WMC Aids Bald Eagle in Recovery

By Melissa Giese (class of 2017)
A large bird was found injured on the side of a gravel road in Effingham, Illinois. The bird was not moving much, and didn’t seem to use its wings or legs. Upon a closer look, this bird turned out to be a bald eagle, our country’s national bird.
  
Initially the bird was found to be dehydrated, had diarrhea, and could not hold himself up. When a wild animal is handled they should be aggressive and try to get away since that is their natural instinct. The eagle did not seem to have the strength to fight during treatments which was very concerning. The eagle was given fluids daily in order to combat the dehydration. Since he would not eat on his own, the team had to force feed food to be sure he was getting appropriate calories each day. It was difficult to tell what was causing these signs but it was suspected that he might have West Nile Virus.
According to the CDC, the West Nile Virus cannot be directly treated and there are no vaccines to prevent infection. Recovery can take several weeks or months and some of the neurological issues can be permanent.
Luckily there is no evidence that people can be infected from affected birds, but raptors can get sick from eating diseased birds. Patients affected must recover on their own, but can be provided supportive treatment such as fluids and pain relievers to help them in their healing process. This was the protocol used by the Wildlife Medical Clinic for this eagle as well.
With just a few days of treatment the eagle began to stand on his own. He became more feisty with the team, showing he was regaining strength. In order to see if the eagle had West Nile Virus, as well as to assess the other organs, a biopsy was completed. The results of these tests were not indicative of anything specific. The liver showed mild inflammation which means that there was an infection going on. The samples were submitted to check for West Nile Virus to confirm that the treatment plan the team was implementing was appropriate. After a few days of processing, it was found that the eagle did in fact have West Nile Virus.
After 12 days of supportive treatment the eagle began eating food on his own. He was gaining strength daily and began exhibiting wild bald eagle behavior such as barking and fluffing his feathers to appear more threatening. Though it was very difficult to treat him due to his increasing aggression, the team was very happy to see him feeling better. Handling was kept to a minimum in order to keep the eagle as stress free as possible.

A little over three weeks into the treatment the eagle was ready to leave the Wildlife Medical Clinic. He was sent to a rehabilitation facility where he was tested for flight capability and hunting capability before finally, being released back into the wild.


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Shell Shocked: Turtle Shell Repair

by Allie Urbanik (vm17)

One day an eastern box turtle was presented to the Wildlife Medical Clinic after being hit by a car. On examination, the most evident and pressing issue was a large carapacial fracture. The fracture involved multiple parts of the caudal carapace, and it was not evident on examination whether lung fields were exposed. Due to the potentially complicated nature of this fracture, radiographs were taken. The radiographs showed possible lung consolidation, suggesting lung exposure or infection. Our next step after taking radiographs was to fix the most glaring problem: the shell fracture.

A shell fracture can be repaired one of several ways. A very common approach is to drill small screws into the shell on either side of the fracture and then wrap wire around the screws, tightening the shell down almost like opposing tissue during suturing. Another approach, and the one taken with our patient, was to epoxy the shell. Layers of epoxy material can be applied to the shell over the cracks as a sealant of sorts. Over time, the bone of the shell will heal. The trauma of the car accident combined with the shell repair necessitated that our patient received medication to control pain and fluids.

After our turtle shell repair, we turned our attention to the fact that our patient had refused to eat since arriving. The stress of handling and captivity, not to mention the trauma of being hit by a car, can cause our patients to lose their appetites. Additionally, inflammation and infection can also cause patients to lose their appetite. Of course, nutrition is vital to the healing process, so getting our little guy fed is of the utmost importance. At this moment we are at a cross roads of sorts. We have just recently been successful at force feeding our patient mealworms and fruits, but it may be necessary to place an esophagostomy tube if our patient stops eating or seems too stressed by the handling. Additionally, at this time of the year, turtles would be preparing themselves for winter hibernation.

With our patient’s shell fracture, releasing her now so that she could overwinter is not an option. As such, she will be a long-term patient in the clinic. Hopefully, we have crossed our most difficult challenges with this patient. We expect a full recovery of the affected shell. The prognosis is excellent. I am constantly astounded by the tenacity and healing ability of our patients. I have no doubts that our little turtle will make a full recovery, and I look forward to releasing her in the spring.

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What is a SOAP?

by Malky Weil (VM Class of 2016)

Hello wildlife enthusiasts! Have you ever wondered how we record our treatments for our patients? We maintain a complete medical record, just like at your doctor’s office and use a method called SOAP. Here is how it works:

S/O: Subjective and Objective observations. This is where we talk about a patient’s mentation. We can call them BAR-bright, alert, responsive (if they are moving around in their cage), QAR-quiet, alert, responsive (if we find them resting but still responding to us), or non-responsive (which would be a bad sign with a patient). We also note if there were feces and urine in the cage and with birds of prey if there were casts. A cast is the non-digestible hair and bones of mice or other prey that are regurgitated while the rest of it is digested. As gross as it may seem, it’s important to note when an animal has normal excretory and bowel movements, because if those movements are absent, it can be a sign of gastrointestinal or urinary system abnormalities. We will note if there is food left over from the previous treatment, if the water appears touched, if the patient shredded all of the newspaper in the cage, and any other observation before we have our hands on the patient. Some observations are objective, such as whether or not there are feces in the cage, and others are subjective, such as what the mentation of the patient is.

The next parts of the SOAP are based on a problem list we keep for our patients. I will give an example for a bird with a broken wing as the problem. If there is more than one problem, we label it A1, A2, P1, P2, and so on.

A: Assessment. This is where we talk about our physical assessment of the problem. For the broken wing patient, we may be observing if the bird is holding its wing upright or drooping it or how the wing bandage looks. This is where we would describe how the physical therapy on the muscles is progressing. For example- “We did passive range of motion on the right wing and the muscles are inflamed, stiff, but the extension is better than it was yesterday.” We also talk about the medicine we gave for the specific problem here. With a broken bone we usually give pain medicine, because broken bones are painful. So we might add here that we gave 0.6ml of tramadol (and give the dosage in mg/kg, and concentration in mg/ml). We may also be giving a non-steroidal anti-inflammatory to help with pain and inflammation in the wing.

P: Plan. This is where we talk about what we plan on doing in the future. So for this bird case, we would say- “Continue to monitor posture, continue passive range of motion every other day, continue tramadol, and continue meloxicam until swelling recedes. Change wing wrap in 2 days.”

ADD: Addendum. This is the section we use to add anything else that does not connect to the problems, but still needs to be recorded. For example: “We cleaned the cage and refreshed the water bowl. We checked the feet and did not see any signs of bumblefoot. We left 3 mice (total 27 grams) in the cage. Patient flapped his good wing when we returned him to his cage.”

Recording our treatments is very important. There are multiple people on a team caring for our patients, and not everyone is there for every treatment. Those not there need to stay current on the case, see how the patient has been behaving, and note if there are any changes to the treatment plan. Having all that information is important when making decisions on the case as well. No one’s memory is perfect, so it is important to have a place to look back on what has been done and how the patient responded. I hope this gives you a little glimpse into what goes into keeping a complete medical record for our patients. The skills we gain doing this important work will be used throughout our careers as veterinarians.

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