TECHNIQUE

Intraosseous Injection of Birds (Disease Investigation & Control - Treatment and Care)

Summary Information
Type of technique Health & Management / Disease Investigation & Control / Treatment & Care / Techniques:
Synonyms and Keywords --
Description Placement of a cannula for intraosseous injection. The following description outlines the procedure as described by Quesenberry & Hillyer (B13.15.w10), Coles (B14), Redig (B11.3.w17) and Mostyn (P3.1999b.w2).
Ulna (distal):
  • Aseptically prepare distal carpus area: pluck feathers (minimal area), scrub area with antiseptic.
  • Wet surrounding covert feathers with alcohol or antiseptic to assist in visualisation.
  • Hold wing with carpal/metacarpal and carpal/ulnar joints flexed.
  • Locate dorsal edge of the distal ulnar condyle visually and by palpation.
  • Support ulna with one hand.
  • Insert needle or intraosseous cannula (length about 1/3 length of bone) (1/2 length of bone, P3.1999b.w2) just below the dorsal edge of the distal ulnar condyle, applying pressure and using a rotational movement.
    • 25-30 G hypodermic needle in smaller birds (P3.1999b.w2)
    • e.g. Amazon parrot size and larger, 20-22-gauge spinal needle
    • Cranes 16-20 gauge spinal needle (B115.8.w4)
  • N.B. resistance decreases once cortex penetrated: continuing resistance may indicate needle is entering lateral cortex and must be re-placed.
  • Remove the trochar (if one is present) once the cannula is seated.
  • Palpate along the bone to check the needle has not exited through the cortex.
    • It should be possible to aspirate bone marrow if the needle is correctly placed. (B115.8.w4)
  • Flush with a small volume of heparinised saline.
  • Place an injection cap over the hub of the needle.
  • Hold the needle or cannula in place with a) tape wrapped around the end of the cannula and sutured to the skin; or b) sterile tissue glue.
  • And/or (further) support may be provided with e.g. self-adhesive bandage such as Vetrap; a gauze pad with antiseptic ointment may be placed to cushion the catheter before a figure-of eight bandage is placed.
    • A loop of tubing attached to the cannula may be incorporated into the bandage.

(B13.15.w10, B14, B115.8.w4, P3.1999b.w2)

OR (as above, with the alternate needle sitings):

Ulna (proximal):
  • Hold wing with elbow flexed.
  • Insert the needle/cannula into the medial aspect of the olecranon (B11.3.w17).
Tibiotarsus:
  • Place the cannula through the tibial crest, travelling distally (B13.15.w10).
Appropriate Use (?)
  • Debilitated birds in which collapse of peripheral circulation makes intravenous access impractical.
  • Neonates in which other parenteral routes are impractical (due to size).
  • Alternative to intravenous route for fluid administration.
  • Once placed, no further restraint required for longer-term administration.
Notes
  • Sterility is essential.
  • Slow administration suggested initially, checking for subcutaneous swelling indicative of improper cannula placement (B13.15.w10).
  • Rate of 10ml/kg/hour suggested for maintenance fluids given by the intraosseous route (B11.3.w17, B13.15.w10).
  • Flow controlled using an infusion pump or by a standard gravity-fed fluid administration set.
  • May be used for fluids and non-irritating drugs.
  • Variable degree of tolerance by patient. Usually good tolerance in e.g. waterfowl, pigeons, raptors, short-term tolerance in psittacines.
  • Warm fluids should be used.
Complications/ Limitations / Risk
  • Requires hospitalisation.
  • Risk of osteomyelitis.
  • Plugging of the needle with a core of bone may occur if an ordinary hypodermic needle is used.
  • May be pulled out by the bird.
  • Bird may become entangled in tubing.
  • Tibial site is useful only for single administration.
  • Must not be placed in pneumatic bones (bones connecting to the air sacs) i.e. femur, humerus.
  • Not suitable for administration of alkaline or hypertonic solutions - may be painful.
Equipment / Chemicals required and Suppliers
  • Spinal needle 20-22 gauge in a 500-1000g bird.
  • 25-27 gauge hypodermic needle may be used in birds weighing less than 150g.
  • Intraosseous cannula with trochar and handle, e.g. Cook Instrumentation.
Expertise level / Ease of Use Procedure should only be undertaken by an individual with appropriate clinical training and practical experience; this would usually be a veterinarian or someone with advanced veterinary technician training.
Cost/ Availability
  • More expensive than standard intravenous injection.
Legal and Ethical Considerations In some countries there may be legislation restricting the use of this type of technique to licensed veterinarians. For example in the UK: "The Veterinary Surgeons Act 1966 (Section 19) provides, subject to a number of exceptions, that only registered members of the Royal College of Veterinary Surgeons may practice veterinary surgery."(see: LCofC1 - RCVS Guide to Professional Conduct 2000 - Treatment of Animals by Non-Veterinary Surgeons).).

Use of Drugs (Medication):

  • Many drugs are not registered for use in particular bird species and care should be taken in their use, with proper regard for possible toxic effects. Consideration should be give to relevant legislation regarding the use of drugs.
  • In the UK, guidelines regarding the use of drugs are set out in the Royal College of Veterinary Surgeons Guide to Professional Conduct 2000: (see: LCofC1 - RCVS Guide to Professional Conduct 2000 - Choice of Medicinal Products).
Author Debra Bourne MA VetMB PhD MRCVS (V.w5)
Referee  
References B11.3.w10, B13.15.w10, B13.17.w16, B14, B119.w2, P3.1999b.w2

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