Avian and Exotic

Animal Anesthesia

Javier G Nevarez DVM

jnevarez@vetmed.lsu.edu

Objectives

Know the avian respiratory anatomy

Air sacs

Know the avian breathing cycle

Know the respiratory stimuli for birds and
reptiles
Know how methods for thermoregulation
during anesthesia
Know how to monitor birds and reptiles
during anesthesia

Avian Respiratory Anatomy

No diaphragm

Complete tracheal rings

Rely on movement of keel bone

Do not inflate ET tube cuff

Syrinx
No epiglottis

ocw.tufts.edu/Content/5/lecturenotes/215768

Avian Respiratory Anatomy

Pneumatic Bones

Humerus, clavicle, keel, ribs, +/- femur

Non expandable lungs

Attached to ribs and dorsal body wall

Air Sacs

Cranial air sacs

Interclavicular (1)
Cervical (2)
Cranial thoracic (2)

Caudal Air Sacs

Caudal thoracic (2)

Abdominal (2)

http://www.paulnoll.com/Oregon/Birds/Avian-Respiratory-2.html

Breathing Cycle

1st Inspiration

1st Expiration

Cd. Air sacs Lungs

2nd Inspiration

Trachea Bronchi Cd. Air sacs

Lungs Cr. Air sacs

2nd Expiration

Cr. Air sacs Bronchi Trachea

http://www.faculty.biol.ttu.edu/schmidt/web_site/ORNITH%20avian%20physiology.htm

Inspiration

Expiration

Ventilation Mechanics

Inspiration

Sternum: cranio-ventral
Ribs: cranial
Increases volume of coelomic cavity
Allows air sac expansion

Ventilation Mechanics

Expiration

Sternum: caudo-dorsal
Ribs: caudal
Decrease volume of coelomic cavity
Compresses air sacs

Gas Exchange

Counter current mechanism

Simple diffusion of O2 and CO2

Parabronchi (3o bronchi)
Capillaries

Breathing stimulus

O2 and CO2

http://sps.k12.ar.us/massengale/bird_notes_bi.htm

Reptile Respiratory
Anatomy

No diaphragm

Complete tracheal rings

chelonians and crocodilians

Incomplete tracheal rings

Rely on rib/coelomic expansion

lizards and snakes

No epiglottis

Reptile Lungs

Varied anatomy

Snakes

Spongy mammal-like
Thin air sac-like
Intermediate/combination
Most only have right lung
Boids may have two

Expandable

Gas Exchange

Counter current mechanism

Simple diffusion of O2 and CO2

Breathing stimulus

O2

Indications for Anesthesia

Radiographs
Surgery
Biopsy
Physical exam

Anesthetic Agents

Injectable

Used less frequently in birds

Inhalants

Used routinely for induction in birds

Used for maintenance in other species

Pain Management

Opioids

NSAIDS

Butorphanol
Meloxicam (Metacam), Carpofen (Rimadyl)

Local/topical

lidocaine

Equipment
Anesthetic machine
Anesthetic masks
ET tubes

2.0 6.0 i.d.

Non-cuffed and cuffed
14g 16g IV catheters
Paper clip/hemostats as speculum

Equipment

Heat source

Heating pads
Heat lamps
Forced-air warmers
Warm fluid bags
Rice/bean bags

Equipment

IV catheters 26g 22g

Emergency drugs
IV/SQ fluids
Monitoring

Doppler
Temperature probe
ECG
Etc.

Incubators

IV Access

Birds

Jugular vein
Ulnar vein
Medial tarsometatarsal vein

Reptiles

Jugular vein
Ventral coccygeal vein
Ventral abdominal vein
Sub-carapacial

IO Access

Birds

Use non-pneumatic bones only!!

Reptiles

Ulna
Tibiotarsus

Femur
Tibia
Carapace/plastron

IO access can be used the same as IV but with

slower volume of infusion

Pre-medication - birds

Opioids

Respiratory depression??
Give 30min to 1 hr before anesthesia

NSAIDS
Diazepam

Pre-medication/induction
-reptiles
Opioids
NSAIDS
Ketamine
Medetomidine
Telazol
Propofol

Induction - birds

Isoflurane/sevoflurane

Mask down
Start at 5% with 1L/min O2

Asses depth

Flaccid wings and legs

Eyes closed
HR/RR
Righting reflex

Maintenance

Isoflurane

0.5% - 2%
500ml 1L/min O2

IPPV

DO NOT EXCEED 15 20mmHg

POP-OFF valve MUST REMAIN OPEN after
breathing
6 12 breaths/min

Determining plane of
anesthesia

Reflexes

Righting reflex
Corneal reflex
Tongue withdrawal
Toe pinch

Monitoring

Stethoscope
Reflexes
Doppler
Temperature probe
ECG
Pulse oximeter
Capnograph

Monitoring Birds

Heart Rate

Respiratory Rate

> 100 bpm is normal

< 100 bpm is of concern
6 12 bpm during anesthesia
IPPV if shallow or inconsistent

Temperature

Birds: 105oF is normal

Monitoring Reptiles (NEW

SLIDE)

Heart Rate

Respiratory Rate

Varies with species, temperature

30-60 bpm is normal
<30 bpm is of concern
4 6 bpm during anesthesia
IPPV in most instances

Temperature

Reptiles: aim for 90 - 95oF during anesthesia

Hypothermia

Heat loss

Convection

Radiation

Heat loss to surfaces and environment

Conduction

Air exchange at body surface

Heat loss from contact (i.e. cold table)

Evaporation

Heat loss from lungs, skin, exposed tissues

Preventing Hypothermia

Forced-air warmers

Heating pads

Reduce radiation losses

Water bath

Reduce conduction losses

Heat lamps

Can reduce convection, conduction, and radiation losses

depending on the blanket type

Reduce conduction, radiation losses

Bean/rice stockings

Reduce radiation losses

Preventing Hypothermia
Forced-air
warmer
Heating
pads

Convection

Conduction

Evaporation

Radiation

Heat lamp

Rice/bean
stockings

Water baths

Recovery
Wean off gas before the end of procedure
Maintain O2 at low flow rate
KEEP WARM!!!!!!!!!!!!!!!!
Breathing stimulus

Birds: CO2 and O2

Reptiles: O2

What can go wrong?

Hypothermia
Respiratory arrest
Cardiac arrest
death

How to fix/prevent it?

Have heat source
IPPV, doxapram
Atropine, epi., CPR
BE PREPARED!!!!

If you run into problems, turn off the inhalant anesthetic and proceed to
treat the patient

Why do things go wrong?

LACK of PREPARATION!!!!!
Lack of monitoring
Patient kept too deep
IPPV not provided on time
Underlying disease
Unknown physiological reasons

Challenging species

Waterfowl

Budgies and Cockatiels

Prone to bradychardia
Hypothermia
Critical recovery period

Eagles and large birds

Excitatory phase during induction

Bradychardia
May require higher % for maintenance

Challenging Species

Reptiles

Usually require IPPV

Unpredictable anesthesia
Difficult to maintain plane of anesthesia

Conclusion
Understand anatomy and physiology in
order to design anesthetic plan and
emergency responses
Perform active, aggressive monitoring
Proper thermoregulation is essential
Be prepared!!!