Emergency Care and First Aid

Emergency Care and First Aid Hierarchy

• CPR follows the "ABC"s: Airways, Breathing, Circulation
• Open and maintain the airway
• Check for breathing
• Give 2 slow breaths if needed
• CPR is not needed if there is a pulse present
• Administer rescue breaths every 3 seconds, 20 times
• Check for a pulse; if pulse is present, CPR is not needed
• In compressions, administer 100/min by giving 5 compressions every 3 seconds
• Provide 1 slow breath
• Repeat the compression and breath cycle 10 times, then recheck the pulse
• Continue the cycle until pulse is felt or exhaustion

Additional Emergency Care Steps

• Address shock
• Halt profuse bleeding
• Cool heatstroke victims
• Warm victims of the cold
• Treat head trauma
• Address poisons and burns, using activated charcoal and cleaning off substances and keeping the area moist
• For minor bleeding and breaks, perform a head-to-toe check, splint, and bandage the injury to protect from further damage; always assume the worst

Understanding Shock

• Shock is the failure of the cardiovascular system, which results in lost blood flow (low blood pressure) and deprives vital areas of oxygen
• Causes of shock include severe injury, blood loss, fluid loss (vomiting/diarrhea), poisoning, infections, heart failure, electrical burns, hyperthermia, and psychological factors
• Signs of shock include poor capillary refill time, pale gums and lips, weak and rapid pulse, dilated pupils, cold extremities, weakness, collapse, and unconsciousness

Treating Shock

• Most seriously injured animals are in shock
• Excitement can worsen the animal's condition
• Keep the animal quiet
• Clear any obstructions like blood, mucus, or vomit
• Administer CPR if the animal is not breathing
• Control any bleeding
• Provide oxygen
• Administer fluids
• Keep the animal warm

Controlling External Bleeding

• Proper restraint can help avoid excitement
• Hemorrhage can be controlled through direct pressure, pressure bandages, or a tourniquet
• Bleeding from the ear, footpad, penis, and feather shafts can cause fatal hemorrhages

Internal Bleeding

• Internal bleeding is often seen with automobile accidents
• Severe internal bleeding can manifest in shock
• Treatment involves supportive care and possibly surgery

Addressing Fractures, Dislocations, and Sprains

• Signs include an inability to use the leg(s), pain, abnormal limb mobility, swelling/discoloration, crepitus, protruding bone fragments, and a limb appearing shorter
• Goal of treatment is to prevent further injury
• For limb fractures above the elbow or knee, splinting may not help; instead stabilize the limb
• Lower-limb fractures should be treated with a well-padded splint; transport if the animal resists splinting extensively

Addressing Head Injuries

• Signs include decreased alertness, incoordination, unconsciousness, convulsions, unequal pupil size, decreased pupillary response (unreliable in birds), vomiting, and blood or fluid from the ear
• Treatment involves keeping animals in dark, quiet locations with their head elevated to relieve blood pressure
• Provide supplemental oxygen and administer anti-inflammatories; the use of steroids may be controversial, with NSAIDs being more common

Recognizing and Treating Heat Stroke

• Signs include panting, open-mouthed breathing, difficulty breathing, disorientation, weakness, salivation, vomiting, diarrhea, increased pulse rate, high body temperature (105-110 F, species dependent), bright red gums, and shock
• Treatment involves moving the animal to cool or shaded areas, lowering body temperature with ice, water, or alcohol, focusing on the core, and administering cool-water enemas
• Take the animal's temperature every 5 minutes and stop cooling when it reaches about 103 F
• Complications include brain damage or other organ/tissue damage

Identifying and Treating Frostbite

• Commonly affected areas include the scrotum, ears, feet, and tail
• Signs include reddened tissues, white or grayish tissue (if still frozen), and eventual tissue death and blackening
• Do not rub or massage frozen tissue
• Never apply snow or ice
• Prevent further contact with cold by warming the area with lukewarm water or warm moist towels
• Stop warming when tissue becomes red and flushed
• Wrap in a heavy, protective bandage to prevent further injury and self-mutilation

Managing Cold Exposure/Hypothermia

• Most animals are well-protected unless they are neonatal, underfed, without shelter, or wet
• Signs include shivering, low body temperature (below 94 F), mental dullness, muscular weakness, and unconsciousness
• Treatment involves preventing further heat loss, warming slowly to prevent tissue damage and vasoconstriction, and covering the core with towels or blankets

Critical Conditions for Small Mammal Prey Species

• Small rodents have fast metabolisms
• There is rapid heat loss due to a high surface area in relation to body mass, rapid fluid loss, and risk of hypoglycemia
• Rabbits and lagomorphs can suffer from GI stasis due to stress or lack of feed, new food may be needed to stimulate motility
• Beavers are often trapped in clamshell traps, which can lead to wounds and pneumonia from sitting in water
• Animals brought in by a pet should be treated as if they have puncture wounds even if none are visible; rabbits at CWRF have a 45% survival rate after cat bites
• Animals hit by cars rarely survive because of their small, fragile bodies, often suffering paralysis or head trauma

Rabbit Hemorrhagic Virus (RHDV)

• RHDV was first detected in domestic animals in China in 1984 and in the United States in 2018
• It was first detected in native wildlife (New Mexico) in March 2020
• It is a Calcivirus that affects wild rabbits, wild hares, and wild and domestic European rabbits
• Transmission occurs through direct contact with sick animals (urine, feces, respiratory secretions), exposure to infected carcasses, fomites, and mechanical transmission (predator feces)
• The virus can remain viable in the environment for up to 90 days
• RHDV targets the liver, causing necrotizing hepatitis; it also affects the spleen and respiratory tracts, and DIC is common
• Early isolates have a 3-9 day incubation with 20-30% mortality, while more recent isolates have a 1-5 day incubation with 70-90% mortality
• Clinical signs: sudden death +/- epistaxis, neuro signs, respiratory signs, jaundice, and blood in feces
• Treatment: supportive care and quarantine
• It is a reportable disease with state officials
• Prevention: quarantine, biosecurity, and a possible vaccine

Rabies and Distemper in Small Mammal Omnivores

• Remember rabies and distemper
• Conditions to Consider: Why the mammal was hit by a car/attacked?
• Common Diseases and Conditions: Hit by car

Raccoon Parvovirus

• Etiology includes raccoon parvovirus, feline parvovirus, and canine parvovirus
• It is highly contagious via the fecal-oral route and can persist for a long time in the environment
• Clinical Signs: acute death with no outward signs, bloody diarrhea, and vomiting
• Mortality rate is over 50%
• Treatment: supportive care
• Prevention involves vaccinating when needed and bleaching or flaming cages

Distemper

• Etiology/History: canine distemper virus (a paramyxovirus)
• Species affected: wild and domestic dogs, coyotes, foxes, raccoons, and big cats
• Transmission: any body fluid, placenta, fomites
• Clinical signs: neurological, respiratory, and GI issues; hardening of keratin footpads
• Euthanize the animal with Distemper due to the fact it can shed the virus for months and there is permanent damage to the body
• Prevention involves quarantining new intakes, isolating sick raccoons, and preventing contact with wild raccoons; vaccination is another method of prevention

Large Mammal Prey Species

• These species are often limited and difficult to handle
• Assessing hydration in young fawns - ears will curl when dehydrated
• Wounds – myiasis/flystrike(the infestation of a wound in a live mammal by fly larvae)
• Use Clostridium antitoxin which releases toxin in times of stress

Common Conditions for Large Mammal Prey Species

• Hung in fence:
  • Punctures
  • Broken limbs
  • Pelvic strain or damage
• Hit by car; often catastrophic in adults
• Attacked by dog; treat punctures
• Stress diarrhea/toxicosis; Clostridium antitoxin on intake

Large Mammal Omnivores and Predators

• Limited, large and difficult to handle without anesthesia
• Common conditions are being hit by a car, or a nuisance situation(Is rehab really an option? Young hopefully did not learn their mom's bad habits)

Small Birds

• Require warmth due to rapid heat loss and high surface area to body mass ratio
• Have Fast metabolisms, which result in: fluid loss and Hypoglycemia
• Are notorious for hiding illness and injury which leads to: fluffed feathers, hunched posture, increased sleeping and inactivity, decreased vocalization and singing, sitting on the floor or lower perches, trembles and seizures, nasal discharge, crusty or wet, and dull, sunken eyes
• Common conditions include: Cat attack, being hit by a window, and air sac ruptures

Air Sac Ruptures in Birds

• Air sac ruptures are due to traumatic events and often occur in conjunction with broken bones, allowing air to naturally dissipate
• Pneumatic bones are part of the air sac system

Waterbirds

• Need water due to psychological need and waterproofed feathers
• Large birds require weight support because they are unable to stand. EX: Towel donuts

Common Conditions that affect Waterbirds

• Hit by car
• Hunting casualty
• Shorebirds stress very easily
• West Nile Disease is Endemic in Africa, Asia, Europe, North America
• Geese are the natural host, and can occur in others as a dead-end infection
• Mortality rate is 20-60% in geese
• Corvids especially susceptible
• Clinical signs include leg/wing paralysis, incoordination, and Opisthotonus

Carpometacarpal Luxation

• "Angel Wing"
• Most common in ducks and geese
• Causes include a Calcium/D3 deficiency, excess protein, or Genetic factors
• Clinical signs are Carpometacarpal joints subluxate and rotate
• Prevention: Limit protein levels/switch off grower feed as soon as possible

Raptors

• Large birds require support if unable to stand
• Feeding Tips: Make sure they can reach down to grab prey, and that they can shred food as they normally can
• Protect flight feathers from feces, wire trashing, etc.

Common Conditions that affect Raptors

• Broken wing/hit by car
  • Often hunting or scavenging on the sides of roads
  • Wind storms
• Lead toxicity
  • Most common in eagles and vultures because water birds eat lead sinkers
  • Lead gets concentrated in predator species
  • Illegal to use lead shot, but it still happens
  • Scavengers like eagles get even more lead from eating carcasses of human hunted animals
• Clinical Signs
  • Weakness, paralysis, droopiness
  • Tremors, seizures, and blindness
• Treatment
  • Calcium EDTA, DMSA, d-penicillamine
  • May take several rounds

Feather Conditions in Raptors

• Methane flares
• Electrocution
• Traumatic injury
• Iatrogenic issues

Molting

• Generally once per year, sometimes all at once, others in stages
• Blood/pin feathers are:
  • Young, growing feather
  • Covered in a keratin sheath
  • Contain lots of blood supply and will bleed profusely if broken
  • Keratin sheath eventually splits and allows feather to come out
• Treatment includes waiting it out, but takes time
• Pulling feather shafts will cause a new feather to grow in sooner, but is painful
• Imping involves Surgical addition of feathers pulled from a donor bird, and can be expensive

Bumblefoot/Pododermatitis - Birds only

• Unvaried pressure on the feet restricts blood flow -> tissue hypoxia and death -> infection
• Secondary infections
• Type I – smoothing of foot bottom, mild scab
• Type II – scab becomes deeply infected
• Type III - Bones, ligaments become infected
• Treatment involves bandaging, antibiotics, or surgery
• Prevention involves proper, varied perches; bandaging in birds that aren’t able to stand properly and watching the “good” leg

Wildlife Drug Use

• All drug use in wildlife is off label
• Each species can potentially have completely different reactions to medications
• Base Doses on similar species and exotic analogs. NWRA Wildlife Formulary & others
• Accurate weights are essential, especially with very small species
• Doses can often be huge ranges
• Consider drug withdrawals prior to release, such as Enrofloxacin being prohibited in food animals

Antibiotics

• Used when there are cat bites, deep punctures, deeply infected wounds, diarrhea, or compound fractures
• Critical sensitivities in rodents and lagomorphs, especially hindgut fermenters
• Only use sparingly, and only those known to be safe in domestic rodents, such as Enrofloxacin, sulfa-trim, tetracycline.
• Use judiciously to prevent resistance to antibiotics

Pain Medications

• Used when there is head trauma/hit by car/hit window, broken bones, or severe wounds
• Pain slows healing
• Rabbits are prone to GI stasis when in pain

Sedatives

• Used when there is severe anxiety, in-depth exams or procedures, or preparation for anesthesia
• Animals have to adjust to the captive life, so only use sparingly

Dewormer/Insecticides

• Some dewormers actually have doses for certain species of wildlife; if not, use closest analogs
• Routes:
  • Oral (powders and pastes) the easiest to administer if you can hide in food, but it is not viable in groups of animals
  • Can be dosed orally directly into the mouth
  • Topical sprays or dermal application, requires handling of the animal
• Choose this option to ensure appropriate dose

Deworming - YES OR NO??

• It will be up to you and your consulting veterinarian to decide on your deworming program

• Probably safe to assume that all wildlife have some sort of parasitism going on

• Option one: deworm all applicable species on intake

  • Pros:
    • Many subclinical infections
    • These infections can become later under other illness or stress.
    • Prevents spread of disease from subclinical animals like zoonotic disease and spread amongst animals
  • Cons:
    • Risks resistance
    • Creates expenses
    • Can have reactions:

• Option two: Only deworm if infestation is directly causing illness in the animal, such as mange, Endoparasitic infestations, or bird mites

  • Mange results in failure of hair growth/Secondary bacterial infections/Anemia
  • Endoparasitic infestations results in weight loss/Anemia
  • Bird mites and lice caused feather damage/Anemia

Pros and Cons of Deworming

• Pros: Less risk of resistance, less expensive, don’t have to worry about possible reactions
• Cons: Miss subclinical carriers/spreaders

Vaccination

• Pros: Reduce incidence of disease while in your facility/Reduce incidence of disease in wild populations after release
• Cons: No or little proof that they actually work, over handling of the animal/creates risk of reactions

Potential Vaccines

• Raccoons should get Parvovirus, Rabies, and Distemper
• Other RVS canids: Rabies, Distemper
• Felids: Feline parvovirus, Rabies
• Birds: West Nile Virus, Avian flu
• Cervids: Clostridium A, C, D