Laser machines have become standard equipment in some veterinarians' offices. Goggles protect physicians' eyes; the laser pen is held like a scalpel.

IT SEEMED Isaac, a three-year-old cockatiel, had been asserting his claim to new territory.

Unfortunately, Wesley, a Nanday conure, figured he had squatter's rights on his cage and refused to budge.

He quickly dispatched Isaac's claim by grabbing the closest offending toe.

By the time Isaac arrived in my office, "mom" had managed with finger pressure to stem the rolling red tide of blood. After quickly assessing the situation, we decided the best approach was to amputate the destroyed portion of the toe.

Since Isaac had presumably already lost a fair amount of blood, it was easy for me to decide how to operate: I used a laser, which controlled not only the current bleeding problem, but prevented further loss.

Isaac fully recovered. In fact, recovery may have been too good. It did not slow him down from repeating his explorations and showing back up in my clinic a few weeks later with the very same problem, same toe, the other foot. I think after the second loss, he has abandoned his Napoleonic tendencies.

Not science fiction anymore
When most people think of lasers, they think science fiction or the ever-popular light show. If they stop long enough to ponder medical lasers, the well-advertised lasik eye procedures come to mind.

But lasers and veterinarians? Most people don’t equate the two – and until relatively recently, neither did many veterinarians.

Certainly when I was in veterinary school, back in the early 1990's, lasers were considered futuristic, not likely to be available for use in general practice anytime soon. We were not taught about lasers or how to use them. I saw just one laser surgery prior to graduation in 1993, and it was considered somewhat experimental.

In the last 10 years, lasers have exploded into the veterinary world, becoming more commonplace in clinics both metropolitan and rural. A laser unit has become indispensable in my own practice. I have been using it for avian surgeries for about four years now and have come to rely on it for a multitude of uses.

Aiming the laser at birds
How could laser surgery benefit your bird? Let’s take a tour of the advantages.

First, a bit of history. That forward thinker, Albert Einstein, first developed the theoretical basis for the use of lasers in 1916. Within 50 years, lasers were being used surgically. Less than a century later, lasers are used for a variety of human medical procedures. Now lasers have become one of the most popular new veterinary surgical instruments.

Laser, as you may remember from high school science, actually is an acronym, for Light Amplification by Stimulated Emission of Radiation. Laser light is different in several ways from “white” light - the light we get from the sun or a bulb. While white light is a combination of all the colors of the spectrum (think the mnemonic ROY G BIV - red, orange, yellow, green, blue, indigo and violet), laser light is one color wavelength, or monochrome. While white light tends to scatter (referred to as “noncoherent”), laser light is focused (“coherent”) and aligned (“collimated”), resulting in a powerful concentrated beam.

So much for physics - how does all this translate into practical surgical uses? Depending on the type of laser and its settings, laser light can be absorbed, reflected, transmitted through or scattered by tissues. In other words, doctors can use lasers to cut tissue, erase it layer by layer, or vaporize it entirely. A laser can be a lot more precise than traditional surgical tools, and faster.

A laser beam zaps this Amazon parrot's papilloma wart.

Laser surgery has other advantages. One of the most important ones for birds is its ability to reduce bleeding by cauterizing on the spot. Thanks to this benefit, veterinarians who may have been reluctant before to undertake certain procedures because of the danger of bleeding now have more options. The laser makes it safer to perform biopsies and repair broken bones, among other procedures.

In fact, some surgeries, such as salpingohysaterectomy – removal of a female bird’s reproductive organs - can be performed with no blood loss at all. This is an especially important benefit for the smallest avian patients such as finches, parrotlets, and budgies, for whom the loss of even one-tenth of a milliliter (1 cc) of blood can be fatal.

Lasers do not traumatize the tissue as much as traditional surgical methods, and they are thought to reduce pain, no doubt another side benefit for avian patients. We all know that any stress, especially that associated with pain, can be life threatening in birds. Finally, lasers can have a sterilizing effect. Any living material in the path of the laser is obliterated, whether it's the tissue of the patient - or invading bacteria.

When you add it all up - better precision, less pain, little to no blood loss, and faster, cleaner operations requiring less anesthesia and resulting in less hypothermia – laser surgery can help patients recover more quickly. Faster recoveries in turn mean shorter hospital stays, so your bird can be back home with you sooner.

Learning the laser
How can you be certain that a veterinarian, who may never have laid eyes on a laser during veterinary school, is qualified to use this new technology on your pet?

All practicing veterinarians are required by their state veterinary board to stay up on the latest medical advances by earning continuing education credits throughout their careers. The number of credits and amount of time allowed to acquire them varies by state. (For instance, Georgia, where I practice, requires 15 hours per year of continuing education.)

When a clinic buys a laser, the company from which it’s purchased provides continuing education credits, approved by the state board, in the form of lecture and laboratory hours. This convenient way for a veterinarian to earn required credits helps ensure at least a minimum of laser instruction.

Many veterinarians also take continuing education laser labs at the annual conferences of professional organizations such as the Association of Avian Veterinarians. The labs are an intensive learning experience where many surgical approaches, techniques, and, most of all, safety are covered. Rest assured, laser surgery is not undertaken lightly. If proper safety precautions are not taken on the human front, one wrong move can put not only the patient, but also everyone in the room, at risk.

Some veterinarians gain avian laser experience with wildlife cases, such as this barn owl, a resident of the Chattahoochee Nature Center in Roswell, Ga.

Practice patients
In my own practice, I gained further experience with wild avian patients from the Chattahoochee Nature Center in nearby Roswell, Ga. These patients benefited from laser surgery while giving me a group to become yet more comfortable with prior to offering the service to my pet bird patients and their families.

My very first laser patient was a barn owl with a cancerous mass on the abdomen. Currently, I am using the laser to treat a turkey vulture who keeps falling off her perch and injuring her keel.

The laser may not be the best option for every type of surgery. I prefer not to use it in the mouth, for instance, because of the danger of the laser burning through the endotracheal tube and igniting the oxygen. You can protect the tube by wrapping it in foil, but I would rather not chance it.

For almost any other type of surgery I need to perform on my small exotic patients – birds, guinea pigs, etc. – I consider the laser a non-negotiable piece of equipment. Once I explain to clients that the extra equipment fee (usually less than $100 in many clinics) will be more than offset by lower surgery fees, they agree. More importantly, my patients seem to recover more quickly.

Tia's laser experience
Lasers seem to make the most dramatic difference in cases where the patient has an open and infected wound, such as the one suffered by Tia, a Goffin cockatoo.

Tia had become a mutilator. She had opened the skin over her breast area and was not allowing the wound to heal. Her previous veterinarian had cleaned out the wound and sutured it several times over the course of a year using traditional surgical techniques.

The area, thickened by old, chronically inflamed tissue, was likely itchy and probably felt strange to Tia's probing tongue. With each surgery, Tia had been collared to keep her from ripping the sutures out. With each stint of collaring, Tia grew more depressed and less the joyful sprite her family once enjoyed.

Since the wound was so large, keeping bleeding to a minimum, especially along the muscle to be cleaned up, was critical. I knew the laser also would help sterilize Tia’s wound, and probably alleviate any unusual skin sensations such as tingling. Laser surgery seemed the logical choice.

The operation went well. Afterward, I was as paranoid as the owners that Tia would destroy the freshly cleaned site. So, I recommended we continue her collar until the area was healed.

Tia's chest healed perfectly—complete with feathers. Her “mom” and “dad” report they can barely tell where the wound was originally.

The laser may not be an answer for all mutilators or all infected areas, but, if it works for your Tia, you and your bird will be glad.

A valuable tool
Lasers are not a panacea. As with any new instrument or technique, even proven ones, there will always be an inherent risk of anesthesia and surgery, among a myriad of other variables.

However, a laser is a valuable new tool in our arsenal to help lessen those risks. If surgery is in your bird’s future, ask if laser is an option.

Tammy A. Parker, DVM is a 1993 graduate of the University of Georgia College of Veterinary Medicine. Currently employed at Loving Hands Animal Clinic in Alpharetta, Ga., Dr. Parker is responsible for exotic animal medicine and surgery. She acts as an advisor for the Georgia Department of Agriculture and volunteers her skills at the Chattahoochee Nature Center Wildlife Clinic. She is an active member of the Association of Avian Veterinarians.

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