Evidence Based Medicine

What is Evidence Based Medicine (EBM)?

ferret-46650_1280It is an applied aspect of clinical epidemiology…??? What that means is that the practice of medicine should be based on valid, clinically relevant research data whenever possible.

The way I like to think of EBM, and why I think it is relevant to my veterinary practice, is that it is a tool to improve my medicine.  There is a variety of information “out there” and we need to rank its usefulness.  Basically, as Dr. McKenzie described it, EMB creates a pyramid of data with super-duper extensive reviews of all the data on the planet at the top…and what is affectionately known as “In My Experience” at the bottom.

Great!  That Makes Everything Easier Right?


Human medicine has oodles of data and studies and reviews of studies and compilations of reviews of studies available to sort through.  Veterinary medicine has not so much.
Exotic veterinary medicine has way less.

Well, How Does EBM Help Then?sneaker

Data has to come from somewhere.  It may well start with an “In My Experience” which turns into a case report or a case series.  Then someone tries to get more information through a study (double blinded is the best!).
Eventually we’ll have enough studies to be able to summarize the data in a great big review.

But until then, EMB reminds us to critically evaluate where our information comes from, not to discard the lower levels but understand they are incomplete.

For more information, check out the Evidence Based Veterinary Medical Association.


Brenda or Bruce

Trying to figure out whether you’ve brought home a Brenda or a Bruce is not always easy when it comes to birds, reptiles and even rabbits.  Luckily our mammal boys will eventually give themselves away once their testicles show up but it’s not always that easy for the others.

Birds are often sexually dimorphic (visually different based on whether they are male or female).  Take the Peacock and Peahen for example – it’s easy to tell who is who.  Some of our parrot-type birds are quite easy to identify as well, while other require DNA testing.

Pacific Parrotlets
In general, the boys are green with pretty blue feathers while the girls are all green.  Even most of the color mutations follow this general pattern.

Boys usually have a bright blue cere and are more likely to speak while girls have a lilac or brown cere and just chirp.  This only a guide!  I’ve see more than one budgie with a blue cere who talked lay a few eggs!  If you have a male budgie whose cere changes color from blue to brown, bring him in to the vet.  Estrogen is the cause of brown colored ceres – any true male who has that much estrogen in his system may have a tumor producing it.

male budgie head female budgie head



They used to be very obvious.  With the original, or wild type, coloration boys have bright orange cheek patches and girls have spots and stripes on the wing and tail feathers.

But people have been breeding them for all sorts of color mutations and now it can be a little harder to tell who’s who.  Check out the American Cockatiel Society or the North American Cockatiel Society for a more in-depth review of cockatiel colors and mutations.

One thing to keep in mind is that all cockatiels start out in “girl feathers”.  When they molt into their adult feathers the boy coloration will show up.  This is especially noticeable when your pretty pearly cockatiel turns out to be a boy and looses all that pretty pearly-ness.

pipper sm

Adult females tend to have red eyes but it’s not a guarantee. Those guys can sure tell themselves apart. We walked a bald female cockatoo past a male one day and you should have seen his eyes pin. He started a preening dance right away. Sadly for him, she wasn’t impressed.

African Grey
Female: belly (or ventral) feathers start dark but usually switch to light farther out
Males: belly (or ventral) feathers start dark and may blend into lighter feathers father out

There’s no way for us to sex them!  However, recent research shows that these guys may have different colorations…in the ultraviolet spectrum. Perhaps one day in the not too distant future we’ll just shine a light on your bird and be able to tell you

If you have to know for sure, DNA sexing is easy and requires just a drop of blood.  Surgical sexing can also be performed but most folks don’t need to go to that extent.

That’s a bit of a broad category, but they are much like Amazons – they keep their biology shrouded in mystery.


Who cares? 
For most companion birds, male vs female is not important.  However, there are illnesses that are specific to reproductive organs.  Knowing that you do or don’t have a girl in your hand can save time if egg related problems are a concern.

Of course, if you are trying to get more birds you’ll be a lot more successful if you pair up a boy with a girl!