well
as electrolytes, the animal may be given appropriate nutrition by
stomach tube, or may be offered food to eat. (D208.5.w5)
- If an individual develops repeated episodes of hypoglycaemia, it may be
necessary to provide fluids containing dextrose by intravenous
infusion until the individual becomes able to maintain adequate levels
of blood glucose. (D208.5.w5)
- In oiled Enhydra lutris - Sea
otters:
- In conscious animals, correct by providing pieces of ice made
from 50% dextrose solution. (B335.5.w5)
- In lethargic/semiconscious animals, give 10 - 20% dextrose at
10-20 mL/kg intravenously to effect. (
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