{"id":1268,"date":"2013-06-19T11:07:28","date_gmt":"2013-06-19T01:07:28","guid":{"rendered":"https:\/\/theveterinarian.com.au\/?p=1268"},"modified":"2013-06-25T14:46:06","modified_gmt":"2013-06-25T04:46:06","slug":"birdie-braces","status":"publish","type":"post","link":"https:\/\/theveterinarian.com.au\/?p=1268","title":{"rendered":"Birdie braces"},"content":{"rendered":"\"Macaw<\/a>For some, the word orthodontist stirs awkward teenage memories of braces and the agonising wait to be rid of mouth metal. But humans aren\u2019t the only species requiring some orthodontic alignment.<\/span>\r\n\r\nUniversity of Queensland Small Animal Hospital Head of Avian and Exotic Pet Service, avian specialist and exotics luminary Bob Doneley is occasionally called upon to fit what he calls \u201cbirdie braces\u201d for beaks that have gone awry.\r\n\r\nWry beak, or scissor beak, as it is known among bird circles, is a condition predominantly of juvenile birds, where the maxillary beak begins to deviate laterally \u2013 usually (for unknown reasons) to the right.\r\n\r\nAs a consequence, mandibular keratin tends to proliferate, unchecked by natural wear that would occur in the case of perfect beak alignment, and pushes upwards. This places additional pressure on the maxillary beak, worsening the defect.\r\n\r\n\u201cIt is probably more common in macaws than other species but any bird can get it,\u201d Doneley said. This includes ostriches which, due to their sheer size, can present with spectacular cases of wry beak. (Doneley\u2019s ostrich practice once extended from Kingaroy to Tenterfield, and from the Gold Coast to St George \u2013 so he\u2019s seen a few ostriches in his time). Doneley has also seen the condition in eclectus parrots.\r\n\r\nEarly intervention may be enough to solve the problem.\r\n\r\n\u201cSometimes it is a matter of the owner simply holding the beak in correct alignment for ten minutes, two to three times a day,\u201d Doneley said. \u201cBut as a general rule, by the time the owner realises the problem is there and then by the time they bring it in to us, the problem has usually got past that stage.\u201d\r\n\r\nMany affected birds will continue to eat, albeit awkwardly. However, the condition can progress to the point where it causes obvious discomfort to the bird.\r\n\r\n\u201cThe potential for a detrimental impact on the bird\u2019s health means this is something we need to treat.\u201d\r\n\r\nThere are multiple theories as to the underlying cause.\r\n\r\n\u201cIt may occur due to a genetic predisposition, and may or may not be directly hereditary,\u201d Doneley said.\r\n\r\n\u201cA lot of affected birds are hatched from artificial eggs, causing some people to ask whether there has been some malpositioning within the egg \u2013 could the beak be pushed against the eggshell while the animal was growing? That could be just enough to cause a deformity.\u201d\r\n\r\nDoneley feels this was the likely aetiology in the affected ostriches he saw.\r\n\r\nAnother hypothesis, given that many of these valuable birds are hand-fed, is that trauma during hand-feeding may lead to wry beak.\r\n\r\n\u201cBirds often hit their beak vigorously against the spoon,\u201d Doneley said. \u201cThough I used to see this condition a lot in ostriches and they were never hand-fed.\u201d\r\n\r\nYet another theory suggests that poor parental nutrition leads to affected offspring.\r\n\r\nTrying to eliminate possible hereditary problems in birds is no simple matter. Desexing macaws is not as straightforward as spaying a dog or cat \u2013 and complicated by the fact that most are sold as breeding pairs. Added to this is the value of many of these birds.\r\n\r\n\u201cBlue and gold macaws sell for around five to seven thousand dollars,\u201d Doneley said. \u201cMany owners are worried about how the deformity might impact on the resale value of these birds.\u201d\r\n\r\nWhen it comes to the question of how to treat affected birds, there are a number of potential options, all with their limitations. The aim is essentially to apply gentle pressure to the beak until it straightens.\r\n\r\n\u201cPeople have tried corrective trimming of the beak with a Dremel , trimming away the abnormally growing parts of the beak which aren\u2019t in wear,\u201d Doneley said. \u201cTrimming the beak back into normal conformation may allow the beak to self-correct, but this strategy is usually not that effective and often combined with another technique.\u201d\r\n\r\nSome avian veterinarians swear by a ramp which is built up from the mandibular beak, often using acrylic with k-wire as scaffolding. The ramp exerts constant pressure on the maxillary beak as it grows, eventually correcting the problem.\r\n\r\n\u201cThe idea is that you build the ramp high enough so that when the bird opens its mouth to fullest extent, it can\u2019t pull the upper beak over the ramp.\u201d\r\n\r\nThe biggest limitation with this technique is that ramps need regular replacement.\r\n\r\n\u201cThe problem is that keratin on the lower beak is growing continually, so you may need to replace the ramp every few days in a juvenile bird,\u201d Doneley said. \u201cIn an adult bird you would be replacing it two to three times a month until beak corrects.\u201d\r\n\r\nSome practitioners drill holes in the beak and anchor the ramp into place.\r\n\r\nBenign neglect is an option, albeit risky as some birds will experience serious difficulty eating.\r\n\r\n\u201cWith ostriches we often left them as most were too big to do anything, but I did treat one ostrich chick with a mandibular ramp made from needles and acrylic with a good outcome.\u201d\r\n\r\nFor pet and aviary birds, Doneley\u2019s preferred technique is trans-sinus pinning.\r\n\r\n\u201cYou basically take K-wire and run it through the bird\u2019s skull, just behind the nares, so actually through the frontal sinus, in through the right and out on the left, anchoring it with a rubber stopper on the right side to stop the device from pulling through.\u201d The rubber stopper is usually the cap off a blood collection bottle.\r\n\r\nWhere the wire exits on the left, Doneley bends it so that it runs down the side of the beak.\r\n\r\n\u201cAt the bottom of the beak you create a little hook in this wire, then you use a rubber band to go around the hook and around the tip of the beak.\u201d\r\n\r\nK-wire is preferred as this has just enough spring in it to provide gentle tension. Juvenile macaws are highly adept at eating foreign bodies, so it helps to anchor the rubber band to the hook with Leucoplast.\r\n\r\nThe procedure is naturally performed under a general anaesthetic, usually isoflurane. Doneley prefers to intubate birds (typically with an appropriately \u2013sized uncuffed endotrachael tube) to ensure the airway is controlled throughout the procedure, which involves a lot of movement of the bird\u2019s head.\r\n\r\n\u201cThe whole procedure takes about ten minutes,\u201d he said.\r\n\r\nOver the following weeks, as the beak continues to grow, the wire gently pulls it into alignment.\r\n\r\n\u201cThe last one we performed took about three weeks to come completely back to normal \u2013 plus an additional week for the pinholes to heal up.\u201d\r\n\r\nDespite the distinctly Frankensteinian appearance of the device, most birds tolerate it surprisingly well.\r\n\r\n\u201cWe give them pain relief on the day of the procedure but it doesn\u2019t seem to cause a great deal of discomfort,\u201d Doneley said. \u201cIt\u2019s a very lightweight framework. While some birds aren\u2019t impressed with this structure on their head, most maintain a good appetite.\u201d\r\n\r\nIt is the owner\u2019s job to maintain placement of the rubber band, which some birds remove with their claws.\r\n\r\n\u201cIt was an owner who came up with the idea of covering the rubber band with Leucoplast tape and we now use this as part of our technique. The potential is always there for the bird to eat the rubber band, but if they did I would hope that it would pass. We have seen feeding tubes removed from the stomachs of macaws so it is something we look out for.\u201d\r\n\r\nThe procedure costs around $400-500.\r\n\r\n\u201cYou don\u2019t need to radiograph these birds, just place the device. Most owners are prepared to do this and prepared for the aftercare.\u201d\r\n\r\nBob Doneley will be co-teaching a workshop with David Vella on Approaches to Avian and Exotic Patients in Sydney in July. For further information visit www.cve.edu.au\r\n\r\nAnne Fawcett\r\n\r\nPictures Bob Doneley","protected":false},"excerpt":{"rendered":"

For some, the word orthodontist stirs awkward teenage memories of braces and the agonising wait to be rid of mouth metal. But humans aren\u2019t the only species requiring some orthodontic alignment. University of Queensland Small Animal Hospital Head of Avian and Exotic Pet Service, avian specialist and exotics luminary Bob Doneley is occasionally called upon […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[29],"tags":[1126,1127,1124,1125,405,1122,1123,1797,855,1128,1121,106],"class_list":["post-1268","post","type-post","status-publish","format-standard","hentry","category-clinical-zoo","tag-alignment","tag-beak","tag-bird","tag-birdie-braces","tag-birds","tag-bob-doneley","tag-braces","tag-clinical-zoo","tag-exotics","tag-heredity","tag-orthodontist","tag-university-of-queensland"],"rise-blocks_total_comments":0,"rise-blocks_categories":[{"term_id":29,"name":"Clinical Zoo","slug":"clinical-zoo","term_group":0,"term_taxonomy_id":29,"taxonomy":"category","description":"","parent":0,"count":13,"filter":"raw","cat_ID":29,"category_count":13,"category_description":"","cat_name":"Clinical Zoo","category_nicename":"clinical-zoo","category_parent":0}],"rise-blocks_excerpt":"For some, the word orthodontist stirs awkward teenage memories of braces and the agonising wait to be rid of mouth metal. But humans aren\u2019t the only species requiring some orthodontic alignment. University of Queensland Small Animal Hospital Head of Avian and Exotic Pet Service, avian specialist and exotics luminary Bob Doneley is occasionally called upon to fit what he calls..","blog_post_layout_featured_media_urls":{"thumbnail":"","full":""},"categories_names":{"29":{"name":"Clinical Zoo","link":"https:\/\/theveterinarian.com.au\/?cat=29"}},"tags_names":{"1126":{"name":"alignment","link":"https:\/\/theveterinarian.com.au\/?tag=alignment"},"1127":{"name":"beak","link":"https:\/\/theveterinarian.com.au\/?tag=beak"},"1124":{"name":"bird","link":"https:\/\/theveterinarian.com.au\/?tag=bird"},"1125":{"name":"birdie braces","link":"https:\/\/theveterinarian.com.au\/?tag=birdie-braces"},"405":{"name":"birds","link":"https:\/\/theveterinarian.com.au\/?tag=birds"},"1122":{"name":"Bob Doneley","link":"https:\/\/theveterinarian.com.au\/?tag=bob-doneley"},"1123":{"name":"braces","link":"https:\/\/theveterinarian.com.au\/?tag=braces"},"1797":{"name":"Clinical Zoo","link":"https:\/\/theveterinarian.com.au\/?tag=clinical-zoo"},"855":{"name":"exotics","link":"https:\/\/theveterinarian.com.au\/?tag=exotics"},"1128":{"name":"heredity","link":"https:\/\/theveterinarian.com.au\/?tag=heredity"},"1121":{"name":"orthodontist","link":"https:\/\/theveterinarian.com.au\/?tag=orthodontist"},"106":{"name":"University of Queensland","link":"https:\/\/theveterinarian.com.au\/?tag=university-of-queensland"}},"comments_number":"0","wpmagazine_modules_lite_featured_media_urls":{"thumbnail":"","cvmm-medium":"","cvmm-medium-plus":"","cvmm-portrait":"","cvmm-medium-square":"","cvmm-large":"","cvmm-small":"","full":""},"_links":{"self":[{"href":"https:\/\/theveterinarian.com.au\/index.php?rest_route=\/wp\/v2\/posts\/1268","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/theveterinarian.com.au\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/theveterinarian.com.au\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/theveterinarian.com.au\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/theveterinarian.com.au\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1268"}],"version-history":[{"count":8,"href":"https:\/\/theveterinarian.com.au\/index.php?rest_route=\/wp\/v2\/posts\/1268\/revisions"}],"predecessor-version":[{"id":1360,"href":"https:\/\/theveterinarian.com.au\/index.php?rest_route=\/wp\/v2\/posts\/1268\/revisions\/1360"}],"wp:attachment":[{"href":"https:\/\/theveterinarian.com.au\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1268"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/theveterinarian.com.au\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1268"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/theveterinarian.com.au\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1268"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}