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Behavioral psychotherapy is particularly useful among clients who are adversely affected with phobias, substance related disorders, and other addictive disorders. Some of the techniques that are used with behavioral therapy include operant conditioning as put forth by Skinner, aversion therapy, desensitization therapy, modeling and complementary and alternative stress management techniques.
Cognitive behavioral psychotherapy, which is a combination of cognitive psychotherapy and behavioral psychotherapy and also referred to as dialectical behavioral therapy is most often used for clients affected with a personality disorder and those at risk for injury and harm to self and/or others.
The Specificity Theory of Moritz Schiff described pain as a sensation that was different from all the other senses in that pain had its own specific nervous system pathways from the spinal cord that traveled to the brain; the Intensive Theory of pain is based on the belief that pain is an emotional state, rather than a sensory phenomenon; the Peripheral Pattern Theory of pain of Sinclair and Weddell describes pain as the result of an intense stimulus applied to the skin; and the Neuromatrix Theory of Pain supports the fact that pain is a dynamic and multidimensional process with physical, behavioral, perceptual, psychological and social responses and one that can only be described by the person who is experiencing it.
Observational behavioral pain assessment scales for the pediatric population are used among children less than three years of age. Some of these standardized pediatric pain scales, in addition to the CRIES scale, include the FACES Pain Scale, the Toddler Preschooler Postoperative Pain Scale (TPPPS), the Neonatal Infant Pain Scale (NIPS), the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS), the Faces Legs Activity Cry Consolability Pain Scale (FLACC), the Visual Analog Scale (VASobs) the Observation Scale of Behavioral Distress (OSBD), the COMFORT Pain Scale and the Pre-Verbal Early Verbal Pediatric Pain Scale (PEPPS) that is used with toddlers.
The sight of blood strikes fear in all bird owners and is a common emergency presentation. Hemorrhage may result from numerous causes including trauma, infectious disease, metabolic and nutritional causes, and neoplasia. Trauma is the most common cause of hemorrhage. The majority of the birds bleeding due to minor trauma can be easily treated. Bleeding blood feathers, fractured or avulsed toenails and beaks, and traumatized wing tips make up the majority of these cases. Bleeding blood feathers must be pulled. Even if the bleeding has stopped, it may resume if the tip of the growing feather brushes a perch, or is groomed by the bird. If the feather appears to be gone but continues to bleed, look or palpate for a remnant of the feather shaft in the follicle (BE GENTLE!). Once the feather is pulled do not put hemostatic agents in the follicle! The bleeding will usually stop if the follicle is pinched closed for 60-90 seconds. If the hemorrhage continues try gluing the follicle closed with a drop of tissue cement in the opening of the feather follicle. Bleeding toenails may be cauterized with a mild styptic such as ferric sub-sulfate or the quick may be covered with a thin layer of tissue cement. Broken beaks are occasionally difficult to stop bleeding. This is particularly true with slab-type fractures of the tip of the upper beak or rhinotheca (common with cockatoos and African Grey parrots (Psittacidae). These fractures may be difficult to diagnosis due to blood spreading from the tip of the beak to the tongue, giving the appearance that the origin of the hemorrhage is elsewhere in the oral cavity. The bleeding will often stop if the broken surface is filed or ground smooth. This also appears to make the broken tip less irritating to the bird. The tip of the beak may be cauterized with hemostatic powder if needed.
Burned birds should be monitored for blood loss and loss of body proteins. Plasma or colloidal fluids may be required in patients where total solids and hence osmolality drops below 1.0 g/dL. Renal function should be monitored by number of droppings and urine volume, uric acid and serum electrolytes. Continued fluids and judicious use of diuretics is indicated in birds with decreased urine output. White blood cell counts are commonly increase within 24 to 48 hours and persist for 5 to 10 days (in the authors experience). Pain medications (analgesics) are indicated in cases where the bird is in pain (see above).
Initial therapy consists of supportive therapy along with chelation. Supportive fluids SQ, IV or IO, depending on the degree of dehydration and volume of polyuria, thermal support, anti-seizure medication if needed, make up the supportive care. Chelation of circulating lead forms nontoxic complexes that are excreted in the bile or by the kidneys. Removal of circulating lead leads to equilibration of lead from tissue and bone for further chelation. Calcium disodium versonate (CaEDTA) is the treatment of choice for initial therapy.32,35 D-penicillamine (PA) may be added to the therapy and has the advantage of oral administration.32, 36
Pesticides seen most often in avian emergency and critical care include insecticides, and rodenticides. The most common insecticides are organophosphates including diazinon, dichlorvos, dieldrin, dursban, and malathion and carbamates (carbaryl). Intoxication generally results secondary to ingestion through contamination of food or water, although secondary poisoning of wild insectivorous species may occur. Pathology and clinical signs result from binding of the insecticide to and inhibition of aetylcholenesterase (AChE) and the resulting accumulation of acetylcholine (ACh) at ganglia and neuromuscular junctions. Organophosphate bonds are irreversible but carbamate bonds are slowly reversible. Signs include anorexia, weakness crop stasis, ataxia, muscular twitching, prolapsed nictitans, increased respiratory secretions, dyspnea, bradycardia and death. Tentative diagnosis is based on history of exposure, clinical signs and response to therapy. Bradycardia not responsive to atropine at 0.02 mg/kg given IV is suggestive, but not established in avian medicine. Definitive diagnosis is based on cholinesterase assay from blood, plasma, or serum, paired with an analogous subject.
First generation (warfarin) and second generation (brodifacoum and bromadoline) rodenticide intoxication or suspected intoxication caused by both primary and secondary exposure (carnivorous birds) are not uncommon presentations. These agents are vitamin K antagonists that deplete and block the synthesis of prothrombin, accessory factors VII, IX, X. As noted earlier, extrinsic clotting factors are not important in avian patients, and low levels of factor VII may decrease the effects of these products. Clinical signs include depression, anorexia, feather follicle and subcutaneous hemorrhage, petechial hemorrhages of oral and cloacal mucosa and bleeding from nares. Many of these patients will present with no history of exposure and no specific symptoms. Once hemorrhage is noted the prognosis is grave.
Your parakeet would need to be seen by a veterinarian and a swab taken from the material examined microscopically to be certain, but, the most common thing that look like what you are describing is an oral yeast infection (similar to Thrush in children). These are treated with topical or systemic antifungal medications and do well if treated.
AlexI cannot be sure without seeing your bird, but the most likely cause id obsessive compulsive behavior (behavioral feather picking). Other possible causes could be: Primary skin disease (bacterial or fungal (yeast, dermatophyte) skin infections), these typically have an exudate or crust on their skin. Viral disease (psittacine beak and feather disease (circovirus), polyomavirus), these cause problems with all the feathers on the bird, not just the areas they can reach or pick. Poor nutrition (vitamin or protein deficency), also would effect other areas of the skin.Birds with behavioral feather picking problems get a benefit from causing pain at the time they pull their feathers. We think that the epinephrine (adrenaline) that is released when they hurt themselves changes chemical levels in their brains that relieve their feeling of anxiety as with people that cut themselves, have obsessive tattoo or piercing behaviors, obsessive shoppers, gamblers, etc.Look to see if your budgie has other signs of illness, work to change its diet to a more healthy pellet and fresh food diet and find toys that occupy its time. Once you can afford to see a vet, find a board certified avian veterinarian who really understands these problems to help you.
Stephen Pennington, PhDUniversity College Dublin, School of MedicineSteve graduated from Imperial College of Science and Technology (Imperial College London) with a joint honours degree in Chemistry and Biochemistry before completing a PhD in Biochemistry at the University of Cambridge. Subsequently, he was an Elmore Medical Research Fellow in the Department of Biochemistry in Cambridge University. His research team in University College Dublin (UCD; www.ucd.ie) is currently developing multiplexed protein biomarker measurements using multiple reaction monitoring mass spectrometry to support the translation of novel multiplexed blood protein biomarkers to clinical diagnostic tests. He founded the UCD spin out company, Atturos (www.Atturos.com) in late 2016 and was awarded UCD's Innovator of the Year in 2018. Atturos aims to develop and deliver advanced diagnostic tests to support better decision making for better patient outcomes.In 2017 he was the lead organiser of the 16th Human Proteome Organisation (HUPO) World Congress, which was held in Dublin and included a Gala Dinner at which former US Vice-President Joe Biden was guest speaker. Steve is currently Professor of Proteomics and Senior Fellow, UCD Conway Institute and past President of HUPO (www.hupo.org) The challenges of developing new protein biomarker tests and delivering them to use for patient benefit will be presented. In the context of a recently initiated EU IMI consortium, particular emphasis will be placed on analytical validation of new multiplexed protein biomarker assays and their use in multi-centre evaluation and validation studies to support the development of new tests in psoriatic disease. Patient engagement and use of patient centric sampling devices for effective test delivery will be introduced. =Connect&tab=Recorded#228 19Thu Sep 16, 2021SeminarPractical Training 153554b96e
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