When dealing with avian or other exotic patients, it can be difficult to obtain access to information on the best ways to diagnose and treat them.

At the American Veterinary Medical Association’s convention this year in Atlanta, Ga., one presenter discussed some of the things he considered important to remember when treating birds in his session: “Avian Medicine: Standard of Care.”

“For the most part people that have dogs and cats generally expect that all veterinarians can treat dogs and cats. For exotics the expectation is that all vets can’t treat these animals,” said Thomas Tully Jr., DVM, DABVP (Avian), professor of avian medicine in the department of veterinary clinical sciences at Louisiana State University’s School of Veterinary Medicine.

Tully said his department at LSU receives between 20 and 30 inquiries a week from veterinarians who treat birds. He believes that there need to be some guidelines so that avian patients can get the best care possible.

“Veterinary medicine has been talking about this for a while, but never done anything to establish standards of care - something that people can use as a reference,” Tully said. “People have danced around it for years.”

Tully referenced a recent edition of the Journal of Exotic Pet Medicine that was devoted entirely to “standards of care” for exotic pets. In veterinary medicine, “standards of care” are not a particular document or set of guidelines. In her introduction to the Journal of Exotic Pet Medicine article (Volume 19, Issue 1, January 2010), Amy Worell, DVM, DABVP (Avian) notes that the term can mean anything from the minimum amount of care needed to treat a patient, all the way to the highest possible level of medicine available.

“The standards of care for a veterinarian treating exotic animal patients may include but are not limited to guidelines for examinations, anesthesia, monitoring of anesthesia, surgical procedures, recovery of patients after surgical and anesthetic procedures, analgesics, currently accepted protocols and medications, knowledge regarding husbandry and medical presentations of exotic species, and record keeping,” Worell writes. “Moreover, with rapid advances in medicine, technology, and pharmaceutical products, standards of care have become a dynamic entity rather than rigid, static dogmas.”

In terms of routine evaluation and treatment of avian patients, Tully said he uses the following protocol:

1. History
2. External physical examination
3. “Hands on” physical examination
4. Formulating differential diagnoses list
5. Diagnostic testing to confirm top differential diagnosis
6. Treatment – also treatment while waiting for diagnostic test results

Another important part of treating avian patients is dealing effectively with their owners. This includes effectively communicating with them on what is required in terms of diagnostic tests or treatment, as well as educating the clients on proper nutrition and care at home.

“You have to educate these owners,” Tully said. “Most of them have no clue, so the best thing we can do is to educate them.”

In the article, “The Goal: Quality Avian Medicine,” in the Journal of Exotic Pet Medicine (Volume 19, Issue 1, January 2010), Stephen Fronefield, DVM, DABVP (Avian) shared his insight on treating avians and interacting with their owners. Fronefield made a list of what he considers the top 10 most important things to go over with bird-owning clients:

1. Discuss the importance of a clean and safe environment of adequate size.
2. Educate the client regarding the nutritional needs and feeding recommendations for the species they own.
3. Environmental enrichment is equivalent to employment and recreation for people and is critical for maintaining normal healthy behavior in a bird.
4. Discuss the importance of routine veterinary care.
5. Discuss psittacosis and the zoonotic potential of this infectious disease.
6. Provide written first aid information for some of the most common emergencies such as bleeding, animal bites, burns, fractures, seizures, and respiratory distress.
7. Provide the owner a list of clinical signs that would be an indication that their bird may be sick.
8. Encourage pet bird owners to acquire an accurate gram scale and have them record their birds weight weekly.
9. Encourage the pet bird owner to assemble an avian first aid kit and provide a written list of what should be placed in this first aid kit.
10. Discuss normal bathing, preening, and molting cycles.

It is important also to treat each client’s bird as if it were the most important bird you see, because to them it is.

“Never underestimate an owner’s love for their companion animal,” Tully said.

Veterinarians who want to treat avian patients should also reach out to the broader community to increase their knowledge, Tully said. Information from bird shows and bird clubs can be useful, as well as interacting with classmates, specialists and consulting websites. He said not to be afraid of asking for advice, and in fact clients like it when they learn their veterinarian is consulting with other veterinarians on tough cases.