Introduction
It is useful to have an understanding of basic avian first aid and having the capability to provide stabilization to a sick or injured bird until the bird can be transported to an avian veterinarian or emergency clinic. A well stocked first aid kit and familiarity with its use can sometimes make the difference between life and death in some emergency situations. It must also be understood that there are limitations to such treatments and in no way should they be substitutes for the proper diagnosis and treatment by an avian veterinarian. Used properly it can stabilize the bird until such veterinary care can be provided.

Basic First Aid Principles
If an emergency situation occurs with your bird try to remain calm and take a systematic approach to providing care. First and foremost determine the nature of the problem. Is it a traumatic episode? Is it due to illness? If you can see the bird is obviously sick then providing the bird with a heat source and basic supportive care as outlined below is essential. If you are not too sure what is going on, gently restrain your bird in a towel appropriate for its size and examine it carefully. Check for evidence of bleeding, trauma, or fractures. Provide hemostasis (stopping bleeding) or other care as outlined below in the section on basic first aid.

In any emergency situation with a pet bird you must be certain that the bird is kept warm. Birds use much of their energy to provide heat and sick or injured birds can rapidly become hypothermic. Birds that are chilling will ruffle their feathers, tuck their head behind their wing and close their eyes in a sleepy fashion. So it is of extreme importance to have a source of heat for sick birds.

Ideally a hospital incubator/cage or brooder of some type with a controlled heat and humidity environment would be available. Sick birds should be kept between 85-90 degrees F. With small birds a heating pad can be placed on the side of the cage and the cage can be wrapped in saran wrap. Larger birds can be kept warm by placing a heat lamp (infrared) near the cage. Place the lamp in such a fashion so that the bird can move away from the heat if it becomes too warm.

Stress should be reduced. If the bird is kept with other birds it should be isolated so that the other birds do not pick on the sick or injured bird. The bird should be kept in a dark and quiet area so that it can remain calm.

Fluid intake is very important as sick or injured birds can become rapidly dehydrated. Placing some glucose in the water or pedialyte can be helpful. If the bird is tame then it can be given small amounts of fluids directly by mouth with a syringe or spoon. If the bird is not tame then the stress of handling could worsen the situation.

Food intake is also of great importance in emergency situations. A sick or injured bird will often quit eating and then quickly deteriorate. Provide the bird with its favorite foods in an effort to entice eating. If the bird is tame the bird can be hand fed. It may be useful to have some hand feeding formula available or some source of nutritional that can be easily administered. Gavage (tube) feeding can be a useful technique to provide nutritional support but it should NEVER be performed by someone who is not well experienced with the procedure as it can be very dangerous if done improperly.

If at all possible, in the event of an emergency, first contact your avian veterinarian or emergency clinic, and ask for information as how to handle your specific emergency situation. Then make arrangements with the veterinary hospital for bringing the bird in to provide the proper diagnostics and treatments.

The First Aid Kit
A well stocked first aid kit can give you the opportunity to handle minor emergency situations and stabilize the bird before getting the bird to an avian veterinarian or emergency clinic. During an emergency you do not want to be rushing around the house trying to find various items so putting the appropriate materials in a “kit” is of utmost importance. Decide where you are going to keep the kit so it can be easily accessed. A sturdy, medium-sized plastic or metal tool box or container would make an ideal Avian First Aid Kit. Make certain that the box is clearly marked so that its does not get misplaced.

On the inside lid of the first aid kit (or on the top of the kit if you prefer) tape the name, address and phone number of your avian veterinarian and the same information for an emergency clinic (or clinics) that provide care for pet birds. Not all emergency clinics do see birds or sometimes only particular veterinarians at certain emergency clinics see birds, so if they are not on duty then the clinic may not see pet birds at that time. Therefore it is important to find out from your avian veterinarian what is the protocol for after hours emergencies and which facility or facilities they recommend. It is also very useful to keep a copy of the medical records for your bird(s) in an envelope in the first aid kit, especially if the bird has had recent, repeated or chronic illnesses. Include any lab work that had been performed as such information can be of critical importance in certain situations.

Useful numbers to have readily available in the case of poisoning or potential toxin exposure is National Poison Control Hotline: 1-800-548-2423 ($30/case) or 1-900-680-0000 ($20 for the first five minutes, plus $2.95 per additional minute. Prices subject to change.

Supplies

• Notebook-for recording any appropriate information or observations
• Environmental thermometer-useful for determining the temperature inside the hospital cage or home-made incubator set up if a thermometer is not already built in
• Small zip-lock bags-use to hold samples, such as unusual droppings, vomited material, objects the bird had been chewing on, etc.
• Towel-for wrapping and securing your bird
• Rubber Gloves-for handling sick birds
• Penlight or small flashlight-to enable better illumination so that bird can be better evaluated
• Magnifying Glass or Jewelers Loupe-Provides magnification so that the bird can be better visualized
• Scissors-for cutting tape, bandages, strings or objects wrapped around the toes
• Hemostat-to remove broken blood feathers or other materials
• Tweezers (forceps)-good quality to pull or remove splinters or other materials
• Wire cutters-in case bird would get wrapped in wire or caught in chain or bell on toy
• Needle nose pliers-can remove blood feathers, unbend chains or quick links that birds may get caught
• Toenail Clippers-good quality clippers to trim broken or shattered nail
• Nail File-blunt end to round off rough edges of cracked toenail or beak
• Stockinet-looks like sock material, can be used by placing bird in stockinet to keep from thrashing and to keep wings close to body, the bird can breathe through the material if necessary. NOTE: must be loose enough so that bird is able to have full and unencumbered movement of sternum so there is no restriction of breathing. If you are not sure how to use the stockinet properly do not use it!
• Neck Brace- gray foam in a circle (appropriate diameter for the type of bird(s) you have) can be used to keep the bird from chewing at feathers and self-mutilating, cut to length to prevent bird from bending neck down to bite skin or feathers then tape it. Note: Be certain that the bird is able to bend down and drink and eat. If you are not sure how to apply this properly…do not use this!!
• Splints- (tongue depressors, Popsicle sticks, small round sticks) can be used to help stabilize a fractured wing or leg by incorporating into a bandage, an aid before transport to the veterinary hospital. Note: If you are not experienced with applying splints and bandages to birds do not attempt this as more complications may develop if applied improperly
• Antiseptic Towelettes-use to disinfect hands
• Gauze pads-for covering wounds or burns
• Cotton balls- for cleansing
• Q-tips-for cleaning out small wounds, swabbing out mouth, getting material out of mouth
• Rubbing Alcohol or Alcohol Swabs-for cleaning skin
• Sterile Lubricant or KY Jelly- use at the direction of your veterinarian to possibly cover or protect a wound. Note: It is generally not a good idea in most instances to apply ointments or creams to bird skin or feathers. Do only if directed by your avian veterinarian.
• Antibiotic ointment –ointments are typically not used topically in pet birds, however in certain instances ointments such as Neosporin can be used for topical wounds. As above use only with the direction of your avian veterinarian.
  Ophthalmic ointment-can be useful in ocular emergencies. Use only ointment provided by your avian veterinarian and only at their direction.
• Artificial tears or contact lens wetting solution-can be used to flush, moisten or lubricate the eyes
• Aloe vera-can be used for minor burns, many human preparations available, be certain to get 100% pure aloe vera
• Sterile Saline-can be used to flush wounds, moisten sterile dressings, flush the nostrils (if something is caught there) flush the crop, flush the eye. Use under the direction of your veterinarian.
• Micropore Tape- paper surgical tape, bandage material that can used to hold gauze or splint in place
• Vet Wrap- available from veterinary supply, tape that has good holding ability and sticks to itself and not the skin, useful for bandaging or splint application
• Tegaderm dressing-helps healing for burns and certain wounds, available from veterinarians
  Liquid Bandage or super glue-can be used for emergency skin repair
• Blood clotting powder-commercially available products such as Quick Stop, Styptic powder, Monsel’s Powder, Clotisol. In a bind, flour, cornstarch, baking soda can be used.
• Silver Nitrate Sticks-can be useful for bleeding nails, use with caution on bleeding feather follicles or skin wounds only with the direction of your veterinarian
• Peptobismol or Kaopectate-can be used in certain cases of gastrointestinal disturbances, toxin ingestion. Use under the direction of your veterinarian.
• Various sizes of syringes-can be used for oral feedings or flushings of wounds or eyes
• Pedialyte or some type of oral electrolyte or revitalizing solution-used to hydrate dehydrated or stressed birds, be certain to keep checking the expiration date.
• Easy Ounces-emergency food for pet birds
• Calcium sources-calcium plus, calciboost, neocalglucon, calcium gluconate, other preparations can be useful, especially in cases of weakness due to long term egg laying behavior
• Hand feeding formula or human baby food-may be used to provide nutritional support to birds that are not eating through hand feeding, syringe or spoon
• Probiotics-can be useful in the alleviation of stress or used as an adjunct to antibiotic therapy
  Antibiotics-Do not use any antibiotics unless you were instructed to do so by your veterinarian. Inappropriate use of antibiotics can interfere with treatment and diagnostic procedures as well as complicating treatment. Over the counter treatments are inadequate to provide proper and effective treatment.
• An Avian Emergency Guide or book with emergency protocols-keep reference book or information nearby to provide assistance

Recognizing Signs of Illness

Since we are dealing with first aid in this article a long discussion of recognizing illness is beyond the scope of this article, however, some key points must be made. One of the most common reasons that birds come into an avian veterinarian on an emergency basis is due to an illness that went unrecognized and untreated until the bird became seriously ill and quite often in a critical state. Birds hide their illnesses as part of their defense mechanism in the wild; however, it is detrimental to their health as a pet bird because hiding the illness from the pet owner leads to the lack of recognition of illness and could lead to their death. Therefore, all pet bird owners should have some familiarity with signs of illness in pet birds.

The key feature in the recognition of illness in pet birds is that you must develop a feel for what is normal for your bird and watch for deviation form those norms. The bird is eating less than normal, is less active or less vocal, the droppings that have suddenly changed appearance or number or breathing changes should all serve to alert the bird owner of potential disease. The more “in tune” you are with your bird the better able you will be to recognize illness before it becomes a significant problem.

Some signs of illness:

• Change in the number, color or consistency of the droppings
• Decrease in food or water intake
• Change in attitude, personality and behavior
• Changes in respiration
• Unusual respiratory noises
• Weight loss or changes in body condition
• Changes in posture
• Abnormal feather development or appearance
• Lack of preening
• Self mutilation
• Discharge form mouth, nostril or eyes
• Staining around vent
• Vomiting or regurgitation
• Any unusual swellings or enlargements
• Evidence of bleeding or dried blood

Common Avian Emergencies
Broken Blood Feather-Adequately restrain bird and identify the source of bleeding. With a hemostat or needle nose pliers, firmly grasp the broken feather or feather stump and firmly pull out the feather fragment. If you are not able to remove the feather stump, apply enough clotting powder to stop the bleeding and seek emergency veterinary care. Identify the open follicle and provide some means of hemostasis. Sometimes gentle pressure for a period of time can stop the bleeding. If there is significant bleeding or pressure alone will not stop it then an agent such as styptic powder (or corn starch, flour, baking soda) can be used sparingly with pressure to clot the blood. Some veterinarians advocate the use of tissue glue to seal the bleeding follicle. After hemostasis has been achieved, keep the bird warm, place in a covered cage and keep the bird quiet, periodically checking to be certain that the bleeding has stopped. Check with your veterinarian to see if any other care is necessary.

Broken Toenail or Beak-Bleeding can be blotted and cautery powder applied with gentle pressure. When bleeding has stopped, place the bird in warm and darkened environment to prevent further excitement. Periodic checking of bird for bleeding is important. If the beak was damaged the bird may be reluctant to eat due to sensitivity. Warm soft foods may be necessary to entice eating in such conditions.

Bleeding from Mouth or Nostrils-Serious emergency situation and should receive immediate veterinary care. Sometimes blood in the mouth can be due to a beak injury, but unless you are sure this has occurred and you can visualize the beak damage get to the veterinarian.

Burns-Apply liberal amounts of cool water. Use topical aloe vera gel or some other soothing non-greasy topical preparation. Seek veterinary care for further evaluation.

Fractures-Immobilize fracture and apply antibiotic ointment to any protruding bone ends. Apply moist sterile saline dressings to open wounds. Keep bird warm and quiet. Seek immediate veterinary care.

Concussions-This occurs when a bird flies into a wall or window. Keep the bird warm and keep the bird in a darkened cage or container. If the bird does not return to normal rapidly and continues to show neurological deficits seek veterinary care.

Ingestion of Toxic Houseplants-The best action is prevention. Keep potentially poisonous plants away from you bird. If your bird does get into a toxic plant try to flush out the mouth as best you can and if possible remove any portions that are still present in the mouth. A few drops of Pepto-Bismol or kaopectate can coat and soothe the GI tract and may retard the absorption of some toxins. Most bird typically shred plants rather than ingest them and coupled with their rapid GI transit time plant toxicosis are not that common in pet birds. However, do try to flush the mouth and then contact your veterinarian for advice.

Toxic Fumes-Any time you notice unusual smells, fumes or smoke, immediately remove your bird to a well-ventilated area free from the fumes, and if necessary out of the house. Use fans, open windows and ventilate the area. If the birds are showing any signs of breathing difficulties seek veterinary care immediately.

Vomiting-A bird that is vomiting can lose condition rapidly and dehydrate. Try to determine the possible cause of the vomiting, illness, foreign body, toxicosis or metabolic disease. Keep the bird warm and quite often a small amount of Pepto-Bismol given orally can be useful. If the bird continues to vomit seek veterinary care.

Loose Droppings-There are many reasons why birds may have watery droppings, including infections, metabolic conditions, GI upsets, dietary indiscretions, intake of succulent foods and numerous other causes. These birds should be kept warm and provided with adequate fluids and electrolyte supplementation to prevent dehydration. Pepto-Bismol and kaopectate can be useful. The bird should be taken to the veterinarian for proper diagnostic work up.

Blood in Droppings-One of the most common reasons for blood in the droppings of pet birds is heavy metal toxicosis, especially lead and zinc. These toxicoses cause blood in the urine or hemoglobinuria. If you notice this with your bird you should seek veterinary care immediately. Blood may also be seen in the droppings with intestinal or cloacal infections, cloacal growths or with difficulties passing eggs. This will be seen as drops of blood in or on the surface of the dropping. Dark tarry droppings may indicate bleeding higher up in the small intestine. Once again veterinary care should be sought.

Animal Bites-Bite wounds from dogs, other birds and various animals have been frequently seen with pet birds. Sometimes the wounds can be quite extensive, involving fractures and may even lead to death. Identify the wound, stop any bleeding, the wound should be cleaned and flushed out. If a fracture is present and you have reasonable ability you can try to stabilize it for transport to the veterinarian.

Cat Bites-The reason cat bites are listed separately is because the bite of a cat can prove fatal to a bird despite a wound not appearing very significant. The bacteria present on cats mouths and claws, Pasteurella multocida can cause a septicemia and lead to rapid death in birds that have been injured by a cat. Veterinary care should be obtained immediately.

Egg Binding –Another potentially serious emergency. There are various degrees of egg binding and sometimes due to straining the bird may even prolapse the cloaca, oviduct or oviduct and egg. If this occurs seek veterinary care immediately. If the bird is trying to pass an egg it is helpful to keep the bird warm and provide calcium sources. Quite often egg binding is due to poor calcium supplementation. If the egg can be visualized, sometimes dipping the bird’s bottom in warm water can facilitate passage of the egg. A small amount of vegetable or mineral oil on the egg and vent can ease passage (use sparingly). Do not apply too much pressure or you may rupture the egg. Veterinary care should be sought if the egg does not pass. If it does pass and the passage was difficult still seek veterinary care to determine why the passage was difficult and what can be done to prevent a recurrence.

Hyperthermia (overheating)- Spray cool water on the feet and body. Rubbing alcohol can be applied to feet to facilitate cooling. Monitor condition. If condition is not resolving seek veterinary care.

Seizures- Definitely a veterinary emergency, seek care immediately. Keep the bird in a darkened box and keep the bird warm. There are numerous causes for seizures so diagnostic tests will need to be performed.

Foreign Objects in Crop- Best treatment is prevention. If this does occur and you have some skills with this, the material can be massaged out of the crop, into the mouth where it can be removed. If you have not done this before it is not recommended to try to do so in an emergency situation. Seek veterinary care immediately. Caught early it can be removed by massaging out through the mouth or through a crop incision. If the material moves down into the proventriculus, removal is much more difficult and will involve surgery. Do not feed the bird before taking to the veterinary hospital.

Conclusion
The information provided above just scratches the surface of avian emergency care. However, the basic first aid principles provided can hopefully prove useful to you in any emergency situation you face with your avian companions. This information is not to be used as a replacement for veterinary care, rather as an adjunct until veterinary care can be provided. The most important consideration is that prevention is the key; many of these situations can be avoided with good husbandry practices and precautions.

References
Several sources were used available from various websites.

Niles Animal Hospital and Bird Medical Center
7278 N. Milwaukee Ave. Niles, IL 60714
847-647-9325 FAX 847-647-8498

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