Every Bird Matters
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Ask a Bird Vet

October 31, 2013

Staff Spotlight: Dr. Rebecca Duerr, DVM MPVM — and now PhD

rebecca-duerr Caspian Terns with multiple fractures, Brown Pelicans with horrendous sea lion bite injuries, an oiled Great Blue Heron suffering from resulting burns on one-quarter of its body — these are just some of the avian patients over the past year in the care of Dr. Rebecca Duerr, our staff veterinarian.

In June, we were thrilled to congratulate Dr. Duerr for completing her PhD studies and contributing invaluable research to the complex field of oiled wildlife care. For her dissertation, she focused on assessment of nutritional depletion in birds affected by petroleum. Oiled birds endure extreme stress during the wash process, and as Dr. Duerr’s research has showed, most of these animals arrive at wildlife facilities in an extremely debilitated state, requiring much-needed nutrition, hydration and medical care prior to the procedure. When there are hundreds of birds in care during oil spill emergencies, what a response team feeds these compromised animals can be a life-or-death decision.

Dr. Duerr recently gave us the backstory on her dissertation, how she got involved with wildlife and her favorite part of the job as an avian vet. For those of you who are mulling a radical career change, read on! Her story may provide you with a little motivation to do so.

How did you get your start in wildlife rehabilitation? 

Dr. Duerr: My husband and I started volunteering at The Marine Mammal Center (TMMC) in Sausalito in 1988 and WildCare in San Rafael, CA in the mid 1990’s while working as jewelers. Pretty much all of our free time was taken up by working with wild animals in one capacity or another. But then we had the opportunity to move to Los Angeles and work as artisans making science fiction movie and TV hand props. What could be cooler than working in Hollywood, right? Off we went.

Among many other projects, we made communicator badges and phaser rifles for Star Trek 8 and Deep Space Nine, made the cigarette gag props from the end of the first Austin Powers movie, and I sculpted several original props for the movie Spawn, but we both really missed working with animals. We finally decided to go back to school and pursue being veterinarians while on the set of Starship Troopers for two weeks, dressing extras in the armor our company had built. I was bored out of my mind and ended up doing a math review book in the wardrobe trailer. We both enrolled at San Francisco State University and completed BS’s in Marine Biology on the way to applying for veterinary school.

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A Caspian Tern with multiple fractures, photo by Dr. Rebecca Duerr. Inset photo: Orthopedic surgery on the tern’s left leg.

I didn’t truly come to appreciate the incredible amazingness of birds until I landed my first paying job at a wildlife center at Wildlife Rescue Inc. (WRI) in Palo Alto, after returning to the Bay Area for school. Four main things struck me while working there:

1) Bird species are amazingly diverse and completely fascinating! I decided I wanted to specifically become a wild bird vet.

2) Wildlife rehabilitation as a field is enormously larger than the marine mammal world — hundreds of thousands of animals go through the hands of wildlife rehabilitators every year in the US, and most are birds.

3) Raptors are wonderful animals but seemed to already get special attention from veterinarians — rehabilitators were often on their own in helping birds of other species.

4) There were very few published resources that explored or explained best practices for doing what wildlife rehabilitators do every day.

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Treating burn injuries on a Great Blue Heron, photo by Dr. Rebecca Duerr

I regretfully left WRI when Dr. Frances Gulland asked me to work for her at TMMC. Her approach of studying the medical problems of rehabilitated marine mammals as a window into what is occurring in each species in the wild and the ocean as a whole, strongly caught my interest and forms the basis of many of my goals for my current work at IBR. I also became involved in wildlife medicine publishing while working at TMMC, and had the opportunity to act as an editorial assistant for the massive textbook Marine Mammal Medicine. I later wrote the seal chapter in a book called Hand-Rearing Wild and Domestic Mammals, for which I also co-wrote the pig chapter and helped edit several others for the editor, Dr. Laurie Gage.

I thought there really needed to be a similar book for birds, and during the tail end of veterinary school I co-edited a book called Hand-Rearing Birds (2007) with Dr. Gage. I wrote four chapters and edited 22—handling the rehabilitation-oriented species while Dr. Gage managed the zoo-oriented chapters. Several International Bird Rescue staff members contributed material to the book, a 400+ page hardcover used as a staple reference text at many zoos and wildlife centers. Dr. Gage and I have also co-written chapters on the care of wild animal orphans for the 10th and upcoming 11th editions of The Merck Veterinary Manual.

What was the focus of your PhD research?

My dissertation is titled “Investigation into the Nutritional Condition and Digestive Capabilities of Seabirds during Rehabilitation in California”. My work focused on identifying the extent of the starved condition of seabirds that enter rehabilitation and the energetic requirements of these animals. I evaluated the validity of various subjective and objective methods of body condition assessment against a gold standard. I also performed the first dietary trial in real oiled birds to explore what we should be feeding these animals when they come into care. The point of studying all this was to guide our delivery of appropriate supportive care when we are presented with hundreds of birds simultaneously. One major finding of my work was that birds that become oiled in the cold ocean off California are not merely dirty but otherwise-healthy birds that need washing. The average bird enters care in extremely poor condition. These birds are essentially on the verge of death from nutritional depletion, on top of having to cope with other nasty effects of oil like skin burns and corneal ulcers.

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An oiled Common Murre undergoes a wash at IBR’s Los Angeles center, January 2013. Photo by Bill Steinkamp

Another finding was that oiled Common Murres did better when fed lower fat diets, which is counter-intuitive. One would expect a starving animal to need as high a calorie diet as possible (e.g. higher fat content), but historical efforts to feed oiled birds high fat diets to get more calories in them may have been counter-productive. Four papers from my dissertation are currently at various stages of readiness for publishing. My master’s thesis was also on oiled bird care, and a paper from it should also be published within the next year. Sorry to say all five will be a bit dry for a general audience!

How long did it take to complete the DVM MPVM PhD trifecta?

Feels like a lifetime! 11 years total (4, 2, and 5, respectively).

Where are you from?

I grew up in Grand Forks, North Dakota, literally just about as far from the ocean as one can get! My dad taught biology at University of North Dakota when I was a kid.

What’s the best part about your job?

The best part for me is the excellent pairing of clinical medicine with endless opportunities for research on how to better surmount the particular problems of oiled and non-oiled aquatic birds. I also really enjoy avian orthopedics and repairing fractured wild birds, and seeing the amazing feats of healing Brown Pelicans are capable of!

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Left: Brown Pelican with a large and deep open wound located in the triangular area between the eye, ear and TMJ resulting from a piece of fishing tackle; Right: the pelican about a month after treatment. Photos by Dr. Rebecca Duerr

November 8, 2012

From Our Vet: One Fish-Hooked Pelican’s Remarkable Recovery

On October 1, young adult Brown Pelican 12-1473 was brought to our Los Angeles facility by Redondo Beach Animal Control with a large, multi-hooked piece of fishing tackle attaching the right side of her head to her right wing.

Once our staff freed her from the hooks, it was readily apparent that her wounds were very severe. The wing had numerous hooks in it, thankfully none causing serious damage, but the facial wound was extremely concerning. The hooks were lodged in the skull and mandible (lower jaw) bones at the temporomandibular joint (TMJ—the jaw hinge), and in addition to a large amount of dead tissue in the wound, there were maggots infesting the area. The bird was emaciated and very weak but responded well to fluid therapy and warmth, and later began eating eagerly when fish was offered.

I first examined the bird a few days later, after she had become stronger and more stable medically. From what I had heard, I thought it was going to be a clear-cut case that might warrant euthanasia, as the amount of damage to important structures was likely to be extensive. Brown Pelicans plunge-dive at top speed, mouth first, into the ocean to catch dinner, so damage to the jaw joint could result in a bird unable to feed itself.

We anesthetized her so I could evaluate the injury. I found a large and deep open wound located in the triangular area between the eye, ear and TMJ, with a piece of dead bone hanging free in the air and deep pockets of infected material that penetrated the jaw muscles and skull. The ear canal appeared uninjured at the edge of the wound but had maggots once again infesting it. I removed the dead piece of bone, excavated dead bone from the skull and cleaned out all the debris. Deep in the wound, I discovered that the TMJ itself was open to the outside world, and joint fluid was oozing into the wound. I had a full view of the articular cartilage of the bony surfaces where the mandible hinges in its groove on the skull, kind of like looking down into the surfaces inside a door hinge.

At this point, it looked like euthanasia was the best option for the bird, as open joints are highly likely to suffer damage from infection, which would likely destroy the important cartilage that allows the hinge to move smoothly. This bird was also missing a piece of the jugal bone, the dead bone removed earlier.

But after finishing cleaning all the dead tissue out of the wound and talking to the staff about how well the bird was doing, I changed my mind. She was eating very well and holding her bill in perfectly normal alignment, even snapping aggressively at people like a normal, frisky pelican should, and the joint surfaces of the TMJ looked currently undamaged, although obviously were contaminated and at risk of deterioration.

 

Considering some of the incredibly nasty wounds from which we have seen pelicans successfully heal, we decided to see what we could do for this bird to facilitate her recovery from this devastating injury. We knew it was a long shot, not only because it was possible the infection would continue to spread despite antibiotic therapy, but also because even if it did heal, the bird could wind up with a jaw joint that didn’t work very well.

We developed a plan of daily wound care to both protect the open joint hinge and foster growth of new tissue in the rest of the wound. Our wound care had to be frequent enough that even if flies laid eggs on the bird, we would be able to remove them before they hatched. Due to the location of the wound, application of wound dressings was a challenge. We could not wrap bandages all the way around the head or else the pouch would be constricted in a manner that prevented the bird from eating. Whenever possible, we allow birds to feed themselves if they are minded to. In this case, I wanted the bird to use the mouth as normally as possible while the joint was healing. We also needed to keep the bird out of the water for a time to prevent the wound dressings from becoming wet with pool water.

Two weeks later, we anesthetized the bird to assess the wound’s progress. I once again found a deep hole with a lot of debris inside, although it was only about one-fourth the diameter of the original wound. Once I cleaned it out and inspected it with magnification, I found that the joint had closed over, and all the tissue inside the hole appeared to be healthy granulation tissue. Due to ongoing concerns with fly strike, and considering how healthy the tissue appeared inside the hole, I decided to suture the wound closed. The bird was able to finally take a bath and enjoy roaming around our pelican aviary.

As of November 1, after a month of treatment, the injury has completely healed, and there is no evidence that the remaining muscles and bones of the jaw are having further problems. The range of motion of the joint is near normal, and the bird is able to eat well and snap at our staff and volunteers with normal-seeming vigor. All medications and treatments have been discontinued, and we are planning to keep the bird a few more weeks to allow any final internal reorganization of the jaw tissue to become as strong as possible before she needs to start plunge diving for dinner out on the ocean again. Meanwhile, she is spending time with other pelicans in our aviary and regaining flight strength and endurance. Release is expected later this month.

 

 

Dr. Rebecca Duerr is International Bird Rescue’s staff veterinarian. She received her BS in Marine Biology from San Francisco State University and her DVM and MPVM degrees from the University of California at Davis.

October 23, 2012

Ask an Avian Vet, Edition #1

Our loyal Facebook fans often pose questions on the intricacies of wildlife rehabilitation and some of the procedures that International Bird Rescue staff has helped pioneer to save injured aquatic birds.

We threw a few recent Q’s over to Dr. Rebecca Duerr, our staff veterinarian. Duerr received her BS in Marine Biology from San Francisco State University and her DVM from the University of California at Davis. Here are her answers:

 

 

Photo by Larry Jordan for The Birders Report

Q: I thought that broken wing bones in birds were impossible to mend. Aren’t they hollow, so when broken they shatter in tiny pieces that are impossible to put together again?

Duerr: We receive a large number of birds with fractures of every bone imaginable, and successful treatment is very common. Yes, some bird bones tend to be hollow, but no, they do not tend to shatter into an unrepairable mess. If anything, I would say that bird bones are easier to fix than mammal bones because birds heal much faster.

In general, the prognosis of a given fracture depends on the species, which bone is broken, whether it is fresh or old, infected or not, the age of the bird, and many other factors. Joint fractures and old infected fractures carry the worst prognosis, fresh uninfected fractures, the best. So the sooner we are able to treat a broken bird, the better it will likely do. The most common fractures we see are fractures of the ulna (wing), which heal very well with wraps and splints, and leg bone fractures in young herons and egrets, which also do very well in splints but sometimes need surgical pinning depending on which bone it is and whether it is compound.

 

What species are particularly difficult to work with in captivity?

Photo by Marie Travers

Each species has its own challenges and common problems. Just like cats and dogs have different typical medical problems from each other, each species of bird has its own issues. But that being said, I would say that loons are probably the most challenging species to deal with in captivity. They are high-stress birds and often enter captivity in extremely poor condition, or even have evidence of chronic health problems such as poor feather quality. Their anatomy is such that they are not built to ever rest on solid land, so when they are not able to be housed in the water they start to develop serious problems right away.

 

How do you remove fish hooks without further damaging a bird’s esophagus/digestive tract?

Depends on the location of the hook and whether it is already piercing the wall of the GI tract. In every case, removal is easiest if the line is left long and attached to the outside of the bird with no tension on it. Having the line still accessible can mean the difference between an easy removal and major surgery. Tension on the line often means that the esophagus or corners of the mouth will be damaged because a tense line can cut into the tissue like a razor. In cases where X-rays show us that the hook is merely sitting inside the stomach not pierced through the wall, we sometimes use a low-tech method of feeding birds a large amount of cotton wadding to stimulate the bird to regurgitate its stomach contents.

Another low tech option for hook removal that works very well in pelicans is while the bird is under anesthesia, have someone with a small hand and skinny arm reach in there and get it out manually. Unfortunately, I have large hands, too big for any except the biggest male pelicans, so I often talk someone with more delicately sized hands through the procedure. Yes, we wear shoulder-length gloves to do this, as the inside of a pelican stomach is about as gross as you might imagine! Another method of hook removal useful when the line is still accessible is to run the line through a thick piece of tubing and maneuver the tube to get the hook secured onto the end of the tube. This method only works in some species.

As a last resort in removing a hook, I will go in surgically wherever I need to go to access the hook. But the very worst fish hook injuries we see are not generally from ingested hooks, but rather when the hook gets lodged in joints such as the hock or elbow or jaw, or pierce the tendons of the legs. Fish hooks that penetrate these areas tend to cause nasty infections and may result in permanent damage to important structures.

 

What’s the trickiest type of surgery you perform at International Bird Rescue?

The trickiest surgeries I perform often involve efforts to save toes, particularly when the middle toe on a webbed foot has a serious infection affecting the bones. Removing the whole toe would mean the bird will lose all the webbing on that foot, which would not be okay if the bird needs its webbing to swim. Sometimes birds even come in with severely contaminated infected bones sticking out of their foot.

After talking about this problem with the tiny number of other vets who work with these species, I started doing a procedure we call “bone deletion,” where the toe is essentially partially deboned, but the soft tissue is left behind to heal and maintain the integrity of the webbing. At first I thought this would lead to the bird having floppy webbing, but so far, the birds I have done this to have developed scar type tissue in the toe that stiffens it up as it heals. Getting these to heal well after having a severe infection can be a challenge, but birds’ ability to heal continues to amaze me.