Go team "Tube Feeding!" - Updated 12/29/2019

[casportpony]

How long will a bird tolerate having the tube? I know you can't leave that tube in very long but what if you have a small syringe (20ml) and need to disconnect it to suck up another syringe-ful before removing the tube?
I've never had to do this yet, but am getting supplies together in case I do.
I was wondering, if the bird is not passing many droppings or if you suspect egg binding, is it safe to still syringe feed? Is there a limit? Is there reason to worry that what you feed will block up in the bird?
The lafebervet link was good with the videos. The quickest way for me to learn is to see it done, then try to replicate.

The best thing to do would be to get a larger syringe. Tube feeding should not be done if a bird has a bowel obstruction, which a stuck egg can cause.

-Kathy

 

[birdman55]

hey Kathy I figured I would write about hawk...and tell the story on your thread...so I contacted Kathy and she helped me thru the first time tube feeding process....my birds eyes were close she was weak she wasn't eating or drinking .....and I had no tube feeding tools so we came up with the solution of a nutrient syringe which I had in the store...some 1/4 " aquarium line taking the lighter to the end that would be going down the bird and softening the end so it wouldn't puncture anything...rounding the edges of the line...and then doing a dry run on the outside to the crop and marking the tube so I knew how far to go down...first I brought the bird in from the cold weather and let it warm up then I made a quick solution of a scoop of sugar and little bit of molasses in a two cup glass of warm water...brought up 25 ml of the solution and tube fed the bird....pics below...then four hours later did the same process but put in 1/2ml of corid in with the solution...hope this is pretty accurate on what you coached me throu....and thanks she is doing great















her on the left side with the flock a couple of days later


hope this helps out for people that have to tube feed...it is a little nerve racking when you first do it....but its great when it turns out to work....also the tube should have no resistance when going down the throat if there is resistance then back up and try again...once the tube is down the bird is normally pretty calm

 

[casportpony]

@birdman55 , thanks for sharing your story!

-Kathy

 

[birdman55]

anytime...thanks again for the help and knowledge...I think I might have gotten alittle smarter...oh looks like im done for the day...lol

 

[Cluckies]

Is this the catheter that is being used? I ordered a different one, but this one looks much closer to the one you show... I think.

 

[casportpony]

4.4.1. Signs of dehydration

• Mental depression
• Skin fold elasticity (less reliable than in mammals)
• Filling time of basilic vein > 1 sec
• Ocular hydration
• Pale, tacky mm
• Cool temperature of extremities
• Increased heart rate
• Decreased blood pressure

4.4.2. Types of fluids

Isotonic crystalloids distribute to all body fluid compartments

• LRS (volume replacement)
• Normosol
  
• 0.9% saline (recommended in head trauma cases)

Nonisotonic crystalloids

• 5% Dextrose in water
• Hypertonic saline

Colloids cannot pass through capillary membranes

• IV volume expanders
• Plasma, whole blood
• Dextrans
• Hetastarch
  
  
  
  • Expands to 1.4 x infused volume
  • 10-15 ml/kg bolus up to QID
• Always give with isotonic crystalloids (40-60% volume)

4.4.3. Fluid administration (see also Avian Diagnostic and Therapeutic Techniques

• Routes of administration: oral, subcutaneous, intravenous, intraosseous
• Fluid volumes: Daily maintenance plus deficits and ongoing losses
• Rates of administration:
  
  • Up to 60 ml/kg IV bolus or IV, IO drip for shock therapy
  • Replace half of total fluid deficit in first 12 - 24 hr
  • Replace the remaining half over the following 48 hours

4.5. Blood Transfusions

4.5.1. Indications

• PCV < 10-15%
• Rapidly dropping PCV
• Hypoproteinemia
• Perfusion deficits

4.5.2. Blood donor choices

Closely matched or identical species blood donors are preferable, however, studies have shown that the source of the donor blood may safely come from a different species than the recipient. The use of pigeon, chicken, or raptor blood has proven to be quite safe, and often lifesaving in psittacines as a one time emergency procedure. Interspecies transfusions will not last as long as intraspecies transfusions. Administration of blood is no more difficult than administration of intravenous or intraosseous fluids. A life saving transfusion should be carried out even when crossmatching is not readily available.
4.5.3. Procedure

Suggested set-up

• Healthy donor bird
• Isoflurane anesthesia (mask)
• ACD or CPDA solution or syringe coated with herparin
• 22 ga. butterfly catheter (collection)
• 24 ga. indwelling catheter (administration)
• Blood component infusion set
• Warm lactated ringers solution
• B-Complex
• Iron dextran

Blood Donor - Blood may be collected from the donor bird from either the jugular or brachial veins. Isoflurane anesthesia of the donor may make the procedure easier to perform, although it is not always required. Ten ml of blood per kilogram of body weight may safely be taken without harm to a healthy donor bird. Blood should be collected in some form of anticoagulant. A syringe coated with heparin, EDTA, or containing a citrate solution (9 parts blood to 1 part ACD solution) will suffice. Heparin anticoagulant is preferred over EDTA for smaller recipients in order to avoid adverse effects (hypocalcemia) in the recipient. Following blood collection, the donor bird should receive an equivalent 10 ml/kg intravenous fluid replacement, as well as intramuscular administration of B vitamins and iron dextran. This supportive therapy is especially important if the donor is used repeatedly. Donated blood is best if used within hours after collection. Storage of avian blood results in an increasing potassium concentration that will become dangerous to the recipient over time (days).
ACD solution

9 parts blood to 1 part ACD solution
CPDA solution

1 ml blood to 0.14 ml CPDA solution
Recipient - The recipient may be given blood through any available vein (cutaneous ulnar, jugular, or medial metatarsal vein). The use of an indwelling catheter or a butterfly catheter is prudent. A small blood administration set which includes an in-line filter is commercially available (Blood component infusion set, 4C2223, Fenwal Laboratories, Deerfield, IL). Care must be taken to minimize stress in the severely anemic patient. Pre-oxygenation and/or oxygen administration during the procedure may be required. Anesthesia of the recipient is usually not necessary, and may be risky. The recipient should also receive intramuscular iron dextran and B vitamins as supportive therapy.

Transfusion

4.5.4. Repeat transfusions

Studies have shown an increased mortality associated with repeated transfusions given to a patient from the same donor within 10 days of the first transfusion. Reasons for this observation are not understood. It is recommended that repeated transfusions should not be given to a patient from the same donor within 10 days and preferably 3 weeks of the first transfusion without crossmatching. If this is unavoidable, the recipient should be given dexamethasone sodium phosphate before repeating the transfusion. Crossmatching with unwashed red cells is apparently not valid . Crossmatching with washed and incubated red cells may be valid, showing either hemolysis or agglutination reactions.
4.5.5. Use of Oxyglobin

There are very good anecdotal reports on the use of Oxyglobin

in birds. No scientific papers or official recommendations for its use in birds are currently available. Since it has become available in 60 ml containers, it is now more practical to use. However, availability is sometimes limited and cost my be prohibitive.

• Studies in chickens and some psittacine species have used 15 ml/kg slow IV or IO route.
• Used in hemorrhagic shock, hemodilution, chronic anemia to increase oxygen to tissues
• No cross matching required
• No observable side effects seen
• Increased PCV for short periods of time only (~ 3 days)

4.6. Nutritional support

Nutritional support is very important and should be considered soon in the therapy plan. Birds will tend to deteriorate and lose body energy and protein stores more rapidly than mammals, due to their relatively high metabolic rate. Blood glucose measurements can assist in determining the immediate need for supplementation, but should not be the only criteria. Enteral nutrition is preferred, but oral supplements should not be given to recumbent patients because of the risk of regurgitation and aspiration. The type of enteral supplementation should be chosen to match the species appropriately. Supplements are available from the major avian diet manufacturers: Roudybush, Harrison, Lafeber, etc.

Gavage

Gavage feeding

• Proper restraint is essential for safe administration and to avoid regurgitation
• Choose a warm enteral product appropriate for the species
• Maximum stomach capacity 50 ml/kg
• To ensure proper placement, visualize the feeding tube past the glottis and palpate the tube separate from the trachea in the neck
• Psittacines are usually gavaged into the crop, other birds are usually gavaged into the proventriculus
• Consider additional parenteral support
• Monitor weight, fecal production, and blood glucose levels

4.6.1. Refeeding syndrome

Severe electrolyte and fluid shifts associated with metabolic abnormalities in malnourished patients undergoing “refeeding”, whether orally, parenterally, or enterally. Phosphorus, potassium, and magnesium shift to intracellular space leading to sudden drops in serum levels.

• Clinical signs are varied, including neurologic dysfunction and cardiac arrhythmias
• Do not offer emaciated animals (TS < 1.0) whole food initially
• Always rehydrate animal first
• Give B vitamins
• Give oral electrolytes first
• Tubefeed formula low in carbohydrates, high in fat with adequate protein
• If the patient is digesting the formula, move gradually on to easily digestible solid food

4.7. Thermal and oxygen support

40% O2 saturation recommended.
Heat sources may include:

• Incubator
• Heating pad
• Heat lamp
• Circulating warm air devices
• Heated room

Distress

4.8. Pain Management Protocols

For all birds with mild to moderate pain
(patient must be euhydrated and not in shock)
Meloxicam PO, SQ

Loading dose 0.2 mg/kg BID (day 1)
0.1 - 0.2 mg/kg BID thereafter
Butorphanol IM

1-4 mg/kg q 2-4 hours
Buprenorphine IM, SQ

0.25 mg/kg BID - TID
5. Common Emergencies

The following common emergencies may be discussed in class :

• Trauma - Thermal burns, cagemate or predator aggression, flying into objects, owner induced trauma, gunshot, entanglement, fractures, lacerations, wounds, bleeding
• Respiratory emergencies - dyspnea from upper or lower respiratory disease or extra-respiratory causes (neoplasia, hepatomegaly, egg binding, ascites, thyroid dysplasia)
• GI emergencies - diarrhea, vomiting, toxin ingestion
• Neurologic emergencies - seizures, head trauma
• Reproductive emergencies - egg binding, prolapse
• Renal emergencies
• Toxicities - ingested, inhaled, skin contact
• Other; bloody droppings

5.1. Table of Common Emergencies

Condition

Clinical signs

Emergency
Diagnostics

Treatment

Comments
Fluffed bird (nonspecific)

Anorexia
Depression
Fluffed feathers

History/PE
PCV/TP
Blood glucose

1. Supportive care - fluids, heat and oxygen
2. Closely monitor for specific symptoms

The "emergency" fluffed birds may be an acute presentation of a chronic disease, usually evident from PE and/or history.
Trauma

Bleeding
Lameness
Wing droop
Wounds

History/PE
PCV/TP Radiography

1. Control bleeding
2. Treat for shock
3. Stabilize fractures
4. Treat soft tissue wounds aggressively
5. Supportive care as required

Trauma is the most common cause of wild bird emergencies.
Lead poisoning

Anorexia
Regurgitation
Diarrhea
GI stasis
Paralysis
Seizures
Hematuria

History/PE
Radiography
Blood lead
CBC
Serum chemistry

1. Diazepam (seizures)
2. Remove lead source - Cathartics/oral chelators, endoscopy, proventriculotomy
3. CaEDTA: 35 mg/kg IM bid x 5d.
4. Supportive care

Consult references for details on various therapy choices. Begin therapy with any serious suspect before blood results are available.
Do not chelate if metal densities are still present in the GI tract.
Egg-binding

Anorexia +/-
Straining
Abdominal distention

History/PE Radiography

1. Warm, moist heat
2. Lubrication
3. If egg in distal position Oxytocin 0.2-2.0 IU IM Calcium 50-100 mg/kg IM
4. Treat for shock if needed
5. If egg in proximal position - laparotomy

There are many variations of egg-binding. Consult references for details in handling these cases. By far the majority of cases respond to moist heat and medical therapy.
Hemochromatosis (Mynahs & toucans)

Respiratory distress
Ascites
Weakness
Anorexia

History/PE
Radiography
Abdominocentesis
CBC
Serum chemistry
Liver biopsy

1. Abdominocentesis
2. Furosemide: 0.15 mg.kg IM tid
3. Oxygen therapy may help
4. Desferoxamine therapy long-term
5. Phlebotomy

Poor prognosis. May need to repeat treatment. Diet management recommended.
Hypocalcemia
(African Grey parrot)

Lethargy
Severe weakness
Tetany/Seizures
Fainting/coma

History/PE
CBC
Serum chemistry
Serum calcium

1. Calcium: 50-100 mg/kg diluted IV or IM
2. Followed by oral calcium supplementation with Neocalglucon 5 ml/30ml water x 7 days 1 ml/30ml water indefinately

Give calcium slowly.
Polytetra- Fluoroethylene toxicity
(burnt Teflon)

Respiratory distress Rapid death

History

1. Oxygen therapy
2. Supportive care

Therapy is usually not successful. Bird most often DOA.
Oil contamination

Hypothermia
Anorexia
Diarrhea
Respiratory distress
Dehydration

History/PE
PCV/TP

Wear proper PPE.

1. Stabilize with supportive care, incl. heat, nutritional and fluid therapy.
2. Remove oil 1st with towel , 1-% Dawn dishwashing liquid, rinse thoroughly till waterproof.
3. Dry completely with warm pet hair dryer, incubator, or heat lamp (be careful not to burn skin!)
4. Treat with antifungals (selected species)

Wash/rinsing should be repeated until water beads up on the feathers. Use water temp. of 103-104 F. Consult references.
5.2. Table of Respiratory Emergencies

Source

Clinical signs

Differential diagnosis

Diagnostic tests

Initial Treatment
Upper Respiratory

Anorexia +/-
Inspiratory dyspnea
Oculonasal discharge
Obstructed nares
Coughing +/-
Sneezing
Choking

Upper respiratory infection
Foreign body obstruction
Inhaled toxins
Thyroid dysplasia
Tracheal parasites

Choanal culture
Sinus flush/culture
Transilluminte the neck
CBC
Radiographs

Staged PE
Oxygen prn
Nebulization?
Air sac cannulation prn
Lower Respiratory

Anorexia/weight loss
Expiratory dyspnea
Coughing +/-
Severe depression
Voice change
Open mouth breathing
Cyanosis

Pneumonia
Air sacculitis
Asthma
Air sac mites
Toxic inhalation (Teflon)
Heart disease

Radiographs
CBC
Serum chemistry
Laparoscopy/biopsy/culture

Oxygen
Nebulization
Surgical intervention?
Supportive care
Abdominal Compression

Anorexia
Dyspnea
Abdominal distention
Lack of droppings +/-

Neoplasia
Hepatomegaly
Egg binding
Ascites/peritonitis

Radiographs
Physical examination
CBC
Serum Chemistry

Abdominocentesis
Surgical intervention?
Oxygen may or may not help
5.3. Table of Gastrointestinal Emergencies

Source

Clinical signs

Differential diagnosis

Diagnostic tests

Initial Treatment
Upper Gastrointestinal

Anorexia +/-
Dehydration
Regurgitation
Emaciation
Weight loss
Palpable crop abnormality

Oral/pharyngeal lesion
Crop infection
Crop motility disorder
Thermal burns and fistulas
Foreign body obstruction
Proventricular dilatation
Lead poisoning
Behavioral regurgitation
Lower intestinal disease (nausea)

Crop swab/flush (culture and cytology)
Radiographs
Endoscopy
CBC
Fecal examination

Supportive care
Withhold food?
Fluid therapy for dehydration
Surgical intervention?
Treat underlying cause
Lower Gastrointestinal

Anorexia +/-
Dehydration
Diarrhea
Emaciation
Weight loss
Feces color change
Lack of feces

Enteritis
Hepatitis
Pancreatitis
Peritonitis
Psittacosis
Toxicity (Lead poisoning)
Obstruction
Parasitic infestation

Fecal examination
Cloacal culture
Radiographs
CBC
Serum chemistry (incl. bile acids)
Psittacosis titer
Abdominocentesis
Laparotomy/laparoscopy/biopsy

Supportive care
Withhold food?
Fluid therapy for dehydration
Surgical intervention?
Treat underlying cause
5.4. Table of Neurologic, Reproductive and Renal Emergencies

Clinical signs

Differential diagnosis

Diagnostic tests

Initial Treatment
Neurologic Emergencies
Seizures
Severe depression/coma
Head tilt, nystagmus
Ataxia
Blindness
Anisocoria
Paresis/paralysis

Trauma
Lead poisoning
Meningitis/encephalitis
Hypoglycemia
Hypocalcemia
Hepatoencephalopathy
Toxicity
Epilepsy
Thiamine deficiency

Ophthalmologic exam
Blood lead level
CBC
Serum chemistry
Serology
Radiographs

Tx. depending on cause
Head Trauma
NO corticosteroids
IV Mannitol?
Fluids (no dextrose)
Pain medication
Oxygen
Cool environment
Reproductive Emergencies
Abdominal distention +/-
Straining +/-
Cloacal prolapse
Depression
History of egg laying +/-

Egg binding
Chronic egg laying
Follicular cysts
Egg peritonitis
Urogenital tumor

Radiographs
Abdominocentesis
Ultrasound
Surgical exploration

Fluids
Heat
Calcium
Oxytocin
Vitamin A and D
Prostaglandins
Surgical intervention?
Renal Emergencies
Depression
Dehydration
Weight loss
Polyuria
Polydipsia
Hematuria
Change in urate color

Renal failure (e.g. gout, aminoglycosides, toxins, ureteral obstruction, hypervitaminosis D, neoplasia)
Hepatitis (e.g. Psittacosis)
Lead poisoning
Diabetes Mellitus
Stress

Radiographs, IVP?
CBC
Serum chemistry
Urinalysis (glucose, blood)
Laparoscopy/biopsy

Supportive care
Fluids and electrolytes
Antibiotics as needed
Treat underlying cause
6. References and Resources

6.1. Texts and Articles

Altman, Robert B., et al. Avian Medicine and Surgery. Philadelphia. W.B. Saunders Co., 1997. Chapter 48
Altman, RB. Heterologous blood transfusion in avian species. Proceedings of the Annual Meeting of the Association of Avian Veterinarians, San Diego, CA, 1983: 28-32.
Critical care. Agnes E. Rupley, ed. The Veterinary Clinics of North America, Exotic Animal Practice. W.B. Saunders Co., 1998.
Degernes, Laurel A., et al. A preliminary report on intraosseous total parenteral nutrition in birds. Proceedings of the Annual Conference of the Association of Avian Veterinarians, 1995., pp.25-26.
Degernes, Laurel A., ed al. Autologous, homologous, and heterologous red blood cell transfusions in cockatiels (Nymphicus hollandicus).Journal of Avian Medicine and Surgery, v.13 (1) : 2-9, 1999.
Harrison, Gregg J. and Teresa L. Lightfoot. Clinical Avian Medicine. Palm Beach, FL : Spix Pub., c2006. Chapter 7,8.
Jenkins, Jeffrey. Critical care. Seminars in Avian and Exotic Pet Medicine, Vol. 3 (4), October 1994.
Mitchell, Mark and Tully, Thomas. Manual of Exotic Pet Practice. St. Luis, MO. Saunders Elsevier, 2009, Chapter 10.
Morrisey, James K., et al. Comparison of three media for the storage of avian whole blood. Proceedings of the Association of Avian Veteirnarians, 1997: pp.279-280.
Quesenberry, KE, and Hillyer, E. Hospital management of the critical avian patient. Proceedings of the AAV Basic Avian Medicine Symposium, Seattle, WA, 1989: 365-369.
Ritchie, Branson W., et al. Avian Medicine: Principles and Application. Lake Worth, Fla., c1994: Chapter 15.
Samour Jaime. Avian Medicine, Second Edition. New York, NY. Mosby Elsevier, 2008, Chapters 5 & 6.
Stone, E.G. and P.T. Redig. Preliminary evaluation of hetastarch for the management of hypoproteinemia and hypovolemia. Proceedings of the Annual Conference of the Association for Avian Veterinarians, 1994.
Seminars in Avian and Exotic Pet Medicine, Vol 13, No 2 (July), 2004

 

[Peanutsmomma]

Thanks to you, Kathy and everyone else on this informative thread. I have a bantam that has to be tube fed for the foreseeable future and lets say I have learned so much more on this thread than I did from my vet.

Thank you, thank you, thank you!

 

[suebgbr]

Thank you for an amazing thread. I came on freaking out as I have been syringing a water, salt, honey and denegard mixture into my light sussex for 3 days. She gurgled and neck stretched a few times but I figured if she is still breathing after my 'nursing' it is better to try as without trying she wouldn't be breathing for much longer.
I got brave and tried a few long dried mealworms on her tongue.
She swallowed but when I looked, I saw the ends poking out of the back of her throat.
I presumed the hole at the end of her tongue went to her crop (water flowing straight along tongue into hole when they drink would make sense) so all the other space around the hole must be lungs.
I thought I had just shoved mealworms into her lungs!
I can breath again now and possibly sleep tonight.
Thank you you Angel xx

 

[alibabba]

So, this is going to be long term...unless they pass, or show pain....


The plastic syringes from the drug store or farm store fail after a few uses, jam at the critical moment. I tried lubing, storing wet, storing dry....

The pharmacist and I had a chat and we concluded there "must be" something for repeated dosing that will not wear as quickly.

Has anyone tiried these? See next post photo. The left is the tube and syringe type currently using, on the right is the new fancy one. Wish i could use the metal, but the guage looks too big and a little short even for the bantams I am feeding.

Has anyone else used this type?

 

[alibabba]

ETA - working great!!!!! tube is a tight fit, but it does fit and no jams. Worth the $15 if it continues to work so well.