birdtoxic.qxd 6/15/01 4:56 PM Page 23 CLINICIAN’S NOTEBOOK Managing Pet Bird Toxicoses J.A. RICHARDSON, L.A. MURPHY S.A. KHAN AND C. MEANS J.A. Richardson, DVM, Dipl ACFE L.A. Murphy, VMD S.A. Khan, DVM, PhD C. Means, DVM ASPCA Animal Poison Control Center 1717 South Philo Road Suite 36 Urbana, Illinois 61802 [email protected] Jill Richardson received her DVM degree from Tuskegee University in 1994. In 1996, following experience in small animal practices in Tennessee and West Virginia, Dr. Richardson joined the ASPCA Animal Poison Control BIRDS ARE CURIOUS BY NATURE, AND SOME HAZARDOUS OBJECTS Center as a Veterinary Poison may be attractive to them. Birds with free household access are more likely to Information Specialist. be exposed to toxicants. Sources of Toxicoses Affecting Pet Birds Reported to the APCC* 11% 27% 12% Pesticides Cleaning products Acknowledgements Plants Medicines The authors would like to thank 25% 25% Harold and Joyce Hamilton, Other, including heavy metals Cindy Dorner, Morgan Wilson, and Information collected between January 1996 - December 2000. Dr. Tracei Holder and the entire staff of the Animal Emergency Clinic of Champaign County. *The ASPCA Animal Poison Control Center, an operating division of the American Society for Photos: Tom Schaefges Photography the Prevention of Cruelty to Animals (ASPCA), is the only animal-oriented poison control Sidney, Illinois center in North America. It is a unique, emergency hotline providing 24-hour-a-day, [email protected] 7-day-a-week telephone assistance. The Center’s hotline veterinarians can quickly answer questions about toxic chemicals, dangerous plants, products or substances found in everyday surroundings that can prove poisonous or fatal to animals. <www.apcc.aspca.org> www.exoticdvm.com EXOTIC DVM VOL 3.1 MAR 2001 23 birdtoxic.qxd 6/15/01 4:56 PM Page 24 CLINICIAN’S NOTEBOOK MANAGING PET BIRD TOXICOSES STEPS IN MANAGING PET BIRD TOXICOSES START ASSESS THE SITUATION PREVENT ABSORPTION ✖ Is the bird seizuring? Ocular Exposure ✖ Is the bird breathing? ✔ Gently flush eyes with tepid tap water or Table 1. ✖ Is the bird in shock? saline for 20-30 minutes (fig a). Examples of Noxious ✖ Is there evidence of hemorrhage? ✔ Use eyedropper to flush in small birds. Inhalants ✔ Perform fluorescein staining and follow-up ✖ Some nonstick surfaces (irons and exams in cases of exposures to corrosive ironing board covers, pots and pans, agents or if redness, pain or ocular woks, drip pans) discharge occurs. ✖ Gasoline fumes ✖ Smoke (any source) STABILIZE THE BIRD Dermal Exposure ✖ ✖ Automobile exhaust/ Administer oxygen if necessary ✔ Stabilize bird first! carbon monoxide ✖ Control seizures ✔ Do not remove toxicants from feathers if ✖ Self-cleaning ovens ✖ Correct any cardiovascular bird is seriously ill. ✔ With light dermal exposures, wash gently ✖ Insecticide sprays and foggers abnormality with solution of mild liquid dishwashing ✖ Chemical sprays (e.g., disinfectants, detergent (e.g., Dawn®) and warm water, deodorizers, furniture polish) rub gently, then rinse with plain warm ✖ Glues, paints, nail polish water to remove soap. Repeat if needed. ✔ With heavy dermal exposures, a thorough ✖ Ammonia or bleach If stable bath may be indicated. Pat dry, keep warm ✖ Mothballs and monitor for signs of hypothermia. ✖ Burning foods and cooking oils ✔ Because detergent may seep between the Patient Information feather barbs, multiple rinses may be ✖ Fumigants (sulfuryl fluoride, ✔ required (fig b). aluminum phosphide) age ✔ sex ✔ An E-collar may be necessary to prevent ✖ Aerosols ✔ health problems? ingestion of toxicant. ✔ recent abdominal surgeries? Table 2. ✔ currently on medication? Inhalant Exposure Common Cardiotoxic Plants Exposure History ✔ when was the exposure? ✔ Remove bird from source and supply fresh ✖ Lily of the Valley Convallaria majalis ✔ how much was ingested? air immediately! ✖ ✔ Humidify oxygen therapy. Oleander Nerium oleander ✔ when did clinical signs occur? ✔ Provide diuretics for pulmonary edema. ✖ Rhododendron species ✔ Bronchodilators may be helpful. ✖ Yew Taxus species ✔ Give anti-inflammatory drugs* and broad- ✖ Foxglove Digitalis purpurea spectrum antibiotics. b ✔ Provide thermal regulation and nutritional support. ✔ Hydration therapy may be necessary. *If corticosteroids are indicated, use with extreme a caution in birds to avoid adverse side effects. 24 EXOTIC DVM VOL 3.1 MAR 2001 birdtoxic.qxd 6/15/01 4:56 PM Page 25 J.A. RICHARDSON, L.A. MURPHY, S.A. KHAN, C. MEANS CONTROL ANCILLARY CLINICAL SIGNS MEASURES Oral Exposure ✖ administer specific “antidote” if ✖ monitor the systems most likely ✔ Crop lavage, with or without activated applicable (fig d) to be affected charcoal ✖ correct thermal regulation, hydration ✖ diagnostic tests ✔ Administer bulking cathartics ✖ diuresis may be beneficial for ✖ supportive care offered until I Emesis exposures to nephrotoxic agents full recovery (fig e) ✔ Do not induce emesis in a bird. Emesis is or to enhance elimination of the considered unsafe in birds due to the poison potential for aspiration and the ineffective- I ness of emetic medications in birds. Adverse effects of diuresis ✔ pulmonary edema I Crop Lavage ✔ cerebral edema ✔ Consider crop lavage for early ✔ metabolic acidosis or alkalosis decontamination (fig c). ✔ ✔ Sedate frightened or fractious birds. water intoxication ✔ Use isoflurane gas and endotracheal tube to prevent aspiration. Contraindications to crop lavage are ingestion of corrosive substances or petroleum distillates. ✔ For lavage, gently flush the crop with warm saline and aspirate repeatedly c d (3-4 times). I Activated Charcoal ✔ As an effective adsorbent for toxicants, give activated charcoal with a gavage tube. ✔ Dosage of activated charcoal is 1-3 g/kg (or 1-3 mg/g body weight) ✔ Activated charcoal is not very effective in adsorbing petroleum distillates, corrosive agents and most heavy metals. I Cathartics ✔ Increases elimination of activated charcoal- bound toxicants. ✔ Use cautiously in birds. ✔ Do not use in dehydrated birds. I Bulking Cathartics ✔ Bulking agents can be useful in removing small solid objects, such as lead paint chips, e from the bird’s GI tract. ✔ One-half teaspoon psyllium (Metamucil®) mixed with 60 ml baby food gruel is administered with a dosing syringe or eyedropper. Repeat to ensure complete removal of the objects 1-2 times daily. ✔ A less effective bulking agent is dilute peanut butter. www.exoticdvm.com EXOTIC DVM VOL 3.1 MAR 2001 25 birdtoxic.qxd 6/15/01 4:56 PM Page 26 CLINICIAN’S NOTEBOOK MANAGING PET BIRD TOXICOSES HEAVY METAL TOXICOSES TOXIN SOURCES CLINICAL SIGNS Zinc I Galvanized wire cages, toys, chains and I Lethargy I Diarrhea I Regurgitation water or food bowls (galvanized coatings I Shallow respiration I Hemolytic anemia I Feather picking may contain up to 99.9% zinc) I Anorexia I Kidney dysfunction I Pale mucous I Zinc hardware (washers, nuts, wire) I Decreased I Cyanosis membranes I U.S. pennies minted after 1983 body weight I Possible liver and I Shivering I Weakness pancreatic I Melena I Polyuria, polydipsia abnormalities I Death Greg Harrison Lead I Lead paint chips I Plumbing material I Depression I Polydipsia I Blindness I Some artist paints I Solder in stained I Weakness I Greenish-black I Circling I Lead weights glass/Tiffany style I Anorexia diarrhea I Hematuria I Lead hardware lamps I Regurgitation I Ataxia (Amazon parrots) I Lead-containing I Lead shot I Abnormal droppings I Head tilt I Death Venetian blinds I Tile, linoleum I Polyuria I Seizures I Lead-coated I Improperly glazed Greg Harrison household bowls Effects on the Body I products I Some antiques Absorbed lead is retained by soft tissues and eventually by bone I Some wine/ I Curtain weights and is slowly excreted through the kidneys. I champagne I Fishing sinkers Lead affects the CNS, renal, hematopoietic, neurologic and bottle foils I Tire weights gastrointestinal systems. I Lead can cause cerebral edema and neuronal damage, demyelination and decreased peripheral nerve conduction peripherally. I Lead can cause anemia through increasing RBC fragility. I Bone marrow suppression is also a potential effect. In some clinicians’ experience, ingestion of heavy metals and other toxins appears to occur most often in a seed-eating bird, suggesting the bird may be seeking nutrients missing from its diet. COMMON HOUSEHOLD HAZARDS* TOXIN SOURCES CLINICAL SIGNS Nicotine — alkaloid derived I Tobacco products I Occur quickly after ingestion, usually within 15-45 minutes. from dry stems and leaves of I Excitation, tachypnea, salivation and emesis. Nicotiana sp. I With severe cases, muscular weakness, twitching, depression, tachycardia, dyspnea, collapse, coma or cardiac arrest. I Death occurs secondary to respiratory paralysis. Products containing I Liquid potpourri, fabric softeners, I Dermal exposure: erythema, edema, intense pain and ulceration. cationic detergents germicides and sanitizers I Ocular exposure: mild irritation to severe corneal injury. I Oral exposure: tissue necrosis and inflammation of the mouth, tongue, pharynx, and esophagus. Polytetrafluoroethylene I Overheated (above 280°C) cooking I Rales, dyspnea, ataxia, depression, restless behavior and acute death. (PTFE)-coated utensils utensils with nonstick surfaces Avocado (Persea Americana) I Leaves, fruit, bark and seeds of some I Small birds: respiratory distress, generalized congestion, hydropericardium, species (toxic principle unknown) anasarca and death. Onset occurs after 12 hours of ingestion, with death occurring