1. Head Trauma in Wildlife Patients

Alison M. Hazel, DVM
Greenwood Wildlife Rehabilitation Center
Longmont, Colorado
amhazel@q.com

• Head trauma is one of most common injuries
that happens to wildlife and brings them to a
rehabilitator. This lecture will review the
current treatment recommendations based on
the latest information from pet medicine.
Assessment and treatments will be discussed in
addition to prognosis for recovery.

Major Categories
None
Shock & Dehydration
Head Trauma
Wounds
Neurological Injuries
Diet & Nutrition Problems
Musculoskeletal Problems
Blood Related Concerns
Ectoparasites
Emotional States
Eyes
Respiratory System
Problems from Old Injuries
Nose & Cere
Gastrointestinal Tract & Stool
Thermal Related Concerns
Skin, Fur & Feathers
Other (Collapse and tumors)
Oil Imposed Conditions
Endoparasites
Mouth & Neck
Poisoning
Abdominal Conditions & Injuries
Ears
Genitourinary System & Urine
Electrical Shock
Dental Conditions
Disease Agents & Conditions
Adverse Effects from Drugs
Relative Fr equency
Lo
Med
Figur e 3 - Relative Fr equency of 28 Major Categories
Hi
Shirley and Allen
Casey, NWRA
Proceedings, 2000.

• Associated with high mortality
• Best treatments remain controversial
• Injured animals need to have immediate
treatment to recover to functional level

• Triage- French for ‘to sort’
• Often observational in wildlife- ABC’s
• Most patients will be in hypovolemic shock
• Most patients will have hypoxemia
• Many patients will have neurogenic
pulmonary edema

• Look for traumatic injuries
• Check skull, back, limbs
• Remember bladders and spleens
• Assess if good prognosis for release
• Remember to check eyes

• Maxilla fractures tend to heal if stable
• Alignment of teeth most important
• Mandible fractures can heal if teeth aligned and
can eat
• Check incisors and molars

• First think about prognosis of other injuries
• Glasgow Coma Scores (conscious, moving,
reflexes)
• Grade head trauma as mild, moderate, or
severe
• X-rays not very useful
• Remember to r/o toxin, malnutrition, viral

• Clinical Signs
• Neurologic, Respiratory Distress
• Star-gazing, Tremors, Paralysis
• Look for signs of trauma and get a good hx
• Nails worn
• Road rash
• Wounds
• Blood from nose and ears

• QAR or depressed
• Unconscious
• Unable to stand
• Abnormal pupils
• Slow heart rate can mean increased cranial
pressure
• Cheney Stokes breathing= brain stem
herniation

• Size
• Reaction to light
• Nystagmus
• Anisocoria
• Progressive dilation with no PLR = brain stem
herniation

• Triage
• Assess prognosis over 12-24 hours
• Check nose and ears, if blood use antibiotics
• Pain control
• Check teeth

• Treat and prevent complications
• Maintain good respiration
• Maintain good blood flow to brain
• Control of intracranial pressure
• Manage fluid needs
• Control seizures if viral caused ruled out

• Elevate head at a 30 degree angle
• Reduces ICP
• Neck/jugulars needs to be straight. No collars/leash
• No not overheat or give any supplemental heat

• Dehydration makes cerebral trauma worse
• Maintain normal hydration
• See resources on fluid therapy in wildlife
• SQ fluid administration- maintenance rate
• Fluids leaves the blood in 1 hour and goes to intercellular
space

• Face mask best for delivery but only if can
safely handle
• Oxygen cages less effective but good for
wildlife
• Small mini-tanks and an induction chamber
• Intranasal oxygen if in veterinary hospital

• IV hypertonic saline then Hetastarch then NaCl
• Mannitol
• Expands plasma by reducing the extracellular space
• IV over 15 minutes and last several hours
• Too much lowers blood pressure and causes
dehydration
• Free-radical scavenger
• Reserve for only severe head trauma- releasable?

• Furosemide (Lasix)
• No studies that show it is helpful
• Dopamine
• Used for low blood pressure that does not improve
with fluids. Prognosis poor in wildlife if need to
think about this

• NSAIDs are considered safe after 24 hours due
to concern of bleeding. Meloxicam maybe
safest.
• Buprenorphine or butorphenol
• Opioids can cause mild increase in ICP but
pain and struggling will increase it even more
• Oral tramadol OK if can eat

• Think rabies first
• Then think distemper, WNV…
• Then think head trauma- history and signs
• Veterinary support
• Seizures greatly increase ICP
• Treat with phenobarbital IM once
• Prognosis??

• Extensively studied
• Helps in animals with brain tumors
• Does not help head trauma
• Higher mortality
• Does help with pain reduction
• Hyperglycemia- worsens head trauma in people

• Known history of trauma- window, etc.
• Appears normal on PE
• Remember vision
• Remember shoulders in birds
• Observe 4-6 hours based on studies in children

• Dark and quiet
• Metacam or other NSAID
• Flight and vision assessment once stable
• No heat
• Oxygen and fluids
• Check vision and wings

• Butorphenol for pain plus NSAID
• Dark and quiet and food at all times
• Check teeth
• Syringe feed if not eating- prevent
dysbiosis/ileus
• Oxygen and fluids

• Remember rabies and other viral causes
• Look for signs- nails, road rash, breathing
• Pain control and darkness
• Prevent injury to patient and yourself
• Oxygen and fluids

• Young mammals can carry rabies
• Rabies virus can be in saliva before they act
sick
• Abnormal behavior, ill, weak and
uncoordinated
• Unafraid or very aggressive
• Juvenile noises
• Unable to fly or erratically flying bats

• Ceftazidime
• Meloxicam
• Buprenex
• Dark and quiet

• All patients should be back to normal 1-2
weeks
• Poor prognosis if worsens over time
• Remember vision and hearing assessment
• Test ability to climb, fly, forage

• Don’t forget to look at whole patient and if can
be released
• Elevate head
• OK to give fluids and keep hydrated
• Don’t over heat and a little cool is OK
• Use something for pain but think first
• Call your veterinarian for help