Written by: Milena Orjuela, PHSS Intern
Pelicans are meant to glide through the sky, dipping in and out of the ocean on a sunny day, and leaving your jaw dropped if they happen to catch a fish near you. That is what I thought until Pelican 21-372 came to our clinic. After taking a quick glance at the bird, I secretly thought to myself, “you are doomed.” Pelican 21-372 first came into our care after being spotted with monofilament entangling its left wing, upper body, and head. It was obvious upon examination that the bird was also malnourished and dehydrated. Our staff noted multiple open wounds in its face, abdomen, legs, and a large malodorous wound on the left patagium. A malodorous wound is characterized by necrotic tissue, or bacterial colonization, often containing both anaerobes and aerobes and is a major obstruction to healing. The patagium, the site of the open wound, is a web of elastic fibers that extends from the head to the wrist and has the very important job of assisting birds in gliding and flying. Such a grave injury on a crucial part of the bird’s wing is why Pelican 21-372’s chances were initially seen as quite poor.
A set of X-rays determined that there were no fractures or broken bones to deal with in addition to the obvious open wounds. Subcutaneous fluids were given to aid with dehydration, antibiotics, pain killers, anti-inflammatories, and Vitamin E were administered to help the healing process, and the pelican was given one dose of anti-parasitic medication. All wounds were thoroughly cleansed and special care was given to the left wing. All dead tissue was removed from the patagium, a topical antibiotic ointment was administered, and the wing was wrapped. Though the physical treatments and medications certainly had a very beneficial role in healing the bird, the laser therapy Pelican 21-372 received is what really allowed such a miraculous recovery.
First developed in 1960, laser therapy can heal major injuries at a cellular level by stimulating a process called photobiomodulation. Photobiomodulation or PBM works as photons enter the tissue and interact with the Cytochrome C complex inside cellular mitochondria. The absorption of light by the Cytochrome C oxidase helps the cells to increase the production of Adenosine Triphosphate (ATP), which is the intracellular energy transfer molecule. This helps to restore the oxidative process which allows the cells to resume normal functions, preventing cell death and associated complications. Additionally, laser therapy can stimulate the production of free nitric oxide (NO) and reactive oxygen species (ROS), which is a powerful vasodilator, and an important signaling molecule, respectively. Together, these chemical compounds and molecules can promote faster signaling, decreased edema, reduced inflammation, and a faster healing process. Looking at the body as a whole, PBM causes a beneficial systemic effect by expanding cellular proliferation, improving microcirculation in the tissue, and inducing growth factor production. Because the results of photobiomodulation are very dose-dependent, the strength of the therapy is selected according to the patient’s clinical presentation. High frequency (above 500hz) penetrates shallow tissue which will inhibit pain, swelling, and nerve damage. In contrast, lower frequency (under 500Hz) targets deeper tissue which speeds the healing process and is specifically used when reproduction of new cells is required.
In this case, our beloved Pelican 21-372 received low-frequency laser therapy, during which 50Hz were administered throughout the treatment. As hoped, the laser therapy significantly improved wound proliferation with comfort and ease. Treatment times should be reduced as healing begins and the injury begins to show improvement. For example, if a 3” incision takes 3 minutes to treat, then a 2” one would take 2 minutes. Any additional photons delivered over the required dose will then become inhibitory, creating a plateau in the healing process. Physical treatments, medication, and the impressive work of the laser therapy made the wound healing so significant that pelican 21-372 was described as a “healing machine” by one of our staff members. Within 16 days of admission, the pelican was spending time outside in the sunny weather, and even flying around the enclosure. It was then that the final round of antibiotics and pain killers were administered, to allow for a few more days of active healing. Although the wound was healed, the Brown pelican needed more time to regain full extension of the wing. Without full extension of the patagium, the bird would not be able to fly. To help the Pelican on the path to regain full extension and fly our staff would do physical therapy on the patient as well as allow the patient to do its own physical therapy by being outside. After nearly four months of this arduous job, all of our efforts yielded great results and Pelican 21-372 was able to be released. Next time you are at the beach and see a pelican flying by, remember that wildlife is precious and take pride in knowing they will be protected and cared for!
