Mortality rate of birds following intravenous administration of iodinated contrast medium for computed tomography

To identify potential risk factors for death following IV or intraosseous (IO) administration of contrast medium in birds undergoing CT scans.

120 birds that underwent 134 contrast-enhanced CT scans.

Medical records of birds of any species that underwent a CT scan which included administration of nonionic iodinated contrast medium from June 2013 to February 2020 were included. Information on birds and use of contrast medium was extracted from the medical records as well as information on deaths following IV or IO administration of contrast medium.

6 birds died shortly following administration of contrast medium. Necropsies were performed in 3 birds (2 cockatiels and 1 macaw), and all had lesions associated with the respiratory tract. When body weight was used as a binary variable to compare odds of death between small birds (≤ 150 g [0.33 lb]) and large birds (> 150 g), small birds had a 97-fold increased odds (OR, 97.5; 95% CI, 9.8 to 966.0) of dying following contrast medium administration. Following 131 CT scans with contrast medium administration (3 scans were excluded because of perivascular or subcutaneous leakage of contract medium), small birds had a mortality rate of 45.4% (5/11), compared with a mortality rate of 0.8% (1/120) for large (> 150 g) birds. Other variables (ie, sex, age, anesthesia or sedation, sedation protocol, and type of contrast medium) were not significantly associated with death after contrast medium administration.

Although the administration of contrast medium cannot be conclusively confirmed as the cause of death in these birds, the high mortality rate for small birds coupled with the temporality of the event following contrast medium administration justifies the cautious use of contrast medium in small sick psittacine birds.