Patient list | RaptorMed.com | Glossary of terms Carolina Raptor Center
26537 Problems Notes Costs
Admission date2024-09-01
Final date -
Days in captivity81
SpeciesRTHA - Red-tailed hawk
AgeHY
SexUNK
StatusReh
Band22096
Infectious - Aspergillosis, suspected
Shot - R shoulder and R femur
Toxin - Lead
Wing droop - right

Cause of injury: Gunshot

Active patient
Aggressive/dangerous
Do NOT release where found

Removed pellet from R shoulder 10/11

Found in Winston-Salem,NC
Forsyth county
Here is a summary of this patient's treatments and expenses:

DescQtyCostSubtotal
Examination1120.00120.00
Daily rate8115.401247.40
Radiographs14300.004200.00
Physical therapy2110.00220.00
Surgery, major11250.001250.00
Surgery, minor2375.00750.00
Complete blood count960.00540.00
Packed cell volume1025.00250.00
Blood lead9180.001620.00
Fecal exam262.00124.00
Total  10321.40

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

2024-09-08

2024-09-08

2024-09-20

2024-09-20

2024-09-20

2024-09-20

2024-10-11

2024-10-11

2024-10-11

2024-10-11

2024-10-11

2024-10-11

2024-10-11

2024-10-27

2024-10-27

2024-10-27
2024-11-20 10:59 RTS
Leftovers: 0
Food: 110 gR (+ vit + Ca)
Terbinafine: 0.76 ml (25 mg/ml susp) PO
Exercise: 6-8x
Note breathing and flight ability

NOLo, BAR, Exercised:8X, Flight ability normal, Not out of breath

2024-11-19 11:34 AL
Leftovers: 0
Food:104g R (+ vit + Ca)
Terbinafine: 0.76 ml (25 mg/ml susp) PO
Note breathing and flight ability

BARP on entry but dropped to ground immediately. Attempted to fly across enclosure but was unable to lift off ground. Breathing normal. NOLO.

2024-11-18 11:05 ls/keo
Leftovers: 0
Food: 102g ck (+ vit + Ca)
Terbinafine: 0.76 ml (25 mg/ml susp) PO
Exercise: 6-8x
Note breathing and flight ability

Audible panting after 3x, OMB. First two laps were across ground. 6x laps total. NOLO

2024-11-17 12:42 JN
Leftovers: 0
Food: 101g m
Terbinafine: 0.76 ml (25 mg/ml susp) PO
nolo; BAR; on perch
Exercise: flew well 6x p2p
no breathing issues noted

2024-11-16 12:21 CPR
Leftovers: 0
Food: 110 g ck
Terbinafine: 0.76 ml (25 mg/ml susp) PO
Exercise: 6-8x
Note breathing and flight ability

BARP. Meds in food. Breathing normally when enclosure was entered. Ex 4x. On first flight across flew from perch to perch with heavy flapping. On second flight flew the full length of enclosure, but landed on ground. did not reperch. When approached would hop across the enclosure. Afterward was breathing with mouth slightly open. NoLo.

2024-11-15 11:52 Dr G/ Keno

Food: 104 g m (+ vit + Ca)
Terbinafine: 0.76 ml (25 mg/ml susp) PO

Examined outside - sounded like she was flying before we got in there, but grounded for us. Did flap back and forth several times, but didn't really get off the ground.
Caught up and palpated - shoulders still palpate symmetrically and she still seems non-painful.
I am a bit disappointed with the lack of progress, but others have seen her fly more so I am hoping that she was just tired out today.
No lead tests yet - so bumped bloodwork to next week. Also recommend sedated palpation and radiographs next week to better evaluate shoulder. Dr Gardner

2024-11-14 11:09 SD
Weight: 1289 grams, Keel score: 2.5, Leftovers: 0
Food: 102 g m (+ vit + Ca)
Terbinafine: 0.76 ml (25 mg/ml susp) PO
Weigh
Keel check
Exercise: 6x
Note breathing and flight ability

BARP. Breathing normal. Exercised 6x. Made 2 full laps p2p then then went to ground. Last 4 laps hop/flying across the ground. Weighed and Keel check: 2.5 approaching 3. Using R wing more. NOLO.

2024-11-13 11:24 RTS
Leftovers: 0
Food:106 g ck (+ vit + Ca)
Terbinafine: 0.76 ml (25 mg/ml susp) PO
Exercise: 6-8x
Note breathing and flight ability

BAR, NoLo, Perching, Flying, Breathing good,

2024-11-12 13:02 jd
Leftovers: 0
Food: 101 g m/ck
Terbinafine: 0.76 ml (25 mg/ml susp) PO
Exercise: 6-8x
Note breathing and flight ability
Breathing was labored after 4th lap, flight ability declined after final 5th lap, attempted to finish exercise but could no longer fly high enough to perch, resorted to hopping, NOLO, perched

2024-11-11 10:52 bt
Leftovers: 0
Food: 100 g ck (+ vit + Ca)
Terbinafine: 0.76 ml (25 mg/ml susp) PO
BARP, exercised 8x, flight was unsteady, not smooth, from perch to perch. Breathing seemed normal
NOLO

2024-11-10 10:34 EGG
Leftovers: 0
Food: 113 g ck
Terbinafine: 0.76 ml (25 mg/ml susp) PO
Exercise: 6-8x
Note breathing and flight ability
BAR, perched on side with ramp. Very focused on where I was. Ex. 7x. Flew twice perch to perch with little drop off. Bird then got spooked and tried to fly away from me in direction of wall and was grounded. Continued with exercise on the ground. Did not get very much lift with one exception. Lap 6 flew across enclosure and was about halfway up the ramp but did not successfully grab on and was grounded again. Did not hear any abnormal breathing, and did not see any open mouth breathing.

2024-11-09 12:27 CPR
Leftovers: 0
Food: 106 g ck
Terbinafine: 0.76 ml (25 mg/ml susp) PO
Exercise: 6-8x
Note breathing and flight ability

BAR. Perched on perch with no ramp. After entry jumped onto the ground. When approached flew length of enclosure low to the ground. Afterwards refused to move. Breathing was normal. NoLo.

2024-11-08 14:55 Dr. G/MS
Leftovers: 0
Food: 110 g m/ck (+ vit + Ca)
Terbinafine: 0.76 ml (25 mg/ml susp) PO
Exercise: 6-8x
Note breathing and flight ability

Today was on perch on far side with no ramp and flew to other high perch. From there, grounded and was unable to get very high, although flapping both wings and getting a couple of feet off the ground. Showing mild improvement. Opted to continue - has not quite been a month since pellet removal. Continue weight and lead checks. Re-evaluate weekly. Dr Gardner

2024-11-07 10:05 mkf
Leftovers: 0
Food: 108 g m+ck
Terbinafine: 0.76 ml (25 mg/ml susp) PO
Exercise: 4-5x
Note breathing and flight ability
Nolo
BAR, but on ground, no heavy breathing observed. Loose feather sticking up on left wing
Hop/flew across cage length 4 times

2024-11-06 15:24 MS

Pushed lead test to 11/14 instead of 11/12

2024-11-06 11:22 sc

Buffy was partially hemolyzed.

PCV/TP
Collection date2024-11-06 11:22:00
PCV36 %
TS4.8 g\dl
Serumstraw
CBC
Collection date2024-11-06
WBC count27400
Corrected count21920
Hets/Neut47% - 10302
  Bands2+
  Toxics0+
Lymphs38% - 8329
Eos8% - 1753
Mono7% - 1534
Baso0% - 0
Thrombocytes
PI2
HemoproteusNEG
LeukocytozoonNEG
PlasmodiumNEG
Read bycd
Banded hets present but fewer than previous readings. Several small hets. Many reactive or degrading lymphocytes. One potentially severely toxic het seen but no other hets showed markers.

2024-11-06 11:05 SC
Leftovers: 0
Food: 114 g ck (+ vit + Ca)
Terbinafine: 0.76 ml (25 mg/ml susp) PO
Blood: CBC lead

When approaching I could see the bird fly from perch to perch. Once inside he flew once more perch to perch. Handled for blood draw. CBC/PCV were obtained but lead kit is out of date. NOLO. There was some dry raspy breathing when we handled so blood was taken while bird was on O2. Breathing got better after being on O2 (less heavy and no more audible rasping). Opted to add terbinafine back to this patient since we will likely handle still.


----------- ORDER CHANGE -------------
Plan for lead when a new kit is in
Add terbinafine for 2 weeks

2024-11-05 09:00 sc

Skipped

2024-11-04 09:45 cd
Leftovers: 0
Food: 109g ck/m (+ vit + Ca)
Exercise: 4-5x
Note breathing and flight ability

QAR, NOLO. on ground in corner, feathers slightly puffed up. Ramp was not propped up on R perch. Reset ramp and coaxed across ground several times, made a few attempts to jump against walls but no successful reperching or flight. Eventually refused to move from corner.

2024-11-03 12:47 JN
Leftovers: 0
Food: 102g m; nolo
BAR; on perch
Exercise: flew from perch to ground on opposite side of enclosure, then jumped to other side 2x rather than flying; did not notice any breathing issues
Note breathing and flight ability

2024-11-02 13:18 MS


----------- ORDER CHANGE -------------
remove "staff only" note

2024-11-02 13:00 CPR

Food: 110 g m/ck
Exercise: 4-5x
Note breathing and flight ability

BARP when entering enclosure. Breathing was normal. When approached the bird flew half way and then hopped the rest of the enclosure's length. Afterwards stayed on the ground. When approached again the bird hopped the length of the enclosure. NoLo.

2024-11-01 17:01 LT
Leftovers: 0
Food: 56 g m (+ vit + Ca)
Weigh
Keel check
Exercise: 4-5 x perch to perch or back and forth.
BID: STAFF ONLY, Note breathing and flight ability

BARP, NOLO. breathing seemed normal and not labored. Struggled to fly after 1 complete pass. Flew to ground then glided/ hopped back and forth between perches.

2024-11-01 11:59 Dr. G/EGG/SD
Weight: 1262 grams, Keel score: 2.5, Leftovers: 0
Weight change: +32 g (3 %)
Food: 54 g m (+ vit + Ca)
Weigh
Keel check
BID: STAFF ONLY, Note breathing and flight ability

BAR. On high perch, but grounded right away. Still cannot get lift, but I do see improvement as the bird is flapping the right wing. Caught up the bird and did some PT (flexing/ extending the right wing). Another observation is that the bird allowed this quite readily and didn't seem particularly painful, whereas previously he would object to having the shoulder manipulated. He also didn't "quit" as readily.
Prognosis is still guarded. However, I think it is possible that the right shoulder is weak and this is decreasing mobility more than a functional issue.
For now - continue daily PT (back and forth). Maybe increase to 4-5 times daily. Recheck in 1 week. D/c all meds. Dr Gardner

----------- ORDER CHANGE -------------
d/c meds

2024-10-31 16:09 ah/jb
Leftovers: 0
Food: fed 54 g m; NOLO
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
Exercise: 2-3 x perch to perch or back and forth. Stop if he seems tired
BID: STAFF ONLY, Note breathing and flight ability
Bird was on the ground upon arrival; he was running on the ground and would get about 2 feet off of the ground but he would not fly. We put him on the perch to try to get him to fly but he went straight to the ground and then ran/hopped to the other end of the enclosure.

2024-10-31 09:34 ME
Leftovers: 0
Food: 54 g ck
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
Exercise: 3 x perch to perch or back and forth.
BID: STAFF ONLY, Note breathing - appears normal
and flight ability - 3x length, 1st P-to-ground, rest ground-to-ground; R wing does not get full extension, is held lower
NOLO

2024-10-30 16:40 SD
Leftovers: 0
Food: 55 g Q/m (+ vit + Ca)
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
Exercise: 2-3 x perch to perch or back and forth. Stop if he seems tired
BID: STAFF ONLY, Note breathing and flight ability

BARP. Stayed perched until encouraged to fly. Breathing was good. Tried to exercise, flew the length of the enclosure and to the ground on first attempt. Attempted to fly on second attempt but ended up half hopping across. Didn't seem to get good extension in R wing. Stopped exercise there. NOLO.

2024-10-30 09:06 sc
Leftovers: 0
Food: 54 g m/ck (+ vit + Ca)
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
Exercise: 3-4 x perch to perch or back and forth. Stop if he seems tired
BID: Note breathing. Note R wing droop

Perched on right perch. NOLO and QAR w/ foot tucked. tried to fly to other perch and ended up on the ground about 2/3 of the way across the enclosure. Fluttered to the other side, not getting off the ground at all. The R wing didn't droop but it didn't extend like the L did during either attempt to fly. No signs of labored breathing and NOLO


----------- ORDER CHANGE -------------
Staff only
Exercise BID for better observation

2024-10-29 16:46 LR
Leftovers: 0
Food: 76 g m/ck

NOLO. BAR. breathing seemed fine. moved to R6 was not shown on sheet. prepped food accidentally fed to R10 small, though ate it anyway.

2024-10-29 11:00 me
Leftovers: 0
Food: 53 g m
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
Exercised: 2x perch to perch while capturing
BID: Note breathing. Note R wing droop
NOLO

MOVED TO:R 6 for more exercise

2024-10-28 16:50 sc/al/srm
Leftovers: 0
Food: 59 g m/ck (+ vit + Ca)
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing. Note R wing droop

qar, perched,nolo, breathing is fine and wing seems fine

2024-10-28 09:10 bt
Leftovers: 0
Food: 50 g ck (+ vit + Ca)
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
QARP, flew to opposite perch then dropped to the ground. Could not get him/her to fly. Stayed on ground in defensive posture. Breathing seemed normal, no wing droop.
NOLO

2024-10-27 16:05 AG
Leftovers: 10
Food: 55 g m/ck
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
Vet check: Recheck R shoulder. Comment on lead levels.
Weigh
Keel check
PT: R wing
Exercise: 3-4 x perch to perch or back and forth. Stop if he seems tired
BID: Note breathing. Note R wing droop

BARP, leftovers, significant R wing droop, will fly, breathing seems WNL

2024-10-27 11:52 Dr G/ CD

Today bird is perched in the far corner on a perch without a ramp. There is a mild right wing droop. He flew back and forth from the two close perches, then once to the farther perch. After that he flew to the ground and was obviously tired and unable to left the right wing as much as left. However, the little bit of flight that he did was more than I have ever seen him attempt.
Brought inside for radiographs, as there has been some question of his breathing as well.
Breathing a little heavily when caught up, but not wet or raspy.
Radiographs: Better musculature of right shoulder than on previous 2 radiographs. The previously noted fragment of the dorsal shoulder (where clavicle and coracoid meet) is still present but a little more indistinct, hopefully suggesting some consolidation of the fracture.
Lung fields appear clear.

Did PT - the shoulder seemed to have good range of motion. However, after a few rotations I could feel some clicking as the wing was lifted cranially (towards the head).
There is a mild roughness to the way the top of the right shoulder feels when compared to the left.
Prognosis is still guarded. It remains to be seen whether or not the fragment can callous into the shoulder in a way that leaves it free to move. Right now I think it is promising that he is flying a little - it is more than I have seen the whole time he has been here.

Agree on plan re: lead. no action taken at this point.
P: start to exercise - 3-4 times only. Will recheck Friday. Dr Gardner

2024-10-27 11:32 cd
Weight: 1230 grams, Keel score: 2.5
Weight change: +11 g (1 %)
Keel just under 3

Feather check
Right
Left
0987654321
Tail
1234567890
 654321123456 
 
  Ok  Fault bar  Dystrophic
  Old  Curled  Broken, not impable
  Extra  Tipped  Missing
  IB, mature  Soiled  Mutilated
  IB  Bent  Unknown
  Imped  Broken, impable   
  Frayed  Singed   
     Stripped   

2024-10-26 16:30 ABH

Food: 55 g m
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO

NOLO. BARP. Alert to feeder presence, did not become defensive or attempt to take flight. Breathing appears to be normal.

2024-10-26 08:40 SC/GC/KJ
Leftovers: 0
Food: 51 g drk m
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing - WNL

BARP on high perch, NOLO. Watchful and attentive; eyes followed me as I moved around enclosure and would puff up chest if I approached too close. Breathing appeared WNL today. Eyeballed food when dropped but not seen flying down to grab. No water to change.

2024-10-25 17:10 ME
Leftovers: 0
Food: 56 g m/ck (+ vit + Ca)
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing
NOLO

2024-10-25 11:20 ME
Leftovers: 0
Food: 53 g ck (+ vit + Ca)
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing
NOLO, BAR
Standing on ground

2024-10-24 16:43 jb
Leftovers: 0
Food: 58 g m
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing
Very BAR, jumping and flapping. Appears to use both legs well
NOLO

2024-10-24 13:11 MKF
Leftovers: 0
Food: 53 g m/ck
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing

BAR, initially on far perch. Jumped to ground and ran around, then went to corner and took a defensive stance. NOLO.

2024-10-23 16:07 jh
Leftovers: 0
Food: 59 g ck (+ vit + Ca)
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing

QAR, on ground when I entered
breathing normal - closed mouth and nothing audible
watched me closely but did not react much to my presence
NOLO

2024-10-23 09:40 cd
Weight: 1219 grams, Keel score: 2.0, Leftovers: 0
Weight change: +101 g (9 %)
Food: 52g ck (+ vit + Ca)
Fluids: 30cc
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
Blood: CBC lead
Weigh
Keel check
PT: Under GA, check incision, consider leaving body wrap off after 10/16 or 17 - under anesthesia
BID: Note breathing

BARP, NOLO. Perched in back left corner, no ramp to that perch. Breathing normally. Tried to fly perch to perch but landed on ground. Skipped/attempted to fly across enclosure during grab attempts. Raising R wing as he does, maybe a little higher than last time I saw him, but still not using well enough to get air under him. Breathing got a little raspy and strained when grabbed, then settled down. Anaesthetized under ISO and oxygen via mask (4% ind, 2.5% maint) for PT. Did several extension reps and moved shoulder around. No considerable stiffness felt. Drew blood from R ulnar vein for cbc & lead, ran PCV/TS with extra. uneventful recovery. Weight is up significantly but keel score is still a bit low. Gave fluids and meds while still in hand.

Blood tests: Buffy coat appears normal and down to 1-1.5%. No lipemia in plasma. Lead level is slightly decreased, seems steady - retest one more time in 10-14 days?

PCV/TP
Collection date2024-10-23 12:07:00
PCV33 %
TS5.4 g\dl
Serumpale yellow
Blood lead
Collection date2024-10-23
Level6.90 ug/dL
CBC
Collection date2024-10-23
WBC count37800
Corrected count27720
Hets/Neut59% - 16354
  Bands2+
  Toxics0+
Lymphs28% - 7761
Eos7% - 1940
Mono6% - 1663
Baso0% - 0
Thrombocytes
PI2
Hemoproteus1+
LeukocytozoonNEG
PlasmodiumNEG
Read bycd
Bands moderate to severe when present. One cell seen with potentially toxic markers.

2024-10-22 16:36 LR
Leftovers: 0
Food: 53 ck/m
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing

BARP, NOLO. Perched well. Breathing was slower but looked a little shaky. back turned to me initially. While placing food turned to watch me. Made no sounds.

2024-10-22 10:19 sc
Leftovers: 0
Food: 56 g ck
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO


BAR, perched on back perch. No signs of heavy breathing. NOLO

2024-10-21 16:14 me
Leftovers: 0
Food: 50 g ck (+ vit + Ca)
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing

Qar,not perched,nolo, breathing seems fine, nothing else of note

2024-10-21 09:30 eb
Leftovers: 0
Food: 56 g ck (+ vit + Ca)
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing

Quiet - on the ground
did not move or react at all upon entering enclosure. not defensive
breathing appeared normal - not strained, gasping. mouth was closed
left wing was more forward on chest than right wing

2024-10-20 17:33 AG
Leftovers: 0
Food: 54 g m
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
PT: Under GA, check incision, consider leaving body wrap off after 10/16 or 17 - under anesthesia
BID: Note breathing
BAR, NoLo, perched on ground, no notes on breathing

2024-10-20 10:37 cd
Leftovers: 0
Food: 56g m
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
PT: Under GA, check incision, consider leaving body wrap off after 10/16 or 17 - under anesthesia
BID: Note breathing

BARP, NOLO. Glided from perch to ground before we entered. Ran around during grab attempts, trying to get off ground but doesn't lift R wing much higher than body level. Anaesthetized under ISO and oxygen via mask (5% ind, 3.5% maint) for PT. Incision looks great, clean. Did full extensions & shoulder movements. Some clicking felt while moving shoulder? possibly tissue movement? Could not locate exact source. Normal recovery, gave meds PO

No audible breathing during grab, but loud wet rasping as we brought him out of the box in the hospital. Calmed down as he was in hand but breathing remained strained. Silent and normal breathing after ane recovery. "Crackling" auscultated in caudal air sacs.

2024-10-19 16:30 ABH
Leftovers: 0
Food: 54 g m
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO

NOLO. Grounded and quiet upon entry. Did not react to feeder presence until approached. Did not become defensive. Did not attempt to take flight. Breathing appears normal.

2024-10-19 11:00 cd/kj
Leftovers: 0
Food: 50g dk m
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
NOLO
Quiet: on ground, only half paying attention, staring into space, breathing was ok

2024-10-18 16:54 MB
Leftovers: 0
Food: 56 g ck (+ vit + Ca)
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing

NOLO, BARP- quiet, stayed perched in one spot, watched me very closely until I left, breathing appeared normal

2024-10-18 09:35 BT
Leftovers: 0
Food: 50 g ck (+ vit + Ca)
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
QAR, stayed on ground while being observed. Breathing normal
NOLO

2024-10-17 15:11 jb/KK
Leftovers: 36
Food: 57 g m
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
PT: Under GA, check incision, consider leaving body wrap off after 10/16 or 17 - under anesthesia
BID: Note breathing

Respirations unlabored. QAR, perched
36g ck LO

2024-10-17 12:04 MS
Weight: 1118 grams, Leftovers: 0
Food: 49 g m/ck
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
Blood: lead
BID: Note breathing

BARP, attempted to fly off perc then fell to ground, R wing drooped. Ran around enclosure quickly. Breathing was fine until bird was grabbed, then started panting heavily. Anesthetized under 3% iso for blood draw since stressed. Lead is up, but after discussing with ME, might be worth testing again in 5 days to see if level continues to raise since there are no clinical signs of toxicity. Recovery was uneventful. NOLO.

PCV/TP
Collection date2024-10-17 12:04:00
PCV30 %
TS5.2 g\dl
Serumclear
Blood lead
Collection date2024-10-17
Level7.80 ug/dL

2024-10-16 17:21 jh
Leftovers: 0
moved to R10L
---
Food: 49 g ck (+ vit + Ca)
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing

QAR, perched by wall, didn't react much to me
Breathing appeared normal from a distance - didn't appear labored, no OMB, and nothing audible
NOLO, placed new food on perch by door

2024-10-16 13:04 TR/SC

Food: 54g m/ck (+ vit + Ca)
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO

Veterinary Recheck, Right Wing Incision and Respiratory Progress:

Patient was showing increased respiratory effort and increased upper respiratory congestion when we visited the enclosure. A decision was made to bring the bird into the hospital building for brief anesthesia for recheck of the surgical incision and also evaluation of respiratory system.

Patient placed under general Isoflurane anesthesia with mask maintenance. Patient did well under brief general anesthesia. Respiratory sounds were improved with patient under general anesthesia as patient was less stressed. Caudal air sacs sounded clear but there is increased respiratory sounds with upper respiratory system. I suspect patient is having a regression of progress with the Aspergillosis due to recent multiple surgeries and anesthesia events and the stress of healing and handling.

The right shoulder bandage was removed and the surgical incision looks excellent! Healing is normal and excellent, tissues dry and healthy. Sutures were left in place.

PT performed on the right shoulder (SC performed this). Right shoulder had near full extension but Sunny mentioned she has to "work" to get that shoulder fully extended.

Plan is to leave bandage wrap off right shoulder and place patient in larger flight enclosure to increase exercise and activity.

Recommend restarting the antifungal therapy for this bird for the next 2 weeks. Recheck radiographs should be considerd in 2 weeks to evaluate respiratory system, depending on clinical progress.

Dr. Tracey Ritzman, DVM, Dipl. ABVP-Avian & ECM

----------- ORDER CHANGE -------------
restart vori

2024-10-15 16:35 lkm
Leftovers: 23
Food: 58 g ck
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing

QARP, watched me intently, slightly defensive, breathing seems normal, beak closed, LO 23 g

2024-10-15 09:38 EA
Leftovers: 62
Food: 54 g ck
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing

QAR, perched then flew to ground, paced along back of enclosure a few times, after feeder left: stood at food without looking at it, did not eat. nothing to note regarding breathing. wing wrap in place. LO: 62g R

2024-10-14 16:31 RMB/srm
Leftovers: 0
Food:63 g r (+ vit + Ca)
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO

BID: Note breathing

qar, perched,no noticeable breathing issues, nothing else of note

2024-10-14 10:30 EB/me
Leftovers: 0
Food: 56 g ck (+ vit + Ca)
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
Anesthetized with ISO via mask (5% induction, 3% maintain) for PT: (L wing bandaged!) full ROM
BID: Note breathing
Incision over R shoulder dry, sutures intact; covered with Telfa and Tegaderm applied padded Fig 8 to R wing
Gave meds PO
NOLO

2024-10-13 16:34 AG
Leftovers: 55
Food: 55 g m
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing
BAR, perched, Breathing appears normal, 2 whole black mice leftover

2024-10-13 10:12 RMB/DG
Leftovers: 36
Food: 54 g m
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing

BAR, perched, turned around and hopped to ground, no abnormal breathing noticed, 36 g LO m

2024-10-12 15:30 ABH
Leftovers: 0
Food: 50 g m
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
DMSA: 1/4 cap (150mg cap) PO

NOLO. BARP. Alert to feeder presence, did not become defensive. Bandage appears intact. Breathing normal.

2024-10-12 10:30 cd/egg
Leftovers: 42
Food: 50g ck
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
DMSA: 1/4 cap (150 mg cap) PO
BID: Note breathing

BARP, hopped to ground during grab. 42g LO removed. Bandage intact. Grabbed and brought inside for blood draw. Mild bruising over R ulnar vein but L wing is bandaged. Drew blood for cbc/pcv/ts/lead. Mild hematoma forming after draw, kept pressure on for a while until bleeding stopped. Strained breathing during handling/blood draw, but none heard before or after grab or in enclosure.

----------- ORDER CHANGE -------------
stop DMSA, recheck in 5d

PCV/TP
Collection date2024-10-12 11:00:00
PCV29 %
TS5.2 g\dl
Serumclear
Blood lead
Collection date2024-10-12
Level5.40 ug/dL
CBC
Collection date2024-10-12
WBC count31200
Corrected count20106
Hets/Neut59% - 11862
  Bands3+
  Toxics0+
Lymphs27% - 5428
Eos4% - 804
Mono10% - 2010
Baso0% - 0
Thrombocytes
PI2
Hemoproteus1+
LeukocytozoonNEG
PlasmodiumNEG
Read bycd
moderate bands, several reactive lymphs

2024-10-11 16:41 LT
Leftovers: 54
Food: 50 g ck (+ vit + Ca) Watch food intake carefully
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
DMSA: 1/4 cap (150 mg cap) PO
Vet check: Recheck R shoulder
Keel check
BID: Note breathing

QAR, standing on ground. Very alert and responsive. 54 g LO M collected. Breathing seemed very normal and not labored at all

2024-10-11 11:33 Dr. G/MS
Weight: 1195 grams, Leftovers: 0
Weight change: +13 g (1 %)
Food: 55 g m (+ vit + Ca)
Clindamycin: 1.20 ml (Compounded 100 mg/ml susp) PO
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
DMSA: 1/4 cap (150 mg cap) PO
Vet check: Recheck R shoulder
Weigh

Bird is BAR in habitat but really unable to fly. He flaps a little and glides slightly, but really no lift. When approached, he lifts the left wing but the right wing stays pretty much mid-body. It is obvious that the shoulder is not healing.
Brought inside and anesthetized for radiographs. Pellet is still in the shoulder, in much the same area. There is definitely a fracture associated, I think it is either a small piece of the coracoid, or the clavicle near articulation with the shoulder.
Also severe muscle atrophy in right shoulder.
After discussion with staff I decided that the options were another attempt to retrieve the pellet, or euthanasia.
See surgical notes:

Prognosis is still guarded, but my hope is that he will be less painful with the pellet (and debris) gone. We still may need to do a lot of PT because there is so much muscle atrophy. Dr Gardner

MOVED TO: R35a

Surgery report
Procedure - Pellet removal
Performed by - Dr G
Surgery time - 30 minutes

While in the radiology room placed two 23 ga needles to try to
pin-point area of pellet. Preserving the needles, moved upstairs
and placed bird in sternal recumbency. Incised through skin of
shoulder dorsal and slightly caudal to point of shoulder, this
is the area that seemed most likely to be the location of the
pellet. 
Bluntly dissected muscle in that location and located a thin
bone there. However, I was able to dissect just behind that bone
and there was a bit of a divot that I thought I could see gray
through. After a little more blunt dissection I was able to grab
the end of the pellet with hemostats and pull it out, along with
some debris and feathers. Explored the pocket a bit more and
pellet out a large piece of exudate, then some smaller pieces
of debris. I was afraid to flush directly into the pocket in
case of penetration to the thorax or the air sacs, but wet some
sterile Q-tips and debrided the pocket well, removing some smaller
pieces of debris. 
Dribbled 0.05 ml of Lidocaine over surgery site (muscle and skin
- avoiding pocket). 
Oppposed muscles with 4-0 PDS in a horizontal mattress pattern.
Closed skin w/ a Ford Interlocking pattern, 4-0 PDS.
Post-op radiographs showed a bit of a deficit in the area that
the pellet was in, and the fracture fragment appeared to have
sunken down a bit ventrally. 
Placed a figure-8 with a body wrap to immobilize right shoulder.
Bandage change and PT under anesthesia every 3 days for at least
a week, at that point can try to leave off but should continue
PT aggressively for at least 2 weeks to prevent the shoulder
from stiffening. Dr Gardner

2024-10-11 10:52 EGG

2024-10-10 15:19 KK
Leftovers: 0
Food: 52 g Q
Voriconazole: 1/4 tab (50 mg tab) PO
DMSA: 1/4 cap (150 mg cap) PO
BID: Note breathing. No noticeable breathing issues. BARP NOLO

2024-10-10 09:22 mkf
Leftovers: 0
Food: 55 g m
Voriconazole: 1/4 tab (50 mg tab) PO
DMSA: 1/4 cap (150 mg cap) PO
BID: Note breathing
Nolo
BAR - breathing appeared normal. Perched, flew length to ground, ran a length on ground where stayed

2024-10-09 15:27 MB
Leftovers: 0
Food: 58 gck (+ vit + Ca) Watch food intake carefully
Voriconazole: 1/4 tab (50 mg tab) PO
DMSA: 1/4 cap (150 mg cap) PO
BID: Note breathing

BAR NOLO. Perched by branch ramp. Flew to ground on other side of enclosure when approached. Hopped/flapped across enclosure after food drop. No noticeable hard/loud breathing.

2024-10-09 09:10 tm

Food: 50 g m (+ vit + Ca)
Voriconazole: 1/4 tab (50 mg tab) PO
DMSA: 1/4 cap (150 mg cap) PO

BAR, P
flew to ground when I entered, then hopped back to underneath perch when I left but did not re-perch
breathing seemed normal, no omb or noise

2024-10-08 17:00 lkm
Leftovers: 0
Food: 52 g m/ck
Voriconazole: 1/4 tab (50 mg tab) PO
DMSA: 1/4 cap (150 mg cap) PO
BID: Note breathing

QARP, watched me intently, became slightly defensive as I approached, beak is closed, noticed some movement in her chest when breathing, but not much and no sound, did not move other than her head to watch me, NOLO

2024-10-08 08:57 bt
Leftovers: 0
Food: 56 g m
Voriconazole: 1/4 tab (50 mg tab) PO
DMSA: 1/4 cap (150 mg cap) PO
QAR, on ground, running while flapping wings, never perched. Breathing was normal
NOLO

2024-10-07 15:50 sc
Leftovers: 0
Food: 53g ck
Voriconazole: 1/4 tab (50 mg tab) PO
DMSA: 1/4 cap (150 mg cap) PO
BID: Note breathing

Perched, not attempts to fly or move. No open mouth breathing or signs of trouble breathing. NOLO.

2024-10-07 11:37 cd

Buffy coat heavily hemolyzed. No lipemia seen.

PCV/TP
Collection date2024-10-07 11:37:00
PCV26 %
TS5.4 g\dl
Serumpale straw
Blood lead
Collection date2024-10-07
Level9.30 ug/dL
CBC
Collection date2024-10-07
WBC count43000
Corrected count24844
Hets/Neut65% - 16148
  Bands3+
  Toxics0+
Lymphs28% - 6956
Eos4% - 993
Mono2% - 496
Baso1% - 248
Thrombocytes
PI2
HemoproteusNEG
LeukocytozoonNEG
PlasmodiumNEG
Read bycd
~1/3 hets are banded or unsegmented. One het with toxic markers, some degranulated. Minimal blasts seen.

2024-10-07 09:15 ME
Weight: 1182 grams, Leftovers: 0
Weight change: -1 g (0 %)
Food: 57g m (+ vit + Ca) Watch food intake carefully
Voriconazole: 1/4 tab (50 mg tab) PO
DMSA: 1/4 cap (150 mg cap) PO
Collected blood for PCV/TS and lead
NOLO
Breathing normal


----------- ORDER CHANGE -------------
Start DMSA

2024-10-06 17:05 RMB/AG
Leftovers: 0
Food: 50g m
Voriconazole: 1/4 tab (50 mg tab) PO
BID: Note breathing - breathing was normal

BAR, droopy right wing and not opening wing all the way

2024-10-06 09:40 RMB/DG
Leftovers: 0
Food: 50g Q
Voriconazole: 1/4 tab (50 mg tab) PO
BID: Note breathing

BAR, perched, jumped at wall and then fell to ground and stood there, breathing looked normal, NOLO

2024-10-05 15:30 ABH
Leftovers: 0
Food: 50 g m
Voriconazole: 1/4 tab (50 mg tab) PO

NOLO. BARP. Alert to feeder presence, but did not become defensive. Breathing appears normal.

2024-10-05 10:16 mm
Leftovers: 0
Food: 52g m/ck Voriconazole: 1/4 tab (50 mg tab) PO
BID: Note breathing - Nothing out of the ordinary seen/heard.
BARP

2024-10-04 17:33 LT
Leftovers: 0
Food: 53 g m (+ vit + Ca) Watch food intake carefully
Voriconazole: 1/4 tab (50 mg tab) PO
BID: Note breathing

BARP. NOLO. Very alert and responsive, breathing seemed regular and not labored

2024-10-04 10:51 Dr. G

Assessed outside. Bird was perched but then went to ground. Still does not extend right shoulder much. It is unclear whether or not the surgery may have caused some stiffness, or this is just secondary to the trauma from the pellet.
If this persists repeat radiographs next week.

2024-10-04 09:45 cm
Leftovers: 0
Food: 50-55g m/ck (+ vit + Ca) Watch food intake carefully
Voriconazole: 1/4 tab (50 mg tab) PO
BID: Note breathing

BARP. NOLO. Breathing appeared normal.

2024-10-03 16:24 KK
Leftovers: 0
Food: 58 g m
Voriconazole: 1/4 tab (50 mg tab) PO
BID: Note breathing. Breathing seemed normal.

BARP NOLO

2024-10-03 11:15 SD
Weight: 1183 grams, Leftovers: 90
Weight change: -20 g (2 %)
Food: 53 g m
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
Weigh
Move to - R6
BID: Note breathing

BARP. Running around enclosure when trying to grab. R wing still drooping. Was breathing good before, but labored breaths after grabbing. Moved to R6. May need new ramp up to perch. 90 g LO ck.


----------- ORDER CHANGE -------------
Stop Enro and Meloxi

2024-10-02 17:28 cd
Leftovers: 0
Food: 93g ck
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing

BARP, NOLO. breathing normally. Jumped off perch and ran back and forth a few times when I approached to drop food. Still breathing fine
Combined FIC & FF - lots of food - may have some LO tomorrow.

----------- ORDER CHANGE -------------
d/c FF & fluids

2024-10-02 12:01 cd

Buffy % greatly reduced, mild hemolysis in buffy, mild lipemia evident in cloudy serum and small layer of fat at top
Recheck lead in 5 days, restart DMSA if elevated

PCV/TP
Collection date2024-10-02 12:01:00
PCV27 %
TS5.4 g\dl
Serumcloudy pale straw, hemolyzed
Blood lead
Collection date2024-10-02
Level5.60 ug/dL
CBC
Collection date2024-10-02
WBC count38000
Corrected count22800
Hets/Neut60% - 13680
  Bands3+
  Toxics0+
Lymphs29% - 6612
Eos8% - 1824
Mono1% - 228
Baso2% - 456
Thrombocytes
PI2
Hemoproteus1+
LeukocytozoonNEG
PlasmodiumNEG
Read bycd
Many immature het forms, only one toxic cell seen. Monocyte count may be off - odd forms seen, immature? Hemoproteus infection still very mild.

2024-10-02 11:43 TR/SC

Food: 37g m (+ vit + Ca)
Force feed: 10g
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
No feeding notes recorded


Recheck Incision, Right Shoulder, Blood Collection for CBC:
Patient was placed under brief general Isoflurane anesthesia for exam and suture removal and blood collection to aid in minimizing stress level.

Respiratory effort in the carrier box observed prior to restraint showed bird to have relatively normal respiratory effort, perhaps very slight increase in effort but no audible abnormal sounds.

Ausculatation of heart and air sacs under anesthesia was normal.

Incision on right dorsal shoulder area has healed excellent. Remaining skin sutures were removed.
ROM checked for right shoulder, compared to left shoulder and right shoulder does have mild reduced ROM compared to normal side. Eblow and carpus on right side are normal with extension.

Patient recovery from anesthesia was normal.

Assessment: Right shoulder joint, reduced ROM and mobility, mild, compared to normal side (left).

Plan: Transfer to larger enclosure to see how patient does with flight and use of the right wing.
Continue medications at this time.

Dr. Tracey Ritzman, DVM, Dipl. ABVP-Avian & ECM

2024-10-01 17:30 me
Leftovers: 0
Food: 48g m with meds
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing
NOLO
Bird on ground in back of enclosure

2024-10-01 09:35 EA
Leftovers: 21
Food: 45g m
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing

QAR, perched then stood on ground. Feeder able to get very close to bird to collect LO, bird watched feeder without taking defensive stance. No notable breathing. LO 21g ck c/u

2024-09-30 16:41 cd
Leftovers: 0
Food: 90g m/ck (+ vit + Ca)
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
BID: Note breathing

BAR, walking on ground in back. Not sure if he was perched before we came in. NOLO! did not grab, left all food on brick closest to him in the back. No OMB noted, little heavy but nothing audible.

2024-09-30 09:15 SC
Weight: 1203 grams, Leftovers: 0
Food: 40g ck (+ vit + Ca) Watch food intake carefully
Force feed: 44g ck c/u big (size C) (+ vit + Ca)
SQ fluids: 35 ml, if not eating
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
NOLO
Anesthetized with ISO via mask for Wound care/bandage change: Check surgical site - sutures intact and dry
Left off wing wrap
PT - good ROM except shoulder in cranial direction - humerus comes up to 90 degrees but not beyond
BID: Note breathing - labored but not gurgling

MOVED TO:R 4 - walking around, wings raised (L higher than R)

2024-09-29 16:10 CD
Leftovers: 45
Food: 27 g m
Force feed: 36 g m c/u big (size C)
SQ fluids: 35 ml, if not eating
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
Tramadol: 0.58 ml (40 mg/ml susp) PO
BID: Note breathing-heavy and a little raspy at start, by end of TX was almost breathing normal.

BARP, a little aggressive. Notes that he had moved his food around kennel but did not eat, 45 g LO


----------- ORDER CHANGE -------------
increase FF

2024-09-29 09:34 RMB
Leftovers: 41
Food: 46 g m
Force feed: 18 g m c/u big (size C)
SQ fluids: 35 ml
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
Tramadol: 0.58 ml (40 mg/ml susp) PO
BID: Note breathing - raspy when first grabbed, settled breathing down during treatment.

BARP, 41 g LO

2024-09-28 16:05 MS
Leftovers: 23
Food: 43 g m
Force feed: 19 g m c/u big
SQ fluids: 35 ml R leg
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
Tramadol: 0.58 ml (40 mg/ml susp) PO
BID: Note breathing

BARP, hopped off perch and tried to foot. Very bitey in hand. 23 g m LO.

2024-09-28 12:59 MS


----------- ORDER CHANGE -------------
add "Note breathing" note

2024-09-28 09:09 RMB
Weight: 1197 grams, Keel score: 2.5, Leftovers: 20
Weight change: +29 g (2 %)
Food:47 g m
Force feed: 20 g m
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
Tramadol: 0.58 ml (40 mg/ml susp) PO

Physical therapy
Limb/jointRight wing
Type
 ElbowWrist
Before130180
After140180
Notes
ROM on shoulder is stiff, could not get full motion. Extension of wing normal after a few tries.
Surgery report
Procedure - Wound debridement
Performed by - RMB
Surgery time - 0 minutes

Placed under 3.5 5 ISO via mask for wound care and PT.  Was very
wraspy when grabbed, comed down once under ISO.  Heart rate was
stable throughout.  Stitches are nice and dry, did cover with
a little SSD.  After PT wrap wing back in padding and figure
8 wrap with body wrap.  Noted that the right elbow is dark green
and slightly swollen, probably from blood draw on Wednesday.
 

2024-09-27 16:40 SC/ME

Food: 100 g m (+ vit + Ca)
Force feed: 25 g m cut in 1/2 (+ vit + Ca)
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/2 tab (50 mg tab) PO
Meloxicam: 0.39 ml (1.5 mg/ml susp) PO
Tramadol: 0.58 ml (40 mg/ml susp) PO

Fed SID due to tropical storm. Nothing significant of note. Small bit of LO's, not weighed.

2024-09-26 15:14 MS
Leftovers: 27
Food: 1 Q leg
Force feed: 1 m
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
Tramadol: 0.58 ml (40 mg/ml susp) PO

BARP, hopped off perch and footed glove. Did not eat AM mouse.

2024-09-26 08:45 sc
Leftovers: 40
Food: 27 g dk m
Force feed: 20 g ck with meds
SQ: 30 since not eating
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
Tramadol: 0.58 ml (40 mg/ml susp) PO
40 g LO (2 M)

Perched and QAR, wrap is still in place. QAR during treatment

2024-09-25 15:24 TR/SC

Surgery report
Procedure - Pellet removal
Performed by - Dr. Ritzman
Surgery time - 35 minutes

Surgical Attempt at Lead Pellet Removal, Right Shoulder Area:

Patient placed under general anesthesia and positioned in dorsal
recumbency. The area of the right shoulder and thoracic inlet
on the right side was prepared for sterile surgery.  A focal
incision was made with #15 blade over the area of the proximal
right corocoid bone (this approach was chosen based on radiography
findings). 
Gentle blunt dissection performed with saline soaked q tips and
small hemostats to divide between the muscle and soft tissues
of this area. 
The proximal right corocoid was identified. Extensive palpation
and visual exam did not reveal the lead pellet. 
Small bone ronguers were used to gently scrape and remove surface
layer of bone of the proximal corocoid. It was still not possible
to identify or find the pellet. After exam in this area it was
decided to stop surgery and close the area to avoid undue trauma
to the tissues in this area. 
Sterile saline flush then closure with 4-0 vicryl in simple continuous
pattern for subcuticular tissues, subdermal layer and then dermis
with simple continous pattern. Small amount of tissue adhesive
placed along dermis incision line. 
Light padded figure 8 to body wrap was performed to support the
wing for a few days post op. 
Sutures can be removed in 10-14 days. 
Blood lead retest performed today. 

Patient recovery from anesthesia was uneventful and normal. 

Dr. Tracey Ritzman,DVM, Dipl. ABVP-Avian & ECM

2024-09-25 14:20 RMB

Food 44 g M
FF: 49g m (+ vit + Ca) Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO

DMSA: 1/4 cap (150 mg cap) PO
Vet check: Discuss case - scope? Remove lead shot?
Weigh

MOVED TO: KR2

----------- ORDER CHANGE -------------
Continue Vori for one more week
Stop DSMA, Recheck blood in one week and possible restart then.
Tramadol for 5 days starting tomorrow.
Stop PT for time being

Buprenorphine 0.58 ml IM tonight

PCV/TP
Collection date2024-09-25 14:20:00
PCV24 %
TS5.5 g\dl
Serumpale straw
Blood lead
Collection date2024-09-25
Level0.00 ug/dL
CBC
Collection date2024-09-25
WBC count61800
Corrected count32960
Hets/Neut69% - 22742
  Bands3+
  Toxics0+
Lymphs26% - 8569
Eos4% - 1318
Mono1% - 329
Baso0% - 0
Thrombocytes
PI3
Hemoproteus1+
LeukocytozoonNEG
PlasmodiumNEG
Read bycd
Morphology hasn't changed significantly since last read on 9/20. Hemoproteus infection is evidently lingering but very mild, saw 3 cells with halter forms around nuclei. High buffy %, hemolyzed, Dr Tracey agrees with indication of band presence.

2024-09-25 13:43 RMB
Weight: 1168 grams, Keel score: 2.5
Weight change: -29 g (2 %)

2024-09-24 16:37 KC
Leftovers: 0
Food: 44 g m/ck
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
DMSA: 1/4 cap (150 mg cap) PO

Alert, on perch and did not move, no sound. NOLO

2024-09-24 10:08 me
Leftovers: 0
Food: 51 g m
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
DMSA: 1/4 cap (150 mg cap) PO

Perched when we entered and then ran back and forth along the ground while we searched for LO. NOLO found. Placed meds in food. R wing drooped noted

2024-09-23 16:51 RMB/srm
Leftovers: 46
Food: 45-50 g m/ck (+ vit + Ca) Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
DMSA: 1/4 cap (150 mg cap) PO

Qar, perched, nothing else of note

2024-09-23 10:15 me
Leftovers: 23
Food: 46 g ck (+ vit + Ca) Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
DMSA: 1/4 cap (150 mg cap) PO
23 g LO
Anesthetized with ISO via mask (5% Induction, 3% maintain) for PT: Right shoulder, flex/ extend, make notes about stiffness ; good ROM of all joints except when trying to pull/push wing cranially - shoulder stiff in that one direction; PT about 2-3 minutes
quick recovery

wing droop noted upon return to enclosure

2024-09-22 15:56 EGG
Leftovers: 0
Food: 52 g ck
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
DMSA: 1/4 cap (150 mg cap) PO
BARP, NOLO. Flared wings slightly as I entered, but did not move or make noise. Kept eyes on me.

2024-09-22 10:45 RMB/DG/FM
Leftovers: 13
Food: 47 g m
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
DMSA: 1/4 cap (150 mg cap) PO

BARP. LOR. checked water - OK.

2024-09-21 16:30 ABH
Leftovers: 0
Food: 47 g ck
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
DMSA: 1/4 cap (150 mg cap) PO

NOLO. BARP. Alert to feeder presence, but did not become defensive. Struck at food shortly after feeder left.

2024-09-21 09:40 mm
Leftovers: 0
Food: 50 g m/ck Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
DMSA: 1/4 cap (150 mg cap) PO
NOLO
BARP watching me

2024-09-20 17:02 LT
Leftovers: 51
Food: 46 g ck (+ vit + Ca) Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
DMSA: 1/4 cap (150 mg cap) PO

QARP, 51g LO M collected. very alert and aware, but very still, only turning around to face me on perch. No vocalization or defensive display. Water was clean

2024-09-20 10:42 Dr. G/SC
Weight: 1197 grams
Weight change: +19 g (2 %)
Food: 52 g m (+ vit + Ca)
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
Vet check: Discuss case - scope? Remove lead shot?
Blood: CBC PCV/TS lead cbc if extra blood, discuss lead if higher than last test
PT: Right shoulder, flex/ extend, make notes about stiffness - under anesthesia

Bird has not been seen flying but perching and overall doing well.
Brought inside for PT, decided to do sedated radiographs if doing well under anesthesia.
Went down very easily and without any dyspnea; no raspiness heard.
Radiographs: Shoulder pellet is more distinct, appears to be more dorsal to shoulder (or maybe just because inflammation is decreased). There looks like there is a bone chip just dorsal to the shoulder associated with the pellet - difficult to tell which bone it is from. Some muscle atrophy noted in R shoulder.
PT went well, good ROM, there is a little "popping" but seems more just like tendons rather than any instability.

I think I can feel where the pellet is - but opted to not explore because Tracey had suggested doing so when she scopes.
Drew blood for PCV/ TS, lead. Lead is up, PCV down so suggested starting oral chelation.
Recheck for scoping Wednesday depending on patient's CBC. My thought is that if it is improving should we scope? Would scoping be a good way to follow success of treatment? Patient was put into a covered mew for more protection.
He was taken off Voriconazole so I put him back on. My impression is at treatment should be past clinical cure.
Dr Gardner

MOVED TO: R7

----------- ORDER CHANGE -------------
start DMSA

PCV/TP
Collection date2024-09-20 10:42:00
PCV28 %
TS4.8 g\dl
Serumclear
Blood lead
Collection date2024-09-20
Level10.40 ug/dL
CBC
Collection date2024-09-20
WBC count60200
Corrected count37457
Hets/Neut57% - 21350
  Bands2+
  Toxics0+
Lymphs27% - 10113
Eos8% - 2996
Mono7% - 2621
Baso1% - 374
Thrombocytes
PI3
HemoproteusNEG
LeukocytozoonNEG
PlasmodiumNEG
Read bycd
Total count is a bit lower than last count. Less immature het forms seen. Some mono & lymphs seem reactive and some hets are much smaller than usual.

2024-09-19 16:09 KK
Leftovers: 0
Food: 49 g m/ck Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Terbinafine: 0.71 ml (25 mg/ml susp) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO

BARP NOLO RTHA was perched and calm and watched the food intently as I put in on the brick.

2024-09-19 09:25 mkf
Leftovers: 0
Food: 45 g m
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Terbinafine: 0.71 ml (25 mg/ml susp) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
Nolo
BAR - perched and remained so, watching as food placed.

2024-09-18 15:59 MB
Leftovers: 33
Food: 56 g m (+ vit + Ca) Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Terbinafine: 0.71 ml (25 mg/ml susp) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO

BAR LO=33g ck. Perched by slanted branch. Watching closely but not moving much.

2024-09-18 15:13 SD
Leftovers: 0
Food: 52 g ck (+ vit + Ca) Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Terbinafine: 0.71 ml (25 mg/ml susp) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO

BARP. Puffing up feathers. Stayed perched while dropping food. NOLO, water good.

2024-09-17 17:14 MS
Leftovers: 0
Food: 54 g m
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO

BARP, very surprised to see me. Flared wings defensively. NOLO.

2024-09-17 09:30 me
Leftovers: 0
Food: 53 g ck Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
NOLO
Perched, BAR, wet

2024-09-16 16:40 GM
Leftovers: 0
Food: 45 g m (+ vit + Ca) Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO

QARP, slightly puffed, watched me intently. NOLO.

2024-09-16 09:24 BT
Leftovers: 0
Food: 45 g m/ck (+ vit + Ca) Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
Perched when entered enclosure, dropped to ground, then flew to back perch. Quiet
NOLO

2024-09-15 15:54 KG
Leftovers: 0
Food: 45g ck
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO

BARP, NOLO. Turned on perch when I approached and stared intently at food when I put it in. Water checked.

2024-09-15 09:29 cd
Weight: 1178 grams, Leftovers: 0
Weight change: -4 g (0 %)
Food: 47g ck (+ vit + Ca) Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
Weigh
PT: Right shoulder, flex/ extend, make notes about stiffness - under anesthesia

NOLO. Flew perch to ground and hopped/ran along ground to evade capture. Brought inside and anaesthetized under ISO and oxygen via mask (3% ind and maint), monitored rr and hr closely. Pronounced excitement phase during ISO induction. R shoulder has good ROM, no stiffness felt. Did some stretching and shoulder rolling for a few minutes. Did locate some firm swelling dorsally, maybe a little warmer than L side? hard to tell. palpated and visualized both sides and they do seem uneven, swollen area ~1 x ~0.75 in and brighter in color. Fast recovery from ISO.

2024-09-14 16:00 ABH
Leftovers: 0
Food: 51 g m
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO

NOLO. BARP. Watched feeder very carefully from entry to exit, but did not become defensive.

2024-09-14 09:00 CD/MLM
Leftovers: 50
Food: 45 g m/ck Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO

2024-09-13 17:00 mb/cd
Leftovers: 37
Food: 48 g m (+ vit + Ca)
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO

37 g LO m, BARP- stayed perched in defensive position

2024-09-13 14:50 Dr G
Weight: 1182 grams
Went to check bird outside after he was moved. He is on the ground and making no attempt at this time to move off the ground. Also he does not extend the right wing at the shoulder much at all when approached.

This bird has two major problems to be addressed:
1. Right wing - pellet in shoulder likely causing pain and inflammation, also unknown damage to area from bullet tract, which is unknown.
2. Extremely high WBC and respiratory stridor when handled (I did not observe today but am told is still present).

There is a possibility that we could resolve the Aspergillosis with treatment, but it would likely be long-term. Without knowledge of a lesion, I would treat until the WBC are close to normal, which could be quite some time.

However, we need to make sure that the shoulder can heal as well, and that can't wait. My recommendation is to start to do PT under anesthesia, acknowledging that there is risk due to respiratory compromise. If the shoulder is stiff or it doesn't seem like it will heal, we should likely euthanize this bird.

Will put on PT every 2-3 days for now. Also, will email Sunny regarding this bird to see if she can arrange with Tracey to scope him Wednesday, or if she even thinks that is necessary.
I would like to try to explore the shoulder and remove the bullet in a week, if he does well otherwise.
Continue all meds for now. Dr Gardner

2024-09-13 14:29 MS
Leftovers: 0
Food: 50 g m (+ vit + Ca)
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
Vet check: Discuss case - remove lead shot

BARP, NOLO. Discussed case with Dr. G, vet notes pending. For now, moved to R10 - large. Per Interns, bird started drooping wing and could not fly up to perch. Has a ramp. Consider removing pellet at a later date due to time. For now, just minimize any interaction.

MOVED TO: R10 - large

2024-09-12 16:37 ah
Leftovers: 0
Food: 47 g ck
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
Bird was on perch upon arrival and BAR, NOLO

2024-09-12 10:57 MS
Weight: 1182 grams, Leftovers: 0
Weight change: +14 g (1 %)
Food: 46 g ck
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
Blood: PCV/TS lead cbc if extra blood, discuss lead if higher than last test

BAR, bitey and footy. Started breathing heavily when laid down on table. Drew ~0.3 cc blood from R basilic vein. Discuss plan to remove lead pellets surgically before starting chelation. NOLO seen in condo.

PCV/TP
Collection date2024-09-12 10:57:00
PCV35 %
TS5.2 g\dl
Serumpale yellow
Blood lead
Collection date2024-09-12
Level7.80 ug/dL

2024-09-11 15:42 jh
Leftovers: 0
Food: 52 g m (+ vit + Ca) Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO

BARP, NOLO
Very curious, hopped off perch when food was dropped

2024-09-11 09:30 AO
Weight: 1168 grams, Leftovers: 0
Weight change: +40 g (4 %)
Food: 61 g ck (+ vit + Ca) Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
Weigh

BAR, Perched. Very feisty bird, will bite anything it can get a hold of. Bird has increased in weight and had NOLO.

2024-09-10 16:30 lkm/me
Leftovers: 0
Food: 44 g m/ck Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO

BARP, hopping all around enclosure, on and off perch, changed papers, watched me intently, ate food as soon as I closed door, NOLO

2024-09-10 09:30 EA/SC
Leftovers: 0
Food: 35g ck + 19g m
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO

BAR, perched
NOLO

2024-09-09 17:28 RMB/srm
Leftovers: 0
Food: 59 g ck (+ vit + Ca) Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO

2024-09-09 13:49 cd

Blood collected and samples prepared on Sat, 9/7. These slides are much more representative and the one I stained has much better views than those collected on 9/4. Didn't collect PCV/TS at this time, scheduled with repeat lead test on 9/12. Left shifted hets are still present. Toxic markers are very minimal if present - may need a vet to look at images, can't say definitively if toxic vs normal. Hemoproteus infection is resolved. Much fewer poikilocytes present; most of slide appears normal in that regard.

CBC
Collection date2024-09-07
WBC count79600
Corrected count79600
Hets/Neut72% - 57312
  Bands2+
  Toxics0+
Lymphs13% - 10348
Eos9% - 7164
Mono6% - 4776
Baso0% - 0
Thrombocytes
PI2
HemoproteusNEG
LeukocytozoonNEG
PlasmodiumNEG
Read bycd
High total count, heterophilia / lymphopenia. PI high end of 2, saw some suspected very immature rbcs. Fair amount of blast cells. Banded hets of varying degrees - close to 40% affected.

2024-09-09 09:59 eb/me

Band changed to: 22096

2024-09-09 09:10 eb/me
Leftovers: 0
Food: 42 g m/ck (+ vit + Ca) Watch food intake carefully
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO

Moved to 17E
BAR
Perched

2024-09-08 17:56 cd
Leftovers: 0
Food: 32g m
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO

BARP, R wing angled forward with body. Stayed perched as I placed food. Opted to leave alone tonight since we already grabbed once today. NOLO. Checked on him about an hour later and he'd already eaten pm food.

2024-09-08 15:08 RMB

US FWS notified via email: illegal cause of injury.

2024-09-08 13:13 Dr. G/ CD
Weight: 1128 grams, Keel score: 2.0, Leftovers: 0
Bird is BAR and quite feisty. We discussed this case before handling and decided to see if we could get radiographs with mild sedation but no anesthesia.
Initially took bird out and ausculted - there was audible breathing initially, and a mild inspiratory wheeze that improved as the bird calmed down.
Gave Butorphanol 0.22 ml IM/ Midazolam 0.22 ml IN
30 minutes later bird was slightly sedate but still fairly alert. We decided to try hooding him, and that allowed for enough sedation that we were able to do a VD and a lateral radiograph with feet being held, wings held for lateral view.
Radiographs reveal that bird was shot - there is a pellet in the right shoulder, and one in the right femur, near the knee, with fragments of shot further proximal on the femur
R shoulder palpates thicker than the left and is painful to extend.
Examined the bird as thoroughly as possible for bullet wounds but was unable to find any.
I think it is likely that the ballistic trauma is causing the respiratory issues - possibly there is some thoracic trauma or trauma to the air sacs. Aspergillus is still a possibility, because it often occurs secondary to penetrating wounds.
P: Continue Voriconazole. Add Enrofloxacin, as well as Meloxicam. Monitor closely. Would like to have Tracey at least evaluate the case Wednesday to see if she thinks it is worth attempting scoping of air sacs or trachea.
Will put down to move out, also d/c PT for now as shoulder is painful.
NOTE: Except initially bird's breathing was fairly normal during handling. Dr Gardner

Food: 58 g m
Enrofloxacin: 3/4 tab (22.7 mg tab) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Meloxicam: 0.39 cc (1.5 mg/ml susp) PO
Vet check: Discuss case - Tracey should we scope?
Radiograph: reattempt rads wit Dr. G

NOLO, BAR

2024-09-07 17:58 MS
Leftovers: 6
Food: 24 g m
Force feed: 20 g ck c/u (size B)
Voriconazole: 1/4 tab (50 mg tab) PO
Iron dextran: 0.11 cc IM

BARP, footy and bitey. Some dried out LO's in back of kennel. Drew blood from r wing for repeat slides. Blood had clotted in green topped tube, so tossed the rest.

2024-09-07 08:40 cd
Leftovers: 7
Food: 30g ck
Voriconazole: 1/4 tab (50 mg tab) PO

BARP, started jumping around erratically when kennel cover was removed. 7g LO removed. Dropped all food.

2024-09-06 17:16 cd
Leftovers: 0
Food: 43g m (one whole 27g m, rest c/u) (+ vit + Ca) Watch food intake carefully
SQ fluids: 30 cc, if not eating PM ONLY
Voriconazole: 1/4 tab (50 mg tab) PO

Perched, very jumpy during grab. R wing hangs a little bit, feathers just barely touching back of perch. NOLO - did not force feed, but opted to grab and give pill due to irregular eating pattern

2024-09-06 09:46 sc
Weight: 1114 grams, Leftovers: 27
Weight change: -27 g (2 %)
Food: 28 g m (+vit/ca)
Force feed: 14 g m c/u (+ vit + Ca)
SQ fluids: 30 cc, if not eating
Voriconazole: 1/4 tab (50 mg tab) PO
PT: PROM right wing

Perched but jumped down. Very jumpy. Opted to do PT with no ane. Left off wrap to see if the wing still hangs. Weight is down, opt to FF more SID to reduce stress.


----------- ORDER CHANGE -------------
FF In PM if LO

Physical therapy
Limb/jointRight wing
TypePROM
 ElbowWrist
Before90120
After140180
Notes
A little stiff in the elbow. Otherwise full rom quickly. no ane used

2024-09-05 16:12 ah/me

Food: fed 29 g m plus 13 g m c/u force fed; NOLO
Force feed: 10-15 g m/ck c/u (size B) (+ vit + Ca)
SQ fluids: 30 cc, if not eating
Voriconazole: 1/4 tab (50 mg tab) PO
Food: 25-30 g m/ck (+ vit + Ca) Watch food intake carefully
Force feed: 10-15 g m/ck c/u (size B) (+ vit + Ca)
SQ fluids: 30 cc, if not eating
Voriconazole: 1/4 tab (50 mg tab) PO
*Bird was wheezing; breaks were given during force feeding

2024-09-05 09:05 me/lm
Weight: 1141 grams, Leftovers: 0
Weight change: -2 g (0 %) with partial crop
Food: 31g whole ck + 8g m c/u FIC
Force feed: 7g m c/u
Voriconazole: 1/4 tab (50 mg tab) PO

BAR perched jumpy fiesty
Weighed
Skipped fluids bc had just eaten
Gave med and some ff

Breathing somewhat raspy/wet at times but not nearly as loud as Tuesday

2024-09-04 17:18 MS
Leftovers: 50
Food: 40 g Q (+ vit + Ca)
Force feed: 18 g Q c/u (+ vit + Ca)
Voriconazole: 1/4 tab (size B) 0 mg tab) PO
Crop: oral swab

BARP. R wing out and drooped. Did not eat previous meal. Reapplied fig 8 + body wrap. Swabbed again for wet mount, negative.

2024-09-04 12:23 MS/RMB/CD
Leftovers: 0
Food: 51 g m (+ vit + Ca)
Voriconazole: 1/4 tab (50 mg tab) PO
Midazolam: 0.22 cc (10 mg/mL inj) IN
Butorphanol tartrate: 0.22 cc (10 mg/mL inj) IM
Blood: CBC PCV/TS
Crop: oral swab
Fecal

BARP, hopped off perch and clung to side of kennel. Attempted sedation for radiographs and blood work but bird was still highly reactive. Removed body wrap. Drew blood from L basilic vein for PCV/TS/CBC. Took oral swab for analysis. Breathing was normal until bird was in hand. When on table, much more labored. Skipped rads for now. Gave meds and dropped AM food. NOLO. Decided to leave wing unwrapped to observe. When put back, bird perched and slightly drooped wing, but righted self.

CBC notes:
Blood is mildly translucent in hematocrit tube and very thin. Buffy coat is 3-4% but strongly red tinted, at least 1% visible not affected by hemolysis. Serum is strictly clear with possibly a slight cloudy tint, no fat sitting on top. Slides are difficult to read due to thin blood. Original slides have no adequate views for a total count but appear high. Made a thicker slide from green top collection tube and took total count from there but unsure how much anticoagulant may have affected it; significantly lower than original appeared.
Will give iron IM with treatment tonight.

Buffy coat - red/pink tint may indicate presence of banded cells. 3-4% confirmed

Fecal
Collection date2024-09-04
ResultsNEG
Fecal
Collection date2024-09-04
ResultsPOS for
capillaria
PCV/TP
Collection date2024-09-04 12:23:00
PCV26 %
TS4.4 g\dl
Serumclear
Blood lead
Collection date2024-09-04
Level6.80 ug/dL
CBC
Collection date2024-09-04
WBC count21800
Corrected count12595
Hets/Neut57% - 7179
  Bands2+
  Toxics1+
Lymphs25% - 3148
Eos7% - 881
Mono11% - 1385
Baso0% - 0
Thrombocytes
PI2
Hemoproteus1+
LeukocytozoonNEG
PlasmodiumNEG
Read bycd
See CBC notes in chart. Mild monocytosis. Bands are strong when present, toxic cells are few and far between with minimal markers. Fair amount of poikilocytes. Reactive clusters.

2024-09-03 17:45 me
Leftovers: 19
Food: 34 g ck Watch food intake carefully
Force feed: 13 g ck c/u (size B)
Voriconazole: 1/4 tab (50 mg tab) PO
19 g LO
perched

2024-09-03 09:15 sc
Leftovers: 77
Food: 23 g dk m
Force feed: 14 g m/ck c/u
SQ fluids: 30 cc
Terbinafine: 0.69 cc (25 mg/ml susp) PO
Voriconazole: 1/4 tab (50 mg tab) PO

Perched and jumpy when we opened the door for treatment. Whole Q piece is under the perch. Started to wheeze before being handld and had wet raspy breathes while being handled. It did subside when the bird calmed down after having the head towel over his eyes and breathing returned to a more normal rate. Wing wrap is still present.

2024-09-02 17:59 RMB/SRM
Leftovers: 22
Food:70 g Q (+ vit + Ca) Watch food intake carefully

Terbinafine: 0.69 cc (25 mg/ml susp) PO
Voriconazole: 1/4 tab (50 mg tab) PO

Did not FF, still had some food in crop.

Gave reminder of Q from the day.

BARP, 22 g LO

Figure 8 and body wraped wing, feathers were resting on prech.

Very raspy while grabbed, calmed down a little with head towel but not a lot.

2024-09-02 09:15 sc
Leftovers: 55
Food: 47 g M/CK (+ vit + Ca)
SQ fluids: 30
Terbinafine: 0.69 cc (25 mg/ml susp) PO
Voriconazole: 1/4 tab (50 mg tab) PO
Check eyes: OU
Fecal - yes

Perched and quiet. No signs of wheezing or heavy breathing. Once handled the bird started to have audible wet breathing. It decreased once the head towel was gone but never stopped completely while in hand. Found 6 small ticks on his face, removed all. R wing does droop and was worse when placed back in kennel, with it resting on the perch. Force fed 1 of 2 mice and left the second on the perch.


Eye exam
Exam date - 2024-09-02
Examiner - sc
RIGHTLEFT
PLRMenacePLRMenace
++++
Stain Stain 
DNE DNE 
Right eye:
Overall WNL
Left eye:
Overall WNL

2024-09-01 15:00 RMB/JK
Weight: 1143 grams, Keel score: 3.5

------------- PHYSICAL EXAM FINDINGS ----------------
Head
Behavior and Neuro: BAR
Other: VERY raspy and congested sounding
Mouth: clean/clear
Ears: clean
Body
Vent: clean
Body condition score: 3.5
Wings
Left wing: NSF
Right wing: NSF
Legs
Left leg: NSF
Right femur: NSF
Feathers: Some junk on outside of feathers lateral left of body
Ectoparasites: flat flies

Exam:
Very BAR, fighter. Very congested sounding as he breathes but doesn't struggle for breath. Examined upright. No fractures palpated and no open wounds. Very healthy looking bird other than raspiness. Suspect asper, treated as such. Finished treatment and placed in KR2 in kennel, immediately perched.

Treatment:
Fluids: 30 ml LRS SQ
Terbin: 0.69 ml PO
Vori: 1/4 tab PO
Bronco
Food: 48 g dk M

When placed food in kennel, not holding wings up equally, right was lower.

Eye exam
Exam date - 2024-09-01
Examiner - RMB/JK
RIGHTLEFT
PLRMenacePLRMenace
++++++
Stain Stain 
DNE DNE 
Right eye:
PLR weak and incomplete; NSF otherwise.
Left eye:
PLR weak and incomplete; NSF otherwise.

Version 4.0.2 - 4.0.7 Thu Nov 21 01:21:24 2024