Avian Restraint and Physical Exam

Don J. Harris, DVM
Avian & Exotic Animal Medical Center
Miami, FL

During the initial encounter between veterinarian and patient, a number of very important dynamics occur. First, the patient is approached, captured, and restrained. Second, the patient is examined by the veterinarian so its condition may be assessed. While the veterinarian is usually focusing on the physical exam, it is the handling of the bird by the veterinarian that the client is most aware of.

For the veterinarian, the physical exam is one of the most important aspects of his initial encounter with a patient. This is when the veterinarian develops a first impression of the patient's condition, and much depends on his or her ability to detect even the subtlest of details. This first encounter between veterinarian and patient is extremely important for the client as well, but for very different reasons. This is where the client develops a first impression of the veterinarian. Everything the veterinarian does with the patient tells the client how thorough, perceptive, knowledgeable, etc. the veterinarian is. For this reason the veterinarian is judged not only by how well he relates information, but also for how well he relates to the animal. Nothing can destroy the confidence an owner has in a veterinarian faster than incompetent handling of the patient during an exam. Therefore, before the physical exam may ensue, the patient must be captured and restrained with minimal distress to both the patient and the owner.

Capture of the patient may be effected through a few basic techniques. Rarely does a pet bird surrender willingly to the entrapment of the handler. Almost always, some form of mechanical assistance, in the form of a towel, net, etc. must be utilized.

The most obvious means of handling large psittacines (capable of biting off a digit of the handler) is a pair of thick gloves, such as welder's gloves. This is also probably the single worst method of handling a pet psittacine. The gloves can be traumatic, they prevent the handler from adequately monitoring the patient's movements and resistance, and they teach the bird to be afraid of hands. There really is no place for gloves in pet bird medicine. Gloves are a mandatory part of falconry, but never are they used to restrain a raptor. Instead, they are used to protect the falconer's hand as it functions as a perch for the bird.

A net is occasionally useful in an avian practice. There comes a time when a flighted bird is able to evade capture by even the most skilled handler. High ceilings or large rooms allow an escapee to stay just beyond reach of those in pursuit. A long-handled fine-mesh net allows the extension of reach necessary to corner the bird. A short-handled net also may be useful to corner and trap an especially quick escapee. The fine mesh is essential to prevent tangling of the bird's legs, wings, or head.

The single most useful tool in a bird capture arsenal is a towel. A regular terrycloth towel can be tossed lightly over an unsuspecting patient temporarily disorienting him and allowing his capture. As the towel is quickly but smoothly draped over the bird the handler takes hold of the patient's neck from behind. The handler's hand encircles the neck somewhat stretching apart the head and shoulders. The bird's neck is held by one hand while its torso and legs are encircled through the towel by the other hand. The wings are usually naturally kept at the bird's side by the weight of the towel. Once the bird is under control the legs are held from the anterior aspect while the head continues to be held from the posterior aspect, and the bird is stretched as much as possible without it being injured. A snugly restrained bird resists much less than one held timidly.

A small bird or a cooperative large bird may be captured with bare hands. Always, the bird should first be captured from the rear and behind the neck. When the handler's hand acts as a wide snug collar around the bird's neck, it is practically impossible for the bird to bite the hand that holds him. Even the bird's feet will have difficulty reaching up to the restraining hand when the bird is properly held.

An aid to the capture of quick patients is darkness. Turning off the lights in a closed exam room may temporarily freeze the bird's attempts to escape. The handler can position himself near the patient, an assistant can turn off the lights when prompted, and the bird can be captured in darkness. This can be quite effective whether a net, towel, or bare hands are employed.

Once the patient is restrained the physical exam should be completed as quickly and atraumatically as possible. All details of all visible aspects of the patient should be noted. The best way to ensure completeness in a physical exam is to adopt a step-by-step routine in which the assessment of every feature of the exam is planned. When a checklist-type approach is used, oversight is less likely to occur.

The best approach is one in which a logical progression is followed through the patient. It may be best to begin with general observations such as respiratory rate and character, cardiac auscultation, etc. in order to ensure that the patient is in no danger from the exam itself. Once vital signs are noted the exam may proceed in whatever sequence the examiner chooses, provided the sequence is complete and logical. Randomly examining the oral cavity, then the legs, then the ears, etc. will inevitably cause omissions of anything from small details to large body parts. Regardless of the presenting clinical signs, omissions should not be allowed. More than one bird has been presented for a nasal discharge only to have a cloacal problem discovered. Once the exam is complete and the bird is released, his response to handling should be noted. Often, poor stress tolerance will be a major indicator that illness exists.

The physical exam should always take into account physical features of the bird's visible environment. The bird's droppings, feathers lost in the cage, spots of blood on the floor, etc. all may reveal important information about the patient. Every detail is a significant detail, even if only to document normalcy.