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Carolina Raptor Center

21733

Problems

Notes

Costs

Admission date	2018-07-25
Final date	2018-09-14
Days in captivity	51
Species	BWHA - Broad-winged hawk
Age	HY
Sex	UNK
Status	E
Band	6070/light blue

Fracture - humerus, left

Ocular - swelling, OD

Cause of injury: Gunshot

Do NOT release where found

Sx 2018-07-26. Removed fixation 2018-09-03

Found in Mount Holly,NC
Gaston county

Here is a summary of this patient's treatments and expenses:

Desc Qty Cost Subtotal

Examination 1 120.00 120.00

Daily rate 51 15.40 785.40

Radiographs 3 300.00 900.00

Physical therapy 10 110.00 1100.00

Surgery, major 1 1250.00 1250.00

Total 4155.40

Costs are estimates based on fees charged at a local avian specialist.

Radiographs and images
2018-07-25	2018-07-25	2018-07-29	2018-08-12	2018-08-27

2018-12-07 12:14 des/me

Histopathology
Examined are sections of eyelids and periorbital tissue reported to be from a broad-winged hawk. Eyelid and adjacent preorbital tissue: Cellulitis, caseous granulomatous, multifocal, severe, with large amount of intralesional bacterial bacilli, and with areas of granulation tissue and mixed cellular infiltrates, and other areas with fibrin.
Comment: The lesion is consistent with bacterial infection.
Special stain for acid-fast bacteria - negative

2018-09-14 11:14 des

BAR but eye looks terrible. Very swollen and wet.
Decided to euthanize.
Masked with ISO and euthanized with pentobarb 1.0 ml IC

Dissected out the eye. Globe/cornea are perfect. The nicitans was very thick and full of a large volume of fluid. The periorbital tisssues and the lower lid were very thick.
Save tissue in formalin.


Sample
Collection date2018-09-14
Typeformalin-fixed tissue
Notes:
Periorbital tissue
Results:
histopathology : Bacterial infection. Acid-fast NEG

2018-09-13 16:45 lmv/jmw

Food: 21 g m, NOLO
Amoxi-Clav: 1 sm tab (62.5, 125 mg tabs) PO
Meloxicam: 0.14 cc (1.5 mg/ml susp) PO
Tramadol: 0.21 cc (40 mg/ml susp) PO

2018-09-13 09:52 ces

Bird on perch up front. NOLO but approachable which is a little odd. Eye does not look worse.
Decided to give him the day off so did not grab. 

Food: 25 g ck 
Amoxi-Clav: 1 sm tab (62.5, 125 mg tabs) PO
Meloxicam: 0.14 cc (1.5 mg/ml susp) PO
Tramadol: 0.21 cc (40 mg/ml susp) PO


Will recheck tomorrow

2018-09-12 17:00 lmv/var

Very BAR, flew into antechamber and had to grab to remove-stressed. OD closed.

Food: 20 g m, NOLO
Amoxi-Clav: 1 sm tab (62.5, 125 mg tabs) PO
Meloxicam: 0.14 cc (1.5 mg/ml susp) PO
Tramadol: 0.21 cc (40 mg/ml susp) PO

2018-09-12 14:04 ces

Perching.  Eye looked the same as earlier today.  Bandage still intact.  Fairly BAR despite the swelling.  NOLO.

2018-09-12 09:30 des

BAR. NOLO. OD does not look great.

Anesthetized with iso via 2.0 mm ET tube
Upper lid is back to normal. Lower lid is diffusely thickened but does not have the ballooned mucosa as it did previously.  The nicitans is swollen with a yellowish mass on the edge. The globe itself seems normal but appears sunken. There is an area of dark/purple possibly non-viable skin over the lateral canthus. Right nare is clear.

Flushed eye. Removed a small piece from the edge of the nicitans. It was meaty so was not able to deflate. Discovered some brownish fluid drainage from the darkened skin. Removed entire patch of skin (about 1x2 cm). Flushed remaining fluid. It communicated with a SQ space in the lower lid but not much fluid came out. The tissue under the removed patch of skin is somewhat meaty and proliferative. This is starting to look neoplastic. I took a small sample for histopath.

Flushed wound and eye. Dressed wound with SSD + adaptic + tega + a few drops of superglue.
Applied drops of BNP and diclofenac 
Recovery was quick.

----------- ORDER CHANGE -------------
Start clamamox and tramadol.

Prognosis is poor. Discussed euthanasia but he is eating so I want to give him a few more days. Probably won't have histopath results for 6 or 7 days due to huricane.

Sample
Collection date2018-09-12
Typetissue biopsy
Notes:
Results:

2018-09-11 17:01 sws

Food: 24 g m, NOLO
Meloxicam: 0.14 cc (1.5 mg/ml susp) PO

2018-09-11 09:41 ha

NOLO

Food: 21 g m
Meloxicam: 0.14 cc (1.5 mg/ml susp) PO

2018-09-10 17:15 bg

Food: 20 g m, NOLO
Meloxicam: 0.14 cc (1.5 mg/ml susp) PO

2018-09-10 09:40 sat/des

BAR. Flighty. NOLO

OD is slightly open. Does not appear very swollen but lids about 3/4 closed.
Dark so didn't get a great look but looks ok. Did not grab.

Food: 21 g m/ck (+ vit + Ca)
Meloxicam: 0.14 cc (1.5 mg/ml susp) PO

2018-09-09 17:00 mlm/rew

NOLO

Food: 23g m
Meloxicam: 0.14 cc (1.5 mg/ml susp) PO

2018-09-09 10:44 des

Anesthetized with iso via 2.5 mm ET tube
Lids are closed and eye seems a bit sunken. The upper and lower conjunctiva look good. No swelling. The nicitans is swollen and appears full of fluid but minor maniuplation seems to have "popped" it although I did not see any drainage. Flushed eye and nasolacrimal duct. The duct was initially filled with thick, ropey fluid but it flushed clear easily.
Eye looks pretty good at this point.
Applied 2 drops of BNP and diclofenac.

2018-09-09 09:40 ces

Weight: 416 grams
Eye swollen shut.  Oozing a milky fluid.  Will need to drain again once DES arrives for surgery. 

2018-09-08 17:00 smv/rma

NOLO, Going from perch to ground. OD closed, appears swollen.

Food: 26g m
Meloxicam: 0.14 cc (1.5 mg/ml susp) PO

2018-09-08 10:10 rep

Food: 23 g m 
Meloxicam: 0.14 cc (1.5 mg/ml susp) PO

NOLO

2018-09-07 17:00 sc

NOLO

Food: 24g m
Meloxicam: 0.14 cc (1.5 mg/ml susp) PO

2018-09-07 08:05 des

BAR. NOLO. It was a bit dark so couldn't see really well.
Lids open and blinking but not completey open. Swelling so much better. Feathers around eye seem wet/soiled.
Did not grab.

Food: 24 g m (+ vit + Ca)
Meloxicam: 0.14 cc (1.5 mg/ml susp) PO

2018-09-06 17:00 ae/ek

Food: 25 g m, NOLO
Meloxicam: 0.14 cc (1.5 mg/ml susp) PO

2018-09-06 08:05 des/ces

BAR. Perched. NOLO
Seems very visual. MUCH less swollen. Still some poofiness in upper and lower conjunctiva but so much better.

Pred and BNP drops OD

Food: 29 g m
Meloxicam: 0.14 cc (1.5 mg/ml susp) PO

2018-09-05 17:04 var

Food: 25 g m, NOLO
Meloxicam: 0.14 cc (1.5 mg/ml susp) PO

2018-09-05 14:54 lea

Added water, OD still swollen. BAR and perched.

2018-09-05 14:16 ces

Eye still very swollen but not worse.  Perching.  BAR.  Ate food from earlier.

2018-09-05 11:40 des

Flying pretty well but volunteer noticed eye swelling.

Massive periorbital swelling OD.

Anesthetized with iso via mask then intubated with 2.5 mm ET tube
Both the upper and lower conjunctiva were massively inflated with thick, cloudy fluid. Some drainage from right nare. Swollen up like balloons. Could not see the globe.
Made stab incision with 18 gauge needle and expressed the fluid. Very thick and hard to remove. Flushed inside pocket with saline. Flushed the nasolacrimal duct. It flushed out easily.  Much less swollen when done. Applied diclofena and bnp drops.
Once swelling was reduced, could evaluate eye. Globe seems fine. Anterior chamber ok. Could not get a great look at PC due to nicitans but what I saw was WNL.  No sign of blood or trauma so I think this may be a tick bite reaction.

LRS 15 ml SQ
Torb 0.08 ml IM
Meloxi 0.15 ml IM
Dex-SP 0.04 ml IM.

Extubated but conjunctiva began to fill and swell again. Replaced tube. Made large cut in lower conj with scalpel blade. It bled alot but did not really help remove fluid. It was very thick and possibly compartmentalized. Flushed upper as well. At this point it looked pretty good but any further manipulation was only going to make it worse. Hopefully the meloxicam and dex will help quickly.

Light blue tape on band.

MOVED TO: R19

----------- ORDER CHANGE -------------.
Switch to BID
Start meloxi.
Recheck eye SID.

2018-09-05 10:55 mmo

Group entry: 2 animals
one has left wing droop - flew 5x
other has R eye edema - flew 6-7x (unable to deterine band numbers; one has orange,
one has no color)

2018-09-04 13:46 ces/rmb

Leftovers: 0
Group entry: 2 animals
Food in cage: 82 g m

2018-09-03 10:04 ces

Moved to R9.

2018-09-03 09:58 des/ces

Food: 46 g m

Carly reports that he is able to fly a bit now.
Anesthetized with iso via mask. Perfect ROM. Removed fixation. IM pin loose. Cross pin still tight.

2018-09-02 13:00 KLH

50g m; NOLO

2018-09-01 12:40 LEH

45gm, NOLO

2018-08-31 12:00 KF

43 g ck (+vit +Ca); NOLO

2018-08-30 12:15 fs/mkf/ces/rjo

48g m nolo

2018-08-29 11:48 RTS115

45gCk+Vit&Ca,NoLo

2018-08-28 10:21 HA

Food: 49 g m (+ vit + Ca)
NOLO

2018-08-27 11:30 dml

Leftovers: 0
55g CK +vit+ca

2018-08-27 11:30 dml

Leftovers: 0
55g CK +vit+ca

2018-08-27 09:35 ces

Weight: 388 grams
No attempt to fly.

Anesthetized with iso via mask for radiograph.  PT went perfectly.  Pins clean and dry.

Physical therapy
Limb/jointLeft wing
Type
 ElbowWrist
Before140180
After140180

2018-08-26 12:30 KLH

Group treatment: 2 patients
101g m; NOLO

2018-08-25 13:00 LEH

Group treatment: 2 patients
105g m, NOLO

2018-08-24 12:30 lmv

Leftovers: 0
Group treatment: 2 patients
BAR

2018-08-23 11:45 mkf/fs/rjo

Group treatment: 2 patients
116g ck nolo

2018-08-22 12:03 RTS

Group entry: 2 animals
54,50gCk+Vit&Ca,NoLO

2018-08-21 11:25 ces/me

Group entry: 2 animals
Food in cage: 55, 46 g m/ck

2018-08-21 11:21 ces

Weight: 391 grams
Perching with minimal droop.  Jumped to ground.  Did not fly.

PT went well.  No anesthesia needed.  Full ROM easily.

Physical therapy
Limb/jointLeft wing
Type
 ElbowWrist
Before140180
After140180

2018-08-20 11:30 dml

Leftovers: 0
Group treatment: 3 patients
165g Ck +vit+ca

2018-08-19 14:00 KLH

Group treatment: 3 patients
158g m; NOLO

2018-08-18 14:00 rew/cfs

Group treatment: 3 patients
58,57,50g m; NOLO

2018-08-17 13:30 KF

Group treatment: 3 patients
159 g ck (+vit +Ca); NOLO

2018-08-16 13:15 fs/mkf/rjo

Group treatment: 3 patients
155g ck/m nolo

2018-08-15 11:00 rts

Group treatment: 3 patients
54, 52, 50 g ck with vit and ca, nolo

2018-08-14 14:42 rmb

Leftovers: 0
Group entry: 3 animals
Food in cage: 161 g m/ck 

2018-08-14 11:38 ces

Slight droop.

No anesthesia needed for PT.  Full ROM easily.  

Plan: reduce PT frequency to E7D

Physical therapy
Limb/jointLeft wing
Type
 ElbowWrist
Before140140
After180180

2018-08-13 11:15 dml

Leftovers: 0
Group treatment: 3 patients
155g CK +vit+ca

2018-08-12 13:32 amp

2018-08-12 10:31 laf/flm/ces

Group entry: 3 animals
Added 60 g m

2018-08-12 10:06 ces

Weight: 373 grams
NOLO
Very BAR.  Flying!

PT without anesthesia.  Perfect ROM.  Pins clean and dry.  HUGE improvement.

Moved to R22.  banded: 6070/orange


Physical therapy
Limb/jointLeft wing
Type
 ElbowWrist
Before140180
After140180

2018-08-11 12:50 rep/ah

Leftovers: 0
Food: 35 g Q (try half mouse) plus 16g mouse

2018-08-10 13:31 des

Weight: 365 grams
BAR. Flapped/flutter to ground but did not try to fly much.
10g LO(R)

Anesthetized with iso via mask. Elbow stiff but got full ROM quickly. No pops from fx.
Used tuning fork.

Tuning fork treatment
-------------------------
Frequency: 128 Hz
Location: 5 x along ventral humerus and elbow.

Physical therapy
Limb/jointLeft wing
Type
 ElbowWrist
Before95180
After140180

2018-08-09 11:30 fs

Food: 32 g Q plus 10 g  mouse  Watch food intake carefully
24 g LO- rem

2018-08-08 08:57 des

BAR. NOLO. On perch. Flew down to ground. Using wing but not level flight yet.

Anesthetized with iso via mask. Got full ROM but elbow stiff at first. Still hear a pop when flexing after full extension.
Used tuning fork.
Cleaned IM pin. Fixation solid. Cross pin clean and dry.


Tuning fork treatment
-------------------------
Frequency: 128 Hz
Location: 5 along ventral humerus and elbow.

----------- ORDER CHANGE -------------
Stop meds. Switch to SID. Contiue PT q3d.

Food: 29 g quail + 20 g m - WILL GET FOOD DROPPED OFF LATER
Tramadol: 0.19 cc (40 mg/ml susp) PO - last dose




Physical therapy
Limb/jointLeft wing
Type
 ElbowWrist
Before110180
After140180

2018-08-07 17:00 dr/svg

Food: 25 g Q, NOLO
Clindamycin: 1/3 cap (150 mg cap) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

2018-08-07 09:10 nen

NOLO

Food: 23 g Q 
Clindamycin: 1/3 cap (150 mg cap) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

2018-08-06 17:00 mar

Food: 22 g Q, NOLO
Clindamycin: 1/3 cap (150 mg cap) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

2018-08-06 09:20 lap

Leftovers: 0
Food: 25 g Q (+ vit + Ca)
Clindamycin: 1/3 cap (150 mg cap) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

NOLO

2018-08-05 17:00 meg/mlm

NOLO

Food: 28g Q
Clindamycin: 1/3 cap (150 mg cap) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

2018-08-05 09:15 ces/cfs

Weight: 369 grams
NOLO
Very BAR.  Jumpy.

Anesthetized with iso via mask.  Full ROM easily. Pins mostly clean and dry.  A small amount of blood at IM pin site.  Cleaned and applied BNP.

Moved to DLB-1.

Food: 25 g Q
Clindamycin: 1/3 cap (150 mg cap) PO
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

----------- ORDER CHANGE -------------
stop meloxicam

Physical therapy
Limb/jointLeft wing
Type
 ElbowWrist
Before120180
After140180

2018-08-04 17:15 lmv/rma/smv

NOLO, perched, BAR

Food: 24g Q
Clindamycin: 1/3 cap (150 mg cap) PO
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

2018-08-04 08:23 ah/er

Leftovers: 5
bird walking around in kennel, alert. fed 23 g Q; 5 g Q LO

2018-08-03 17:00 sc/ksf

NOLO

Food: 22g Q
Clindamycin: 1/3 cap (150 mg cap) PO
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

2018-08-03 08:45 des

Weight: 366 grams
BAR. NOLO

Anesthetized with iso via mask.
A little stiff at first and some pops at fx site but fixation is solid and got full extension. Cross pin clean and dry. IM pin a little wet. Cleaned and applied BNP

Food: 25 g Q (+ vit + Ca) Watch food intake carefully
Clindamycin: 1/3 cap (150 mg cap) PO
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO


Physical therapy
Limb/jointLeft wing
Type
 ElbowWrist
Before110180
After140180

2018-08-02 17:00 ae/tw

Leftovers: 17
BAR, perched

Food: 22 g Q
Clindamycin: 1/3 cap (150 mg cap) PO
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

2018-08-02 13:26 ces

----------- ORDER CHANGE -------------
stop enro

2018-08-02 08:42 ces/fs/des

All food LO(R)

Ate a meal yesterday, so decided to not grab.  Very stressed.
Will move tomorrow after PT.

Food: 30 g Q 
Clindamycin: 1/3 cap (150 mg cap) PO
Enrofloxacin: 1/4 tab (22.7 mg tab) PO
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

2018-08-01 16:30 lap/hmo

NOLO

Food: 25 g Q
Clindamycin: 1/3 cap (150 mg cap) PO
Enrofloxacin: 1/4 tab (22.7 mg tab) PO
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

2018-08-01 09:00 mmo

25 g lo(R)

Gave the day off from force feeding.

Food: 28 g Q (+ vit + Ca) 
Clindamycin: 1/3 cap (150 mg cap) PO
Enrofloxacin: 1/4 tab (22.7 mg tab) PO
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

2018-07-31 16:45 dr

Leftovers: 23
23g LO Q-whole wing; also had 24g what looked regurgitated Q with orange perch plastic mixed throughout

Food: 25 g Q, 
Clindamycin: 1/3 cap (150 mg cap) PO
Enrofloxacin: 1/4 tab (22.7 mg tab) PO
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

May to need to FF in am.

2018-07-31 08:30 ces/cfs

Weight: 362 grams
24 g lo(R)

Perching, BAR.  No droop.

Full ROM easily.  Pins clean and dry.  Suture line healthy.

Food: 26 g Q 
Force feed: 29 g  
Clindamycin: 1/3 cap (150 mg cap) PO
Enrofloxacin: 1/4 tab (22.7 mg tab) PO
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO



Physical therapy
Limb/jointLeft wing
Type
 ElbowWrist
Before140180
After140180

2018-07-30 17:07 ERL, Mar, BG

Food: 27 g Q  Watch food intake carefully
Clindamycin: 1/3 cap (150 mg cap) PO
Enrofloxacin: 1/4 tab (22.7 mg tab) PO
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

24g Q LO

2018-07-30 09:00 ces/eam

25 g lo(R)

left wing droop

Food: 26 g Q (+ vit + Ca) 
Clindamycin: 1/3 cap (150 mg cap) PO
Enrofloxacin: 1/4 tab (22.7 mg tab) PO
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

2018-07-29 17:00 meg

Food: 27g Q
Clindamycin: 1/3 cap (150 mg cap) PO
Enrofloxacin: 1/4 tab (22.7 mg tab) PO
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

14g LO (R)

2018-07-29 09:29 ces

Weight: 383 grams
All food lo(R)
Perching.  BAR.

Anesthetized with iso via mask.  PT went well.  Could feel popping at the fracture site but it is not unexpected.  Pins clean and dry.  Scrubbed and applied BNP.  Suture line bloody.  Scrubbed and applied BNP.  The area of devitalized skin on the ventral side is unchanged.  Applied SSD, telfa, and tegaderm.  Did not rewrap wing.

Food: 31 g Q
Force fed: 20 g FL
SQ fluids: 15
Clindamycin: 1/3 cap (150 mg cap) PO
Enrofloxacin: 1/4 tab (22.7 mg tab) PO
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO
Tramadol: 0.19 cc (40 mg/ml susp) PO

----------- ORDER CHANGE -------------
stop torb, start tramadol, switch to PO antibiotics, stop fluids, start FF as needed

Physical therapy
Limb/jointLeft wing
Type
 ElbowWrist
Before140180
After140180

2018-07-28 17:00 rma/lmv/smv

NOLO?? Unsure, not written.

BAR, perched.

Food: 24g Q
Force fed: 25g fl c/u
SQ fluids: 15
Clindamycin: 0.26 ml (150 mg/ml inj) SQ
Enrofloxacin: 0.26 cc (22.7 mg/ml inj) SQ
Butorphanol: 0.08 cc (10 mg/ml inj) IM
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO

2018-07-28 09:05 erl/rep

Weight: 382 grams, Leftovers: 21
Food: 21 g m 
SQ fluids: 15
Clindamycin: 0.26 ml (150 mg/ml inj) SQ
Enrofloxacin: 0.26 cc (22.7 mg/ml inj) SQ
Butorphanol: 0.08 cc (10 mg/ml inj) IM
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO
Weighed

2018-07-27 17:31 rew/sc

BAR, standing on the ground. Feisty.

Cage soaked--water dish had been too full and it looks like he knocked it partially over. Changed papers, reduced water in dish.

13g m LO(R)

Food: 23g dark m
SQ fluids: 15
Clindamycin: 0.26 ml (150 mg/ml inj) SQ
Enrofloxacin: 0.26 cc (22.7 mg/ml inj) SQ
Butorphanol: 0.08 cc (10 mg/ml inj) IM
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO

2018-07-27 08:25 des

Weight: 399 grams
BAR. Perched. 10 g LO(R)
Food: 15 g m (+ vit + Ca) Watch food intake carefully
FF 7 g FL
SQ fluids: 15
Clindamycin: 0.26 ml (150 mg/ml inj) SQ
Enrofloxacin: 0.26 cc (22.7 mg/ml inj) SQ
Butorphanol: 0.08 cc (10 mg/ml inj) IM
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO

MOVED TO: R16c

2018-07-26 17:30 lea/cfs

BAR, perched, removed towel. No flat flies.


Food: 20 g m (+ vit + Ca) Watch food intake carefully
SQ fluids: 15
Clindamycin: 0.26 ml (150 mg/ml inj) SQ
Enrofloxacin: 0.26 cc (22.7 mg/ml inj) SQ
Butorphanol: 0.08 cc (10 mg/ml inj) IM
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO

2018-07-26 09:00 des

Still has some flat flies. Sprayed with Bronco after recovery

Surgery report
Procedure - Fracture repair - humerus
Performed by - des
Surgery time - 29 minutes
Cleaned ventral side. Wounds are minor but there is a new patch
of skin that appears a bit devitalized.
Dorsal approach. Very difficult to palpate distal bone end due
to swelling. Proximal end is intact but has a few long jagged/oblique
points but the bone column is intact. There are two large bone
fragments that attached to soft tissue but loose. They appeart
to involve the very distal 1-2 mm of the pectoral crest but the
majority of the crest is intact. Large flap of deltoid muscle
pulled back with the bone fragment. Flushed wound. Drove IM from
fx and exited at the shoulder. Removed distal tip, aligned the
ends and drove distally. Placed bone fragments back into place.
Note there was still a 6 mm bone gap on the cranial/dorsal surface.
Replaced muscle belly over it and secured in place with 4-0 vicryl
(3 interrupted sutures). Flushed and closed skin. Drove distal
cross pin. Decided to not risk placing a proximal cross pin due
the fissures in the proximal end. Had to replace skin sutures
as they tore out when I removed the masking tape. Set rotation,
bent the pins and created a sidebar with VTP. Applied BNP to
the pins and suture line. Covered the suture line with tegaderm
and placed fig-8 body wrap.
The fracture was very proximal and difficult to repair but I
think the procedure went as well as could be expected and I believe
the prognosis is pretty good.

2018-07-25 18:30 hmo/lap

BAR, perched, wings spread. Stressed during treatment.

Food: 20 g m (+ vit + Ca) Watch food intake carefully
SQ fluids: 15
Clindamycin: 0.26 ml (150 mg/ml inj) SQ
Enrofloxacin: 0.26 cc (22.7 mg/ml inj) SQ
Butorphanol: 0.08 cc (10 mg/ml inj) IM
Meloxicam: 0.13 cc (1.5 mg/ml susp) PO

2018-07-25 14:30 des

US FWS notified via email: illegal cause of injury.

2018-07-25 14:20 des/ces

Weight: 383 grams, Keel score: 3.5
Found in the road.


------------- PHYSICAL EXAM FINDINGS ----------------
Head
  Behavior and Neuro: BAR
Body
  Body condition score: 3.5
  Fat: Keel
Wings
    Left humerus: proximal fracture, small wound on ventral side, no bone exposed
Legs
  Ectoparasites: flat flies

Gave 0.08 cc torb IM on intake. 

Anesthetized with iso via mask for radiograph. Rad shows a comminuted fx of proximal third. It seems to be just distal to the pectoral crest but the ventral side opposite the crest may be fragmented. Can't tell for sure on palpation. 

Cleaned wound and flushed well.  Applied SSD, telfa, and figure-8 with body wrap.

Gave 20 cc LRS SQ, 0.25 cc enro and clinda SQ, and 0.03 cc meloxicam IM.

Swarming with flat flies.  Sprayed with bronco.
Quick recovery from anesthesia.  Placed in KR2. 
Plan: surgery tomorrow. Prognosis is guarded.


Eye exam
Exam date - 2018-07-25
Examiner - des
RIGHTLEFT
PLRMenacePLRMenace
++++++++
Stain Stain 
DNE DNE 
Right eye:
WNL
Left eye:
WNL
Eye exam
Exam date - 2018-07-25
Examiner - des
RIGHTLEFT
PLRMenacePLRMenace
++++
Stain Stain 
DNE DNE 
Right eye:
PC WNL
Left eye:
PC WNL