Avian SurgeryWord下载.docx

Avian SurgeryWord下载.docx

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Radiosurgicalunits,lasers,microsurgerytechniques,extremelysafeanesthesia,surgicalmagnification:

yes,aviansurgeryhascomealongway!

WhenIfirstjoinedtheAssociationofAvianVeterinariansbackin1981,manysurgicalprocedureswereoftendiscussedasalast-ditchprocedureforpets,orforwildbirdsdestinedforre-release（andthus,needingnear-perfectrepairsofinjuries）.

Justabouttheonlycommonlyperformedaviansurgerytwentyyearsagowassurgicalsexing.Manypetownersandbreedersreliedonthisprocedure,utilizingrigidendoscopicequipment,toaccuratelyidentifythesexofabird.Surgicalsexingwasusuallyperformedundergeneralanesthesia,eitherprovidedasananestheticgasmixedwithoxygen,orasacombinationofinjectablemedications（labeledforuseindogsandcats,usually!

）Sincethoseearlydaysofaviansurgery,therehavebeenmanywonderfuladvancesthatmaketheproceduresextremelysafeandprecise,improvingthequalityoflifeformanyavianpatients!

SurgicalSexing

Surgicalsexingusedtobethesinglemostcommonsurgicalprocedureperformed.Let'

slookattheinitialusesofthefiber-opticsendoscopeanditsuseinsexingbirds,andthenfollowwhereavianmedicinehassoaredfromthere.

Priortosurgicalsexing,mostavianvetsrecommendedfastingthebirdforaperiodoftimetopreventregurgitationduringanesthesia.Aphysicalexamwouldbeperformedoneachbirdpriortotheprocedure.Onceabirdwasanesthetized（andwe'

llgointothatlater）,anareaontheleftsidenearthehipandthighbone（femur）wouldbepreppedforsterilesurgery.Thefeatherswouldbeplucked,theareascrubbedwithsurgicalsoap,asteriledrapewouldbeplacedoverthesiteandasmallincisionwasthenmadethroughtheskin.Ahemostatorbluntprobewouldbeforcedthroughthemuscles,andasteriletubewouldthenbeslippedintothehole.Thishollowsleevethenprovidedaccessintothebodycavityofabird.Usuallyanairsacwouldneedtobepuncturedtoprovidethebestvisualexam.Abright,coollightsourcewasconnectedtoarigidfiber-opticsendoscope（usuallydesignedforhumanjointsurgery）,andthissteriletelescopewouldthenfitintothehollowsleevealreadyinplace.Thiswouldallowthesurgeontovisuallyidentifythesingleovaryofaparrot,foundontheleftsideonly,ortheinternaltesticleontheleftside.Parrotsdohavetwotesticles,bothrightandleft.So,surgicalsexingwasperformedontheleftside,sincethesolitaryovaryisnormallyfoundonthatside.Inmanycases,bycarefulmanipulationofthescope,bothtesticlescouldbeidentified,whichwouldaidinconfirmingsexualidentification.

Whiletheaviansurgeonwaslookingforthegonad（ovaryortesticle）,itwaspossibletoevaluatethebirdforpotentialproblems,suchasanenlargedliverorspleen,cloudyairsacs,abscessesorscartissue.Itwaspossibletoswabalesionforbacterialorfungalculture,andfortheverybravesurgeon,anorgan（liver,kidneyorspleen）mightbebiopsiedformicroscopicevaluationandtesting.Therewere,however,limitationswithsurgicalsexing.Aninexperiencedsurgeonmightmisidentifythesexofthebird.Cloudyairsacsoranenlargedproventriculus（stomach）couldobscuretheareawherethegonadwaslocated,makingsexualidentificationverydifficult,orimpossibleonoccasion.Ifanenlargedorganwasseen,thatdidnotconstituteadiagnosisinitself.Often,additionaltesting,suchasbloodcounts,bloodchemistriesandserologywouldalsobenecessarytoprovideanaccuratediagnosis.

Becausetheovaryandtesticleschange,oftendramatically,betweenbreedingseasonandothertimesoftheyear,surgicalsexingcouldoftendiscernifthegonadwas"

active"

ornot.Thiswasoftenhelpfulinformationiftheexactageofabirdwasnotknown（forexample,ifitwasanimportedbirdwithnohistoryormedicalinformationprovided）.Butvisualexaminationoftheovaryortesticlecouldnottellifthebirdhadsuccessfullybredbefore;

theinformationwaslimitedtotellingifthegonadwasactiveornotatthetimeofexamination.Occasionally,areasoftheovarycouldindicatethatthebirdhadovulatedpreviously.

Oncetheovaryortesticlewasidentified,thesurgeonwouldapplyatattoousingsterileinkinjectedintothewingweboftheappropriatewingtopermanentlyidentifythesexofthebird.Sincefemales（ofparrotspecies）usuallyonlypossessanovaryontheleftside,theleftwingwebwastattooedtoidentifyhens.Sincemaleshavetesticles,leftandright,theyweretattooedundertherightwing.（Asanaidtohelpusremember,weweretoldthat"

malesarealwaysright"

sotattoothemaleunderrightwing!

）Sincethereweresomanyfemalevetsinterestedinavianmedicine,wewouldjustsmileandsmuglylettheguysthinktheyhadsomethingoveronus!

Ha!

Afterthetattoowasapplied,theincisionmayhavebeenclosedwithonesuture,oradropofamedicalgradesuper-gluewouldbeused.Themusclesthatwereperforatedduringtheprocedurewouldnotbesutured,sincetheywouldslidebackintonormalpositiononcethebirdwasstanding.Oncethesurgeonfinished,thebirdwasusuallywrappedupinatoweltosleepofftheanestheticagent.Withgas,thebirdwouldusuallywakeupfasterthanifhadbeengiveninjectableanesthetic.

Anesthesia

WhenIbegandoingsurgeryonbirds,thebestinhalationanestheticavailablewashalothane.Thisgaswasbeingusedonhumans,andwasquicklyadoptedforuseinsmallanimalsandbirds.Oneofthebiggestadvancesinaviansurgerywastheintroductionofisoflurane.Thisgas,whileveryexpensivewhencomparedwithhalothane,wasmuchsaferforbirds.Withbothinjectableanesthetics（mostoftenketamine,combinedwithotherdrugs,suchasValiumorxylazine）andhalothane,therewasalwaystheveryrealriskofanestheticdeath,usuallyfromanidiosyncraticreactiontoadrug,heartproblems,respiratorydepressionoraninadvertentoverdose.Problemswithhalothaneincludeddepressionofthecardiacandrespiratorysystems,potentialliverdamageandheartcontractionrhythmproblems.Isoflurane（which,likehalothane,comesinaliquid）iscarefullypouredintoaprecisemachinecalledavaporizerthatcontrolstheamountgasemittedwithadial.Thevaporizerisconnectedtoanoxygensource.Thegasisdeliveredthroughatubethatisconnectedtoafacemaskorendotrachealtube（whichisplacedinthebird'

swindpipeorairsac）.

Isofluraneisthepreferredinhalationanestheticagentforbirds.Itoffersveryrapidinductionofanesthesiaandrapidrecovery,anditcauseslessdepressionofcardiacoutputthanotheragents,itcausesfewerproblemswithheartrhythmproblemsanditislesstoxictotheliverthanhalothane.Anewergasanestheticagent,calledsevoflurane（UltaneTM,AbbottLaboratories,NorthChicago,Illinois）,mayeventuallysupercedeisofluraneasthegasanestheticagentofchoiceforaviananesthesia.Whileisofluranealreadyoffersrapidinductionandrecovery,andpreciseadjustmentofanestheticdepthduringsurgery,sevofluraneoffersevenmorerapidrecoveryafterprolongedsurgery.However,anaviansurgeonmustpurchaseanew,speciallycalibratedvaporizerinordertobeginutilizingsevoflurane.

Whensomepeoplethinkaboutgasanestheticagents,theythinkaboutthoseusedalongtimeago,andoftenglamorizedinoldmovies,agentslikechloroformorether.Etherisveryvolatileandflammable,andasparkinthesurgicalsuitecouldresultinseriousfire!

Itwasverydifficulttocontroltheamountofchloroformbeingadministered,soassaferanestheticagentsweredeveloped,drugslikeetherandchloroformwerenolongerused.

Inthisdayandage,thereisnoreasonforananestheticagenttobedeliveredviacottonballsoakedinanesthesia.Allofthecommonlyusedgasanestheticagentsrequireapreciseanestheticvaporizertosafelyandaccuratelydeliverthecorrectanestheticdose.

Anesthesiaisnotanall-or-noneprocess.Anesthesiaisprovidedtoabirdtoensurethatthebirdwillfeelnopainduringtheprocedureandtoprovidethedegreeofmusclerelaxationnecessarytoperformtheprocedure,yet,thegoalistokeepthebirdatthelightestplaneofanesthesiapossible.Forexample,ifthebirdflincheswhenfeathersarepluckedfromthesurgicalsite,itisprobablynotdeeplyenoughasleepformostsurgicalprocedures.Withallanestheticagents,thereisarangeofdepth,andifabirdisanesthetizedtoodeeply,itmaydevelopcardiacproblems,andthecentersinthebrainforbreathingmaybecomedepressed,resultingincessationofbreathing.Thisiswhyabirdmustbecloselymonitoredduringanesthesiaandsurgery.

AirSacTubes

Sincebirdshaveairsacs,therespiratorysystemisdifferentthanthatofanyothertypeofanimalsthatveterinariansencounter.Hopefully,priortoperformingsurgeryonabird,avetwilltakeadditionaltraininginavianmedicineandsurgeryinordertobecomemoreproficient.Therearemanyorganizationsthatprovideexcellentcontinuingeducationinavianmedicine.Ifabirdneedstohavesurgeryperformedonthebeak,orinthemoutharea,insteadofplacingthebreathingtubeintothewindpipe（correctlycalledthetrachea）,atubecanbeplacedintoanairsacthroughaholemadeinthebirdelsewhereonthebody.Theoxygenandanestheticgascanthenbeadministeredthroughtheairsac,keepingthebeakandmouthfreeoftubesinordertosafelyperformsurgerythere!

Howcoolisthat?

Anairsactubecanalsobeplacedwhenabirdishavingdifficultybreathingduetoanobstructioninthetracheaorrelatedareas.Forexample,ifaseedisinhaledintothewindpipe,it