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Suffield Veterinary Hospital
 Avian History Form

This information will become a permanent part of your birds medical record.  Please take the time to complete it as carefully as possible.  Thank You.     top

Owners Name

Birds Name

Species
How long have you owned this bird?
From what source did you acquire it? Pet shop Breeder Other Other
What do you feed your bird? (be specific)
Do you give any supplements?              
Does your bird appear to have any problems?

No

Yes
If yes what symptoms have you noticed?
When did the symptoms first appear?
Has your bird had any previous illnesses?

No

Yes
If yes, please describe
Has your bird received any medication's recently?

No

Yes
If yes, please describe
Have there been any changes in the birds environment?

No

Yes
Has your bird's appetite changed in any way? No

Yes

  
Has there been any change in the color or consistency of the bird's droppings?

No

Yes

  
Have you noticed any signs of respiratory problems?

No

Yes

  
Have you noticed any regurgitation?

No

Yes
Does your bird have any cage mates?

No

Yes
If yes, are the cage mates showing any signs of illness?

No

Yes
Have any new birds been added to your aviary or household?

No

Yes
Has your bird been exposed to any other birds, including wild birds?

No

Yes

Other Comments

SPECIAL MEDICAL TECHNIQUES

The following information is provided to assist you in your discussions with your veterinarian.  Should you be directed to give injections, the technique will normally be demonstrated for you.  However, you may find these notes helpful for additional information or to clarify instructions.

  • Have all material close at hand and ready to use.  Use an assistant.  Catch the large patient with a towel (minimize stress by removing perches for easy catching).
     
  • Enfold the bird in the towel so that wings and heads are covered.  Have your assistant hold the toweled body against them, using one hand to hold the feet tightly.
     
  • Use your finger to locate the keel bone in the center of the chest.  Run your finger to the top and bottom so you can find your total area of injection sites.  Feel the muscle mass to each side of the central bone.  Use an alcohol-moistened cotton swab to move the feathers off the central area, so that you can see your site.
     
  • Hold the syringe by the barrel (one hand) and put the needle in at an angle, to about half of its length.  In a very thin bird, you may hit bone (no problem, just pull the needle out slightly).
     
  • Use your other hand to pull back on the plunger before injecting.  If you happen to be in a blood vessel, you will see blood come into the syringe.  Again, just move the needle slightly should this happen.
     
  • Now you are ready to inject.  Afterwards, rub the injection site to prevent bleeding.  Alternate sides of the chest used for each injection.

An example of the educational material that is useful in increasing compliance when sending patients on medication routines home.  (A) Detailed instructions for proper injection of medication.  (B)  Diagram of avian anatomy for proper placement of needle.

 

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Revised: 05/18/06