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    Published on: May 21, 2024

    Nursing European Hedgehogs in General Practice

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    Description

    Hedgehogs are often brought into small animal veterinary practices by members of the public for emergency care. The initial triage of hedgehogs is the same as that provided to domestic species, however hedgehogs can be quite difficult to handle and assess if you do not have experience working with them. The aim of this presentation is to provide support for veterinary professionals and to instil confidence on how to triage and provide first aid for hedgehogs, and how to nurse them in the short term before transferring them to a suitable wildlife hospital or rehabilitation centre

    Learning Objectives

    • Be able to nurse hedgehogs before they can be transferred to a wildlife hospital or rehabilitation centre
    • Be able to make decisions regarding euthanasia of hedgehogs
    • Gain a good understanding of common ailments that affect hedgehogs
    • Be able to triage and provide emergency first aid for hedgehogs
    • Be able to confidently handle hedgehogs

    Transcription

    Hello, everyone. I'm Gemma. And today I'm going to be talking about the nursing of European hedgehogs in general practise.
    So, today I'm gonna, basically run through how to care for hedgehogs that are brought in by members of the public. So we're going to be talking about, how to deal with hedgehogs in general practise when people bring them in for sort of emergency care. The initial triage of hedgehogs is is generally the same as what you provide to domestic species.
    So our cats, our dogs, our rabbits. However, with hedgehogs, it can be really difficult to handle them and to also assess them if you don't have any experience of working with them. So the aim of this presentation is to provide you with support, and to instil some confidence on how to triage these these patients, providing first aid for hedgehogs and then how to nurse them in the short term before transferring them to a suitable wildlife hospital or a rehabilitation centre.
    So our learning points for today, to be able to confidently handle hedgehogs, to be able to triage them and provide them with emergency first aid to gain a good understanding of hedgehog ecology. So it's really important if we're treating an animal that we understand what's normal for them. What their day to day behaviours are and their sort of, normal ecology to gain a good understanding of the common ailments that affect hedgehogs.
    You know, we have some really common ones that people often see in practise. So we'll go through some of those today, be able to make decisions regarding euthanasia of hedgehogs. Unfortunately, sometimes when hedgehogs are brought into us, there is very little sort of medical or emergency care that we can provide for them.
    And actually, the most humane thing to do is is euthanasia, and then finally be able to nurse hedgehogs before they can be transferred to a wildlife hospital or rehabilitation centre. So the beloved European hedgehog, hedgehogs are predominantly a nocturnal species, so they are most active in the night time. They are Omnivores.
    Their diet is mostly made up of, things like slugs, millipedes, earthworms, caterpillars and other insects. But they also enjoy sort of fruits, mushrooms, and in general, practise well later on in the presentation. I will.
    I'll go through, what we can feed them in general practise. But as Omnivores, we, we have quite a range of food that we can feed them. Hedgehogs commonly live in woodland edges or hedgerows or suburban habitats.
    They are very common in people's gardens. And they're very beloved by the British public. So most of the hedgehogs we tend to see in practise are ones that have been brought in by sort of members of the public from there from their gardens.
    Hedgehogs are predominantly solitary species. So they only really come together to mate or sort of mothers and babies. You may see out together, often they can travel up to sort of 2 to 3 miles every night to find food.
    Which is, which is quite far when you imagine sort of how how small they are. Their average lifespan is about 2 to 3 years in the wild, but then in captivity, they can live up to sort of 10 years. Their breeding season is between April and September, and the average weight of a adult hedgehog is below sort of 1.5 kg.
    I think the heaviest I've seen is around 1.5. I don't think I've ever seen one above that weight.
    Generally sort of males that are that heavy. And the current sort of UK population is under a million, and unfortunately, our hedgehogs are in decline. So, on the Great Britain's, red list for mammals, they are classified as vulnerable to extinction.
    However, on the sort of IUCN red list, where they classify sort of endangered species all over the world, they are classified as least concern. Hedgehogs do hibernate during the winter, and they hibernate in an hibernaculum, from about November until Easter, and that really depends on the weather. So if it's warmer a bit earlier, they may come out of hibernation earlier, and vice versa.
    If it's colder a bit earlier, they may go into hibernation a bit quicker. So admission to the hospital. So you've had someone, perhaps a member of the public, call up and say that they found a hedgehog, and they want to bring it in to see you.
    And it's really important when you're on the phone to take a detailed history. So, Where was the hedgehog found? When was it found?
    What time of the day? What time of year is it? And what was the hedgehog actually doing when you found it?
    It's quite a good idea to create a sort of wildlife admission form. And I'm happy to sort of email a copy of our practises over to anyone who would like it. But a detailed history is absolutely vital because depending on the time of year, time of day and, sort of the weather that might depend on whether it's, sort of a need to take that hedgehog in.
    Also really important to ensure that the member of the public is aware that when they hand the hedgehog over, it may not be returned to them. You know, in some instance, instances where, the member of the public may have a a suitable garden. And it's possible to sort of, return the hedgehog to that area.
    And it's a suitable area. Then perhaps that you know, that might be suitable for a particular case. But just a reminder that, you know, hedgehogs obviously are wild animals.
    They're not pets, and they may not necessarily be able to go back into their garden if it's not a suitable habitat. So it's important to transfer them into a suitable container. Often they'll be brought in in sort of a cardboard box or or something like that, A temporary carrier, so you can sort of transfer them to a cat carrier or triage box that you can see in the photo there.
    And until you're able to triage the hedgehog, or, you know, transfer them into a kennel. Smaller hedgehogs can get through quite small gaps. So if you are putting them in sort of a metal kennel, just bear that in mind.
    The kind of, perspex glass ones are probably more suitable and to keep hedgehogs contained. So examination. So all hedgehogs that come in need ideally need an examination as soon as they come into the practise.
    First of all, you can just do a visual exam, so examine them from a distance, first to really sort of ascertain their demeanour, their gait, if they're being, you know, vocal at all Often If hedgehogs are vocalising, generally they are in pain so important to note that down. If they are vocalising, or sometimes youngsters will just vocalise if they're a bit stressed. A sniff test, which sounds quite funny.
    But smelling a hedgehog may be able to give you a lot more information than you think. Often, you can sort of smell signs of infection. Which, you know, sounds sounds a bit silly, but, you know, it can give you quite a lot of information when you're doing a physical exam, then, obviously, really important to wear gloves.
    Hedgehogs can carry, sort of zoonotic diseases particularly, fungal infections and things like brain worms. So really important to wear gloves Well, with all wildlife. But, particularly, if you're handling hedgehogs, always fully uncurl them.
    So when you're doing a physical exam, make sure that they're sort of un uncurled all the way. And you can use the bounce technique, which I'll show you a little video of shortly. Stroke the spines, or you can even wait for them to sort of uncurl for themselves.
    If you've got the time, you may need to use sort of general anaesthesia so potentially sort of gassing them down. But it's really important to do a full nose to tail examination. Just to ensure that they don't have any sort of life threatening injuries before you kind of house them or, you know, set them up for a long term or even short term care.
    So how to uncurl a hedgehog? So I'll just show you a little video here of me uncurling a hedgehog. So use both your hands.
    Gently bounce the hedgehog until you can get one hand under the jaw, like in the video there and one hand under over the hind limbs. Slowly continue to bounce them until you expose their abdomen and can gently stroke the spines like I did in the video. Using your thumb to help expose those hind limbs.
    That way you can give them a thorough examination from nose to tail without missing any of the limbs, missing any part of their abdomen or their genitals, et cetera. So next we're gonna talk about hedgehog anatomy and the common ailments that can affect hedgehogs. And I just had to put this photo in because I think it's amazing.
    The snail D, I think is a particular favourite on that photo. So if we start with, with the head So our nose, eyes and mouth, it's really important again to remember hedgehogs ecology. So hedgehogs rely on their sense of spell to hunt.
    Severe damage to the nose may need to result in euthanasia if they're not able to hunt for themselves. So any kind of, fractures to the skull around the sort of rostrum there. Blind hedgehogs cannot be released.
    And you know, there are some sort of wildlife rehabilitation centres and hospitals that will keep hedgehogs in sort of suitable predator free captivity. But even this is questionable. Obviously, if they're blind, they can't exhibit sort of normal behaviours.
    Infected eyes, can be treated using sort of eye ointments and drops, which obviously need to be prescribed by your vet. And hedgehogs do quite commonly get dental disease. Particularly if they're in any kind of prolonged captivity.
    So I've got a photo there of us doing a dental on a hedgehog. When I was working in a wildlife, hospital and rehabilitation centre, we had some disabled hedgehogs that needed sort of long term care or physiotherapy. And whilst they were with us, of course we'd feed.
    We feed them, you know, feeding them dry food, and, meal worms, et cetera. But they're not having their normal natural diet, which means that they're not wearing down their sort of plaque that builds up on their teeth. So it's important to sort of carry out routine dental work just to make sure that their teeth were staying nice and healthy so they can get sort of dental disease and dental problems, the same as our sort of cats, dogs, rabbits that we see in general practise.
    So next we'll move to the skin and spines. Now there are a couple of common ailments with hedgehogs, and I've got some photos here. So one of which you can see an X ray at the top there of balloon syndrome.
    Now, balloon syndrome is often caused by trauma or sort of small wounds, which allows air into the subcutaneous space. So sort of between the, the spines, and the sort of body cavity. This can be really easily fixed by just removing the air and you can use a needle and syringe, so sort of thoroughly prep the area and then use a large needle and syringe and essentially suck the air out.
    Sort of recording how much you're you're taking out each time, another sort of ailment that hedges can get, which you can see. In the third photo, down with the stripy blanket is pop off syndrome. Now, this is the prolapse of the, orbicularis muscle, which is often caused by trauma or a struggle.
    This can actually happen when you're handling them, so just take a lot of care. Be careful when you're handling them when you're trying to uncurl them. It does require a a general anaesthetic to replace them.
    But, once they're asleep and relaxed, you can generally replace this muscle quite easily. Often we see hedgehogs with burns. So particularly around sort of bonfire night, November time, people will be setting up bonfires in their gardens, So just get, members of the public to check their bonfires.
    It's often useful to do sort of an, social media campaign to say, you know, check your bonfires for wildlife. This, can obviously cause sort of charred spines, damage to the skin and also obviously damage to the eyes. And, the lungs from smoke inhalation.
    Another common injury for hedgehogs is trimmer injuries, particularly in the summer months when people are sort of cutting their grass or cutting back gardens or hedgerows. You can often see hedgehogs with really deep lacerations and sometimes really severe wounds to their sort of nose or their limbs. And another really common one, which we've got a photo of.
    The second photo down there is entanglement. So in this photo, we've got an entanglement of some garden wire, which often people use to stop, animals from eating their plants. So really important to remove the wire.
    Or, you know, if it's a trap or string et cetera, as soon as possible and then, monitor those patients for any pressure necrosis, especially if the wire has been wrapped around limbs or around their nose or face. Continue with our skin and our spines. Ectoparasite are quite common in hedgehogs, So our ticks and our fleas, important that we're not sort of, over spraying insecticidal sprays.
    So Johnson's insecticidal spray is really, really good. But just being careful with volumes, that's great for getting rid of fleas. If you have access to that in practise, ringworm, which we kind of touched on earlier.
    So obviously a zoonotic disease that we can get from hedgehogs, so treatment with AOL or insole for six weeks. And then you can also do sort of aloe vera massages. The photo I've got there of the then and now, was a hedgehog with ringworm.
    And he pretty much lost all of his spines. So we were doing aloe vera massages to try and encourage that spine regrowth after treatment. And you can just see how, how successful That was from the sort of then and now.
    And that was about sort of 6 to 8 weeks of of treatment. Mange is another one that hedgehogs will will definitely get, got a photo at the, the bottom sort of right corner there of the hedgehogs with mange. And you can treat them with ivermectin once a week for about three weeks.
    And generally that's enough to, to treat the mange there, another sort of common, ailment of hedgehogs for their skin spines as fly strike or myiasis, has a really, really sort of distinctive smell so really important to remove any maggots immediately. So using a toothbrush or clippers, you could also use an ivermectin flush as well to get rid of those fly eggs. So next we'll move on to the respiratory system.
    Probably the most common ailment, and the, issue that you'll probably see most in hedgehogs is lung worm. We often see it in our autumn juveniles, but also, adult hedgehogs as well. And this causes sort of quite horrible coughing, wheezing, nasal discharge.
    And they often present as really lethargic and weak. And sadly, often it's quite a poor prognosis, sort of. By the time a member of the public has found them, they're often at quite a late stage of the the lung worm.
    There is a worming regime, which I can happily email to you, which involves antibiotics, steroids, fluids, Ventolin, leide. And there's some success with a I know of people in practise that have used a, at the wildlife hospital that I previously worked at. They are currently doing a trial.
    So, I can let you know the sort of results from from that trial. But also adding in bis soven to help clear any, mucus. And, and also nebulization can work really well.
    So I've got a photo of the flexi NB used at the wildlife hospital that I previously worked at, using F 10 nebuli. And that did really help with the hedgehogs that had quite severe lung worm and sort of damage to their lungs. Any hedgehog with sort of dyspnea, obviously any dyspneic patient.
    They often require oxygen therapy at the point of triage. You can often treat them with sort of Ventolin and F 10 nebulization. Again.
    Often the dyspnea can be caused from lung worm. Any trauma to their rostrum as well. So I've got a photo at the top there of, hedgehogs that had some really, really nasty trauma, to his nose.
    And they really have this distinct sort of upper respiratory noise. I won't try and recreate it now, but, if they've got any palate, nose or jaw fracture, they do tend to have quite a distinct kind of almost like squeaky breathing. That once you've worked with hedgehogs for a while, you'll, you'll sort of that's that sort of sound will be very distinctive.
    And you'll sort of know straight away that they've got a, sort of any kind of palate or nose fracture moving on to the digestive system. Sorry for anyone that's eating. We've got some photos of faeces here.
    So, as with our sort of domestic species, diarrhoea, can be quite common. So from dehydration, this can sometimes call rectal. What?
    Cause rectal prolapse In young hedgehogs, You've got a photo of there so they often need, like a minor surgery to, to to sort of fix that prolapse. Green faeces is actually quite normal for juveniles, especially if they're still on milk. So don't be too alarmed if they do have sort of a green green faeces.
    Heals can get a number of ender para sites. So round worm, lung, worm capillaria and thorny headed worm, fluke and coccidia Ah, So it's quite useful if you, you, yourself or someone in practise is a practise hand at using the microscope and having look for, any of these endoparasite generally fine. Just smearing a bit of the faeces on a microscope slide popping a cover slip on and having a look.
    You'll often come across, you know, if they have lung worm or if they have, thorny headed worm or fluke. It's important to remember as well that there are some sort of zoonotic diseases that hedgehogs can pass on cryptosporidium and salmonella. So again, just another reason why we need to be wearing gloves when handling hedgehogs or handling their faeces or cleaning them out.
    And if you are doing any faecal testing a wet prep and doing sort of, faecal flotation is probably the best way of finding, finding those worms. But yeah, you can sort of do a direct smear onto a slide as well. That does work quite well for hedgehog faeces.
    So the skeletal system. So, naturally, the same as you know, our domestic species heals can sustain sort of limb fractures. There has been quite a lot of success with sort of surgical repair or casting.
    I've got a photo at the top there of, a hedgehog that had a jaw fracture. Which, doctor Steve Smith, who's one of the vets at, Tin Pos Wilder Hospital, fixed whilst I was working there. That was a really interesting case.
    And that hedgehog actually healed. Really, Really Well, hedgehogs older hedgehogs tend to get O osteoarthritis, and they can also get some spondylosis as well. So yeah, older hedgehogs.
    Unfortunately, skull fractures are very common in, in hedgehogs, often due to entanglement, road traffic collisions or sort of any kind of trauma. Sometimes when they've been attacked by a dog as well, if a if a dog kind of grabbed their head, we often see fractures of the zygomatic arches, and they do tend to heal quite well. But any flat fractures of the sort of mandible, they do require surgical intervention, so you can see that, the photo there got quite a nasty fracture.
    It's really important to, check the pads of their feet. And sort of lower limbs. For any signs of dragging.
    Often, you know, hedgehogs will be brought into us, and, you know, they're kind of curled up in a ball, and we don't really see we are not able to watch their gate. Unless we put like a camera on them or they you know, they don't think that we're there to to be able to watch them sort of walk. So it's important that we have a look for those wounds that will show us any signs of whether they have been sort of dragging, dragging their feet or if their proprioception is particularly bad.
    Physiotherapy can really help with amputees. Obviously, it's sort of personal preference. In terms of amputation, some rehabilitation centres and wildlife hospitals are pro amputation.
    Others, not so much. You have to bear in mind that if these animals are going to be released into the wild, they need to be able to thrive, not just survive. Hedgehogs obviously can get a build up of op, parasites, things like ticks.
    And obviously, if you remove a hind limb, of, of a hedgehog, they may not be able to sort of scratch away the ticks that might build up behind the ear of that missing leg. So all things to consider when we're looking at the sort of skeletal system, if they do have any fractures of kind of a plan of, what's best for the hedgehog overall in the long term. So autumn juveniles, commonly autumn juveniles will be brought into general practise.
    Often if, you know, remember, the public's had a mother hedgehog. And they've had a litter sort of under the shed or in their hedgehog house or somewhere in their garden. We may see autumn juveniles that have been born quite late.
    Commonly these autumn juveniles will have lung worm. Sadly, the autumn juveniles do tend to have quite a high mortality rate. They do need to be sort of quite healthy.
    Overall, if they do sort of succumb to lung worm, and they basically they need to be well enough to be able to cough up those worms. And if they're not, if they're really sick and dehydrated and weak, they just won't be able to cope with the, with the disease. Sadly, ODD so out during the daytime.
    If these guys are out during the daytime, they're normally always quite sick or injured. Unless they are moving with purpose. Now, normally, this refers to sort of older or pregnant or lactating females.
    You know, if you see a hedgehog out in the day in the sunshine and it's moving with purpose, you know, it's got a mouth full of moss or a mouth full of draw or, you know, nest materials that it probably is a pregnant or lactating female, trying to make a nest for her babies If it's a small hedgehog flat out in the sunshine, you know, with flies on it or something like that. Generally, you know, it's in need of some assistance. So, TSTH too small to hibernate.
    These little guys will need over wintering. So our autumn juveniles often always need over wintering. So if you've got space in the practise, and your you know, clinical directors or your you know, head nurse practise manager is happy for you to overwinter hedgehogs fantastic.
    Otherwise, you know, taking your your work home with you, as we often do as nurses, you can keep hedgehogs at home in a garage in a shed. As long as they've got some sort of heat source, if they're really young for the really cold sort of winter nights, you can feed them up and then often release them in spring time before Easter. So they can, sort of be released then into the wild.
    Really? Sometimes it can be quite difficult to review faecal samples in autumn. Juveniles.
    I know we've already sort of touched on the green faeces being quite normal because they're still having milk. So sometimes it can be a little bit tricky. And sometimes, autumn juveniles can have or ju juvenile hedges can have quite like mucousy faeces, so it can be a bit more difficult to, check their faecal samples.
    But once you've done a few, it tends to get, a little bit easier. And there's lots of help. Online, if you're reviewing any kind of hedge faecal samples, so it's worth worth having a look if you're, if you're sort of practising that so often, baby hedgehogs.
    So baby hedgehogs are born with their eyes closed. They come out pink with really white spines. So we've got a photo of one at the top there that we had in at, twinkles.
    If you do have one, that's this small we would recommend feeding, royal Cannon baby cat milk, ideally, if you can with a pinch of clos, every 1 to 2 hours. And then once they, reach sort of 5050 to 100 and 50 grammes, then increase to sort of 3 to 4 hours feeding, or decrease rather, use a per pet. And if you do have sort of a pet with a teeth, then fantastic.
    If you're in sort of general practise and you don't, a syringe can work pretty pretty well too. So gently pop that tee into the hedgehog's mouth and then squeezing out a few drops until they begin to lap. Similarly, if you are using a syringe, then just, you know, really slowly, popping that plunger down until they're lapping for themselves, try not to flood their mouth as this can result in inhalation pneumonia.
    So try and go sort of slowly with with the feeding initially until they sort of start to lap on their own, toting the same as other mammals. They do need stimulation before and after each feed. So gently rubbing the hedgehog's genitals, to stimulate urinating and defecating so generally find like a bit of cotton wool with warm mortar and works really, really well for that.
    Weaning can then begin when the hedgehog's teeth start to appear. So that's normally when they get to around sort of 200 grammes. At that point, you can then provide some, milk in a bowl of water and then some sort of wet puppy food, mixed in with some vitamin supplements if you can.
    But wet puppy food will be fine, and you can always sort of mash up some of the milk, the Royal Cannon baby cat milk with some, puppy food as well, and they'll start to sort of lap and and and chomp on that. If you do at any point, have a mother and babies brought in, which can happen occasionally. You know a nest might be disturbed, which might result in You having to admit the mother and the babies always keep them together, so don't don't separate them.
    Keep them in the same, cage or kennel. You could house them in sort of a a normal metal cage. But again, once those baby hedgehogs start running around, they might be able to fit through the bars of a metal cage, so generally find, like a guinea pig cage.
    Or, you can get sort of critter cages, which is the top photo and the bottom photo there. That was a hedgehog that I, took home from practise. Initially thought to have sort of sustained an injury to her side, but but actually, it was starting to heal.
    Really? Well, she was really, really sort of skinny and dehydrated and took her home. And then the following day, she was surrounded by babies.
    So then ended up having to keep her until she had her babies, and they could all be released. But really important that they are kept in a really quiet area of the hospital. Again, if you are able to take them sort of home into a shed or a garage.
    This might be more suitable than being in a in a busy hospital. Perhaps if you have an isolation ward which isn't used quite as often, or a separate kind of, small mammal ward. That would be preferable.
    Just somewhere quite quiet so that, you know, mum isn't getting too stressed, important to provide her with sort of water. Dry cat biscuits, hedgehogs, love, dry biscuits, and plenty of wet cat or dog food. Provide her with some nest material, ripped up newspaper works.
    Really? Well, hay and straw. Ideally, sort of.
    If you can cover one half or one side of the cage, just so she's got somewhere for some privacy, and she'll probably want to keep the babies in there. Ideally, once, you know that, Mum has given birth, Try not to handle them, if possible, and And try not to handle mum either. Ideally, certainly not within the two weeks of her giving birth if possible.
    If I was your mom has quite severe injuries. There may have to be exceptions to this, but it can cause sort of extreme stress. And, you know, mom can actually, you know, harm or or even, you know, eat.
    Eat the young if she's, extremely stressed. So try and stay as hands off as you can. I would recommend just cleaning out the side where you place the food and water.
    Don't disturb the nest. So, you know, even if it's, you know, becoming quite sort of smelly. Try not to disturb the nest if you can.
    Normally, Mum will be quite good at coming out of the to urinate and defecate. And it'll only be sort of the the baby's waste products in in the nest. So, ideally, if you can just clean out the area where the nest isn't, that will cause sort of minimal, minimal disruption to your mum and and to the babies.
    So, when you've admitted your, your hedgehog a basic triage protocol would be to do a visual examination, which we've talked about already, uncurl and do a complete nose to tail examination. So obviously that initial visual visual exam to just see for any obvious injuries, see for any entanglements, or, you know, dragging of any limbs. If they are walking and then do your sort of complete un Karl no tail examination.
    Weigh them at that point, that's really important. So you can work out drug doses. If they are really, really cold, and really dehydrated, I would recommend probably providing them with subcutaneous fluids first, heating them up, and then trying to uncurl them when hedgehogs are really, really cold.
    Really hypothermic. It's extreme can be difficult to uncurl them. Even with the bounce technique, if they're, you know, freezing freezing especially, sort of older hedgehogs, juveniles.
    It tends to be, and sort of younger hedgehogs. It's a bit easier to uncurl them, but an adult that's, you know, really dehydrated, emaciated and stone cold is very, very difficult to uncurl them until you sort of warm them up a little bit. So I would recommend warming them up in a in an incubator or with some heat disc or heat pad first, and then trying to sort of finish the rest of your your triage or examination.
    Ideally, you know, once you've done the exam and you found out what's wrong if you, deem them to be any pain, and you want to provide them with analgesia, we recommend, meac. So that's the That's the dose for the dog cat meac there. So 0.5 megs per kig.
    Once a day subcutaneously. And if you can just see the photo there of, administering fluid therapy, just at the bottom, left hand side there, that's where I would recommend to go for your subcutaneous injections, into the skirt rather than directly into the spines, because that can be quite sort of painful. And if you get into the base of one of the spines, it's quite hard to, for that sort of fluid to spread, and actually gets stuck in the sort of base of the spine.
    So we definitely recommend doing any subcutaneous injections in the skirt of the hedgehog. So that's that fluffy bit where you can see me injecting that fluid and, fic, can provide them with a stronger pain Relief, at a 0.0.
    3 megs per kig. Up to three times a day intramuscular, And then if antibiotics are indicated, if they've got sort of quite a severe infection. Obviously, again, all of this is to your sort of vets discretion.
    But I would recommend, Oxy L a or amoxicillin L A at 100 to 100 and 50 megs per kig. Every other day. Subcutaneously or cino?
    100 megs per kig, once a day, and that's also subcutaneously. But again, as I said, you know, obviously check with your your vet first. Fluid therapy People are often shocked by the 100 mils per kilogramme.
    They think that that's quite a lot. So for a 200 gramme hedgehog, 20 mils of fluids is is very normal. Seems like a quite a lot.
    But actually, it's not at all, for for hedgehogs, especially if they're really dehydrated, 100 mils per kig. You know, we may even go sort of over that if they're extremely dehydrated. It's also important to provide them with any antiparasitic.
    So obviously, if it's indicated, you know, if they're covered in fleas, the Johnson's insecticidal spray is absolutely brilliant. If they're covered in ticks, then Panama at a, 0.04 mils per kick dose works.
    Really, really? Well, of course, if they've got any wounds really important at the point of triage to clean and flush and pack any wounds. So, iodine, you know, works really well for sort of cleaning flushing with saline, and packing with the most sort of appropriate, topical treatment.
    So if you've got quite a severe infection, something like manuka honey would work. Really? Well, if you have burns, you know, perhaps a silver cream, something like flama Zine.
    If you have an open wound, perhaps something like in Tracy just to keep that wound sort of moist. While you're trying to create a sort of granulation bed, like I said earlier, placing them in an incubator if they're really hypothermic and also providing some flow by oxygen, if it's indicated, You know, if they're dyspneic, perhaps if they you are suspecting of a, a skull fracture or sort of damage to their, rostrum or, you know, they're struggling. The sound like if they're struggling to breathe in any way, put them on flow by oxygen.
    If you are lucky enough to have an incubator like the intensive care unit that you can see in the photo That does have an oxygen, outlet there. So that's a, quite a useful incubator to have, because you can pop them on oxygen whilst also, simultaneously heating them up if you are unable for any reason, not to uncurl them if you can't and tell them, or if you think that there if the reason for hospitalisation requires a G a then, induce them and carry out emergency treatment. So, you know, for example, the the hedgehog in the photo there that had netting.
    That requires a sort of a really urgent general anaesthetic, because I wasn't unable to uncurl this hedgehog just by using the bounce tech. So it was really important to find out where that netting was attached to. It was actually wrapped around both its back legs.
    So had we not, anaesthetized it straight away to remove that netting, it could have caused pressure necrosis and that hedgehog perhaps could have lost, lost a limb. Now, there are a few reasons why we may, need to euthanize a hedgehog straight away. A fractured spine.
    So you can see in the photo there that hedgehogs got a really nasty spinal fracture. A fractured pelvis, which in particular in females may cause. So when, they're released back into the wild loss of two or more limbs.
    Of course, if they, in some cases, if they've lost one limb, and they they perhaps have arthritis in their other limbs. That may be another reason to, to call the euthanasia if they are permanently blind or deaf. And then the last one, which I think is the most important one is the inability to thrive in the wild.
    So there's a big difference between, an animal surviving in the wild and an animal thriving. And we want to make sure that any patient that we're releasing is able to thrive and have a good quality of life. Not just sort of survive.
    So the route of euthanasia, I would recommend, using a gas chamber, or using a mask, and gassing them with iso fluorine and then injecting intracardiac, in ventral recumbency is probably the easiest say having them on their back and then popping, popping a a sort of long needle straight straight into the heart. Now, if your head dogs do have any wounds, wounds should obviously be cleaned and flushed. With iodine and packed and dressed at the point of triage, if necessary.
    Any maggots or fly eggs need to be removed and flushed with Panama. You can do a one in nine ratio. So that's one mill of Panama to nine mils of water when you're flushing, to get rid of any fly eggs.
    And if they do have any flags in their, sort of fur, you could obviously clip clip those out, too. Any deep wounds can be packed with, in Tracy or her medical grade honey, as we sort of talked about earlier, at the, bottom. There, you can see some photos of, a couple of baby hedgehogs that have got, dressings actually sutured to their head.
    So dressings are really notoriously difficult to keep up, place on the head, which is often an area where hedgehogs sustain injuries. So you may need to sort of suture and a leave in in place. Just to ensure that, you know, the, the honey or the flamin, is doing what it needs to do.
    Unfortunately, hedgehogs are quite disgusting. They tend to, pass faeces everywhere and then roll around in their faeces. So if they do have any open wounds, we want to try and keep them as clean as possible.
    And actually suturing a a piece of, dressing material is often the best way to keep those dressings in place. Any non healing wounds? Derma zole is quite magic.
    And you can use that, to apply to those wounds. And F 10 can also really aid in sort of healing and prevent infections, too. So, some, quite, useful topical treatments to keep on the keep on the shelf If you have a patient, hedgehog that has a fracture.
    Ideally, these should be stabilised at the point of triage. So if you are able to palpate a fracture or you've done some X rays and you've been able to see a fracture, you can use, Gus splints or aluminium splints, which can be sort of moulded to the patient's leg. Fat glass also works.
    Really? Well, we were really lucky at to you because we had a wood cast machine. So we actually use, those small casts that you can see in the photo there were actually just created out of, wood that once heated up is really, malleable and pliable, and you can actually just mould it to the shape that you need it to be.
    So splints in hedgehogs should be positioned at the back of the limb, which is the same as, obviously, cats and dogs. And then, of course, dressing should be changed regularly, as they'll become soiled really quickly with hedgehogs. You know, as we've talked about there, they're pretty disgusting when they're in captivity.
    So yeah, and really important to keep them clean. And of course, they will need a general anaesthetic to to stabilise, the fractures and and apply those, those dressings. Hedgehogs.
    Obviously, if you're trying to, outstretch your limb, they're just gonna call back, curl back up into a ball, So you do need to anaesthetize them. So you've got sort of full flexibility. Of that of that leg, if you do have a fracture, diagnostics.
    So after the initial sort of triage stage of stabilising them, you may wish to do sort of further diagnostic tests. So X rays and ultrasound. You may want to do some faecal testing.
    And if there are any sort of major fluctuations in weight, So if you sort of, be caring for them short term and their weights decrease quite rapidly, then it may be worth doing some sort of further further diagnostics. You also may wish to do some ringworm testing. So using a, demay plate that you can see in the photo there, they can be really useful for confirming, ringworm.
    If you do have patients that you suspect have ringworm. And you're not really successful with a woods lamp or, or just visual inspection of of the ringworm lesions. So if you are needing to, anaesthetize hedgehogs, for sort of initial examination, or if sort of extensive injuries are suspected or you just you can't incur them, you may need to anaesthetize them for diagnostics such as a X ray and ultrasound as we as we've discussed or for any sort of surgery.
    So I've got a photo of some masks, that we've kind of adapted to suit hedgehogs. But you can also intubate them. And I know that might sound mad because they're very small.
    But, luckily in the veterinary profession, we are getting much better at intubating rabbits, guinea pigs, and smaller mammals. So hedgehogs are no different. So, you can use a sort of, a 2, 2.5 or even actually, I've got managed to get a three at some point into a a hedgehog's trachea.
    Obviously, it depends on the size of the hedgehog. I would recommend using inch of be wouldn't recommend using the spray because that volume is far too much for a hedgehog. But just using a small one mil syringe, and just supplying a very, very sort of small amount, to to the, the back of the throat, and then using a laryngoscope to intubate, like in the photo there.
    If you're doing a hedge or anaesthetic, I would definitely recommend using a capnograph or multi parameter machine. And you can also use a Doppler probe directly onto the heart. Which then you can sort of monitor the heart rate really carefully.
    And also a pulse oximeter. So in the photo there, you can see. There's a hedgehog having some surgery on his leg.
    We've got a clear drape there. The hedgehog is, masked with an adapted mask. The pulse oximeter is on his foot, and then you've got the Doppler there directly over the hedgehog's heart for for monitoring.
    So if you are needing to give any pain relief, any antibiotics or any sort of worming treatments, I've got some doses there which, which you're more than welcome to take a screenshot of, obviously check with your veterinary surgeon that they're happy with the doses, as they'll need to sort of prescribe them. But those are the doses, that we commonly use and that I would use in hedgehogs. So buprenorphine meac cino Amoxicillin.
    Ivermectin. Presa. So Johns, and mail as well, which can be used for treating ring one.
    So, before we wrap things up, our short term nursing considerations for hedgehogs. So whilst they are in, sort of captivity with you whilst they're in hospital really important to monitor their, defecating, their urinating, their drinking and their eating very carefully, monitor their weight daily. Obesity can be really common in captive hedgehogs.
    And if they do become obese whilst they're in captivity, that actually can be quite life threatening for a hedgehog If they are obese. Unfortunately, they cannot roll up into a ball, which is their only method of sort of protecting themselves. So, any kind of predator such as a badger, if they are really, really obese hedgehogs, they won't be able to ball up.
    And, a badger will quite easily be able to sort of open them up and, and attack them so really important that we're monitoring their weight and not over feeding them. If they do become in appetent, you can try lots of different foods. Hedgehogs really like AD.
    Or there also is a sort of parental feeding liquid called ens ensure, which is actually for for people, which is really highly calorific, which hedgehogs seem to really like, also important to offer them dry food as well. And this can also help with the, dental, issues that they get. They really love crunching biscuits.
    I actually think there's no better sound than listening to a hedgehog eat, dry biscuits. So if you do have a hedgehog in, pop them some dry biscuits in and I'm sure they'll love them, keep keep them in an area ideally of the hospital with minimal footfall. Obviously, we've talked about this for mums and babies, but hedgehogs in general, try and keep them away from cats and dogs if you possibly can.
    So, in terms of accommodation, and food for hedgehogs whilst they're with you in the hospital. Wet cat and dog food and dry cat biscuits are suitable for adult hedgehogs in sort of a small bowl like you. You can see in the photos there any juvenile.
    So any hedgehog under the size of sort of 200 grammes really should be provided with kitten or puppy food. And ideally, some roll cannon kitten milk as well, in sort of a shallow dish important that we don't give them any sort of deep dishes because they can sort of, get their heads stuck in there and, do silly things like, sort of drown in water so really important to keep those dishes nice and shallow. Metal cages used for cats and dogs can be suitable for adults, but our smaller juvenile hedgehogs really should be housed in, like a guinea pig or a hamster cage.
    Like the one in the photo in the, top right there that you can see just so that they're not able to escape through those small bars or get themselves stuck If you do have a hedgehog that requires, rehabilitation or sort of more intensive care treatment, really important to transfer them to a rehabilitation facility or a wildlife hospital as soon as possible? And an amazing resource to find a facility close to you is help wildlife. If you go to their website, there's loads of amazing advice on there, as well as directory of all the wildlife hospitals and rehabilitation centres across the UK.
    I popped some, some images of the sort of most popular ones or the busiest ones who wildlife aid, Vale Hospital Secret World, and also twinkles. And, you know, these places can also provide you with really good advice. So if you haven't been able to find the advice that you need of help wildlife, then ringing a wildlife hospital, they'll be more than happy.
    To talk you through, how you can help a hedgehog in need. So thank you so much for listening. I've got some references here.
    If anyone's interested, for all the topics covered today and if you do have any questions, I'm more than happy for you to send me an email. GL Crowley at Hotmail.co.uk.
    And I look forward to hearing from you. Thank you very much.

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