Anesthesia in Birds and Exotic

Pet animals

Presented by
Ganga Prasad Yadav
M.V.Sc.
Veterinary Surgery & Radiology
Indications for anesthesia
Restraining and Sedation
Diagnostic Imaging
- X-ray and Ultrasound
Surgical procedures
- Fracture repair and Growth removal
Transportation
Control of convulsion
- Seizure
Capturing of exotic animals
Euthanasia
 General considerations For
Anesthesia
Pre-anesthetic considerations
1. Discussion with Owner.
2. Reduce the animal’s stress.
3. Pre-surgical evaluation and
animal selection
a. Physical examination
- Quiet observation
- Contraindication to anesthesia
 b. Laboratory evaluation
-Complete CBC, biochemical profile
(minimum: PCV, TP, BUN and Glucose).
c. Diagnostic evaluation
- X-ray
- Ultrasound
- ECG
- Endoscopy etc.
Pre-anesthetic Fasting
Necessary to prevent regurgitation.
In birds, when fasting is impossible, Crop
needs to be empty.
Due to high metabolic rate,
hypoglycemia in very small birds and
exotic pet animals.
 Time period for pre-anesthetic food
with drawl in birds and exotic animals
Types of animal Time(hour)
Birds <100 gram 0
Large psittacine birds 1 to 2
Raptor, Ratite, waterfowl 12 to 24
Carnivores reptile ingesting whole prey > 5 days
Reptile < 200 gram 2 to 4
Reptile 200 to 500 gram 12
Reptile > 500 gram 24+
Fish 12-24
Rodent < 200 gram 0-2
Rodent > 200 gram >6
Guinea pig 6-8
Ferret 3-6
Rabbit 0-24
• Maintaining homeothermy
- Small animals are predisposed to
hypothermia due to high surface area to
volume ratios.
- Ectotherms (Reptiles and Fish).
- Core body temperature
 Digital/esophageal/rectal or cloacal
thermometer used.
- Heat sources: incubator, warm air blanket
etc.
• Fluid therapy
- Administer if anesthetic procedure
more than 20 minutes.
- 10-20 ml/kg body weight per hour
during anesthesia.
- Preheated fluid to 26-35° C for animals
weighting less than 1 kg and for all
ectotherm.
 Sites for Parenteral access or Injections in
birds and exotic pets
Species Sites
Birds IM, IO, Jugular and Medial metatarsal
Rat and Mouse SQ, IM, IP, IO, IV, Jugular and Lateral tail
Gerbil SQ, IM, IP, IO, IV, Lateral tail, Saphenous and Metatarsal

Hamster SQ, IM, IP, IO (Tibial crest), IV, Lateral tarsus, Cephalic
and Lingual
Chinchilla SQ, IM, IP, IO, IV, Jugular, Cephalic, Tail, Lateral
saphenous
Rabbit: SQ, IM, IP, IO (trochanteric fossa), IV, Marginal ear vein,
Jugular and Cephalic, Lateral saphenous

Guinea pig SQ, IM, IP, IO (trochanteric fossa). IV, Marginal ear vein,
Jugular and lateral Saphenous veins

Ferret SQ, IM, IP, IO, IV, cephalic, jugular, lateral saphenous
and lateral tail
Note: IM, Intramuscular; IO, Intraosseus; IP, Intraperitoneal; IV, Intravenous and SQ,
Subcutaneous
 Oxygen Supply
• Necessary in Respiratory compromised or anaemic patients.
• Facemask.
• Endotracheal tube: Cuffless tube is used.
• Air sac canulation in birds: if surgery of head, trachea or syrinx.

Fig.: Epiglottis in raptor

Fig.: ET tubes

Figure: air sac canulation in bird

 Premedication in birds
Indications :
1. Restraining
2. Sedation
3. Analgesia
4. muscle relaxation
5. Reduce drugs required for
induction and maintenance
6. Smooth recovery etc.
 Preanesthetic sedatives and other drugs are
rarely used in birds with exception of
analgesics (eg. Butorphanol) due to stress from
handling.
 Anticholinergic drugs such as atropine and
glycopyrrollate are not routinely used to birds
because thickened respiratory tract secretions
increase the risk of airway or endo-tracheal
tube occlusion. Used only if history of
bradycardia.
 Local Anesthesia in Birds
 To provide analgesia.
 Lignocaine@<4 mg/kg.
 Toxic dose of local anesthesia
(Lignocaine) is approximately
≥4 mg/kg.
 Bupivacaine: 2mg/kg at the
site of incision or as ring
block provide 4 hours of
analgesia.
 Injectable sedatives, anesthetics and
analgesic drugs used in birds
drugs doses
Atropine 0.01-0.02 mg/kg IV, 0.02-0.08 mg/kg IM

Glycopyrrolate 0.01-0.02 mg/kg IV, IM

Buprenorphine 0.01-0.10 mg/kg IM

Butorphanol 0.1-4.0 mg/kg IM

Fentanyl 0.2mg/kg IM

Diazepam 0.05-0.15mg/kg IV, 0.2-0.5mg/kg IM

Midazolam 0.05-0.15mg/kg IV, 0.1-0.5 mg/kg IM (7mg/kg intranasally)

Detomidine 12mg/kg intranasally

Ketamine < 1kg: 30-40mg/kg im; >1kg: 15-20 mg/kg im

Ketamine/midazolam 20-40mg/kgIM+4mg/kgIM

Ketamine/xylazine 10-30mg/kg IM+2-6mg/kg IM

Propofol 10mg/kg slow iv infusion until effective, upto 3mg/kg maintenance doses

Flunixin meglumine 1-10mg/kg iv, im

carprofen 2-10mg/kg IM, 1 mg/kg SQ

 Inhalent Anesthesia in
Birds
 Used for both induction and maintenance.
 Isoflurane is currently the anesthetic choice
although Sevoflurane is excellent but more
expensive.
 Induction and maintenance at 3% to 4% and 1%
to 2.5% respectively for Isoflurane and 4% to 6%
and 3% to 4% respectively for Sevoflurane.
 Oxygen flow rate of 150 to 200 ml/kg/min but
1L/min in most medium and large birds
(approximately >300 grams).
 Monitoring of anesthesia
• By monitoring heart rate,
respiratory rate and
temperature.
• Anesthetic monitoring
equipments can be useful
and includes Figure: ECG leads in
bird
 ECG machine
 Pulse Oximeter
 Capnograph
 Doppler flow detector.
 Recovery of Patient
• Keep warm.
• Keep hydrated.
• Provide food as
soon as possible
after recovery.
• Maintain analgesia
for couple of days. Fig.: bird is in incubator during
recovery phase
 Anesthetic emergencies
1. Apnea 2. Blocked Endotracheal tube 3. Cardiac arrest
4. Depression of respiratory rate during a long period of
anesthesia
 Anesthesia in Reptile
History and Physical examination
Laboratory evaluation: CBC, PCV,
BUN, Uric acid and Glucose.
Other evaluations (dehydration, anemia
and acid base imbalance) must be
corrected prior to anesthetic induction.
Although regurgitation and aspiration is
unlikely, fasting is recommended because
of impaired digestion.
 Preanesthetics in Reptiles
 Preanesthetics are rarely indicated,
except in large, aggressive, and/or
venomous reptiles.
 Anticholinergics make respiratory
secretions more viscous.
 Intubation is similar to birds.
 Oxygen flow rate @ 1L/0.3-1kg;
1L/5-10 kg for larger reptiles.
Premedication and analgesic
drugs used in reptile
 Induction anesthesia
Inhalants are
commonly used, using
clear plastic chamber.
IV injection of
anesthetics is not
Figure showing induction by Fig.: Clear plastic
generally practical in face mask in Gecho chamber
these species but drugs dose
induction via IM propofol 5-10mg/kg iv, ic in snakes
injection can be carried 10 mg/kg iv, io in lizards
12-15 mg/kg iv in chelonian
out using pole syringes 10-15 mg/kg iv in crocodilia
or blow pipes. ketamine 20-60 mg/kg im
5-15 mg/kg iv, io
Propofol IV
Tiletamine/zolazepam 10-40 mg/kg im in squamates
induction. 5-15 mg/kg im in chelonians
and crocodilians
 Maintenance
• Inhalents anesthetics
- Isoflurane
- Sevoflurane

Inhalent drugs concentration

Isoflurane 3-5% Induction

1-2% Maintenance

sevoflurane 3-5% Induction

3-4% Maintenance
 Monitoring
• Herat rate, respiratory rate,
temperature.
• Different reflexes: righting reflex
• Eosophageal stethoscope.
• ECG leads should be placed near the Fig.: Monitoring by using
hearts. doppler flow detector
• Due to thick skin(scales), difficult to
use Pulse oximeter and invasive
blood pressure monitoring.
• Small reptiles may be hypothermic,
so external heat sources should be
applied.
 Recovery
• Takes hours to days with
injectable anesthetics but
fast with inhalent
anesthetics.
• Oxygen supply should be
continue until animal is
breathing regularly on its
own.
• Supply fluid and heat
according to needs.
• Provide analgesia
 Emergencies
Emergency conditions Drug s Dose

Bradycardia Atropine 0.01-0.04 mg/kg SC, IM, IV,

Cardiac arrest: supply 100% Epinephrine 0.1- 0.2 mg/kg IV, IO, IC,
oxygen Intratracheally

Respiratory arrest (apnea) Doxapram 5 mg/kg IM, IV; repeat every 10

min if required
 Anesthesia in Rabbit
• Preanesthetic consideration
1. History and Physical exam
- minimal handling to reduce
stress
2. Laboratory evaluation
- CBC, TP, Glucose, X-ray,
Ultrasound
3. Fasting is not necessary
4. Stabilize fluid and electrolyte
 Preanesthetic in Rabbits
drugs dose comments
acepromazine 0.25-1 mg/kg IM, SC, IV Mild to mod. Sedation,
duration 4 hours.
Acepromazine+ 0.5+ 0.5 mg/kg IM, SC Mod. sedation
butorphanol
diazepam 1-2 mg/kg IM, SC, IV Mod, to deep sedation,
duration 30-180 min
ketamine 25-50 mg/kg IM, IV Mod. To heavy sedation,
duration 1 hour(IM), 15-
20 min(IV)
Midazolam 0.5 -2 mg/kg IV, IM, IP Mod, to deep sedation,
duration < 2 hour
Xylazine 1-5 mg/kg IM, IV Mild to profound
sedation, duration 30-60
min
Endotracheal tube intubation
 Mostly 2.5 – 4 mm
internal diameter tubes
are used.
 Intubating can be
difficult in rabbits.
 Intubation: with the help
of Laryngoscope and
blind intubation without
laryngocope.
 Oxygen flow 0.5 - 2
L/min. Fig.: ET tube intubation
 Induction of Anesthesia
• Either injectables or inhalants are used.
Anesthetics Dose (mg/kg)
Ketamine + Diazepam 10+2; IV
Ketamine + Midazolam 25+1; IM
Ketamine + Xylazine 35+5; IM
50+5; IV
Medetomidine+Fentanyl+Midazolam 0.2+0.02+1; IM
Medetomidine+ketamine+Butorphanol 0.1+5+0.5; SC, IM
Propofol 3-6; IV

Induction by inhalent anesthetics

1. Isoflurane 2% to 3%
2. Sevoflurane 3% to 5%
Maintenance and Monitoring
Maintenance
1. Isoflurane 0.25% to 2%.
2. Sevoflurane 2% to 3%.
Monitoring
 Exception: Palpebral reflex is normal with surgical plane of
anesthesia..
 Surgical depth- pinnal reflex, pedal withdral reflex and
pedal pinch reflexes(faint forelimb reflex but no hindlimb
reflex) and jaw tone .
 Monitor respiration rate and depth.
 Central ear artery is a useful for peripheral pulse.
 Recovery
 Keep the animal warm if temperature is subnormal.
 Monitor the animal’s hydration status.
Analgesia
 Anesthesia in ferrets
• Similar to that of domestic cats
for endotracheal intubation, face
mask and anesthesia.
• Do not have sweat glands so
vulnerable to heat stress.
• Ferrets should be fasted for < 4 h
prior to planned procedures
- to reduce the risk of vomiting or
regurgitation and aspiration.
•Fluid therapy by IV or SC or IO.
Premedication and analgesics drugs
used in ferrets
drugs Doses(mg/kg)
Atropine 0.02-0.05 SC, IM, IV
Glycopyrrolate 0.01 IV, SC, IM
Acepromazine 0.1-0.3 IM, IV
Xylazine 1-2 SC, IM
Ketamine 5-15 IM
Diazepam 0.3-3.0 SC, IM
Butorphanol 0.4 IM; 4-6 hourly
flunixin 0.5-2.0 SC, 12-24 hourly

SC: subcutaneous, IM: intramuscular & IV: intravenous

 Anesthetic induction drugs for
Ferrets
For induction, both injectables anesthetics or
inhalent anesthetics used.
Common injectable anesthetics are given in the table
below.
drug Dose(mg/kg)
Ketamine/acepromazine 25+0.25 IM
Ketamine/diazepam 5-25+0.5-2 IM
Ketamine/xylazine 25+1-2 IM
Ketamine/butorphanol 15+0.2 IM
Ketamine/butorphanol/ acepromazine 15+0.2+0.1 IM
Pentobarbital 25- 30 IV, 36 IP
Propofol 3-6 IV
 Induction and
maintenance anesthesia
• Induction and Maintenance by inhalant
gas anesthesia
Inhalent anesthetics Concentration

Halothane 3-3.5% induction

0.5-2.5% maintenance

Isoflurane or 5% induction
Sevoflurane

2-3% maintenance
 Monitoring
• Anesthetic depth monitoring using physiologic
reflexes such as palpebral, muscle tone,
withdrawal reflex and gross purposeful
movement.
• Monitoring of heart rate and rhythm: bell or
esophageal stethoscope.
• Observation of patient and anesthetics bag and
auscultation of lung fields for respiratory rate,
rhythm and depth using bell stethoscope.
• Prone to hypothermia and hyperthermia, so
temperature should be monitored also.
 Recovery
• Maintain heat and fluid support.
• Supply oxygen till showing sign
of recovery.
• Extubation only done after
swallowing reflex.
Emergency drugs used in
Ferrets
 Anesthesia in rodents
• Rodents includes the pet species
Guinea pig, rats, mice, gerbils and
hamsters.
History and Physical exam
• Accurate weight
Laboratory data
• CBC, TP, Glucose, BUN, Creatinine,
ALT and AST.
Fluid therapy
• Fluids are usually administerd as
boluses.
• Subcutaneous and intraperitoneal
routes are also used in emergency to
maintain hydration status.
• Intubation: 12 to 18 G
plastic intravenous
catheters.
• Face mask: mostly used
due to small tracheal size
or narrow oropharynx.
• In guinea pigs, frequent
aspiration of the secreted
materials from nasal and
oropharynx, so necessary
to ensure a clear airway.
Sedative and premedication used
in rodents
Drugs doses
Atropine 0.05-0.1 mg/kg SC
glycopyrollate 0.01-0.02 mg/kg SC
Ketamine 20-40mg/kg IM
Midazolam 1-2 mg/kg IM
Acepromazine 0.5 – 2.5 mg/kg IM
Xylazine 5-10 mg/kg IM, IP
Carprofen 5 mg/kg SC
butorphanol 0.1 mg/kg SC
Induction and Maintenance
Induction:
• By both injectables and
inhalent anesthetics.
• Injectable anesthetics
1. Propofol: 10 mg/kg IV
2. Ketamine + Midazolam :
5-15+ 0.1- 0.5 mg/kg IM
• By inhalant anesthetics
1. Isoflurane 2% to 3%
2. Sevoflurane 3% to 5%
Maintenance
1. Isoflurane 0.25% to 2%
2. Sevoflurane 2% to 3%
 Monitoring
• Anesthetic depth monitoring using physiologic reflexes such as
palpebral, pinnal reflex, muscle tone, withdrawal reflex and
gross purposeful movement.
• Basic physiologic monitoring: heart rate, respiratory rate, and
body temperature
• Because of the very high heart rates, the ECG is almost
exclusively required to obtain correct heart rate.
• Noninvasive blood pressure monitoring is best achieved in rats
and mice using Doppler flow detector and sphygmomanometer.
• Pulse oximetry and capnogrpahy.
• Fluids need to be administered to avoid hypovolemia and
maintain stable hemodynamics .
 Recovery
• Maintain heat
• Fluid support
• O2 supply till recovery
• Pain medication
Emergency drugs used in
Rodents
 Fish anesthesia
• Indications
- Any painful procedure like
trauma.
- Sedation during shipping.
- Diagnostic imaging.
- Stripping milt (eggs).
 Preanesthetic consideration
 A thorough pre-anesthetic physical examination,
cardiovascular system is not redially achievable.
 Use least amount of restraint possible. Use wet latex
gloves when handling the fish to minimize
disruption to mucous membrane.
 Withhold of food should be 12 to 24 hours to reduce
- risk of regurgitation of food that may lodge in gills
and
- degradation the water quality.
• Preanesthetic
medicines are not
commonly used.
• Ectotherm so maintain
body temperature
from external sources.
• Hypothermia
prolongs recovery and
decrease immune
system.
 Anesthetic agents in fish
Agent concentration comment

MS-222(tricaine methane 75-125mg/ml Induction dose

sulfonate) ( Sodium bicarbonate
added to maintain pH).

50-75mg/ml Maintenance dose

Etomidate 2-4mg/L Minimal effective dose

7-20mg/L Maximum safe dose.

Clove oil (Eugenol) 40-100mg/L Effective dose

Isoflurane 0.40-0.75ml/L Induction dose

0.25-0.40ml/L Maintenance dose

Level of sufficient
anesthesia reached when
 Total loss of body
equilibrium
 Loss of muscle tone
 Decreased
respiratory rate
 No response to
external stimuli.
• Anesthetic Overdose:
- Move fish to untreated, oxygenated water.
- Increase gentle flow of water over the gills.
- If spontaneous respirations do not occur within
2 minutes, assist respirations:
1. Move the fish gently through the water.
2. slowly pump oxygenated water into the
fish’s mouth and across its gills.
 References
1. Handbook of Veterinary Anesthesia, 5th edition by William W.
Muir, III, John A.E. Hubbell, Richard Bednarski and Phillip
Lerche.
2. The Merck Veterinary manual, 10th edition.
3. Anesthesia for the Pet practitioner, 3rd edition by Karen
Faunt.
4. Anesthesia of Exotic Pets by L.A. Longley.
5. Essential of Avian Medicine and surgery, 3rd edition by Brian
H. Coles.
6. Avian Medicine, 2nd edition by Jaine Samour.
7. Compendium Journal.
THANK YOU