Hornbill case method: 50 questions

An 8-year-old male red-billed hornbill. He has been listless for the past few days, and this morning he is sitting on the perch with his belly resting on it, feathers fluffed. When picked up, his lower abdomen is taut like a balloon and he is breathing with his bill slightly open. For several years his diet has been mainly apple, grapes, raisins and a commercial parrot pellet. Room temperature is 24°C.

Which is the most appropriate first action?

1. Assume constipation, drip a little olive oil into the bill and watch
2. Keep warm, avoid stimulation, write down the diet and go to a clinic that treats hornbills the same day
3. Warm the abdomen with a hot towel and gently massage it to release gas
4. Assume malnutrition, increase raisins and fruit, and wait for strength to return

AnswerB. Keep warm, avoid stimulation, write down the diet and go to a clinic that treats hornbills the same day

ExplanationIn a frugivorous hornbill, a swollen abdomen with open-mouth breathing strongly suggests liver enlargement and ascites from iron storage disease. The fluid compresses the lungs and air sacs, making breathing difficult, and sudden death can occur; this is a high-urgency condition and a same-day vet visit is the guideline. The type of food and its iron content are key to diagnosis and treatment, so write them down and bring them. Oil in the mouth risks aspiration, and abdominal massage compresses the fluid and swollen liver, worsening breathing. Raisins are high in iron and increasing them advances the disease.

IssuesA high-iron diet of parrot pellets and raisins was continued for years without knowing about iron storage disease, which is specific to frugivorous birds. No vet visit was made at the lethargy stage, and the problem was not noticed until fluid had accumulated.

ImprovementSwitch the staple to a frugivore pellet with under 100 ppm iron and stop raisins and citrus. Record weight weekly and see a vet at a 5% loss or lethargy. Identify a clinic that treats hornbills ahead of time.

A 4-year-old black-and-white hornbill. Normally she picks up fruit with the bill tip, tosses it upward and catches it neatly in her throat, but today she fails repeatedly and drops it on the floor. On close inspection there is a small step at the right edge where the bill halves meet, and she is shaking her head frequently. She has eaten less than half her usual amount. There is no bleeding.

Which is the most appropriate interpretation and response?

1. She is just playing, so leave her alone until she finishes eating
2. A misaligned or painful bill may be preventing eating; hand-feed soft fruit and see a vet the same day
3. File down the step on the bill so both sides line up
4. It is loss of appetite, so increase insects and see a vet if there is no improvement in a few days

AnswerB. A misaligned or painful bill may be preventing eating; hand-feed soft fruit and see a vet the same day

ExplanationHornbills cannot hold objects with their feet; they toss food with the bill and swallow it whole. If the bill edges are misaligned or painful, the tossing motion goes wrong and the bird cannot eat. Bill cracks and casque damage are often deeper than they look, and if intake is down by half, a same-day vet visit is the guideline. Until then, hand-feed bite-sized pieces of soft fruit to support intake. Filing the bill yourself can damage nerves and blood vessels and further disrupt the bite. Leaving it for days leads to weight loss and dehydration.

IssuesThe change in eating was almost interpreted as play, with no thought of a bill problem. The bill and casque were not inspected regularly, so it is unknown when the step appeared.

ImprovementDuring daily hand-feeding, check the alignment of the bill halves and the casque for cracks or chips, and record with photos. Count the fruit pieces given so intake can be confirmed by eye. Make any bill abnormality a same-day vet rule.

A 3-month-old red-billed hornbill. Hand-reared from before fledging on mainly mashed fruit and mealworms. Recently it cannot grip the perch well and often comes down to the floor, and the left leg looks bent outward. The wings also droop slightly. Appetite is fine, and the cage is in a windowless room.

Which is the most appropriate response?

1. It is a temporary growth-phase deformity, so wait for it to grow out
2. Double the mealworms to add protein
3. Splint the leg to straighten it
4. Suspect metabolic bone disease, soften the floor, restrict movement and see a vet the same day

AnswerD. Suspect metabolic bone disease, soften the floor, restrict movement and see a vet the same day

ExplanationA diet of only fruit and mealworms is low in calcium and high in phosphorus, and without UV light the bird cannot make vitamin D, so the growing bones weaken, causing metabolic bone disease. Leg deformity and weak grip are signs of progression; left untreated, they lead to fractures and permanent deformity, so a same-day vet visit is the guideline. Until then, soften the floor and limit height to prevent fractures from falls. Mealworms have far more phosphorus than calcium, and increasing them makes it worse. Amateur splinting risks breaking the weak bones.

IssuesThe owner did not know that hand-reared young birds need calcium supplementation and UV light, and raised it on fruit and insects alone. In a windowless room with no sunlight, the environment could not support bone formation.

ImprovementDust insects with calcium supplement and mix a low-iron juvenile pellet into the staple. Provide a bird UV lamp or daily sunbathing through a screen. During growth, have a vet check weight and bone condition every two weeks.

A 2-year-old red-billed hornbill. Droppings have been loose for 3 days, and this morning watery green droppings contained grape skin and flesh almost intact. On the scale she is down 8% from last week. She ate until yesterday, but today took one bite and stopped. Room temperature is 25°C. Leftover fruit has been lying on the cage floor since yesterday.

Which is the most appropriate first response?

1. Reduce fruit, keep warm, photograph the droppings and see a vet the same day
2. Give yogurt to balance the gut and watch for a week
3. Mix a tiny amount of human over-the-counter antidiarrheal into fruit
4. Fast her to rest the gut and give only water until the next morning

AnswerA. Reduce fruit, keep warm, photograph the droppings and see a vet the same day

ExplanationWatery droppings with undigested fruit and an 8% weight loss suggest a digestive tract infection from parasites, bacteria or fungi; a same-day vet visit is the guideline. Birds have a fast metabolism, and continued diarrhea with reduced appetite leads rapidly to dehydration and weakness. Photos of the droppings, and a fresh sample if possible, help with fecal testing. Until the visit, reduce fruit that spoils easily, give a small amount of low-iron pellets and keep warm to limit exhaustion. Birds cannot digest dairy, and human medication is dangerous with unknown dosing. Fasting a small bird causes an energy crash and can itself be life-threatening.

IssuesNo vet visit was made when loose droppings persisted for 3 days, and leftover fruit was left out, creating an environment where bacteria and fungi multiply. Routine weighing would have caught the loss earlier.

ImprovementRemove leftover fruit within a few hours and wash dishes daily. Weigh every morning and record; see a vet at a 5% loss. Schedule an annual fecal test and consult the vet if dropping color or form changes for 2 days.

A 6-year-old great hornbill. Two weeks ago the flight cage was relocated during a house move, and the bird spent several days in a cramped shipping box in the meantime. Since this morning he has been breathing with his bill open on the perch, making a whistling sound. His call is hoarse and his tail bobs with each breath. Appetite is down, and in a corner of the cage there were damp bark chips and rotting fruit.

Which is the most appropriate response?

1. It is temporary stress, so watch quietly for a week until he settles
2. Assume he is hot, mist his body and point a fan at him
3. Keep him dark and quiet, remove the rotting material, and go to a clinic that treats hornbills the same day
4. Spray a human inhaler medication into the cage to ease breathing

AnswerC. Keep him dark and quiet, remove the rotting material, and go to a clinic that treats hornbills the same day

ExplanationAfter the stress of transport and environmental change, inhaling mold from damp bedding and rotting fruit strongly suggests aspergillosis. Open-mouth breathing, breathing sounds and voice change are signs of advancing lesions in the air sacs and lungs; it progresses quickly with a high fatality rate, so a same-day vet visit is the guideline. Keep him dark and quiet to reduce handling stress and remove the source of mold. Wetting the body and fanning lowers body temperature and exhausts him. Human medication is dangerous, and a week of waiting will be too late.

IssuesRight after the major stress of a move, damp bedding and rotting fruit were left in place, creating a breeding ground for mold. Breathing sounds and voice changes were not recognized as early warning signs.

ImprovementFor 2 weeks before and after any environmental change, check appetite, breathing and voice daily. Replace bedding as soon as it gets wet and remove leftover fruit within a few hours. Consult the vet before any necessary move, and maintain ventilation and 50–70% humidity afterward.

A 10-year-old red-billed hornbill, 20% over standard weight. Lately he spends more time on the floor instead of the perch, standing on the left foot with the right held up. The center of the right sole is red and swollen with a small scab. The only perch is the same single plastic one of uniform thickness since purchase, and the floor is concrete covered with newspaper.

Which is the most appropriate response?

1. Apply human antibiotic ointment and wrap with an adhesive bandage
2. Replace the perch with natural wood of varying thickness, soften the floor, and see a vet within a few days
3. Peel off the scab, disinfect, and remove all bedding to dry it out
4. He lacks exercise, so chase him to make him fly more

AnswerB. Replace the perch with natural wood of varying thickness, soften the floor, and see a vet within a few days

ExplanationA hard perch of uniform thickness, a hard floor and obesity together put constant pressure on the same spot of the sole, causing bumblefoot (pododermatitis). At the stage of redness, swelling and a scab, change the environment and see a vet within a few days to check for infection and depth. Left alone, the ulcer deepens and can reach bone. First install several natural-wood perches of different thicknesses, lay soft material on the floor and begin weight loss. Do not use human ointment or bandages on your own judgment, and peeling the scab spreads infection. Forcing a bird with a painful foot to fly also damages the other foot.

IssuesA single perch of uniform thickness concentrated load on the same part of the sole. Obesity was left unaddressed and the soles were never checked, so the inflammation went unnoticed until it swelled.

ImprovementInstall 3 or more natural-wood perches of different thickness and material, and lay soft bedding such as bark chips. Review fruit amounts, record weight weekly and reduce. Check the soles weekly at hand-feeding and see a vet at the redness stage.

A 12-year-old wreathed hornbill. Over the past 2 months she has gradually lost weight despite a good appetite, and her keel bone has become prominent. Soft droppings persist, and she sometimes rests fluffed up. Her cage mate is healthy. The family caring for her includes a toddler and a grandmother undergoing chemotherapy. She has never had a fecal test.

Which is the most appropriate action for the owner?

1. It is natural decline with age, so increase fruit for nutrition
2. Prioritize the family's health and watch the bird for another month
3. The mate is healthy, so rule out infection and give vitamins
4. Consider chronic infection such as avian tuberculosis, see a vet, and keep immunocompromised family members away from care

AnswerD. Consider chronic infection such as avian tuberculosis, see a vet, and keep immunocompromised family members away from care

ExplanationChronic weight loss with a good appetite and ongoing diarrhea in a hornbill suggests avian tuberculosis (Mycobacterium infection) or chronic parasitic or fungal infection. Avian tuberculosis contaminates the environment through droppings and is a zoonosis that can infect immunocompromised people, so the toddler and the family member in treatment should avoid care duties, and the bird should be seen and tested within a few days. The mate may carry a latent infection even without symptoms. Assuming old age and increasing fruit adds iron load, and waiting prolongs the risk to people.

IssuesTwo months of weight loss was attributed to aging, and basic tests such as fecal exams were never done. Immunocompromised family members were doing the care, with no awareness of zoonotic risk.

ImprovementGet fecal tests at intake and annually, and record weight weekly to catch continued loss early. Have healthy adults do the care with gloves, hand washing and masks during cleaning. Tell the family's doctors that a bird is kept at home.

A 1-year-old red-billed hornbill. When swallowing fruit he stretches his neck repeatedly and holds his mouth half open as if uncomfortable. Opening the bill reveals white, cheese-like deposits at the back of the mouth and on the tongue, with bad breath. Recently he was fed overripe banana that had sat in the refrigerator for days and old pellets from long-term storage. Weight is slightly down.

Which is the most appropriate response?

1. Scrub off the white deposits with a cotton swab and disinfect the mouth with gargle solution
2. Suspect oral Candida or similar, stop the old food, and see a vet the same day for testing
3. Increase soft banana to make swallowing easier and watch for a week
4. Assume vitamin deficiency and mix supplements into the fruit

AnswerB. Suspect oral Candida or similar, stop the old food, and see a vet the same day for testing

ExplanationWhite cheese-like deposits in the mouth with difficulty swallowing are typical signs of fungal infection such as Candida or of Trichomonas, and overripe fruit and old feed encourage their growth. If lesions spread to the throat or crop the bird cannot eat, so see a vet the same day for oral testing and proper treatment. Scrubbing the deposits injures the mucosa, causing bleeding and worsening, and human gargle solution is harmful to birds. More sweet, soft fruit feeds the fungus. Supplements do not address the cause.

IssuesOverripe fruit and long-stored pellets were fed continuously, creating conditions for fungal growth in the mouth. The apparent difficulty swallowing was taken as the bird being fussy, delaying a check of the mouth.

ImprovementUse fresh fruit the same day and finish pellets within a month of opening. Watch bill movement and swallowing during hand-feeding, and open the bill monthly to check the color inside the mouth. Consult the clinic the same day if anything is wrong.

A 5-year-old great hornbill. In the evening, the moment a dog barked near the cage he panicked and flew head-on into the wire mesh. After falling to the floor he returned to the perch, but there is a vertical crack in the front of the casque (the structure on top of the bill) and blood is slowly seeping from the split. He cannot close his bill and does not bring food to his mouth when shown it.

Which is the most appropriate first response?

1. Fix the crack with super glue and watch if the bleeding stops
2. Squeeze the casque hard to stop the bleeding and rinse with water
3. Cover the head with a cloth, keep warm in a dark box, press gently with gauze and see a vet immediately
4. Wait a few days until he can eat, and see a vet if there is no improvement

AnswerC. Cover the head with a cloth, keep warm in a dark box, press gently with gauze and see a vet immediately

ExplanationThe casque is a hollow structure of bone and keratin, and cracks often reach the sinuses or bone. Bleeding and an inability to close the bill mean not only that he cannot eat but that infection and blood loss are life-threatening, so this calls for an immediate vet visit. Excitement increases bleeding, so cover the head, keep dark and quiet, and transport while pressing gently with gauze. Super glue damages tissue and seals in infection. Squeezing the casque widens the crack, and rinsing with water hinders clotting. Waiting days leads to starvation and infection beyond help.

IssuesThe cage was where the dog's barking could reach, with hard mesh directly in front when the bird startled. There was no awareness that this animal crashes when panicked, and no cushioning on the surfaces the casque could hit.

ImprovementPlace the cage out of sight and earshot of dogs and cats, and board or pad the surface in the main flight direction. Cover the cage with a cloth in advance when outside stimuli are expected. Make casque and bill trauma an immediate-vet rule and keep a dark transport box ready.

March; a pair of red-billed hornbills, a 7-year-old male and 5-year-old female, has entered breeding season. For several days the male has been relentlessly chasing the female, and this morning she is huddled in a corner with a bleeding wound on the back of her head and swelling around the eye. The male keeps calling in front of the nest box. The female does not move even when shown food.

Which is the most appropriate first response?

1. Pair fights are natural, so add nest boxes and wait for it to settle
2. Immediately separate the two with a divider, rinse and press the female's wound, and see a vet the same day
3. Scold the male, remove the nest box and stop breeding
4. Apply plenty of human antiseptic to the female's wound and let her rest in the same cage

AnswerB. Immediately separate the two with a divider, rinse and press the female's wound, and see a vet the same day

ExplanationDuring breeding season hornbills become intensely territorial and aggressive, and in a cage with no escape one can relentlessly attack and kill the other. Wounds to the head and around the eye are easily deepened by the powerful bill and can cause eye damage and head infection, so see a vet the same day. First protect life by physically separating the two, then rinse the wound with saline and press with gauze. Adding nest boxes does not stop the attacks, and human antiseptic damages mucosa and eyes. Resting in the same cage invites another attack.

IssuesThe chasing, a warning sign of attack, was observed for days without action, and there was no divider or hiding place for the female to escape to. Management did not anticipate the rise in aggression during breeding season.

ImprovementBefore breeding season, make the cage dividable and provide screened hiding places and multiple feeding platforms for the female. Set a rule to separate the same day if chasing or pecking is seen. Make compatibility checks before cohousing and daily observation records during breeding season a habit.

A 2-year-old red-billed hornbill. On a sunny afternoon during free flight in the living room, he flew hard into a window whose curtains were open. After falling to the floor he lay still for a while, then stood up, but the left wing hangs clearly lower than the right and he cannot lift it. He can walk. No bleeding is visible.

Which is the most appropriate response?

1. Hold the wing against the body, wrap lightly in a towel, rest in a dark box and see a vet the same day
2. Extend the wing to check for a fracture, and splint it with chopsticks if broken
3. He can walk, so judge it minor, return him to the cage and watch until tomorrow
4. Break a human painkiller into a small piece and give it for the pain

AnswerA. Hold the wing against the body, wrap lightly in a towel, rest in a dark box and see a vet the same day

ExplanationA wing that droops and cannot be lifted after a collision suggests a fracture, dislocation or shoulder ligament injury, and movement worsens the damage, so a same-day vet visit is the guideline. Until then, hold the wing against the body in its natural position, wrap lightly in a towel and restrict movement in a dark box. Extending the wing to check or splinting it yourself can shift bone fragments and injure vessels and nerves. Even if he can walk, wing damage does not heal on its own and he may never fly again. Human painkillers are harmful to birds with no known dose.

IssuesWindows were not covered during free flight, so a bird that cannot perceive glass as a barrier could hit it at full speed. The risk of letting an animal that needs flight space fly freely in a small room was underestimated.

ImprovementBefore free flight, always cover windows and mirrors with curtains or cloth, stop ceiling fans and inform the family. If possible, build a long flight cage rather than relying on indoor free flight. Keep a dark transport box and towel ready and note the after-hours contact of a clinic that treats hornbills.

In the morning, a 4-year-old red-billed hornbill is found hanging upside down from the side of the outdoor cage with one foot pushed through the wire mesh, flapping violently. The mesh openings are just big enough for a toe to fit through, and the ankle is beginning to redden and swell. She is calling and thrashing, and struggles even harder when approached.

Which is the most appropriate first response?

1. Watch from a distance until the thrashing stops
2. Pull the foot quickly out of the mesh
3. Support the body from below, cover the head with a cloth, free the toes one by one, rest in a dark box and see a vet
4. Cut the mesh open with pliers and leave the foot as it is

AnswerC. Support the body from below, cover the head with a cloth, free the toes one by one, rest in a dark box and see a vet

ExplanationHanging upside down, the more she struggles the more the ankle risks fracture, dislocation and impaired blood flow, and breathing becomes difficult. First support her weight to take the load off the foot, cover the head to darken and calm her, then free the toes one at a time following the direction of the mesh. If swelling remains afterward, a fracture or ligament injury is possible, so rest in a dark box and see a vet the same day. Pulling the foot breaks toes or the ankle. Watching only prolongs the damage, and cutting the mesh makes her thrash and get cut on the sharp ends.

IssuesThe mesh had openings just big enough for a toe, and the possibility of a foot pushing through was never considered. Discovered in the morning, it was unknown how long she had been hanging.

ImprovementUse mesh fine enough that toes cannot enter, or line the inside with boards or finer mesh. Install lighting or a camera so the cage can be checked at night. Keep a restraint cloth and dark transport box ready and share the procedure for a hanging bird with the family.

A 3-year-old red-billed hornbill. While trimming nails at home, one nail was cut too deep and blood is dripping from the tip. Pressing with a tissue has not stopped it after 5 minutes; the bird is thrashing and flailing its foot, and there are spots of blood on the floor. Potato starch and a commercial bird styptic powder are in the room.

Which is the most appropriate response?

1. Wrap the thrashing bird in a cloth, press styptic powder or potato starch onto the nail tip for several minutes, and see a vet if it does not stop
2. Stand the bird with the foot down so blood flows easily and wait for it to stop on its own
3. Rinse the nail tip under running water and let the bird fly free to distract it once clean
4. Sear the nail tip with a lighter to cauterize it

AnswerA. Wrap the thrashing bird in a cloth, press styptic powder or potato starch onto the nail tip for several minutes, and see a vet if it does not stop

ExplanationBleeding from a cut nail vessel is a large proportion of body volume in a small hornbill even in small amounts, and thrashing raises blood pressure and makes it harder to stop. Wrap in a cloth to calm the bird and press styptic powder or potato starch onto the bleeding point for several minutes. If it does not stop after several attempts or the bird becomes weak, see a vet the same day. Standing with the foot down, rinsing with water and free flight all prolong bleeding. Searing damages tissue, invites infection and risks burns on a thrashing bird.

IssuesThe nail was cut deep without checking the position of the blood vessel, and trimming was started without styptic powder at hand. Restraint was inadequate, so the bird thrashed and bleeding was prolonged.

ImprovementAlways have styptic powder at hand for nail trims and cut only the tips, a little at a time. Use natural-wood perches to wear nails down daily and reduce trimming. For large species or when unsure, have the clinic trim and learn restraint from the vet.

A 9-year-old great hornbill. When the door was opened during cage cleaning, he startled and struck his bill on the metal door frame. About 1 cm of the upper bill tip is chipped off, the cut surface is slightly red and a little blood is seeping. He rubs his bill on the floor and tries to pick up fruit, but it slips and he cannot grasp it. The casque looks undamaged.

Which is the most appropriate response?

1. The bill grows like a nail, so do nothing and expect it to grow back
2. File the chipped area smooth yourself and return to the normal diet the next day
3. Press the bleeding area gently with clean gauze, hand-feed soft fruit and see a vet the same day
4. Reduce food for a week until the pain subsides, and see a vet if he loses weight

AnswerC. Press the bleeding area gently with clean gauze, hand-feed soft fruit and see a vet the same day

ExplanationA chipped bill tip with a visible red surface means the damage reaches the vascular and nerve layers, with pain and infection risk. A bird that cannot grasp with the bill cannot eat and will weaken within days even if not a small species, so see a vet the same day for treatment of the surface and a check of the bite alignment. Until then, place bite-sized pieces of soft fruit directly in the mouth. The bill does grow, but with the tip missing the alignment goes wrong. Filing it yourself enlarges the damaged surface, and reducing food while waiting for weight loss invites weakness.

IssuesWhen opening the door for cleaning, no care was taken over the bird's position or startling movements, and the bill was struck on the metal frame. The owner did not understand that bill damage directly prevents eating and underestimated the urgency.

ImprovementDo cleaning and entry when the bird is calm, speaking first, and wrap hard metal parts such as door frames with padding. Make bill and casque damage a same-day vet rule and keep soft fruit for assisted feeding and a transport box ready.

A 6-year-old red-billed hornbill. While closing the door after putting in food, the bird poked her head out in curiosity and her long bill was caught between the door and the frame. The door was opened at once, but she is shaking her head with the bill half open, and a horizontal line is visible near the base of the upper bill. Bleeding is slight. She returned to the perch but is restless and rubbing her bill on it.

Which is the most appropriate response?

1. Keep dark and quiet, hand-feed food and water, photograph the line and bill movement, and see a vet the same day
2. The pain is temporary, so leave her alone and expect it to heal as she rubs it
3. Wrap the line on the bill with tape to fix it and remove it after a week
4. Touch the bill and move it side to side to check whether it is broken

AnswerA. Keep dark and quiet, hand-feed food and water, photograph the line and bill movement, and see a vet the same day

ExplanationWhen the long bill is pinched, a crack or fracture can occur at the base. A visible line with the bill held half open makes a crack likely, which can lead to malocclusion, infection and inability to eat, so a same-day vet visit is the guideline. Excitement spreads the damage, so keep dark and quiet and check whether she can eat by hand. Photos give the vet useful information. Leaving it worsens the crack; taping cannot hold the right position and damages the skin. Moving the bill to check is dangerous and advances a fracture.

IssuesThe owner did not anticipate the curious hornbill's habit of poking its head out of the door and closed it quickly. The door design made it easy to catch the long bill, and there was no habit of checking the bird's position before closing.

ImprovementAlways check the bird's position before closing the door and close it slowly. Install a feeding hatch so food can be changed without opening the door. Pad the door edges and share a same-day vet rule for bill and casque damage with the family.

At 10 a.m., the inner door of the outdoor flight cage was opened while the outer door was still open, and a 3-year-old wreathed hornbill flew out and landed on a high branch of a tree in the neighbor's garden. She is a registered CITES Appendix II individual and the registration card is at home. She is watching from the branch, but a neighborhood dog has started barking and crows are gathering. The temperature is 12°C.

Which is the most appropriate first action?

1. Climb the tree to try to catch her
2. Chase after her calling her name loudly and follow the direction she flies
3. Show a favorite fruit and call her back quietly, have a family member keep her in sight, and report to the police and municipal office
4. Wait for her to come back on her own, and search in a few days if she does not

AnswerC. Show a favorite fruit and call her back quietly, have a family member keep her in sight, and report to the police and municipal office

ExplanationRight after an escape, the best chance of recovery is while the bird is still in sight. Without startling her, show a favorite fruit and guide her with the usual call while a family member tracks her position without looking away. At the same time, report to the police and municipal office and circulate the registration card number. A tropical hornbill loses body heat rapidly outdoors at 12°C and is at high risk from crows and cats, so waiting days is fatal. Climbing the tree or chasing loudly drives her further away, and once out of sight recovery is nearly impossible.

IssuesThe purpose of the double door was not understood, and the inner door was opened with the outer door open. There was no set procedure for opening doors or checking whether the bird was near them. No contact list or recall training existed for an escape.

ImprovementPost a notice enforcing the double-door procedure: close and lock the outer door before opening the inner one. Train the bird in normal times to come to hand for fruit and a call. Carry a one-page sheet with a copy of the registration card, a photo and contacts for the police, municipal office and neighbors.

In the evening, in the dim cage, the owner stepped on the foot of a 2-year-old red-billed hornbill that was pecking at fallen fruit on the floor. The bird screamed and flew up to the perch, but cannot grip with the right foot, which hangs limp. One toe points in an unnatural direction and is bleeding slightly.

Which is the most appropriate response?

1. Press the bleeding with gauze, soften the floor, restrict movement and see a vet the same day
2. Turn the toe back into position by hand and tape it to the neighboring toe
3. Since it could fly up, assume the bones are fine and watch until morning
4. Give extra favorite foods to distract from the pain and have it walk to promote recovery

AnswerA. Press the bleeding with gauze, soften the floor, restrict movement and see a vet the same day

ExplanationAn inability to grip with a toe pointing unnaturally almost certainly indicates a fracture or dislocation; left alone it causes deformity, necrosis and bumblefoot. Press the bleeding with gauze, lower the perch and soften the floor to prevent worsening from a fall, restrict movement and see a vet the same day. Repositioning the toe yourself lets bone fragments injure vessels and nerves, and amateur taping cuts off blood flow. Being able to fly up does not rule out a fracture. Making it walk advances the injury.

IssuesThe owner entered in dim light without checking underfoot. Despite the bird's habit of foraging on the floor, the floor dish was placed near the entrance, creating a situation where the bird was underfoot.

ImprovementSpeak before entering to check the bird's position, turn on the light and watch your feet. Place the feeding platform high up or against the wall and remove fallen fruit daily. Make foot injuries a same-day vet rule and keep a transport box ready.

At midnight, woken by a noise, the owner finds a 15-year-old great hornbill lying on the floor after falling from a perch 2.5 m high. The wings are half open; he is breathing but cannot get up. He ate normally until yesterday, but had lost a little weight over the past month. The floor is concrete with only a thin layer of newspaper.

Which is the most appropriate response?

1. Put him back on the perch and watch until morning
2. Pour water into the bill to bring him round
3. Wrap in a towel, place in a dark box kept at around 28°C, call the emergency (after-hours) animal hospital and transport
4. He just wants to sleep on the floor, so cover him with a blanket and leave him

AnswerC. Wrap in a towel, place in a dark box kept at around 28°C, call the emergency (after-hours) animal hospital and transport

ExplanationA bird that fell from a high perch at night and cannot stand may have fractures or head trauma from the fall, and the cause of the fall is likely a hidden medical crisis such as weakness, a seizure or iron storage disease. This calls for contacting an emergency (after-hours) animal hospital now; until transport, restrict movement, wrap in a towel, place in a dark box and keep at around 28°C. Returning him to the perch risks another, more serious fall, and pouring in water causes aspiration. Covering with a blanket and leaving him means his condition will worsen by morning, too late to help.

IssuesDespite the warning sign of weight loss in an elderly bird, no vet visit was made, and a high perch with a hard floor, an environment that makes falls serious, was left as it was. No emergency hospital contact had been looked up.

ImprovementFor elderly birds or those losing weight, lower the perches and lay thick bark chips or padding on the floor. Record weight weekly and set a rule to see a vet if loss continues. Keep the contact of an after-hours clinic, a transport box and warming equipment ready.

On a weekend afternoon, a 4-year-old red-billed hornbill in indoor free flight picked up a child's marble lying on the floor with its bill, tossed it upward just like fruit and swallowed it whole. The owner, who saw it happen, caught the bird in a hurry. For now the bird is perching normally and shows no sign of distress.

Which is the most appropriate first response?

1. Turn the bird upside down and pat its back to make it bring up the marble
2. It does not seem distressed, so wait a few days for it to pass in the droppings
3. Give salt water to induce vomiting
4. Record the size of the object and the time, and urgently contact and visit a clinic that treats hornbills

AnswerD. Record the size of the object and the time, and urgently contact and visit a clinic that treats hornbills

ExplanationHornbills habitually toss and swallow objects whole, and a hard foreign body like a marble can lodge in the crop, stomach or intestine and cause obstruction or perforation. By the time symptoms appear it may be too late, so even without symptoms contact the clinic urgently, have an X-ray to locate it and let the vet decide on removal. Reporting the size, number and time of ingestion speeds diagnosis. Inverting and patting can send it into the airway and cause choking, and salt water causes toxicity. Waiting days means leaving a bowel obstruction untreated.

IssuesSmall hard objects were lying in the room where a bird with a habit of swallowing whole was flown free. Free flight was started without tidying the child's toys or checking the floor.

ImprovementBefore free flight, check the floor and shelves and put away everything small enough to swallow. In homes with children, limit free flight to a designated room. Make foreign body ingestion an immediate-contact rule even without symptoms, and post the clinic's number where it can be seen.

After lunch, a visitor unfamiliar with birds thought "it likes fruit" and handed a slice of avocado from a salad to a 5-year-old red-billed hornbill, which swallowed it on the spot. An hour later the bird is fluffed up and motionless on the perch, breathing somewhat fast and stretching its neck. No vomiting yet.

Which is the most appropriate response?

1. It is fruit, so assume no problem and carry on as usual
2. Suspect avocado poisoning, contact the clinic urgently, keep warm and transport
3. Give milk to neutralize the toxin
4. Make it drink lots of water to flush it out and check the droppings the next morning

AnswerB. Suspect avocado poisoning, contact the clinic urgently, keep warm and transport

ExplanationPersin in avocado is highly toxic to birds and can cause respiratory distress and heart failure, with death within hours. Fluffing up, rapid breathing and neck stretching after ingestion are the onset of poisoning and call for an immediate vet visit. Contact the clinic, report the amount and time, and transport quietly while keeping warm. Birds cannot digest milk and it has no neutralizing effect. Large amounts of water do not remove the toxin and risk aspiration. Dismissing it as fruit is fatal.

IssuesFamily and guests did not know which foods are toxic to birds, and anyone could feed it on the basis that it likes fruit. There was no rule banning guests from feeding the bird.

ImprovementPost a list of forbidden foods on the cage: avocado, chocolate, citrus, raisins and others. Tell guests and family that only the owner feeds the bird. Decide in advance the poisoning contact number and how to record the time of ingestion.

A 3-year-old red-billed hornbill. With winter coming, the owner began giving two mandarin orange segments daily "for vitamins" plus a few highly palatable raisins as treats. The staple is low-iron pellets, but lately the fruit has increased and the bird leaves the pellets. The bird is lively and weight is unchanged, but the abdomen feels slightly firm to the touch.

Which is the most appropriate view of this feeding and response?

1. The bird is lively and weight is stable, so the current feeding can continue
2. Stop the mandarin and raisins, return to a low-iron pellet staple, and have the firm abdomen checked by a vet within a few days
3. Vitamin C suppresses iron absorption, so give even more mandarin
4. If the bird leaves pellets, stop them and meet its needs with fruit alone

AnswerB. Stop the mandarin and raisins, return to a low-iron pellet staple, and have the firm abdomen checked by a vet within a few days

ExplanationHornbills absorb iron from the gut very efficiently, and combining high-iron raisins daily with vitamin C-rich citrus that promotes iron absorption is the feeding most to be avoided, as it accelerates iron storage disease. Iron accumulates in the liver and the bird is already severely ill by the time symptoms show, so even without symptoms a firm abdomen may mean liver enlargement; see a vet within a few days for blood tests. Continuing because the bird seems lively is dangerous, fruit alone is nutritionally unbalanced, and increasing vitamin C is the exact opposite of what is needed.

IssuesHuman health assumptions were applied directly to the bird, without knowing that iron combined with citrus is harmful to frugivorous birds. Treats were allowed to displace the staple, unbalancing the diet.

ImprovementLimit fruit to low-iron kinds such as papaya, apple and melon, and never give citrus or raisins. Feed the low-iron pellet staple first and fruit afterward. Make an annual blood test to check liver values a habit.

Late on a January night, heavy snow causes a power outage, stopping the air conditioner and panel heater in the room with the indoor flight cage of a 7-year-old great hornbill. In one hour the room has dropped from 25°C to 16°C and is still falling. The bird is fluffed up and motionless on the perch. In the house there are disposable hand warmers, blankets, cardboard boxes and a portable gas stove.

Which is the most appropriate response?

1. Move the bird to a cardboard box, place cloth-wrapped hand warmers outside the box or in its corners, and cover with a blanket to keep warm
2. Burn the portable gas stove next to the bird to heat the room
3. Stick hand warmers directly on the feathers to warm it quickly
4. Even a tropical bird can endure one night, so do nothing until morning

AnswerA. Move the bird to a cardboard box, place cloth-wrapped hand warmers outside the box or in its corners, and cover with a blanket to keep warm

ExplanationTropical hornbills lose strength rapidly below 15°C and can reach a dangerous state from hypothermia within hours. Rather than heating the whole large cage, it is more efficient and safer to move the bird to a small cardboard box, place cloth-wrapped hand warmers where the bird cannot touch them directly and cover with a blanket to trap heat. Warmers stuck directly on cause low-temperature burns and risk ingestion if they come loose during struggling. A gas stove risks carbon monoxide poisoning and fire, and in a closed room the bird collapses first. Leaving it until morning leads to hypothermia.

IssuesThere was no preparation for keeping warm in a midwinter power outage, and awareness that tropical birds are vulnerable to cold was weak. Heating relied solely on electricity, with no power-free warming method prepared.

ImprovementKeep a power-outage kit of cardboard box, blanket, disposable hand warmers and thermometer together. If possible, obtain a battery pack or generator. Set a procedure to move the bird to a box and keep warm during winter outages, and to evacuate to a warm place if the outage lasts more than 2 hours.

2 p.m. in August, 36°C. The shade cloth on the outdoor flight cage was blown off by the wind and direct sunlight was hitting the cage. A 5-year-old wreathed hornbill is on the floor with wings spread and drooping, bill wide open, breathing fast, staggering and unable to perch. The fruit put in that morning has dried out and the water dish is empty.

Which is the most appropriate first response?

1. Submerge the body in ice water to bring the temperature down fast
2. Move to a cool, shaded room, wet the feet and underside of the wings with room-temperature water, fan, and contact the clinic
3. Pour cold water into the bill to rehydrate
4. Reattach the shade cloth and watch on the spot until it settles

AnswerB. Move to a cool, shaded room, wet the feet and underside of the wings with room-temperature water, fan, and contact the clinic

ExplanationWings spread and drooping with open-mouth breathing and staggering is a severe stage of heatstroke, and left untreated leads to death from organ damage. Move immediately to a cool indoor space, wet areas with blood vessels close to the surface such as the feet and underside of the wings with room-temperature water, fan, and contact the clinic while gradually lowering body temperature. Even if consciousness returns, a same-day vet visit is required. Ice water causes shock through sudden vasoconstriction, and water poured into the bill of a bird with impaired consciousness is aspirated. Fixing the shade and waiting delays cooling.

IssuesThe shade cloth fastening was not checked on a scorching day, and the bird was left in direct sunlight until afternoon. The water dish and fruit were not checked during the day, and there was no habit of patrolling to check temperature and the bird's condition.

ImprovementIn summer, check the shade fastening every morning, and on days above 30°C move the bird indoors or use air conditioning. Provide several water dishes and feed fruit in small amounts several times. Patrol at least twice during the day, and make sure the whole family knows the signs of drooping wings and panting.

A 6-year-old child has been helping daily by washing the food dish of a 3-year-old red-billed hornbill and picking up fallen fruit with bare hands. Sometimes the child ate snacks afterward without washing hands. For 3 days the child has had repeated fever and watery diarrhea. The bird has had slightly soft droppings for a week but is lively with a good appetite.

Which is the most appropriate action for the owner?

1. Decide it is a cold in the child, unrelated to the bird, and let the child continue helping
2. Make rehoming the bird the top priority and look for a new owner right away
3. Take the child to a pediatrician and mention the bird, have the bird get a fecal test, and suspend the child's care duties
4. Scalding the cage will solve it, so leave the bird and child as they are

AnswerC. Take the child to a pediatrician and mention the bird, have the bird get a fecal test, and suspend the child's care duties

ExplanationIt is highly likely that bacteria such as Salmonella reached the child's mouth from hands that touched droppings and leftover food. Fever and watery diarrhea in a young child easily cause dehydration, so first see a pediatrician, mention the contact with the bird and get appropriate testing. At the same time, have the bird get a fecal test, and if it is a carrier, treat it and disinfect the environment. Until the source is identified, suspend the child's care duties and have an adult handle care with gloves and hand washing. Assuming no link to the bird delays diagnosis, rehoming is not an infection control measure, and disinfection alone does not treat the child.

IssuesThe child was allowed to handle droppings bare-handed, and hand washing was not enforced. The bird's soft droppings were left for a week, and the family had no awareness of zoonotic disease.

ImprovementDo not let young children handle droppings or food dishes; have adults do care with gloves and wash with soap afterward. See a vet if the bird's droppings are abnormal for 2 days. Wash dishes separately from human tableware and schedule an annual fecal test.

To form a pair, a 2-year-old female red-billed hornbill was acquired from a domestic breeder. Out of the shipping box she is lively with a good appetite. The resident 4-year-old male is healthy, but the owner wants her "to settle in quickly" and intends to release her into the male's flight cage on the day of arrival. The new bird has not yet had a health check or fecal test.

Which is the most appropriate response?

1. She is lively, so house them together the same day and check compatibility early
2. Quarantine in a separate room for at least 30 days, complete a health check and fecal test, then introduce in stages
3. Put them in the same cage but keep food dishes separate for a week
4. Quarantine is unnecessary, but disinfect the cage just in case before housing together

AnswerB. Quarantine in a separate room for at least 30 days, complete a health check and fecal test, then introduce in stages

ExplanationEven a bird that looks lively may carry parasites, bacteria, fungi or avian tuberculosis with an incubation period, and these often break out after the stress of transport. Quarantine the new bird in a separate room for at least 30 days, confirm there are no problems with a health check and fecal test, then introduce through a divider before housing together in stages. During quarantine, care for her after the resident bird and use separate equipment. Same-day cohousing risks both infecting the resident bird and attack by the territorial resident male. Separate dishes alone or disinfection alone do not prevent contact transmission.

IssuesThe owner did not understand the purpose of a quarantine period and equated lively with healthy. In the rush to form a pair, the danger of suddenly putting two strongly territorial hornbills in the same space was also overlooked.

ImprovementBefore acquiring a new bird, prepare a quarantine room and cage and build at least 30 days of quarantine and a health check into the plan. During quarantine, separate the order of care and the equipment. Start introductions through a divider and set a rule to stop if chasing occurs.

April; a 6-year-old female red-billed hornbill. Her mate has been carrying mud to the nest box and she had begun sealing the entrance a few days ago, but this morning she is not in the box; she is in a corner of the floor bobbing her tail, abdomen swollen, straining intermittently. She has not passed droppings and walks awkwardly. She laid last year too, but this winter there was little daylight and the diet was mostly fruit.

Which is the most appropriate response?

1. Push her into the nest box so she can lay calmly
2. Press on her abdomen to help the egg out
3. Laying is natural, so leave it to the male and watch until tomorrow
4. Suspect egg binding, keep warm at around 30°C, dark and quiet, and see a vet the same day

AnswerD. Suspect egg binding, keep warm at around 30°C, dark and quiet, and see a vet the same day

ExplanationA breeding-season female with a swollen abdomen, intermittent straining and no droppings strongly suggests egg binding. The egg compresses the cloaca, impairing defecation and nerves, and she can deteriorate within half a day to a day, so a same-day vet visit is the guideline. Until then keep warm at around 30°C, dark and quiet to conserve her strength. Calcium deficiency and lack of daylight weaken shell formation and uterine contractions. Pressing the abdomen can break the egg and injure the oviduct; pushing her into the box or waiting until tomorrow invites a fatal delay.

IssuesOver winter, a fruit-heavy diet left her short of calcium and sunlight, and her body was not prepared for laying. The straining was read as laying in progress, and egg binding was not known as an emergency.

ImprovementFrom before breeding season, dust insects with calcium supplement and use a UV lamp. Observe a laying female's droppings and abdomen daily and set a rule to see a vet if straining lasts several hours. Have a warming box and the clinic's number ready for egg binding.

A 9-year-old female red-billed hornbill. Standard weight is 150 g but she has risen to 210 g, and she breathes open-mouthed after flying even a short distance. Her abdomen is soft and swollen, and she increasingly leaves the perch to spend time on the floor. Because she enjoys it, the owner has left grapes and banana out all day and given large amounts of mealworms daily. The cage is 1.5 m wide with almost no flight distance.

Which is the most appropriate response?

1. Reduce fruit and insects, return to a low-iron pellet staple, provide flight space and see a vet within a few days
2. She is just fat, so halve the food and weigh her in a month
3. Not flying is laziness, so chase her to force exercise
4. A soft belly is a sign of health, so keep things as they are

AnswerA. Reduce fruit and insects, return to a low-iron pellet staple, provide flight space and see a vet within a few days

ExplanationWeight 40% above standard, open-mouth breathing after slight exertion and a swollen abdomen point to obesity and fatty liver, and possibly liver enlargement from iron storage disease. Unlimited sugary fruit and excess insects are classic causes of obesity. First return to a low-iron pellet staple, give fruit in set amounts split into several feedings, and provide flight space. The abdominal swelling must be distinguished from liver disease, so see a vet within a few days for blood tests. Sudden food restriction strains the liver, and forced exercise by chasing causes breathing distress and collisions.

IssuesPalatable fruit and insects were given without limit while the pellet staple was neglected. With no flight space, exercise was inadequate, and with no weighing the 40% gain went unnoticed.

ImprovementMake low-iron pellets the staple, set a daily fruit amount split between morning and evening, and limit insects to a few times a week. Build a flight cage at least 3 m wide, record weight weekly and review when it exceeds standard by 10%. Check the liver with an annual blood test.

A July morning, room temperature 30°C. A 5-year-old red-billed hornbill shook his head and regurgitated right after eating fruit, three times in 2 hours. The vomit smells sour. Melon left out since last night is slimy on the surface and attracting flies. The bird is fluffed up and keeps peering into the water dish and moving away.

Which is the most appropriate first response?

1. Regurgitation is courtship behavior, so ignore it and continue the normal diet
2. Withhold all food and water for a full day to rest the stomach
3. Break a human anti-nausea pill into a small piece and give it
4. Remove the rotten fruit, keep warm, offer a little fresh food, photograph the vomit and see a vet the same day

AnswerD. Remove the rotten fruit, keep warm, offer a little fresh food, photograph the vomit and see a vet the same day

ExplanationFruit left out in summer rots within hours, and bacteria and yeast multiply and cause vomiting in a bird that eats it. Repeated vomiting over a short time leads to rapid dehydration, and crop infection or bacterial infection is possible, so a same-day vet visit is the guideline. First remove the rotten material, keep warm, offer only a small amount of fresh food to see whether he can keep it down, photograph the vomit and go to the vet. Courtship regurgitation is directed at a partner and differs from sour-smelling, repeated vomiting. Withholding food and water from a small bird causes hypoglycemia and dehydration, and human medication is dangerous.

IssuesFruit was left out overnight in hot weather, leaving rotten food available to the bird. Knowledge of hot-season food management and of distinguishing vomiting from courtship behavior was lacking.

ImprovementIn summer, feed fruit in small amounts morning and evening and remove leftovers within 2–3 hours. Wash dishes every time and use air conditioning on days above 28°C. Make vomiting twice or more a same-day vet rule and get into the habit of photographing the vomit.

May; a 7-year-old female red-billed hornbill has been in the nest box for 3 weeks with the entrance sealed with mud and droppings. The male passes fruit and insects through the slit. This morning a dozen or more flight and tail feathers were found in a pile below the box. Peering through the slit, the female has almost no wing feathers and looks ragged, but she takes food from the male and responds to calls.

Which is the most appropriate interpretation and response?

1. A serious illness caused the feather loss, so break open the box, remove her and see a vet
2. Assume mite infestation and spray insecticide into the box
3. This is the normal molt of an incubating female; leave the box alone and check the male's feeding and food consumption daily
4. The male is not feeding enough, so widen the entrance and have the owner put food in directly

AnswerC. This is the normal molt of an incubating female; leave the box alone and check the male's feeding and food consumption daily

ExplanationWhile a female hornbill is sealed in the nest cavity incubating, she sheds her flight and tail feathers all at once, cannot fly, and grows new feathers inside the nest. This is a normal molt specific to the species and not illness as long as she takes food and responds. The greatest risks at this stage are the nest being disturbed or the male's feeding being interrupted. The owner should leave the box alone and record daily the amount and type of food the male carries and the female's responses. If the male stops eating or the female stops responding, consult a vet. Breaking the nest, insecticide or widening the entrance all lead to abandonment of the breeding attempt or poisoning.

IssuesThe owner did not know about the hornbill's incubation molt and almost mistook feather loss for disease. No information on the normal course of breeding versus abnormalities had been obtained from a vet or breeder beforehand.

ImprovementBefore attempting breeding, learn the stages and timing from sealing through incubation, molt and fledging, and prepare an observation chart. Fit the nest box with a viewing window or camera and record the male's food consumption daily. Agree criteria for abnormality with the vet in advance.

At night, a 3-year-old red-billed hornbill is lying on the floor and does not respond when called. A finger beside the keel bone feels no clear beat, and the rise and fall of the chest is very slight and hard to see. The eyes are half open and there is vomited fruit around the bill. The emergency (after-hours) animal hospital is 30 minutes away by car.

Which is the most appropriate response?

1. Perform repeated chest compressions on the keel bone as for a human
2. Give mouth-to-bill rescue breaths
3. There is no response, so judge it dead and leave it until morning
4. Wipe the vomit from around the bill to clear the airway, and transport immediately in a dark, warmed box while calling the emergency hospital

AnswerD. Wipe the vomit from around the bill to clear the airway, and transport immediately in a dark, warmed box while calling the emergency hospital

ExplanationBirds have thin keel bones and ribs; human-style chest compressions cause fractures and internal organ damage and do not suit a respiratory system based on air sacs. When the bird is unresponsive and the beat is hard to feel, the best an owner can do is wipe vomit from the bill and nostrils to clear the airway, keep it in a dark, quiet box at 28–30°C, and call the emergency hospital with the arrival time while transporting immediately. Blowing into the bill pushes vomit into the lungs. Even slight chest movement means the bird may be alive, and assuming death and leaving it until morning throws away the chance of rescue.

IssuesThe owner had never checked the normal breathing rate or keel-side heartbeat and could not compare with normal in a crisis. It was not known that chest compressions are dangerous in birds, and no emergency contact or transport preparation had been made.

ImprovementWhile the bird is healthy, learn what the beat beside the keel and the chest movement of breathing feel like. Keep a warmable transport box, hand warmers and blanket as a set and post the emergency hospital's number. Share the order of airway, warmth, transport with the family.

December; a 4-year-old red-billed hornbill perched for a long time in front of a panel heater mounted on the wall of the indoor cage. In the evening, the bird came down to the floor favoring one foot; on the sole, the base of the big toe is white and macerated-looking with red swelling around it. The bird keeps pecking at the foot with its bill. The heater surface was hot to the touch.

Which is the most appropriate first response?

1. Move the heater away, cool the area with room-temperature water for a few minutes, protect it, and see a vet the same day
2. Apply a thick layer of human burn ointment, wrap with gauze and watch for a few days
3. Hold ice directly on the area for 10 minutes or more
4. Tape over the area to stop the pecking and keep using the heater as is

AnswerA. Move the heater away, cool the area with room-temperature water for a few minutes, protect it, and see a vet the same day

ExplanationA white change with swelling on a sole that was in prolonged contact with a heater surface is a low-temperature burn; the skin on a bird's sole is thin, and infection can progress to bumblefoot or necrosis, so a same-day vet visit is the guideline. First move the heat source away, cool the area with room-temperature water for a few minutes to halt progression, keep the bird dark and quiet so it does not peck, and transport. Human ointment is unsuitable for birds and causes poisoning when licked. Ice applied directly adds frostbite. Tape damages the skin, and continuing the heater causes another burn.

IssuesA hot heater was installed where the bird could touch it directly, and its temperature was never checked. The bird's habit of staying long in a warm spot was not considered, and the risk of contact burns was overlooked.

ImprovementMount heaters outside the cage or behind mesh out of reach of bill and feet. Check the surface temperature by hand and keep a thermometer in the cage at 22–30°C. Check the soles daily at hand-feeding and see a vet the same day for anything abnormal.

A 6-year-old red-billed hornbill. Startled by a noise at night, she flew in the dark cage, hit her head on the wall and fell to the floor. Ten minutes later she is standing, but her head tilts to the right, her left eye stays closed and she walks slowly in circles in the same direction. There is a little blood on the feathers of her head. The bill and casque are undamaged.

Which is the most appropriate response?

1. It is a mild concussion, so return her to the perch and let her sleep quietly until morning
2. Massage the neck to straighten it
3. Shine a bright light to check whether the eye opens and keep filming
4. Wrap in a towel in a dark box, suspect head trauma, contact the emergency hospital and transport

AnswerD. Wrap in a towel in a dark box, suspect head trauma, contact the emergency hospital and transport

ExplanationHead tilt, one eye closed and circling after a collision are signs of brain or inner ear damage or intracranial bleeding from head trauma, and can worsen within hours, so this calls for contacting the emergency (after-hours) animal hospital now. A bird's skull is thin, and internal damage can be severe even when the visible wound is small. Until transport, wrap in a towel in a dark box to prevent stimulation and another fall. Massaging the neck spreads the damage, and strong light can trigger seizures. Returning to the perch risks another fall, and losing time filming is dangerous.

IssuesThe possibility of the bird startling and flying at night was not considered, and the dark cage walls had no cushioning. Not knowing that head tilt and circling are serious neurological signs, the owner almost dismissed it as a concussion.

ImprovementKeep a dim night light on and pad the wall surfaces the bird may hit when startled. Make neurological signs after a head impact (head tilt, circling, one eye closed) an immediate-vet rule. Keep a dark transport box and the emergency hospital's number ready.

An 8-year-old male great hornbill in breeding season. The instant the owner put a hand into the nest box to clean it, the powerful bill clamped onto the back of the hand. The bill is biting deep, will not release, and the hand is bleeding. The more the owner tries to pull away from the pain, the harder the bird squeezes. A cloth and the bird's favorite grapes are nearby.

Which is the most appropriate first action?

1. Endure the pain and wrench the hand free by force
2. Grab the bill with both hands and pry it open
3. Hit the bird's head to startle it into opening its mouth
4. Stop moving, do not pull the hand, cover the head with the cloth and show the grapes to make it open its bill

AnswerD. Stop moving, do not pull the hand, cover the head with the cloth and show the grapes to make it open its bill

ExplanationA large hornbill's bill clamps with great force, and pulling the hand makes it squeeze harder and tears the wound. First stop moving and do not pull; cover the head with a cloth to block its vision and calm it, then show a favorite food to make it open its bill. Once released, return it to the perch and keep your distance for the day. Bites are deep and infect easily, so rinse under running water, apply pressure, and see a surgeon if bleeding does not stop or there is swelling or heat. Prying the bill open can break the casque or bill, and hitting the bird makes it bite harder and destroys trust.

IssuesIn breeding season, when territoriality peaks, a hand was put into the nest box, the center of the territory, without protection. The strength of a large species' bill and the procedure for a bite were not known in advance.

ImprovementAvoid work around the nest box in breeding season, or move the bird to another section first. Protect arms with thick gloves and long sleeves when handling. Keep a cloth and a favorite food at hand, and share the bite procedure and criteria for seeing a doctor with the family.

A 5-year-old red-billed hornbill still wearing the identification leg band fitted as a chick. This morning she was reluctant to put weight on one foot when perching; on inspection the leg is swollen above and below the band, the band is cutting into the skin, and the foot beyond it is purplish and cold. She keeps pecking at the band. The band is metal and there is no tool to cut it.

Which is the most appropriate response?

1. Blood flow may be compromised; restrict movement, see a vet the same day and ask to have the band removed
2. Cool it and watch for a few days until the swelling goes down
3. Twist the band open with pliers to remove it
4. Oil the band to make it slide and pull it off even if forced

AnswerA. Blood flow may be compromised; restrict movement, see a vet the same day and ask to have the band removed

ExplanationA band cutting in with a purple, cold foot beyond it is a sign that blood flow is nearly cut off; left alone, the foot becomes necrotic within days and is lost. See a vet the same day to have it removed safely with proper tools. Until then restrict movement and keep her dark and quiet so she does not peck the band. Twisting the band with household pliers breaks the thin leg bone, and oiling and pulling injures the swollen tissue and makes the swelling worse. Watching for days is the same as waiting for necrosis.

IssuesThe possibility that the band would no longer fit with growth or swelling was not considered, and the band fitted as a chick was left on without inspection. Knowledge that changes in foot color and temperature signal impaired blood flow was lacking.

ImprovementCheck regularly that the band rotates freely and consult a vet early if it is tight. If identification is required for a CITES individual, consider alternatives such as a microchip. Check the color and temperature of the soles and legs weekly and see a vet the same day for anything abnormal.

A 2-year-old red-billed hornbill. During free flight she fell into a basin of water in the bathroom, and by the time the owner noticed she was soaked to the head and struggling to grip the rim. Lifted out, she is drenched all over, limp with wings spread, and trembling finely. She brought up a little water from her mouth. Room temperature is 20°C.

Which is the most appropriate first response?

1. Blast her with a hair dryer at close range to dry her quickly
2. Let her perch and watch until she dries naturally
3. Hold her upside down and shake to get all the water out
4. Blot the water with a towel, lower the head and wipe water from the mouth, keep warm at around 28°C and contact the clinic

AnswerD. Blot the water with a towel, lower the head and wipe water from the mouth, keep warm at around 28°C and contact the clinic

ExplanationHornbills rarely bathe and their feathers do not repel water well, so falling into water strips body heat rapidly, and water in the airway causes aspiration pneumonia. First blot the water with a towel, lower the head slightly and wipe water from the mouth and nostrils, then warm in a box at around 28°C until the trembling stops. If she brought up water or is limp, pneumonia or progressing hypothermia is possible, so see a vet the same day. Hot air at close range causes burns and overheating, and shaking upside down sends water into the airway. Natural drying lets hypothermia progress.

IssuesA container of water was in the free-flight area and the bathroom door was open. It was not anticipated that a flying bird can mistake a water surface for floor and fall in, and hazards were not checked before free flight.

ImprovementBefore free flight, empty all containers of water and close bathroom and kitchen doors. Use a shallow, wide water dish in the cage, no deeper than the feet can reach. Check in advance how to use a warming box, towel and hair dryer (low setting, at a distance) for a drowning incident.

A 3-year-old red-billed hornbill in indoor free flight was repeatedly pecking at a live extension cord. With a loud crack the bird fell to the floor and lies motionless with wings spread, the tip of its bill slightly blackened. It is breathing, but shallowly. The cord is still plugged in and the bird's foot is touching it.

Which is the most appropriate first action?

1. Immediately pick the bird up with bare hands and return it to the cage
2. First unplug the cord to cut the power, then keep the bird warm and contact the clinic immediately
3. Splash water on the bill to cool the burn
4. It is not moving, so judge it dead and do not touch it until morning

AnswerB. First unplug the cord to cut the power, then keep the bird warm and contact the clinic immediately

ExplanationIf an electrocuted bird is still touching a live cord, touching it with bare hands electrocutes the owner too. Unplugging the cord to cut the power is the top priority; then wrap the bird in a towel, keep warm in a dark box and contact the clinic at once. Besides burns in the mouth, electric shock can cause arrhythmia and pulmonary edema hours later, so a same-day vet visit is needed even if the bird seems to settle. Splashing water on the bill risks electric shock and lowers body temperature. If it is breathing it is alive, and leaving it until morning is fatal.

IssuesThe habit of a curious bird to peck at everything was not considered, and a live cord was left exposed in the free-flight room. The basic safety step of cutting the power first in an electric shock was not known.

ImprovementCover cords in the free-flight room or unplug and put them all away during free flight. Share with the family a list of things dangerous to peck (cords, houseplants, small objects). Confirm the order of cutting power, warming and vet visit for electric shock, and post the clinic's number.

A 6-year-old female red-billed hornbill preparing to breed. The top of the nest box was opened for inspection, and in a moment of inattention the bird perched on the edge and the wind blew the lid down onto her toe. The lid was lifted at once, but the base of the toe is swollen and the skin is split and bleeding. She will not put the foot down and grips the perch with one foot.

Which is the most appropriate response?

1. Bleeding is slight, so let it stop on its own on the perch
2. Pour human antiseptic directly on the wound and wrap with an adhesive bandage
3. Pull the toe to straighten the bend
4. Apply pressure with gauze, restrict movement, photograph the wound and see a vet the same day

AnswerD. Apply pressure with gauze, restrict movement, photograph the wound and see a vet the same day

ExplanationA swollen toe base with a laceration and refusal to bear weight may mean a fracture, ligament injury or tendon rupture; left alone, infection or deformity can leave her unable to grip a perch. Apply pressure with gauze, lower and soften the floor to restrict movement, and see a vet the same day. A photo of the wound helps the vet's assessment. Human antiseptic damages tissue and an adhesive bandage cuts off blood flow. Pulling the toe to straighten it risks displacing bone fragments. Even slight bleeding, if it continues, is a heavy burden on a small bird.

IssuesThe lid was left open while the owner looked away in a space where the bird was present, and the risk of the wind dropping it was not considered. A nest box whose design could pinch a bill or toes was used without a latch.

ImprovementFit the nest box lid with hinges and a securing hook, and never let go of it while open. Inspect with the bird moved to another section or when it is away. Make pinching accidents with doors, lids and gaps a same-day vet rule and keep gauze and a transport box ready.

On a summer afternoon, a 3-year-old red-billed hornbill in free flight in the living room flew toward the spinning ceiling fan, was struck on the wing by a blade and fell to the floor. The bird got up at once but drags the right wing; several flight feathers are broken with split tips, and there is bleeding at the base of the wing. For a moment the owner did not understand what had happened.

Which is the most appropriate first response?

1. Stop the fan, press the bleeding with gauze, wrap the wing against the body, and see a vet the same day in a dark box
2. Pull out all the broken feathers from the root to stop the bleeding
3. The bird got up, so judge it minor, return it to the cage and observe until tomorrow
4. Spread the wing, cut the broken feathers short with scissors and disinfect

AnswerA. Stop the fan, press the bleeding with gauze, wrap the wing against the body, and see a vet the same day in a dark box

ExplanationA wing struck by a spinning fan often hides not just feather damage but fractures, joint dislocation and deep muscle injury; if it is dragged and bleeding, a same-day vet visit is the guideline. First stop the fan to prevent a second accident, press the bleeding with gauze, hold the wing against the body in its natural position and wrap lightly, then transport at rest in a dark box. Pulling broken feathers from the root causes heavy bleeding from the vascular shaft. Spreading the wing to cut feathers worsens a fracture, and getting up does not rule out bone damage.

IssuesThe ceiling fan was not stopped before free flight, and the danger of a rotating object in the flight path was overlooked. There was no fixed checklist for the room before free flight.

ImprovementMake a pre-flight checklist (stop fans, cover windows, empty water, put away cords, close doors) and check it every time. If possible, switch from indoor free flight to exercise in a flight cage. Make wing injuries a same-day vet rule.

The day before, a contractor had sprayed insecticide on the persimmon tree in the garden. A family member unaware of this picked up fallen fruit and fed it to a 4-year-old red-billed hornbill. The next morning the bird is drooling, wings trembling, staggering and slipping off the perch. The pupils look constricted and the droppings are watery. The owner only heard about the spraying this morning.

Which is the most appropriate response?

1. It ate too much fruit, so fast it to rest the gut
2. Give milk to dilute the poison
3. Decide not to feed garden fruit in future and wait for the bird to recover
4. Suspect pesticide poisoning, ask the contractor for the product name, contact the clinic urgently, keep warm and transport

AnswerD. Suspect pesticide poisoning, ask the contractor for the product name, contact the clinic urgently, keep warm and transport

ExplanationDrooling, trembling, staggering, constricted pupils and watery droppings after eating freshly sprayed fruit are signs of poisoning by an insecticide such as an organophosphate, and death follows if it progresses to paralysis of the breathing muscles. Contact the clinic now, and confirm the product name and spraying time with the contractor to speed decisions on antidote treatment. Until transport, keep warm, dark and quiet and put nothing in the mouth. Fasting does not address the cause, milk does not dilute the poison and risks aspiration, and waiting for recovery is fatal.

IssuesThe garden spraying was not shared within the family, and fallen fruit was fed without checking. There was no awareness that, unlike store-bought fruit, garden fruit may carry pesticides, wild bird droppings and insects.

ImprovementMake it a rule to feed only washed, purchased fruit and never fruit from the garden or park or wild insects. Tell the whole family about planned spraying or pest control and keep the bird away afterward. Decide in advance the poisoning contact and the procedure for reporting the product name.

Early summer; a family member handed cherries brought by a visitor, pits and all, to a 5-year-old red-billed hornbill. The bird swallowed about 10 whole, one after another. Two hours later the bird keeps stretching its neck and making swallowing motions, and several hard lumps can be felt lined up in the crop. No droppings yet, but the bird is still lively.

Which is the most appropriate response?

1. The pits will pass in the droppings, so give plenty of water and wait until tomorrow
2. Press hard on the crop with your fingers to force the pits out of the mouth
3. Contact the clinic, report the number swallowed, follow their instructions and see a vet the same day
4. The bird is lively so there is no problem; the rest of the cherries can be given too

AnswerC. Contact the clinic, report the number swallowed, follow their instructions and see a vet the same day

ExplanationWild hornbills swallow large-pitted fruit whole and regurgitate the pits, but in captivity swallowing many hard pits at once can cause them to lodge in the crop or stomach and obstruct. Neck stretching and hard lumps lined up in the crop are signs that passage is stalled; first contact the clinic with the number and time, and see a vet the same day for an X-ray to locate them. Pressing the crop injures the esophagus and can send a pit into the airway. Plenty of water does not move hard pits, and giving more guarantees an obstruction.

IssuesA family member unaware of the swallow-whole habit gave fruit with pits, and the owner had set no rules for preparing fruit. Food brought by visitors was allowed to reach the bird unmanaged.

ImprovementMake it a family rule to remove pits and cores and cut fruit into bite-sized pieces before feeding. Post on the cage which fruits are allowed and how to prepare them. When guests visit, only the owner feeds the bird. Make contacting the clinic the rule for any ingestion, even without symptoms.

At 9 p.m., an earthquake of seismic intensity 6-lower tilts the posts of the outdoor flight cage and buckles part of the mesh. A 5-year-old black-and-white hornbill inside is panicking and crashing into the mesh. The municipality has issued an evacuation order and the family is about to head to the shelter. The outside temperature is 8°C. At hand are a hard carrier, towels, hand warmers, and 2 days' worth of fruit and pellets.

Which is the most appropriate response?

1. Darken the area to calm the bird, restrain it in a towel, place it in the carrier, keep warm, and evacuate together with the registration card and food
2. Leave the bird in the cage with extra food and come back to check once things settle
3. Open the cage door so the bird can escape freely
4. Chase and grab the panicking bird with bare hands

AnswerA. Darken the area to calm the bird, restrain it in a towel, place it in the carrier, keep warm, and evacuate together with the registration card and food

ExplanationA tilted cage can collapse in an aftershock, crashing into the mesh risks casque and wing damage, and 8°C outside is fatal to a tropical bird, so take the bird along when evacuating. First darken the surroundings to calm it, wrap the wings in a towel to restrain it, place it in a hard carrier the bill cannot strike, and warm with cloth-wrapped hand warmers. Take the CITES registration card, food, water and the clinic's number too. Leaving it risks hypothermia and collapse of the cage; opening the door makes recovery impossible and raises legal problems. Chasing a panicking bird leads to serious collision injuries.

IssuesThe possibility of the outdoor cage being damaged in an earthquake and the procedure for evacuating with the bird had not been considered. Whether the shelter accepts pets and what documents are needed to evacuate with a CITES individual had not been checked.

ImprovementPack an evacuation bag with a hard carrier, towels, hand warmers, 5 days of food, a copy of the registration card, photos and the clinic's number. Check the cage's earthquake anchoring and the municipality's rules on evacuating with pets. Practice restraint and placing the bird in the carrier once a year.

February; an 8-year-old red-billed hornbill kept in a room with the air conditioner heating all day. The hygrometer reads 25%. Recently the bill surface has become whitish and dry with fine vertical cracks, and the skin on the feet is cracked with some bleeding. The bird keeps rubbing its bill on the perch and sneezes more often. Appetite is normal.

Which is the most appropriate response?

1. Apply hand cream to the bill to restore its shine
2. Turn off the heating to restore natural humidity and let the bird get used to the cold
3. The cracks will heal naturally, so ignore them until spring
4. Raise humidity to 50–70% with a humidifier, watch for mold in wet bedding, and see a vet within a few days

AnswerD. Raise humidity to 50–70% with a humidifier, watch for mold in wet bedding, and see a vet within a few days

ExplanationHornbills from rainforest and savanna do best at 50–70% humidity; when heating dries the air to 25%, the keratin of the bill and the skin of the feet crack, and dry mucous membranes cause sneezing and respiratory signs. Raise the humidity with a humidifier and see a vet within a few days to check for bleeding or infection in the foot cracks. When humidifying, ventilate and change bedding thoroughly so it does not get wet and moldy. Human cream is harmful when licked, and turning off the heating causes hypothermia in a tropical bird. Left alone, the cracks deepen and become infected.

IssuesFocused only on temperature, the owner did not realize how much the heating was drying the air. Despite having a hygrometer, the proper range was not known, and the bill and skin changes were not linked to dryness.

ImprovementKeep a thermo-hygrometer in the cage and hold 50–70% with a humidifier in winter. Inspect bedding daily and change it when wet to prevent mold. Check the bill and foot skin weekly and review humidity at the first sign of dryness.

A September evening; a large typhoon is forecast to hit directly overnight. A 6-year-old wreathed hornbill in the garden flight cage is clinging to the perch in the strengthening wind and rain, and the mesh is flexing and rattling in the wind. Flying debris could strike the cage. There is a spare large cage indoors, and the bird normally comes to hand when called with fruit.

Which is the most appropriate response?

1. Cover the cage completely with a tarp and let the bird spend the night outside
2. Catching the bird in the dark once the wind is strong will cause panic, so wait until morning
3. Before dark, call the bird over with fruit, restrain it in a towel and move it to the spare cage indoors
4. Open the cage door so the bird can find a safe place on its own

AnswerC. Before dark, call the bird over with fruit, restrain it in a towel and move it to the spare cage indoors

ExplanationIn a typhoon, an outdoor cage faces combined dangers: collapse in strong wind, flying debris, body heat loss from rain, and panic from the noise leading to crashes into the mesh. The safest course is to call the bird over the usual way while it is still light and before the wind peaks, restrain it in a towel and move it to the spare cage indoors. A tarp catches the wind and makes the whole cage more likely to topple, leaving the bird trapped inside. Catching in the dark in the wind is dangerous for both, and the bird may be seriously injured while waiting for morning. Opening the door leads to escape and accidents.

IssuesAlthough the typhoon's approach was known, the decision to evacuate from the outdoor cage was left until the last moment. Despite having a spare indoor cage, no procedure or timing for moving the bird during weather warnings had been set.

ImprovementSet a procedure to move the bird indoors in daylight as soon as a storm warning becomes likely. Keep the spare indoor cage always ready for use. Inspect the outdoor cage post anchoring yearly and clear the garden of anything that could become flying debris.

At the weekend the owner swept dried droppings caked on the floor of the flight cage housing 3 hornbills with a broom, without a mask, working for an hour in the rising dust. Ten days later a 38.5°C fever, dry cough, severe headache and muscle pain set in, and after 3 days of over-the-counter cold medicine the fever has not come down. One of the birds has recently had soft droppings and been listless.

Which is the most appropriate action for the owner?

1. It is just a cold, so keep taking cold medicine and rest at home
2. Assume it is unrelated to the birds and watch with fever reducers until the cough settles
3. If the birds are the cause, rehoming is the only option, so start looking for a new owner
4. See a doctor and report keeping birds and the dropping-cleaning work, and have the listless bird tested too

AnswerD. See a doctor and report keeping birds and the dropping-cleaning work, and have the listless bird tested too

ExplanationHigh fever, dry cough, headache and muscle pain after inhaling dust from dried droppings is the typical course of psittacosis (Chlamydia infection), which can become severe pneumonia if untreated. The history of bird contact is essential to the human diagnosis, so be sure to tell the doctor about the birds and the cleaning. At the same time, have the listless bird tested, treat it if it is a carrier and prevent spread to the other birds. Waiting with cold medicine or fever reducers lets the pneumonia advance; rehoming the birds does not treat the patient and hinders identifying the source.

IssuesThe owner did not know that inhaling dust from dried droppings is the main route of psittacosis, and cleaned without a mask or wetting the droppings. The bird's soft droppings and listlessness were left unaddressed and not linked to the human symptoms.

ImprovementMist droppings before cleaning and wear a mask and gloves. See a vet if a bird's soft droppings or listlessness last 2 days. Tell the family's regular doctor that birds are kept and always mention it when feverish.

A November morning; a dead crow is lying on the wire mesh roof of the outdoor flight cage, and its droppings have fallen through the mesh onto the feeding platform. The 4-year-old black-and-white hornbill inside looks healthy. Unusual wild bird deaths have been occurring nearby and an avian influenza alert has been issued. The owner is about to remove the carcass with bare hands and hose down the feeding platform.

Which is the most appropriate response?

1. Do not touch the carcass bare-handed; contact the municipal office or Livestock Hygiene Service Center, isolate the bird indoors and replace the feeding platform and all food
2. Dispose of the carcass bare-handed, hose down the platform and feed as usual
3. The bird is healthy so there is no problem; just bag the carcass and put it in the household trash
4. Give the bird human cold medicine as a precaution

AnswerA. Do not touch the carcass bare-handed; contact the municipal office or Livestock Hygiene Service Center, isolate the bird indoors and replace the feeding platform and all food

ExplanationWith unusual wild bird deaths in the area, a carcass and droppings that fall into the cage can be a source of avian influenza. Do not touch the carcass bare-handed; contact the municipal office or Livestock Hygiene Service Center and follow their instructions. Move the bird indoors where it cannot contact wild birds, replace the contaminated platform, food and water entirely, work in gloves and a mask and wash your clothes. For the next 2 weeks observe appetite, breathing and neurological signs daily, and phone the clinic before visiting if anything is wrong. Bare-handed handling or hosing alone spreads infection, and household disposal loses the authorities' chance to test. Human medicine is useless and harmful.

IssuesThe outdoor cage roof was mesh only, so wild bird droppings and carcasses could fall straight in. Local reports of wild bird deaths were not applied to husbandry, and the readiness to handle a carcass bare-handed showed low risk awareness.

ImprovementCover the outdoor cage roof with corrugated sheeting or similar so wild birds cannot perch on it. Switch to indoor housing when wild bird deaths or avian influenza alerts are reported. Prepare in advance the contacts for a carcass (municipal office, Livestock Hygiene Service Center) and protective gear.

7 a.m. on a winter morning, room temperature 18°C. An 11-year-old red-billed hornbill is lying on its side on the cage floor; when called it only opens its eyes slightly and cannot get up. Breathing is slow and the body feels cold to the touch. It ate until last night, but food intake had been falling for several days. Your regular vet opens at 9.

Which is the most appropriate first response?

1. Quickly push fruit into its mouth to give it energy
2. Wait as is until opening time and go to the clinic at 9
3. Wipe the body with a damp cloth to wake it up
4. Move to a dark box kept at 28–30°C, phone the clinic even before opening to confirm they can take it, and transport

AnswerD. Move to a dark box kept at 28–30°C, phone the clinic even before opening to confirm they can take it, and transport

ExplanationLying on its side, barely responsive and cold, the bird is in a dangerous state of advanced hypothermia and weakness; with a bird's fast metabolism, death can follow within hours. Warmth is the top priority: move it to a dark box with cloth-wrapped hand warmers, hold 28–30°C, phone the clinic even before opening, and transport at once to a facility that can take it. Pushing food into a bird with impaired consciousness causes aspiration or choking, and wiping with a damp cloth strips more body heat. Leaving it for 2 hours until opening will very likely be too late.

IssuesThe drop in food intake over several days was not taken as a cue to see a vet, and a room temperature of 18°C in winter was wrongly assumed adequate for a tropical bird. No clinic reachable at night or early morning had been looked up.

ImprovementKeep the room at 22°C or above in winter and check the thermometer daily. Record food intake and weight daily and see a vet if a decline lasts 2 days. Keep a warming box and hand warmers ready, and post the contact for a clinic that can respond early morning or at night where the whole family can see it.

A 5-year-old great hornbill. In a fight with his mate, the side of the casque was gouged and bright red blood keeps dripping. A pool of blood is forming on the floor, and the agitated bird flings blood each time he shakes his head. At hand are clean gauze, styptic powder, bandages and a cloth. The clinic is 40 minutes away by car.

Which is the most appropriate way to control bleeding until transport?

1. Cover the head with a cloth to calm him, hold gauze on the bleeding site with gentle pressure and transport
2. Wrap the whole casque tightly in bandage to fix it
3. Pack the wound full of styptic powder and wait for it to dry without pressing
4. Rinse the casque under running water, repeating until the bleeding stops

AnswerA. Cover the head with a cloth to calm him, hold gauze on the bleeding site with gentle pressure and transport

ExplanationThe casque is a structure of bone and keratin with blood vessels running through it, and bleeding from a gouge increases with agitation. First cover the head with a cloth to block his vision and calm him, hold clean gauze on the bleeding site with pressure light enough not to widen the split, and transport like that. Separate him from the other bird at once. Wrapping the casque tightly widens the split and blocks the nostrils, impeding breathing. Styptic powder works on small bleeds from nails or the bill tip, but packed into a large wound it becomes a nidus for infection, and without pressure the bleeding will not stop. Running water washes away clots and prolongs bleeding.

IssuesThe pair's breeding-season aggression was not monitored and no divider was prepared. The correct pressure technique for heavy bleeding and the reason the casque must not be bound tightly were not known.

ImprovementSet a rule to separate the same day if chasing is seen, and prepare a divider and escape space. Keep a bleeding kit (gauze, styptic powder, cloth) with the transport box, and share with the family the procedure of gentle pressure and transport for casque bleeding.

A 4-year-old red-billed hornbill with a suspected wing fracture must be taken to a clinic an hour away by car. It is midsummer and the car is hot. At hand are a small hard carrier, a birdcage, towels, ice packs and newspaper. The bird is agitated and tries to flap in the birdcage, its long bill hitting the bars.

Which is the most appropriate way to transport?

1. Put it in the birdcage by the window so the view outside distracts it
2. Put it in a large cardboard box so the wings can move freely, and load it in the trunk
3. Wrap the wing against the body in a towel, place in the carrier on a non-slip mat, cover with a cloth to darken, and keep cool with air conditioning
4. Carry it on the owner's lap held in bare hands

AnswerC. Wrap the wing against the body in a towel, place in the carrier on a non-slip mat, cover with a cloth to darken, and keep cool with air conditioning

ExplanationIn a bird with a suspected fracture, flapping during transport shifts bone fragments and damages vessels and nerves, so hold the wing against the body in its natural position, wrap lightly in a towel and restrict movement. Line a hard carrier that the bill and casque cannot strike with a non-slip mat, cover it with a cloth to darken and reduce agitation. In midsummer keep the car cool with air conditioning and place cloth-wrapped ice packs where they do not touch the bird. A view from a birdcage excites the bird and makes it hit its bill on the bars. A large box cannot restrict movement, and the trunk gets very hot. Holding it bare-handed invites struggling, falls and bites.

IssuesA dark hard carrier and restraint technique for transport had not been prepared, leaving the owner hunting for equipment after the injury. The effect of summer car temperatures and of darkening was not understood.

ImprovementKeep a hard carrier large enough that the bill does not strike, fitted with a towel and non-slip mat, ready at all times. Learn restraint from the vet and practice a few times a year. Check in advance how to use cloth-wrapped hand warmers or ice packs according to the season.

1 a.m.; a 10-year-old red-billed hornbill has come down from the perch and is huddled on the floor, breathing fast with the bill open, abdomen distended. It has been listless for several weeks and losing weight. The emergency (after-hours) animal hospital is 50 minutes away by car; your regular vet opens at 9 a.m. The owner is torn, thinking the stress of the trip might make it worse.

Which is the most appropriate decision?

1. Avoid the stress of travel and wait for the regular vet to open at 9
2. Search the symptoms online and try remedies from similar cases
3. Keep warm and film until morning to prepare material for the vet
4. Abdominal distension with open-mouth breathing meets the criteria for an immediate vet visit; phone the emergency hospital and transport in a warming box

AnswerD. Abdominal distension with open-mouth breathing meets the criteria for an immediate vet visit; phone the emergency hospital and transport in a warming box

ExplanationAbdominal distension with open-mouth breathing most likely means liver enlargement or ascites from iron storage disease, or a tumor, compressing the breathing, and in birds respiratory distress becomes fatal within hours. This meets the criteria for contacting the emergency hospital now; the danger of waiting 8 hours for opening time far outweighs the stress of transport. Carried quietly in a dark warming box, stress can be kept to a minimum. Time spent on internet searches or filming only delays the visit, and the bird may stop breathing while waiting for morning.

IssuesThe listlessness and weight loss of several weeks were not taken as the chance to see a vet, leading to indecision at night once the symptoms became severe. The criteria for an immediate vet visit were not known in advance, and the stress of travel was overestimated.

ImprovementSee a vet in daytime at the stage of 5% weight loss or listlessness. Post the immediate-visit criteria (open-mouth breathing, abdominal distension, lethargy, heavy bleeding, suspected fracture) on the cage and save the emergency hospital's address and number. Keep a warming transport box ready and act without hesitation even at night.

A 7-year-old great hornbill under treatment for aspergillosis. In the evening he suddenly went into violent open-mouth breathing, stretching his neck and gasping, tail pumping up and down, and then his movements grew weak. There is slight chest movement. The clinic has been reached by phone and said they are preparing to receive him. There is no oxygen canister or pet oxygen concentrator at home.

Which is the most appropriate thing the owner can do until transport?

1. Press hard on the chest to restart breathing
2. Wipe secretions from the bill and nostrils to clear the airway, and transport immediately in a dark, warmed box without shaking, in well-ventilated air
3. Mist the face with a spray bottle to stimulate him and wake him up
4. Wait at home until breathing settles before setting off

AnswerB. Wipe secretions from the bill and nostrils to clear the airway, and transport immediately in a dark, warmed box without shaking, in well-ventilated air

ExplanationA bird with aspergillosis has lesions in the air sacs and trachea, and sudden respiratory distress comes from airway obstruction or spread of the lesions. What the owner can do is wipe secretions from the bill and nostrils to clear the airway, place him in a dark, quiet, warmed box to cut oxygen consumption from agitation, and transport at once without shaking. The clinic has an oxygen chamber and treatment ready, so give them the arrival time and hurry. Chest compressions damage a bird's thin keel and air sacs and are fatal. Wetting the face causes heat loss and aspiration, and waiting at home prolongs oxygen deprivation.

IssuesDespite the high likelihood of sudden deterioration during treatment for respiratory disease, there was no means of providing oxygen and no transport plan for a crisis. The reason chest compressions must not be done on birds was not understood, and hesitation risked costing time.

ImprovementDuring treatment for respiratory disease, discuss with the vet how to handle a crisis and arrange oxygen (a pet oxygen canister or a loaned oxygen chamber). Write out and post the airway, warmth, transport procedure and keep a dark transport box ready for immediate use. Record daily breathing rate and chest movement to notice changes early.