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T. Tully1
1Louisiana State University School of Veterinary Medicine, Veterinary Clinical Sciences, Baton Rouge- Louisiana, USA
Thomas N. Tully, Jr., DVM, MS, DABVP (Avian), ECZM (Avian)
Louisiana State University – School of Veterinary Medi- cine
Baton Rouge, Louisiana
1. Administer the least amount of  uids needed by the patient
2. Restore perfusion and hydration without volume over- load
3. Have a treatment goal
4. Assess clinical response toward treatment goal 5. Early intervention
If it is determined the patient can withstand the stress
of handling and treatment then  uid therapy may be initiated. Normosol or Lactated Ringers Solution can be administered through the following routes: subcutane- ous, intravenous, intraosseous, orally and through the cloaca. Anatomic sites commonly used for IO catheter placement include the distal ulna (larger birds), proximal ulna, proximal tibiotarsal bone and lateral femur (young and small birds). Placement of the IO catheter begins with proper site preparation, similar to epithelial prepara- tion for an IV catheter. A 22-gauge, 11⁄2” spinal needle is the catheter of choice in most psittacine cases although any size needle may be used, provided that a stylet is inserted into the needle prior to placement of the IO catheter into the medullary cavity of the bone.1 When the IO catheter is placed in the distal ulna, the distal wing tip is  exed and the needle is inserted at a 45 to 60° angle, and this angle is reduced once the catheter enters the cortex.2 The needle should be advanced to the hub, stylet removed and the catheter  ushed with heperized saline. The catheter is capped with a PRN and managed as an IV catheter. Intraosseous catheters require more maintenance than an IV catheter and should be  ushed 6 to 8 times a day to maintain patency. Subcutaneous  uid
therapy is not an effective method of rapid restoration of circulatory  uid volume.3 Adding hyaluronidase (Wydase, Wyeth-Ayerst Pharmaceuticals, Philadelphia, PA) to lac- tated Ringer’s solution (LRS) for SC  uid administration has been recommended as a method to increase the absorption rate of the  uid into the circulatory system.1
When determining the dehydration de cit of a psittacine patient, the veterinarian must estimate the percentage
of de cit prior to calculating replacement  uid volumes. Parameters applied to measure dehydration status in psittacine species include skinfold elasticity, corneal moisture, appearance of the globe and packed cell volume. Dehydrated psittacine chicks have wrinkled and reddened skin, with a sunken face and prominent eyes.4 It is generally believed that in most cases of severe trau- ma or disease a 5% to 10% dehydrated status should
be estimated for the avian patient. The estimated de cit should be replaced over a 48 – 72 hour period.1 The rec- ommended daily  uid maintenance formula for psittacine species is 100 ml/kg/day, and baby birds consume 2 to 3 times the maintenance  uid levels as adult patients.1 but may range between 50 – 150 ml/kg/day depending on species of bird being treated. Recent recommenda- tions to compensate for tissue  uid loss are a crystalloid (e.g. LRS) 10 ml/kg + colloid (eg, hetastarch) at 5 ml/kg increments. The crystalloid/colloid combination given at 1 to 2 bolus infusions will generally raise the blood pres- sure to greater than 90 mm Hg systolic. Fluids should
be warmed before administration and bolus  uids can be given with relative safety IO or IV over a 3 – 5 minute period. Once the  uid de cit is replaced and the bird is eating and drinking normally for 2 or 3 days, the mainte- nance hydration therapy can be discontinued.
Fluids therapy may be replaced through subcutaneous, intravenous or intraosseous administration. Subcutane- ous  uid replacement can be achieved using a 26 or 25 gauge needle attached to a syringe  lled with a warmed crystalloid or colloidal agent. The sites usually preferred for subcutaneous administration are the featherless ingui- nal and/or axillary regions of most avian species. Intra- venous catheters are placed in the jugular vein of larger birds and median metatarsal of smaller companion avian species. The distal ulna and proximal tibiotarsal bone
are the recommended sites for IO catheter placement. Although IO catheter placement is easier in smaller birds, these catheters require more maintenance to prevent plugging. Intraosseous catheters have a similar delivery to IV catheters and are much easier to place, especially in smaller species.
Lactated Ringer’s solution (LRS), 2.5% dextrose in 4.5% saline, and 0.9% saline comprise the commonly used isotonic crystalloid solutions administered to avian species. The necessity for continuous  uid
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