IV vs IO contrast in parrots

VRU 63(5): 539-545

Study: The study is a prospective randomized blinded crossover group study that compares intraosseous (IO) and intravenous (IV) iodinated contrast administration for CT imaging in Hispaniolan Amazon parrots (Amazona ventralis). The study aims to determine the feasibility of IO iodinated contrast enhancement for CT in birds and to compare the enhancement quality of IO and intravascular iodinated contrast administration.

Methods: The study included 10 adult Hispaniolan Amazon parrots weighing 260–325 g. Each bird underwent pre- and postcontrast CT scans using both routes of contrast administration with a wash-out period of at least 1 week between the two methods. Scans were evaluated subjectively for diagnostic quality and objectively with Hounsfield units measured over three organs: the brain, right kidney, and liver.

Results: The results showed that all scans were diagnostic, and there was no statistically significant measurable difference in contrast enhancement between the two methods in any of the three organs. Subjectively, IO catheters were technically more difficult to place, but once in place, they were easier to manipulate for the imaging procedure and provided no complications upon removal. Minimal adverse side effects were noted from the IO catheters.

Conclusion: The study concludes that in this small study, IO iodinated contrast administration was comparable in enhancement characteristics to intravenous administration for CT imaging in Hispaniolan Amazon parrots. While successful IO catheter placement was slightly more challenging in this study, the route of choice may better be determined by clinician preference, size (weight), and conformation of the bird being imaged. Having the option of an IO route of contrast administration could add to the success of obtaining a contrast-enhanced CT in birds lacking vascular access due to size or conformational challenges.

Representative CT images depicting regions of interest for the measurement of pre- and postcontrast Hounsfield units in both IV and IO studies (window level = 35 HU, window width = 360 HU, soft tissue reconstruction algorithm, 0.625 mm slice thickness). Pre (A) and post (B) transverse images at the level of the mid-calvarium with ROIs drawn over the brain. Pre (A) and post (B) transverse images at the level of the mid-celom with ROIs drawn over the liver. Pre (A) and post (B) transverse images at the level of the caudal celom with ROIs drawn over the right kidney

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