Wildlife Center of Virginia » NBGE Medical Updates, July-August 2008

NBGE Medical Updates, July-August 2008

Medical Updates since September 1 2008
Medical Updates from May/June 2008
Statement from Ed Clark, President and Co-Founder of the Wildlife Center of Virginia
Cause of Growth on Norfolk Botanical Garden Eaglet Confirmed as Avian Pox [5/28/08]
WVEC Chat Room Transcript – WCV President Ed Clark answers questions [5/30/08]
Background paper on Avian Pox

Support the Wildlife Center’s care of the Bald Eaglet

UPDATE: August 27 2008, 12 noon

by Dr. Dave McRuer, Director of Veterinary Medicine at the Wildlife Center of Virginia

This morning Bald Eagle #08-887 was brought into the clinic and anesthetized for another beak-trimming procedure. Using a Dremel rotary tool, the Center veterinary team [Dr. Elizabeth Daut, Licensed Veterinary Technician Leigh-Ann Horne, and I] trimmed back growth from the top and bottom portions of the eagle’s beak. The procedure took about 30 minutes and blood was also taken for a routine health assessment; the eagle will be on pain medication for the next day or two due to the trimming.

We expect that we’ll be bringing the bird in for a beak-trim every two to three weeks as we attempt to correct the curvature in the eagle’s beak. It’s likely that we will need to continue this kind of beak trimming for six months – or more – as the eagle’s beak slowly grows out At this point, this beak-trimming will be our treatment strategy; for the time being, we’re not anticipating reattaching the acrylic brace.

As noted in yesterday’s update, the hole left by the pox lesion on the eagle’s beak continues to heal beautifully. With the eagle anesthetized, we were able to examine that area more closely. There is significant new cell growth (skin cells) around the site, and we’ll be looking for new keratin growth in the near future. Until this occurs, the right side of the upper beak is still growing faster than the upper left side and the curvature will remain. With any luck, the beak’s growth plates (that form the new keratin) are not permanently damaged and both sides will eventually grow at the same rate, thus realigning the beak.

UPDATE: August 26 2008, 4pm

by Dr. Dave McRuer, Director of Veterinary Medicine at the Wildlife Center of Virginia

Earlier today Bald Eagle #08-887 was examined in his pen by all three Center veterinarians. The hole left by the pox lesion on the eagle’s beak continues to heal beautifully. There is significant new cell growth around the site, and we would expect to see the development of new keratin during the next few weeks.

The eagle’s beak still has a significant curve. At this point, we will attempt to correct this curvature by trimming the beak every two to three weeks [similar to the Dremel-trim undertaken on August 1]. We anticipate bringing the eagle into the Center’s clinic sometime later this week for another beak trim.

[+] The Norfolk Botanical Garden Eaglet

UPDATE: August 17 2008, 5:00pm

by Dr. Natalie Hall

Eagle 0887 is remaining very active. He has not been eating as well this past week, but today we determined that he is just being very choosey about his food. We had given him a dose of pain medication to determine if discomfort could be the issue, but that did not change his appetite. However, he ate well this morning after we offered him a “chop plate”. It seems that he likes his mice specially prepared for him.

Later this month the vet staff will discuss whether and when to move the eagle to a larger enclosure so that he can get more exercise.

UPDATE: August 4 2008, 4:30pm

The Wildlife Center of Virginia recently sent a blood sample from the Norfolk Bald Eagle [Patient #08-887] to AMR Laboratories in Plymouth Meeting, Pennsylvania to determine the gender of the bird.

This afternoon Wildlife Center Licensed Veterinary Technician Leigh-Ann Horne received the following email:

Dear Ms. Horne,
The BAEA you had tested (08-887) is a male

AMR Laboratories

For more information on avian sexing, please see the AMR Laboratories website


[+] Norfolk Botanical Garden Eaglet, 8/5/08		[+] Norfolk Botanical Garden Eaglet,, 8/5/08		[+] Norfolk Botanical Garden Eaglet, 8/5/08

UPDATE: August 4 2008, 8:00am

by Dr. Natalie Hall

This weekend the eagle has been doing well. He was sore from his beak dremmeling, so on Saturday morning he was reluctant to eat and had to be force-fed his morning meal. However, we increased the dose of his pain medication, and he ate well the rest of the day.

Yesterday (Sunday) he was eating well on his own and seemed very comfortable without any additional pain medications. He is now hopping from perch to perch, balancing himself as needed with his wings. We are happy to see him beginning to use his wings more and moving around freely in his enclosure.

UPDATE: August 1 2008, 4pm

by Dr. Dave McRuer, Director of Veterinary Medicine at the Wildlife Center of Virginia

The Norfolk eagle was brought into the clinic this afternoon to receive the first of many future beak trims. The deviation in the beak continues to prevent the eagle from ripping into its prey. However, the bird can eat cut-up bits of fish, mice, and rats, and can even swallow mice whole (this is normal for the species).

We anesthetized the bird in order to trim off excess tissue (keratin) in hopes that the beak will grow in a more linear fashion if it is not pressing on the lower beak. The acrylic patch over the old pox lesion came off earlier this week and the hole that was created in surgery appears to be smaller. There is a lot of new cell growth around the site; within the next couple of months, the hole should be completely filled.

We are still unsure whether the growth plate (that creates the hard surface of the beak) has been damaged by the pox lesion. If so, the beak will always have a deviation and will have to be maintained with monthly trimming. In that case, needless to say, the eagle would not be releasable. As it seems I’m fond of saying, “time will tell”.

We are considering replacing the acrylic ridge on one side of the beak but will wait a few weeks in order to assess the results of today’s beak trim.

The bird certainly seems to enjoy the new outdoor facilities and presently spends time on the highest perch in the enclosure, next to an adult Bald Eagle housed on the other side of the wall.


[+] Dr. Natalie Hall anesthetizing the Bald Eagle for surgery.		[+] Dr. Dave McRuer and Dr. Hall reshaping the eagle’s beak. Dr. Dave is using a Dremel rotary tool for the task.


[+] Reshaping the eagle’s beak		[+] The spot on the eaglet’s beak where the avian pox-lesion was growing is visible. This spot is slowly healing. During the beak-trim procedure, Dr. Dave did some debriding of the beak, removing some necrotic tissue.

UPDATE: July 27 2008, 8:00pm

by Dr. Natalie Hall

The eagle has continued to do well today. He is eating his chopped mice bits on his own with no assistance. He will not be able to tear his own food up until his beak deviation is fully corrected, so until then we will continue to cut his food up for him. He has also been trying out some different perching spots in his enclosure today and continues to remain active.

Tomorrow he will be re-evaluated during “outdoor rounds”. Once we have determined he is stable and strong again, we can again approach correcting the beak deviation. In the meantime he appears to be very content in his new enclosure.

UPDATE: July 26 2008, 8:00pm

by Dr. Natalie Hall

This evening the eagle is still stable, and he is eating on his own without assistance now – for the first time since he was admitted! We are still giving him a “chop” plate, but he ate eagerly this morning without having to be hand-fed. He is also very energetic today and has been strolling around his enclosure a lot. So, at this time, he appears to be improving!

UPDATE: July 26 2008, 7:30am

by Dr. Natalie Hall

A quick update. Last night [Friday] the rehab staff was able to hand-feed solid food to the Norfolk eaglet, which is a great improvement. This morning we will be checking to ensure he did not regurgitate any of it. If not, we can continue hand-feeding him solid food.

UPDATE: July 24 2008, 6pm

by Dr. Dave McRuer, Director of Veterinary Medicine at the Wildlife Center of Virginia

There are hills in this report; however, I’m glad to report more ups than downs. The eagle is still having problems eating. In fact … he doesn’t eat on his own and hasn’t since he was admitted. We re-swabbed the crop today, and the previously diagnosed yeast infection, although still present, has been much reduced. Dr. Elizabeth Daut performed a fluoroscopy scan on the awake bird yesterday [Wednesday] to monitor if the gastrointestinal tract was still functioning. In this evaluation, it was observed that the administered contrast agent easily moved through the crop with strong muscular contractions, but there was an increased retention time in the first portion of the stomach. This suggests that the GI tract is still functional but perhaps there’s a problem in the stomach.

As of two days ago, the eagle was still regurgitating its tube-feeding formula; however, this only occurred when people approached his cage. At this point, we’ve ruled out most physiological causes for the regurgitation and are leaning toward calling this a behavioral/stress disorder. Based on these findings, the eagle was moved outside yesterday into a larger pen [approximate dimensions 8 feet by 14 feet] where he can stretch his wings and hopefully feel more comfortable. So far, all reports suggest he loves the extra space (walking around, honking at his neighbors) and he hasn’t regurgitated yet today. While the bird was spending most of his time perching on the side of the disassembled pet carrier, new perches have been installed to make sure he’s actually perching on an appropriate substrate. The pen is also surrounded by two other eagles and we hope this will aid in his “behavioral training”.

Our plan is to start the bird on solid food again tomorrow (hand feeding) and if that goes well, attempt the surgery for his beak again next week.

The eagle has also been favoring one foot for the last several days. No external lesions exist, and we performed x-rays today which indicated that all boney structures are normal. We will continue to monitor these clinical signs but are less concerned, based on today’s examination.


[+] The Norfolk eaglet in its new outdoor home. More suitable perches were later attached to the carrier top		[+] The Norfolk Bald Eaglet, 7/24/08


[+] The Norfolk Bald Eaglet, 7/24/08		[+] The Norfolk Bald Eaglet, 7/24/08

UPDATE: July 17 2008, 6pm

by Dr. Dave McRuer, Director of Veterinary Medicine at the Wildlife Center of Virginia

The Norfolk eaglet just keeps running into medical roadblocks. Since the surgery last Saturday, the patient has been struggling to keep food down – no matter whether we offer it on a plate, place food in its mouth, or force food into the crop. On Wednesday, we decided to perform a crop swab, sending a cotton swab into the crop and sampling for bacteria, fungus and yeast. In a normal bird, there are small numbers of all of these organisms. In the Norfolk eagle, we found an over-abundance of yeast which can alter the pH of the crop and damage the mucosal lining, causing a condition called crop stasis. Crop stasis can be painful and birds often regurgitate their food. Treatment involves supportive care, such as fluids, and tube feeding directly into the stomach, avoiding the crop. We have also started the bird on a drug called Metoclopramide which will increase gastrointestinal motility (help food move through the GI tract). We’re also treating the yeast with an antifungal medication called Nystatin and taking care of pain and inflammation with a non-steroidal anti-inflammatory drug. With luck, the yeast will decrease in number giving the crop lining an opportunity to heal – hopefully within a week. Once the yeast is gone, we’ll start hand-feeding mice once again.

Until the yeast is taken care of, the risk associated with anesthesia and the replacement of the acrylic ramp is too great. Hopefully we’ll be able to put the ramp back on within the next two weeks. Until then, the trick will be to get enough nutrients into the eagle and get rid of the yeast infection.

UPDATE: July 15 2008, 2pm

by Dr. Dave McRuer, Director of Veterinary Medicine at the Wildlife Center of Virginia

The Bald Eaglet continues to recover from surgery. In the past couple of days, there’s been no recurrence of the post-surgery hemorrhaging, and this morning the bird kept down solid food [we're back to feeding cut-up mice]. For the time being, we are moving back to hand-feeding the eagle smaller quantities four times a day [rather than three larger daily feedings]. The eaglet gets very stressed when handled and, as a precaution, we took samples this morning to retest for an aspirgillous fungal infection. These results should be available by the end of the week.

With these changes, and given that we’ve determined that the eagle is no longer contagious, we have moved the bird outside. For the time being, he will still be housed in a small enclosure [similar to the housing he was in before surgery]. We’ll continue to monitor the eagle’s condition closely and plan to apply a new prosthetic barrier within the next week.


[+] The Norfolk Bald Eaglet in the avian critical-care unit		[+] The Norfolk Bald Eaglet in the avian critical-care unit


[+] The Norfolk bald eaglet being moved outside		[+] The eaglet in new outdoor housing

UPDATE: July 14 2008, 9am

by Dr. Elizabeth Daut and Dr. Natalie Hall

The eaglet is stable and continues to recuperate in the avian critical-care chamber. The eagle was tube-fed last evening. We’ll be checking on feeding this morning – either a continuation of the easily digestible liquid diet or back to some finely diced mice. We’ll be monitoring the eagle’s hematocrit levels and will be supplementing with fluids and possibly oxyglobin if necessary.

The methacrylate brace that was attached to the eaglet’s lower jaw during Saturday’s surgery loosened slightly, and the decision was made to remove the brace temporarily. The brace will remain off until the eagle regains some strength and some additional healing of the pox lesion area occurs. The brace will be remolded and reattached by Wildlife Center vets. This is not a difficult or a lengthy procedure but is necessary to help correct the misalignment of the bird’s beak.

UPDATE: July 13 2008, 9pm

by Dr. Natalie Hall

The eagle is still stable this evening. He has had no more significant hemorrhaging. The bandage on his beak has remained on and will likely be removed tomorrow [Monday] morning so we can re-evaluate the area.

The main concern today has been keeping him stable. He had some regurgitation early this morning and had difficulty keeping solid food down. In addition to his other medications, we treated him with some metoclopramide to promote gastrointestinal contractions in the correct direction. Once the regurgitation stopped we tube-fed him a very easily digestible hospital diet this evening. Because of this and the extra handling we had to do today, we have postponed his bloodwork until tomorrow morning. We are trying to give him what he needs but also minimize his stress.

As far as his attitude goes, this afternoon he was standing up peeking curiously around his privacy curtain, chirping at us and watching us admit another patient. He tires easily, but he is moving around and is more interested in his environment today.

So, we are not out of the woods yet, but at this time the hemorrhage appears to have resolved and he is stable.

UPDATE: July 13 2008, 9am

by Dr. Natalie Hall

On Saturday [July 12] we had two bleeding episodes, one just after recovery and one around 6 p.m. At both episodes we packed the rhinal cavity and applied pressure bandaging, and administered additional pain relievers (butorphanol, which is in the morphine family). The pain reliever helps to keep the eaglet more comfortable and calms him, both of which will help keep his blood pressure from becoming too high. Since the 6 p.m. bleeding episode we have not seen any more hemorrhage.

I stayed at the clinic until 9:30 last night to monitor the eaglet, and then came back in at 1 a.m. to check on him and administer more pain medication to ensure he stayed comfortable overnight. By 9:30 last night he was standing with his head up and moving around a bit, and at 1 a.m. he greeted me at the cage door, eyes wide open, head up, and chirping “hello” to me. Dana Calhoun, a Licensed Veterinary Technician, came in at 3:30 am and he was stable at that time also.

Early this morning we administered another dose of pain medication, and he has appeared stable throughout the morning with no more evidence of hemorrhage. Today, we will be closely monitoring him, continuing to administer pain meds, anti-inflammatories, antibiotics, and fluids. At this time the plan is to leave the heavy bandaging on another 24 to 36 hours to allow the affected blood vessels some time to clot and recede. After that we will remove the bandaging, and closely monitor for hemorrhage again. This afternoon we will be checking his hematocrit to determine if the bleeding has made him anemic, and, if so, how severe the anemia is.

There are two main time periods when we will be concerned about the bleeding starting up again. The first will be during this morning’s feeding. During feeding he is much more active, and will be moving his head a lot, which will increase the risk for hemorrhage again. The second time period will be after the bandage removal. We hope the feeding goes well this morning so that we will be able to continue hand feeding him. However, if needed, we can change to using a hospital tube-feeding diet for a few days until the risk of hemorrhage is past.

The eaglet has been very comfortable in his critical care chamber overnight, where he has been receiving oxygen supplementation and warmth. Please pass on a HUGE thank-you to the donor who provided us with it – it has made a tremendous difference in the level of supportive care that we have been able to provide for him. (We also use it on an almost daily basis with other patients who need that extra care and a warm, quiet, cozy place and oxygen supplementation.)

UPDATE: July 12 2008, 8pm

by Dr. Dave McRuer and Dr. Natalie Hall

Post-operative bleeding continues to present a real challenge. We have now had two episodes of bleeding – one just after surgery, the second at about 6 p.m. Although bleeding during surgery was minimal, we suspect the normal increase in blood pressure post-surgery, combined with the extremely vascular region within the sinus, has led to a general oozing of blood across the surgical field.

We have given the eagle medication to locally control bleeding, have re-packed the surgical area in order to apply pressure to the sinus region, and are giving the eagle fluids to help make up for the blood loss. The bird is in a special avian critical-care chamber, where it’s receiving supplemental oxygen in a warmed environment. Center veterinary staff will be monitoring the eagle periodically overnight.

UPDATE: July 12 2008, 4pm

Statement of Ed Clark, President and Co-Founder, Wildlife Center of Virginia, July 12, 2008

The day finally arrived when surgery was performed on our eaglet from the Norfolk Botanical Garden. We were all left speechless by the outcome. We would never have believed that so much could be accomplished during a single two-hour procedure.

Originally, surgery had been scheduled for the removal of the viral growth that had deformed the little eagle’s beak and threatened its life. However, thanks to very aggressive treatment and intensive care provided by the veterinary staff of the Wildlife Center of Virginia, the growth literally fell off the bird’s beak last week, revealing nice healthy tissue underneath. The combination of drugs to fight secondary infection and build the little bird’s immune system clearly worked, and worked very well.

With the external growth no longer being an issue, attention turned to the removal of any remaining viral growth from inside the bird’s beak, and to doing what could be done to realign the badly deformed upper beak. The viral growth on the left side of the beak had restricted normal bone growth. As the right side grew normally, the tip of the beak was pushed more and more to the left. The result was a beak so badly misaligned that the bird could not even feed itself, let along preen feathers and care for itself properly.

Dr. Avery Bennett, a board-certified veterinary surgeon and Professor of Veterinary Clinical Medicine at the University of Illinois at Urbana-Champaign who specializes in birds and exotic animals, volunteered his time to fly in and perform the surgery. Dr. Bennett is considered to be the best surgeon in the country for this type of delicate procedure. He was assisted in surgery by Dr. Dave McRuer, Director of Veterinary Services at the Wildlife Center. Dana Calhoun, one of the Center’s Licensed Veterinary Technicians, managed anesthesia and monitored the bird’s breathing and heart-rate during the surgery. Both of the Center’s other veterinarians, Dr. Elizabeth Daut and Dr. Natalie Hall, were close at hand to manage instruments, provide an extra set of hands when needed, and to be of general assistance.

From the outset, Dr. Bennett was very upbeat and optimistic. I confess that some of the rest of us remained skeptical that enough could be done.

Essentially, Dr. Bennett first removed damaged tissue from the outside and inside of the beak, until the entire opening where the viral growth had once been was surrounded by normal, healthy tissue. Then, Dr. Bennett began to trim the beak so that alignment was even possible. The tip of the deformed upper beak had to be cut back so that the lower beak could fit properly under the curved end. Once this trimming was done, the bird’s beak could be properly aligned and held in place manually. Just seeing this little bird’s face take on normal features left scarcely a dry eye in the surgical suite. At that point, even the most skeptical among us began to think a miracle was really going to be possible.

The next step was to craft an extension of the lower beak that extended up along the left side of the upper beak. This extension forces the upper and lower parts of the beak to align when the bird closes its mouth. Crafted from a very specialized medical acrylic, the extension was anchored to the lower beak using wires that had been imbedded in the lower jaw. While the device looks pretty strange, sticking up beside the eaglet’s beak, it is certainly no worse than the original growth must have been. The hole in the side of the upper beak where the viral growth had once been was then closed using a fine wire mesh over the opening, and another application of the medical acrylic on top of that.

Both the upper and lower extensions and patches were then sanded smooth using a special tool like a Dremmel Tool. Once the surgery was complete, the little eagle was brought out of anesthesia, and the post-surgical issues began to present themselves.

A typical issue for post-surgical patients is bleeding. Blood vessels which have been cauterized during surgery can open up and allow blood loss after surgery. This is because during the surgery, when the patient is under anesthesia, its blood pressure drops. When the patient wakes up, especially after an extremely invasive procedure like this one, there is considerable pain. There is additional stress when an animal discovers there is something fastened to its body that it cannot shake off, or claw off. This pain and stress causes the blood pressure to rise, sometimes leading to resumed bleeding. That was the case with the eaglet.

The area from which the last remnants of viral growth had been removed began to ooze blood. Even though the amount of blood loss was almost negligible, even a few drops on the bright yellow acrylic patch looked serious. Fortunate, the eaglet was being closely monitored, and the bleeding was quickly brought under control.

So, where are we?

Well, for the first time since laying eyes upon this bird, I can imagine an outcome that is not bleak. We still have a very long way to go before we will know if the surgery to realign the beak will be successful, but the prognosis has certainly improved dramatically. Naturally, we are being asked how long it will be before the little eagle can be released. That is an outcome too far into the future to worry about right now. First, we want to restore this eaglet’s ability to feed itself and care for itself, which means that the beak has got to be properly aligned. If that can be achieved, and I say if advisedly, we will then turn our attention to longer term options and opportunities.

Right now, we are extremely thankful we have been able to bring the bird fully through the life-threatening viral infection, rid its little body of the invasive growth, and begin to repair the damage done by this very serious disease. Honestly, we are further along than I ever thought we would be – ever thought we could be, given the very poor condition of the bird when it arrived on May 22. I am overwhelmed by the skill and competence of my colleagues, and by the special artistry of Dr. Avery Bennett.

Above all, we are sustained and motivated by the thousands of people around the world who care so deeply for this little eagle.

While it sounds trite to talk about miracles, at least as far as some sort of super-natural event, I truly believe that all who have cared for and cared about this little eagle have generated a true miracle. There is now hope where once there was none. We are still a very long way from declaring complete success with this little bird, but so-far-so-good.

There is a long road ahead for the little eaglet. It will have to get used to the artificial extensions of its beak. It will have to endure the pain from the surgery and the pressure on its beak. And, on top of all that, it will have to continue to grow and thrive. It is too soon to tell whether this little bird will ever go back to the wild, but for the first time we can begin to speculate about its long-term future. For the first time, we can feel more optimistic that it will actually have a future.

Thanks to all who have helped us defray the costs of caring for this bird, and all who have sent us good wishes and encouragement. The success we have had to this point is a team effort, and everyone who cares is an important part of that team.

We’ll keep you posted.


[+] Dr. Nathalie Hall and Dr. Elizabeth Daut prepping the eaglet for surgery		[+] Surgery prep with Dr. Bennet


[+] Surgery in progress		[+] Dr. Dave McRuer, the Center’s Director of Veterinary Medicine, and Dana Calhoun, one of the Center’s Licensed Veterinary Technicians, monitoring the eagle’s condition after surgery


[+] The Norfolk baby Bald Eagle after surgery. The Center veterinary team constructed a large acrylic brace, attached to the lower jaw, to keep the eagle’s beak in proper alignment. The brace is lightweight but very hard.

Bald Eagle Undergoes Successful Surgery, WVIR-TV

Baby Eagle’s Growth Removed, Beak Fixed, The Daily Progress

UPDATE: July 10 2008, 8am

by Dr. Dave McRuer, Director of Veterinary Medicine at the Wildlife Center of Virginia

On July 8, I took pictures of the eaglet’s beak to send to Dr. Avery Bennett for review before surgery [scheduled for July 12 at the Wildlife Center]. The lesion was very dry, much reduced in size, and certainly didn’t appear to be giving the bird any problems. After a careful review of the images, Dr. Bennett outlined his surgical plan to debulk the lesion and then to decide on the best method of closing the resulting “hole” in the side of the beak. Options to straighten the beak would then be considered.

On July 9, when the Center’s veterinary staff went to examine the eaglet, they found that the lesion had fallen off on its own – it was nowhere to be found! The eagle’s immune system was obviously doing its job and taken care of the lesion on its own. Underneath the spot where the mass had been was a beautiful bed of granulation tissue, indicating both the end of the mass and recovery by the body.

We took new x-rays of the bird’s head to determine the status of the internal mass. Although soft tissue doesn’t show up incredibly well with this modality (hence the original trip to Augusta Medical Center for the MRI), we could not find any trace of the internal lesion. All in all, great news for the eagle.

The next step is to determine what to do with the crooked beak. I’ve brought Dr. Bennett up-to-date on the latest news about the mass and have been chatting with him about various options. These would include a tension device to bring the beak back into alignment; shaping the beak under general anesthesia and then continuing to keep it short in order to reduce the deviation in the beak; or doing nothing at all surgically and continuing supportive care (feeding) to see if the deviation in the beak will correct itself. Dr. Bennett will be traveling to Virginia later this week as planned.

Whatever technique is used, full correction of the beak will ultimately depend on symmetrical growth of the keratin beak from the growth plate. If that growth plate has been permanently damaged, the beak may continue to have altered growth for the rest of the bird’s life. This may be a viable option for a captive bird, but certainly not for a wild one. Time will tell.

Baby Eagle’s Lesion Falls Off, The News Virginian