Management of a total beak avulsion in a cockatiel

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A 4-year-old female cockatiel presented to the Cornell University Hospital for Animals Exotics Service for a traumatic, total upper and lower beak avulsion. On presentation, the rhinotheca and gnathotheca (keratinized surface of the upper and lower beak, respectively) was completely avulsed and two-thirds of the distal mandible was fractured and avulsed. Minimal bleeding was noted from the avulsion sites. A guarded prognosis was discussed with owner as the bird’s impaired feeding ability would potentially result in its progressive anorexia, weight loss, dehydration, and death. Supportive care over euthanasia was elected by the owner. Initial therapy included maintenance fluids, antibiotics, analgesics, and anti-inflammatory agents. The avulsed sites were left to heal without surgical intervention. Orthogonal radiographs of the head showed the fracture and avulsion of the distal two-thirds of both the pre-maxilla and mandible and no additional skull fractures. The bird received nutritional support via gavage feeding and direct syringe feeding of a soft diet (Emeraid Nutri-support®). The bird’s prognosis of being nutritionally managed at home with direct syringe feeding was guarded to poor; therefore, an esophagostomy feeding tube was surgically placed while the bird was under general anesthesia. The cockatiel recovered well and received her medications and food through the feeding tube. The bird was discharged to the owner four days following presentation. Hand feeding of soft foods was encouraged to meet the bird’s metabolic energy demands. Complications with the heightened metabolic state of the bird following a severe trauma resulted in dramatic weight loss documented in follow up visits. A denser calorie diet (Kaytee Exact®) and longer recovery time helped the bird regain weight in three weeks post-presentation. Restrospective research on psittacine nutrition revealed that the cockatiel’s metabolizable energy requirements were underestimated; this was likely an important contributor to the bird’s initial weight loss. Communications with the owner six months following the incident reveal that the cockatiel is eating and drinking independently and is now within the normal weight range for its species. In addition, keratin has grown over the remaining pre-maxilla and mandible.
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Senior seminar paper
Seminar SF610.1 2010
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Cockatiel -- Wounds and injuries -- Treatment -- Case studies
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