When taking a medical history from a client it is very important how you word your questions. Asking, “Does Oscar always sit in the corner of his cage?” is leading the client, and possibly in the wrong direction. Instead ask an open question such as “Where does Oscar spend most of his time when he’s in his cage?” Just as when you are performing a physical examination, your job is to collect as much information as possible and asking questions in the same order every time will lead to a complete history.
Your initial visit with avian patients can be very time consuming but necessary. Once you have all this information documented future visits will be much quicker. On the repeat visits be sure to always ask it there have been any changes in life style since the last visit. If the client has brought medical records from another hospital be sure to review all the information prior to entering the exam room if possible.
Know not just the patient and client’s name but how to pronounce them prior to entering the exam room. Most avian owners are very well educated on their species of bird, you should be also.
When entering the exam room be sure to introduce yourself to the client. You do need to greet the patient as well, but many avian patients are not used to strangers and do not travel often so you should approach them slowly. Keep in mind one of the first parts of history taking includes observing the patient so rushing up to the cage will most likely unsettle the bird.
The following list of questions and concerns may seem unnecessary to some clients, especially if the bird is ill; take a few moments to explain the importance to the client. You need to consider the reason the bird is being seen and collect all the information needed to immediately treat him, but at some point you will need to have all the questions answered.
It is a good idea when taking a history to use a checklist; this is a great way of making sure we do not forget anything. See our detailed checklist in our Specialty Folder.
Signalment Plus
Species
Hatch date/approximate age
Sex and how it was determined
How long have they owned the bird?
Where did they obtain him from?
Was he quarrantined at time of purchase?
Is he hand tamed?
Is he fully flighted?
Is he ever outside? If so, is he caged? Protected from the environment?
Any past medical problems?
Any other pets at home? If so what are they?
Any recently deceased pets? If so what was the cause of death?
Presenting Complaint-Ill Visit
What is the bird presenting for today?
How long has it been going on?
Is the problem progressing, getting better or staying the same?
Is he eating/drinking like normal?
What is the consistency of the droppings? Is that normal?
Any other pets or people sick at home?
Any change in life style?
Has there been any weight change?
Diagnostic History (Have these been done and if so when)
Chlamydiosis and Psittacine Beak and Feather Disease test
Avian Fecal Profile
Culture and Sensitivity cloaca or chloanal slit
Chemistry and CBC panel
Diet
How is his appetite?
Describe the diet? What brand of food are they eating? Pellets or seed?
How much food is offered daily?
How much of the food is consumed?
Are any human foods offered and if so what kind and how much?
Do they receive any vitamins? If so what kind and how often?
Remember NO caffeine, alcohol, avocado, parsley, or chocolate.
How often is the water changed?
Is the water offered in a bowl or water bottle?
What type of water is offered?
Behavior
Describe the bird’s personality.
Has his attitude changed? If so please describe the change.
Has his voice changed? If so please describe the change.
Describe the bird’s molting habit.
Describe the bird’s sleeping patterns
Does he forage?
Grooming (Is he in the need of)
Nail trim
Beak trim
Wing clip
Does he bathe? If so how often?
Cage
Are there any cage mates? If yes, how many and species.
Is the cage covered in the evening?
What is the light cycle? Does he get 12-14 hours of darkness?
Describe the cage in detail. Size? Brand or material cage is made of?
Perches: types, quantity, location
Bowls: type, size, location
Toys: type, material they made of, quantity, location,
Do they spend any time out of their cage?
If so where are they?
Are they unattended when out of their cage?
What type of substrate is used for cage lining?
How often is the cage cleaned? Water bowl? Food bowl? Perches?
Describe the color and consistency of the droppings.
References:
Exotic Animal Care – Tully and Mitchell
Exotic Animal Medicine for the Veterinary Technician – Ballard and Cheek
