案例讲稿小宠

1、Clinical Examination: Examination, Handling of exotic animals - blood sampling and injectionMike Cannon BVSc MACVSc Cannon & Ball Veterinary ClinicWest WollongongLearning about exoticsBooksAssociationsAAV; AEMV; ARAVAAVAC; UEP; PGFConferencesUSAAAVARAVAEMVAustraliaAAVACUEP SIGPGF CVEInternetBirdmedV

2、INExotic DVME-vet ExoticUEP Yahooother vetsIdentify every Reptile!Clinical Examination of Bird 6 Steps1. History2. Examination of Environment3. Distant Examination4. Physical Examination5. Body Weight & Measure6. Select Basic Laboratory TestsClinical Examination of Reptile1. History2. Examination of

3、 Environment3. Distant Examination4. Physical Examination5. Body Weight6. Snout:CloacaMeasurment (Body Length)7. Determination of Gender 8. Diagnostic Procedures/Basic Laboratory TestsReptiles History8 Major areas to investigateHusbandryHusbandryHusbandryHusbandryHusbandryHusbandryHusbandryHusbandry

4、History for Small MammalsSignalmentBreed, Age, Desexed?GeneralHow long in owners care?Source of pet?Other pets that mix with it?HandlingHow often handled?How many people handle?Previous Medical HistoryVaccination history?Details on any previous medical problems & treatments used?HousingIndoors or Ou

5、tdoors?Size and construction enclosureBedding type?How often cleaned?Access to unfiltered sunlight?Time exercising outdoors?Water source?DietMain components & % ?Any commercial foods?Any diet changes?Fact Sheets or Cheat SheetsNormal Rabbit ValuesBody Temperature (oC)38.5 - 40.0Heart Rate (beats/min

6、ute)130 - 320Respiratory Rate (/minute)30 - 60Tidal Volume (ml/Kg)4 - 6Blood Volume (ml/Kg)57 - 65BP mmHg (systolic/diastolic)90 139 / 60-90Water Consumption (ml/Kg/day)50 - 100Food Consumption (g/Kg/day)50Urine Production (ml/day)20-350 (avg = 130)Faecal Pellet Production (per day)150 / 2.5-3.0 Kg

7、BWThe Examination begins .with First ContactNurse/ReceptionistSimple, Clear Client InstructionsClient Instructions Prior to AttendingIf it is cold or windy - protect the bird.Do not clean the cage Bring in a sample of any vomitus, diarrhoea etc.Bring any medications etc. that have been used.Make sur

8、e that the bird is panied by someone who knows the current historyIf they are unable to attend telephone contact available,detailed written history.Telephone ListNurse can discuss with a client seeking advice about an ill bird.Easily recognisable clinical signs which may suggest significant problems

9、 for the bird:Common Signs of Illness - S.B.L.Weight Loss Anorexia/InappetanceInability to swallow Vomiting/RegurgitationAbnormal odour Swelling - head/ mouth/ neckInactivity Visible lumps or masses Haemorrhage Abnormal feathersFluffed Feathers Droopy WingsDecreased Preening Vocalisation changesA br

10、eak in routine - abnormal behaviourEYESUnilateral or bilateral discharges Changes in clarity or colour Closing of one or both eyes -partial (squinting) or completeSwelling around one or both eyesNOSTRILS/NARESUnilateral or bilateral discharges Plugging of one or both nostrilsBubbles appearing at nar

11、esRESPIRATORYOpen-mouthed breathing when at rest (very serious)Audible respiratory noises (Sneezing, wheezing, gasping etc.)MUSCULOSKELETAL/NEUROLOGICALBalance problems Limping or lack of full weight-bearing on one limbSwollen foot/feet and or joint/jointsDroppingsChange in quality and/or quantity o

12、f components of scatsFaeces Urates UrineRules of ThumbAny bird that appears ill to its owner is seriously ill !Always be Guarded with your PrognosisA “Healthy” Appetite does not equate to a “Healthy” BirdOne Day of illness in a Budgerigar is equal to 1 weeks illness in mammalsPRESERVATION REFLEXSign

13、s of IllnessObvious S.B.L.SubtleLess ActiveReduced appetiteDecreased preeningAbnormal behaviourabnormal perching locationSlower to avoid contact with other birds/people/predatorsSpot the Sick Bird?Diagnostic ApproachCollect History & Distant ExaminationList a Likely Differential DiagnosisList Sample

14、s you would collect to confirmList Equipment you require for these tests & gather prior to restraining the birdPerform Physical ExaminationRevise Differential DiagnosisRevise Samples to CollectHistoryAllow the bird to settle down from the excitement of travel and the waiting roomPerform a distant ex

15、amination of the patient to look for subtle signs of disease while collecting HistoryMore time spent collecting history than with dogs & catsIllness is most often a result of a Management or Husbandry Problem!Your job is to identify this problemPet or Aviary Bird?Pet Always in Cage?Free Flight?Pet b

16、irds may be exposed to more toxins as they wander around the housePet or Aviary Bird?AviaryFlock Health Problem?ask for a description of Aviarysizefloor type (Substrate)designaspect (N or NE is best)Any Preventative Medicine Program?Size and Type of cage?Floor surface or substrate?Climbing and hidin

17、g facilities provided? Normally kept inIndoor enclosure ?Outdoors aviary? Sizefloor typedesignAspect it faces - North or North-East is best ! West & South protected?Age of Bird?What is the animals age?Often this is unknownlook at quality of skin around eyes and feet & inspect the beakYoungInfection

18、more commonOlder Birds Age related problems e.g. Neoplasia, NutritionalHow Long Had the Bird?“New” BirdInfection, Stress“Old” BirdNutritional, Psychological, NeoplasticSource of the Bird?Bred on PremisesEndemic ProblemsHusbandry ProblemPurchasedPrivate PersonBird Dealer Some sources are know by repu

19、tation to be either good or bad.Exposed to a host of infectious agents and environmental conditions. Any other Birds Acquired recently?Discuss any clinical signsConcern re carrier status of new birdsDiscuss Quarantinewhere it is done (Spatial proximity to other birds)Any treatments or testing donePe

20、riod quarantinedHistory of Recent Illness?This BirdOther Birds on the PremisesToxinsInfectious Any Illness in People?ZoonosesChlamydiaSalmonellaDietWhat are the characteristicss of the diet? Nutritional disease is extremely common.Many birds are suffering from malnutrition.Type of food items provide

21、dQuantity offeredFrequency of feedingMethod of presentationAny supplements providedWhen was the last mealDietCurrent Diet?Food & Water Consumption?Favourite Foods?High Fat Content SeedsSunflower SafflowerPeanuts Niger“All Seed Diet”Commercial DietsAny recent changes?Cage CleaningThe frequency?The cl

22、eaning methods used? Disinfectant used?This is a means of determining the clients approach to hygiene and some potential sources of toxins.Water supply?Source and quality of the waterType of water container used.Prefer: stainless steel, glass or glazed ceramicAvoid: earthenware, galvanised, plasticH

23、ow often is the water changed? XLight sources?Type of light provided?Incandescent?Fluorescent?What is the availability of ultraviolet light or exposure to direct sunlight? What is the normal photoperiod provided? Many birds housed indoors are subject to internal lighting as people are in the room. T

24、his can result in them being exposed to very long light intervals - much longer than the natural interval.Cage Mates?Describe any cage mates? Size, Gender, Species, InteractionsHealth status? New introductions or departureswhen was the most recent? Any other birds acquired recently in the collection

25、? Behavioural Changes?Often not noticed by Client First, Subtle Signs of IllnessDecreased Activity or sitting in an unexpected position?Allow you to come closer than normal “Tamer than normal”Increased Huddling, Sleeping, HidingNormal handlingDescribe normal handling? How often is it done? Describe

26、the techniques used? Is the bird a pet that is handled regularly?Current ProblemsWhat are the current signs of disease that are causing concern & how long have they been evident? Describe these signs of this patient or of any other birds on the premises.Any Medications Used?Bring them InExpiry DateS

27、torage ConditionsWhat was the response?Check AdministrationDose, Frequency, MethodAlways ask the client to describe how the drug was used to rule out any errors in administration.Examination of EnvironmentOften this is not availableanimals come in a travel cage. gathered during the history taking or

28、 a visit to their home. Take note of such details as cleanliness of the water dish or transport enclosureUse this observation to make an assessment of the general level of hygiene and sanitation. Examine Cage and EnvironmentLevel of Hygiene - Floor & WaterdishDiet provided & Is it being eaten?Droppi

29、ngs NormalFaeces & Urates/UrineStress Polyuria from travellingAbnormal SignsVomitusRegurgitationDistant Examination of BirdDemeanour - BARPostureNormal Level of ActivityAssess Respiratory Rate & DepthSubjective Assessment of Weightshape of pectoral mass and abdominal profile.Ask if bird is accustome

30、d to handling IS IT SAFE TO CATCH THIS BIRD?Identify & Assess your PatientList of Common Diseases by SpeciesView the listSelect 3-4 most common problems that fit the clinical pictureAid in Differential DiagnosisTurquoisine ParrotNeophema pulchellaCommon Problems:Ascarids,ChlamydophilaBacterial Septi

31、caemiaPhysical ExaminationConsistent approachStart at the head and move distallyPalpate, auscultate, transilluminatePay particular emphasis to any suggestive signs detected during the history and distant examination, so that they may be explored in more detail. Powder Down FeathersPreservation Refle

32、xCloacaExamine the cloaca and vent swellings, encrustations or soiling faeces stuck to feathers indicates loose droppingsIf the tail is gently flexed dorsally, the vent will open slightly inspection of the cloacal mucosainsertion of a swab. Faeces & UratesMost birds will pass faeces that is formedUr

33、ates are often passed at the same time. Normally they are distinct from the stoolUrates are normally chalky paste that is pure white to yellow in colourMost birds will also pass a small amount of clear liquid urine. FaecesBiliverdinuria is abnormal green discoloration of the uratesassociated with li

34、ver disease, anorexia or haemolytic anaemia. birds have biliverdin rather than bilirubin. Any abnormal faeces should be collected & examinedfaecal flotationfresh warm, saline smear.LimbsPull out each limb individuallyPalpate the bones & muscles from shoulder or hip to distal end of each digitExamine

35、 each joint for full range of motion or any swelling. A weak limb abdominal/renal tumours, fractures or neurological disease. Unilateral lameness is more common than bilateral. Assess the length of the claws. Overgrown claws may be associated with poor substrate. Inspect the plantar aspect of each foot. Post ExaminationRe