Professional Documents
Culture Documents
Hist edition by
Louise Bauck, BSc, DVM. MVSc
Neither the author nor AAHA assumes responsibility for or makes a rep
resentation about the suitability or accuracy of the information contained
in this work for any purposes, and makes no warranties, either express or
implied, including the warranties of merchantability and fitness for a par
ticular purpose. Neither AAHA nor the author shall be held liable for
adverse reactions to or damage resulting from the application of this
information including, but not limited to, drug identification, usage
dosage, or equivalency or resulting from any misstatement or error con
tained in this work. The condition of a specific patient or the circum
stances in a particular situation may warrant alterations in drug dosages
or treatment from those set forth herein. Package information provided
by manufactuers should always be reviewed before administration or
preparation. Rapid advances in veterinary medicine may cause informa
tion contained herein to become outdated, invalid, or subject to debate by
veterinary professionals. AAHA and the author are held harmless from
any and all claims that may arise as a result of any reliance on the infor
mation provided.
American Animal Hospital Association Press
12575 W. Bayaud Avenue
Lakewood, Colorado 80228
(800) 252-2242
www.aahanet.org
2002 by American Animal Hospital Association Press
All rights reserved. No part of this publication may be reproduced or
transmitted in any form or by any means, electronic or mechanical,
including photocopy, recording, or any information storage and
retrieval system, without permission in writing from the publisher.
ISBN 1-58326-035-8
Dedication
This book is lovingly dedicated to my wife Karen, and our children,
Courtney and Christopher, who are the light of my life, and have
endured much during this project.
It is also affectionately dedicated to my parents, Steve and Georgia
Sakas, whose loving upbringing and support throughout my life have
had an immense impact on my success personally andprofessionally.
Special Dedication
Contents
Illu strations.................................................................................................... xiii
Tables.....................................................................................................xvii
Forew ord.........................................................................................................xix
Preface....................................
xxi
Acknowledgments .....................................................................................xxiii
1 Important Advice to Give Pet Bird Owners .............................
References ......................
32
Additional Equipment
References ............................................................................................47
Radiology .............................................................................................. 96
Laparoscopy, Ultrasound, and Computer-Assisted Imagery ........ 98
Avian Necropsy ....................................................................................99
References .......................................................................................... 100
4 Grooming .........................................................................................105
Restraint .............................................................................................. 105
Nail Trimming ...................................................................................... 107
Beak Trimming .................................................................................... 108
Wing Clipping ...................................................................................... 110
References .......................................................................................... 113
References ..........................................................................................140
7 Formulary: Avian Drug D osages........................................................ 143
Antimicrobial Agents ..........................................................................143
Antifungal Agents ..............................................................................148
Antihelmintic/Antiparasitic Agents
...............................................150
Nebulizing Agents ..............................................................................153
Psychotropic Agents ..........................................................................155
8 Avian Diseases.................................................................................171
Nutritional Diseases ..........................................................................173
Obesity/Hepatic Lipidosis
Vitamin A Imbalances
Calcium, Phosphorus, and Vitamin D3 Imbalances
Iodine Deficiency/Goiter
Hemochromatosis
Lipomatosis/Lipomas
Self-Mutilation
Vaccine Reactions
Abscesses/Granulomas/Tuberculosis Lesions
Xanthomatosis
Dermal Cysts/Macaw Acne
Trauma ................................................................................................246
Fractures
Broken Blood Feathers
Torn Pygostyle/Tail Base Laceration
Split Sternum
Subcutaneous Emphysema
Beak Injuries
Cat Bites and Scratches
Liver Conditions..................................................................................265
Reproductive Conditions ................................................................. 267
Unwanted Egg Laying
Egg Binding
Reproductive-Associated Peritonitis
Ovarian Cysts
Ovarian/Oviductal Tumors
Prolapsed Cloaca
Prolapsed Oviduct/Uterus
Sexual Behavior and Aggression
Mate Aggression
Infectious Diseases
Mycotic Infections
Orthopedic Problems
Beak Abnormalities
References ..........................................................................................314
Resources .............................................................................................327
Color P la te s ...........................................................................................333
Index....................................................................................................... 343
Illustrations
Figure 1
13
Smuggled bird.
Figure 2
17
Thinning scales (pressure sores) in the middle of the foot.
Figure 3
18
Ulcerated hock.
Figure 4
19
Commercial nesting material wrapped around the toes of a canary.
Figure 5
19
Coat hanger puncturing beneath the lower beak in a macaw.
Figure 6
38
Mouth speculum for examining mouths of birds.
Figure 7
38
Scale with pot attachment.
Figure 8
40
Modified human infant incubators for birds.
Figure 9
52
Blackened feathers caused by trauma or rubbing on cage.
Figure 10 .................................................................................................. 53
Vomiting bird.
Figure 11 .................................................................................................. 57
The classic sick bird.
Figure 12 .................................................................................................. 57
Stained feathers above nares indicating nasal discharge.
Figure 13 ..............................................
58
Figure 14 ..................................................................................................58
Budgerigar with renal adenocarcinoma.
Figure 15 ..................................................................................................60
How to hold a bird.
Figure 16 .................................................................................................. 67
The beak of a bird with fatty liver disease.
Figure 17 ....................
67
Figure 18 ..................................................................................................68
Papillomatous growth in the choanal slit of a macaw.
Figure 19 .................................................................................................. 68
Cockatiel with ocular discharge, conjunctivitis, and periophthalmic
swelling.
Figure 20 .................................................................................................. 70
Crop fistulation in a hand-fed blue-fronted Amazon parrot.
Figure 21 .................................................................................................. 71
Use of a moistened cotton-tipped applicator to evert the vent
margins.
Figure 22 .........................................................................
72
Figure 23 .................................................................................................. 96
Radiograph showing grit in the ventriculus.
Figure 24 .................................................................................................. 97
Barium radiograph of a normal bird.
Figure 26
.......................................................................................... 116
Human incubator modified for hospitalized bird.
Figure 27 ...................................................................................
118
Figure 32
........................................................................................ 187
Cockatoo with psittacine beak and feather disease.
Figure 36 ..........
194
Figure 38 ................................................................................................201
Avian polyomavirus in a neonatal macaw.
Figure 40 ................................................................................................214
Knemidokoptic mange in a budgerigar (scaly face).
Figure 45 ......................................
233
Figure 53 ........................
248
Blue and gold macaw with broken blood feathers and mutilated
quills.
Figure 54 ................................................................................................249
Torn pygostyle (split tail) in a cockatiel after a fall from the cage.
Figure 55 ................................................................................................250
Split sternum in an Amazon parrot.
Figure 56 ................................................................................................254
Periorbital swelling in a budgerigar with sinusitis.
Figure 57 ................................................................................................257
Air sacculitis in an Amazon parrot.
Tables
Table 1
77
Blood Volume That Can Be Withdrawn Safely
From Common Sizes of Pet Birds
Table 2
81
Avian Hematologic and Biochemical Values for Selected Species
Table 3
89
Culture Sites and Common Flora
Table 4
117
Intravenous Bolus Fluid Administration in Pet Birds
Table5
.................................................................................................. 124
Gavage Feeding in Pet Birds
Table 6
171
Organization of Diseases, Conditions, and Abnormalities
Table 7
190
Diagnostic Flow Chart for Psittacine Circovirus
Table 8
241
Common Differential Diagnoses for Complaints
That May Feature Feather Loss
Table 9
252
Common Differential Diagnoses of Complaints
That May Feature Respiratory Signs
Table 13 ..................................................................................................285
Common Problems That May Be Presented With
Nervous System Abnormalities
Table 14 ................
Common Pediatric Problems Seen in
Domestically Raised Large Psittacines
305
Foreword
Dr. Sakas attended the University of Illinois, College of Veterinary Medicine, as
did I, back when many veterinary practitioners believed that If it flies, it dies. Dr.
Sakas, however, had the good fortune to have Dr. Theodore Lafeber as his mentor.
Dr. Lafeber was a true pioneer in the field of avian medicine and surgery. He
developed a line of avian products, including a pelleted parrot diet and the first
commercially available hand-feeding formula for baby parrots.
In vet school, Dr. Sakas was the SCAVMA (Student Chapter of the American
Veterinary Medical Association) class representative, and later president of that
organization. He invited Dr. Lafeber to come and lecture to the veterinary students
about avian medicine, bringing budgerigars for the students to work with. For
many of us, this was our first introduction to hands-on avian medicine.
Dr. Sakas worked for Dr. Lafeber at Niles Animal Hospital while he was a vet
student and helped Dr. Lafeber write the educational materials that accompanied
his products. Dr. Sakas continued to work with Dr. Lafeber for five years and
eventually took over the practice, which remains approximately 50% exotics
and 50% small animal. The experience that Dr. Sakas gained while in practice
with Dr. Lafeber set him on course to become the excellent avian practitioner
that he is today.
I had the pleasure of knowing Dr. Sakas during vet school, and even then I knew
he was destined to become a leader in the field of avian medicine. We maintained
our friendship while attending avian continuing education conferences, and it was
at an AAV (Association of Avian Veterinarians) conference that I first met his
future wife, Karen. He so impressed my own mother and aunt, who were also
attending an AAV conference with me, that they still speak today of his humor,
graciousness, and fear of heights.
I can think of no one more qualified to author a text on the practice of avian med
icine than Dr. Sakas, who now oversees a practice of five veterinarians, lectures all
around the country on avian medicine, is on the Admissions Committee for the
University of Illinois College of Veterinary Medicine, and still finds time to be a
great father to his two children. This text will be an extremely valuable addition to
your library and will be a most helpful, practical book for all avian veterinarians.
This text has been developed by Dr. Sakas from his wealth of practical knowledge
gained in his busy avian practice. I predict it will become the book that veterinar
ians and technicians will turn to in the busy, work-a-day world of avian practice
when factual and practical information regarding a case is needed.
Avian medicine has progressed beyond anything that any of us could have envi
sioned back in the days when Dr. Lafeber was teaching us how to properly hold
and medicate a budgerigar. The science of avian medicine changes stillalmost
dailyas researchers and practitioners alike add to our knowledge. This text
incorporates the most up-to-date information available regarding bacterial, fungal,
viral and protozoal infections, as well as the most accurate nutritional, husbandry,
toxicology, pediatrics, grooming, and behavioral information. I have no doubts
that this book will be an excellent resource for the doctors and staff of veterinary
hospitals, whether they treat one or twenty avian patients per day.
Margaret Anne Wissman, DVM
DAB VP, Avian Practice
Preface
Current pet industry figures place the number of pet birds in the United States at
approximately 60 million and report that pet birds are in an estimated 15% of all
U.S. households.1 The reasons for the increasing popularity of pet birds are
numerous. Birds are basically low-maintenance pets. They are typically allowed in
housing units that do not allow cats and dogs, and nationwide an increasing num
ber of pet stores are carrying birds. Further, the number of larger birds available for
sale has increased in great part because of success in hand-raising them domesti
cally. Such hand-raised birds are tamer, calmer, and less likely to carry exotic dis
eases than birds raised in the wild and imported, and they have already bonded
to people, making them more desirable pets than wild-caught birds.
The surge in popularity of pet birds has brought with it an explosion of informa
tion about the understanding of bird diseases, nutrition, and husbandry. Through
the efforts of veterinarians, bird breeders, and aviculturists, great advancements
and improvements have been seen in the field of aviculturea number of which
have occurred since AAHAs 1993 publication of the first edition of this book, A
Practitioners Guide to Avian Medicine, by Dr. Louise Bauck. The purpose of this
new edition is to provide practitionersboth those who are already involved in
avian medicine and those who are introducing bird care to their practiceswith
the most current, scientifically supported information in the care and treatment of
pet birds in an easy-to-access format.
The book begins with a discussion of important issues for practitioners to review
with new and existing bird owners. The focus then shifts to the essentials of man
aging an avian practice, including the basic equipment needed for handling, diag
nosing, and treating pet birds as well as strategies for the marketing and
day-to-day management of an avian practice and strategies for increasing the
avian caseload. The remainder of the book focuses on the treatment of birds, with
chapters on avian diagnostics and grooming techniques, treatment techniques,
therapeutics, and diseases.
This book is intended as a useful quick-reference guide for practitioners, veteri
nary technicians, and astute aviculturists. However, it is not intended to provide the
Acknowledgments
There are numerous people involved in a project of this magnitude. A special thank
you to Dr. Marge Wissman, who authored the Foreword, reviewed the manuscript,
and provided excellent insights and suggestions. I am indebted to Beverly Rokes
for her excellent editorial work on the manuscript and to Cork Rech for shepherd
ing this project to completion in fine fashion. The editorial staff at AAHA was out
standing and was a pleasure to work with on this project.
I would also like to thank the outstanding support staff at Niles Animal Hospital
and Bird Medical Center for their support and patience and holding down the
fort during this project, especially the long-termers: Ruth Lenover, Sue Cook,
Rebecca Hawkinson, Deb Koss, Jan Meyers, Eileen Fricke, and Sandy Downie. I
would also like to acknowledge my associate veterinarians that have picked up the
slack while I was attending to the book. I would like to especially thank Dr. Sarah
E. Roelofs, who has been a stalwart associate and one of the finest veterinarians
that I have ever known.
I would also like to acknowledge some individuals that played important roles in
my professional development. A special acknowledgement to the late Dr. William
H. Mason (Biology Department Head, Auburn University), who helped me
develop valuable teaching and researching skills, but also for being a dear friend
and mentor who helped me realize my goals. Acknowledgements to the other
members of my graduate committee at Auburn, Dr. William Current, Dr. Wilford
Bailey, Dr. Phil Klesius, and especially Dr. Ronald Schultz (currently at University
of Wisconsin College of Veterinary Medicine), whose keen insight in immunology
was indispensable to my masters research. Special acknowledgements also to the
faculty and staff at the University of Illinois College of Veterinary Medicinemy
experiences as a student were positive and have served me well, but the continued
close relationship after graduation is especially treasured by me. A heartfelt
acknowledgement to that old marine, Dr. Erwin Small; your mentoring and friend
ship while I was a student and now as a graduate veterinarian mean the world to
me. You are truly a legend in your own time.
I would also like to acknowledge my clients and other aviculturists from whom I
have learned so much, and your faith in me is appreciated. Acknowledgements
also to the bird clubs and associations that I have lectured to on a regular basis
through the years, as you are an important part of aviculture: Northern Illinois
Parrot Society, Greater Chicago Bird Club, West Suburban Cage Bird Club, Joliet
Regional Avian Alliance, State Line Bird Fanciers, Cream City Feathered Friends
(Milwaukee, WI), MACAW (Madison, WI ), LARRA (LaCrosse, WI) and MARE.
I am indebted to fellow avian veterinarians who have provided quality research
and insights into avian medicine, expanding my knowledge base and enabling me
to provide better care for my avian patients. A special acknowledgement to the late
Dr. James Grimes (Texas A&M University), whose knowledge, eagerness to share
that information, and friendship were very special to me. I would also like to
acknowledge Dr. Shivaprasad (University of California, Fresno), whose quality
avian pathology, doggedness in an effort to provide answers, and overall knowl
edge have been deeply appreciated, in addition to his abiding friendship. I would
also like to thank Dr. Roger Wells, for his assistance when I was evaluating PTFE
toxicosis. Acknowledgements to the avian veterinarians whose work through the
years have been essential in the development of the avian medicine knowledge
base that is reflected in this book: Dr. Gregory Harrison, Dr. Walter Rosskopf, Dr.
Alan Fudge, Dr. Keven Flammer, Dr. Susan Clubb, Dr. Scott MacDonald, and Dr.
David Phalen, to name just a few. I would especially like to single out Dr. Branson
Ritchie whose quality work in avian medicine has had a tremendous impact on my
work as an avian veterinarian and as part of this book. Thanks for the kind per
mission to use his flow chart for the diagnosis of psittacine circovirus. I appreci
ate his collegiality, friendship, and support. Through his work (and that of his
associates at the University of Georgia), we have made great strides in avian med
icine, ultimately elevating the level of care and improving the quality of life for our
avian companions.
Issues to Consider
All too often, people sell or give away a bird because the relationship with the bird
was a poor one. Even worse, birds die due to inadequate and improper care. The
avian practitioner can aid clients in a well-thought-out and well-researched deci
sion by having the client evaluate the following considerations before making a
bird purchase:1
The time commitment he or she is willing to make
The expense he or she is willing to incur
Possible housing restrictions (e.g., for apartment and condominium dwellers)
or veterinarian who opens his or her hand to see a bird lying prone or breathing
heavily and not moving. Although canaries will generally come to within a short
period of time, such stress should be avoided. Canaries should always be watched
carefully during any procedure that requires handling, including grooming.
The life span of canaries is about 10 to 12 years, although the author saw one in
his practice that lived to be 19 1/2years old. For people who are looking for a bird
with a beautiful song, a male canary is a good choice. For those who are looking
for an affectionate companion, a female canary is a good choice if singing ability
is not a consideration. Easy to care for, canaries are good starter birds.
Small Parrots
A current trend in pet bird ownership has been toward small parrots. They cost less
than larger birds, require smaller cages and less space, and possess many appeal
ing attributes. Small parrots are becoming a pet of choice for many families and
they are increasingly available due to the success of domestic breeders in hand
raising them.
Quaker/Monk Parrots (Myiopsitta monachus) Possessing an engaging, enter
taining personality, quaker parrots (also known as monk parrots) can be very affec
tionate pets, especially if they have been hand raised. They typically develop a
close bond with the pet owner, often with one family member in particular.
Unfortunately, when quakers become sexually mature, their desire to breed can
lead to sexual aggression or bad habits such as feather picking.
Quakers have moderate to good talking ability. Though their words may not be
especially clear, they are quite vociferous. They are long-lived birds, generally
living into their twenties. One quaker in the authors practice lived 28 years.
They are highly adaptable birds and are considered pests in some parts of the coun
try. In the Chicago area, for example, there are extensive colonies of quakers that
live in the wild, surviving the harsh winters. It is rumored that these birds escaped
from a quarantine station years ago. Today, they have become well established in
various communities, where they have built large communal nests.
Overall, quakers make affectionate pets. Owners should, however, be cautioned to
expect some seasonal sexual behavior.
Conures (Aratinga spp., Pyrrhura spp., Nandayus sp., Cyanoliseiis sp.) Over
the years, conures have developed a questionable reputation as pets. Imported
Patagonian conures were feared by knowledgeable aviculturists because they were
Large Parrots
African Grey Parrots (Psittacus sp.) Probably the best talkers of all the parrots,
African grey parrots have an unmatched ability to imitate sounds and the human
voice. They are extremely intelligent birds, but with that intelligence may come
associated neuroses. Some African grey parrots can be extremely nervous, becom
ing upset and distrustful of newcomers if there are changes in their routine. In addi
tion, emotional and/or sexual frustration can lead to aggression or feather picking.
There are two common subspecies of African grey parrots: Congos and Timnehs.
Congos are distinguished by their larger size, black beak, and bright red tail.
Timnehs are smaller, have a lighter, brownish beak and a dusky reddish-brown tail.
Some bird owners feel that Timnehs are less nervous than Congos, seem to social
ize better, and learn somewhat better. However, hand-raised African grey parrots of
both subspecies make affectionate companions.
With their phenomenal ability to mimic, their affectionate nature, and their long
life span (many live longer than 40 years), these birds make outstanding pets for
owners who understand their intelligent nature and make the commitment to
interact with them, stimulate them mentally, and meet their emotional needs.
Eclectus Parrots (Eclectus sp.) Several species of eclectus parrots are avail
able, all of which are beautifully colored, highly intelligent birds with excellent
talking ability. One of the few parrot species with sexually dimorphic coloration,
the males are predominantly green and the females are predominantly red.
Eclectus parrots can be very enjoyable pets, will bond quite strongly to their own
ers, and are long-lived. However, they have a number of behavioral quirks that
make them a poor choice for inexperienced bird owners. Generally high-strung
birds, they can display aggressiveness or feather picking during the breeding sea
son. People who own pairs of these parrots often find that the female tends to be
the more aggressive bird and will attack or pick on the male. The male tends to be
calmer, leading to the perception that males make the better pet. Purchasing a
hand-raised young bird can help to minimize problems; however, birds of either
gender, whether hand raised or not, can be a problem during mating season.
Owners who are familiar with bird behavior and problem management will do
much better with eclectus parrots than will more inexperienced owners.
Amazon Parrots (Amazona spp.) Amazon parrots are the most popular of the
large parrots. Many species are available with different colorations, personali
ties, and mimicry ability. Talking ability is one of the most important determi
nants in cost. Although all Amazon parrots possess the ability to talk, some are
considered excellent talkers, such as the yellow-naped Amazon and the double
yellow-headed Amazon. The latter species are the parrots often seen singing and
talking on television or performing at animal shows. Unfortunately, along with
their rambunctious nature, these birds tend to show very aggressive behavior,
such as biting and screaming, when they reach sexual maturity. It is not uncom
mon to see yellow-naped and double yellow-headed Amazon parrots put up for
sale at 5 or 6 years of age by owners who can no longer handle the aggression and
biting of a dominant bird.
Other popular species of Amazon parrots include spectacled, Mexican red-headed,
lilac-crown, orange-winged, blue-crowned, and mealy Amazon parrots. The spec
tacled Amazon parrots are the smallest species and are one of the few Amazon par
rots with sexually dimorphic coloration. Their talking ability is somewhat limited,
but they possess a nice disposition. Blue-crowned and mealy Amazon parrots are
among the largest of the Amazon parrots and are generally the most mellow. They
are relatively good talkers, but they have a loud call.
Owners should be encouraged to purchase domestic, hand-raised, young Amazon
parrots, since even the more aggressive species can be affectionate pets if they
have a good start and an experienced bird owner. Older Amazon parrots that are
put up for sale should be regarded with caution, as they may have undesirable
behavior traits.
Amazon parrots have life spans that may exceed those of their owners. It is not
unusual to see birds that are more than 60 years of age. One yellow-naped Amazon
in the authors practice lived to be over 100 years of age.
Although Amazon parrots can make entertaining, affectionate, interactive pets and
can have great talking ability, they are not recommended for novice bird owners
due to their dominant personality at sexual maturity. Any client wishing to pur
chase an Amazon parrot should be counseled to research the various species and
their attributes so that a proper selection can be made.
Cockatoos (Cacatua spp.) Highly intelligent and sensitive birds, cockatoos are
the cuddlers of the bird world, enjoying handling and having close physical con
tact. However, these attributes, which make them so appealing as pets, also have
a downside: cockatoos can become extremely demanding for attention, exhibiting
screaming or feather picking when they do not receive it. Although cockatoos can
talk quite clearly, vocalizing in a high-pitched, sweet-sounding voice, they usually
do not possess a large vocabulary.
Many different species of cockatoos are available, varying in appearance, person
ality, and price. Goffins cockatoos are the smallest species. They are very active,
playful, and amusing, but because of their high-strung nature, they do not tend to
be cuddly. Bare-eyed cockatoos are considered to be the best talkers of the cock
atoos. Although they are not commonly chosen by pet bird owners, probably due
to the somewhat unattractive large patch of bare skin around both of their eyes,
they make good pets. Citron, sulphur-crested, and umbrella cockatoos are more
common as pets due to their attractive appearance and lower cost. They are intel
ligent, gentle, and enjoy being handled. Rose-breasted cockatoos are attractive
pinkish-red and gray birds, but they are high-strung and possess limited talking
ability. Because they have a tendency to become overweight and develop fat
deposits, owners must be counseled on nutritional management. Moluccan cock
atoos are impressive in size and coloration, but they are among the most demand
ing of all birds for their owners attention. Most would be happy to be cuddled
with their owners 24 hours a day. Due to the impracticality of that arrangement,
they often develop feather picking, self-mutilation, or screaming behaviors. The
latter can be quite deafening due to the large size of these birds.
Cockatoos are long-lived birds, with a life span often exceeding 50 years. Handraised young birds are preferred as pets because they are easier to tame than birds
that were not hand raised. Cockatoos may not be practical for people with aller
gies, due to their powdery feathers. These birds are ideal pets for non-allergic
clients who are looking for a sweet, cuddly, affectionate bird and have the time to
provide it with a large amount of attention.
Macaws (Ara spp., Anodorhynchus sp.) Macaws range in size from the small
miniature macaws to the hyacinth macaws, the largest of the parrots. In general,
both the small and large macaws are very intelligent, active, mischievous, and
good talkers. Miniature macaws commonly seen as pets include the noble, yellowcollared, and severe macaws. They are intelligent, playful, and good talkers, but
they can be somewhat feisty on occasion and can have behavioral changes dur
ing periods of sex hormone activity. Overall, they are a good choice for people
who like macaw features but do not want to deal with the size and behavioral chal
lenges of the larger macaws.
The different species of large macaws vary in size, coloration, and temperament.
Large macaws may tend to favor one person, which can pose problems when the
birds go through sexual hormone cycles. They can, for example, be highly protec
tive of the family member who is the object of their desire and aggressive
toward other family members. In addition, sexual frustration can lead to aggres
sion and feather picking. Finally, because of the large size of these birds, owners
must be financially prepared to invest in extra-large, extra-strong cages and flight
areas. On the positive side, large macaws are long-lived, with life spans rivaling
those of humans, and they are, for the most part, entertaining, affectionate pets.
Owners should be counseled about the behavioral characteristics of these birds so
that they can be sure they are selecting the right bird.
The blue and gold macaw is the most common macaw pet variety, largely due to its
personality and to the success of domestic breeding. Intelligent and somewhat tem
peramental, blue and gold macaws possess fairly good talking abilities. Having a
mischievous nature, they will constantly test the pet owner.
Scarlet macaws are the most colorful of all the macaws and are the best talkers.
However, they have a feisty disposition and a tendency to give unprovoked
bites. For owners who can deal with these challenges, they make wonderful pets,
but they are not a good choice for a first-time bird owner.
Green-winged macaws, despite their large size and imposing beak, are the gentlest
of the large macaws. A good choice for a first large bird, they are affectionate, gen
erally easy to handle, and have a decent talking ability.
Military macaws are less common as pets than the three large macaws already dis
cussed, as they are often high-strung, have a tendency to nip, and have a poorer
talking ability than the other macaws. Although they can make wonderful pets in
the right situation, military macaws may be too much of a challenge for inexperi
enced bird owners.
Hyacinth macaws are, as noted earlier, the largest of all parrots. Beautifully col
ored and having gentle dispositions, they are the dream bird of many bird
fanciers. However, their cost can be prohibitive for many people. In addition, they
do not have great talking ability, and they can show some aggressive behavior
when they reach sexual maturity, which can be especially problematic due to their
size and strength.
Different types of macaws have interbred in captivity, producing several varieties
of hybrid macaws that are seen as pets, including Catalinas, harlequins, rubies, and
shamrocks. In contrast to other types of hybrid animals, they are not sterile. Some
bird organizations do not recognize hybrids, as they are not naturally occurring
species. Nonetheless, they possess the typical macaw characteristics and make
excellent pets.
Prior to taking a new bird home, the buyer should prepare a list of questions and
concerns to discuss with the seller. It is best for the buyer to write down this list,
since in the excitement of taking a bird home, key questions might be forgotten.
For birds that are not yet weaned, the buyer should question the seller about the
formula being used, the feeding schedule, and a weaning plan to be enacted when
the bird is converted to self-feeding. For birds that are already weaned, the buyer
should ask about the type of food and supplements, if any, that are currently being
provided and about the feeding schedule being used. Until the bird has acclimated
to the new environment, its diet should not be changed.
Special considerations come into play when young birds are purchased. Young
birds are sweet and affectionate and they develop a wonderful bond with people,
but unless they are already weaned the new owner will need to spend time with the
seller learning how to properly hand feed the bird.
The new ownereven if he or she is experienced with birdsshould practice
hand feeding the bird under the watchful eye of the seller before taking the bird
home and feeding it without assistance. Ideally, the breeder or pet retailer will
allow the new owner to prepare the food, check the temperature, and feed the bird
under his or her guidance a few times, so that the new owner can develop all the
necessary skills. The owner must learn to prepare the formula that the breeder or
retailer has been using and to feed it at the same consistency and temperature that
has been used, or the bird may refuse to eat. The bird may also refuse to eat if there
is any variation in the way it is fed, such as its position or the position of the
feeders hand. Finally, practice is also essential to ensure that new owners learn
proper feeding techniques. Improper handling or accidental overfilling of the crop
can cause the bird to aspirate food into its trachea, lungs, and air sacs, which may
result in sudden death or aspiration pneumonia.
Because hand feeding can harm or kill a bird if done improperly, some breeders
and pet retailers have a policy of not selling any birds before they are weaned.
Young birds that have been weaned before purchase will still develop a strong
bond with the new owner.
When a newly weaned bird is purchased, the new owner should check the birds
droppings at the breeder or pet retailer before taking the bird home to develop a
feel for the normal appearance and number of droppings for the bird. When the
bird is taken home, the new owner should carefully evaluate the droppings to make
sure the bird is continuing to eat satisfactorily. With the stress of being placed in
a new environment, it is not unusual for a newly weaned bird to stop eating.
Should the number or appearance of the droppings indicate that the bird is not eat
ing enough, the bird may need to be hand fed again until it begins to eat on its
own. If such is the case, the owner should check with the breeder for suggestions.
Whether the young bird that is purchased is weaned or being hand fed, the new
owner should be instructed to weigh the bird each morning at the same relative
time before feeding using an accurate scale. Such scales can be purchased inex
pensively. Whereas a slight fluctuation in daily weight is normal, a steady weight
decline should be cause for concern. Similarly, whereas a decline in weight is
normal when a bird is being weaned, a rapid drop in weight could indicate that
the bird is being weaned too quickly. New owners should record the daily
weights and note trends.
The owner of any new bird should be instructed to isolate the bird for at least 30
days away from any other birds. Even if the bird has been given a clean bill of
health by an avian veterinarian, some conditions may be undetectable or may be
incubating, only to develop at some later time when the bird is stressed. In addi
tion to the risk of the new bird transmitting a disease to other birds in the collec
tion, the new bird, stressed by being placed in a new environment, is also more
prone to picking up diseases that are already present in birds in the collection.
Such diseases may be subclinical in the healthy, unstressed birds but cause prob
lems for the new arrival with its lowered resistance. The 30-day period is sug
gested because disease conditions will generally become apparent in this time
frame, especially since the bird is being stressed by placement in the new envi
ronment.
Contrary to the belief of some people that isolation is important only for larger
birds, isolation is important for small birds as well. It is not unusual for small
birds to carry such serious diseases as chlamydiosis and Mycoplasma sp. infec
tions as well as parasitic infections, such as giardiasis, that are readily transmissi
ble to the other birds in a collection. Not only should the isolated bird, large or
small, be kept in a separate room from other birds, preferably in a room with sep
arate air flow, but the owner should be instructed to wash the birds utensils sepa
rately from those of the other birds and to wash his or her hands thoroughly after
handling the isolated bird.
Even if all of these precautions are taken, it cannot be guaranteed that a new bird
will not be a source of disease for other birds in a collection. Birds can, for exam
ple, be carriers of chlamydiosis but show no outward signs of the disease. Other
diseases, such as proventricular dilatation disease (PDD), can persist undetected in
a bird for long periods of time and cause outbreaks years later. Until more research
is conducted and more diagnostic tests are developed, however, the 30-day isola
tion is an owners best defense against risk to the birds in his or her collection.
a source of zinc that can lead to new wire disease, a heavy metal toxicosis that
is occasionally encountered in birds.2 Galvanized wire (e.g., chicken wire) and
clips used to construct cages, as well as galvanized containers and dishes, when
not properly treated, contain zinc.2Adding to the problem, the white rust on gal
vanized metal is also toxic. Scrubbing the metal with a brush and a mild acidic
solution (such as vinegar) can remove some of the loose zinc, reducing but not
totally eliminating the risk.
All owners should be instructed to check cages for any sharp projections or edges,
which can pose a hazard. In addition, cages for larger birds must be sturdy, as
these birds can easily dismantle a cage designed for a smaller bird. Further, since
larger birds will damage even a sturdy cage over time, owners should be instructed
to periodically look for any loose or bent pieces of metal that can cause injury. Bar
spacing should also be checked to ensure that it is the correct width for the bird.
Spacing that is too wide can allow a bird to escape or, worse, to get its head caught
between the bars.
Cage Accessories
Because birds spend most of their lives on
perches, it is essential that the perches be
comfortable, constructed in ways that will
help prevent foot problems, and be regu
larly and thoroughly cleaned. Care should
be taken that the perches in a cage are of
different diameters, allowing more even
wear on the feet and helping to prevent
ulceration and bumblefoot. If birds have
thinning scales in the middle of their feet
(Figure 2), the perch diameters are too
small; if the scales are thinning at the
hock (Figure 3), the perch diameters are
too large.
Figure 2
Thinning scales (pressure sores) in the middle of
the foot. This condition can be caused by the use
of all small-diameter perches. (P. S. Sakas, DVM)
Perches are available in numerous shapes and a variety of materials. Flat perches
are advantageous for small birds. For both large and small birds, the cage should
contain at least one soft perch, such as tubing or rope; for small birds, one perch
Cage toys should also be mentioned. Owners should be instructed about the haz
ards of some of the commonly available
cage toys. For example, glass mirrors can
be hazardous to large birds; stainless steel
mirrors are a much better choice. Toys
with sharp edges or hooks can lead to
severe injury. Some toys that are safe for
smaller birds can be dangerous to larger
birds, as they may dismantle the toy,
exposing hazards (Figure 5). They can, for
example, easily remove a bell from a toy
and get it lodged on their beak or crack
open a toy to expose a lead weight within.
Figure 5
daily. Other good choices include rawhide chews, cuttlebone/mineral blocks, lava
rocks, branches from outside, cardboard, wooden clothespins, bones, pine cones,
white pine wood (in perches or scraps), and rope.
Cage covers are also important, since birds need at least 8 to 10 hours of darkness
every evening to obtain adequate rest. The covers serve other important purposes
as well. For example, they help to keep the cage warm if the temperature drops at
night. In addition, partially covering the cage can provide birds with a retreat in
which they cannot be seen, which is especially important for new and nervous
birds. Placing a synthetic cloth bird tent or a box inside the cage can also create
such a retreat.
Household Dangers
Owners may not realize the potential danger to pet birds of common household
furnishings. Windows and mirrors do not appear to be barriers to flying birds,
and thus must be covered if birds are allowed to fly freely in the home. Similarly,
all open containers of water, such as glasses, sinks, commodes, and pots, should
be covered. Too often, a bird will try to take a drink from one of these contain
ers, lose its balance, fall in, and drown. Yet another potential hazard is the ceil
ing fan. Cockatiels are particularly at risk for injury from ceiling fans due to their
soaring flight.
The loss of a pet bird through an open door or window is not an uncommon
occurrence. Another dangerous situation is for a free-flying bird to perch on top
of a door (such as to a closet or pantry) because the owner may be unaware that
the bird is there and close the door, causing foot and leg injuries to occur.
Sometimes the injury is an abrasion, but more often than not, it is a fracture or
near amputation.
Another common source of injury to pet birds is other household pets. Cats, dogs,
ferrets, and other birds can cause serious injury, even to large birds. An untreated
cat bite or scratch can result in bacterial septicemia, which can be lethal to birds.
Owners should seek veterinary care promptly if their birds are bitten or scratched,
even if the birds look fine, so that proper antibiotic therapy can be started. Injuries
from dogs and ferrets are more often blunt trauma or puncture wounds. Jealous or
aggressive birds in the household can also cause severe injuries to other birds,
including traumatized or avulsed beaks. The most common types of injury caused
by other birds are toe lacerations, fractures, and amputations.
Though perhaps not generally thought of as a household danger, loud noises
should be avoided, since birds have sensitive hearing. Loud noises can cause
stress, leading to lowered resistance to infection, feather picking, and other behav
ioral problems.
Because of their small size and efficient metabolism, birds are particularly sensi
tive to many chemicals. Compounds that have been found to be toxic to birds
include agricultural and gardening chemicals, insecticide and herbicidal sprays,
rodenticides, mothballs (naphthalenes), and denture cleansing solution.
Disinfectants used to clean bird cages and accessories can be dangerous if used in
more concentrated amounts than recommended by the manufacturer or if allowed
to lie in pools at the bottom of cages. Cages should always be rinsed thoroughly
after disinfectants are used. Salt consumed in large amounts can be toxic, but con
suming salt off a pretzel or potato chip is not dangerous. Cigarette butts left care
lessly around the home in ashtrays are dangerous; if ingested, they may cause
death. Drugs consumed in excessive quantities or administered improperly can
also be problematic. Owners should be cautioned to follow the recommended
dosages and routes of administration prescribed by the veterinarian for all med
ications given to birds.
The danger of lead poisoning has already been mentioned. In addition to the lead
paint used on older cages or accessories, lead can also be found in curtain weights,
cuckoo clock weights, fishing sinkers, toys, shotgun shot, bullets, solder, putty,
linoleum, mirror backings, costume jewelry, zippers, unglazed ceramics, ceramics
produced in foreign countries, wine bottle foil, leaded glass, and more. In older
homes, birds may chew through top layers of safe paint and ingest the lead-based
paints used long ago. Owners must make sure that birds do not ingest objects con
taining lead or zinc.
Because birds like to nibble at vegetation, toxic houseplants may cause a problem.
However, the documented cases of plant poisonings in birds are actually quite
rare.5 It is believed that the rapid gastrointestinal transit time in birds may play a
role in the low incidence of this type of toxicosis.5 Nevertheless, if potentially
toxic houseplants are present in the household, the client should take measures to
prevent access by their birds. Local poison control centers can provide lists of
such plants to bird owners.
Another household danger to birds is toxic fumes. Due to the efficiency of their
respiratory tract and their small size, birds are more sensitive to toxic elements in
the air than are humans. Indeed, some airborne toxins that appear to have no
immediate effect on humans can cause sudden death in birds. The sources of air
borne toxins that are dangerous to birds are aerosol sprays (the propellant in the
sprays is toxic), burning or overheated cooking oil or butter, polymer fumes in
spray starch, fumes from self-cleaning ovens, paint fumes, smoke from burning
food, nonstick plastic sprays used to coat cooking utensils, cigarette smoke, carbon
monoxide (from car exhaust, water heaters, furnaces), natural gas, and overheated
polytetrafluoroethylene (PTFE, commonly known as Teflon), or any other material
that emits fumes. Owners should be encouraged to limit their birds exposure to
any fumes and, if a strange smell or fumes are noted, to remove the bird to an area
free of fumes and having good ventilation.
In addition to the household hazards already mentioned, hot cookware, food, and
range tops can be dangerous. The best advice a veterinarian can give bird owners
is to supervise birds whenever they are in free flight.
The question then becomes what type of diet veterinarians should recommend to
bird owners. Researchers have not yet determined exactly what constitutes a com
plete, balanced diet for pet birds, and it is likely that the requirements may vary
from species to species. It is known, however, that a seed diet alone is inadequate.
A much better choice is one of the excellent formulated diets now manufactured
commercially for pet birds.
Whatever the food fed to pet birds, it should be clean, fresh, and from a reputable
source. Spoiled foods and moldy or dirty grain can be possible fungal sources.
Poor-quality com and peanuts are common sources of toxin-producing molds.
Fresh fruits and vegetables should be washed thoroughly to remove any residual
insecticide contaminants. Perishable foods should be refrigerated or frozen; nonperishable foods can be treated the same way or stored in an area that is neither
damp nor dusty.
pellet/seed bars and cakes (Avicakes and Nutriberries from Lafeber Company).
Because birds are attracted to seeds, these bars and cakes are generally more read
ily accepted than formulated diets, and because the seeds and pellets are tightly
bonded together, the birds ingest both portions. Having many of the advantages of
a formulated diet, and being readily accepted, they can be used as a transition food
in the conversion process to a formulated diet. A disadvantage is that they contain
a higher fat content than formulated diets, due to the inclusion of seeds.
Many avian veterinarians market avian nutritional products. Samples might be
displayed in the examination room, where discussions of these products usually
take place.
Seed Diets
Accepted for many years as the proper food for birds, seed diets are now known
to be nutritionally deficient and should be discouraged. Not only are seeds incom
plete foods, but birds tend to eat only their favorites of the seeds provided, leading
to even greater nutritional deficiencies. A diet composed of seeds alone can lead to
vitamin A deficiencies (due to the deficiency of this vitamin in seeds), calcium
deficiencies (since the high fat content in seeds binds the calcium, making it nutri
tionally unavailable), vitamin D3 deficiencies, vitamin E deficiencies, amino acid
deficiencies, obesity, and other conditions.7
Unfortunately, birds that have been raised on seed diets will often be unwilling to
convert to a formulated diet. For such birds, it is essential that the seed mix is fresh,
such as the bagged varieties in most pet stores, is free of bugs, mold, dust, and
musty odors, and includes a variety of seed types. It is also essential that the seed
diet be supplemented, as discussed in the following sections.
Because many supplements come in powdered form, owners should be advised to
place them in the drinking water or to mix them with moist food rather than sprin
kle them onto the seeds. (Most birds, however, prefer their water unaltered.) When
powdered supplements are placed in drinking water, the water should be changed
at least once daily. For vitamin supplementation, a drawback to this type of admin
istration is that vitamins lose some of their potency when placed in water, and the
additives in some vitamins (such as dextrose) can promote bacterial growth in the
water. When powdered supplements are sprinkled onto seed, the powder will sift
to the bottom of the dish or be lost when the bird hulls the seed. Thus, it is impos
sible to determine how much of the supplement the bird is actually ingesting. Care
must always be taken to avoid oversupplementation, which can be as detrimental
to birds as deficiencies.
Vitamin Supplements
Vitamin supplementation is essential for birds on seed diets. A number of excellent
avian vitamins are available commercially, some of which are designed for partic
ular conditions or situations. Owners should be instructed to select a preparation
that is appropriate for the particular needs of their birds and to follow the manu
facturers instructions closely.
Some manufacturers produce combination supplements that contain vitamins,
minerals, amino acids, and probiotics (the so-called beneficial bacteria). Although
most of the probiotic organisms included in these supplements do not form per
manent gut colonies of beneficial bacteria, they may still act beneficially intraluminally.8
Because vitamin A deficiencies are among the most common nutritional problems
seen in pet birds, all owners should be advised to provide their birds with addi
tional dietary sources of vitamin A. Foods rich in vitamin A, or beta-carotene,
include red, yellow, and orange vegetables (such as carrots, sweet potatoes, dark
yellow squash, papaya, and red peppers), egg yolk, and dark green leafy vegeta
bles (such as spinach and broccoli).
Mineral Supplements
For birds on seed diets, daily mineral supplementation is needed to provide proper
proportions of calcium, phosphorus, and vitamin D3, which is required for the
proper absorption of calcium. Mineral supplementation is especially important in
birds that are laying eggs, since calcium deficiency can lead to egg binding.
Calcium and vitamin D3 supplies should be evaluated carefully for all breeding
birds, as both oversupply and undersupply of these nutrients can lead to problems.
Oversupplementation of vitamin D3, for example, has been implicated in problems
in macaws and other species.9
Protein Supplements
In birds on seed diets, supplementation with proteins can compensate effectively
for the protein deficiencies of seeds. Limiting amino acids, such as lysine and
methionine, should also be administered. Sources of protein include meat, fish,
beans, cheese, and eggsall should be offered in limited amounts.
Liquids
Without a fresh, clean source of drinking water, pet birds cannot survive. As noted
earlier, water bowls must be cleaned thoroughly every day to prevent the buildup
of bacterial contaminants. Chlorinated, well, or bottled water can be used, but well
water should be evaluated periodically for contaminants. Some birds have a fond
ness for nectar, tea, coffee, and juices. Given in moderate amounts, these liquids
will not harm a bird.
Table Foods
Pet birds are omnivorous and can digest most table foods well. However, they
should not be fed any one of them to excess. Whereas table foods can be a valu
able nutritional supplement for birds, they must be treated as a supplementthat
is, as an adjunct to a formulated diet. Birds fed a diet of table foods alone will often
do well initially, but they will begin to be selective, eating only their favorite
foods, and nutritional deficiencies will occur.
When supplementing a birds diet with table foods, a number of precautions must
be taken. Feeding calorie-dense table foods (pasta, cereal products, eggs, beans)
will complicate nutritional evaluations, particularly for those birds that depend on
the vitamin and mineral contents of formulated diets without additional supple
mentation. Further, calorie-dense foods significantly decrease the birds calorie
intake from its staple diet. Care must also be taken with fatty foods. Birds fed diets
high in fats tend to be overweight, may have oily feathers, and may have an
enlarged liver that is infiltrated with fat.
In addition, high-cholesterol foods should be strictly limited or avoided. Like peo
ple, most birds are long-lived and can be subject to atherosclerosis. Although the
risk factors have been insufficiently studied in birds, at least three of the risk fac
tors described in humans (obesity, high-fat diets, and exposure to cigarette smoke)
frequently occur in companion birds.10
Some avocados have been shown to be toxic for birds, and chocolate in all forms
should be strictly avoided because of the potential for a toxic reaction.
It should be noted that birds fed a table food diet will produce more urine and thus
tend to have more watery droppings than birds on seed or formulated diets due to
the high water content in table foods. Further, the color of the droppings may
change depending on the type or color of the table food eaten (see color plates on
pages 333-342).
Feeding Procedures
There are two commonly used feeding procedures, free choice (or cafeteria style),
in which food is left in the cage all day long, and feeding the birds two meals a
day.4 For birds fed seed or table food diets, the former method can lead to nutri
tional deficiencies, since the birds will tend to eat only the seeds or foods they pre
fer. For birds fed formulated or combination diets, this problem is nonexistent.
Feeding a bird two meals a day with nothing in between, except for an occasional
treat, parallels the way birds forage in the wild and has many advantages for the
bird and owner. With a definite mealtime and eating schedule, birds will begin to
anticipate eating and will eat heartily, reducing the wasting of food.4 Coordinating
the feeding times with those of the owner (or any other birds in the house) and
offering limited amounts at mealtimes may enhance social behavior and avoid
obesity.11In addition, the hungry bird will likely develop a bond of friendship with
the person providing the food as it begins to associate that person with the pleas
ure of eating, and it will learn to accept hand-fed treats between meals. Yet another
advantage to this type of feeding regimen is that the owner can be present when the
bird is eating and thus can easily observe what, how much, and in what manner the
bird eats. A watchful owner will quickly recognize any deviation from normal and
can consult his or her veterinarian for advice.
A two-meal-a-day feeding program can also be useful in training and developing
a reward system. Like other animals, birds will respond to a food reward if they are
hungry. Favorite foods can be withheld from the regular meal and given as a treat
to provide positive reinforcement for desirable behaviors. As the relationship
between the owner and bird develops, a display of affection, such as a caress, may
suffice as a reward.
begun, the bird should be given a complete physical examination, including blood
work, to determine if it will be able to withstand the stress of the process.
When recommending diets or feeding strategies to owners, it is important to con
sider each case individually. In addition to differences in feeding history, nutrient
requirements, and food preferences between bird species, there are also differ
ences in owner compliance. Some owners will be very resistant to feeding nonseed
diets. The owner may perceive a nonseed diet as being monotonous. (In actuality,
seed mixes are generally monotonous nutritionally, since many birds will select
and eat only one type of seed.) Two means of conversion are described in the fol
lowing sections.
Twice-a-Day Feeding
Birds should not be starved into eating new foods. If a bird is currently being fed
cafeteria style, the twice-a-day feeding conversion process will allow a natural
hunger and a keen appetite to develop, cause the bird to break out of a pickyeater habit, and cause it to be more apt to eat the formulated diet presented. The
following conversion procedure has been shown to work well.4 The owner
begins by discontinuing cafeteria feeding and providing the birds favorite foods
(such as seed) three, and later two, times a day.12 The length of the meal period
will vary depending on the desired result. When the purpose is to switch the bird
to a formulated diet, mealtimes of 1 hour in the morning and 1 hour in the
evening work well. If weight loss is the goal, 15-minute mealtimes may be
required. Each evening, all food is removed from the cage, and it is supplied
again the following morning.
After the bird has adjusted to the feeding schedule, small amounts of the new
food are introduced. It is often helpful to begin with one of the crossover foods
available commercially, such as a combination product of seeds and pellets
bound together with a vitamin and mineral coating. Birds will recognize this
food as a seed-type food and often will take it readily, facilitating the complete
conversion to a formulated diet. The new food that is introduced is kept in the
cage between feeding periods. When formulated diets are used, they should be
offered moist as well as dry; fruits or greens may be chopped and mixed in with
the formulated diets.
Because of the hunger the bird will develop as a result of switching to a twice-aday diet, the bird will soon begin to sample the new food. One study found that
90% of group-housed cockatiels consumed a novel diet within 48 hours. The
remaining 10% were reexposed to the new diet at a later date, at which time 90%
consumed the food.13 It should be noted that groups of birds are more easily
manipulated in terms of diet than are single pet birds, but the latter will generally
respond as well.
An alternative approach is to offer the new food before the start of the usual meal
period, either first thing in the morning or in the evening, since hunger may make
the bird less discriminating about new foods. The owner should be encouraged to
also offer the new food, by hand, outside the cage. Friendly birds may be more
likely to try a new food administered in this way, and with all birds, the technique
may help to develop a bond of friendship.
Once the conversion to a formulated diet is begun, the owner should begin to mix
small amounts of the new food with the regular diet. The ideal starting mix is 25%
formulated diet and 75% regular diet. When the owner is convinced that the bird
is taking in some of the formulated diet, the mix should be switched to 50% for
mulated diet. When this phase is complete, the mix is adjusted to 75% formulated
diet and finally to 90% formulated diet and 10% table food. Additional supple
ments will not be needed unless indicated by specific conditions, such as during
breeding or other times of stress. The rate of conversion will depend upon the
acceptance of the new diet by the bird. Thus, the length of each phase can be quite
variable. Any bird can be converted with little stress in a period of 30 days by
using this method of gradually increasing the proportion of formulated diet until it
has been replaced the seed diet.7
Interval Feeding
An interval feeding method can also be effective, but it takes more work on the
part of the owner. With this method, small amounts of food (a mixture of the new
food and the regular food) are offered at intervals throughout the day and removed
as soon as the bird stops continuous ingestion.14As the bird adjusts to this feeding
program, the amount of new food can gradually be increased in the mixture.
Owner Monitoring
Whatever method is used, it is essential that the owner monitor the birds condition
during the conversion process, since it is a time of extreme stress for the bird. The
owner must observe whether the bird is, indeed, taking in the new food and, with
single birds, must monitor weight, since birds will quickly deteriorate if they are
not eating. Small birds may die within as little as 48 hours if they do not eat.4 The
birds activity level and the number and characteristics of its droppings must also
be monitored. A bird that has become quieter than normal or that is spending
excessive periods of time sitting ruffled up during the conversion process may not
be getting enough to eat. Further, a decrease in the number of droppings or a
change in the normal appearance of the droppings may indicate potential prob
lems. Droppings that are flat or that have little fecal portion may be indicative of
lack of eating. However, some color change in the droppings is often normal.
Ingestion of a brown formulated diet, for example, will change the droppings to
brown. If the bird is fed a multicolored formulated diet, the bird may have a
favorite color and eat only that portion of the diet, with resultant color change in
the droppings. Particular table foods may also cause color change. Strawberries
result in red droppings; concord grapes, purple. And, as noted earlier, droppings
will become more watery with the ingestion of table foods (see color plates on
pages 333-342).
Owners should be advised to revert to the previous step should problems develop
during the conversion process. When attempting to change a birds diet, patience
is the key to success.
References
1. Davis, C. Common Types of Cage Birds and Comments on Their Temperaments and
Pet Quality. In Rosskopf, W. J. and Woerpel, R. W. eds., Diseases o f Cage and Aviary
Birds, 3rd ed., Baltimore, MD: Williams and Wilkins, 1996: 11-18.
2. Van Sant, F. Zinc and Parrots: More Than You Ever Wanted to Know. In
Proceedings of the Annual Conference of the Association of Avian Veterinarians, St.
Paul, MN, 1998: 305-312.
3. Murray, M. J. Intensive Care of the Critically 111 Bird. In Proceedings o f the North
American Veterinary Conference, 1998: 12: 763-766.
Reference Materials
With the large amount of information available on avian medicine, it can be diffi
cult to know which will best meet specific needs. Discussed below are several ref
erence materials and sources that can prove quite useful to veterinary staff engaged
in the practice of avian medicine.
Any veterinarian interested in avian medicine should become a member of the
Association of Avian Veterinarians (AAV). Members receive a quarterly journal
that includes current research and topics related to avian medicine. In addition,
the AAVs yearly conference provides an opportunity to hear researchers from
around the world present their most recent findings and includes an informative
scientific program with basic to advanced topics as well as wet labs. Any veteri
narian planning to become involved in avian medicine should attend the AAV
conference, as it meets the needs of the beginning as well as the experienced
avian practitioner. See page 327 of the Resources section for contact informa
tion.
An avian reference library should be developed that includes veterinary as well
as lay publications. Several excellent avian medicine textbooks are available.
See pages 327-328 of the Resources section for a listing of recommended addi
tions to your library.
Two excellent periodicals pertaining to avian medicine are Seminars in Avian and
Exotic Pet Medicine, which focuses on a particular topic each issue and is pub
lished by Harcourt Health Sciences; and Veterinary Clinics o f North America:
Exotic Animal Practice, a new addition to a well-respected series. Others are listed
on page 328 in the Resources section.
As noted in Chapter 1, a successful avian practitioner should be able to identify the
major varieties of pet birds and aspects of their care. A number of lay publications
are particularly useful in this regard, including numerous books on particular vari
eties of pet birds. An especially valuable resource for identifying parrots is Parrots
of the World 1, a lavishly illustrated reference with color drawings of every imagi
nable type of parrot. It is also recommended that veterinary offices subscribe to
some popular bird magazines (Bird Talk, Bird Breeder, Companion Parrot
Quarterly, and Wild Bird are particularly good sources) because they discuss the
varieties of birds and provide information on training, taming, and husbandry.
Quite often, bird clients will subscribe to these magazines as well and will ques
tion their avian veterinarians about information they have read in the articles.
Although a number of website and other information sites are available electroni
cally, it is important to be cautious about accepting some of this unreferenced
material at face value.
Basic Equipment
Veterinary facilities will already possess the standard equipment needed for the
care of pet birds: a microscope, a centrifuge, radiology equipment, an anesthesia
machine, and means of sterilization. Other equipment required for a bird practice
is discussed below. Much of this equipment will be useful for the treatment of a
variety of small animals, not just birds, making the investment a good one for
most veterinarians.
Source of Magnification
A binocular head loupe with magnification is helpful during the physical exami
nation, especially when dealing with small birds.
Ophthalmic Forceps
Small forceps (not rat-toothed) are useful during the physical examination for
cleaning debris from the nares and for opening the mouth of a smaller bird for
an oral exam.
Mouth Speculum
Mouth specula, which are available
in a variety of sizes, are essential
for completing an oral examina
tion, especially with larger birds
(Figure 6). Some practitioners pre
fer to use scissors, hemostats,
gauze strips, or Nylabones instead
of a speculum to open the beak
during the oral examination.
Figure 6
Mouth speculum for examining mouths of birds. Stepdowns can open mouth to varying degrees or enable use
with a variety of bird sizes. Small specula are available for
smaller varieties of birds. (P. S. Sakas, DVM)
Grinding Tool
A small hand-held drill with grinding attachments is useful for grinding the beak
and nails. A variable-speed drill with a cone-shaped attachment is especially effec
tive for shaping the beaks of even small birds. A drawback to the use of grinding
tools is that it is difficult to adequately disinfect the grinding head, with the result
ant risk of disease transmission.
Laboratory Equipment
A well-equipped laboratory with the ability to perform in-house diagnostic tests is
invaluable for providing rapid diagnosis and effective treatment.
Hematology For basic hematology, microhematocrit tubes, coverslips, and
stains are all that are needed.
Serology Practitioners will find one of the currently available chemistry sys
tems extremely useful for performing in-house avian chemistries on serum and
plasma. These systems can provide individual panels on a small amount of sam
ple. While the initial cost of these systems is expensive, the systems can be used
not only for performing plasma and serum chemistries on birds and pocket pets but
also for obtaining instantaneous answers for canine and feline medical cases and
for conducting presurgery workups. If a chemistry system is not available in the
practice, many commercial labs offer avian diagnostic services, including hema
tology and serology. For the collection of serum samples, Microtainer serum sep
arators are invaluable. This equipment can be used to collect blood for immediate
use or for transport if more sophisticated testing is required than can be done inhouse.
Microbiology Because avian diagnostics often involves the staining of fecal
samples, cloacal swabs, and exudates, as well as culture/sensitivity testing, all vet
erinary practices should possess standard microbiology equipment. Microbiology
stains frequently used include Grams, Wrights, Diff-Quik, acid-fast, and
Gimenez. Performing in-house culture/sensitivity testing is not difficult, provided
that antibiotics commonly used in avian therapeutics are tested. Many commercial
labs also provide this service. In addition, local veterinary or human hospitals are
often willing to work with avian samples. Culturettes are ideal for collecting and
transporting samples. Because of their small size, calcium alginate swabs are use
ful for obtaining samples from small birds.
Radiology Equipment
In addition to standard radiology equipment, it is useful to stock high-detail film.
High-detail dental film can be economical since it can be used in place of
the more expensive standard film for small birds, such as budgerigars, or to high
light a particular area, such as a fracture site. Avian positioning boards
care unit and a pediatric unit should also be available, the former for critical cases
and the latter for hand-fed neonates.
Feeding Tubes
Because sick birds often need supplemental nutrition, hospitals should be well
stocked with gavage feeding equipment. Most often, small, metal-ball-tipped crop
needles and red rubber or soft plastic blind-ended feeding tubes with side ports are
used. Red rubber urethral catheters are especially effective. Different-sized gavage
tubes are used for different avian speciesfor example, an eight French tube is
used for budgerigars.
Chapter 5 lists appropriate sizes of gavage tubes and volumes of feeding solution
to be administered for different species. Some practitioners prefer to use metal
gavage tubes, which are widely available as well.
Syringes
U-100 insulin syringes (30- and 50-unit sizes) are used for most injections in birds.
If tuberculin syringes are used, 26- to 30-gauge needles are preferable. It is also
helpful to have a microliter syringe for delivering minute amounts of medication.
Catheters
Spinal needles (20- and 22-gauge) should be stocked for intraosseous fluid admin
istration. If a fluid pump is not available for this procedure, a burette will be
needed to limit fluid volume. Butterfly catheters (27-gauge) are also very useful in
exotic animal practice.
Nebulizer
A nebulizer is indispensable for birds with severe respiratory tract or air sac dis
ease, since injected or orally administered antibiotics alone will not reach thera
peutic levels in the air sacs. Human hospitals, medical suppliers, and respiratory
therapy companies may be able to supply used equipment. Practitioners should not
hesitate, however, to purchase a new nebulizer. This important piece of equipment
is not inordinately expensive and is useful for treating severe respiratory disease
not only in birds but in a number of other small animals as well.
used is 4-0 to 6-0 suture with a swaged-on needle.2 Generally, multifilament suture
handles better than monofilament suture.2 However, in contaminated or infected
wounds, monofilament nylon is the suture of choice because it does not allow bac
terial wicking.2 For body wall closure, a strong, slowly absorbable material that
causes minimal tissue reaction is needed; for suturing the skin, a rapidly absorbed
material may be selected, as it eliminates the need for suture removal.2
Anesthesia Equipment
Small endotracheal tubes, which are commercially available, are very effective
for delivering gas anesthesia to birds and small mammals. For small birds, syringe
cases (e.g., the 3-cc size) can be adapted and used as face masks. Most avian prac
titioners use only isoflurane for avian surgery. Purchasing isoflurane is an invest
ment that is well worth the money. With isoflurane, birds can be anesthetized
quickly and safely through a face mask, and recovery is usually rapid. Sevoflurane
has been used successfully in avian patients with advantages of more rapid control
of anesthetic depth and faster recovery from prolonged procedures.3 However, its
cost (at the time of this writing) is much greater than that of isoflurane. A Doppler
flow detection apparatus is a useful tool for monitoring arterial flow during sur
gery.3 The brachial and tarsal arteries can be used for this procedure.
Radiosurgical Unit
A radiosurgical unit is particularly beneficial in avian practice. Because it pro
vides hemostasis and allows for incisions with minimal hemorrhage, it has revo
lutionized avian surgery. The more practitioners use these units, the more they
grow to depend upon them and to develop further applications. Another advantage
is that the radiosurgical unit can be used for other small animal surgery, a factor
that helps to justify its cost.
Endoscope
An endoscope has multiple purposes in avian surgery. For one, it can be used to
determine the sex of birds. Although an otoscope can also be used for this purpose,
an endoscope provides much better visualization with a smaller incision. Adapters
are available that utilize the otoscope base to create a reasonable endoscope that is
not as costly as an entire endoscopic setup. However, the advantages of using an
endoscope justify the cost of purchasing one. In addition to their use in sex deter
mination, endoscopes can be an important diagnostic tool for evaluating internal
organs, and with specific attachments, they can greatly facilitate biopsy sampling.
Endoscopic examination of the trachea can be performed in cases of foreign body
aspiration, syringeal disease, or tracheitis.4 The most commonly utilized endo
scopic systems in avian medicine have a diameter of 1.9 mm, 2.7 mm, or 4.0 mm,
with the 2.7 mm most often used as an excellent compromise between size and
light transmission 4
Additional Equipment
Several other supplies are also useful in avian practice. Beak-repairing resins and
dental acrylics, for example, are very useful for repairing the beak after trauma and
for correcting malocclusions. A supply of microchips and a microchip scanner
should be available, since microchips are being used more and more frequently for
bird identification. Ultrasonic imagery and fluoroscopy may become more fre
quently utilized diagnostic tools in the future. Laser surgery is becoming more
popular in avian practice.5Endoscopic applications with a laser include avian cas
tration, ovary ablation, oviduct ligation, and renal mass debulking and removal.6
Time Management
Avian practitioners often feel stressed by the amount of time they spend exchang
ing information with their clients and performing routine procedures. Training vet
erinary technicians and other support personnel to take over these responsibilities
can alleviate much of this problem.
Information Exchange
With regard to time spent exchanging information with clients, support staff can be
trained to professionally discuss the finer points of husbandry, biology, and pur
chasing options with bird owners, freeing up much time for the veterinarian to
perform the more technical aspects of veterinary medicine. Whether by phone or
in the examination room, technical staffwith adequate trainingcan provide
nutritional and other counseling to the owner. (As noted earlier, samples of qual
ity avian nutritional products can be displayed in examination rooms to facilitate
the discussion of recommended products.) Continuing education programs are
available to provide training in many of these areas. Staff should be encouraged to
stay abreast of current trends and developments by obtaining personal subscrip
tions to lay avian publications. Staff should also be instructed to direct callers with
wildlife concerns to a local licensed rehabilitator after demonstrating both interest
and compassion to the caller.
In addition to the help provided by technicians and support staff, the veterinary
practice can educate clients through the use of printed handouts, such as those
published by the Association of Avian Veterinarians, and pertinent books and
magazines. Using these resources will not only save the veterinarian time but will
also increase compliance. Printed handouts are nearly always required for infor
mation retention.
Time will also be saved through the use of an avian history form on which the
client is asked to provide information about why the bird is being seen, the num
ber of birds in the collection, the source of the bird to be seen, when the bird was
purchased, the birds diet, droppings, lifestyle, etc. Clients can fill out this form
while waiting in the reception room, and the veterinarian can scan it before enter
ing the examination room. The use of the form allows the veterinarian to quickly
focus on relevant information and also makes it unnecessary for the veterinarian to
spend valuable time writing down history points on the medical record. The his
tory form should be kept with the birds file, where it can be viewed by any other
practitioners who may later consult on the case.
Routine Procedures
The other aspect of the time management problem is the time veterinarians spend
performing routine procedures. Training animal health technicians and support
staff to perform some of the basic avian procedures will dramatically shorten the
time the veterinarian spends in the examination room.7 Indeed, an avian practice
will not be cost effective if support staff cannot perform the following procedures:
1. Restraining birds properly
2. Basic grooming, such as the trimming of wings, beak, and nails
3. Demonstrating the administration of oral and injectable medications to the
owner following the examination
4. Setting birds up in the hospital unit and providing heat, perches, medication,
hydration, and alimentation (by gavage if needed)
5. Sedating birds (with veterinary supervision) and taking avian blood samples
and radiographs
Excellent training in these procedures is offered through the continuing education
programs of the Association of Avian Technicians, the AAV, and other large
national veterinary association meetings.
Technical staff can also be given the responsibility for caring for a clinic bird. Not
only will they gain valuable experience with regard to husbandry and nutrition, but
they will also have the opportunity to practice taking normal blood smears, per
forming radiographs, and conducting other simple procedures.
erinary hospital can be offered or an open house hosted following the completion
of the seminar.
It is also helpful to become a member of a local bird fancier club. Veterinarians can
gain additional exposure for their practices by offering to write articles pertaining
to avian medicine or a question/answer column for the club newsletter.
Another way to increase the avian caseload is to set up displays that demonstrate
the practices interest in avian medicine in the reception room or waiting areas.
Plaques, photographs, and framed posters work well, as does keeping a clinic bird.
Most clients assume veterinarians have expertise in treating dogs and cats; how
ever, such assumptions are seldom made about birds. Typically, veterinarians need
to demonstrate that they have expertise in treating birds.
In addition to showing the offices interest in birds, the clinic bird serves to
demonstrate proper husbandry practices to clients. In this regard, it is helpful to
post a plaque or sign near the cage specifying husbandry recommendations that
are demonstrated, such as the importance of providing a roomy cage and keeping
it clean, feeding formulated diets when possible, and using a variety of perch
types and toys.
Some avian veterinarians promote their interest and expertise in avian medicine
by creating a separate avian clinic, complete with its own name and special hours,
within the confines of the conventional dog and cat hospital. The presence of
such a clinic conveys the feeling of specialization. A word of caution is in order,
however. The clinic staff should be careful to not describe the veterinarian as a
specialist in birds until and unless the veterinarian becomes board certified in
avian medicine. Such certification is available through the American Board of
Veterinary Practitioners.
References
1. Forshaw, J. and Cooper, W. T. Parrots o f the World. Neptune City, NJ: TFH
Publications, 1978.
2. Bennett, R. A. Suture Materials. In Proceedings of the North American Veterinary
Conference, 2000: 14: 860.
Avian
Diagnostics
Whenever a bird is brought into the veterinary office for a routine checkup or for
treatment, it is essential that the bird be given a complete physical examination.
Not only are early signs of diseases subtle and easy to miss in birds, but birds
have a natural defense mechanism of masking illness to avoid predation or
harassment by other birds, making diagnosis more difficult. A thorough history
and a complete examination that includes observation of the bird in its cage,
hands-on examination, and appropriate laboratory work are essential for identi
fying problems and developing an effective treatment plan. This chapter covers
each of these areas in detail.
History Taking
Before examining a bird, it is important for the practitioner to obtain as much
information as possible from the owner using a comprehensive, systematic
approach. Key questions to ask include the following:
How long have you owned this bird?
Where did you obtain it? From a pet store? A breeder?
What, if anything, have you noticed to be wrong with the bird?
When did the problem start?
Does the bird have a history of previous illnesses? If so, what treatment was
used, and was it effective?
Do you have any other birds at home? Have any of them been ill? Have any
of them died?
Has this bird been in contact with other birds or bird fanciers?
Have there been any changes in the birds environment?
Have you noticed any behavioral changes in the bird?
What type of diet do you feed the bird?
Do you give the bird nutritional supplements? If so, what types?
Have you recently changed the type of food you are giving the bird or has the
source of the food changed?
Have the birds droppings changed?
Where is the cage located at home?
Is the bird always in the cage? If it is allowed freedom, is it watched when out
of the cage?
These questions are intended as a framework for history taking. Each avian prac
titioner will develop his or her individual set of questions.
Although the practitioner or a technician can ask the owner these questions in the
examination room, it is more efficient, as noted in Chapter 2, to have the owner
fill out a history form while waiting in the reception area. By scanning the form
prior to meeting with the owner, the practitioner will be able to focus his or her
attention on particular concerns during the appointment. Some practitioners cre
ate their own history form. Others use or adapt the excellent form the AAV pro
vides to its members.
Level of Sanitation
A good starting point for the cage examination is to evaluate the level of sanitation.
A filthy food or water cup may be responsible for a gastrointestinal disturbance. In
addition, the food and water cups should be the proper size and construction for the
variety of bird.
materials, including lead-based paints, solder, and untreated galvanized metal (see
discussion in Chapter 1).
The cage fittings, cracks and
crevices, and slots on the ends of
perches should be checked for
mites, which can emerge from
these locations to take blood meals
from the bird at night. An
engorged mite appears red in
color; those seen on perches and
other cage locations may appear
whitish or black.
Figure 9
The quick scan of the cage will
also inform the practitioner if the Blackened feathers caused by trauma or rubbing on cage.
Discoloration will remain until bird molts in new feathers.
cage toys are appropriate and safe (P. S. Sakas, DVM)
for the bird. As noted in Chapter 1,
larger birds can easily dismantle toys designed for smaller birds (see Figure 5 on
page 19). Certain toys may contain lead (used as a weight), so it is important to
check for cracked toys. It is also important to check for any sharp edges or hooks
on the toys.
Nutrition
Next, the food and nutritional supplements provided to the bird should be evalu
ated to determine the birds primary source of nutrition, to see whether vitamins
are being provided, and to determine whether mineral sources are available to the
bird. If fruits and vegetables are in the cage, they should be fresh, and the owner
should be asked if they have been washed.
One of the most important determinations an avian practitioner should make is
whether or not a bird is eating. The cage floor and food cup should be checked for
seed hulls, regurgitated food, and vomitus to determine whether the bird is eating
and ingesting the food it is given. Even though the owner may report often seeing
the bird eating from its food bowl, it may not be eating. The bird may simply be
scooping seed out onto the floor. Another possibility is that the bird is consuming
only grit (a tendency of birds with gastrointestinal disorders). Or, the bird may be
hulling the seed and not ingesting it, something commonly observed in young
hand-fed birds that are simply playing with their food. In the latter situation, the
owner may mistakenly believe that the bird is eating on its own and discontinue
hand feeding.
If hulled seed is observed on the bottom of the cage, two other considerations
must also be taken into account. The bird may be regurgitating the food, or it may
be vomiting. Regurgitation is a normal part of courtship behavior. Even when
there is only one bird in the cage, the bird may exhibit courtship behavior toward
a favored member of the household, regurgitating its food in an effort to feed that
person. Vomiting, however, is not normal. Vomited food can be distinguished
from regurgitated food by its position in the cage and its appearance. Whereas
regurgitated food is brought up and deposited on the cage floor, near mirrors, or
near toys, vomited food is flung out of the mouth and can be found in sticky clus
ters throughout the cage, often adhering to the cage bars. Further evidence of
vomiting can be found on the birds head feathers, which will often be pasted with
vomitus that is sometimes mixed with seed (Figure 10). The practitioner should
be aware, however, that vomit
seen in a cage might simply be the
result of a bird getting carsick on
the way to the office.
It can be difficult to evaluate if a
bird on a formulated diet is eating,
as there are no hulls to evaluate.
Quite often the bird will grind the
formulated food into a powder and
not ingest it. Evaluation of the
droppings (see next section) will
provide indications of eating.
Figure 10
Vomiting bird. Dried vomitus and seed material are adhered
to feathers of the head. (P. S. Sakas, DVM)
colored green; because seed imparts no color to the droppings, the green bile color
predominates (see Plate 1 on page 335). In birds that eat food other than seed, the
fecal color will be different. Birds fed blackberries, for example, will have reddishpurple droppings (see Plate 2 on page 336). Birds on formulated diets will gener
ally have brownish droppings. However, many commercially available formulated
diets are now colored, resulting in droppings that are the color of the food the bird
eats (see Plate 3 on page 336 and Plate 4 on page 337). Quite often, a bird will eat
only one particular color of such formulated diets (usually red).
Not only will the color of the droppings vary with diet, but the consistency will
also. A bird that eats fruit, vegetables, and other succulent foods will have more
watery droppings. A bird fed a formulated diet may have increased water intake,
which will also lead to more watery droppings with a less formed fecal portion
and increased urine. The consistency of the droppings will vary with the species
of bird. For example, lories are notorious for sloppy droppings due to their intake
of nectar.
If droppings suddenly change in consistency or color, a problem may exist. Hence,
it is vital that the practitioner ask about the birds normal diet and whether the
droppings have changed in any way.
Observing the fecal portion can provide important clues to the state of a birds
health. If a bird is not eating, the fecal portion may be scant, or the droppings may
be mainly urine with a small amount of bile (see Plate 5 on page 337). Although it
is normal for a bird to occasionally pass only liquid urine and urate crystals with
no fecal matter, if such droppings predominate, a problem exists. A reduction in
the amount of fecal portion or the number of droppings indicates a reduced food
intake. It may also indicate interference with the normal passage of fecal matter,
such as occurs with vomiting.
Droppings that have become larger or more bulky could also indicate disease. Two
possible causes are (1) a malabsorptive condition and (2) interference with the
normal passage of droppings (e.g., by a tumor or partial blockage of the cloaca).
With such conditions, a large amount of material will often build up before it is
expelled. Large, bulky droppings are not, however, always indicative of disease. In
fact, it is common for birds to hold their droppings overnight and then deposit a
large dropping in the morning. If a large dropping is noted on cage papers, it is
due to cloacal papillomas. Other signs of this condition include straining to defe
cate and the presence of papilloma tissue (which looks almost like a strawberry)
around the vent and in the cloaca.
The urate portion of the droppings should be off-white to gray in color. Yellow or
neon-green urates may indicate hepatitis or hepatic lipidosis1 (see Plate 10 on
page 340). Neon-green urates may also be suggestive of chlamydiosis (see Plate
11 on page 341). Blood in the urates or urine is indicative of a kidney disturbance
or toxicosis, particularly heavy metal poisoning (see Plate 12 on page 341 and
Plate 13 on page 342). If discolored urates or urine is found on newspaper, it is
important to check both sides of the newspaper. The discoloration may simply be
the result of colored ink bleeding through the paper. Causes of green-colored
urine include liver disease (especially chlamydiosis), bile staining from feces,
and dietary intake.1
Figure 11
The classic sick bird. Ruffled, eyes closed, and poor posture
on the perch. (P. S. Sakas, DVM)
The feathers of the bird should be clean and well preened. Dirty, tattered feathers
may indicate that the bird is not preening itself due to illness, that the cage is caus
ing mechanical damage to the feathers, or that the bird is emotionally upset.
Staining of the feathers above the nares indi
cates rhinitis (Figure 12). Pasting of the
head feathers indicates that the bird has
vomited. If droppings are stuck to the feath
ers around the vent, the bird may have a gas
trointestinal disturbance or an abdominal
mass (Figure 13).
Restlessness, shifting of the body weight, or
favoring of one leg may indicate pain or
dysfunction due to disease or injury. There
can be a number of causes: Improper perch
sizes can lead to pressure sores, ulcerations,
Figure 12
and bumblefoot (see Figure 2 on page 17
Stained feathers above nares indicating nasal
and Figure 3 on page 18). In small birds, discharge.
(T. J. Lafeber, DVM)
such as finches and canaries, nesting mate
rial wrapped around the toes can lead to necrosis (see Figure 4 on page 19). Leg
bands that are too tight can cause irritation that, in extreme cases, can result in
swelling and necrosis. In budgies, they can cause renal swelling, and renal adeno
Figure 13
Feather loss and vent soiling in a young budgerigar affected
with giardiasis. Megabacterial forms were also noted on
duodenal cytology impressions. (L. M. Bauck, DVM)
Figure 14
Typical posture of budgerigar with renal adenocarcinoma
paresis with the inability to grip. (P. S. Sakas, DVM)
Dyspnea and tail bobbing are signs of more severe respiratory problems, with
causes ranging from a primary respiratory problem to an abdominal enlargement.
There may, for example, be a space-occupying lesion in the abdomen that is pre
venting the full expansion of the abdominal air sacs. A bird that is dyspneic, mouth
open and gasping for air, should be considered critically ill and handled with
extreme caution.
If a bird is cyanotic, indicated by the bluish color of the skin, legs, and beak, it may
be in extreme respiratory distress. The practitioner should not be fooled, however,
by the normal bluish color of the legs of some pet birds, particularly male budgies.
Torticollis, opisthotonos, ataxia, arching, paralysis, and seizures in pet birds can be
due to a variety of sources, the most common being hypocalcemia. However, vita
min deficiency, infectious disease, toxicity, head trauma, cerebrovascular distur
bance, and tumors should not be ruled out.
If there is any concern that a bird displaying neurological abnormalities may have
been smuggled into the country, Newcastle disease (velogenic-viscerotrophic
Newcastle disease, or VVND) must be considered. In pigeons, a variant of VVND
is paramyxovirus, which can also lead to central nervous system signs.
Although handling and restraining techniques vary for small and large birds, as
described in the following sections, the following recommendations apply for all
birds, regardless of size.
Because birds breathe through
expansion and contraction of thenair sacs, facilitated by their inter
costal muscles, free movement of
the sternum is essential for respira
tion. Any undue pressure on the
sternum will restrict breathing.
When handling a bird, the handler
should never close his or her fin
gers around the birds chest; rather,
the bird should be cupped in the
hand to allow for sternal movement
(Figure 15).
Figure 15
How to hold a bird. There is free sternal movement, and
fingers should not be closed around the chest.
(P.S.Sakas, DVM)
The amount of restraint required will vary with the individual bird. Whereas handraised neonates will generally require minimal restraint, holding wild-caught
untamed birds for an exam may require the help of an assistant or two.
Finally, it cannot be overemphasized that overzealous restraint of a bird can lead
to injury. Even a healthy bird can die as a result of being improperly handled.
Fracture or dislocation of a limb can happen all too easily as a result of poor han
dling, as can wing injury and many other problems. A lesser problem is bruising
caused by excessive pressure put on the sides of the face to facilitate immobi
lization of the bird. Although the bruises are harmless and will quickly resolve,
they are easily seen on white-faced birds such as macaws and African grey par
rots and will be a source of irritation for the client if he or she feels the bruising
was due to mishandling.
Small birds can be captured and restrained bare-handed. However, cloth or paper
towels will facilitate the restraint of larger birds, and an adequate supply of clean
towels is recommended. Prior to capture, the towel can be used to hide the
restrainers hands so the bird cannot get a direct line on his or her fingers, and dur
ing capture, the towel can be draped over the bird to protect its wings. Using a
towel to hide ones hands during capture will also help to prevent the bird from
becoming hand shy; the bird may, however, become towel shy. Finally, with all but
the largest parrots, proper restraint of a bird in a towel will enable one person to
complete the exam without assistance.
The use of heavy gloves for restraint purposes is not recommended. Although the
gloves can be a successful means of capture and restraint, there are several disad
vantages associated with their use. As far as client relations are concerned, grab
bing a bird with heavy gloves appears rough and can leave the client with a bad
impression. For the birds sake, gloves have another disadvantage: The bird may
associate the gloved hand with the bare hand and develop a fear of hands alto
gether. And from the practitioners perspective, gloves are difficult to clean thor
oughly, and clean stock may be depleted if several birds are seen daily. In addition,
gloves will not protect the birds wings as well as a towel will, and two people will
be required to complete the exam. Gloves are a mandatory part of falconry, but
they are never used to restrain a raptor. Instead, they are used to protect the fal
coners hand as it functions as a perch for the bird.3
If the bird to be examined is in a high-risk group for a psittacine virus, such as
beak and feather disease virus or polyomavirus, the practitioner and anyone
assisting him or her should put on a smock or other protective outerwear before
handling the bird.
Birds should be removed from their cages head first. Such removal limits the
likelihood for injury to the bird should its wings work free as it is being taken
from the cage.
A word of caution: Nearly all birds will attempt to bite when captured.
Techniques to get a bird to stop biting include blowing into the face of the bird,
using a mouth speculum or similar device to open the beak, and simply releasing
the bird. Another technique that has been found to be effective is to twirl quickly
around in a circle while holding the bird. The motion will disorient the bird, caus
ing it to release its hold.4 Until capture and restraint techniques are mastered, the
practitioner will likely endure many bites. Though the normal reaction to a bite
may be to squeeze the bird harder or to drop the bird, such actions, clearly, should
be avoided!
encountered restraining the wings and feet, the practitioner should not hesitate to
use a towel.
Untamed birds are harder to catch. When attempting to capture an untamed bird,
patience is of utmost importance. The capturer must wait for the right opportu
nitya time when the bird is facing away from him or her or climbing on the cage
bars, facilitating grabbing the head from behind. Once the birds head is secured,
a towel should be wrapped around the birds body. If the bird is difficult to capture,
removing the perches, toys, and cage accessories may be helpful.
Practitioners will develop their own techniques for capturing untamed birds that
persist in facing them or that roll over on their back to resist capture. One sugges
tion is to try to distract the bird so that it will turn its head. If all else fails, the per
son trying to capture the bird can, holding a towel in both hands, try to quickly
scoop up the bird and gain control of the head. Although it is discouraging to have
difficulty capturing birds and to endure painful bites, the practitioner should not
give up. Capture techniques will improve with time.
Figure 16
Characteristic changes seen in the beak of a bird with fatty
liver disease: overgrowth and areas of hemorrhage (dark
spots). (P. S. Sakas, DVM)
Figure 17
A hybrid macaw baby with a number of developmental
abnormalities, including the lateral deviation of the maxilla.
Multiple daily physiotherapy interventions early on are rec
ommended to correct most beak abnormalities.
(L. M. Bauck, DVM)
The epithelium of the oral cavity should be smooth, relatively dry, and odor free.
If a bacterial infection is present, the epithelium may have a grayish cast and pos
sibly a pungent odor, and off-white oral lesions may be seen. Such lesions may
also be caused by hypovitaminosis A (one of the most common nutritional defi
ciencies seen in pet birds and a common cause of oral lesions), candidiasis (espe
cially common in young birds being hand raised), trichomoniasis, and avian pox.
Occasionally, abscesses will be seen, particularly on the sides of the tongue.
The margin of the choanal slit should be sharp, clean, and bordered by numerous
sharp papillae. Blunted or absent papil
lae, thickened edges to the choanae, and
white plaques indicate vitamin A defi
ciency and provides ample opportunity
for secondary pathogen invasion.1
Choanal viral papillomas may be noted in
Amazon parrots, macaws, and particu
larly hawk-headed parrots (Figure 18).
Occasionally, these papillomas may be
Figure 18
peppered throughout the oral cavity. Papillomatous growth in the choanal slit of a
When in close proximity to the glottis, macaw. (P. S. Sakas, DVM)
they can interfere with respiration.
Menace response is equivocal at best in birds, and its absence is not diagnostic. It
is not uncommon to see slight, dynamic anisocoria.5 In all birds, the pupil cannot
be dilated with atropine or other smooth muscle mydriatics.1
Schirmer tear testing is practical only for large birds; normal values must be esti
mated from normal fellow eyes or other birds of the same species.6 Fluorescein
dye testing and conjunctival and corneal cytology collection are performed as in
mammals.6 Schiotz tonometry is feasible only in large birds and normal values
have been reported to be 11-25 mm Hg.6 Topical anesthetic should be used spar
ingly and to effect only, since the potential for systemic toxicity exists.6
Figure 20
Crop fistulation in a hand-fed blue-fronted Amazon parrot.
(P. S. Sakas, DVM)
Figure 21
Use of a moistened cotton-tipped applicator to evert
the vent margins enables better visualization of papil
lomatous lesions during cloacal examination.
(P. S. Sakas, DVM)
only rarely, their presence can be determined by brownish debris in the feather
shaft, which will normally be clear. The diagnosis can be confirmed by opening
the shaft and examining the contents microscopically. If mites are present,
exoskeletons will be easily seen.
Auscultation
Auscultation is best done with a pediatric stethoscope. Although a birds heart
rate is difficult to evaluate due to the rapid beat, auscultation can be used to
detect heart murmurs in larger birds. It can also be used to detect respiratory
abnormalities.
Sex Determination
Because the reproductive organs of birds are internal and few species of pet
birds have sexually dimorphic coloration, sex determination is often difficult
and mistakes are frequently made. Eclectus parrots are one of the few pet birds
in which sex can easily be determined by coloration: Males are green and
females are red. In most of the other pet birds with sexually dimorphic col
oration, color differences are subtle, making sex determination more difficult.
In birds that do not have sexually dimorphic coloration, there are no easy guide
lines for sex determination.
With a few of the common pet bird species, there is a reasonable chance of cor
rectly guessing the sex. As noted earlier, the cere of the male budgie is generally
deep blue, whereas it is generally pale blue to brown in the female. In addition,
the nares of the female budgie is usually encircled by a pale rim; the nares of the
male lacks the rim and is blue. The males also tend to be more vocal and are
more likely to talk.
The sex of a gray cockatiel can be distinguished after the bird has undergone its
first molt at about 8 months of age. Prior to this point of reaching sexual maturity,
both sexes have identical feathering. At the time of the first molt, as the new feath
ers grow in, the head of the male becomes more yellow, the orange spots by the
ears become brighter, the bars (or stripes or spots, depending on ones perspective)
on the underside of the flight feathers disappear, and the speckled tail feathers are
replaced by solid gray feathers. In the female, there is little change at the first
molt; the colors may become somewhat brighter, but the bars on the underside of
the flight feathers are retained, as is the speckling on the tail feathers. In cockatiels
with color mutations, sex is difficult to determine.
The practitioner can use coloration to ascertain if a clients information about his
or her cockatiels sex is accurate. Quite often, breeders determine the sex of very
young cockatiels by behavioral differences (the males tend to be more vocal and
rambunctious than the females). Breeders may also make reasonable guesses due
to their knowledge of the genetic backgrounds of their breeding pairs and the vari
eties of offspring they produce.
The sex of canaries can sometimes be visually determined. In males, the vent
region protrudes somewhat; in females, it is more flush with the surrounding skin.
The difference is subtle but can usually be observed with experience.
In cockatoos, eye color can be, but is not always, an indicator of sex. Females that
have become sexually mature develop a red coloration to their irises, which is
very distinct from the deep brown color of the male iris. Not all females develop
this color change, however. Thus, whereas all cockatoos with red irises are defi
nitely female, cockatoos with brown irises may be males, immature females, or
mature females that have not undergone the eye color change.
Numerous other techniques are used to determine the sex of pet birds, but most of
them are quite questionable. One such method is pelvic sexing, where the birds
pelvic bones are palpated on the ventral abdomen to determine the amount of
space between them. According to proponents of this method, males have very lit
tle space between the pelvic bones whereas females have widely spaced bones.
Anyone with extensive experience with birds of known sex, however, realizes that
wide variations in pelvic spacing exist in either sex, making this technique highly
unreliable. Head shape, eye shape, size, beak width, and other subtleties have also
been used, but the accuracy of sex determination with these measures greatly
depends on the skill of the evaluator; even for skilled persons, the differences can
be difficult to discern.
The sex of most parrots cannot be distinguished externally. In these and other
birds that are not sexually dimorphic, the veterinarian can make an accurate
determination of sex through endoscopy or DNA analysis of a blood sample or
feather. Surgical sexing by endoscopy is usually performed for breeders who
want verification of the sex of a bird as well as an evaluation of the condition of
the gonads and other organs. DNA blood sexing has proven to be a safe and effec
tive technique for sexing birds, is performed by commercial laboratories, and is
widely used. Except for breeding purposes, however, there really is no need to
know the sex of a bird.
Age Determination
Owners of birds that have been hand raised will often know their hatch dates, and
birds that have been domestically bred will often have a closed leg band specify
ing the year of hatching as a two-digit designation rotated 90 in relation to the
other identifying information on the band. (Quarantine bands, in contrast, provide
no information about the age of the bird.) For all birds without hatch-date docu
mentation or bands specifying hatch date, age determination is difficult.
With experience, a practitioner will be able to make a relative guess as to whether
the bird is young or old. Young birds have a relatively dark iris. As birds age, the
iris gradually lightens in color until it matches that of an adult. Thus, although
evaluation of the iris will not provide an actual age, it will give an indication of
whether the bird is younger or older.
In budgies, another distinguishing characteristic is the number of black feather
lines on the top of the head. In very young budgies, these lines (which are oriented
parallel to the cere) extend all the way to the margin of the cere. As budgies
mature, solid, nonstriped feathers replace the striped feathers by the cere. Thus,
young budgies will have a dark iris and feather lines extending to the cere.
After a bird matures, it is virtually impossible to determine an age range. Even in
birds in which features or colorations intensify or develop with age, a specific age
range cannot be determined. The best that can be done is to determine whether a
bird is young or older and mature. For example, yellow-naped Amazon parrots
develop their yellow nape as they mature, and double yellow-headed Amazon par
rots gradually develop more yellow coloration on their head as they age.
As one becomes more experienced with birds, feather coloration, behavior, and
other features can help to provide a relative estimate of the age of a bird.
However, as noted earlier, the specific age of a mature bird cannot be accurately
determined. Practitioners will see 50- and 60-year-old parrots and 14- and 15year-old budgies that are indistinguishable from birds that are much younger.
Weight
Once a bird becomes an adult, its weight should remain relatively constant.
Because of feathering, merely looking at a bird will not give an indication of its
weight. Although palpation of the breast bone will provide some indication of
musculature, weighing the bird on a scale at each physical examination is highly
recommended. Weight comparisons will provide valuable information about the
birds state of health.
Clinical Pathology
Because the hands-on examination can be much less revealing in birds than in
other animals, clinical pathology plays an important part in the avian physical
examination. A comprehensive physical examination should include a complete
blood count (CBC), a fecal examination, and a choanal or oropharyngeal smear.
Some practitioners also include cloacal and choanal cultures, blood chemistries,
serology, radiographs, and other specific tests.
This section begins with a discussion of blood collection, which is required for
hematology, chemistry, and immunologic studies as well as for virology and
Chlamydophila studies and for determining gender based on blood-cell DNA. The
discussion then turns to specific aspects of clinical pathology.
Blood Collection
Multiple sites can be used for blood collection in birds. Considerations in select
ing the site include the size of the bird, its state of health, the volume of sample
required, and the experience of the person drawing the sample. Prior to undertak
ing blood collection in a seriously ill bird, the practitioner must carefully consider
whether the bird will be able to withstand the stresses involved in handling and in
blood collection itself.
During blood collection, sample volumes totaling 0.5-1% of a birds body weight,
amounting to approximately 10% of the birds total blood volume, can be safely
removed.8 The volume actually drawn should depend on the amount needed for
testing and the condition of the bird. Table 1 lists volumes of blood that can be
safely drawn from a variety of species.
Table 1
Blood Volume That Can Be Withdrawn
Safely From Common Sizes of Pet Birds
Budgerigar (35 g)
0.35 ml
Cockatiel (95 g)
0.95 ml
3.00 ml
Macaw (1,000 g)
5.00 ml
Venipuncture Blood can be collected from the ulnar vein, the medial metatarsal
vein, or the jugular vein.
Ulnar Vein: The ulnar vein is used extensively for blood collection in poultry
but less often in pet birds. Located on the ventral aspect of the wing, the vein
is easily detected where it passes over the elbow. Because the lack of subcu
taneous tissue in this area predisposes hematoma development, the ulnar vein
is best used as a collection site in sedated birds, which will not move or strug
gle during collection. However, in sedated large birds, the ulnar vein is the
preferred site for the injection of intravenous antibiotics or fluids, so it is sel
dom used for blood collection.
When the ulnar vein is used for blood collection, assistance is required, since
the wing must be held in an extended position. The feathers should be wetted
with alcohol or water to visualize the vein (a method preferred over plucking).
The vein may or may not need to be held off. Then, a 1/2-cc or 1-cc insulin
syringe with a 28-gauge needle should be used to enter the vein proximal to
the elbow. The cap should be used to angle the needle, bevel up. Because cap
illary action will quickly fill the barrel, the plunger will not be needed in the
syringe. In fact, it is recommended that the plunger not be used, as its use will
often collapse a vein.4 If the sample is drawn quickly, anticoagulant will not
have to be added, but it should be readily available. The use of anticoagulant
is not recommended, since it dilutes the blood sample. Due to the ease of
hematoma formation, pressure may need to be applied to the vein for several
minutes following sampling.
Medial Metatarsal Vein: The medial metatarsal vein, which runs superficially
along the metatarsus and appears to fit in a groove in the bone, is easily visu
alized in large birds, but birds as small as lovebirds and cockatiels can also be
sampled from this site.4 When this vein is accessible in awkward young birds
with full crops, it is preferable to use it rather than the jugular and wing veins
for blood collection, since its use minimizes the risk of aspiration of food dur
ing restraint.
In birds with thickened, scaly skin, visualization of the medial metatarsal vein
may be difficult. The vein can still be used, however, with the needle passed
into the supposed area of the vein. The scaliness and thickness of the skin will
help to prevent hematoma formation.
When using the medial metatarsal vein for blood collection, the bird is
restrained in dorsal recumbency with the leg extended. The vein may or may
not need to be held off. The needle (a 1/2-cc or 1-cc insulin syringe with a
28-gauge needle) is inserted below the hock and passed distally to proximally.
Care must be taken to not penetrate the joint. Pressure should be applied to the
vein for a few minutes following sampling.
Jugular Vein: The most common vein used for blood collection in large and
small pet birds is the jugular vein. The jugular vein varies in size and location,
but the right jugular is usually larger than the left. The vein can be seen in the
featherless area alongside the cervical vertebrae. In both large and small birds,
the (right) jugular vein can provide a large volume of blood with a relatively
low incidence of hematoma formation. If blood collection from this site is
done improperly, however, the procedure will be stressful to the bird.
Sampling from the jugular vein requires only that the bird be held in left lat
eral recumbency with wing tips and feet held by the handlers right hand and
the head held in the left hand.9 A small amount of alcohol is applied to the
unfeathered portion of exposed skin to reveal the jugular vein. The jugular
vein is held off, and the needle (1/2-cc or 1-cc insulin syringe with a 28-gauge
needle) is carefully inserted to avoid tearing the delicate vessel. After the sam
ple has been collected, pressure should be applied for a few moments to seal
the puncture site.
Skin Prick Some practitioners prefer to use the skin prick technique in small
birds. The skin over the medial metatarsal vein is punctured with a 25-gauge
needle, and blood is collected directly from the skin. Pressure is then applied
for hemostasis.
Avian CBC
Blood counts should be performed as part of any routine yearly physical examination, new bird examination, and evaluation of a sick bird, if the condition of the
bird will allow it. Performing the screening CBCs described in this section is sim
ple and, once incorporated into practice, is beneficial both financially and diagnostically, enabling rapid diagnosis and treatment. It is probably the most useful of
all diagnostic tests.10
Table 2
Avian Hematologic and Biochemical Values
for Selected Species12________
A frican g rey
A mazon
B u d gerig ar
C aiq ue
1.
6-13
5-11
5-17
6-11
3-10
3-8.5
8-15
2.
Hematocrit (%)
45-53
38-48
41-53
37-50
44-58
38-48
47-55
3.
2J-4.4
3.0-4.6
2.6-4.5
3.0-5.0
2.1-4.3
2.5-4.5
2.5-3.5
4.
Albumin (g/dl)3
0.2-2.4
1.57-3.23
0.3-2.4
1.9-3.52
0.9-1.2
1.8-2.5
5.
Amylase (IU/I)
415-626
210-530
184-478
205-510
302-560
244-290
6.
Aspartate aminotransferase
(AST) (I U/l)
110-340
100-365
150-344
130-350
156-375
145-350
118-364
7.
12-96
13-90
33-154
18-60
32-117
15-70
12-112
8.
Calcium (mg/dl)
8-14
8.5-13
8-13.9
8.5-14
8- 11.2
6.5-11
8.3-11.1
9.
Cholesterol (mg/dl)
100-250
160-425
148-228
180-305
120-230
145-275
126-220
140-411
165-412
117-425
55-345
117-368
90-300
124-384
256-360
190-350
246-378
190-345
216-456
190-390
170-372
154-378
145-465
160-368
155-425
156-384
145-435
147-270
2-11
4.5-9.5
2 .2-10
2.5-11
2.3-10
4.8-13
4.5-14
C ategory
C ategory
C anary
C ockatiel
C ockatoo
C o nu r e
1.
3-10
4-9
5-11
5-10
5-13
5-11
5-13
4-11
2.
Hematocrit (%)
45-56
37-49
43-57
36-49
40-54
38-48
42-54
36-49
3.
2.1-4.8
2.4-4.1
2.M .8
3.0-5.0
2.4-4.9
3.0-4.2
2.8-4.5
4.
Albumin (g/dl)3
5.
Amylase (IU/I)
6.
Aspartate aminotransferase
(AST) (IU/I)
7.
8.
Calcium (mg/dl)
0.8- 1.8
0.7-1.8
1.2-2.4
1.8-3.1
1.1- 2.6
1.9-3.6
113-870
228-876
192-954
100-450
132-351
145-345
128-396
95-345
140-360
145-355
147-378
125-345
44-108
20-85
34-112
25-87
32-105
15-55
8.2-10.9
8-13
8.1-11.7
8-13
8.1-11.7
7-15
90-200
140-360
96-212
145-355
144-202
120-400
160-420
30-245
147-418
95-305
153-408
35-355
228-440
200-445
206-418
185-355
216-418
200-345
120-350
122-378
120-455
208-414
220-550
216-408
120-390
4.1-13
4-12
3.4-11
3.5-10.5
3.8-11
3.5-10.5
3.0-11
2.5-11
5.5-13.5
9.
Cholesterol (mg/dl)
160-360
205-435
continued
C ateg ory
1.
D o ve
E c lec tu s
Lo ry
L o vebird
9-13
9-15
4-10
8-13
7-16
3-8 .5
---
2.
Hematocrit (%)
42-50
45-55
35-47
47-55
-----
44-55
38-50
3.
2.1-3.7
3.2-4.3
2.8-3.8
1.9-4.1
2-3.5
1.8-3.7
2.8-4.4
4.
Albumin (g/dl)3
1.2- 1.6
1. 1- 2.0
1.3-2.1
1.26-1.96
1.2- 2.1
562-684
150-645
__
2.3-2.6
2- 2.8
5.
Amylase (IU/I)
6.
Aspartate aminotransferase
(AST) (IU/I)
111-372
144-339
120-370
141-369
150-350
130-360
110-345
7.
40-106
30-110
10-35
20-97
20-65
12-90
13-65
8.
Calcium (mg/dl)
8- 12.6
8.1-11.9
7-13
8-11.5
6.5-13
8.4-11.7
8-14
9.
Cholesterol (mg/dl)
124-257
100-261
130-350
100-257
100-228
95-335
180-388
132-410
220-345
178-396
160-392
52-245
219-396
145-245
192-388
200-300
220-390
195-405
198-386
200-425
2-11
2.5-11
124-302
2-12
2.8-11.5
225-354
105-355
164-386
150-388
2.5-12
C ateg or y
M acaw
M ey e r s parrot
M y nah
Pa rro tlet
10-20
6-12
8-14
8-12
6-13
38-50
48-55
1.
3.3-11
3.5-11
2.
Hematocrit (%)
42-56
35-48
45-53
3.
2.4-4.4
2.1-4.5
3.0-4.3
0.3-2.4
1.24-3.11
2- 2.8
239-564
150-550
__
__
156-352
4.
5.
Albumin (g/dl)3
Amylase (IU/I)
6.
Aspartate aminotransferase
(AST) (IU/I)
7.
65-168
100-300
7-100
6-35
8.
Calcium (mg/dl)
8.4-11.9
8.5-13
9.
Cholesterol (mg/dl)
96-264
100-390
8.2-10.4
200-352
30-96
8.2- 10.8
126-244
88-361
100-300
250414
210-360
145-345
212-294
228-372
70-220
70-350
1 8-12
2.5-11
2 1-11
2.3-12
__
__
110-224
__
__
__
252-384
__
4.1-12
continued
C ategory
1.
P igeon
Q uaker
5-13
4-11.5
8-17
4-10
9-16
45-54
35-47
45-58
35-46
45-51
2.3-4.3
2.2-4
2.S-3.7
2.8-3.6
1.1-2
2.19-3.19
1.3-2
1.26-2.52
135-358
150-365
130-380
150-285
176-316
15-92
14-60
21-90
25-65
8.2-10.4
7-13.5
8.4-10.8
7-12
176-258
130-295
100-262
116-408
192-402
__
212-368
125-300
210-395
200-350
232-326
179-384
138-360
3.5-12
2-12
3.5-10
2 2-12
3.5-11.5
3.0-9.5
R ing neck
PARAKEET
R osella
S enegal
T o ucan
8-14
45-54
9-15
45-60
6-14
4-11
8-18
4-10
45-60
36-48
42-60
45-60
2.9-4.1
3.5-4.4
2.8-4.4
3-5
1.0-2.4
1.45-2.28
1.4-2.4
--13-23
2.
Hematocrit (%)
3.
4.
Albumin (g/dl)3
38-50
2-5.5
5.
Amylase (IU/l)
6.
Aspartate aminotransferase
(AST) (IU/I)
7.
__
100-350
8-65
8.
Calcium (mg/dl)
8-13
9.
Cholesterol (mg/dl)
220-375
100-250
55-155
C ategory
1.
2.
Hematocrit (%)
3.
4.
Albumin (g/dl)3
5.
Amylase (IU/I)
6.
Aspartate aminotransferase
(AST) (IU/I)
7.
8.
Calcium (mg/dl)
9.
Cholesterol (mg/dl)
R ed belly
PARROT
PlONUS
__
152-386
116-258
8.4-10.4
8-10.9
__
__
__
__
120-330
100-350
141-340
130-330
20-94
20-85
8.4-10.8
6.5-13
16-86
8 .8 - 11.8
10-15
114-250
104-254
151-396
100-330
__
220-354
281-396
256-354
140-250
222-363
220-350
150-318
121-348
153-396
180-319
200-400
3.3-12
3.4-11
2.3-12
2.3-10
2.4-14
4.0-14
continued
Table 2 Notes
Note 1. The values listed in the first line for each category are from Laboratory Reference
Ranges (USA units) for Selected Species California Avian Laboratory, Citrus Heights,
CA. In A. M. Fudge, Laboratory Medicine: Avian and Exotic Pets. Philadelphia: W. B.
Saunders, 2000:376-387.
Note 2. The values listed in the second line for each category are from Reference Values for
Selected Hematological Determinations and Plasma Biochemistries. Miami, FL: Avian
and Wildlife Laboratory, University of Miami, July 1998.
Note 3. For albumin (category 4), the values listed in the second line are from the University of
Miami and were obtained through electrophoresis.
Note 4. A "in the tables indicates that documented range values for this parameter are
unavailable.
not feel comfortable performing hematology procedures can send the blood sam
ples to one of the commercial laboratories that perform avian clinical pathology.
Automated analyses using laser and impedance technologies promises to
become the most accurate method of counting avian WBCs.14 The general prin
ciple is that as cells pass through a laser beam, light scatter measurements are
taken at three different angles and a portion of the beam is depolarized.14Due to
the variation among leukocyte types, this information can be used to count
WBCs and classify the sub-populations.14 The results with avian blood have
been encouraging and reproducible.14
Fecal Examination
Another important component of the avian physical examination is the micro
scopic examination of droppings. Evaluation of both wet mounts and Gram
stains is useful.
Wet Mounts With this procedure, a small amount of fresh dropping is placed on
a slide and mixed with one or two drops of saline. A coverslip is added, and the
slide is examined under low and then high power. With experience, one will be
able to recognize normal background bacteria, undigested food material, and other
normal components.
Normal avian droppings should not contain an abundance of bacteria, and the nor
mal population is generally cocci. If there is a predominance of bacilli, Gram stain
ing should be done to determine whether the bacilli are gram negative and
potentially pathogenic. Large amounts of gram-positive bacilli are sometimes
noted, but generally they are simply the result of the bird being fed Lactobacillus
as dietary supplementation, either as an additive or as a component of a commer
cial diet. Motile bacteria are almost always pathogenic.
An occasional nonbudding form of Candida is normal, but budding yeast and
mycelia are indicative of invasive, infective forms. Birds fed bread products will
frequently have nonpathogenic yeast in their droppings.15
Parasitic infections can also be diagnosed from the evaluation of wet mounts.15
Protozoa can be detected in fresh samples or in samples preserved in 5% formalin
for staining and dark-field phase-contrast microscopy.4 Examination of wet
mounts can also reveal the presence of Giardia, Hexamita, and Trichomonas.
Occasionally, helminth eggs may be detected.
Gram Stains Gram staining is an important means of determining the charac
ter of the bacterial population in the droppings, but it is only a screening tool.
Gram-positive bacteria constitute the normal alimentary tract flora in birds; the
pathogens most commonly isolated from birds are gram-negative. However, the
presence of a few gram-negative bacteria in psittacine droppings is normal.15
Caution must be exercised when interpreting the presence of gram-negative bac
teria, since most studies have failed to correlate the presence or absence of gramnegative bacteria with culture results.15 Gram staining should be just one aspect of
a diagnostic screening. It is important to also evaluate the bird and its clinical signs
and, for final confirmation of the bacteria and pathogenicity, to perform
culture/sensitivity testing.
collecting a sample with a sterile swab or syringe. The bird is held in sternal
recumbency, tilted slightly tail up. The flushing solution should not be forced
into the naris but instead should be allowed to flow easily through the choana or
the other naris.
Urinalysis
The value of the urinalysis has been questioned for some time but it is a valuable
and underutilized diagnostic tool.12 Serum uric acid levels do not increase until
significant, and often irreversible, renal disease exists which heightens the impor
tance of early detection of disease.12 As the urine does mix with feces in the
cloaca, careful collection of the sample and judicious interpretation of the urinal
ysis is critical.12
Polyuria/polydipsia and elevated blood uric acid levels are indicators for uri
nalysis.17The urine can be collected off a clean, non-absorbent surface, such as
an exam table or plastic wrap/wax paper placed on the bottom of a cage.12 The
urine specimen, especially the sediment, should be examined immediately after
collection. 12
Mammalian dipsticks are not calibrated for bird urine, but some determinations
can be made with them nonetheless.18 Identifying renal casts, excessive red and
white blood cells, and microorganisms in the urine sediment may be suggestive of
some kidney disease processes.18
Table 3
Culture Sites and Common Flora
C ulture
S ite
Indications for
C ulture /C yto lo gy
S ample
C o llectio n
C ommon
F lora
Cloaca
Abnormalities with
digestive, urinary,
or reproductive tracts
Swab
Anaerobes and
gram-positive
bacteria
Crop
Moistened swab
Normal
alimentary
flora
Choana
Abnormalities of upper
respiratory tract or oral
cavity
Swab
Normal
alimentary
flora
Surgically or
saline sinus
flushing
Sterile
Conjunctiva
Conjunctivitis; epiphora
Moistened swab
or spatula
Sterile
Trachea
Chronic cough;
inspiratory dyspnea
Swab or tracheal
wash taken while
bird anesthetized
Sterile
Best sampled
endoscopically
Sterile
Internal organs
C o m m e n ts
Adapted from K. Flammer, "Common Bacterial Infections and Antibiotic Use in Companion Birds. In Antimicrobial
Therapy in Exotics Supplement to Compendium on Continuing Education for the Practicing Veterinarian, 20 (3A),
1998:34-48.
Blood Chemistry
In general, serum is preferred over whole blood or plasma for chemistry analysis.
However, there are some commercial laboratories that prefer to run chemistries on
plasma.4 If plasma is desired, the use of lithium heparin is indicated in most
instances.12 Collection and storage of blood should be done carefully, as mishan
dling can damage the cells and lead to inaccurate results.
The following basic tests are recommended for any avian chemistry profile. Their
results will provide a good evaluation of the birds state of health. A listing of the
values for various species of birds is provided in Table 2 on pages 81-84.
Protein Normal serum protein values are described for various species in
Table 2 on pages 81-84.2021 Low protein levels may indicate malnutrition, mal
absorption, chronic disease, renal disease, liver disease, parasitism, or stress.20
Elevated values indicate dehydration, shock, chronic inflammation, egg produc
tion, or infection.22 Hemolysis and lipemia will also produce elevated values.10
Calcium Normal serum calcium values range from 5.5-15 mg/dl for most
species.2021Low calcium levels, which are frequently seen as the cause of seizures
in birds, can result from poor calcium supplementation in the diet, renal disease,
and other metabolic conditions.23 Ovulating birds have elevated calcium levels,
apparently related to the calcium needed for eggshell formation.
Oversupplementation with vitamin D3 will increase serum calcium and lead to
renal mineralization.23 Neoplasms will also elevate serum calcium.10
Glucose Normal serum glucose for most birds ranges between 200 and
450 mg/dl.20,21 Hypoglycemia occurs with malnutrition, liver disease, fasting, and
systemic disease.23 Hyperglycemia may occur during breeding, stress, egg yolk
peritonitis, and pancreatitis.23 Diabetes mellitus is commonly seen in budgies and
cockatiels but has also been described in several other species of birds.24 Diabetic
birds usually have glucose values that are higher than 700 mg/dl; frequently the
value is over 1,000 mg/dl.22 A diagnosis of diabetes is facilitated by repeated
serum glucose testing; persistently high glucose levels over time will rule out the
other causes of transient hyperglycemia (such as stress or eating).10
Cholesterol Normal serum cholesterol values in birds have not been well doc
umented, but normal seems to range between 100 and 300 mg/dl.2021 Elevated lev
els can be seen in birds on high-fat diets, obese birds, and birds with
hypothyroidism.23 Low levels can be seen in birds with liver and kidney disease.23
Uric Acid Uric acid is the primary nitrogenous waste product of the avian kid
ney, and its level in the serum is an excellent indicator of renal function.10 Uric
acid is excreted independently of the glomerular filtration rate, and may not be an
accurate indicator of early renal disease.25 In general, blood uric acid levels elevate
when renal function drops below 30% of its original capacity, although this has not
been proven in birds.18 Normal values vary depending on the measurement tech
nique but generally range between 2.0 and 10.0 mg/dl (up to 15.0 mg/dl in some
species). In literature, it has been reported that uric acid levels greater than 10
mg/dl indicate renal disease or compromise.18 Even with advanced renal disease,
the uric acid level may remain within normal limits but on the high end of the
range.4 In end-stage liver disease, the value may decrease.23 The most consistent
laboratory abnormality in avian renal disease is persistently elevated uric acid lev
els, especially after fluid therapy.18
Aspartate Aminotransferase (AST) Previously termed serum glutamicoxaloacetic transaminase (SGOT), AST is considered one of the more reliable
indicators of liver disease in caged birds.22 Serum values greater than 350IU/I are
considered abnormal and are often indicative of liver disease. Liver, heart, or mus
cle damage can also result in elevated values.23 The AST should be run with CPK
to help rule out muscle damage/wasting.25 This test is not of benefit in diagnosing
chronic or end-stage liver disease as the values will be low or decrease due to loss
of hepatocytes.26
Bilirubin Although serum bilirubin is not an important test for liver disease in
birds, since icterus is due to biliverdin, the main biliary pigment in birds, eleva
tions of bilirubin may be seen in severe liver disease.23A word of caution: Often,
yellow plasma is due to elevated carotene levels in the blood and not elevated
biliverdin or bilirubin levels. When yellow plasma is observed, the owner should
be questioned about the nature of the birds diet, since high consumption of
carrots, sweet potatoes, squash, and other carotene-rich vegetables can raise blood
carotene levels.
Lactate Dehydrogenase (LDH) Normal serum LDH levels range between 70
and 400 IU/I.20 LDH is found in muscle, liver, kidney, and red blood cells.25
Elevated values are most common with liver disease in birds, and the values are
thought to rise and fall more quickly than AST levels in birds with this condi
tion.22 These differences may provide information on the chronicity of the liver
disease.23 Elevations may also occur with heart or muscle damage.23 Any hemol
ysis can cause an increase, confusing the interpretation of results.25 If values are
increased when creatinine phosphokinase (CPK) values are normal, liver disease
is probably indicated.26 As with uric acid and AST, decreased values are seen in
end-stage liver disease.
Bile Acids Bile acids have been found to be the most sensitive indicator of liver
disease in birds. Their concentration indicates the clearing capacity of the liver.26
Normal values range between 6.0 and 144 mol/l.20,21 When liver function is com
promised, bile acids are not reabsorbed from the blood by the liver, so the propor-
tion in the peripheral circulation increases. Elevated values have been correlated
with liver disease in many avian species.27Experimental findings suggest that val
ues greater than 70 mol/1 in fasted racing pigeons and most psittacine species,
and values greater than 100 mol/1 postprandially, should be considered elevated
and therefore suggestive of hepatobiliary disease.28 In Amazon parrots, values
greater than 145 mol/1 are considered elevated.28 With cirrhosis of the liver,
serum bile acid levels decrease due to the reduction in bile acid production.26
Creatinine Phosphokinase (CPK) Measurement of serum CPK is a useful aid
in distinguishing between muscle and liver disease in birds. Since CPK is found
primarily in cardiac and skeletal muscle, an elevation usually indicates a muscu
lar condition. Normal CPK values range between 100 and 300 IU/I.22 Elevations
occur with damage to skeletal muscle (e.g., from injections, trauma, and feather
picking) and with myocardial disease.22 When run with AST, this can help rule
in/rule out liver disease.25 Elevations also often occur with advanced proventricu
lar dilatation disease.4
Gamma glutamyltransferase (GGT) A test that has not been widely used, but
may be useful, is GGT. It is an enzyme in the avian liver that is cell-membrane
bound.25 It is poorly sensitive but highly specific for liver disease and elevations
have been associated with hepatic carcinomas in psittacines with papillomatosis 29
Amylase Normal serum amylase values range between 100 and 600 IU/I in
most birds.23 Elevated levels, as high as three times the upper limit of the normal
range, may be seen with acute pancreatitis.23 In some cases of enteritis, even in the
absence of pancreatic lesions, amylase levels may be almost twice the upper limit
of normal. Amylase elevations may also indicate proventricular dilatation disease,
but in most cases of this disease amylase activity is normal or only slightly ele
vated 23 Zinc toxicosis can cause severe pancreatitis with a resultant increase in
serum amylase.25
Lipase Although serum lipase levels are poorly established in pet birds, eleva
tions may indicate severe cases of acute pancreatitis.10
Artifactual Changes
The artifactual change that is most commonly encountered, and most significant,
is hemolysis.30 Marked hemolysis may make interpretation of blood chemistries
nearly impossible. Hemolysis results in elevations of AST, bile acids, glucose, cal
cium, phosphorus, total protein, albumin, potassium, amylase, lipase, and CPK.30
Lipemia is another artifactual change that can have a significant effect on the
interpretation of clinical pathology data. In contrast to mammals, this is generally
not a post-prandial lipemia, thus fasting has little effect on the lipemic state.30
Lipemia is often a normal physiologic state in ovulating hens.30 Lipemic plasma
and serum in non-ovulating birds may indicate a potential metabolic problem.30
Lipemia may artifactually increase AST, bile acids, glucose, calcium, phosphorus,
total protein (refractometric), and uric acid.30 Decreases in albumin, sodium,
potassium, chloride, and amylase may occur.30
Other changes can affect biochemical data. Overhydration with parenteral fluids
may result in hemodilution, decreasing certain biochemical values, while con
versely, dehydration may elevate them.30 Exogenous corticosteroids can increase
AST, LDH, and CPK.30 Many intramuscularly administered agents, including
most vitamin preparations, enrofloxacin, and doxycycline will also elevate many
plasma enzymes.30 In trauma patients, alterations in biochemical analysis (includ
ing transient elevations in blood glucose, and enzymes such as AST, LDH, and
CPK) can be caused by blood loss, tissue damage, infection, and excitement.30
Electrophoresis
Electrophoresis has received much attention recently as a valuable diagnostic tool
in avian medicine and has been utilized with increasing frequency. Today it is an
integral part of well- and sick-bird diagnostics.31 Most frequently, electrophoretic
methods are used in birds to determine the percentage of the major protein frac
tions in serum: pre-albumin/albumin, alpha-1 globulins, alpha-2 globulins, betaglobulins, and gammaglobulins. Electrophoresis complements the CBC and
biochemical analysis by enabling the exact quantitation of serum protein.31 This
enables more precise detection of various disease states, as abnormal patterns in a
birds electrophoresis pattern can be compared to the normal electrophoretic pat
tern for that species.31
In healthy birds, albumin is the largest protein fraction, constituting up to 40% of
total serum protein in some species.32 An inflammatory process will result in a
decrease in albumin concentrations and an increase in total protein due to eleva-
tions in the alpha-, beta-, and gammaglobulin fractions.32The end result of these
changes is a decrease in the albumin/globulin (A/G) ratio. Other conditions that
result in a decrease in the A/G ratio include egg yolk peritonitis and chronic infec
tious diseases, such as aspergillosis, chlamydiosis, and tuberculosis.32 Frequently,
the total protein concentration will be within normal range while the A/G ratio is
decreased. This occurrence indicates that the A/G ratio is of greater clinical impor
tance than total protein concentration.32
A decrease in albumin level can develop due to reduced albumin synthesis in
chronic liver disease or chronic infection.32 Albumin loss also occurs with renal
disease, parasitism, gastrointestinal disease, and overhydration.32 Albumin
increases occur with dehydration.32
An increase in alpha- and betaglobulins can result from acute nephritis, severe
active hepatitis, systemic mycotic infections, and nephrotic syndrome.32 An
increase in gammaglobulins, which are composed primarily of immunoglobu
lins, will occur with antigenic stimulation, such as in cases of acute or chronic
inflammation, infection, chronic active hepatitis, vaccinations, and immunemediated disorders.27
Plasma electrophoresis, in reality, does not offer value as a specific diagnostic test
for any specific disease process in avian patients.33 It is a powerful diagnostic tool
as a sensitive measure of inflammation and debilitation, and in this sense offers
great potential in avian medicine.33
breeders, the practitioner should emphasize the importance of testing and control
measures for conditions that can cause the breeder serious economic loss, such as
polyomavirus, proventricular dilatation disease, and papillomatosis. These discus
sions, too, should be documented. Some practitioners suggest including a table in
the avian examination forms that lists common and important tests with check
boxes requiring the practitioner to note whether they were discussed, performed,
or declined.9 It may be helpful to refer to AAHAs Legal Consent Forms for
Veterinary Practices, Third Edition, for samples.
Radiology
Radiology is an important part of the diagnostic process that tends to be underused.
Radiographs can be taken as part of a health examination, especially in a post pur
chase examination so that any abnormalities can be identified or baseline data can
be established.35Although this should be done in the ideal world, radiographs are
not commonly taken during most health examinations.35 Radiographs are useful in
the sick bird for evaluation of fractures, masses found on palpation, reproductive
disease, respiratory disease, evaluation of a specific organ or in cases of non-specific illness, which is quite common in birds.35 Radiographs have been helpful in
diagnosing such conditions as heavy metal toxicoses, noted by the observation of
metal fragments on the radiograph. Fluoroscopic studies have shown promise in
the early identification of abnormal gastroin
testinal motility, such as that which occurs with
proventricular dilatation disease.36
Because of the extensive air sac system in the
avian patient, radiographic contrast is usually
good. A grit-filled ventriculus can serve as a
useful landmark, particularly in the small bird.
(Its position is left of the body midline, at the
level of the acetabulum [Figure 23]).
Displacement of the ventriculus can indicate the
position of abdominal enlargements.
Before performing any radiographic proce
dures on a bird, the birds condition needs to be
carefully evaluated. It must be determined if
the bird will be capable of tolerating the stress
and handling of the radiographic procedure or,
if anesthesia is to be used, if the bird can be
safely anesthetized.
Restraint is very important during avian radiol
ogy. Many practitioners prefer to use anesthesia
during the procedure, since manual restraint
techniques can be stressful to the bird and result
Figure 23
Grit in the ventriculus is a useful landmark
when evaluating avian radiographs. The
position of the ventriculus is normally near
the left acetabulum; a change from this
position is an aid in evaluation of abdomi
nal lesions. Note the excessive grit in the
intestinal loops. Quite often birds with
gastrointestinal disturbances overeat grit,
possibly leading to impaction.
(T.J. Lafeber, DVM)
with the location in the intestinal tract, and pathologic conditions such as neo
plasms or foreign bodies can alter the passage of barium. Because the transit of
barium may be rapid through the GI tract, radiographs of the upper GI system
should be taken immediately and then at 5, 10, and 30 minutes. Radiographs of
the lower GI tract should be taken at variable times, depending upon how far
along in the tract the area of interest is located.
All avian radiographs should be filed separately for easy retrieval and comparison.
In addition, it is extremely helpful to have on hand a file of normal radiographs for
different species and age-groups. Not only do these films serve as excellent refer
ence material for the clinician, they are also invaluable for comparison when
demonstrating abnormalities to clients. It should be noted that juvenile psittacines
normally have a comparatively large GI tract; this should not be mistaken for
abdominal dilatation.15
Avian Necropsy
Performing necropsies is an important part of avian medicine. Frequently, avian
veterinarians are presented with birds that died suddenly at home. Birds are
very sensitive to airborne toxins or other potential household hazards. However,
because birds tend to hide their illnesses, quite often they are near death or dead
by the time a client notices that there is a disease condition. Necropsies can help
determine the cause of these mysterious deaths. Necropsies are also useful as
a training tool for avian practitioners due to the wide array of conditions seen in
pet birds.
If a bird dies while under treatment for a disease condition, it is good practice to
recommend a necropsy, as both the veterinarian and pet owner will benefit from
the knowledge gained. If the client is a breeder (or the practitioner wants to do it
just for good will and/or informational purposes), the gross necropsy could be per
formed at no charge or at a reduced fee. However, if histopathology is necessary,
these charges would then be passed along to the client.
Many times clients are hesitant to have a necropsy performed because they would
like to take the bird home for burial or do not want the bird dissected. These fears
can be alleviated by discussing the importance of the necropsy in providing answers
and offering the option of a cosmetic necropsy. In a cosmetic necropsy, few or
no feathers are removed and an opening is made just large enough to adequately
evaluate the internal organs and obtain whatever samples are necessary. The inci
sion is then sutured or tissue glued so that minimal disturbance is evident. However,
depending upon the circumstances, a complete and thorough necropsy is preferred.
Due to their high body temperature, autolysis can occur very quickly in birds. A
necropsy should be performed as soon as possible, otherwise the bird should be
refrigerated. Wetting the bird with soapy water prior to refrigeration can facilitate
cooling.39 The bird should never be frozen as artifactual tissue changes will ensue,
making histologic interpretation difficult.39 Under certain circumstances, the bird
could be frozen prior to necropsy, but the owner needs to understand that freezing
and thawing will make gross observations difficult and severely hamper histopatho
logic analysis. However, viral or bacterial isolations and some toxicologic analyses
can be conducted on frozen samples.
The instruments used for mammalian necropsy can also be used for birds, but
smaller sizes facilitate the procedure. Due to the risk of potential zoonoses, gloves
and a surgical mask should be worn, the feathers should be soaked with soapy water
to prevent aerosolization of pathogens, and the work area should be thoroughly dis
infected following completion of the necropsy.39
A detailed description of the avian necropsy technique is beyond the scope of this
book; however, a few important points should be made. Before performing the
actual dissection, carefully evaluate the bird for overall condition and check for
any obvious external abnormalities such as wounds, swellings, discharges, and
staining. Follow a systematic approach when performing the necropsy. Remember
the old adage, You miss more by not looking than by not knowing. Over time, a
familiarity will develop with normal avian anatomical appearance, as well as patho
logical and artifactual changes seen on necropsy, which will enable the practitioner
to become more effective when performing the necropsy.
Multiple samples should be taken and saved in a 10% buffered formalin solution.
If viral, bacterial, or toxicologic studies may be needed, some tissue samples should
be frozen. Cultures can also be obtained. If performing a necropsy on a neonate
or juvenile, check for the bursa of Fabricius (on the dorsal aspect of the cloaca)
and, if present, it should be submitted due to its involvement in many disease con
ditions. Be certain to carefully document the necropsy findings and diagnostic
impressions. Finally, when submitting samples, deal with a pathologist or labora
tory that is skilled in avian histopathology. Avian veterinarians are fortunate
because, due to the increase in pet birds, many excellent diagnostic facilities and
pathologists are available.
References
1. Flammer, K. What You Can Learn From the Physical Examination. In Proceedings
of the North American Veterinary Conference, 2000: 14: 868-870.
2. Murray, M. J. The Avian Physical Examination. In Proceedings o f the North
American Veterinary Conference, 2001: 15: 742-743.
3. Harris, D. J. Avian Restraint and Physical Exam. In Proceedings o f the North
American Veterinary Conference, 2000: 14: 881.
Grooming
In avian practice, offering grooming services can be a double-edged sword. On the
favorable side, it is a useful adjunct to the medical practice, providing a conven
ient service for the clients as well as offering the practice an additional means of
income. Grooming is usually done as part of the yearly visit to the veterinarian;
however, some avian patients, such as those with chronic conditions that require
regular grooming visits, will need to be seen on a more regular basis. Whether a
bird is seen for grooming one time or more a year, clients feel reassured when the
procedures are done in a quality avian practice, as they expect that their bird will
be handled humanely and efficiently, there will be good sanitation practices, and
the most up-to-date and effective techniques will be used.
Unfortunately, offering grooming services also has an unfavorable side. If a client
feels that his or her pet was mishandled during a grooming procedure or that
grooming was improperly performed (e.g., if the bird does not eat after a beak trim
or can still fly after a wing clip), the client may become dissatisfied with the prac
tice as a whole and not return. Quite often, an avian practice will be judged, at least
initially, by the grooming and handling skills of its staff.
For all of these reasonsand, most important, for the health of the birdit is
essential that veterinary offices perform grooming procedures properly and with
handling that minimizes stress and injury to the bird.
Restraint
Proper restraint of the bird is one of the most important components of any groom
ing procedure. Improper handling can result in injury and/or undue stress to the
bird or, even worse, can result in death. A full discussion of the proper techniques
for capturing and restraining pet birds was provided in Chapter 3. Because of their
importance, key points are reiterated here.
It cannot be overemphasized that even a healthy bird can become severely stressed
and die if it is improperly handled. Thus, it is of critical importance that anyone
handling a bird during grooming monitor it for any signs of discomfort, stress, dys
pnea, or other signs that indicate a possible problem. Birds that are held in a towel
for grooming should always be monitored carefully, since they may become very
excited, struggle, and become overheated. Further, in struggling to free them
selves, birds may twist and contort, potentially causing restrictions to breathing,
fractures, or dislocations.
If any irregularities are noted, the grooming procedure should be immediately
stopped and the situation assessed. Any bird that is extremely stressed or having
breathing difficulties should be allowed to rest until it returns to normal.
When handling white-faced birds, such as African grey parrots and macaws, it is
important to avoid applying pressure to the facial skin during restraint, as the
facial skin can develop reddened, bruised areas quite easily. Although these
bruises are harmless and will usually resolve quickly, the client may feel that the
bird was handled roughly.
Finally, when handling baby birds, it is vital that the fullness of the crop be deter
mined through palpation and that any bird determined to have formula in its crop
be handled very carefully to prevent regurgitation and aspiration. (The risk for
applying accidental pressure on the crop, and thereby pushing formula up the
esophagus and into the mouth, increases when a bird is struggling.) In addition to
attempting to keep struggling to a minimum, the person handling the bird should
monitor it for any signs of food material retropulsing into the oropharynx. If a
problem occurs or the risk is ascertained to be too great, the groomer should rec
ommend postponing the procedure and having the client return when the bird has
an empty crop.
Two other areas of concern relate specifically to grooming procedures. First,
overzealous restraint of a birds toes during clipping should be avoided, as dis
locations or fractures can occur. Holding the toes by the distal phalanx should
also be avoided, since an ill-timed twist can cause injury. Following nail clip
ping, it is a good idea to check for any dislocations. Not only is it always bet
ter to evaluate for potential injury before a bird is brought back to the client, but
toe dislocations can be easily reduced by careful manipulation and, in the vast
majority of cases, will remain in place with no further intervention.
Second, although it may seem obvious, it bears noting that whenever a grinding
tool is used, the operator must be cautious. Good control of the device must be
maintained and care taken to not allow the grinding head to catch in the towel or
come in contact with an errant human or avian digit or the birds beak or tongue.
Some birds will become extremely nervous when they hear the sound of the
grinder, so it is very important to watch birds carefully during the trimming pro
cedure. Beak trimming can be especially stressful when a grinding device is
used due to the vibration and heat produced; thus, it is of utmost importance to
monitor the birds condition when grinding and shaping beaks.
Nail Trimming
Nail trimming is probably the most frequently performed grooming procedure in
pet birds. Because these birds spend most of their time on perches with little
opportunity to wear their nails down, the nails overgrow readily and become quite
sharp. Overgrown nails are problematic due to the risk of breakage and snagging,
but they are also painful to the owner when the bird is perching on his or her shoul
der, which is usually what prompts the request for grooming.
During the grooming visit, the groomer should instruct the bird owner of measures
that can be taken to help facilitate nail wear. For example, the owner could have
the bird walk on a variety of surfaces or could place a coarse-surfaced perch, such
as a cement perch, in the cage. Sandpaper perch covers should be discouraged, as
they can irritate the birds feet and do not wear the nails down adequately.
The instrument used to trim a birds nails will depend on the size of the bird and
personal preference. The nails of small birds can be trimmed with human finger
nail clippers, small pet nail clippers, or sharp wire clippers. For birds the size of a
small parrot and larger, larger clippers, such as quality dog nail clippers (either
guillotine or side cut), or larger wire clippers can be used. A tool that many prac
titioners find ideal for trimming the nails of birds of all sizes is a variable-speed
grinding tool with a cone-shaped grinding attachment. The nail can be trimmed
further back than with a clipper, as the grinder cauterizes the nail somewhat. It also
can be used to remove sharp edges from the nail (though this can also be done with
a fingernail file following clipping). All nail trimming tools should be checked
periodically to ensure that they have sharp edges. Dull edges can cause nail trauma
and a painful clip.
It is sometimes difficult to determine how far back to trim a nail. With birds that
have white nails, the clip should be made just distal to the apparent blood vessel,
which can be visualized as a pink or red coloration in the nail. If the bird is small,
the nail can simply be clipped to this point. In large birds, the nail can be ground
down to this point or can be clipped and then smoothed. For birds that have black
nails, the groomer has to rely on past experience when deciding how far back to
trim a nail.
Nails that are very overgrown can be problematic, as the quick will extend further
out into the nail than normal. If such nails are trimmed to the length that is usually
desired, there is a high likelihood of bleeding. Using a variable-speed grinding tool
will enable the nail to be trimmed shorter than by clipping, due to the cauterization
the grinding tool provides. When trimming overgrown nailsindeed, during any
grooming proceduresome means of hemostasis should always be within reach.
Several problems can occur as a result of cutting a nail too short. Not only will
bleeding likely occur, but the bird may experience quite a bit of pain. As a result,
it may hold its foot up, sometimes for a short period of time but sometimes for as
long as a few days, which can be quite upsetting to the client. Another problem
with trimming nails too short (whether or not bleeding occurs) is that the bird may
have difficulty holding onto its perch. The groomer should always try to keep the
nails at a length that will allow the bird to grip its perch. No client wants to see his
or her bird continuously slide off its perch!
The use of a grinding tool for nail trimming does have a downside. As noted ear
lier, the grinding heads are difficult to disinfect adequately and thus may be a vehi
cle for transmitting diseases, such as psittacine beak and feather disease, when
bleeding occurs. Following the grooming of any bird known to have an infectious
disease, the grinding heads that were used should always be discarded.1
Beak Trimming
Although an overgrown beak may be the result of insufficient beak activity or
chewing, it may also have a pathological etiology. For that reason, whenever a bird
that has never had a physical examination or has not been examined in over a year
is brought in for a beak trimming, the groomer should strongly recommend that the
client schedule a physical exam before the beak trimming is done, so that the cause
of the beak abnormalities can be determined.
The same instruments used for trimming birds nails can be used for trimming the
beak. As with nail trimming, many practitioners find a variable-speed grinding
tool ideal for trimming and shaping the beak, as the speed can be controlled to
minimize vibration. The noise created by the grinder can, however, frighten some
birds, and some head vibration can be noted during the procedure, especially with
small birds. If clippers are used for trimming the beak, it is preferable to leave the
beak a little longer than desired with the initial clip and then finish by shaping the
beak with a grinding tool or appropriate file.
Before trimming a beak, it is essential to have a mental image of the normal
appearance of the beak for the type of bird being groomed. With this image firmly
in mind, the beak can be trimmed to the proper length and shape. With smaller
birds, the beaks can be clipped to the appropriate length and shape. With larger
birds, grinding or a combination of clipping and shaping is required. If the lower
beak is overgrown, the upper beak can be gently positioned inside the lower beak,
giving the groomer direct access to the overgrown beak tissue and allowing for
quick grooming.1
Trimming a beak too short can lead to bleeding and can be painful to the bird, pre
venting it from eating for a variable number of days (the length of time being
dependent on the severity of the injury). If a high-speed grinder is used, the
groomer must always exercise care when shaping the sides of the beak, where the
hard beak is not very thick, to avoid wearing through the hard beak to the under
lying vascular and sensitive tissues. Caution must also be taken to minimize vibra
tion whenever a grinding tool is used to trim the beak of a small bird. The beaks
of birds with hepatic lipidosis should be trimmed with great care due to their com
promised condition and inability to tolerate stress. With these birds, a grinder
should be used sparingly, if at all.
During involved, lengthy beak trimming procedures, such as the correction of a
beak with a severe malocclusion, it is often advisable to let the bird rest partway
through the procedure. Alternatively, the practitioner may want to anesthetize birds
for such procedures. Due to the safety of isoflurane anesthesia, avian practitioners
are also using this agent to anesthetize highly excitable birds prior to even routine
beak trimmings.
Wing Clipping
Wing clipping is not a necessity, but it is generally recommended for pet birds to
protect them from many of the dangers in the household. Not only can wing clip
ping prevent birds from flying into windows, mirrors, walls, and ceiling fans, but
it can also keep them from landing on hot cooking surfaces, falling into open con
tainers of water, and escaping through doors or windows accidentally left open. If
a client is able to monitor his or her bird carefully and prevent such dangerous sit
uations from developing, then wing clipping may not be necessary. However,
clients who have free-flying birds and a lot of traffic into and out of their homes
should strongly consider wing clipping. Weaned neonates should not be fully
clipped until they have some knowledge of flight.
Wing clipping can also be an effective tool in training a bird. Because fully
flighted birds tend to be more independent and difficult to tame than birds with
clipped wings, owners of new birds should be encouraged to consider clipping
their birds wings until the bird is adequately trained. If the bird continues to be
tame after its wing feathers grow back and the owner can manage the bird during
flight, then the wings can be left alone.
One situation in which wing clipping may not be desirable is when there is the risk
of attack by a cat or dog. Flight is the main advantage that pet birds have over a
rambunctious dog or cat.
Because flight is an important part of quality of life and exercise for many pet
birds, owners may want to consider seasonal or partial (reduced flight) wing clip
ping. The former is often appropriate for birds that become aggressive or difficult
to handle during periods of hormonal behavior. Wing clipping at these times seems
to be helpful in calming some of the activity. However, some high-strung birds,
such as African grey parrots and cockatoos, become upset after wing clipping and
will chew or shred the cut portions of their wing feathers, especially if longer por
tions of the cut flight feathers remain.
There are two basic types of wing clips and variations of each (as will be dis
cussed later in this section). However, a few key principles apply no matter what
type of wing clip is performed. First, wings should be clipped evenly on both sides.
Although there have been some proponents of clipping only one wing, which
unbalances the bird and makes flight difficult, birds clipped in this way have so lit
tle control when they attempt flight that they run the risk of suffering injury. With
both wings properly clipped, a bird will be capable of a smooth, descending flight
but will not be able to attain elevation.
Second, the practitioner should never guarantee that a bird that has had a wing clip
will be unable to fly when it is taken outside. Birds are so well adapted for flight
that, when the conditions are right, even a clipped bird may be capable of enough
flight to escape. It is also possible that a bird that has been clipped has undergone
(or is undergoing) a molt, unbeknownst to the owner, and has developed enough
new feathers to be capable of flight. Because of the many instances in which bird
owners have lost their clipped birds after taking them outside, some veterinary
offices display a plaque warning owners that a properly performed wing clip does
not guarantee against flight in all situations. Other offices put a message to that
effect on the invoice whenever a bird is given a wing clip. Due to liability issues,
some type of disclaimer is a good idea.
Third, the severity of the wing clip should depend on the variety of bird. Some
lighter, more aerodynamic birds will need a more severe wing clip than heavierbodied birds. For example, cockatiels require more clipping of flight feathers to
restrict flight than do Amazon parrots and African grey parrots. Cockatiels are
sometimes capable of flight even after all their flight feathers have been clipped!
Practitioners should test-fly a bird after a wing clip if any uncertainty exists about
the effectiveness of the clip. The ideal room for the test is one that is carpeted, has
few obstacles, and can be closed up to prevent escape.
Fourth, if wings are clipped too severely, the bird may drop abruptly rather than
having descending flight and may incur significant injury. Three common injury
sites are the beak, the sternum, and the tail base. Splitting the skin over the ster
num is an injury that often occurs in birds that are unable to ease descent and
land on a hard, uncarpeted surface. The skin at this site is very thin and can eas
ily be traumatized. Tail-base laceration may occur in birds such as cockatiels,
especially young birds that have recently had their wings clipped and were not
proficient fliers at the time of the clipping. These birds tend to hit the ground
hard with their rumps and tear the skin ventrally at the margin of the uropygium.
Both of these injuries usually require surgical intervention and can be prevented
by proper wing clipping.
As noted earlier, there are two basic types of wing clips with variations of each.
The standard wing clip involves clipping the first 5 to 10 outer flight feathers (pri
maries) on both wings (Figure 25). The feathers are clipped just below the covert
feathers, seen from a dorsal aspect. The number of primary flight feathers trimmed
depends on the type of bird and its flying ability.
Figure 25
View of dorsal wing surface. The cutting line indicates where primary flight feathers should
be clipped (just below the primary coverts). The number clipped, between 5-10 primaries,
depends upon the type of bird and degree of flight restriction desired. (L. M. Bauck, DVM)
A variation to the standard clip exists in which the feathers are clipped near their
base, leaving only a short portion of the quill. The reasoning behind this clip is that
it will not promote feather chewing of the wing fragment and is still aesthetic. A
disadvantage to this clip is that the very short quills afford no protection to emerg
ing blood feathers during a molt. Whichever method is used, care should be taken
to make an even cut. Clients who see a jagged cut often think the job was done
incorrectly, even though that may not be the case.
The other basic type of wing clip is the cosmetic clip. It is less effective at restrict
ing flight and thus is less preferred by practitioners. However, this type of clip is
requested by some clients, since the clip, when properly done, is barely noticeable
in birds in normal resting position with wings folded. The standard clip, in con
trast, is sometimes much more noticeable. The cosmetic clip is accomplished by
leaving three or four of the outer primary flight feathers and clipping the remain
ing primaries as well as the secondary flight feathers if more flight restriction is
desired. As with the standard clip, the covert feathers on the dorsal side of the
wing are used as a guide for where to clip the feathers or the feathers are clipped
near the base. The cosmetic clip is especially preferred by macaw owners, as it
maintains the beauty of the birds wings. However, because this clip is not very
effective in restricting fight, birds that have had a cosmetic clip should not be
taken outside. The risk for escape is simply too great.
When clipping the flight feathers, the groomer should be careful to avoid cutting
blood feathers, which are the newly developing feathers that have blood in the
shaft. These feathers will bleed if they are cut. The groomer should also avoid cut
ting all of the fully developed feathers around a blood feather, leaving it without
support. There is a strong possibility that such unsupported blood feathers will
break and bleed with even normal activity. Whenever a blood feather is present,
the groomer should leave a fully developed feather on one side of it to provide sup
port and should instruct the client to return to have the clip completed (usually for
no charge) after the blood feather has fully developed.
Finally, because any short wing clip will make a bird more prone to breaking blood
feathers as they emerge (since the blood feathers will not be protected by sur
rounding feathers), a longer clip should be used with birds that are prone to blood
feather breakage.
References
1. Wissman, M. A. Personal communication.
Treatment Techniques:
Supportive Care for
the Sick Bird
Following the completion of the physical examination and diagnostic testing, most
sick birds can be sent home with appropriate medications and instructions for their
administration. If the bird has been ruffled, the client should be advised to keep the
bird warm through the use of either a heat lamp or a home incubator. An effective
home incubator can easily be made by wrapping a heating pad around the side of
the cage and then wrapping the entire cage and heating pad in plastic wrap with
holes provided for ventilation. The client should be told to monitor the bird for any
changes and to count daily droppings.
Birds that are too ill to be sent home should be transported to a hospital unit for the
appropriate level of care. Birds that are vomiting should rarely be sent home;
rather, they should be hospitalized and medicated with injectable drugs until the
vomiting subsides. Once the bird has ceased vomiting and is stable, it can be sent
home, where treatment can be continued. If a bird is so ill that minimal or no han
dling or diagnostics can be completed, basic supportive care should be instituted
until the bird is stabilized and diagnostics can be completed. The basic means of
supportive care for a hospitalized birdheat, fluid therapy, drug therapy, and gav
age feedingare described in this chapter.
Heat
As mentioned in Chapter 2, a temperature-controlled environment is essential for
a sick bird. Although commercial avian incubators or modified human infant incu
bators are ideal (Figure 26), kennels or cages with heat lamps and aquariums
equipped with heating pads or heat lamps can also be used. A sick, ruffled bird
should be maintained at 80-95F;1 some critically ill birds may require tempera
Figure 26
Human incubator modified for providing a controlled heat
and humidity environment for hospitalized bird. Perches can
be easily made or purchased to fit inside the incubator.
(P. S. Sakas, DVM)
Fluid Therapy
Advances in the use of fluid therapy have led to great improvement in the survival
rate of sick birds. The route of administration should be based upon the clinical
status of the patient, severity of the disease being treated, composition of required
fluids, speed of action desired, and the ease of administration.2
When fluids need to be administered quickly, an intravenous (IV) bolus or an
intraosseous (IO) catheter is used. Birds will not tolerate standard IV catheteriza
tion. With the safety of isoflurane anesthesia, some practitioners anesthetize birds
during fluid administration. However, discretion must be used, since birds that
require fluid therapy are usually critically ill and may not survive anesthesia.
Fluids used include normal saline, 5% dextrose solution, and lactated Ringers
solution (preferred for most clinical conditions). All fluids should be warmed to
100-102F (38-39C) prior to infusion.3
Treatment with hypertonic saline or colloidal fluids may be beneficial to birds that
are hypovolemic or have suffered acute blood loss.4 Synthetic colloids increase
plasma colloid osmotic pressure and expand intravascular volume greater than the
volume infused.4
Hetastarch is a synthetic colloid that expands plasma volume and improves oxy
gen delivery to the tissues.4 Oxyglobin, a stroma-free polymerized bovine hemo
globin solution, has similar colloidal properties, but in addition to improving
tissue perfusion, it is also capable of carrying oxygen to the tissues.4 Both of
these products have been used in pet birds and show promise. However, studies
are still limited.
The veins that can be used for administration of IV boluses are the ulnar (pre
ferred in large birds), the medial metatarsal, and the jugular (used in very small
birds). The bolus is injected with a 25- to 28-gauge needle, which is often bent to
facilitate placement. Table 4 lists maximum volumes of fluids that can be given
over a 2- to 4-minute period for the various speciesof petbirds. Typically, fluids
are given at 10-15 ml/kg per bolus up to 30 ml/kgper bolus.1 If sitesare rotated,
the bolus fluids can be given three times a day.
Table 4
Intravenous Bolus Fluid
Administration in Pet Birds
(Representing Various Sizes of Birds)'
Budgerigar (jugular vein)
1.0 ml
2.0 ml
7.0 ml
12.0 ml
When an intraosseous catheter is used for rapid fluid administration, the catheter
can be inserted into any bone with a rich marrow cavity, but the dorsolateral por
tion of the distal ulna is most frequently used. Other sites include the proximal
tibia, the proximal ulna, and the distal radius. For short-term usage in medium
and large birds, the proximal tibia is ideal; for long-term usage in these birds, the
distal ulna works better. Pneumatic bones, such as the humerus and femur, can
not be used.
In medium to large birds, an 18- to 22-gauge, 1.5- to 2.5-inch spinal can be used
as the cannula; in smaller birds, a 25- to 30-gauge hypodermic needle can be used.
Prior to insertion of the cannula, the feathers over the accessible end of the bone
selected for catheterization are plucked and the skin is cleaned. Then, the needle
is aligned with the long axis of the bone, inserted, and rotated through the cortex
into the cavity. The stylet will prevent a bone plug from blocking the needle. After
the stylet is removed, the needle hub is taped and sutured in place and the wing is
secured with a figure-eight bandage. A burette or infusion pump is then used to
regulate the volume of fluid administered. Maintenance of an intraosseous catheter
is identical to that of other indwelling catheters and should include flushing with
heparinized saline every 6 hours.2 Catheters should be replaced after 72 hours.1
Fluid volumes given to birds via the intraosseous route are calculated in much the
same manner as for other animals. That is, the deficit is corrected and mainte
nance fluids and electrolytes are provided. A typical bird, 7-8% dehydrated,
weighing 1 kg, would require 70-80 ml of replacement fluid plus 50 ml per kg
body weight per day for maintenance.5Pediatric patients have higher maintenance
requirements.6 Fifty percent of the deficit is administered in the first 12 hours
(bolus every 3 hours). The remainder, including maintenance, is given over the
next 48 hours (bolus every 8 hours). A portion of the maintenance fluid can be
given subcutaneously.5 The maximum
volume per bolus dose of fluids should
not exceed 1% of body weight, given by
slow IV infusion.5
Jugular catheters are also sometimes
used for intermittent fluid administration
(Figures 27 and 28). A port-type cap is
used and secured for easy access.
Indwelling IV catheters are not generally
used in other locations in birds because
of vein fragility, but there are some
instances where they have been used
with various degrees of success. Jugular
Figure 27
Quaker parrot with jugular vein exposed (right lat
eral surface). (L. M. Bauck, DVM)
Figure 28
Placement of 22-gauge indwelling vascular
catheter, flushed with heparinized saline and to be
used for intravenous bolus fluid replacement ther
apy. Sutured and bandaged in place.
(L. M. Bauck, DVM)
Oral fluids are easy to administer, have minimal side effects, and allow rapid
delivery of large volumes of all types of fluids.2 However, absorption of fluids to
the general circulation is slower than other routes and may be further delayed in
metabolically compromised patients.2 Oral fluids can be successfully utilized
when treating mild cases of dehydration or speed of response is not a factor.2
Oral fluids are contraindicated with vomiting, malabsorption, ileus, crop stasis, or
bowel impaction.2
Subcutaneous fluids are easy to administer, however, the variety of solutions avail
able for use are limited to isotonic compounds.2The vasoconstriction of peripheral
vessels that occurs with severe dehydration or shock retards fluid absorption from
subcutaneous locations.2Multiple sites are available for subcutaneous fluid admin
istration, including the webs of the wings, the intrascapular region, the breast
region, and the inguinal region. The fluids can be delivered with a 22-gauge nee
dle until the skin is taut. If multiple sites are used, a total of 5 ml of fluid can be
given to a budgie, and up to 40 ml can be given to a macaw. Rosskopf's recom
mendation is to deliver 0.05 ml of fluid per gram of body weight per day (50
ml/kg/24 hours) in divided doses in multiple sites.7
Fluid replacement will also be assisted by gavage feeding. However, in seriously
ill birds, intravenous or intraosseous fluid administration should be used to hasten
stabilization. In birds in general, fluids are absorbed more slowly with subcuta-
Blood Transfusions
Birds have a great capacity to withstand acute hemorrhage by maintaining circu
latory volume through compensatory mechanisms that shunt blood from large
muscle capillary networks and pelvic and abdominal areas directly into the vena
cava.2An acute blood loss of 30% of the total volume can occur without altering
clinical status in the normal patient (avian blood volume is typically 6-13% of
total body weight.2
Avian compensatory mechanisms will falsely elevate the PCV immediately after
a bleeding episode and a true equilibrium PCV will not occur for up to 24 hours
after the hemorrhagic event.2 Iron dextran and B vitamins should be given to birds
with any degree of blood loss, as iron dextran has been shown to induce a rapid
increase in the PCV in anemic birds.2
If an equilibrated PCV is below 15%, a transfusion with cross-matched or het
erologous blood should be considered 2 The blood should be collected in heparin,
which does not bind the calcium like EDTA.2 Partial cross-matching can be
accomplished by mixing recipient serum with donor red blood cells, incubating at
40C for 30 minutes, and checking for hemolysis or agglutination.2 Blood at a
dose of 5% of body weight can be administered through the jugular vein or
intraosseous catheter.2 The use of synthetic colloids (Hetastarch, Oxyglobin)
shows promise in the treatment of acute blood loss in birds.4
Drug Therapy
General guidelines for the common means of drug administration in birds are
given in the following sections.
dal border (the cranial aspect of the abdomen). Since the sternum is a large, pro
tective bone in birds, there is little danger of penetrating into the body cavity if the
injection is given within the limits of the aforementioned landmarks. In finches
and neonatal birds, intramuscular injections should be delivered at a shallow angle
to minimize hemorrhage and to avoid penetration of the sternum. Leg muscles
should never be used for intramuscular injections due to the pain caused by inject
ing into a small muscle mass.5 Some medications may cause irritation, necrosis, or
abscessation at the injection site, and local tissue reactions commonly occur when
large quantities of drugs are injected or when the formulation contains propylene
glycol or glycerol.2 Alternate sides with subsequent injections to decrease the
amount of muscle swelling and necrosis.3
formulated diets, since these birds drink more water. However, the bitter taste of
many medications (e.g., enrofloxacin) may discourage birds from drinking nor
mally, which is a particularly undesirable effect in sick birds that may already be
dehydrated. Further, some medications become unstable in drinking water or when
exposed to light. Medicated drinking water has typically been used when treating
flocks of smaller birds or large number of patients.2
Table 5
Gavage Feeding in Pet Birds
T ype of
B ird
Amazon parrot
Budgerigar
Canary
Cockatiel
Cockatoo
Conure
Finch
Lovebird
Macaw
C atheter S ize
(F r e n c h )
10-18
8-10
5-8
10
18
10-14
5
10
18
A mount
F eeding
per
30-35 ml
1-2 ml
0.25-0.5 ml
3 -4 ml
40-45 ml
6 -8 ml
0.25-0.5 ml
3 -4 ml
30-60 ml
The number of times a day gavage feeding can be performed will depend on the
emptying time of the crop, since this type of feeding should be performed only
when the crop is empty. Thinner solutions will pass through the crop more rapidly
than thicker solutions. Generally, hospitalized birds are gavage fed two to three
times daily.
As noted earlier, before administering a feeding solution by gavage, it is important
to evaluate the fullness of the crop. Administering the solution to a bird with a par-
tially full crop can cause the solution to back up into the esophagus, leading to
aspiration. If the crop is not emptying, the contents should be removed through
aspiration, and small amounts of feeding solution should then be administered.
To estimate the length of feeding tube needed, the practitioner should measure the
distance from the mouth to the crop. Because canaries do not have a well-developed crop, the estimate for canaries should be for the distance to the crop region.
A mark can be made on the tube to aid in visualizing how far to insert the tube.
Just prior to inserting the tube, the practitioner should extend the birds neck
slightly, with the birds head held upright, so that when the feeding tube is intro
duced, its passage will be as straight as possible. The tube should then be intro
duced on the left side of the mouth and passed gently but firmly over the tongue
toward the right side of the neck. Doing so will pass the tube into the esopha
gus, which runs down the right side of the neck. Due to the superficial position
of the esophagus in the neck, the practioner can usually feel the tube passing
into the esophagus.
In small birds, a speculum will not be required for holding the mouth open, but a
speculum may be required for larger birds. A rubber Nylabone with a hole drilled
in the center can be used as a speculum in medium to large birds with a slight
chance of damaging beak tissue.11 Sometimes, merely displacing the upper beak
laterally a centimeter or so will allow the passage of the tube in large birds with
out the use of a speculum.
The tube should be passed slowly and carefully and never forced. Forcing a
feeding tube can puncture the esophagus or crop. In addition, it is important to
ensure that the tube has reached the crop before beginning to deliver the solu
tion. Simply palpating the crop will let the practitioner know whether the tube is
in the correct position.
When the tube is in position, the feeding solution should be slowly delivered. The
filling of the crop can be seen and felt. The birds mouth should be closely watched
for any evidence of solution welling up in the oropharynx, which would indicate
an overfilled crop or a poorly positioned tube. If this occurs, the tube should be
removed and the bird turned over with head directed downward, so the solution
can pass out of the mouth.
Occasionally, a bird will retch or vomit after tube feeding. If vomiting occurs fre
quently, the tube feeding technique and condition of the bird should be evaluated
to determine the cause of the problem.
Anesthesia
Due to the stress birds experience as a result of handling and restraint, sedation and
anesthesia are used frequently in avian medicine. As with mammalian species, the
best results will be achieved if a careful evaluation of the bird is performed prior
to the administration of sedation or anesthesia.
Fasting is not always required prior to sedation or general anesthesia, and in
small species fasts of more than a few hours may be harmful. In general, all that
is required is an empty crop. Lorikeets should not be allowed to eat or drink for
at least 4 hours before general anesthesia;12 neonate psittacine species may need
to fast for up to 6 hours, since their larger relative crop volume takes more time
to empty.
The bird should be positioned so that its sternum can move freely and will be read
ily visible to the personnel administering anesthesia. Whenever possible, the bird
should not be positioned in dorsal recumbency, as the weight of the sternum and
muscle mass significantly decreases the respiratory minute volume and may con
tribute to respiratory acidosis.
Avian patients require thermal support during anesthesia, which is best provided
with an infrared brooder lamp (or other radiant incandescent heat source). This
means of thermal support has been shown to be superior to circulating hot water
pads for maintaining core body temperature in birds.13
Fluid support may also be necessary. Fluid is generally administered
intraosseously (10-20 ml/kg body weight/hr) or by intravenous bolus administra
tion. With very small patients, warmed fluids can be given subcutaneously in small
amounts every 15-20 minutes.
The bird should be carefully monitored by constant assessment of the heart rate
through auscultation, EKG, or doppler flow apparatus placed over the brachial or
tarsal arteries.14 Depth of anesthesia should be continually monitored through
Pain Management
Pain management is poorly understood in avian species. Indications that a bird is
in pain include its behavior, appearance, or symptoms of discomfort (i.e.,
decreased activity, anorexia, and abdominal tenseness).1 Injuries such as bums,
crushing trauma, beak trauma, or trauma to the extremities are commonly associ
ated with pain.1 Agents that can be used to provide relief include aspirin,19 flunixin, butorphanol, and buprenorphine.1
References
1. Murray, M. J. Intensive Care of the Critically 111 Bird. In Proceedings of the North
American Veterinary Conference, 1998: 12: 763-766.
2. Ritchie, B. W. Drug and Fluid Administration in Birds. In Proceedings of the North
American Veterinary Conference, 2001: 15: 769-771.
3. Oglesbee, B. L. Medical Management Techniques in Companion Birds. In
Proceedings of the North American Veterinary Conference, 2001: 15: 765-766.
4. Lichtenberger, M., et al. Administration of Oxyglobin and 6% Hetastarch After Acute
Blood Loss in Psittacine Birds. In Proceedings o f the Annual Conference o f the
Association of Avian Veterinarians, Orlando, FL: 2001: 15-18.
19. Bennett, R. A. Pain Management in Pet Birds. In Proceedings of the North American
Veterinary Conference, 2000: 14: 867.
Avian
Therapeutics
This chapter provides some general guidelines for drug use and administration in
avian medicine. The discussion then becomes more specific, with guidelines pro
vided for various drug categories.
General Guidelines
Although avian therapeutics and drug dosages are available from many sources,
including scientific articles1and formularies in certain avian texts,2-5 drug dosages
in birds are poorly established. Most drugs used in avian medicine have not been
tested in pharmacologic studies; rather, the dosages are generally empirically
based or based on clinical experience.
It is important to note that drugs that are effective in certain avian species may be
inappropriate or toxic in others.5 Further, in the critically ill bird, stabilization of
the bird is essential: Antibiotic therapy alone is not adequate. Before beginning
diagnostic testing or treatments in any bird, the practitioner needs to evaluate the
hydration status and condition of the bird to determine if fluid therapy and/or nutri
tional support is needed.
Selection of rational drug therapy is dependent upon several factors, including
the condition of the bird, diagnostic findings, culture and sensitivity results, and
the capability of the owner to medicate the bird. Although injectable medications
are the ideal means of treating a bird, quite frequently the owner is reluctant to
treat the bird in this fashion. Oral administration is the next best technique and
the means most often employed in avian practice. It takes some time to teach
clients how to medicate a bird, but once they have become adept at the procedure
they can administer an accurate, measured dose.
As noted in Chapter 5, most medications given in drinking water generally are not
as effective as those given by injection or oral treatment. Not only does medication
in drinking water lose potency over time, but it also may discolor the water and
cause it to be distasteful, which will lead to nonacceptance by the bird. For birds
that are ill and perhaps dehydrated, this situation could lead to further deterioration
of their condition. Still another factor is the variable water consumption of birds;
one can never be certain that birds are achieving therapeutic levels of drugs that
have been administered in their drinking water. Nonetheless, medicated water
makes it easy to treat birds on a flock or aviary basis and is often the only means
of treating an overtly wild or aggressive bird. If medications are given through the
drinking water, bird owners should be instructed to limit foods that have a high
water content, such as fruits and vegetables, to prevent the birds avoidance of the
medicated water due to hydration via the food.5
Aminoglycosides
Aminoglycosides are bactericidal, are confined to the extracellular space, poorly
penetrate the eye and central nervous system,1 and are excreted through the kid
neys. They are not absorbed from the gastrointestinal tract, so they must be
administered parenterally.1 They are relatively toxic in relation to other antibi
otics, potentially causing nephrotoxicity, ototoxicity, and other neurologic dys
function.1 Thus, they should be used with caution in dehydrated birds or birds
with renal disease.
Aminoglycosides provide excellent results against most gram-negative bacteria
and Staphylococcus but poor results against most Streptococcus and anaerobes.1
Gentamicin, tobramycin, and amikacin are the aminoglycosides commonly used in
avian practice. Amikacin is preferred, as it is the least nephrotoxic.6 Gentamicin
can be used to reduce expense or to treat amikacin-resistant organisms.6 It is avail
able in several topical ophthalmic preparations that are useful in pet birds. Due to
the nephrotoxicity of gentamicin, the condition of a bird under treatment should be
carefully monitored. Tobramycin provides good results against Pseudomonas.1
Aminoglycosides are synergistic with penicillins and cephalosporins, so both
groups of drugs are potentiated when they are used in combination.4 Treatment
with aminoglycosides can be administered once or twice a day. As noted above,
the drawbacks for their usage are their potential nephrotoxicity and the need to use
parenteral administration.
Cephalosporins
Cephalosporins are bactericidal and are widely distributed to the extracellular
space but poorly penetrate the central nervous system or abscessed tissue.6 They
are excreted through the kidneys and are considered less toxic than many other
antibiotics.1 Their low toxicity is advantageous for birds with compromised
hepatic or renal function.
Quinolones
Enrofloxacin is bactericidal, widely distributed, and excreted primarily through
the kidneys.1 It is well tolerated orally, but intramuscular injections can be irri
tating.1It is one of only a few antibiotics that are effective when administered in
the drinking water.1
Highly effective against most gram-negative bacteria and some gram-positive
bacteria with once or twice daily dosing, enrofloxacin has no effect against anaer
obes.1Unfortunately, many avian practitioners overuse enrofloxacin, employing
it for almost any disease condition. A disadvantage of enrofloxacin is its relative
inactivity against many Streptococcus spp. and all anaerobes.1Another problem
is that it is unpalatable, so that birds will often refuse oral administration.1
Disguising the taste with fruit juice or some type of flavoring is sometimes help
ful for acceptance.
Penicillins
Penicillins are bactericidal and widely distributed to the extracellular space but
poorly penetrate the central nervous system.1 They are excreted through the kid
neys and are considered less toxic than many other antibiotics.1 As with
cephalosporins, their low toxicity is advantageous for birds with compromised
hepatic or renal function.
The spectrum of effectiveness and route of administration vary with the particu
lar penicillin drug.1 Ampicillin and amoxicillin are available in both oral and
injectable forms and are effective against many gram-positive but few gram-neg-
Tetracyclines
Tetracyclines are bacteriostatic with wide tissue distribution.1 Unlike most other
antibiotics, the route of excretion varies from drug to drug.1Oral preparations have
reduced absorption in the presence of calcium and magnesium.1 Injectable forms
can be irritating and cause necrosis at the injection site.1Long-term treatment may
lead to immunosuppression and lower the normal gut flora, leading to the devel
opment of opportunistic infections, such as candidiasis.1
Tetracyclines can be used to treat a variety of organisms, but their primary use in
avian medicine is for the treatment of chlamydiosis, with doxycycline being the
drug of choice.1 Unlike most tetracyclines, doxycycline is minimally affected by
calcium, and fungal overgrowth is less likely.4Treatment of chlamydiosis has been
accomplished through injectables, oral dosing, and addition to food and water with
variable success.1Tetracyclines can be used in combination with bactericidal drugs
to treat bacterial septicemia and chlamydiosis.4
Trimethoprim-Sulfonamide Combinations
Trimethoprim-sulfonamide combination drugs are bacteriostatic, have good tis
sue penetration,1and are excreted through the kidneys. Careful monitoring should
be conducted, since sulfonamides can cause renal damage in dehydrated birds.1
Trimethoprim-sulfonamide combinations have good efficacy against many grampositive and gram-negative bacteria except for Pseudomonas.1 They are available
in oral and injectable forms. The oral form is usually tolerated well; however,
some birds may develop gastrointestinal upset or vomiting after administration,
particularly macaws.1The injectable form can cause irritation at the injection site.1
Trimethoprim-sulfamethoxazole is the most common combination of drugs in this
category used in birds, as it provides excellent broad-spectrum results.1The main
disadvantages to trimethoprim-sulfonamide combinations are their potential to
cause regurgitation and the possibility of renal damage in debilitated birds.1
Antifungal Agents
Fungal diseases are among the most frustrating avian infections to diagnose and
treat.5Aspergillus is found throughout the environment, and quite often aspergillo
sis is the result of poor husbandry practices. Chronic fungal diseases involving
Aspergillus spp. and Candida albicans are often due to immunosuppression.5
Occasionally, secondary bacterial infections will complicate a fungal condition.
Due to the nature of the fungal organisms and the pathological changes they pro
duce in the tissues, it is difficult to achieve therapeutic levels of antifungal agents
in affected tissues, decreasing treatment success.5Thus, treatment of fungal infec
tions requires long-term therapy and is expensive. With the use of newer antifun
gal drugs, such as fluconazole and itraconazole, better success has been achieved
in treatment. Terbinafine has shown promise in the treatment of systemic fungal
disease with lower incidence of toxicity.7 Due to the potential side effects of anti
fungal agents, the general health status of the bird should be carefully monitored.5
Corticosteroids
In birds, corticosteroids may be used for their anti-inflammatory, anti-neoplastic
and immunosuppressive properties (as in mammals).8 They can be given as part
of emergency therapy to treat shock, trauma, toxicoses, or central nervous system
injury.8
The effects of corticosteroids in birds are somewhat different than in mammals. In
addition to the glucocorticoid activity seen in mammals (increased glycogenolysis,
lipolysis, gluconeogenesis and protein metabolism), birds also have significant
mineralocorticoid activity (increased glomerular filtration rate and potassium
retention).8They may also suppress both humoral and cell-mediated immunity.8
Glucocorticoid therapy may also cause hyperphagia, polyuria, polydipsia, or
decreased growth and can interfere with normal metabolism.8 Glucosuria, hyper-
Antiparasitic Agents
The misuse of antiparasitic and antiprotozoal drugs, especially in poultry, has
resulted in many effective drugs being removed from the market.5 Most dosages
for drugs that are available were developed for poultry. Since some of these drugs
can be toxic, close supervision of a bird during treatment is important.5Droppings
should be checked to be certain that the bird is free from parasites. In addition to
drug therapy, management of the environment is an important part of the treatment
plan. Reduction in vermin and vector contact with birds, a clean aviary, quarantine,
and post-purchase physical examination of new birds are important preventive
measures to maintain an aviary free of parasites.5
Nebulizing Agents
Nebulization therapy is an effective treatment for respiratory disease in pet birds.
Conditions such as air sacculitis are difficult to treat without nebulization. Because
of the poor blood supply in birds air sacs, most drugs administered orally or par-
Psychotropic Agents
Behavioral problems in avian medicine are frustrating for the practitioner and bird
owner alike. Over the past few years, there has been an increasing trend to control
such problems as feather picking and other unwanted behaviors with psychotropic
agents. The use of these drugs has been based on work with mammals and usage
in pet birds by avian practitioners. Psychotropic agents should be used with cau
tion due to their many potential side effects. Medical causes for any behavioral
abnormalities should be explored and behavior modification techniques employed
before psychotropic agents are administered.
Topical Agents
Topical medications should be used cautiously and applied sparingly. Any prepa
ration, especially a cream or ointment, that is applied too heavily or carelessly can
be rapidly distributed throughout the feathers as the bird preens, resulting in oily,
greasy, or matted feathers.4 This decreases the insulating property of the feathers
and may result in feather loss. Ointments and creams should not be applied directly
to the feathers. Instead, they should be applied conservatively to unfeathered parts
of the body.4 If a lesion must be treated in a feathered area, the medication should
be applied carefully and treatment stopped if the feathers become oily or greasy 4
Application of mild detergents can remove these medications from the feathers 4
Ophthalmic ointments should be used sparingly to avoid feather loss around the
eyes. Any excess medication around the margins of the eyes should be blotted up.
Steroidal ointments have been implicated in systemic absorption with harmful side
effects, so they should be used with caution.8
References
1. Flammer, K. Common Bacterial Infections and Antibiotic Use in Companion Birds.
In Antimicrobial Therapy in Exotics Supplement to Compendium on Continuing
Education for the Practicing Veterinarian, 1998: 20(3A): 34-48.
Formulary:
Avian Drug Dosages
Route Code Guide
1C
IM
IO
IT
=
=
=
=
intracardially
intramuscularly
intraosseously
intratracheally
IV = intravenously
PO = per os; orally
SC = subcutaneously
Antimicrobial Agents
D rug D o sag e an d R o u t e
C o m m ents
Acyclovir
80 mg/kg q8h PO4,6,7 or
20-40 mg/kg q12h IM4
Amikacin
10-15 mg/kg q12h IM, IV3,4,8
Amoxicillin
150-175 mg/kg q6h PO or
150 mg/kg q6h IM3
Amoxicillin-clavulanic
acid
150 mg/kg q8h PO9
Azithromycin
40 mg/kg q24h PO11
Carbenicillin
100 mg/kg q8h IM12 or
100 mg/kg q12h PO13
Cefadroxil
100 mg/kg q12h PO2
Cefazolin
50-75 mg/kg q12h IM2
Broad-spectrum antimicrobial.
Cefotaxime
75-100 mg/kg q6-8h IM, IV3,12 Good broad-spectrum antimicrobial that is effective
against many gram-negative and gram-positive
organisms. Penetrates the blood-brain barrier.
Ceftazidime
75-100 mg/kg q6-8h IM, IV13
Ceftiofur
50-100 mg/kg q6h IM5
Ceftriaxone
75-100 mg/kg q6-8h IM, IV3
Broad-spectrum cephalosporin.
Cephalexin
50-100 mg/kg q 6 -8 h P 0 13
Effective against many gram-positive and some gramnegative organisms. Good for treating staph
dermatitis. Palatable.
Cephalothin
100 mg/kg q6h IM, IV1013
Chloramphenicol
50-70 mg/kg chloramphenicol Good tissue penetration, but bacteriostatic nature limits
palmitate q6-8h PO12 or
effectiveness. Activity against some gram-positive and
50 mg/kg chloramphenicol
gram-negative organisms. Human health concern;
succinate q8h IM3
avoid skin contact. Chloramphenicol palmitate can be
compounded commercially.
Chlorhexidine
10-30 ml/gal. drinking water3
or topical 0.5% solution3
Chlortetracycline
In feed: 1% in pelleted food
Used for treatment of chlamydiosis. Doxycycline is more
or 0.5% in millet for 45 days3,4
effective. Candida overgrowth possible.
PO: 1,000-1,500 mg/l drinking
water or 1,500 mg/kg soft
food for 45 days3-4
Ciprofloxacin
15-20 mg/kg q12h PO, IM12
or 250 mg/l drinking water for
5 -10 days14
Clindamycin
100 mg/kg q24h PO3
Effective against gram-positive and anaerobic
For treatment of osteomyelitis:
organisms.
150 mg/kg q24h PO2
Doxycycline (Vibramycin)
Cockatiels and Amazons:
40-50 mg/kg q12-24h
PO3,15
African grey parrots,
cockatoos, and macaws:
25 mg/kg q12-24h PO3,15
Doxycycline (Vibravenos)
Long-acting injectable for treatment of chlamydiosis. Not
Macaws: 75-100 mg/kg IM
available in U.S. Large volume of injection requires
once, then weekly for 6 -7
multiple injection sites.
injections3,15
Other psittacines:
25-50 mg/kg IM once, then
weekly for 6 -7 injections3,15
Doxycycline hyclate
Cockatiels: 500 mg/kg hulled Suggested treatment for chlamydiosis. Cockatiels
require lower dose in food or water as toxicosis can
seed16 or
result.
400 mg/l drinking water17
Other psittacines:
1,000 mg/kg soft food16 or
400-600 mg/l drinking water17
Enrofloxacin
7.5-15 mg/kg q12-24h PO,
IM3,12
Erythromycin
PO: 10-20 mg/kg q12h3
Soluble powder: 500 mg/gal.
drinking water3
IM: 60 mg/kg q12h12
Gentamicin
2.5 mg/kg q12h IM12
Isoniazide: Ethambutal:
Rimampin
(40:40:60 mg/ml) 1 ml/kg
q24h PO18
Kanamycin
10-20 mg/kg q12h IM19
Lincocin-spectinomycin
Water-soluble powder
1/81/4 tsp./16 oz. drinking
water for 10-14 days10
Lincomycin
75 mg/kg q12h PO10 or
1/81/4 tsp./16 oz. drinking
water10
Metronidazole
q12h for 10 days
10-30 mg/kg PO3,20 or
100 mg/l drinking water or
100 mg/kg soft food21 or
10 mg/kg q24h for 2 days
IM3,22
Nitrofurazone
(9.2% powder)
1 tsp./gal. drinking water3,13
Oxytetracycline
58 mg/kg q24h IM3,7,12
Cockatoos: 50-100 mg/kg
q2-3 days SC, IM3,12
Piperacillin
100-200 mg/kg q6-8hlM ,
IV 3,4,12
Rifampin
10-20 mg/kg q12h PO3,4
Sulfachlorpyridazine
1/4-1 tsp./l drinking water3,5
Tetracycline
Soluble powder:
(10 g/6.4 oz.): 200 mg/gal.
drinking water for 5-10
days10
Suspension/solution:
(100 mg/ml): 200-250
mg/kg q12h PO3,17
Ticarcillin
150-200 mg/kg q6-8h IM,
IV3.23
Tobramycin
2.5-5 mg/kg q12h IM3,4,10
Trimethoprim*
sulfamethoxazole
96 mg/kg q12h (2 ml/kg) PO4
or 16-24 mg/kg q12h PO3
or 48 mg/120 ml drinking
water2
Tylosin
(250 g/8.8 oz. solution)
1/2 tsp./gal. drinking water2
Antifungal Agents
D rug Dosage and Route
C omments
Amphotericin B
1.5 mg/kg q812h IV for 3
days3,4,23 or
1 mg/kg q812h IT3,4,24,25 or
100 mg/kg q24h PO for 10
days26
Chlorhexidine
(20 mg/ml solution)
10-25 ml/gal. drinking
water4,13
Clotrimazole
0.2 ml/kg q24h for 5 days IT2
or 10 mg/ml topical flush25
Fluconazole
2 -5 mg/kg q24h for 7-10 days Used for treatment of systemic candidiasis. May be
PO3,4,27 or
regurgitated by some birds. Has safest therapeutic
5-15 mg/kg q12h for 14-60
index of azole antifungals. Less effective than
days PO2
itraconazole in treating aspergillosis but has been
used for that purpose. Due to penetration ability,
recommended for treating central nervous system
infections.
Flucytosine
20-50 mg/kg q12h for 21 days Has been used to treat aspergillosis in conjunction with
PO3
amphotericin B. Can be useful in treatment of
systemic candidiasis.
Itraconazole
5 -10 mg/kg q12h for 45
weeks PO3,28
African grey parrots:
5 mg/kg q24h PO3,28
Ketoconazole
20-30 mg/kg q12h for 21 days For treatment of systemic candidiasis. Tablets can be
PQ3,4,25
crushed and added to orange or pineapple juice,
lactulose, or 1M HCI and water.
Miconazole (1 or 2%)
Use topically, as needed4
Nystatin
(100,000 units/ml)
1 ml/300 gq8-12hP O or
1 ml/l drinking water3,4,19
STA solution
Use topically, as needed3
Terbinafine
hydrochloride
10-15 mg/kg q12-24h PO,
250 mg tablet can be
crushed and suspended in
25 ml of distilled water29 or
nebulized as 1 mg/ml
aqueous solution (500 mg
terbinafine +1 ml
mucomyst + 500 ml
distilled water)29
Anthelmintic/Antiparasitic Agents
D rug D o sage a nd R o u t e
C o m m e n ts
Amprolium
(9.6% solution)
2 -4 ml/gal. drinking water for
5 -7 days3,30
Carbaryl 5% powder
Topical:
Lightly dust feathers3,23,30
Nest box:
1-2 tsp., depending on size
of box3,23,30
Carnidazole
Adults: 200 mg/kg PO,
once3,31
Young: 100 mg/kg PO,
once3,31
Chlorsulon
20 mg/kg PO, three times,
2 weeks apart3
Clazuril
5-10 mg/kg q24h for 3 days
PO, then 2 days off, then
treat for another 3 days3,30
Crotamiton
Topical23
Dimetridazole
1 tsp./gal. drinking water3,13,30
Lories:
1/2 tspigal. drinking water3
Fenbendazole
For treatment of ascarids:
20-50 mg/kg PO, repeat
in 10 days3
For treatment of flukes and
microfilariae: 20-50 mg/kg
q24h for 3 days PO3
For treatment of Capiliaria:
20-50 mg/kg q24h for
5 days PO3
Ipronidazole
500 mg/gal. drinking water for
7 -30 days3,4
Ivermectin
200 g/kg PO, SC, IM, repeat
in 10-14 days, or use
topically3,4,32
Levamisole (13.65%)
5 mg/kg IM; repeat in 14 days3 Treatment for nematodes. Also has immunomodulating
Flock treatment:
effects. Low therapeutic index. IM injection may cause
5-15 ml/gal. drinking water
reaction,
for 1-3 days3,4
Mebendazole
25 mg/kg q24h for 5 days
PO4,23
Metronidazole
10-30 mg/kg q12h for 10 days Some effectiveness against anaerobic bacterial
PO3,20 or 100-400 mg/1
infections. Used to treat protozoal infections caused
drinking water or 100 mg/kg
by Giardia, Trichomonas, and Hexamita. Use with
soft food21 or
caution in finches.
10 mg/kg q24h for 2 days
IM3,22
Niclosamide
50 mg/kg via gavage; repeat
in 10-14 days4-30
Oxfendazole
10-40 mg/kg PO; single
dose30
Praziquantel
PO: 10-20 mg/kg; repeat in
Treatment for tapeworms and flukes. Injectable may be
toxic to finches.
10-14 days3-13
IM: Flukes9 mg/kg q24h for
3 days, then oral
administration for 11 days3
Tapeworms9 mg/kg once;
repeat in 10-14 days3
Pyrantel pamoate
4.5 mg/kg PO; repeat in 10-14 Treatment for gastrointestinal nematodes.
days3,4,23
Pyrethrin products
(0.150%)
Topical: Lightly mist feathers3
Pyrimethamine
0.5 mg/kg q12h PO (Mix tablet Treatment for Plasmodium, Sarcocystis, and
with 21 ml water and 4 ml
Toxoplasma. Use in combination with trimethoprimKY jelly for 1 mg/ml
sulfamethoxazole for Sarcocystis.
suspension)3,33
Quinacrine
5 -10 mg/kg q24h for 7 days
PO3
Pigeons: 100-300 mg/gal.
drinking water for 10-21
days34
Ronidazole
6 -10 mg/kg q24h for 6-10
days PO35 or
400 mg/gal. drinking water for
3 -5 days30
Sulfadimethoxine
(12.5% solution)
25 mg/kg q12h for 5 days PO2 Treatment for coccidiosis.
Thiabendazole
For treatment of ascarids:
250-500 mg/kg PO; repeat
in 10-14 days3,23
For treatment of Syngamus:
100 mg/kg PO q24h for
7 -10 days3,23
Nebulizing Agents
D rug D o sag e a nd R o u te
C o m m e n ts
Acetylcysteine
(20% solution)
200 mg/9 ml sterile water2 or
200 mg/8 ml sterile water +1
ml amikacin or gentocin2 or
2 -5 drops in nebulizing
solution23
Amikacin
50 mg/9 ml sterile water2
Aminophyiline
25 mg/9 ml sterile water or
saline for 15 minutes2
Amphotericin B
1 mg/ml sterile water for 15
minutes q12h210
Antifungal agent.
Carbenicillin
200 mg/9 ml saline2
Chloramphenicol
100 mg/9 ml saline or sterile
water for 15 minutes2
Bacteriostatic antibiotic.
Clotrimazole
1% solution for 30-60
minutes2
Erythromycin
1 ml injectable solution/10 mi
saline q8h3
Gentamicin
50 mg/9 mi sterile water for 15 Used in treatment of rhinitis, pneumonia, and air
minutes or
sacculitis.
50 mg/8 ml sterile water + 1 ml
20% acetylcysteine2
Terbinafine hydrochloride
For treatment of respiratory fungal infections.
Nebulized as: 1 mg/ml
aqueous solution (500mg
terbinafine +1 ml mucomyst
+ 500ml distilled water)29
Tylosin
1 g powder/50 ml distilled
water for 60 minutes2
Psychotropic Agents
Drug Dosage and Route
C omments
Amitriptyline
1-2 mg/kg q12-24h PO3,4
Carbamazepine
3-10 mg/kg PO2
Clomipramine
hydrochloride
0.5-1.0 mg/kg q12-24h
PO 4,36,37
Doxepin
0.5-1.0 mg/kg q12h PO4,37
Fluoxetine
1-2 mg/kg q12h PO37
Haloperidol
Initial dose if > 1 kg:
0.2 mg/kg q12-24h PO
Initial dose if < 1 kg:
0.15 mg/kg q12-24h PO3,4
Naltrexone
1.5 mg q12h PO37,38
Nortriptyline
2 mg/120 mi drinking
water3,4,39
C o m m e n ts
Acemannan
Topical40
Aloe vera
Topical3
Ammonium solution
Topical3
Bacitracin/Neomycin/
Polymixin
Intraocular/intranasal/topical;
use q8-12h4
Chloramphenicol
Intraocular/intranasal/topical;
use q8-12h
Chloramphenicolprednisolone acetate
Intraocular/intranasal/topical;
use q812h4
Ferric subsulfate
Topical3
Gentamicin sulfate
Intraocular/intranasal/topical;
use q8-12h4
Gentamicin sulfatebetamethasone
Intraocular/intranasal/topical;
use q8-12h4
Neomycin
Intraocular/intranasal/topical;
use q8-12h3
Antibiotic ointment.
Oxytetracycline
hydrochloride with
polymixin B
Intraocular/intranasal/topical;
use q8-12h
Miscellaneous Agents
Drug Dosage and Route
Comments
Acetaminophen (325 mg
elixir concentration)
0.15 ml elixir/l drinking water5
Analgesic.
Acetylsalicylic acid
(aspirin; 325 mg tablet)
1 tablet/250 ml drinking
water3,23,41 or
5 mg/kg q8h PO42
ACTH gel
1-2 lU/kg IM4
Allopurinol
Stock solution:
Crush 100 mg in 10 ml
water (mix 1 ml per ounce
of drinking water or give 10
mg/kg orally q412h)13,43
Aminopentamide
0.05 mg/kg q12h IM, SC; 5
doses maximum3
Aminophylline
4 mg/kg q6-12h PO2 or
10 mg/kg q3h IV2
Atropine
0.5 mg/kg IM, IV, 10, IT2 or
0.01-0.02 mg/kg SC, IM3,44
0.2 mg/kg q3-4h IM, IV45
Cardiopulmonary resuscitation.
Preanesthetic. Rarely used; secretions may thicken and
occlude airway.
For treatment of organophosphate toxicity.
Bismuth sulfate
1 ml/kg q812h PO4,46
Butorphanol tartrate
3 -4 mg/kg as needed PO, IM,
IV3,47
Analgesic, antitussive.
Caffein-Natrium-Salizylate
50%
Dropwise to effect PO48
Calcium disodium
versenate
(Calcium EDTA)
35 mg/kg q12h IM13,45,46 or
20-40 mg/kg q8-12hlM 3
Celecoxib
10 mg/kg PO for at least 6 to
12 weeks
Charcoal (activated),
kaolin
2 -8 mg/kg as needed, PO3,4,46 Adsorbs toxins. Use 1 g/5-10 ml water
Cimetidine
5 -10 mg/kg q812h PO4 or
300 mg/5 ml drinking water3
Cisapride
1 mg/kg q12h PO5
Colchicine
(with probenecid)
0.04 mg/kg q24h PO; can
gradually increase to
q12h4,49
Deferoxamine
Dexamethasone
2 -4 mg/kg q8-24h IM, IV13,51
Dexamethasone sodium
phosphate
Dextrose (5-50%
solution)
50-100 mg/kg SC, IM, IV,
slowly to effect4
Diazepam
0.5-1 mg/kg q8-12h IM, IV, as
needed3,23 or 2 .5 -4 mg/kg
PO as needed3
Digoxin
Initial: 0.02-0.05 mg/kg
q12-24h PO48
Maintenance: 0.01 mg/kg
q12-24h PO48
Dimercaprol
Dimercaptosuccinic acid
(DMSA)
Dinoprost tromethamine
0.02-0.1 mg/kg once; IM,
intracloacally3,4
Diphenhydramine
hydrochloride
1-4 mg/kg q8h PO3,23 or
1-2 ml/120 mi drinking water4
Docusate sodium
(50 mg/ml syrup)
Doxapram
Respiratory stimulant.
Echinacea
2.5 drops/kg PO or
5 drops/cup drinking water3
Epinephrine (1:1,000)
Ferric subsulfate
Topical, as needed3
Fludrocortisone
Flunixin meglumine
1-10 mg/kg IM, IV3,4,23
Furosemide
0.1-0.2 mg/kg q12-24h IM,
PO48
Glipizide
0.5 mg PO every 12h for
cockatiels56
Hemicellulose
Small amount on food daily,4
0.5 tsp./60 ml hand-feeding
formula or gruel45,46 or
1-3% of gavage feeding45,46
Human chorionic
gonadotropin
250-500 lU/kg IM on days 1,
3, and 7 or once every 4 -6
weeks2,57
Hydrochloric acid
(1 mole/l)
Mix at rate of 30 ml/pint of
drinking water58
Hydroxyzine
2.0-2.2 mg/kg q8h PO or 4
mg/100-120 ml drinking
water39
Insulin, NPH
0.5-3 units/kg IM23
alpha-lnterferon
50,000 lU/kg IM q24h for 5
days, then q7 days for 60
days, then q30 days59
Kaolin-pectin
2 ml/kg q12h PO23,51
Gut protectant.
Lactobacillus
1 pinch/day/bird PO or
1 tsp./qt. hand-feeding
formula3
Lactulose
0.3 ml/kg q24h PO or divided
q12h PO3,4
Leuprolide acetate
750-800 pg/kg IM, provided in Used in many reproductive disorders, especially to
control unwanted egg laying behavior or cystic ovarian
7.5 mg kit; suspend in sterile
water to volume of 15 ml (500
disease.
Mg/ml) and store in aliquots of
0.25 ml (or volume most
used)60
Levothyroxine
0.02 mg/kg q 12-24h P 013
or 0.1 mg tablet/4-12 oz.
drinking water61
Mannitol
0.5 mg/kg q24h IV3,4,52
Mebolerone
10 pg/kg q24h PO or 3 -6
drops/oz. drinking water
daily4
Medroxyprogesterone
acetate (150 mg/ml)
5-25 mg/kg IM, SC, repeat in
4 -6 weeks if needed,3 or
0.03 ml/100 g (up to 150 g);
0.027 ml/100 g (150-300 g);
0.025 ml/100 g (300-700 g);
0.022 ml/100 g (700+g)4
Methylprednisolone
0.5-1 mg/kg PO, IM3
Metoclopramide
0.5 mg/kg q812h PO, IM,
IV3,4
Mineral oil
0.3 ml/35 g or 3.5 ml/500 g
q12-24h PO46 or
5-10 ml/kg q12-24h PO4
Oxytocin
5 lU/kg IM; may repeat in 30
minutes62
Pancreatic enzyme
1/8 tsp./kg food4,19
Neonates: 1/8 tsp./14 oz.
hand-feeding formula63
D-penicillamine
55 mg/kg q12h for 1-2 weeks
PO54
Phenobarbitai
1-5 mg/kg q812h PO3 or 4 -8 Anticonvulsant and sedative. May aid in some feathermg/120 ml drinking water4
picking conditions.
Pralidaxime
10-100 mg/kg q24-48h
IM 45,46,53
Prednisolone
0.5-1.0 mg/kg IM, IV3,23
Anti-inflammatory agent.
Prednisolone sodium
succinate
0.5-1.0 mg/kg IM, IV4
10-20 mg/kg IM, IV23
2 -4 mg/kg IM, IV23
Propanolol
0.2 mg/kg IM or 0.04 mg/kg
IV3'4
Sodium bicarbonate
1 meq/kg IV, IO, q15-30
minutes to maximum of 4
meq/kg3
5 meq/kg IV, IO, once2
For CPR.
Sodium sulfate
0.5-1.0 g/kg PO42 or 2 g/kg
slurry for 2 days3
Used to increase weight in anorectic cases. Exercise
caution with hepatic or renal disorders.
Stanozolol
(IM form: 50 mg/ml)
25-50 mg/kg 1-2 times
weekly IM3 or 2 mg/4 oz.
drinking water13
g-Strophantin
Dropwise to effect PO
1 mg/kg IM48
Sucralfate
25 mg/kg q8h PO3
Used in cases of chronic egg laying. Contraindicated in
birds with liver or kidney disease. Used in canaries for
decreased libido or to stimulate singing.
Testosterone
IM: 8 mg/kg weekly, as
needed13,23
Drinking water administration:
Mix 100 mg in 30 ml of
water to make stock
solution. Then use 5-10
drops stock solution/30 ml
drinking water, mixed fresh
daily, for 5 -10 days.2,4
Vitamin K,
0.2-2.5 mg/kg q24h IM, as
needed3
For warfarin toxicity: 0.2-2.5
mg/kg q12h IM for 7 days3
Nutritional Support
D r ug D o sag e a n d R o u t e
C o m m e n ts
Calcium glubionate
(Neo-calglucon)
150 mg/kg q12h PO or
1 ml/30 ml drinking water64
Calcium supplementation.
Calcium gluconate
5 -10 mg/kg q12h SC, IM, as
needed3 or
50-100 mg/kg IV, slowly to
effect3
Calcium lactateglycerophosphate
5-10 mg/kg for 7 days IM, as
needed64
Calcium supplementation.
Dextrose
(5-50% solution)
50-100 mg/kg SC, IM, IV,
slowly to effect4
Iodine
Mix 2 ml in 30 ml of water to
make stock solution. Then
use 1 drop stock
solution/30 ml drinking
water. Gradually decrease
from daily to weekly
administration as
improvement is noted.55
Iron dextran
10 mg/kg IM; repeat in 7-10
days3,4
Lactobacillus
1 pinch/day/bird PO or
1 tsp./qt. hand-feeding
formula3
Osteoform powder
1/8 tsp./kg food55
Sodium iodide
(20% solution)
0.3 mg/kg IM64
Vitamin A
0.05-0.1 ml/100 g IM
Vitamin A, D3 and E
0.1-0.2 ml/300 gIM 3
Vitamin B complex
1-3 mg/kg IM; dosage
depends upon thiamine
content3
Vitamin B12
(Cyanocobalamin)
250-500/ig/kgIM 23
Administer weekly.
Vitamin C
(Ascorbic acid)
20-40 mg/kg IM23
Vitamin E-selenium
0.06 Se mg/kg every 3-14
days IM, as needed64 or
0.05-0.1 mg/kg every 14
days IM3
References
1. Flammer, K. Common Bacterial Infections and Antibiotic Use in Companion Birds.
In Antimicrobial Therapy in Exotics Supplement to Compendium on Continuing
Educationfor the Practicing Veterinarian, 1998: 20(3A): 3448.
2. Carpenter, J. W., Mashima, T. Y., and Rupiper, D. J. Exotic Animal Formulary.
Manhattan, KS: Greystone, 1996.
3. Ritchie, B. W. and Harrison, G. J. Formulary. In Ritchie, B. W., Harrison, G. J., and
Harrison, L. R. eds., Avian Medicine: Principles and Application. Lake Worth, FL:
Wingers Publishing, 1994: 457-478.
4. Rosskopf, W. J. and Woerpel, R. W. Formulary of Most Commonly Used Medications
in Pet Avian Medicine. In Rosskopf, W. J. and Woerpel, R W. eds., Diseases o f Cage
and Aviary Birds, 3rd ed. Baltimore, MD: Williams and Wilkins, 1996:1029-1040.
5. Tully, T. N. Formulary. In Altman, R. B., Clubb, S. L., Dorrestein, G. M., and
Quesenberry, K. eds., Avian Medicine and Surgery. Philadelphia: W. B. Saunders,
1997: 671-688.
6. Parrot, T. New Clinical Trials Using Acyclovir. In Proceedings o f the Annual
Conference of the Association of Avian Veterinarians. Phoenix, AZ: 1990: 237-238.
7. Ritchie, B. W. Avian Viruses: Function and Control. Lake Worth, FL: Wingers
Publishing, 1995.
8. Lumeij, J. T. Psittacine Antimicrobial Therapy. In Antimicrobial Therapy in Caged
Birds and Exotic Pets. Trenton, NJ: Veterinary Learning Systems, 1995: 38-48.
9. Orosz, S. E., Jones, M. P., Zagaya, N. K., and Frazier, D. L. Pharmacokinetic
Disposition of Amoxicillin Clavulanic Acid in Blue-fronted Amazon Parrots. In
Proceedings of the Annual Conference of the Association of Avian Veterinarians. St.
PaulMN, 1998:17-23.
10. Clubb, S. L. Special Species: Birds. In Johnston, D. E., ed., The Bristol Veterinary
Handbook o f Antimicrobial Therapy, 2nd ed. Trenton, NJ: Veterinary Learning
Systems, 1987: 188-199.
11. Limoges, M. J. Plasma Pharmacokinetics of Orally Administered Azithromycin in
Mealy Amazon Parrots. In Proceedings of the Annual Conference o f the Association
o f Avian Veterinarians. St. Paul, MN: 1998: 41-45.
12. Bauck, L. and Hoefer, H. L. Avian Antimicrobial Therapy. In Seminar o f Avian
Exotic Pet Medicine. 1993: 2: 17-22.
13. McDonald, S. E. Summary of Medications for Use in Psittacine Birds. In. Journal of
the Association of Avian Veterinarians. 1989: 3: 120-127.
28. Hines, R. S., Sharkey, P., and Friday, R. B. Itraconazole Treatment of Pulmonary,
Ocular and Uropygial Aspergillosis and Candidiasis in Birds. In Proceedings of the
American Association o f Zoo Veterinarians. Padre Island, TX: 1990: 322326.
29. Dahlhausen, B., Lindstrom, J. G., and Radabaugh, C. S. The Use of Terbinafine
Hydrochloride in the Treatment of Avian Fungal Disease. In Proceedings o f the
Annual Conference of the Association o f Avian Veterinarians. Portland, OR: 2000:
35-39.
30. Marshall, R Avian Anthelmintics and Antiprotozoals. In Seminar o f Avian Exotic
Pet Medicine. 1993: 2: 33-41.
31. Dorrestein, G. M. Diseases of Passerines. In Proceedings of the Annual Conference
of the Association of Avian Veterinarians. Boulder, CO: 1985: 53-71.
32. Hogan, H. L., et al. Efficacy and Safety of Ivermectin Treatment for Scaley Leg Mite
Infestation in Parakeets. In Proceedings o f the American Association o f Zoo
Veterinarians. 1984: 156.
33. Clubb, S. L. Sarcocystis in Psittacine Birds. In Schubot, R. M., Clubb, K. J., and
Clubb, S. L. eds., Psittacine Aviculture. Loxahatchee, FL: Aviculture Breeding and
Research Center, 1992: 20-24.
34. Harlin, R W. Pigeons. In Proceedings o f the Annual Conference of the Association
o f Avian Veterinarians. Philadelphia: 1995: 361373.
35. Ramsey, E. C. Trichomoniasis in a Flock of Budgerigars. In Proceedings of the
Annual Conference of the Association o f Avian Veterinarians. Phoenix, AZ: 1990:
308-311.
36. Ramsey, E. C. and Grindlinger, H. Use of Clomipramine in the Treatment of
Obsessive Behavior in Psittacine Birds. In Journal o f the Association o f Avian
Veterinarians. 1994: 8: 9.
37. Welle, K. R. A Review of Psychotropic Drug Therapy. In Proceedings o f the Annual
Conference of the Association of Avian Veterinarians. St. Paul, MN: 1998: 121-124.
38. Turner, R. Trexan (Naltrexone Hydrochloride) Use in Feather Picking in Avian
Species. In Proceedings o f the Annual Conference o f the Association o f Avian
Veterinarians. Nashville, TN: 1993: 116-118.
39. Gould, W. J. Caring for Birds Skin and Feathers. In Veterinary Medicine. 1995: 1:
53-63.
40. Swaim, S. F. and Gillette, R L. An Update On Wound Medications and Dressings.
In Compendium on Continuing Education for the Practicing Veterinarian. 1998: 20:
1133-1143.
41. Wheler, C. Avian Anesthetics, Analgesics and Tranquilizers. In Seminar of Avian
Exotic Pet Medicine. 1993: 2: 7-12.
42. Bennett, R. A. Pain Management in Pet Birds. In Proceeding o f the North American
Veterinary Conference. 2000: 14: 867.
43. Rupiper, D. J. Allopurinol in Simple Syrup For Gout. In Journal of the Association
o f Avian Veterinarians. 1993: 7: 219.
44. Taylor, M. T. Avian Anesthesia: A Clinical Update. In Scientific Proceedings of the
First International Conference of Zoo Avian Medicine. Oahu, HI: 1987: 519-524.
45. LaBonde, J. Household Poisonings in Caged Birds. In Kirk, R. W. ed., Current
Veterinary Therapy XII, Small Animal Practice. Philadelphia: W. B. Saunders, 1995:
1299-1303.
46. LaBonde, J. Toxicity in Pet Avian Patients. In Seminar of Avian Exotic Pet Medicine.
1995: 4: 23-31.
47. Bauck, L. Analgesics in Avian Medicine. In Proceedings of the Annual Conference
o f the Association o f Avian Veterinarians. Phoenix, AZ: 1990: 239-244.
48. Krautwald-Junghanns, M. E. and Straub, J. Avian Cardiology: Part 1. In
56. Pollock, C. G., Pledger, T., and Renner, M. Diabetes Mellitus in Avian Species. In
Avian
Diseases
This chapter discusses many of the diseases and conditions seen in pet birds. To
provide structure to the chapter, the diseases and conditions have been arranged in
categories, such as nutritional diseases, zoonoses, feather abnormalities, and toxi
coses. Because many of the conditions could readily fall into two or more differ
ent categories (e.g., aspergillosis could be listed as a mycotic condition, a
respiratory condition, or a pediatric condition), practitioners wishing to quickly
find a specific disease or disorder are encouraged to refer to Table 6, which shows
the organization used in this chapter.
Table 6
Organization of Diseases, Conditions, and Abnormalities
Nutritional Diseases
Obesity/hepatic lipidosis
Vitamin A imbalances
Hypovitaminosis A
HypervitaminosisA
Calcium, phosphorus, and vitamin D3
imbalances
Iodine deficiency/goiter
Hemochromatosis
Viral Diseases
Pachecos disease
Pox virus
Psittacine beak and feather disease
Papillomatosis
Proventricular dilatation disease
Newcastle disease
Pigeon paramyxovirus
Polyomavirus
Parasitic Diseases
Caused by helminths
Tapeworms
Flukes
Ascarids
Baylisascaris procyonis (raccoon roundworm) and
Baylisascaris columnaris (skunk roundworm)
Capillaria
Syngamus (gapeworms)
Filarial worms
Caused by protozoa
Trichomonas
Giardia
Hexamita (Spironucleus meleagrides)
Coccidia
Sarcocystis
Haemoproteus
Atoxoplasma
Cryptosporidia
Caused by arthropods
Air sac mites
Knemidokoptes (scaly face/scaly leg mite)
Dermanyssus (red mites)
Feather mites
Biting lice
Mycoses
Mycotoxicosis
Candidiasis
Aspergillosis
Zoonoses
Chlamydiosis (psittacosis)
Salmonellosis
Tuberculosis
Influenza A
continued
Allergies
Hypersensitivity pneumonitis (pigeon breeders lung,
bird keepers lung)
Acute hypersensitivity pneumonitis
Subacute hypersensitivity pneumonitis
Chronic hypersensitivity pneumonitis
Dermatologic Conditions
Brown hypertrophy of the cere
Lipomatosis/lipomas
Self-mutilation
Vaccine reactions
Abscesses/granulomas/tuberculosis lesions
Xanthomatosis
Dermal cysts/Macaw Acne
Feather Abnormalities
Feather cysts
Alopecia
Neonatal feather dystrophy
French molt
Feather picking/chewing
Trauma
Fractures
Broken blood feathers
Tom pygostyle/tail base laceration
Split sternum
Subcutaneous emphysema
Beak injuries
Cat bites and scratches
Respiratory Diseases
Upper respiratory infections
Rhinitis/sinusitis
Cockatiel lockjaw (temporomandibulitis)
Mycoplasmosis
Pneumonia and air sacculitis
Ascites/hepatomegaly
Allergic respiratory disease
Gastrointestinal Conditions
Vomiting and regurgitation
Abnormal droppings
Enteric bacterial diseases
Pancreatic exocrine insufficiency
Megabacteriosis (avian gastric yeast)
Liver Conditions
Reproductive Conditions
Unwanted egg laying
Egg binding (dystocia)
Reproductive associated peritonitis
Ovarian cysts
Ovarian/oviductal tumors
Prolapsed cloaca
Prolapsed oviduct/uterus
Neurological Conditions
Stroke syndrome
Epilepsy
Hypocalcemia syndrome
Renal Conditions
Gout
Polyuria
Endocrine Conditions
Diabetes mellitus and diabetes-like conditions
Hypothyroidism
Abdominal Distension
Cardiovascular Conditions
Congenital heart diseases
Pericarditis
Hydropericardum/hemopericardum
Myocardial insufficiency
Myocarditis
Endocardial disease
Arteriosclerosis
Cardiovascular therapy
Toxicoses
Toxic fumes
PTFE toxicosis
Lead toxicosis
Zinc toxicosis
Pediatric Problems
Nutritional problems
Aspiration pneumonia
Crop stasis
Crop burn/crop fistula
Infectious diseases
Mycotic infections
Orthopedic problems
Leg deformities
Constricted toe/annular toe deformity
Beak abnormalities
Lateral deviation of the maxilla
Mandibular prognathism or maxillary
brachygnathism
Nutritional Diseases
Due to their rapid metabolism, birds have high nutritional needs and, concomi
tantly, manifest signs of malnutrition more quickly than many other animals.
Indeed, malnutrition is a frequently diagnosed disease condition in pet birds, and
many of the other diseases that are diagnosed actually may be due to a lowered
resistance to pathogenic organisms resulting from a poor level of nutrition.1
Nutritional problems seem to be prevalent in pet birds undergoing reproductive
cycles and in pet birds with special nutritional requirements. Common problems
include calcium deficiency (often associated with a number of reproductive com
plications, such as egg binding and oviductal prolapse), vitamin D3 deficiency
(and associated calcium problems), vitamin A deficiency, and goiter. A number of
less well defined complaints also may have a nutritional component, including
poor feathering, crooked keels and backs, rotated tibia (splay leg), fatty liver syn
dromes, pododermatitis, and several ataxic syndromes.
The dietary needs of the many species of avian pet or breeding psittacine that are
relatively rare in captivity may differ significantly from those of other psittacines.
Research has shown, for example, that hand-fed palm cockatoos may suffer from
maldigestive syndromes.2 Careful review of the nutritional history is indicated
when considering the etiology of such complaints.
Some of the more common nutritional problems seen in pet birds are described in
the following sections.
Obesity/Hepatic Lipidosis
High fat diets, such as seeds, may result in obesity and may be associated with sev
eral important clinical syndromes, including atherosclerosis, hypertension, car
diovascular dysfunction, and hepatic lipidosis.3 The incidence of atherosclerosis
appears to be higher in Amazon parrots five years of age and older than in other
avian species.4 High blood cholesterol levels are clearly associated with athero
sclerosis in people, but a link between high cholesterol and atherosclerosis in birds
has yet to be established.4
Other pathologic conditions that could be associated with high fat diets and obe
sity include infertility/reproductive disease (e.g. egg yolk peritonitis and egg bind
ing), musculoskeletal abnormalities (arthritis, plantar pododermatitis, and cranial
cruciate ligament rupture), acute necrotizing pancreatitis, diabetes mellitus, lipo
mas, thyroid dysfunction, and gastrointestinal malabsorption.3
Obesity with resultant hepatic lipidosis is one of the more common nutritional dis
eases seen in pet birds.1 It is particularly common in budgerigars due to the highfat seed diet these birds normally consume. Not only can this type of diet lead to
obesity, but the fat can bind to calcium, leading to lowered blood calcium. Seed is
also low in vitamin A, which can lead to lowered resistance to disease.
Even more detrimental, fat infiltration can severely compromise the functioning of
the bodys organs. Two organs that are particularly affected are the liver and the
heart. Over time, as fat that has accumulated in the bloodstream infiltrates the
liver, the amount of functional liver tissue decreases, and liver function is greatly
compromised. This condition, called hepatic lipidosis, can also result in the liver
becoming quite enlarged. Fat may also accumulate around the heart, interfering
with normal function. Due to the excessive weight, the bird may be unable to fly
or may tire easily.
The following may be characteristic signs of hepatic lipidosis in the budgerigar:
Obesity. The bird may be overweight, with fat deposits on the chest and
abdomen, so that the bird has a buxom chest or abdomen.
Overgrown beak. With hepatic lipidosis, the beak sometimes grows rapidly
and abnormally5 (see Figure 16 on page 67). Technicians should be trained to
recognize signs of hepatic lipidosis, so that when an owner brings a bird in for
a beak trim, he or she can recommend an examination with the practitioner if
there is evidence of the disease. The beak trim should be done cautiously on
these birds, as they can easily become stressed or die during the routine pro
cedure due to the abnormal liver condition.
Black spots on the beak and toenails. Due to the compromised liver function,
the birds blood may not clot properly, and black spots may be seen on the
beak and toenails.5 The spots are areas of hemorrhage, like bruising.
Enlargedfatty liver. Though an enlarged liver (Figure 29) cannot always be
detected with the naked eye, it can be palpated manually during a physical
examination. In small avian patients, the liver can be seen through the skin if
the feathers and skin are moistened with a small amount of alcohol.
Most birds that show all or most of
these clinical signs are in serious
condition. A high fat level may dis
rupt the bodys normal metabolism,
compromise the functioning of its
organs, and subject the bird to sec
ondary disease. The bird may not
be able to withstand even simple
stress, and sudden death can occur.
However, the disease can be
Figure 29
detected before it gets to a serious
Cross-section
of
liver
from
bird with hepatic lipidosis. Note
state through regular physical
the almost total replacement of liver tissue with the fatty infil
examinations that include blood tration. (P. S. Sakas, DVM)
testing. Many times, the blood
tests will show lipemia, anemia, and icteric plasma, indicating liver disease.
Identified early, the disease can be treated with nutritional management. Ideally,
it can be prevented entirely through proper nutrition with an adequate homemade
or commercially prepared diet, such as a formulated diet. Owners of birds on
seed diets should be given handouts about the disease conditions that can result
and be told of the importance of dietary change. Treatment of obesity includes
increasing exercise.3
Vitamin A Imbalances
Hypovitaminosis A
Birds on all-seed diets will likely suffer from a vitamin A deficiency, since
peanuts and most seeds and grains (except yellow com) are devoid of this vita
min. Because vitamin A maintains mucous membranes and other epithelial sur
faces, low levels of vitamin A will result in decreased resistance of these tissues
to disease-producing organisms.6As a result, respiratory and sinus infections are
more severe in birds with deficient levels of vitamin A.6Vitamin A deficiency can
also lead to hyperkeratosis, or thickening of the skin with excessive scaliness and
flakiness of the feet.1
Signs of hypovitaminosis A often seen by avian practitioners include white plaques
on the roof of the mouth, excessive oral mucus (caused by changes in the salivary
and tear glands), and blunting of the choanal papillae.6 Quite often, birds brought
to the hospital for some type of respiratory difficulty described by the owner as
sneezing or coughing have developed the condition as a result of the excessive
mucus and mouth lesions caused by vitamin A deficiency. If secondary infections
have developed, pustules or abscesses may be seen in the oral cavity, crop, or res
piratory tract. In severe cases of vitamin A deficiency, there may also be changes
in the kidneys that can lead to gout. Other signs of vitamin A deficiency are fad
ing of the pigmentation of the skin and feathers, failure of young birds to gain
weight, low hatchability rates, and high hatching mortality.
The best and safest way to ensure that a bird will not suffer from a vitamin A defi
ciency is to provide it with adequate nutrition. Birds that prefer seeds should be
given a commercial vitamin supplement, administered on the food or in the water.
All birds should also be provided with foods that are rich in vitamin A. In addition,
beta-carotene supplementation is effective. Readily converted by birds to the
active form of vitamin A, beta-carotene cannot be oversupplemented to produce
toxicosis. Injectable vitamin A is usually used for clinical cases.
Another means of supplementation is to periodically add a few drops of vitamin A
from a punctured vitamin A gel capsule to the birds diet. Some breeders add a tea
spoonful of cod liver oil to each pound of seed, since vitamin A has been shown to
improve reproductive results. The use of cod liver oil is not recommended, how
ever, as it can become rancid and promote the destruction of vitamin E. In all of the
other forms noted, vitamin A supplementation is an effective means of increasing
birds resistance to disease and yielding better reproductive results.
Hypervitaminosis A
Oversupplementation of vitamin A has the potential to be toxic in birds (as in other
animals), but this condition is not well documented in birds. In other animals,
overdoses of vitamin A have been shown to cause a wide variety of signs, includ
ing weakness and bone abnormalities.7
Figure 30
Multiple skeletal deformities including bowing and folding
fractures in a neonatal blue and gold macaw. Poor dietary
supplementation of the hen was suspected to be the cause.
(P. S. Sakas, DVM)
High calcium in the diet can cause other problems as well. Young, growing birds
fed high-calcium diets can develop kidney problems leading to kidney failure and
mineralization. In addition, high calcium levels without increased levels of man
ganese and zinc will interfere with the absorption of these trace elements.1
If too much phosphorus is provided, low calcium levels will result. The excess
phosphorus will bind with calcium in the intestine to form an insoluble chemical,
calcium phosphate. The remaining phosphorus is still absorbed, but blood calcium
levels will be low.
Vitamin D Imbalances
The primary function of vitamin D is to regulate calcium metabolism. Vitamin D
toxicosis occurs when vitamin D is present in the diet at high enough levels to
stimulate the excessive absorption of calcium from the diet or its resorption from
the bone.12Hypercalcemia occurs, but initially (before calcium levels get too high
and with a normal glomerular filtration rate [GFR] by the kidneys) the calcium can
be excreted.12The GFR will fall, however, when nephrolithiasis occurs due to pro
longed hypercalciuria, producing the elevated blood calcium levels that occur with
vitamin D toxicosis.12
The level of vitamin D that causes toxicosis varies with the form of vitamin D,
amounts of vitamin A and calcium in the diet, and the health of the kidneys.
Cholecalciferol (vitamin D3), which is used in most diets and supplements, is
10 to 20 times more toxic than ergocalciferol (vitamin D2) in birds that have
been tested.12 However, ergocalciferol is not effective in replacing vitamin D3
and its function.12
Oversupplementation with vitamin
D3 can cause kidney mineralization
and widespread metastatic calcifica
tion due to the increased calcium
absorption (Figure 31). Decreasing
calcium in the diet can slow the rate
of nephrolithiasis if toxic levels of
vitamin D3 have been fed.12
Increasing evidence suggests that
many bird species, including many
Figure 31
cage bird species, are more sensitive
Mineralized
kidneys
in
a cockatiel that was oversupple
to vitamin D3 or calcium intoxica
mented with vitamin D3 and calcium. (P. S. Sakas, DVM)
tion than poultry.13 In a comprehen
sive review of renal lesions found in cage birds submitted for necropsy, metastatic
calcification of the kidney was one of the most common lesions identified.13 Blue
and gold macaw nestlings seem to be more susceptible to metastatic mineralization
than other species.13 Cockatiels seem to have a similar sensitivity to higher vita
min D3 and calcium levels as the macaw.14 The potential source is supplemental
vitamins and minerals that many owners feel are necessary even when their birds
are on apparently adequate diets.13
The safest and most effective way to help overcome mineral imbalances is to pro
vide a nutritionally adequate diet, either homemade or commercially prepared
(such as a formulated diet). In seedeaters, a balanced calcium/phosphorus/vitamin
D3 supplement should be provided. Other sources of minerals that have been
shown to be safe for birds are calcium carbonate (found, for example, in cuttlebones, plaster blocks, mineral blocks, and oyster shells), calcium gluconate sup
plements, liquid-combination calciums available commercially, and such natural
sources as spinach, broccoli, cheese, yogurt, and milk. Crushed eggshells may also
be used but must not be raw due to the risk of salmonellosis.
Care must be taken when supplementing young birds. Most commercial handfeeding diets contain adequate levels of minerals; adding additional amounts,
unless clinically indicated, can lead to mineralization of the kidneys.
With the advent of formulated diets, deficiencies of vitamin D3 and calcium are
mostly confined to birds fed only seeds.14 However, nutrient toxicoses have
become more frequent, predominantly from excesses of vitamin D3 and calcium.14
Levels of dietary vitamin D3 and calcium should be kept below 2000 IU/kg and
1.0% respectively.14 In adult macaws, which appear to be more sensitive to higher
levels, 1500 IU/kg and 0.8% should be considered a prudent maximum.14 The
general maintenance requirements will be met in most species at 500 IU/kg vita
min D3 and 0.3-0.5% calcium.14
Iodine Deficiency/Goiter
Many seeds are deficient in iodine, which is a building block of thyroxine and is
essential for normal thyroid gland function. For that reason, birds fed seed diets
must receive supplemental iodine as a part of a balanced vitamin/mineral source
added to the food or water. (Iodine appears to be provided in adequate amounts in
formulated diets.) Iodine is especially important in budgies, which appear to be
particularly susceptible to thyroid problems.1The same condition has occasionally
been reported in other species of birds.1
Iodine deficiency can lead to thyroid dysplasia (a malformation of the thyroid
gland), which is commonly termed goiter. Because the thyroid glands are located
at the branching of the trachea into each lung, just above the heart, the enlarged,
dysplastic glands put pressure on the trachea and syrinx, with resultant displace
ment and breathing difficulties. A click, wheeze, or the incessant squeaking in a
budgerigar, heard on both inspiration and expiration, will point to this condition.
Any budgerigar presented for respiratory wheezing should be evaluated for thyroid
hyperplasia. Other clinical signs can include vomiting and engorgement of the
jugular vein, due to the partial occlusion of the thoracic inlet.
The development of thyroid dysplasia is gradual, and the condition worsens over
time, with the respiratory noises becoming more noticeable as the thyroids enlarge.
Quite often, the bird will be in extreme distress, sometimes forced to hold its head
upright to facilitate breathing. Further, the condition can be complicated by sec
ondary invasion of bacteria and fungus. The iodine deficiency may also produce
some degree of hypothyroidism, which is manifested by weight gain, the devel
opment of fat deposits, lethargy, and poor feather quality.15,16
Although thyroid dysplasia is mainly seen in budgies and occurs in rare occasions
in cockatiels and canaries, the potential exists for all birds to suffer from iodine
deficiency. The severity of the condition will dictate treatment: A mild case can be
corrected by the addition of supplemental iodine in the diet; a severe case may
require hospitalization and daily injections of sodium iodide until the condition
resolves. The best manner of treatment, however, is prevention through the proper
provision of trace elements in a formulated diet or by the use of a supplement for
birds on a seed diet.
Budgerigars with thyroid tumors may have clinical signs identical to goiter.
However, while goiter will resolve quickly with iodine supplementation, thyroid
tumors will not.1
Hemochromatosis
Hemochromatosis, or iron storage disease, develops from an inability to eliminate
iron with excess accumulation and associated cellular damage in various tissues
including liver, spleen, gut, heart, pancreas, and kidney.17It seems to be associated
with increased dietary iron or increased absorption of dietary iron.17 Chronic stress
with resultant blood breakdown, a lack of certain enzymes, genetic predisposition,
and combination etiologies have all been suggested as causes.18 Frugivorous
species of birds seem predisposed to hemochromatosis when high dietary iron is
present, perhaps due to their efficient intestinal absorption of nutrients.17
Hemochromatosis is mainly seen in mynahs and toucans and often results in their
presentation for dyspnea. It is rarely reported in psittacines.17 Other signs include
a distended abdomen (ascites and liver changes) and discolored droppings.
Birds with this condition are generally treated with long-term weekly phle
botomies19 to reduce the iron load. In the procedure, 10% of the birds blood
volume can be removed safely at one time, which equals approximately 1% of
the birds body weight. In birds with ascites, this percentage should be
decreased, as their body weight may be artificially elevated. Serum iron levels
should be monitored to ensure that they are 150 mg/dl or less, and a CBC or
hematocrit should be used to make certain that the bird has recovered from each
phlebotomy. Deferoxamine, an iron chelator, has also been used in the treatment
of this condition.
Prevention of iron storage disease can be achieved through dietary management,
which has been facilitated by the availability of better diets. Low-iron diets and
bottled water are recommended for birds in any species that are susceptible to the
condition that have not developed the disease. Long-lived mynahs that have not
developed the condition have been found to eat a diet high in human food with lit
tle reliance on mynah pellets.18
Minimal iron requirements for growth and maintenance of hemoglobin have been
determined to be 65-85 ppm for poultry, on the other hand a maximum of 150 ppm
is suggested for mynah feed.20 On an overall basis, minimal dietary iron require
ments for all animals may fall between the range of 60-100 ppm.20
Viral Diseases
Pachecos Disease
Though Pachecos disease is not as common as it once was, due to importation
restrictions, there has recently been an increase in the number of cases of this fastspreading disease.21 It is caused by a herpesvirus, but more detailed characteriza
tion of the Pachecos disease virus suggests that Pachecos disease is caused by a
heterogeneous group of herpesviruses.22 It has been suggested that these viruses
are more common than previously thought, suggesting that there may be a signif
icant number of infections that are caused by non-pathogenic or relative non-pathogenic psittacine herpesviruses,22
Pachecos disease is a peracute to subacute, generally fatal disease of parrots.23
Outbreaks of Pachecos disease occur sporadically in recently or long estab
lished collections of parrots where mortality can vary from a single bird to hun
dreds of birds.23 The disease can have a rapid onset with acute death and no
obvious clinical signs. If present, clinical signs include depression, anorexia,
Pox Virus
Pox virus is relatively uncommon today due to restrictions on importation. Species
susceptibility to the pox virus is varied. In the past, the virus was seen most fre
quently at importation or breeding centers for such birds as the blue-fronted
Amazon. Outbreaks of canary pox are still occasionally seen. In southeast Florida,
pox virus outbreaks occur in juvenile Amazon parrots each summer, indicating a
reservoir of pox virus in the wild psittacines of Florida.21
The best known form of the pox infection is the cutaneous form, which is identi
fied by swelling or ulcers on the eyes, face, and feet. Serous ocular discharge,
rhinitis, and conjunctivitis may occur, followed by ulcerations and crusts on the
eyelids. The condition becomes more severe with the presence of secondary,
opportunistic organisms.29 Some birds survive these cutaneous manifestations.
Quite often, however, they will have disfigured eyelids and corneal abnormalities.
Diphtheritic and septicemic forms of the infection produce dyspnea and have
higher associated mortality rates.9The diphtheritic form produces necrotic lesions
in the trachea, larynx, and oral cavity, leading to respiratory difficulties. When the
lesions are secondarily infected, mortality rates increase.29
Amazon parrots and lovebirds commonly manifest the cutaneous and diphtheritic
forms. The prognosis for affected Amazon parrots usually is good, although some
may have disfiguring eye damage. Lovebirds do not seem to fare as well, with as
high as 75% morbidity and mortality having been seen in susceptible popula
tions.29 The septicemic form is more common in canaries. There is an active onset
of dyspnea followed by death, with most of the birds (greater than 70%) dying
shortly after developing clinical signs.29
Transmission of the virus requires a break in the epithelium of an uninfected bird
and either direct contact with the virus from an infected bird or indirect contact
with a contaminated object or insect.29 Mosquitoes and mites serve as the primary
mechanical vectors, with epomitics more common in the spring and fall when
mosquitoes are most prevalent.
Antemortem diagnosis can be accomplished by the detection of clinical signs or
the isolation of the virus from vesicles, pharyngeal swabs, or feces.29 Histologic
evaluation can reveal the presence of cytoplasmic viral inclusion bodies.
Treatment for pox virus consists of supportive care and the isolation of infected
birds. Although the virus is not carried by survivor birds, it can survive in crusts
and debris for extended periods of time. For that reason, when the virus is detected
it is essential to sanitize the aviary and to destroy any contaminated materials that
cannot be sterilized, such as nests and wooden nest boxes.29
Vaccines to prevent pox virus are no longer available. In the past, before restric
tions were enacted, Amazon parrots were vaccinated against pox virus toward
the end of the importation period, reducing the occurrence of the disease in the
United States.
Figure 32
Cockatoo with psittacine beak and feather disease.
Changes in the beak and feathers are seen.
(P.S.Sakas, DVM)
cute form of the disease, where there is severe and progressive anemia and
leukopenia.31 In older birds, feather dystrophy may occur, but is replaced by non
specific signs associated with immunosuppression.31
Lovebirds have demonstrated the potential for spontaneous recovery from infec
tion.31 Young adult birds are primarily affected with PBFD and may develop both
feather lesions and show evidence of immunosuppression (Figure 33).31
Eclectus parrots with PBFD have vary
ing degrees of feather dystrophy.31 In
adults, there seems to be a correlation
between fatal polyomavirus infection
and PBFD.31
New World species of birds may have
either subclinical or clinical infec
tions.31 When a bird is clinically
affected, feather dystrophy, as in cocka
toos, predominates.31 Some PBFDinfected birds of South American
descent have spontaneously recovered
from the disease.30
Figure 33
Lovebird with psittacine beak and feather disease.
(P. S. Sakas, DVM)
DNA probes as soon as 2 days after natural exposure, well before the development
of clinical symptoms.25 Most adult birds infected with psittacine circovirus will
develop a transient viremia, detectable using DNA probes, but will clear the virus,
seroconvert, and remain clinically normal.25
A diagnostic flow chart (see Table 7 on page 190), used with the kind permission
of Dr. Branson Ritchie, and based on his work with psittacine circovirus, has been
included to assist in the diagnostic process with psittacine circovirus.30 The flow
chart has been divided into sections for birds that have normal feathers and birds
that have abnormally developing feathers.
If a bird from a breeding aviary with feather abnormalities is found to be positive
for psittacine circovirus 1, psittacine circovirus 2, or any variant of circovirus, the
bird should be removed from the area as quickly as possible.30Virus-infected birds
with feather abnormalities shed large concentrations of virus in their feather dust,
which can be easily carried to other birds by the wind, clothes, skin, or hair.30All
areas, supplies, and equipment that could be contaminated with feather dust from
the infected bird should be repeatedly cleaned and disinfected.30Following an out
break, evaluate whether cleaning efforts have been sufficient by DNA probe test
ing of air ducts, carpets, enclosures, or dusty areas.30
Although PBFD is considered to be a terminal illness, good nursing care and
treatment with antibiotics may improve the quality of life of affected birds for
short periods of time. Ideally, all breeding cockatoos and newly purchased
cockatoos should be tested for this disease, as should other birds at risk.
Hatchlings may benefit from the eggs being placed immediately into incubators
and isolated nurseries.32
Large concentrations of virus can be detected in feather dust collected from areas
where birds with active cases of PBFD are housed, indicating that contaminated
dust is a major vehicle for natural virus transmission.26 Because the virus per
sists in the environment and can be collected from walls, vents, or any dusty
areas, sound hygiene (along with DNA probe tests) is vital for preventing the
spread of PBFD.26
Table 7
Diagnostic Flow Chart for Psittacine Circovirus
Bird has normal feathers
Test blood for psittacine circovirus nucleic acid using DNA probe-based assay.
Positive test
Negative test
In a bird with no feather abnormalities, result indicates that the bird has been exposed to
psittacine circovirus and viral nucleic acid is present in the blood. Most birds that are
exposed to the psittacine circovirus will have virus present in their blood for a brief period.
Indicates the bird was transiently infected and that the birds immune
system was able to clear the viral nucleic acid from the blood. Birds
with normal feathers that have cleared an infection should be consid
ered resistant to psittacine circovirus.
Birds that are recovering from PBFD will be blood negative for
months before all of the affected feathers (the cells of which will
retain psittacine circovirus until molted) are replaced during the
molting process with new uninfected feathers. As long as dys
trophic feathers, or their associated dust, are present, the bird
should be considered infected.
Notes:
a. The proprietary nucleic acid sequence for psittacine circovirus 1 and psittacine circovirus 2 developed by the researchers
at the University of Georgia are currently available in the United States through ANTECH, the Comparative Pathology
Laboratory at the University of Miami, IDEXX, and the Infectious Diseases Laboratory at the University of Georgia.
b. Testing for psittacine circovirus is also provided by Research Associates Laboratories, Milford, OH.
Papillomatosis
Papillomas that occur on the skin of finches and African grey parrots have been
shown to be caused by a papillomavirus.27 Those found in the cloaca of psittacine
birds have an undetermined cause, though it has been reported that herpesvirus
like particles have been found in a papillomatous cloacal lesion.27 Cloacal papilloma-like lesions are common in New World psittacines. The disease condition,
called papillomatous-like disease, has an epidemiology that is consistent with that
of a contagious disease. If a bird with papillomatous disease is introduced into an
aviary, other susceptible birds are likely to develop the disease.34 There is a high
prevalence of papillomatosis observed in the mates and parent-raised offspring of
birds with the condition.34
With papillomatosis, the reddish cauliflower growths are found most frequently in
the cloaca (or prolapsed out of it)
(Figure 34), around the larynx, or
in the crop or upper gastrointesti
nal tract, where they interfere with
such activities as swallowing,
digestion, and defecation.27 In the
case of growths in the cloaca, fresh
blood will occasionally be seen on
droppings before a growth is spot
ted. In the case of growths around
the laiynx, wheezing and exercise
Figure 34
intolerance may be reported. Papillomatous growth in the cloaca of an Amazon parrot.
Papilloma-like lesions can also Lesions of this degree may cause blood in the droppings or
interference with their passage, resulting in the bird making
interfere with reproduction, with straining noises when passing droppings.
the effect dependent upon the loca (P. S. Sakas, DVM)
tion and severity of the lesions.27
When wheezing and voice changes occur, differential diagnoses must be made,
since there can be a variety of causes, including papillomas, syringeal aspergillo
sis, and other upper airway obstructions or infections. Likewise, red masses
attached to the vent can be papillomas, a prolapsed oviduct, a prolapsed vent, or a
prolapsed pygostyle. The appearance of a mass in combination with the species
presented can be very suggestive; for example, Amazon parrots and macaws are
only gastrointestinal dysfunction, some will show only CNS signs, and some will
show a combination of both. Other infected birds will be asymptomatic but shed
the virus continually, serving as the cause of outbreaks in susceptible birds in an
aviary or pet retail facility. In some outbreaks, numerous cases of PDD will occur
simultaneously. Sometimes, several birds will die in an outbreak and the problem
will appear to resolve, only to reappear years later. It is more common, however,
for many of the birds exposed to an affected bird to remain asymptomatic.27
Outbreaks of PDD appear to be worse in the northern United States, especially
during the winter months when aviaries are closed (with less airflow) due to the
cold winters.20
Definitive diagnosis can be achieved through the histologic demonstration of lymphoplasmacytic infiltrates within nerves, ganglia, and neuropil and through the
absence of normal myenteric plexi, especially within the nerve tissue of the gas
trointestinal tract.27 Most frequently, the diagnosis is made through postmortem
submission of a complete set of tissues, including proventriculus, ventriculus,
brain, and spinal cord tissue.27At necropsy, emaciation, pectoral muscle atrophy,
and dilation of the GI tract, including the proventriculus, are observed.39 Some
gross necropsies of birds with PDD may appear normal, and histologic changes
can be easily missed, as well.
Antemortem diagnosis of PDD is difficult, since no specific diagnostic test is
available commercially at the time
of this writing. Rather, diagnosis is
based upon observing the charac
teristic clinical signs and ruling out
other conditions that may produce
those signs. Plain and contrast radi
ographs are useful for demonstrat
ing gastric abnormalities in
affected birds. Common radi
ographic findings are proventricu
lar dilatation or distension and
Figure 36
increased barium transit time Barium radiograph of a macaw with PDD. The dilatation of
(Figure 36). However, practitioners the proventriculus is marked; however, other conditions
be ruled out before making the final diagnosis. Crop
should not automatically assume should
biopsies have proven useful in diagnosis.
that a bird with a dilated proven- (P. S. Sakas, DVM)
triculus has PDD, since other conditions may also produce this radiographic
change. Further, the proventriculus of neonates is normally dilated and should not
be misinterpreted as indicating PDD.27
Other diseases that may cause proventricular enlargement and dilatation, delayed
gastric transit time, poor ventricular contractility, and perhaps even neurologic
signs, include diffuse and localized gastrointestinal bacterial, fungal or yeast infec
tions (fungal proventriculitis, candidiasis), heavy metal toxicosis (lead, zinc),
megabacteriosis, intestinal obstruction (partial or complete), clostridial enteritis,
neoplasia, parasitism, and paramyxovirus.40 Severe respiratory distress and
aerophagia may also mimic PDD radiographically, although other clinical signs
should be apparent40
Antemortem diagnosis is further hampered by the fact that proventricular and ven
tricular biopsies are not generally recommended due to the risk they pose and the
tremendous distension produced by the condition. Full-thickness crop biopsies
have shown some promise in the detection of PDD and are commonly used as a
definitive test. However, they are helpful only if the results are positive, since false
negative results can occur.39 Because it is important to include nerve tissue sam
ples in this type of biopsy, the crop should be sampled in an area that has at least
one large blood vessel and associated ganglia.39 Further, the biopsy size should be
at least 1 cm x 1 cm, and it should be taken from the left midlateral aspect of the
crop. In several studies, changes consistent with PDD were reliably detected in
68-78% of the crop biopsies collected from positive birds.27 Thus a positive crop
biopsy in a bird with suggestive clinical signs is of diagnostic value, but a negative
crop biopsy in a bird with suggestive clinical signs does not rule out PDD.27 No
birds were observed to have lymphoplasmacytic infiltrates in the crop without
concomitant lesions in the proventriculus and/or ventriculus.27
Fluoroscopic studies demonstrating abnormal esophageal and ventricular motility
have been suggested as being useful in early diagnosis.41 However, it may not be
readily available, and it does not confirm a specific etiology for the decreased
motility.40 Blood chemistry may also be useful, since serum amylase and lipase
levels are elevated in some patients, and hypoalbuminemia may be present.42
Other possible indications of PDD are elevated CPK (see Table 2 on pages 81-84)
and feather changes.
not be euthanized.20 Hygiene practices should be corrected. Fresh air and sunlight
play a role in the reduction of exposure to PDD.20
One of the best means for bird owners to limit the risk of exposure is to have a
closed aviary with no new additions. If new birds are to be added to a collection,
be certain of the source and their past medical history, and place them in quaran
tine for 3 months, as the disease has a one-week to three-month incubation
period.20 The most frustrating aspect of this disease is that despite maintaining a
closed aviary or practicing strict isolation techniques, a bird with PDD may
already be in a collection without having displayed clinical signs.
To date, no vaccine or other preventative measures are available.43 Until a vaccine
or an accurate diagnostic test is developed that can detect the presence of the virus
or antibody response to it, birds that have been exposed to PDD should be isolated
or kept in single-bird households where there is no risk of exposure to other birds.
When an effective screening test for PDD becomes available, the birds in isolation
can be evaluated.
Newcastle Disease
Newcastle disease is a highly contagious, multi-strain viral disease that affects
most bird species. The most virulent form, exotic Newcastle disease (VVND), is
caused by a paramyxovirus and results in high mortality in many types of birds,
including chickens, psittacines, and birds of prey. The disease is often associated
with smuggled Amazon parrots, particularly Mexican red-headed, yellow-headed,
and yellow-naped Amazon parrots.
It was the fear of entry of Newcastle disease that led to the development of the
USDA quarantine system for birds, which requires all imported avian species to
undergo a 30-day quarantine before being allowed entry into the United States.
Because of the virulent nature of the disease, the USDA constantly monitors for
outbreaks. Prior to the establishment of the quarantine system, Newcastle disease
had been reported in shipments from every country that exported exotic birds, with
birds from Mexico, Central America, and Southeast Asia being the most com
monly affected.
The disease has a seasonal incidence. Most occurrences are reported in the spring,
a time that corresponds with the rainy season in many countries from which
affected birds are imported. Unfortunately, spring is also the time that most smug
gling occurs, since baby birds are available, which are highly prized.
Some birds can survive after being infected with Newcastle disease and remain
carriers of the infection. Shedding of the virus may be intermittent and induced by
stress. In a closely confined flock, aerosol transmission is the primary means of
spreading the disease. In pet birds, transmission seems to more commonly result
from direct contact with infected birds and contamination of food and water with
virus that has been excreted in the feces.
In psittacines, the incubation period for Newcastle disease is 3 to 28 days.44 The
disease is particularly difficult to diagnose, since no characteristic lesions or other
signs are seen. In some cases,
acute death and high flock mortal
ity occurs, especially affecting
young birds. In older birds, signs
may include depression, diarrhea,
and respiratory distress. In birds
with protracted disease, neurologi
cal signs may also be seen, includ
ing
ataxia,
incoordination,
torticollis, circling, and seizures
(Figure 37). Lesions seen on post
Figure 37
mortem examination are variable; Seizing bird suffering from Newcastle disease. Bird was a
however, the visceral lesions com smuggled spectacled Amazon parrot whose head was
bleached yellow to create the appearance of a double yelmonly seen in poultry are rarely low-headed Amazon parrot. (P. S. Sakas, DVM)
demonstrated in pet birds.
Carcasses will often show hemorrhages, much like those seen in birds that have
died from Pachecos disease or polyomavirus.
Any suspect cases of Newcastle disease should be immediately reported to the
regional USDA office, and the birds should be given up to a USDA-approved lab
oratory for diagnostic evaluation. The birds will be quarantined until viral isola
tion and typing are complete. Diagnosis will be based upon isolation of the virus
from cloacal or pharyngeal swabs. If a bird is found to not have Newcastle dis
ease or is found to have a domestic strain, it is returned. If Newcastle disease is
isolated, the bird is destroyed, other exposed birds are tested, and the premises are
cleared for 30 days.
If a bird is suspected to have died from Newcastle disease, samples of brain, lung,
colon, spleen, and tracheal tissue should be submitted to the USDA national lab in
Ames, Iowa. There, the virus will be isolated through the inoculation of embryonated chicken eggs.
In poultry, vaccination has made control of Newcastle disease possible. However,
use of this vaccination in pet birds is strictly prohibited by federal regulations. The
use of vaccines could produce an immune flock and could mask asymptomatic car
riers, since vaccination does not eliminate carriers.
Newcastle disease has zoonotic potential. In human infections, the clinical signs
acute conjunctivitis, malaise, and sinusitisresolve in 1 to 3 weeks. These signs
may not always be reported due to their similarity to influenza.
Pigeon Paramyxovirus
Another form of paramyxovirus causes pigeon paramyxovirus, a neurological dis
ease seen in both wild pigeons and pigeons kept for racing and shows. The virus
is transmitted through ingestion or inhalation of contaminated respiratory secre
tions or feces, and shedding of the virus by contaminated birds can continue for up
to 1 month.45 In birds exposed to the virus, the incubation period ranges from 5
days to over a month. Free-ranging pigeons can introduce the virus to a loft.45
Clinical signs of pigeon paramyxovirus include polyuria, polydipsia, diarrhea, and
such neurological signs as incoordination, tremors of the head and wings, circling,
paralysis, head shaking, and torticollis.45 Often, birds with these neurological signs
die due to their inability to eat and function. However, birds that learn to eat
despite their neurological condition can survive. Pigeons in the wild that have been
poisoned by heavy metals, organophosphates, or nuisance-control chemicals may
display similar signs. Accurate diagnosis of pigeon paramyxovirus can be made
through viral isolation or detection of the virus through histopathologic evaluation.
Vaccinations are available that prevent the disease, but they do not prevent the
infection or shedding of the virus.45 Nevertheless, adult birds should be vaccinated
several months before breeding or before the racing or show season. New birds
should be vaccinated during the quarantine period. Young birds can be vaccinated
at 3 to 4 weeks of age.45 Control measures include isolating any birds with clini
cal signs, quarantining new birds, and preventing access of free-ranging wild
pigeons to aviaries.
Polyomavirus
Polyomavirus is one of the most threatening of all avian pediatric diseases.44 The
first generalized infection associated with an avian polyomavirus was described in
the 1980s as budgie fledgling disease, as it affected young budgerigars. (It was
originally documented as a papovavirus.)27A similar polyomavirus has since been
shown to be associated with morbidity and mortality in some passerines and vari
ous nonbudgerigar psittacines.27 Both forms of the disease affect neonates most
severely and are characterized by peracute to acute death in preweaning babies.30
Epizootiologic data indicate that avian polyomavirus is a significant cause of mor
tality in psittacine birds less than 150 days old.26 In addition to chicks, adult
psittacines can become ill and may die from the virus.26
Because polyomavirus is environmentally stable, transmission occurs easily
through direct contact with clinically or subclinically infected birds as well as with
virus-contaminated environments.26 Virus outbreaks have been associated with
inadequate quarantine procedures, virus-contaminated environments (such as nest
boxes and incubators), and the mixing of unvaccinated birds with infected birds.26
The budgerigar condition induced by avian polyomavirus, budgie fledgling dis
ease, may appear as sudden death or death following a brief illness with such clin
ical signs as depression, petechial or ecchymotic hemorrhage, feather
abnormalities, and abdominal distension.44 The growth of affected nestlings may
also be stunted 46 If budgerigars are older than a few weeks of age when infected,
they may exhibit feather dystrophy.44 Polyomavirus has also been implicated as
one of the causes of French molt in budgerigars, with another cause being a
budgerigar form of the psittacine beak and feather disease virus. Budgerigars are
known to develop persistent polyomavirus infections and should be considered a
risk for transmitting the disease.27Although individual birds may clear themselves
of the virus, the virus may circulate through the flock, causing the flock to act as
a carrier.44
tion are also seen.44 Birds between 16 and 21 weeks of age show variable response
to the infection, ranging from subtle feather dystrophy to death 44 Birds over 6
months of age generally experience a brief viremia with or without clinical signs.44
There are more subclinical adult infections than fatal neonatal infections; however,
the carrier state in psittacines is undetermined.44
Diagnostic tests are available to facilitate the diagnosis of polyomavirus. Assays
to detect anti-polyomavirus antibodies and a DNA probe test to detect poly
omavirus nucleic acid are being utilized, but both tests have inherent limita
tions.26 The detection of anti-polyomavirus antibodies in a single serum sample
merely indicates a previous, and typically transient, infection.26 Polyomavirusspecific DNA probes can be used to detect viral nucleic acid in blood, cloacal
swabs, fresh tissues, or environmental samples collected from areas that may
have been contaminated with virus (e.g., hospital, nursery, aviary, pet shop, or
car).26 If a bird tests positive on the DNA probe test, viral nucleic acid is present
in the bird. However, positive results may indicate an active infection, exposure,
or vaccination.26Active shedding should be determined via a cloacal swab. If the
swab test is positive, the bird is shedding polyomavirus nucleic acid.26 Shedding
may occur for weeks to months as the virus is cleared.26 Repeat testing after 90
days is highly recommended.26 If a bird tests negative on the blood DNA probe
test (within the limitations of the test procedure), it is considered a true negative
at the time of sample acquisition.26
Postmortem examinations of neonates that have died from polyomavirus infection
reveal random areas of profound hemorrhage (usually subcutaneous) caused by
vascular necrosis, hepatomegaly, pericardial effusion, splenomegaly, and ascites.44
A DNA probe analysis of the affected tissues can confirm the diagnosis.
Histopathology may demonstrate hepatic necrosis with karomegaly and intranu
clear inclusion bodies in the liver and spleen 44
The treatment for affected birds is supportive care. Survival once hemorrhage is
visible is unknown.44
Control measures primarily consist of vaccination and minimizing exposure.44
The inactivated avian polyomavirus vaccination that is available is safe,
immunogenic, and efficacious.27 Within a flock, prevention requires the vaccina
tion of two crucial groups of birds, the breeding flock and the young birds.27
Breeding birds should be vaccinated twice, with a 2-week interval between vac-
Parasitic Diseases
The parasites commonly seen in avian practice are helminths, protozoa, and
arthropods. In companion and aviary birds, parasitic infections are most common
in birds that were recently imported or were kept in outside aviaries. Because
many neonate birds sold by pet retailers and brokers in the United States are bred
in warm climates (such as Florida) in outside aviaries, where there are plentiful
intermediate hosts, even domestically raised birds may harbor parasites. As
described in the following sections, the effects of parasitic disease range from
benign to acute death.
Helminths
Tapeworms
Tapeworm infestations are not seen as frequently as they once were due to limita
tion of importation. However, tapeworms are not limited to imported birds; they
can also be found in domestically raised birds.21 Tapeworms are most often seen
in finches, African grays, cockatoos, and eclectus parrots.47With tapeworms, there
is no direct correlation between eosinophil number and parasitism.47 Generally,
infestations are nonpathogenic, with many birds remaining asymptomatic. Large
numbers of worms can, however, cause impaction, and with severe infestations
birds may die following a period of weight loss and diarrhea 47
Tapeworms have indirect life cycles and require an intermediate host48 Diagnosis
is made by identification of proglottids or whole worms in feces. Individual eggs
may not be noted in routine fecal samples unless a proglottid in the feces has rup
tured. Identification of six hooks on onchosphere and hexacanth larvae further
aids in the recognition of tapeworm ova. Praziquantel is the treatment of choice,
although other anthelmintics have been used with success.
Control includes elimination of the intermediate hosts, including insects, slugs,
free-living orbatid mites, and earthworms.48
Flukes
Flukes, or trematodes, are usually found in Old World species, since the interme
diate hosts of origin (usually an arthropod) are not present in the United States 47
Hepatic trematodes have been described in cockatoos and are periodically seen in
raptors.48 Renal trematodes have caused serious losses in Gouldian finches.49
Diagnosis is through identification of the characteristic egg in the feces.
Fenbendazole and praziquantel have been used for treatment.47 Ivermectin may be
used in combination with one of the aforementioned drugs.
Ascarids
Roundworms are frequently found in birds maintained in enclosures with access to
the ground; however, birds in outdoor suspended flight cages and even neonates
that have been parent-fed but kept outdoors for a period of time are at risk.49
Infestations are common in budgies and cockatiels.
The life cycle of the roundworm is direct: A 2 to 3 week period is required for the
embryonated larvae to form in eggs, and the eggs are viable for long periods in
moist, warm environments.49 The eggs are resistant to disinfectants but can be
controlled with steam and flaming. Embryonated eggs that are ingested are
directly infective. The roundworm larvae encyst in tissue, and stress may cause the
cysts to activate.
Birds that have tested positive for roundworms should be periodically retested. An
even better strategy is to periodically worm any bird that has tested positive or
passed ascarids in the feces.21Also recommended is periodic worming of any out
door breeding flock.
Clinical signs occurring with severe infestation may include distended abdomen,
weight loss, diarrhea, malabsorption, intussusception, blockage, and death.
Diagnosis is through direct fecal examination and fecal flotation. Pyrantel pamoate
and fenbendazole have been shown to be effective in treatment.48
Capillaria
Thread-like nematodes, Capillaria are gastrointestinal tract parasites that can be
found in most species of companion and aviary birds.48 They are most common
in macaws, budgies, canaries, pigeons, and raptors.49 The parasite has a direct
life cycle: 49 The eggs are passed in the feces, embryonation can take 2 weeks,
and the eggs can remain infective in the environment for months.48 Some birds
that ingest the eggs remain asymptomatic; others develop weight loss, anorexia,
vomiting, or anemia.49
Diagnosis is through identification of the characteristic bipolar egg on fecal
flotation or the scraping of suspected gastrointestinal tract lesions. Drugs used in
treatment include mebendazole, fenbendazole, pyrantel pamoate, and, less effec
tively, ivermectin.21
Syngamus (Gapeworms)
Gapeworms are rare in companion birds51 but are seen quite often in wild birds,
chickens, and ducks.50 Most infestations occur in young birds; adults are gener
ally resistant to infestation. When the parasite is present, it can be visualized in
the trachea. Like many of the other parasites already discussed, gapeworms have
a direct life cycle. Various transport hosts may be involved in the life cycle,
notably the earthworm.50
Diagnosis is through the observation of clinical signs, which include coughing,
open-mouthed breathing, dyspnea, and head shaking, through visualization of the
parasite, or through detection of the eggs in the feces.50Treatment includes the use
of thiabendazole, mebendazole, and ivermectin and the mechanical removal of the
worms.50 Control is accomplished by preventing access to gapeworm eggs.50
Filarial Worms
Filarial worms have an indirect life cycle, being transmitted to birds by bloodfeeding flies.47 Diagnosis can be made through the detection of microfilariae in
peripheral blood smears. Prior to the implementation of importation restrictions,
when there was widespread importation of birds, microfilariae were commonly
detected in blood smears of imported cockatoos and imported Solomon Island
eclectus 47 Quite often, they were found in conjunction with Haemoproteus.
Adult filarial worms may lodge in the body cavity, eye chambers, heart, air sacs,
joints, feet, or legs 47 Occasionally, needle aspirates of suspicious swellings on the
feet of affected birds will reveal microfilariae or portions of the adult worm.
Protozoa
Trichomonas
Trichomonas is a gastrointestinal parasite that does not require an intermediate
host. It is passed by direct contact or through the ingestion of contaminated food
and water.48 Parents may pass it to their young during feeding.48 There are no
resistant cyst forms, only motile trophozoites, which are 8-14 microns long, pos
sess an undulating membrane, and move in a jerky manner.48 Their body size
remains constant during movement.
Trichomonas infestations are best known for their effects in pigeons, where they
cause canker, and in raptors, but they also may affect pet birds.52 Although
budgerigars, finches, and cockatiels are the most frequent hosts, infestation with
this protozoan has also been reported in domestically raised large psittacines.
Infestation sites include the oropharynx, esophagus, crop, trachea, and intestine.
Pathogenic strains can cause inflammation and white plaques on gastrointestinal
mucosa. They can also cause necrosis, with the accumulation of cheesy material
that can occlude the esophagus and trachea.48 Infestation causes poor growth
and high mortality in young birds; in adult birds, it causes emaciation, dyspnea,
and vomiting.48
Diagnosis is made through direct smears of affected areas or direct examination of
fresh feces, but trichomoniasis can be very difficult to diagnose in the live pet
bird. The parasite is extremely delicate, is killed by drying, and is incapable of
encystment.52 Diagnosis may be facilitated by mixing fresh, unstained samples
with saline and then identifying the motile forms. Because Trichomonas may live
intracellularly, tissue may need to be scraped, slightly damaging the epithelium,
for proper diagnosis.21 Negative crop swabs do not rule out this disorder.53
Effective drugs are not widely available, making treatment difficult. Carnidazole
and ipronidazole are good choices if they can be obtained. Metronidazole and
dimetridazole also have been used to treat Trichomonas, but they may not be as
effective as the other drugs mentioned.
Giardia
A gastrointestinal parasite, Giardia has a motile trophozoite stage found in the
intestinal tract and a resistant cyst stage. Trophozoites can cause severe changes in
the gut, interfering with food absorption and causing irritation to the intestine,
which can facilitate secondary bacterial invasion. As the trophozoites pass through
the gut, they encyst. The cysts are stable in the environment and serve as a source
of infestation, with direct transmission following the ingestion of food or water
contaminated with the feces from infected birds.
Most reports of Giardia in psittacines involve budgies (especially young birds),
cockatiels, lovebirds, and gray-cheeked parakeets.47 However, as a result of
improved diagnostic tests, Giardia has been detected in just about every psittacine
species.21 Giardia is commonly found in the feces of asymptomatic adult budgies
and cockatiels, suggesting that there is an asymptomatic carrier state with inter
mittent shedding.47
Clinical signs, when present, include loose, malodorous stools, mucoid diarrhea,
gram-negative enteritis, anorexia, depression, recurrent yeast infections, and
hypoproteinemia. The droppings of infested birds may have a brownish or pale
color and may be poorly formed. In neonatal budgies and cockatiels, infestation
can result in poor growth and high mortality. Feather picking and pruritus have
also been described as clinical manifestations, especially in cockatiels.49
Diagnosis can sometimes be made through the examination of fresh feces mixed
with saline (not water), since a plain wet mount may show the motile, pear-shaped
forms of Giardia. If the feces are more than 10 minutes old, however, the tropho
zoites may not be recognizable. Due to the intermittent shedding of trophozoites
and cysts, multiple fresh samples may need to be tested. For a definitive diagnosis
when the motile forms cannot be spotted, feces can be preserved in 5% formalin
and sent to a commercial laboratory for phase-contrast evaluation with special
stains.21A fecal trichrome test can also be utilized for diagnosis, with the samples
preserved in polyvinyl alcohol for testing.54 It is recommended to collect three
consecutive samples to increase the likelihood of finding Giardia.54 ELISA
(Enzyme Linked Immunosorbent Assay) testing is also being used.47
Treatment of Giardia is difficult, since many of the most effective drugs are no
longer on the market. Metronidazole has been used, but its exact efficacy is
unknown. Ipronidazole is thought to be a superior treatment, but it is not widely
available in the United States. Relapses are common after treatment, due to either
endogenous Giardia or exposure to environmental reservoirs.
Control measures include keeping the aviary clean and dry, which reduces both the
number of cysts and their viability and helps to prevent reinfestation. The use of
water bottles will also help to reduce the risk of reinfestation.21
Although each species of Giardia has a limited host range and the species isolated
from birds have not been found to infest other animals, clients should be warned
of the potential human hazard.55
Hexamita
Observed in cockatiels and lories, Hexamita (now renamed Spironuclens meleagridis)49 are similar to Giardia but lack the sucking disc, are more truncated, and
swim in a smooth, linear fashion. As with Giardia, the cysts are infective and the
trophozoites can cause loose stool and weight loss. Diagnosis and treatment are
similar to the protocol for Giardia.
Coccidia
Coccidiosis is common in mynahs, toucans, pigeons, and lories. In addition, it has
been reported in imported finch species56 and may affect breeding flocks of com
mercially raised birds, including budgerigars and canaries.57
In pigeons, coccidiosis is a common cause of enteritis.47 In mynahs and toucans,
infestations rarely cause clinical signs unless the birds are stressed by crowded,
unsanitary conditions.
Transmission occurs through the ingestion of food and water contaminated with
feces that contain unsporulated oocysts, which are less than 45 microns in length 47
Diagnosis is made through direct fecal examination, flotation, or histopathology.
Sulfa-based poultry water medications have been used to treat coccidiosis in
breeder flocks.57Metronidazole has also been used in treatment. Control measures
include improving hygiene and management to reduce fecal/oral contamination.
Sarcocystis
Sarcocystis is a coccidian parasite that
undergoes sexual multiplication in
opossums, the definitive host.47 When
the opossums pass the oocysts in their
feces, the oocysts may be picked up by
an intermediate host, which may be a
bird, or transported to intermediate
hosts by cockroaches, other insects, or
arachnids. In the intermediate host, the
parasite undergoes asexual reproduc
tion, spreads through the bloodstream,
and encysts, often in striated and car
diac muscle47 (Figure 39).
Figure 39
Widespread sarcocystis in the striated muscle of a
conure (skin removed for easy visualization).
(P. S. Sakas, DVM)
Sarcocystis is found in North and South America and has been associated with
acute death in a variety of psittacines.47 Pathogenicity has been found to be
dependent upon the species of bird and the infective dose of the parasite. Old
World psittacines are highly susceptible; New World psittacines are relatively
resistant. Infestations are peracute, and birds often die before sarcocysts (which are
visible to the naked eye) develop in the muscle. If clinical signs are seen, they may
include dyspnea, yellow urates, lethargy, and elevated LDH and AST (see Table 2
on pages 81-84)47 However, diagnosis is usually made at necropsy.
Treatment of Sarcocystosis is difficult, but trimethoprim-sulfa drugs and
pyrimethamine have been used, separately or in combination.58
Because the psittacine birds that are particularly at risk for sarcocystosis are those
kept in outdoor facilities within the range of opossums,47 control measures should
include fencing outdoor aviaries to prevent opossum access. Additional control
measures include eliminating or preventing transport hosts, such as insects and
arachnids, access to the aviary. Although the problem is most often seen in areas
where there are a large number of outside aviaries, such as Florida, it has occurred
in other areas as well. As just one example, a pet owner in Illinois had two African
grey parrots die from sarcocystosis. The birds had been locally raised and had
never been out of state. However, the owner placed them in an outdoor porch area
for several hours a day during the warm weather, and opossums were frequently
seen in the area. Most likely, the condition developed because of transport hosts.
Haemoproteus
Normally considered nonpathogenic, Haemoproteus is a commonly occurring
avian blood parasite that is particularly seen in imported cockatoos, pigeons, and
other wild birds.59 Before restrictions on importation were imposed, up to 50% of
newly imported cockatoos, compared to only 5% of long-term captive birds, were
found to be positive for this parasite.47
Clinical signs can include splenomegaly, hepatomegaly, and pulmonary edema.
High parasitemia can cause clinical problems if birds are stressed or immuno
compromised. Racing pigeons infected with this parasite can perform poorly in
comparison to healthy birds.
Diagnosis is made through a peripheral blood smear and the identification of
gametocytes that encircle the nucleus of erythrocytes. Treatment is not recom
mended for asymptomatic birds. When clinical signs are present, quinacrine
can be used.60
Atoxoplasma
Atoxoplasmosis, caused by the Isospora-like coccidian parasite Atoxoplasma
sp., is a severe, often fatal, disease affecting a wide variety of passerine birds.61
Young fledglings and canaries are especially susceptible.47 There is confusion
regarding the true identity of the organisms classified as Atoxoplasma and a
growing consensus that it would be better placed in the Isospora genus and dis
solving the Atoxoplasma genus.61
The life cycle of the Atoxoplasma of canaries and other passerines appear to
involve several extraintestinal asexual generations, followed by sexual and asex
ual generations in the intestinal tract.61 The parasite undergoes an asexual repro
ductive cycle in the mononuclear cells and then disseminates through the
bloodstream to parenchymal organs.47
Atoxoplasma sp. are apparently host specific, and birds are most likely affected by
the ingestion of oocysts from the environment.61 Infection appears to be long-lived
in individual birds, and fecal shedding has been reported to last as long as 8
months.61 The oocysts are hardy in the environment and not susceptible to most
disinfectants, making control difficult. The intermittent shedding of oocysts by
adult birds and the persistence of the oocysts in the environment contribute to the
transmission of the organism to the young birds in the population.61
Clinical signs are non-specific but may include depression, anorexia, diarrhea,
hepatomegaly, and dilated gut loops, which may be visualized through the skin.47
Up to an 80% mortality rate from atoxoplasmosis has been seen in juvenile birds
2 to 9 months of age.47
Diagnosis can be made through the identification of the oocysts, which are approx
imately 20 \i long, in the feces.47 However, Atoxoplasma oocysts are not always
present in the feces, making the diagnosis of the disease or the identification of
carrier birds difficult. Definitive diagnosis is usually achieved by identifying the
organisms microscopically, in buffy coat smears, or histopathologically, through
liver biopsy or necropsy.61
A PCR assay has been developed that will detect an rDNA fragment of
Atoxoplasma in feces, blood, and tissues of infected birds.61 Results have shown
that there are distinct, consistent differences in DNA sequences from the different
species of birds tested, indicating that different species of passerines may be
infected with distinct Atoxoplasma species.61 The DNA sequences were most
closely related to Isospora robini, supporting the assertion that Atoxoplasma sp.
are most closely related to Isospora sp.61
The PCR assay can be used to diagnose clinical atoxoplasmosis in both live birds
and at necropsy, as well as identifying chronically infected birds.61 It can also be
used to evaluate programs designed to decrease the morbidity and mortality of the
disease and determining the efficacy of a treatment protocol.61
No treatment has proven effective, although primaquine suppresses the tissue form
and sulfachlorpyridazine may decrease oocyst shedding.47 Control is difficult due
to the resistance of the oocysts in the environment and the difficulty in detecting
the organism due to the intermittent shedding of oocysts or in birds that are har
boring the extraintestinal form of the organism.61
Cryptosporidia
Cryptosporidiosis has been observed to cause diarrhea and enteritis problems in a
wide variety of animals, including pet birds.47 In flock conditions, it has been
found to affect mixed species, including parrots, cockatiels, budgerigars, and
finches.62 In the Gouldian finch, it has been reported to cause diarrhea and death.56
Most mortality associated with Cryptosporidia affects juvenile birds, which may
exhibit clinical signs of diarrhea and weigh loss. Gross necropsy lesions are usu
ally restricted to the small intestine, which may be dilated.56,62 Although
Cryptosporidia in mammals is known to be zoonotic, in birds it is not.
Arthropods
Air Sac Mites
Air sac mites, Sternostoma tracheacolum, affect the respiratory tract of canaries,
finches (especially Lady Gouldians), budgerigars, and cockatiels.47 The entire life
cycle of this arthropod occurs in the respiratory tract of the infested host. The par
asite is transmitted through a number of means, including coughing, which spreads
the eggs and mites; beak wiping, which dislodges mites from the beak onto cage
equipment; and ingesting feces containing mites that had been coughed up and
then swallowed.47 Nestlings will pick up the mites from direct contact with their
parents or from nest material.
Clinical signs include dyspnea, stertors (wheezing and squeaks), coughing,
sneezing, nasal discharge, open-mouthed breathing, beak wiping, and depres
sion. These signs may range from mild to severe, with the extreme being death
by asphyxiation.47
Diagnosis in the live bird is difficult. Transillumination of the trachea has been
suggested for visualization of the small mites.47 Other means of diagnosis include
direct fecal examination for the presence of eggs, tracheal washes, and the obser
vation of clinical signs. Often, response to therapy is the best diagnostic test.47
Necropsy samples from the opened trachea and bronchi will show tiny grayish or
brownish mites; the mites are more difficult to locate in the air sacs. Histological
studies of lung tissue may reveal portions of mites.
The treatment of choice for air sac mites is ivermectin, but it should be used with
caution in such small patients. Because of the small volume to be administered, it
is recommended that ivermectin be diluted in propylene glycol. Dichlorvos strips
are also sometimes used for the treatment of this condition. The strips are typically
placed in a medium-sized bird room for several days and then removed.
Regardless of the treatment method chosen, repeated courses of therapy may be
needed to eradicate the mites.
Control measures include cleaning the environment to remove mite eggs. If the
problem is new to an aviary, it is important to determine if any birds have recently
been obtained. New birds should always be isolated for 30 days.
Figure 40
Figure 41
Knemidokoptic mange in a canary (scaly leg or tasselfoot). Crusted lesions and tissue proliferation can
cause marked changes in the feet. Excessive scali
ness on the feet of canaries can also be caused by
a vitamin A deficiency (hyperkeratosis), so the con
ditions should be distinguished by a skin scraping.
(P. S. Sakas, DVM)
canaries (as scaly leg or tassel foot [Figure 41]), but other birds have also been
affected. Typically, the mites cause crusted lesions and tissue proliferation on the
beak and face, the feet and legs, or the vent and wings. As the mites burrow, they
create the characteristic honeycombed appearance in the affected tissues. Young
birds are most commonly affected with this condition and are believed to obtain
the mites latently from parents in the nest.64 Often, Giardia is seen in conjunction
with this condition.
Scaly face lesions in budgerigars develop and spread slowly, typically beginning
on the featherless parts of the face, starting at the commissures of the beak and
spreading to the rest of the beak, cere, and eyelids.63The lesions may spread to the
legs and vent through preening.63 In severe cases, the feathered part of the face
may become affected and the beak may become overgrown and disfigured due to
an increased growth rate in the bed of the beak at the points of infestation.63
Hyperkeratosis of the cere may cause nasal obstruction and respiratory difficulty;
lameness and feather-picking may occur in severe cases.63
Scaly leg in canaries or other passerines causes hyperkeratotic lesions of the legs
and feet. It can sometimes be confused with the hyperkeratosis caused by hypovi
taminosis A, but can be distinguished by a skin scraping and detecting the presence
of the Knemidokoptes mite. In scaly leg, the feet may be distorted, claws may be
overgrown, and toes may slough.63 Skin fissures and secondary bacterial infec
tions may occur.63 Birds may be unable to perch and walk on their hocks.63 Serum
exudate released by tunneling mites can
harden and lead to decreased flexibility
of the legs.63
Diagnosis is made through the charac
teristic appearance of lesions and
through the identification of mites and
eggs in skin scrapings of crusts
(Figure 42). In addition, clear cello
phane tape can be touched to the
lesions and then examined under the
microscope. Commercially available
mite protectors will not eliminate
nor prevent the Knemidokoptes mite.
Figure 42
Knemidokoptes mite. They are easily found in skin
Feather Mites
Numerous feather mites have been described in birds. Prior to importation
restrictions, these mites were usually seen in newly acquired imported birds.
They are still commonly seen in birds housed outdoors in semitropical environ
ments.21 Occasionally, an immunocompromised bird may pick up feather mites
from a wild bird.21
Feather mites have specific microhabitats, including particular portions of the
feather.64 Generally, they are nonpathogenic in host-adapted species, but they can
cause clinical problems in non-host-adapted species or when, with heavy infesta
tions, the mites move from the feathers to the skin. Quill mites reside in the pulp
of developing feathers and cause damage to feather growth.47
Diagnosis is made through visualization of the mites and, for quill mites, through
examination of feather pulp.47 Treatment includes the use of topical pyrethrins and
ivermectin. For quill mites, affected feathers should be removed.
Biting Lice
Biting lice can cause pruritus and poor feather condition. Diagnosis is made
through direct observation of the parasites or of the eggs (nits) attached to the
feathers (often in precise locations).64 Most species of biting lice are host-specific
and die quickly when they leave the host. Dusting with pyrethrins can control
infestations.
Mycoses
Mycotoxicosis
Mycotoxicosis is a condition resulting from the ingestion of any of the various
species of toxin-producing fungi that grow on grains and other foodstuffs.
Mycotoxins, the toxic metabolites produced by these fungi, pose a serious threat
to avian health.6 The toxin may remain even after the fungus has stopped repro
ducing. The amount of toxin present in the food varies due to many factors. Quite
often, the toxin may be concentrated on certain areas of the food, causing hot
spots.65 Because of the generally low concentrations in other areas of the food, it
is often difficult to isolate mycotoxins from the food, environment, or bird. Adding
to the difficulty, the toxin frequently disappears from the environment or food
before clinical signs of mycotoxicosis become apparent.65 It is not uncommon, for
example, for a bird to consume the part of a food contaminated with a mycotoxin
hot spot while the remainder of the food is not contaminated, resulting in nega
tive analysis results.
The clinical signs of mycotoxicosis vary depending on the type of toxin, the
species of bird, and the nutritional and physiologic status of the bird.65A stressed
bird on a poor diet is more likely to be affected than a healthy one. Identification of
mycotoxicosis is difficult, since the signs mimic many other conditions 65As there is
no specific antidote, the best that can be done is to prevent exposure.65All foods and
seeds fed to birds should be clean and fresh. Spoiled and moldy or dirty grains, which
may be a fungal source, should be avoided. In addition, all food should be stored in
an area controlled for temperature, humidity, and air flow.6 Special caution should be
taken to avoid poor quality com and peanuts, as these are common sources of toxinproducing fungi.
Candidiasis
Small numbers of nonbudding Candida organisms are recovered commonly from
the gastrointestinal tract of many normal birds.66 However, detecting large num
bers of budding forms may signal a problem. Candidiasis is generally seen in very
young birds, particularly those being treated with antibiotics. It is a common prob
lem in cockatiels, in which it seems to be a primary condition. In other species of
birds, it is usually secondary to other diseases, immunosuppression, overtreatment
with antibiotics, hypovitaminosis A, malnutrition, or poor sanitation.66
Clinical signs of candidiasis may include whitish plaques in the mouth, under the
tongue (cockatiels), and in the crop.18The crop may be palpably thickened and, in
severe cases, take on a Turkish-towel appearance. General malaise, vomiting,
regurgitation, crop stasis, and abnormal droppings may also be symptoms.66
Differential diagnoses include trichomoniasis,52 bacterial infection, and vitamin A
deficiency.
Diagnosis can be made through examination of oral swabs, crop flushes, or drop
pings. The characteristic organisms can be seen on unstained as well as stained
preparations. High numbers of budding yeast organisms seen on a direct fecal,
mouth, or crop smear, with subsequent growth on fungal culture, should be con-
Aspergillosis
Aspergillosis is a noncontagious opportunistic infection caused by inhalation of
Aspergillus fungi, particularly the ubiquitous soil fungus Aspergillus fumigatus.67
Birds are constantly exposed to these and other fungal spores, generally without ill
effect. However, the spores can become pathogenic under certain conditions.65
With aspergillosis, these conditions include immunosuppression and exposure to
overwhelming numbers of organisms.66
Aspergillosis is predominantly a disease of the upper and lower respiratory tracts of
birds and can occur as an acute or chronic disease.67The spores that are inhaled infect
the respiratory epithelium, producing an inflammatory response.
Immunosuppression resulting from stress, malnutrition, preexisting disease, or
prolonged antibiotic or corticosteroid therapy plays a major role in the develop
ment of the chronic form of the disease.65 Poor husbandry practices play a role in
both the chronic and acute forms, as nonhygienic conditions and poor storage of
food material can lead to an increase of fungal spores in the environment, increas
ing the burden of fungus to which the birds are exposed.66
Conditions that favor fungal growth include damp feed, feed utensils, or litter
(especially corncob and eucalyptus bark soiled with feces), dry feces, decaying
organic matter, and dark, damp conditions with poor ventilation.65,66 Low humid
ity and excessive dust interfere with the normal functioning of the ciliated respi
ratory epithelium, predisposing a bird to respiratory mycoses.65 Dusty, deteriorated
food can contain numerous fungal spores.65
The acute form of aspergillosis is seen most often in wild birds or psittacines kept
in poor sanitary conditions and develops following inhalation of massive numbers
of spores, overwhelming the
immune system66 (Figure 43). The
birds suddenly develop severe,
life-threatening respiratory diffi
culty and most die before a diagno
sis can be made. The chronic form
of the disease is more commonly
encountered.66 Continual low-level
stresses or poor husbandry prac
tices enable the normal number of
spores in the environment to cause
Figure 43
disease in an immunocompromised
Acute aspergillosis in a young African grey parrot. Note the
bird. Initial lesions are most often Aspergillus growth on the lung. (P. S. Sakas, DVM)
found in the thoracic and abdomi
nal air sacs and in the large airways, especially the syrinx.66 Through hematoge
nous dissemination, the fungus moves into other organ systems. The extent of
fungal colonization depends upon the integrity of the hosts immune system 66The
progression of aspergillosis is slow and insidious, and clinical signs are usually
inapparent until fungal colonization is extensive.66
Clinical signs of aspergillosis resemble those of other chronic debilitating diseases
and are not diagnostic. The acute form has a rapid onset usually followed by sud
den death; however, birds that survive the initial onslaught can show anorexia,
dyspnea, polyuria, and polydipsia before death.65 In the chronic form, clinical
signs are variable and depend upon the location of the lesions and organ systems
involved. Signs frequently include dyspnea, lethargy, depression, and emacia
tion.65 Often, the first noticeable change is prolonged time for the recovery of nor
mal breathing after moderate exertion.65
Aspergillus has been reported as a cause of rhinitis and sinusitis in psittacines.66
There can be chronic purulent nasal discharge with the development of a rhinolith
or proliferative nasal granuloma.67 Secondary bacterial infections are common.
Lesions involving the upper respiratory tract (trachea, syrinx, bronchi) are fre
quently associated with changes in vocalizations (decrease in volume, change in
focal densities within the lung and/or air sacs.66 Changes may also be seen in other
affected organ systems.
The observation of typical lesions by endoscopy or exploratory surgery, followed
by biopsy and identification of the causative agent through cytologic and
histopathologic examination of the lesions, will provide a definitive diagnosis.65
Culture of the organism from the site of infection can also be accomplished with
these methods.
Serologic testing has shown great promise in the diagnosis of aspergillosis. The
Minnesota Raptor Center (St. Paul, MN) has long offered an Aspergillus serum
enzyme-linked immunosorbent assay procedure.68 There is good clinical correla
tion with positive results and active disease in some species of raptors and other
species of birds, however, false negatives can occur.68 This might be explained by
the fact that immunocompromised patients cannot mount an antibody response.68
The University of Miami (Division of Comparative Pathology/Avian and Wildlife
Laboratory) provides diagnostic testing that utilizes an aspergillosis panel, includ
ing Aspergillus antigen and antibody testing and protein electrophoresis.
Protein electrophoresis has demonstrated mild to moderate beta-globulin increases
in an approximated 30% of birds affected with mycotic disease, with more severe
changes seen in birds with more acute presenting disease.69 Gamma-globulin
increases may also occasionally be seen.69
Examination of avian Aspergillus titers had been inconclusive due to the low titers
generally seen in many normal birds and the failure of avian species to produce
significant levels of antibody.69 The development of an ELISA test for Aspergillus
antibody, however, has been helpful in the diagnosis of aspergillosis.70 It tests for
a group-specific antigen and thus detects reactivity to all Aspergillus species. The
only known cross-reactants are molds, including Penicillum.69
In poor antibody producing birds and before birds develop antibody, circulating
antigens can often be detected concurrent with clinical signs.69 Chronically
infected birds demonstrate low antibody titers but positive antigen titers.69 With
treatment, these birds become negative for antigen while producing high levels of
antibodies.69Through the use of paired samples, antibody and antigen titers can be
measured for response to treatment.69 Because a significant number of confirmed
aspergillosis cases have been found with weak antigen or antibody titers, results
Zoonoses
Birds are affectionate pets, and the contact between the pet bird and owner is often
intimate, allowing for the transmission of pathogenic organisms. Although the
incidence of zoonotic disease from pet birds is low, there must be an awareness of
the potential zoonoses.
Chlamydiosis (Psittacosis)
Chlamydiosis (ornithosis in nonpsittacine birds) is a common and important dis
ease in pet bird medicine. It is a natural disease of birds that may be transmitted to
humans. The zoonotic form is called psittacosis. The causative has been reclassi
fied from Chlamydia psittaci to Chlamydophila psittaci?1 It is a gram-negative
bacterium and obligate intracellular organism.73 The new discoveries that led to
the reclassification will result in further studies of Chlamydia sp. and
Chlamydophila sp. These studies will result in improved diagnostic tests and treat
ments and vaccine development.
Prior to importation restrictions, chlamydiosis was most common in recently
imported birds. With the decrease in the number of imported birds, there may be a
reduction in the frequency of the disease in large psittacines. Unfortunately, the dis
ease still exists in breeder flocks, and domestically bred young birds still present
with it. It is quite often diagnosed in budgerigars and cockatiels, among other
species. In these breeder flocks, the parent birds are often imported and the flocks
are openthat is, the breeders continuously add to their collections without nec
essarily quarantining the new birds or feeding medicated food for 45 or more days.
The chlamydial organisms are transmitted through secretions, droppings, and
feather material. During acute illness, they are shed extensively in the droppings.
Carrier birds may also shed the organism, though they do so periodically and show
no sign of the disease. The time between exposure and onset of illness is variable,
generally ranging from 3 days to several weeks. However, latent infections are
common in birds, and the active disease may not develop until years after expo
sure.72As with a number of the diseases already discussed, a bird may remain an
asymptomatic carrier until stressed.
The manifestations of the disease in birds are variable, ranging from asympto
matic to acute death. When clinical signs occur in birds, they include abnormal
droppings, weight loss (with the appetite appearing either normal or abnormal),
depression, heterophilia (normal values are given in Table 2 on pages 81-84),
splenomegaly, and air sacculitis. Conjunctivitis and upper respiratory tract signs can
be seen, especially in budgerigars and cockatiels; frequently, they are the only clin
ical signs displayed in these birds. Large psittacines usually show a loose stool and
polyuria. A characteristic sign in Amazon parrots and macaws is the presence of
lime-green urates (biliverdinuria) (see Plate 11 on page 341). Very young parrots
(hand-fed neonates), cockatiels, and many other bird species may also show abnor
mal droppings, often with yellowish urates. Because the color changes in the drop
pings are thought to be produced by liver inflammation, the appearance of the
droppings can be considered suggestive only of systemic or liver disease.
Antemortem diagnosis can be accomplished through a variety of methods, includ
ing the following:
Hematology. Although hematology can be an aid to diagnosis for chlamydio
sis, it cannot actually confirm a case. The blood picture obtained is that of
leukocytosis, monocytosis, anemia, and usually icterus.51
Stained smears o f exudate. Variable results have been obtained with cur
rently used stains.
Isolation and identification o f the organism in culture. The gold standard for
the definitive diagnosis of Chlamydophila psittaci in the avian patient had
been culture and isolation of the organism.72 For this method, pharyngeal,
fecal, or cloacal swabs are generally used. Although this is a good diagnostic
method for chlamydiosis, it may not be as reliable as some of the other meth
ods, since the organisms are intermittently shed, have an obligate intracellu
lar nature and are extremely labile. To have the best opportunity for
Chlamydophila psittaci culture and isolation in a live patient, serial fecal sam
ples or combined choanal/cloacal cultures should be collected for 3 to 5 con
secutive days and pooled in transport media supplied by the diagnostic
laboratory.72 Liver and spleen samples are preferred (from necropsied
patients) for isolation of the intracellular bacterium.72 A drawback is that it
takes up to 2 weeks for test results to be generated.74
Isolation tests (ELISA). These tests detect the presence of the Chlamydophila
psittaci organism in pharyngeal, fecal, or cloacal swabs or in samples of exu
date. As with the previous method, however, isolation tests may be unreliable
due to the intermittent shedding of the organisms. Further, treatment with
antibiotics will suppress shedding. Thus, birds that are not shedding but are
positive for the disease will be misdiagnosed. Isolation tests may be used in
the veterinary office as a quick screening method for Chlamydophila psittaci
infected birds that are shedding.51
Serology. Serological testing is highly effective for demonstrating the pres
ence of Chlamydophila psittaci antibodies. In addition to being used for
diagnostic purposes when illness is noted, serological testing is an excellent
means of screening new bird purchases, since it will detect not only birds
infected with Chlamydophila psittaci but also birds that have been exposed
tothe organism.
Three Chlamydophila serologic assays have been commonly used:
Complement fixation (CF) is used to detect anti-Chiamydophila IgG; latex
agglutination (LA) was used to detect both anti-Chlamydophila IgG and
IgM, but is no longer used because of difficulties producing consistent anti
gens; and elementary body agglutination (EBA) is used to detect antiChlamydophila IgM.74 The EBA can detect infected birds within 15 days of
infection and is generally positive by the time the bird is showing signs of ill
ness.75 In a typical immunoglobulin response to an antigen, IgM levels
increase quickly and then wane, while IgG levels increase later and persist.
Thus, recently infected birds are likely to be EBA positive initially and then,
about a week later, to be CF positive.74 Birds that are seronegative rarely
have clinical disease.74
It appears that as long as an infection persists, CF titers remain detectable.74
However, in chronic infections, EBA titers may fall to undetectable levels.74
When birds are treated, EBA titers will become negative. In many birds, CF
titers will also become negative; however, CF titers have been documented to
persist for many months in birds thought to be appropriately treated.74
Disadvantages to serological testing are that it will not detect carriers and
that there is a lag time in antibody production in acutely ill birds. Rarely, a
bird with chronic chlamydiosis may be EBA negative.75 The EBA works
very well for psittacine birds, but may have some limitations in other
species, particularly doves and pigeons.75 For these species complement fix
ation (CF) is recommended.75
DNA polymerase chain reaction (PCR) probes. This test is designed to detect
the specific nucleic acid sequence of the Chlamydophila psittaci organism in
blood samples or samples from a combination choanal/cloacal swab.74It is the
most sensitive of the tests available today for detecting chlamydiosis in cur
rently infected birds. It does not rely upon an antibody response and has the
potential of detecting infected birds before they are positive by serologic
methods.74The major disadvantage of PCR is its extreme sensitivity in detect
ing small quantities of contaminating and irrelevant target nucleic acid.76 It
does not differentiate between nucleic acid from viable or nonviable organ
isms, so that a positive result might indicate environmental exposure.76
Another disadvantage is that the PCR assay is inhibited by tetracyclines and
other antibiotics (as with other isolation tests).75
New diagnostic tests. Two new tests have been developed to detect ribosomal
RNA (rRNA) and/or ompA gene for the family Chlamydiaceae, the Taq Man
and multiplex tests.72 By detecting rRNA, which will reveal the presence of
replicating Chlamydophila psittaci organisms, this new technology will
determine if viable organisms are found in the patient.72 These tests will be
available to veterinarians in the future and show bright promise for advanced
technology in clinical veterinary situations.72
Owners need to be cautioned about the limits of specificity and accuracy associ
ated with whatever test is used. Current Chlamydophila psittaci diagnostic meth
ods are a source of frustration, since no single test or combination of tests will
absolutely determine if a bird is free of Chlamydophila psittaci. Serological test
ing provides an initial opportunity to screen for potentially positive birds, either as
part of a new purchase examination or as a means of detecting subclinical chroni
cally infected birds. Isolation techniques are the only currently available tech
niques for detecting a carrier, if the bird happens to be shedding the organism at the
time of sampling. Blood testing by DNA probe appears to be useful for the detec
tion of currently infected birds; however, negative results need to be interpreted
appropriately.77A combination of serology and DNA probe (oral/cloacal PCR) is
likely the most sensitive and specific means of detection in most species.74 Even
with it, the problem exists of determining how to address the seropositive, antigenand DNA-probe-negative bird.77
For all of these reasons, combining test results with history and physical findings
is always recommended before coming to a diagnostic conclusion. Other differ
ential diagnoses for a thin bird with abnormal droppings and a severe heterophilia
include aspergillosis and avian tuberculosis.
The treatment of chlamydiosis involves immediate placement on appropriate
antibiotics and, in critical cases, good nursing support. Doxycycline is currently
the drug of choice. Quinolones also may be helpful as an adjunct to therapy,78 but
current data on their use in the treatment of chlamydiosis are restricted to a few
species. The treatment for Chlamydophila psittaci should be administered for a
minimum of 45 days.
Doxycycline can be injected intramuscularly once every 5 to 7 days. As noted in
the formulary (Chapter 7), Vibravenos is not currently available in the United
States or Canada, but compounding pharmacy brands may be available.
Doxycycline can also be administered as an oral suspension once or twice daily, or
added to food at the rate of 1,000 mg/kg food (wet weight). For the latter method
of administration, a mixture of com, beans, cooked rice, and an oatmeal carrier has
been suggested.79 In addition, doxycycline-medicated formulated diets may be
available on a limited basis. Chlortetracycline-medicated formulated diets and
seed, which are more widely available, can also be used. Current sources of med
icated feed include Avi-Sci Inc. (St. Johns, MI (800) 942-3438), Pretty Bird
International, Inc. (Stacy, MN (800) 356-5020), Rolf C. Hagen (Tropican)
(Mansfield, MA (800) 225-2700), Roudybush (Sacramento, CA (800) 326-1726),
and Ziegler Brothers, Inc. (Gardners, PA (800) 841-6800).72 Unfortunately, birds
that are unfamiliar with a pelleted diet may not make the transition and will have
to be treated orally or with intramuscular injections.72
There are recommendations for medicating birds with doxycycline through the
drinking water and maintaining therapeutic blood levels.72,80 The advantages are
low cost, easy preparation, and good acceptance by the birds.80 The major disad
vantage is the possibility of toxicosis if water consumption increases (hence doxy
cycline consumption).80 Doxycycline toxicosis can cause acute hepatitis,
accompanied by increases in AST, LDH, and bile acids, with affected birds show
ing non-specific signs of illness, including, inactivity, ruffling, anorexia, weight
for 70% of the cases in which the source was known.81 Most human cases of
Chlamydia psittaci (Chlamydophila psittaci) are associated with birds.81
Salmonellosis
Salmonellosis is one of the most commonly reported zoonotic diseases, but it is
rarely contracted from pet birds. When it is seen in pet birds, it is mainly in pigeons
and African grey parrots, though rarer occurrences having been reported in
finches, macaws, and other species.
Salmonella infections are caused by an aerobic gram-negative rod bacterium, but
the severity varies depending upon the Salmonella serotype, the number of organ
isms, the host animal, and its immune status. Clinical signs in birds include diar
rhea, weight loss, arthritis, abscessation, and death, with the disease being most
severe in young birds. Pigeons may develop osteoarthritis of the wing, especially
on the elbow. Birds that survive an infection can become asymptomatic carriers
and shed organisms in their droppings. Salmonella can survive for extended peri
ods in organic matter, feces, and dirt. Transmission is through the ingestion of
contaminated food and water or through direct contact with aerosolized drop
pings and feather dust.
Diagnosis of salmonellosis in birds is made through the isolation of bacteria
from infected tissues or droppings. Due to the intermittent shedding of the bac
teria, multiple cultures must often be performed. Treatment is with the antibi
otics indicated by the culture. Therapy may take weeks, and, as noted earlier, a
carrier state may develop.
In humans, most cases of salmonellosis acquired from birds have been associated
with egg consumption. The most common symptoms of human salmonellosis are
gastrointestinal problems. Headaches, chills, abdominal pain, and nausea may pre
cede vomiting and diarrhea, which may be bloody. Generally, the very young and
elderly are affected. The incubation period varies from 6 to 72 hours, and any
organ or body tissue can be affected.
Tuberculosis
Mycobacterium tuberculosis causes most cases of tuberculosis in humans; in birds,
M. bovis and M . avium are primarily responsible for the disease, but birds are also
susceptible to M . tuberculosis.51 Birds have contracted tuberculosis from human
companions. The transmission could potentially occur when food is routinely
passed by mouth between the owner and the bird.
Avian tuberculosis is a chronic disseminated disease caused by the Mycobacterium
avium complex (MAC), a group of 20 distinct serotypes of bacteria.83 These
organisms infect a wide range of vertebrates, including avian species and humans.
In man, the infection is generally opportunistic in immunocompromised individu
als.83 Captive, free-range, and pet birds can be infected, as MAC is a commonly
occurring bacteria, so it is not unexpected that there will be a general incidence in
these populations.83 Anecdotal reports suggest that environmental factors, stress,
and genetics all play a role in the development of the disease.83
A wide range of birds have been described as having the disease, with gray
cheeked parakeets noted for commonly having the condition. In the authors prac
tice, the disease has been seen in many species, from finches to large parrots.
Tuberculosis has become established in bird collections in some zoos, where it has
caused serious losses of valuable specimens.
The onset of the disease is slow in birds, and the course is prolonged. The
mycobacteria are spread by aerosols and by direct contact with body excretions.
Infection is usually through the alimentary tract through the chronic ingestion of
contaminated food and water. Since birds lack lymph nodes, the disease becomes
widespread. A normal immune response may wall off some of the organisms, caus
ing them to die or become inactive. The latter, however, can flare up years later
when the bird is subjected to stress. Weight loss and chronic wasting are consistent
signs of the disease. Other signs include diarrhea, lethargy, weakness, poor feath
ering, polyphagia, dyspnea, nodular skin lesions, arthritis, bone pain (lameness),
and abdominal enlargement82 (Figure 45).
Antemortem diagnosis is difficult and unreliable. Hematologic changes include a
marked elevation in the leukocyte count (due to heterophilia) and a low hematocrit
(see Table 2 on pages 81-84). Radiographic evidence is usually minimal but may
include osteomyelitis, granulomas in affected tissues, or proventricular and intestinal
Influenza A
Many strains of Orthomyxovirus cause influenza in humans, but only influenza
A has been associated with animals other than humans. Because many species of
birds have been naturally infected with a wide variety of influenza A strains,
there is a large reservoir of infection and a great potential for avian reservoirs to
spread the disease worldwide. Indeed, evidence suggests that birds may serve as
a reservoir for influenza strains that may cause influenza pandemics, such as the
1997 outbreak in poultry in Hong Kong. Most avian isolates are from asympto
matic birds.
There is considerable variability in the pathogenicity of the avian influenza virus.
Most infections produce no or few clinical signs; however, virulent strains have
caused devastating losses in wild birds and poultry. The virus has been isolated
from several passerine and psittacine species, although the disease in pet birds is
rare. Diagnosis in birds is made through the isolation of the virus from tracheal or
fecal samples.
Direct transmission from humans to animals is rare but can occur. In humans, the
disease leads to conjunctivitis and upper respiratory disease.
Allergies
Although not technically zoonoses, allergic problems due to pet birds are quite fre
quent and merit discussion. Clinical signs in people with allergies to birds include
malaise, chills, fever, shortness of breath, myalgia, and coughing. Hypersensitivity
pneumonitis and interstitial pneumonia have been associated with exposure to
feathers, aerosolized droppings, and other agents. In addition, inhaled avian source
antigens can cause severe disease in hypersensitive individuals. In such people,
exposures to avian antigens can severely compromise health and quality of life. It
is believed that the allergic response is due to bacterial endotoxins in fecal extracts.
Hypersensitivity Pneumonitis
(Pigeon Breeders Lung, Bird Keepers Lung)
Hypersensitivity pneumonitis, or extrinsic allergic alveolitis (EAA), is a condition
that is being seen more often in people who are keeping birds. There are three
forms: acute, subacute, and chronic.
Prevention
The following are four basic steps that bird owners can take to minimize the risk
of developing hypersensitivity pneumonitis.
1. Limit exposure to avian antigens by keeping most rooms free of avian anti
gens. Quite often, the people that suffer from this condition have birds in
almost every room of their homes, so they are constantly inhaling the anti
genic material. Instead, all birds should be kept in a bird room.
2. Clean the cages regularly to prevent the accumulation of feathers and feather
dust and the drying of fecal matter with resultant aerosolization.
3. If several birds are kept, purchase an air cleaner to remove the airborne anti
gens. Not only will the air cleaner minimize the risk to the bird owner, but it
will also remove these irritants from the birds themselves.
4. If hypersensitive to allergens, do not clean the cages; rather, have another
family member do so. If this is not possible, then a mask of some type should
be worn to limit antigen exposure.
Bird owners should be advised to seek medical attention if they experience respi
ratory irregularities, especially nonresolving cough conditions or breathlessness
upon exertion or even mild exercise. Smokers have a lower incidence of hyper
sensitivity pneumonitis than nonsmokers do in comparable bird-owning popula
tions, since tobacco smoke reduces the exposure of antigens to alveoli by
contributing to airway obstruction and also impairs the function of the pulmonary
macrophages lining the alveoli.85 Thus, problems due to smoking may mask signs
of the disease and co-exist with it.
Dermatologic Conditions
The following sections, Table 7 on page 190, and Table 11 on page 259 cover
some of the common dermatologic conditions seen in pet birds.
Lipomatosis/Lipomas
Lipomatosis is a condition caused
by the infiltration of fat and fatty
tumors (lipomas) into the skin,
abdominal cavity, and liver
(Figure 46). The condition can
develop due to a hereditary predis
position, high-fat diets, hypothy
roidism, or a combination of these
factors. Dietary management is
recommended for the treatment of
the condition.18
Figure 46
Large lipoma on the chest of a budgerigar. (P. S. Sakas, DVM)
Self-Mutilation
Among the most challenging cases for the avian practitioner is the management of
the chronic skin mutilator (Figure 47). Little is known about the exact etiology of
this condition.87 Stressful living conditions are thought to predispose a bird to selfmutilation.63 Secondary bacterial infections often follow. In lovebirds, infection
with Agapornis pox (lovebird pox) virus has been implicated.63 Outbreaks in
Figure 47
Self-mutilation in a Fischers lovebird. Biopsy negative.
Other common locations include rump and axilla.
(L .M. Bauck, DVM)
in place until all the wounds have completely healed and there is no remaining evi
dence of scabbing, since birds can be drawn to a scab and through picking at it
resume the self-mutilation cycle.
Some psittacines will show a decrease in self-mutilation in response to gluco
corticoids or antihistamines, suggesting an allergic or autoimmune basis to some
instances.87 Other treatments include metronidazole, topical and injectable vita
min A and E, aloe vera gel, removal of feathers from the periphery of the lesion,
and improved nutrition.63
Surgical debridement and primary wound closure may be indicated if wounds do
not heal in 5 to 6 weeks.63 Birds with severe lesions may develop scarring.
Vaccine Reactions
Vaccines are or have been available for use against canary and psittacine pox as
well as Pachecos disease and avian polyomavirus. Occasionally, a bird will
develop a granulomatous reaction at the site of a previous vaccination. Some
birds (cockatoos, in particular) seem to be sensitive to adjuvants and may
develop a firm nodule or nodules 4 to 16 weeks after vaccination.18A dry ulcer
or crust may appear, and a severe reaction may produce an open wound.
Manufacturers discourage the use of vaccinations for Pachecos disease in cock
atoos and also recommend that in all species these vaccines be administered subcutaneously instead of intramuscularly.
When reactions to vaccinations occur, conservative treatment is recommended.
The use of steroids for more than a few days may be unwise, as birds are gener
ally sensitive to the immunosuppressant effects of steroids. In addition,
aspergillosis may develop with relatively little encouragement in some birds
under the influence of stress and/or steroids.
Abscesses/Granulomas/Tuberculosis Lesions
External abscesses and granulomas are not particularly common in pet birds.
Occasionally, a sinusitis will result in a granuloma in the infraorbital position. In
such cases, surgical treatment is usually necessary. Medical therapy for abscesses
or granulomas should be augmented by a review of the diet to rule out predispos-
ing factors, such as vitamin A deficiency. Avian tuberculosis lesions, which have
been seen on the head, neck, and flank of the Amazon parrot as well as some other
species, may require special treatment considerations.89
Xanthomatosis
A xanthoma (yellow mass) is an inflammatory swelling resulting from the accu
mulation of lipid-laden macrophages, giant cells, free cholesterol, and variable
degrees of fibrosis.63 The exact etiology is unknown, but a high lipid diet, a disor
der of lipid metabolism, ingestion of toxic fat-soluble substances, trauma, and
underlying pathology such as hernias or lipomas have been implicated 63 Birds
with this condition often have elevated serum cholesterol.63
Xanthomatosis may be manifested as single or multiple discrete nodules or as a
diffuse thickening of the skin anywhere on the body.63 The skin appears feather
less, yellow-brown, friable, vascular, and sometimes quilted in appearance.63
Intense pruritis occurs with self-mutilation in some cases.63 Xanthomatosis of the
wing tip may cause the wing to droop and become traumatized.63
Fine needle aspirates and cytology will reveal highly vacuolated macrophages,
multinucleated giant cells, and cholesterol crystals.63A biopsy is recommended for
definitive diagnosis of this condition.
Treatment for xanthomatosis consists of surgical excision whenever possible.90
Although this treatment may result in large open wounds, prognosis is poor if
all the abnormal skin is not removed. Quite often partial wing amputation is
necessary.
Feather Abnormalities
The following sections and Table 8 cover some of the common feather abnormal
ities seen in pet birds.
Table 8
Common Differential Diagnoses for Complaints
That May Feature Feather Loss
Problem
Species Commonly
Affected
Feather picking/chewing
Xanthomatosis
Budgerigars, cockatiels
Giardiasis
Cockatiels, budgerigars
Knemildokoptic mange
Budgerigars, canaries,
European goldfinches,
green-winged macaws
Baldness (alopecia)
Budgerigars
Psittacine beak
and feather disease
Cockatoos, other
psittacines occasionally
Feather Cysts
Feather cysts can develop in any bird but most frequently are reported in
canaries, particularly in large breeds, such as the Norwich or Gloucester. In
canaries, feather cyst development may have a hereditary basis. Other possible
etiologies include nutritional deficiencies, trauma to the feather shaft and/or fol
licle, or occlusion of the feather follicle opening from an infectious episode.63
The possibility of a vertically transmitted viral infection causing folliculitis with
secondary cyst formation has been suggested.63 Birds with feather follicle cysts
should not be used for breeding.63 The cysts are often large (1-2 cm), multiple,
dry, and irregular (Figure 48). Other feathers in affected tracts frequently are
clubbed or malformed.18 Usually, it is the pectoral and dorsal tracts that are
affected although large feather cysts can develop on the wings and tail. Feather
cysts have a tendency to recur or redevelop, especially at the time of molting. In
cockatiels and macaws, feather cysts typically occur as large single masses on
Alopecia
Feather loss on the back of the head is seen most frequently in the cockatiel,
canary, and zebra finch. In the cockatiel, certain color patterns have been associ-
ated with reduced feathering behind the crest. In the canary, baldness is more com
mon in males than females and may be related to a hereditary predisposition or
have a hormonal basis.18To date, however, canary baldness is not well understood
and its treatment has not been well documented. As a result, the selection of a
course of treatment is basically trial and error.18 Occasionally, the condition will
respond to thyroid supplementation, but it is important to watch for signs of over
dosage, such as hyperexcitability. Testosterone supplementation has also been
found to be helpful in some cases.18 In zebra finches, either sex may show feather
loss on the head and neck, resulting from picking by a more dominant member of
the group. If picking by another bird is suspected, the practitioner should check the
top of the birds head for small black spots, which are the remnants of blood feath
ers that were picked off. Treatment consists of separating out the less dominant
individuals from the group.
French Molt
French molt is a condition seen in budgerigars that causes varying degrees of
feather maturation problems. It may result from a polyomavirus infection or from
a budgerigar form of psittacine beak and feather disease.18Affected birds lose their
primary wing feathers or lose all feathers except their down and pinfeathers. As a
result of their poor feathering, they are unable to fly and are termed runners or
creepers. There is no treatment for this condition.
Feather Picking/Chewing
Feather picking and chewing are two of the
primary dermatological complaints seen in
avian practice (Figure 50). Although some
birds engaging in self-mutilation have (or
had) an underlying physical disorder, many
times birds will continue to mutilate feath
ers without any evidence of pathology.
Most birds engaging in self-mutilation
show a typical pattern of feather damage or
picking that progresses from the chest
feathers to those of the rest of the trunk, the
legs, and the wings. Not all birds follow
this pattern, however. Some confine their
chewing to the wing and tail primaries;
others chew all feathers but those. Cage
mates may also pluck each other, extending
damage up onto the head.
Figure 50
Feather picking in a confined and socially iso
lated severe macaw. (L. M. Bauck, DVM)
Nutrition can also play a role. Basic seed and table food diets can create multiple
nutritional deficiencies that can be manifested as abnormal skin and feather
development.93 This can result in plucking behavior or medical problems that
develop later in life.93 The dyes, preservatives, and pesticides that are contained
in seeds and most pelleted diets may also be detrimental in birds, especially
African grey parrots, eclectus parrots, and some cockatoos,93 possibly leading to
skin and feather abnormalities.
Factors that contribute to stress should also be considered, as they may exacerbate
or lead to feather mutilation. For example, parrots in the wild expend considerable
time and energy searching for food and water as well as husking, shelling, and
destroying seedpods, fruits, and nuts. These activities, as well as many normal
social interactions with others in their species, usually are absent in captivity, pos
sibly contributing to stress. In birds socialized with humans, other causes of stress
include separation anxiety and frustration about being left behind and confined to
their cage when their owners depart for varying lengths of time. For birds that nat
urally flock, being kept alone in a cage can cause stress. The inability of captive
birds to engage in normal reproductive behavior can also be problematic. All of
these factors may contribute to stress and exacerbate or lead to feather mutilation.
Various medical conditions may be responsible for feather picking and should be
ruled out as potential causes. These include ectoparasites (generally not a com
mon cause), endoparasites (including Giardia, especially in cockatiels, and occa
sionally tapeworms or roundworms), hepatic disease (pruritus may be associated
with liver dysfunction), coelomic cavity granulomas or masses, neoplasia (with
localized plucking related to an underlying mass), folliculitis or dermatitis (pri
mary or secondary, and may involve bacteria, virus, or fungus), allergies (difficult
to determine in birds), endocrine abnormalities (such as hypothyroidism), and
heavy metal toxicoses (particularly zinc toxicosis).93
Treatment of feather mutilation in birds in which no underlying pathology can be
found involves providing occupational therapy to the bird to displace the destruc
tive behavior away from the feathers (see the following paragraph), attempting to
increase social interactions, increasing exercise, ensuring that the bird gets ade
quate sleep, and, in some cases, considering a breeding situation for the bird. In a
word, any stressful factors that can be identified should be modified.
Trauma
Fractures
The most common fracture of the pet bird, particularly in smaller species, is the
fractured tibiotarsus. Fractured legs can usually be recognized by their non-
weight-bearing appearance. Often, the leg will be held up and out. In the
budgerigar, careful evaluation should be performed to distinguish a subsacral
mass (a renal or gonadal tumor) from a traumatic fracture, as both result in nonweight-bearing limbs. Wing fractures can be recognized by the drooping appear
ance of the wing.
Because of the lack of muscle cover over much of the limbs of pet birds, care
must be taken when handling a bird with a fracture, and steps must be taken
immediately to prevent the fracture from becoming comminuted. If circum
stances permit, isoflurane anesthesia should be used to facilitate examination and
immobilization of the fracture.
External fixation is commonly used in the management of distal fractures.
However, fractures of the femur or humerus in larger birds may benefit from inter
nal fixation. A general rule to follow for leg fractures in pet birds is, if it is above
the knee, pin it; if it is below the knee, splint it.
Popular pinning techniques include a modified Kirschner-Ehmer technique (pins
are held externally with acrylics, resins, or thermal casting tape); an intramedullary
polypropylene shuttle pin technique (using bone cement and/or cerclage); or a com
bination of these methods." Figure 52 shows some common external fixation (band
aging) techniques used in small avian species. The splinting of fractures in pet birds can
Figure 52
Some common bandaging techniques used to manage limb injuries in birds. (A and B) For fractures
involving the humerus, the carpus is anchored to the upper chest and back; wing primaries are
secured to the tail (distally to the vent). (C) Figure-eight bandage for fractures or injuries to the radius,
ulna, carpus, or manus. (D) Altman splint or "sandwich cast. Fractures of the proximal tibia or femur
often are better managed with other techniques. (L. M. Bauck, DVM)
be facilitated by the use of moldable plastic or padded moldable metal splints, such as
SAM splints, which can be trimmed to the size required and shaped accordingly.
Figure 53
Blue and gold macaw with broken blood feathers and muti
lated quills. (L. M.. Bauck, DVM)
Generally, this injury will occur when an emerging wing primary is bumped or
damaged and the bird exacerbates the damage by chewing or pulling on it. The
injury is frequently seen in the African grey parrot and the cockatiel. As noted in
Chapter 4, some authorities believe that wing clipping may predispose birds to this
problem, since the emerging pinfeathers no longer have the protection of other
full-length feathers.
If a bird is bleeding and the source of the hemorrhage is a broken blood feather, the
shaft of the feather should be grasped firmly with fingers or tweezers and pulled
out. Merely applying some form of hemostasis at the broken end of the feather and
not removing the entire feather is not recommended, since the clot may loosen and
the bleeding resume. Clotting powder and steady pressure should then be applied
to the feather follicle with a cotton-tipped applicator to control the bleeding. It is
important to avoid frequent dabbing or rubbing, which may interfere with clot for
mation. If there is not a stump to grasp, the blood feather base should be cleaned
slightly and surgical glue applied, as it will sometimes seal the hollow shaft.
Once the bleeding has been controlled, the bird should be placed in a covered cage
or darkened room and periodically checked for bleeding. As noted in Chapter 3,
agents that can be used to stop bleeding include styptic powder, a styptic pencil,
silver nitrate sticks, and commercial products such as Quickstop and Monsels
powder (ferric subsulfate). Cornstarch, baking soda, or flour can be used if the
aforementioned agents are not available. When the bird is sent home, a follow-up
visit should be scheduled.
Split Sternum
A split sternum is an injury that is common in African grey parrots with clipped
wings, which frequently fall heavily after attempting flight, crushing or breaking
the skin over the sternum (Figure 55). Although hemorrhage often occurs with this
Subcutaneous Emphysema
Subcutaneous emphysema, or the collection of large amounts of air under the skin,
is caused by the traumatic rupture of one or more air sacs. The condition can occur
as a result of a crash or fall, as a result of a cat injury, or during surgery. It fre
quently occurs in neonatal birds, though the reason is not known. With subcuta
neous emphysema, the skin balloons away from the underlying subcutis, and
occasionally severe distortions will occur.
Treatment usually involves aspiration, sometimes several times a day, of the air
collecting under the skin. In cases in which the air continues to collect under the
skin, stents or drains have been recommended.101 Some mild cases resolve with
out treatment.
Beak Injuries
Most serious beak injuries are caused by intraspecies aggression, usually related to
incompatible pairs and reproductive behavior. Cockatoo males may attack hens,
either inside or outside the nest box, and generally direct their attacks at the beak.
Eclectus parrot hens may act aggressively toward the males, although they rarely
cause serious injuries.
Treating a serious beak injury usually involves salvaging the beak that is still
viable, cleaning and debriding jagged edges or holes, and filling defects that are
small enough to benefit from remodeling.102Any beak injuries involving shear
ing defects close to the base of the beak usually will result in permanent beak
loss. Prosthetic devices may be difficult to keep in place. Because even minor
beak injuries can be very painful, the eating behavior of birds with injured beaks
should be monitored closely. Systemic antibiotics are recommended for all pen
etrating beak injuries.
Respiratory Diseases
Rule-outs for primary respiratory disease include bacterial or fungal air sacculi
tis/pneumonia, Chlamydiosis, hemorrhage, respiratory tract toxins (polytetrafluoroethylene toxicosis), sarcocystosis, and allergic pneumonitis.103 Other disease
states that may result in dyspnea include cardiac disease; abdominal disease,
including ascites, ovarian enlargement, and reproductive disorders; and neopla
sia.103 Rule-outs for tracheal obstruction include seed hull/food aspiration (espe
cially in cockatiels); Aspergillus granulomas, secondary to squamous metaplasia
from vitamin A deficiency; oral papillomatosis; and thyroid disease.103
Because of the large number of systemic illnesses that can affect the respiratory
tract, either primarily or secondarily, careful evaluation is often required to diag
nose these serious disorders. Localized upper respiratory complaints can also pose
difficulties, as owners may become frustrated with the tendency for relapse, and
repeated courses of antibiotics are often undesirable. The following sections and
Table 9 cover some of the common respiratory diseases seen in pet birds.
Table 9
Common Differential Diagnoses of Complaints
That May Feature Respiratory Signs
P roblem
S p e c ies A ffe c te d
K n o w n A g e nts
T ypical S igns
Upper respiratory
infection
Various
Klebsiella,
Pseudomonas,
Mycoplasma,
viruses, Chlamydophila
Bordetella bacterial
infection
Cockatiels
Bordetella
Rhinitis, "lockjaw
Pox
Canaries, blue-fronted
Amazon parrots, lovebirds
Pox virus
Pneumonia,
air sacculitis
Various
Bacteria, fungi,
Chlamydophila
Fungal
tracheitis/syringitis
Aspergillus,
Mucor
Foreign body
Various
Nuts, seeds
Stertor, dyspnea
Goiter
Budgerigars
Thyroid enlargement
Stertor
Papillomatosis
Papillomatous
growth near glottis
Wheeze, dyspnea
Chlamydiosis
Various
Chlamydophila
Canaries, finches
Stemostoma
Abdominal
enlargements
Various
Neoplasms, ascites
Dyspnea
Sarcocystosis
Cockatoos, birds in
outdoor aviaries
Sarcocystis
Chronic obstructive
pulmonary disease-like
syndrome
Macaws
Allergic component
Airborne toxins
Various
PTFE, others
Treatment is most effective if started veiy early in the disease process. However,
treatment for this disease has been generally unrewarding.109Not only does the use
of antibiotics alone seem to be insufficient for eliminating the disease, but antibi
otic therapy may also result in subclinical carrier birds.18 In cockatiel aviaries,
treatment has included the use of antibiotics, the attempted detection of carriers,
the elimination of positive birds, and disinfection of the aviary.109 Treatment is
often complicated by the presence of secondary infections caused by gram-negative bacteria and/or yeast.108
Temporomandibulitis caused by an Enterococcus species carries a better progno
sis than one caused by Bordetella, since Enterococcus infections respond better to
antibiotic therapy.107 Intensive nursing care, including gavage tubing, if possible,
may result in survival of some mildly affected young cockatiels. If the jaw is
locked completely shut, a percutaneous indwelling crop tube may be tried.
Mycoplasmosis
Chronic upper respiratory tract infections caused by Mycoplasma are common in
budgerigars and may be enzootic in many cockatiel flocks.110A serous nasal dis
charge is classically seen, as are sinusitis, swollen eyes, and other upper respira
tory signs. These signs, however, resemble signs of chlamydiosis. Mycoplasma is
difficult to culture, as the pathogens grow slowly (taking 2 to 4 weeks) and the cul
ture may become overgrown with contaminants or more rapidly growing com
mensal organisms.110 Doxycycline is the drug of choice,110 but enrofloxacin has
also been shown to be effective.111
Figure 57
Air sacculitis in an Amazon parrot. The air sac walls are
thickened and opaque, and the air sacs are filled with
caseated purulent material. Due to the poor blood supply in
air sacs, air sacculitis can be difficult to treat without nebu
lization therapy. (P. S. Sakas, DVM)
Ascites/Hepatomegaly
Because of impingement on the respiratory tract, disorders causing chronic
hepatomegaly or ascites often feature respiratory signs as a principal complaint.
Hemochromatosis, which affects mainly mynahs and toucans and often results in
their presentation for dyspnea, is an example of this type of problem. Liver pathol
ogy in Amazon parrots, including fatty change, cirrhosis, and bile duct carcinoma,
can result in similar signs. Likewise, in budgerigars, fluid in the abdomen, which
is most likely associated with a gonadal or renal neoplasm, can cause severe dys
pnea. Reproductive disorders in cockatiels can lead to abdominal distension and
ascites with accompanying respiratory signs. Cardiovascular disease in many
species of birds can lead to the development of ascites.
Gastrointestinal Conditions
The most common causes of gastrointestinal disease in adult psittacines are dietary
disturbances, gram-negative bacteria, Chlamydophila psittaci, yeast, foreign body
ingestion, megabacteria, heavy metal toxicosis (lead or zinc), and proventricular
dilatation disease.117 Other conditions to consider include hepatic lipidosis, intes
tinal parasites, viral infections, Mycobacteria, and Clostridium}11
Table 10
Common Differential Diagnoses for
Vomiting and Regurgitation in the Pet Bird
S p ec ies
A ffe c te d
K no w n
A g e n ts
Candidiasis
Cockatiels,
budgerigars
Candida
Trichomoniasis
Budgerigars,
cockatiels, finches
Trichomonas
Proventricular
dilatation disease
Macaws, others
Virus suspected
Bacterial gastro
intestinal tract infection
Various
Gram-negative
bacteria
P roblem
T y p ic a l S ig ns
Foreign body
Various
Various
Vomiting
Abdominal mass
Budgerigars, others
Renal or gonadal
neoplasm
Proventricular
adenocarcinoma
Grey-cheeked
parakeets, others
Neoplasm
Toxicoses
Various
Pesticides, lead,
zinc, medications,
oxidized (i.e., rancid)
baby formula
Behavioral
Budgerigar
Reproductive behavior
leading to courtship or
bonding
Overfeeding
Weaning
Possible pathogenic causes of vomiting in pet birds include: bacterial, fungal, viral,
and parasitic infections of the gastrointestinal tract; proventricular dilatation dis
ease; proventricular or abdominal neoplasia, which can interfere with the passage
of material through the gastrointestinal tract, causing vomiting; certain toxicoses
(lead, zinc, insecticides), which can produce vomiting due to gastrointestinal irrita
tion; metabolic disease (hepatic, viral, pancreatic); and foreign body ingestion.
Several commonly used medications are another possible cause of gastrointestinal
irritation. For example, trimethoprim-sulfamethoxazole and trimethoprim-sulfadiazine combinations are not well tolerated by macaws and many neonatal birds.118
Ketoconazole and related drugs can cause vomiting, as can butorphanol, xylazine,
and doxycycline oral suspensions.
Abnormal Droppings
As noted in Chapter 3, clients should always be instructed to bring 24 hours worth
of droppings, on the cage papers, with them when they come for any visit. It is not
unusual for bird owners to make mistakes when evaluating droppings. Many con
fuse polyuria with diarrhea, and few are completely sure about the normal appear
ance of urates and stool. Owners frequently look at a dropping with bright green
or yellow urates and report that the droppings are okay or that the bird has
green diarrhea. In addition to correcting owners misconceptions, it is vital to
train technicians and other nursing personnel to carefully recognize, describe, and
save abnormal droppings.
Table 11 can serve as an aid in determining the condition that may be responsible
for changes seen in pet bird droppings.
Table 11
Guide to the Evaluation of Abnormal Droppings
D ropping
D escr iptio n
C ause o f C hang e
P o ssib le C o n d it io n s
F ec al P o r t io n
Semi-formed/loose
Color changes
Table 11 (continued)
D r o p p ing
D e sc r iptio n
C a u se o f C hang e
P o ssib le C o n d itio n s
Brown droppingspellet eater (will also be increased
urine production)
Various colored droppingsrelated to color of food
eaten:
Colored pellets cause changes (e.g., fecal portion
red if bird favors red pellets)
Table food causes changes (e.g., carrots can
cause orange-colored droppings)
Malabsorption/maldigestion
Maldigestion/malabsorption
Grayish coating
Mucus secondary to
gastrointestinal irritation
Voluminous droppings
Gastric malfunction,
gastrointestinal hypermotility
Blood in feces
Bleeding in oviduct
Superficial wounds
Polyuria
Blood in urine
Hemoglobinuria
Hemolysis
Color changes
Dietary
Biliverdinuria
U r in e /U ra tes
Some examples of normal and abnormal droppings are provided in the color plates
on pages 333-342.
from pale brown to gray to white (see Plate 8 on page 339). The stools have also
been described as having a popcorn-like appearance, due to their color and size.
The etiology of pancreatic exocrine insufficiency is uncertain, but treatment is
accomplished through dietary supplementation with pancreatic enzymes applied
directly on the food (Viokase, Pancreazyme, Prozyme). A small amount should be
applied initially, since some birds may not savor the taste. The amount should then
be gradually increased until the droppings return to a more normal size and color,
indicating adequate absorption of the food. Therapy may be lifelong.
severely affected birds, Gram staining of the droppings may reveal the organism.
Hematology reflects poor physical condition with anemia and low total pro
tein.120 Because they are facultative organisms, megabacteria can be difficult to
isolate on culture.119
Radiographs may reveal proventricular dilatation as well as an hourglass-like con
striction between the proventriculus and ventriculus.121 Thickening of the proven
tricular wall can also be seen with contrast studies.
Necropsy findings will indicate proventriculitis and proventricular dilatation. The
proventricular wall may be thickened with small hemorrhages, and a thick mucus
layer may cover the mucosa, particularly in the lower part of the proventriculus.123
The organism will be apparent in scrapings taken from the proventricular mucosa.
The koilin layer of the ventriculus may be loosened, becoming brown in color and
having a rough surface.120 In birds with more excessive bleeding, the intestinal
loops may contain black ingesta.120
Elimination of the disease can be difficult, as no effective treatment is known.
Megabacteria have been shown to be resistant to tested antibiotics. In addition,
control of the disease has not been adequately described. Treatment protocols that
show some promise attempt to lower the pH of the proventriculus (often with
Lactobacillus) to reverse the effects of the disease and make the environment less
habitable for the megabacteria. Acidification of the drinking water with hydrochlo
ric acid may help in some cases of megabacteriosis, as well as in cases of enteritis
that are not responsive to traditional therapy.123 For this treatment, a 1 mol/1 solu
tion of HC1 is mixed at a rate of 30 ml/pint of drinking water.124Acidifying the GI
tract with apple cider vinegar, white vinegar, or grapefruit juice has also been sug
gested.123 The pH of the water should not fall below 2.5 and treatment should be
continued for several weeks.120 Chlorhexidine (Nolvasan) in the drinking water
has been suggested as a treatment, but it has not been shown to be effective.
Fungicides have also been tried and there have been reports that amphotericin B
has been effective in treatment.120,123 Oral amphotericin B at 100 mg/kg PO SID
for 10 days exhibits the highest rate of success.119 It is not absorbed systemically
from the GI tract after oral administration, so higher doses can be given in contrast
to the IV dose.119 Amphotericin B can be difficult to obtain in the oral formula
tions, but it can be made at certain compounding pharmacies.
All clinically ill birds should be treated, however, there is a debate whether nonclinical birds displaying megabacteria in their droppings should be treated.119
Factors in making this decision include: the difficulty in treating the bird; the expo
sure to other birds; the ability of the owner to recognize signs of disease if they
develop; and owner compliance.119
Megabacteriosis is a controversial condition, to say the least. Although there is
agreement presently as to its fungal nature, questions still exist as to whether
megabacteria are normal flora or are indicative of disease, and the manner of treat
ment that is most effective. More research is needed to gain a better understanding
of the condition.
Liver Conditions
Hepatic disease is a common finding in pet birds. The liver plays a role in numer
ous metabolic processes and its function is tied to several body systems including
the digestive, reproductive, hemopoetic, and endocrine.125 Liver disease is multi
faceted and usually involves numerous different pathologic processes.125
Commonly reported causes include: infectious agents (bacteria, fungi, viruses,
parasites); metabolic or nutritional anomalies (hepatic lipidosis, visceral gout, iron
storage disease); inflammatory diseases (chronic active hepatitis, hepatic fibro
sis); neoplasia; toxin exposure; and amyloidosis.126
An accurate history should be helpful in the evaluation of avian liver disease.
Information should be obtained as to the diet of the bird, exposure to known tox
ins, source of the bird, exposure to other birds, egg laying history (if applicable),
and other pertinent information.125A high-fat diet can lead to hepatic lipidosis and
vitamin A oversupplementation can result in liver toxicosis.125 Active egg laying
causes estrogen-stimulated lipogenesis, often slight hepatomegaly, elevated
plasma proteins and cholesterolwhich should all return to normal once the ovary
is quiescent.125 Mycotoxin exposure from moldy food is commonly implicated as
a cause of vacuolar fibrosing hepatopathy but the avian liver is potentially sensi
tive to any number of toxins.125
The clinical signs of liver disease in birds are non-specific and can range from a
fluffed, lethargic bird to sudden death.126Affected birds may exhibit weight loss or
The treatment of avian liver disease should focus on decreasing clinical signs
(weight loss, anorexia, bleeding) while addressing the hepatic pathologic changes
(inflammation, fibrosis, neoplasia).125 Supportive care should include heat,
humidity, fluid therapy, readily digestible foods, and appropriate antibiotics.
Lactulose has been described as aiding treatment of birds with hepatic
encephalopathy.125 Colchicine may help to decrease collagen formation and has
been used successfully in some cases of hepatic fibrosis.125 Severely hypoproteinemic birds may benefit from Hetastarch or Oxyglobin treatment.125Birds with
coagulopathies and concurrent liver disease may be given parenteral vitamin K
until bleeding is controlled.125 Obese birds with hepatic lipidosis may respond to
dietary changes and increased exercise.125 Evaluation of the clinical signs, phys
ical re-evaluation, and periodic monitoring of the laboratory abnormalities will
help gauge the success of treatment.125
Reproductive Conditions
Avian reproductive conditions are a common and often difficult to manage
problem in companion avian practice.127 The most common hormonally
induced syndromes include chronic egg laying, cloacal prolapse, cystic ovaries,
oviductal disease, reproductive related peritonitis, pyometra, salpingitis, metri
tis, and undesirable hormone-related behaviors, such as aggression, regurgita
tion, and masturbation.127
Management of these conditions include controlling stimuli that promote hormone
production (e.g., changing the photoperiod), removing nesting sites, and separat
ing affected birds from perceived or actual mates.127 Treatment options include
hormonal control with drugs such as medroxyprogesterone (Depo-Provera), chori
onic gonadotropin (Pregnyl), and leuprolide acetate (Lupron). Medroxyproges
terone is often effective but may cause serious side effects, such as obesity,
lethargy, hepatic lipidosis, diabetes mellitus, hepatic cirrhosis, and death.127
Chorionic gonadotropin has been demonstrated to be a safer alternative with sig
nificantly less side effects; however, it has not been consistently effective in man
aging these disorders and patients may become refractory to treatment.127
Leuprolide acetate has been considered cost prohibitive, is not readily available,
and has therefore not been used extensively in pet birds until recently.127 Results
with the use of leuprolide acetate in the management of avian reproductive condi
tions have been encouraging.
Figure 58
Egg-bound cockatiel with multiple eggs in the
oviduct. (T. J. Lafeber, DVM)
Egg Binding
Egg binding is a condition in which a hen is unable to deliver an egg with normal
effort in a reasonable amount of time.130 Dystocia involves the mechanical
obstruction of oviposition (egg laying). There appears to be a species predilection
for egg binding, with frequent occurrences seen in cockatiels, budgerigars, and
lovebirds. However, other psittacines and occasionally canaries and finches have
also presented with this condition.130 Egg binding should be considered an emer
gency situation, as often the bird will be in shock, respiratory distress, or circula
tory collapse. Causes of egg binding may include oviductal muscle dysfunction,
secondary to excessive egg laying, calcium metabolic disease, vitamin E and sele
nium deficiencies, malnutrition, obesity, inadequate exercise and muscle strength,
malformed eggs, mechanical tears or damage to the oviduct, oviductal infections,
systemic disease processes, genetic predisposition, and environmental stressors.131
Sometimes, the problem will manifest with the first egg produced, especially in
birds fed an inadequate diet.
Signs of egg binding or dystocia will vary according to the severity of the condi
tion, size of the bird affected, and degree of secondary complications.131 Clinical
signs include abdominal enlargement (usually with a palpable egg present in the
abdomen), weakness, acute depression, abdominal straining, persistent tail wag
ging, a wide stance, failure to perch, labored breathing, and death.131 The vent will
often be dilated, due to the reproductive cycle. An obturator paralysis-like syn
drome may also occasionally be seen in hens that have had a problem with ovipo-
Avian
Medicine
A Guide for
Practitioners
sition. An egg lodged in the pelvic canal may compress the pelvic vessels, kidneys,
and sciatic nerve, causing lameness, paresis, or paralysis, as well as circulatory
disorders and shock.131 When this occurs, several weeks may be required after the
egg has been removed before the bird can walk normally. A single injection of dex
amethasone early on could be of some help. Pressure necrosis may occur to the
oviductal wall.131 Dystocia may cause metabolic disturbances, as well as interfer
ing with normal defecation/urination, causing ileus or renal disease.131
Prior to beginning any diagnostic procedure, the practitioner must determine if the
bird is in adequate condition to tolerate the stress of the procedure, as many birds
that present with dystocia will be in compromised condition. It may be necessary
to stabilize the bird before doing anything
else. The next step is to palpate the abdomen
to detect the presence of eggs. Detection of
eggs high in the oviduct may require radi
ographs. Detection of soft-shelled eggs may
be difficult through abdominal palpation.
Administering calcium prior to radiographic
procedures may help to delineate poorly cal
cified eggs. Another diagnostic aid for situa
tions in which there is no clearly delineated
egg but an enlarged abdomen is to check for
the presence of endosteal bone formation
(hyperostosis), which is stimulated by estro
gen in the laying hen124 (Figure 59). The
Figure 59
medullary cavities of the bones will appear
Hyperostosis (endosteal bone formation) in an
white due to the deposition of the calcium egg-laying cockatiel. The medullary cavities of
bones are bright white due to the deposi
needed for egg production and will serve to the
tion of calcium stimulated by elevated estrogen
indicate that the abdominal enlargement has levels during a reproductive cycle. Contrast
with Figure 58, where the bird has
a reproductive origin. However, ovarian this
depleted the calcium stores so that there is no
cysts as well as some ovarian and testicular hyperostosis evident, and egg binding ensued.
(T. J. Lafeber, DVM)
tumors can also cause these changes.
Care must be taken when palpating the abdomen to avoid rupturing the egg, as
quite often the egg will be thin or soft shelled. Further, not every hen with a pal
pable egg is egg bound; eggs can normally be felt during the 18 hours when they
are in the shell gland during development.130A diagnosis of dystocia can be made
if oviposition is difficult or prolonged.
An essential part of any therapy for dystocia is the administration of calcium,
which is usually given intramuscularly. If a bird is stable and acting normally, a
good strategy is to provide 1 to 2 days of calcium therapy before determining if
more aggressive measures will be required.124 Usually, most minor cases of dys
tocia will respond to calcium supplementation along with heat, humidity, and other
supportive care. Lubricating the vent probably will not accomplish much.
Oxytocin can be given but can be problematic if the egg is adhered to the oviduct.
Prostaglandin E2 (PGE2) has been shown to relax the uterovaginal sphincter and
increase uterine contractions.131 If the uterus is intact and there is no obstruction,
such as a neoplastic mass or an egg adhered to the oviduct, PGE2 gel may be
applied to the uterovaginal sphincter, at a dose of 0.1 ml per 100 g bird.131
Contractions may expel the egg in 15 minutes.131
If no egg is forthcoming after medical management and the egg is very close to the
vent, manipulation (milking) can be tried. This process, where the egg is gently
manipulated down to the vent where it can be removed, can be facilitated with the
use of isoflurane anesthesia. Another aid to the procedure is the placement of a
small amount of lubricant (K-Y Jelly) in the cloaca to moisten the membranes,
which can adhere to the shell if they are dry.130For low eggs that cannot be milked
out, a popular strategy is to puncture the egg, withdraw its contents, and then col
lapse the egg laterally. For this procedure, a 22-gauge needle can be placed into the
egg through the wall of the ventral abdomen, if the egg is readily palpable in this
location. The egg fragments may require at least 48 hours to pass.130 Antibiotic
therapy is recommended.
Prostaglandin treatment, manual delivery, and ovocentesis are contraindicated
in cases of ectopic eggs, oviductal rupture, oviductal torsion, and mechanical
obstruction.131 In these cases, surgical removal is the preferred method of
treatment.
In severe cases of egg binding and dystocia that do not respond to the treatments
that have been discussed above, the only option is to perform a laparotomy and
remove the egg. A portion of the oviduct is usually removed as well (salpingec
tomy) to prevent repeat occurrences. No matter what technique is used, the prac-
titioner should always check for the presence of and remove additional eggs.
Following egg removal, the bird should be placed on a protocol aimed at prevent
ing further reproductive activity, including environmental management and possi
bly hormonal therapy (see Unwanted Egg Laying section, pp. 269-272).
Reproductive-Associated Peritonitis
Peritonitis associated with the presence of yolk material, generally referred to as
egg yolk peritonitis, is usually caused by such conditions as ectopic ovulation and
oviductal disease132 and may be found in association with other diseases such as
malnutrition, metabolic disorders, and systemic infections.131 Ectopic ovulation
does not necessarily result in peritonitis, as it is a common occurrence, with the
eggs resorbed, usually without any problems.131 Oviductal disorders that may
result in peritonitis include salpingitis, oviductal rupture, cystic hyperplasia, and
neoplasia.131 Budgerigars and cockatiels seem to be especially affected by this
condition.
Clinical signs of egg yolk peritonitis are not very specific. They include weight
loss, lethargy, anorexia, and, on some occasions, abdominal enlargement or
ascites.132 For diagnosis, an association should be made to recent egg-laying or
reproductive behavior. A common hematologic finding is leukocytosis with a rela
tive heterophilia. Hypercalcemia, hypercholesterolemia, and hyperglobulinemia may also be found.132 An abdominal tap may reveal yolk or fat globules.
Radiographs may reveal endosteal bone formation (hyperostosis), indicating an
active reproductive cycle, enlargement in the area of the ovary and oviduct, abdom
inal fluid, and even an obvious egg, but may be otherwise nonspecific. Ultrasound
may reveal an active ovary, ovarian cysts, abdominal fluid, and any oviductal
masses, such as cysts, granulomas, or neoplastic masses.131
Treatment depends upon the condition of the bird. Mild cases will usually resolve
with supportive care alone.132 More severe cases will initially require therapy for
shock, antibiotics, and supportive care. Single or minimal injections of steroidal
anti-inflammatories have proven useful in birds that are severely depressed or have
significant abdominal distension.131 When the bird is stable, surgical intervention
can be performed, if required. During surgery, the egg yolk and any egg material
should be removed, any adhesions should be broken down, and, when possible, a
salpingectomy should be performed.
Ovarian Cysts
Ovarian cysts are sometimes seen in budgerigars and cockatiels but can occur in
hens of any species. The etiology of these cysts appears to have an endocrine or
neoplastic basis.132Cystic ovarian disease results from follicular dysgenesis, either
by hypothalamic or pituitary dysfunction, or from native anatomic defects in the
reproductive system.131 The cysts can become quite large, and a clinical sign is
often significant abdominal enlargement.
Advanced ovarian cystic disease may cause depression, inappetance, and abdom
inal distension, which may result in secondary peritonitis.131 Birds may show
reproductive associated behaviors without laying eggs.129 Hematologic changes
include leukocytosis (relative heterophilia), and biochemical analyses may reveal
peripheral hypercalcemia, hyperglobulinemia, and hypercholesterolemia.129
Diagnosis of ovarian cysts can be aided by radiography, as endosteal bone for
mation (hyperostosis) is usually seen (see Figure 59 on page 272), indicating
reproductive activity. Abdominal structures may not be readily distinguished due
to the presence of ascites. However, observation of the position of the ventricu
lus (facilitated by grit in the lumen) can provide a diagnostic clue, since the ven
triculus will often be displaced from its normal position when ovarian cysts are
present. Barium radiographs can further aid in delineating the origin of abdomi
nal enlargement. Fluid obtained from an abdominal tap of the ascitic fluid will be
clear to yellow in color and have low cellularity. Ultrasound may reveal fluidfilled cysts in the area of the ovary.131
Treatment includes transabdominal aspiration of the cysts, surgical removal of the
cysts or ovary, and hormonal therapy.132 (See section on controlling unwanted egg
laying on pages 268-271.) The use of leuprolide acetate led to improvement or res
olution of cysts and clinical signs associated with them in 73% of the cases.127
Leuprolide acetate was used every fourteen days along with supportive care,
including antibiotics and anti-inflammatories, until the cysts disappeared and clin-
Ovarian/Oviductal Tumors
Ovarian and oviductal neoplasia can occur in any species of pet bird but are more
commonly seen in budgerigars. Various types of tumors have been described.
Clinical signs usually include abdominal distension (and associated complica
tions such as abdominal herniation), left leg lameness, dyspnea, inappetance,
chronic reproductive associated behavior, and secondary sex characteristic
changes (such as cere color change).131 Diagnosis can be accomplished through
history and physical examination, radiography (possibly a contrast study) or
ultrasonography demonstrating an enlargement in the area of the ovary, or
exploratory laparotomy.131 Egg binding, oviductal impaction, and ascites may be
seen in conjunction with reproductive tract neoplasia.131 When a tumor is present,
prognosis is poor, as complete removal can be difficult and impractical due to the
location of the ovary.131 Chemotherapy has been attempted, but no conclusions
can be drawn as to its efficacy.131
Prolapsed Cloaca
Prolapses involving the cloaca include cloacal papillomas, eversion of the entire
cloaca (proctodeum/urodeum) out of the vent, and other conditions. Fortunately,
eversions of the entire cloaca are uncommon. Most often, cloacal prolapses are
seen in cockatoos.37
The etiology of cloacal prolapses is unknown. Although viruses have been most
commonly theorized to be the cause, current thought is that these prolapses are
more likely due to the breakdown of attachments to the body wall caused by a sud
den increase in intra-abdominal pressure (as occurs with herniation) that is possi
bly related to reproductive behavior.133
If a prolapse has gone untreated, the bird may require intensive support therapy.
The degree of support will depend on how much tissue has prolapsed, how long it
has been prolapsed, and whether necrosis has occurred. If the prolapse is the first
the bird has had and it is easily reduced with minimal tissue damage, lateral stay
sutures or a purse-string suture can be placed around the vent. The bird should not
be released from the hospital until it is able to pass droppings normally. The
sutures should generally remain in place for an extended period of time to facili
tate the development of attachments to the cloaca and prevent further prolapses.
Unfortunately, this procedure may not have long-term success, as many birds that
present with this condition have repeated prolapse episodes. In such situations, a
cloacopexy involving a midline incision and stay sutures attaching the proximal
portion of the cloaca to the caudal ribs is usually recommended.130Environmental
changes should be implemented to reduce reproductive stimulation (outlined in
controlling unwanted egg laying section on pages 268-271), and the mate or per
ceived mate should be removed.127 Hormonal treatment may be attempted to pre
vent recurrence (leuprolide acetate every fourteen days for three treatments with
appropriate antibiotics and anti-inflammatories). However, cases often recur and
require chronic management.127
Prolapsed Oviduct/Uterus
A prolapse of the caudal reproductive structures is most commonly seen after a
bout of egg laying, but it can also
occur prior to or during a reproduc
tive cycle.9 Prolapsed oviducts are
most often seen in the budgerigar
and cockatiel (Figure 60).
Predisposing factors may include
abnormal or soft-shelled eggs, mal
nutrition, obesity, salpingitis,
and/or cloacitis.131 Typically the
uterus protrudes through the
cloaca, often with a partial pro
Figure 60
lapse of the vagina and cloaca.131 Prolapsed oviduct in a cockatiel. (P. S. Sakas, DVM)
An egg may or may not be con-
tained within the prolapsed structure. Obviously, these cases need to be treated
immediately to prevent necrosis of the exposed tissues.
If an egg is present in the prolapsed oviduct and the oviduct opening can be
located and is dilated enough, the practitioner may be able to manipulate the egg
through the opening. Often, however, the tissues will be dried out and the egg will
be adhered to the oviduct. In such cases, moistening the tissues and exposed por
tions of the egg with saline may loosen the adhesions. If the opening is too small
or the egg is too adherent, the oviduct can be incised with a scalpel blade and the
egg removed.
In all cases, the prolapse then needs to be replaced. In birds that are treated early,
the tissues can usually be easily replaced. In cases in which the tissue is swollen,
topical applications of 50% dextrose can reduce the swelling and ease replace
ment. Once the prolapse is replaced, a purse-string suture or stay sutures can be
placed around the vent. Unfortunately, by the time veterinary care is sought in
most oviduct/uterus prolapse cases, the tissues have been prolapsed for a long
period of time and quite often are already undergoing necrosis. The prognosis for
such birds is guarded, both because of the necrosis and because the tissues have a
tendency to prolapse again. Although a cloacopexy-type operation may be per
formed,134 it is not unusual for the sutures to tear through the wall of the oviduct.
A salpingectomy has been suggested for managing some of these cases. Because
the birds condition will likely be compromised, intensive supportive care will be
required, including heat, fluids, antibiotics, and dexamethasone. Any predisposing
factors, such as malnutrition, should be corrected. Medical therapy to decrease
hormonal levels has included leuprolide acetate, medroxyprogesterone, and chori
onic gonadotropin.131
reproductive cycle as soon as any of these behaviors are observed. The conserva
tive measures outlined in the section on unwanted egg-laying behavior (changing
the photoperiod and behavioral modification) should be tried initially. If the bird
is able to fly, wing clipping, which limits the birds independence and seems to
calm birds, can also be helpful. If none of these methods work and the behavior
is irritating to the owner, medical therapy may be tried. In the past, medrox
yprogesterone was commonly used for calming sexual behavior of both male and
female birds; however, it has fallen out of favor due to its side effects and today
is used with great caution, if at all.93 Calming or mood-altering drugs, such as
those used for feather-picking (doxepin, clomipramine, fluoxetine, and haloperidol), have also been used. Leuprolide acetate can often eliminate or decrease
aggression to a level where the owner can begin to appropriately handle and train
the bird.127Hormonal therapy is not a quick fix for these behavioral problems and
is not a substitute for behavior counseling; it expedites the process.127 Not all
aggression is reproductive in nature or hormonally driven, and only those cases
where the birds have a history of reproductive behavior, are of appropriate age,
and exhibit clinical evidence of reproductive activity should receive hormonal
therapy as part of their management.127 Treatment failures may result from the
behavior being due to another cause, a behavior of long duration, or an extremely
strong stimulus to which the bird reacts.127
Mate Aggression
Mate aggression is a behavior commonly observed in cockatoos that is related to
the sexual aggression displayed during reproductive activity. It typically occurs
because the male is ready to breed and the female is not. If a nest box is present,
the male will often force the female to remain inside. The male may also brutalize
or kill the female, usually crushing her beak or inflicting trauma to her head.
Means to prevent such aggression include clipping the wings of the male to give
the female a better opportunity for escape and having more than one exit available
in the nest box so the male cannot prevent the female from exiting.124 Another
method is to fill the nest box with small pieces of wood. Not only does this
method mimic the natural cycle in which the male clears the nest area for the
female, but often the female will be ready to breed by the time the male has
cleared the nest of the wood.18 It also provides the male with the opportunity for
chewing behavior and for working out aggressions on the wood pieces. If none of
these methods work, the pair can be separated and eventually the male can be
tried with another female. If the male turns out to be a chronic offender, he should
not be used for breeding.
Neoplasia
Of the 27 orders of the class Aves, psittaciform birds have the highest reported
incidence of neoplasia.135Neoplasms are more commonly reported in the budgeri
gar than in any other vertebrate animal.135 Some studies show that as many as
90% of avian and subcutaneous tumors are benign with the majority being lipo
mas, xanthomas, or papillomas.135 The following sections and Table 12 cover
some of the common neoplasms seen in pet birds.
Fibrosarcomas
Fibrosarcomas are a very common tumor seen in the pet bird, occurring most often
on the wings, legs, and face90 (Figure 61). Most of these masses are firm and
raised, with signs of hemorrhage or mutilation, and the overlying skin is firmly
attached. The masses usually are quite vascular and may be locally invasive.
Differential diagnoses include other neoplasms, xanthomas, vaccine reactions,
abscesses, granulomas, injury (such as a prolapsed pygostyle), and feather cysts.
Table 12
Common Differential Diagnoses for
Masses of the Skin and Subcutis
M ass T ype
S p e c ie s
C o m m o n ly A ffec te d
C o m m o n L o cation a n d A ppearance
Fibrosarcoma
Budgerigars, cockatiels
Carcinoma
Various species
Cutaneous lymphosarcoma
Various species
Lipoma
Budgerigars, rose-breasted
cockatoos
Abdominal protrusion
Budgerigars
Cloacal papilloma
Prolapsed cloaca
Cockatoos
Prolapsed oviduct
Budgerigars, cockatiels
Cockatiels, cockatoos
Abscesses/granulomas
Various species
Tuberculosis lesions
Vaccine reactions
Cockatoos
Subcutaneous nodules
Feather cysts
Carcinomas
Squamous cell carcinomas have occasionally been documented in the pet bird.90
They may be internal (usually gastric) or external (occurring on the uropygial
gland, beak, and skin).90 Their appearance may vary from that of a shallow ulcer
to a more proliferative mass. Differential diagnoses should include more benign
neoplasms, such as keratomas and keratoacanthomas, idiopathic self-mutilation,
infections, and injuries.
Treatment for carcinomas consists of surgical excision, as soon as possible, using
cryosurgical or radiosurgical techniques if indicated. Photodynamic laser therapy,
a relatively new modality in cancer treatment, has been implemented in the treat
ment of a squamous cell tumor in a cockatiel, but at this time it is only a research
tool.136 Confirmation histology should be done on the excised tumor, as on any
possible neoplasms. Cytology is helpful in differentiating many neoplasms from
other masses and can sometimes be done in-house.
Cutaneous Lymphosarcomas
Lymphoreticular neoplasms occasionally affect the skin of pet birds and have been
reported in the canary, cockatiel, and African grey parrot, among others. These
masses are locally invasive and often are paler or yellower than the surrounding
skin. The skin is attached and involved. In addition, cutaneous masses have been
reported on the face in some birds.137
Prognosis for these types of tumors is poor, although prednisolone at a dose of
1-2 mg/kg body weight daily was used in the treatment of an African grey par
rot with facial lymphosarcoma.137 Treatment of cutaneous lymphosarcoma in the
cockatoo using such drugs as vincristine, cyclophosphamide, doxorubicin, and
L-asparginase (by intraosseous catheter) has also been described in detail.138
Lipomas
Much argument exists over what treatment (if any) is indicated in the management
of a lipoma and over the relationship of a lipomatous mass to obesity. Lipomas
have been described as yellowish soft bodies that usually are located subcutaneously on the chest or abdomen (see Figure 46 on page 237). They also may be
intra-abdominal. The skin overlying these masses may take on changes that are
suggestive of xanthomatosis, becoming yellowish, quilted, or thickened. Some
lipomas, particularly in the budgerigar and rose-breasted cockatoo, may occur near
the vent and mechanically interfere with the birds movements. Liposarcomas also
have been described with grayish irregular fatty areas present.
Surgical intervention may be indicated for large, obstructive, or suspicious fatty
masses. However, conservative management will be suitable for the majority of
small lipomas. Treatment may include calorie reduction, exercise, and even hor
mone therapy. Some practitioners have tried treating affected birds with thyroid
hormones; however, neither the relationship between hypothyroidism and lipoma
formation nor the effects of additional exogenous thyroid hormones are known.
tended abdomens, draining off a portion of the abdominal fluid may relieve dysp
nea. Few birds survive longer than 6 months after diagnosis.
Figure 62
Barium radiographs of a budgerigar with a renal adenocarcinoma. The enlarged kidneys
can be visualized through the displacement of the intestines ventrally on the lateral view.
(P. S. Sakas, DVM)
Pituitary Masses
The pituitary tumor is another neoplastic condition that is common only in the
budgerigar,137 although it has also been reported in a cockatiel.138 Signs include
blindness, mydriasis, circling, tremors, and abnormal droppings. Polyuria and
polydipsia have also been reported in association with this tumor.137 The progno
sis for birds presenting with a pituitary mass is poor, and euthanasia is recom
mended once exophthalmos is evident.
Neurological Conditions
Clinical signs of neurological disease include head tilt, ataxia, inability to perch,
paralysis/paresis, and seizures. Rule-outs include trauma (hitting a window while
flying); ingestion of heavy metal or other toxins; egg yolk stroke; epilepsy; pitu
itary neoplasm; metabolic disease (hypoglycemia, hypocalcemia, hepatic disease);
and primary central nervous system (CNS) diseases such as bacterial diseases,
Chlamydophila, proventricular dilatation disease (PDD), psittacine beak and
feather disease (PBFD), sarcocystis, and fungal diseases.103
The following sections and Table 13 cover some of the common nervous sys
tem abnormalities seen in pet birds. Many of these disorders can appear sim
ply as weakness or depression in their late stages, making diagnosis
particularly challenging.
Table 13
Common Problems That May Be Presented With
Nervous System Abnormalities
P roblem
S pecies A ffe c te d
K n ow n A g e nts
T ypic a l S ig ns
Various
Lead, zinc
Other toxins
Various
Pesticides,
polytetrafluoroethylene gas, others
Hypocalcemia
Dietary, metabolic
Egg binding
Cockatiels, lovebirds,
others
Possibly
hypocalcemia
Obturator paralysis
Various
Difficulty in passing
egg
Renal/gonadal mass
Budgerigars
Pressure on
sciatic nerve
Pituitary mass
Budgerigars
Pressure on brain
Head trauma
Various
Concussion
Epilepsy
Red-lored (green-cheeked)
Amazon parrots
Unknown
Newcastle disease
(VVND)
Paramyxovirus
Paramyxovirus
(non-Newcastle)
Finches, cockatoos,
pigeons
Paramyxovirus
group 3
Proventricular
dilatation disease
Macaws, cockatoos
Stroke Syndrome
A stroke syndrome has been described in older budgerigars,18 but strokes can
affect any of the pet birds. When a cerebrovascular insult occurs, there will be a
sudden onset of central nervous system signs or generalized paralysis.18 Steroid
injections may result in remission.18
Epilepsy
Epilepsy has been described in many species of birds but appears to be especially
common in red-lored Amazon parrots, peach-faced lovebirds, and mynahs.139As
in dogs, the diagnosis of idiopathic epilepsy is made by ruling out other causes of
seizures, some of which include hypocalcemia, encephalitis (including proven
tricular dilatation disease), heavy metal toxicosis, trauma, parasitic encephalopa
thy, hepatic encephalopathy, neoplasia, and vitamin deficiency.139 Epileptic
seizures can range from mild to grand mal in intensity. Valium is the drug of choice
to treat a bird that is undergoing seizure activity. Phenobarbital is used for long
term seizure control.
Hypocalcemia Syndrome
Hypocalcemia syndrome is a condition seen in African grey parrots that is charac
terized by low blood calcium levels and associated intermittent seizures.18Because
African grey parrots are not able to mobilize calcium from their bones when it is
needed, they have no calcium reserve and can go into hypocalcemic tetany when
their blood calcium levels are
low.18 Mature African grey parrots
between 2 and 5 years of age are
predominantly affected.18
Necropsy findings usually demon
strate enlarged parathyroid glands
that, when examined histologi
cally, show severe degeneration18
(Figure 63). It has been speculated
that a virus is responsible for this
condition, since not all calciumdeficient African grey parrots show
clinical signs.18
Figure 63
Enlarged parathyroid glands in a pionus parrot suffering
from ataxia and seizures. Normally, parathyroid glands are
imperceptible on the thyroid gland. (P. S. Sakas, DVM)
and the need to provide them with adequate mineral supplementation. In addition,
periodic testing of blood calcium levels is recommended and can easily be incor
porated into the yearly physical examination. Due to the increased awareness of
the calcium needs of African grey parrots, this condition has become less com
mon over recent years.18
Renal Conditions
Gout
Common in older budgerigars but possible in any psittacine, gout is a disease
marked by the deposition of uric acid or urates in tissue. High levels of uric acid
in the blood precipitate this deposition. Although the uric acid is not toxic, the
precipitated crystals can cause mechanical damage to the tissues. The etiology is
unknown, but possible predisposing factors for the development of gout include
renal disease, dehydration, high-protein diets, and genetics. Feeding meat can
increase uric acid levels, possibly producing gout and amino acid imbalances.12
Gout often is described as occurring
in two forms: visceral and articu
lar.12The two forms may occur sep
arately or simultaneously.
Visceral gout, which is considered
the acute form of the disease, is
characterized by whitish uric acid
crystals deposited on the major vis
ceral organs, usually the liver, kid
ney, pericardium, heart, and air
Figure 64
sacs (Figure 64). Generally, tophi
are not present in the joints.12 The Visceral gout. Uric acid deposition on the pericardium and
heart. (P.S.Sakas, DVM)
disease is difficult to detect, as
there are no characteristic clinical signs. Anorexia, depression, and lethargy may
be seen. Birds may die suddenly or waste away. Visceral gout is not characteristic
for any particular condition; rather, it may be an antemortem event related to dehy
dration, a nephrotoxic event caused by impairment of kidney function due to a
A Guide for
Practitioners
Polyuria
Polyuria can be seen in diabetes but is also associated with renal damage or fail
ure, excessive water intake (often the result of a bird being fed a favored fruit or
greens), certain neoplastic conditions (such as pituitary adenomas), and stress. An
increase in liquid urine may also be produced by birds on formulated diets. Renalorigin polyuria may result from systemic disease conditions, primary renal disease,
or treatment with certain drugs, such as aminoglycosides (see color plates on pages
333-342). Serum uric acid levels of greater than 10 mg/dl may be helpful in indi
cating renal disease conditions.
Endocrine Conditions
Diabetes Mellitus and Diabetes-Like Conditions
Type I insulin-dependent diabetes mellitus is the most common form of diabetes
in mammals, in which irreversible destruction of beta cells leads to low insulin
levels.141Type II is non-insulin dependent diabetes, the cellular response to insulin
is impaired due to an underlying condition such as obesity or adrenal disease.141
Diabetes in many avian species may follow a third model in which excess
glucagon levels are present, which stimulates lipolysis, gluconeogenesis, and gly
colysis.141 Glucagon is the major regulator of carbohydrate metabolism in granivarous avian species.141
Polyuria is the usual presenting complaint for diabetes mellitus, which is common
in the cockatiel, budgerigar, and Toco toucan. A dipstick in the urine usually will
show 4+ glucose, and blood glucose levels will range from 800-1,500 mg/dl.18
Polyphagia, weight loss, and depression may accompany the condition. Diabetes
mellitus may be secondary to egg yolk peritonitis or pancreatitis. Some cases of
diabetes may be temporary, perhaps related to a pancreatitis condition.
In avian species, diabetes-like conditions also exist. Birds with these conditions
exhibit variations to the pathophysiology of diabetes mellitus. Some individuals,
for example, appear to be affected by a glucagon excess instead of an insulin
deficiency.142
Treatment for diabetes mellitus requires the use of injectable insulin, and has
been employed successfully to manage avian patients. Treatment may be
impractical in small birds, and hypoglycemic shock is easy to induce. Blood glu
cose levels should be monitored if possible, especially when initiating therapy.143 Insulin usually is administered once daily, with 0.002 IU being a typical
dose for a bird of budgerigar size and 0.01-0.10 IU being the usual dose range
for parrot-sized birds.143
Glipizide can be used for the control of diabetes because many diabetic birds
appear to be resistant to the effects of insulin (due to an underlying condition such
as obesity or adrenal disease).141 Glipizide has been used successfully in treating
persistently hyperglycemic cockatiels.141The cockatiels were dosed with glipizide
at 0.5 mg per os every 12 hours and placed on a pelleted diet and a gradual weight
loss plan.141 Polyuria, polyphagia, polydipsia and lethargy quickly resolved once
the drug was started and, due to the clinical improvement, glipizide treatment was
discontinued after one year.141
Hypothyroidism
Hypothyroidism is common in budgerigars.18 Xanthomatosis, lipomatosis, over
grown beaks, fatty hepatosis, chronic overweight condition, and lipemia with ane
mia may all be associated with this condition.18 The disease appears to be the
result of a primary failure of the thyroid gland rather than an iodine deficiency.
Accurate evaluation of the thyroid gland condition can be accomplished only with
a thyroid stimulating test; resting thyroid levels are not reliable in pet birds because
virtually all assays will report low or undetectable levels.68 Several years ago the
only affordable veterinary TSH (thyroid stimulating hormone) was withdrawn
from the market, leaving only a very costly human TSH product.68Thus, due to the
expense of, and the difficulty in, performing the thyroid stimulation test, treatment
of hypothyroidism in budgerigars and other hypothyroid suspects is usually initi
ated based on clinical signs alone. Skin and feather follicle biopsy specimens inter
preted as being consistent with endocrine dysfunction can suggest a diagnosis of
ensuing hypothyroidism.68 The treatment of choice is thyroid supplementation
with L-thyroxine.
During treatment, the bird should be carefully monitored for signs of overdose,
such as rapid breathing, hyperexcitability, rapid weight loss, and any other
symptoms related to an increased metabolic rate. The dosage can be adjusted
according to the clinical response and the resolution of the clinical signs.
Abdominal Distension
Rule-outs for a distended abdomen include egg binding or other reproductive
related disorders, such as egg yolk peritonitis, cystic ovaries, ovarian neoplasia,
abdominal herniation, and testicular neoplasia.103 Other rule-outs include obesity,
organ enlargement (hepatomegaly, renomegaly), cardiovascular disease, hepatic
disease, granulomas, neoplasia, and foreign body impaction.103 Cases that include
paresis or paralysis of the limbs, loss of muscle mass, and concurrent respiratory
signs/distress have a poorer prognosis.103
These birds may present for obvious abdominal distension, dyspnea, straining, egg
binding, or general signs of illness.103 The owner may bring in a bird that is a
chronic egg layer that is believed to be egg bound. Birds, typically budgerigars,
may also present for lameness or paresis, which the owner suspects is due to a
sprain or broken leg. Physical examination may reveal abdominal distension, plac
ing renal neoplasia at the top of the differential diagnoses list.
Owners must be warned that birds with abdominal distension have compromised
breathing, can tolerate little handling, and could expire even with minimal stress.
If possible, a quick abdominal palpation could be performed to get an indication
of the nature of the enlargement and to detect the presence of an egg. Palpation
should be performed cautiously if fluid is present, as increased pressure could
cause rupture of the abdominal air sacs and allow fluid to flood the respiratory sys
tem, causing sudden death.
The bird should be given supportive care including oxygen, warmth, humidity,
fluids and (if indicated) calcium, steroids and antibiotics.103 Removal of abdom
inal fluid may be necessary in cases of severe ascites. Once the bird is stable, spe
cific treatment based on the underlying causes should begin. Radiographs
(usually barium studies) and ultrasonography can be useful in determining the
cause for the distension.
Cardiovascular Conditions
Heart disease in birds occurs much more frequently than may be assumed by read
ing veterinary literature. A comprehensive overview of avian cardiology was pre
sented by Krautwald-Junghanns and Straub; the following discussion is based on
that information.144
Diagnosis of cardiac diseases in birds is difficult, as systematic investigations
about heart disease in cage and aviary birds are lacking; most descriptions are
based upon individual experience. Diagnosis is further complicated by clinical
signs that are non-specific or because the cardiac disease is accompanied by other
diseases that complicate the clinical presentation. Diagnostic measurements in liv
ing birds are significantly limited because there is no palpable pulse and ausculta
tion is difficult to evaluate.144
Radiographs generate data on the size of the heart shadow, as well as secondary
changes that may arise in other organs (ascites, hepatomegaly, and renomegaly).
Enlargement of the heart shadow can be caused by different factors (dilatation,
hypertrophy, pericardial effusion and tumors), but distinction radiographically
between these etiologies is not possible so far.144
Electrocardiographic (ECG) information is limited because reference values cur
rently exist for only selected species. Echocardiography will enable evaluation of
the structure, size, and contractility of the avian heart, but sonographic examina
tion requires extensive experience and expensive equipment.144
In comparison with free-living birds, caged birds are frequently compromised by
restricted exercise, nutritional deficiencies, and abnormal climactic conditions.
When coupled with their already high blood pressure, pet birds have many poten
tial risk factors for cardiovascular disease. In a study conducted with more than
200 psittacine birds that were sent in for routine necropsy, macroscopic lesions of
the heart and/or large vessels were found in more than one-third of the birds.144
Diseases of the heart may occur as a result of congenital, idiopathic, or toxic fac
tors. A variety of heart alterations occur secondarily as acquired disease and/or
compensation/decompensation due to other organ insufficiencies (e.g. lung, liver),
tumor degenerations, or systemic infections. Age-related diseases in pet birds have
not been studied.144
Pericarditis
Inflammation of the pericardium may occur in the process of infectious and/or
degenerative diseases. Exudative pericarditis is often caused by bacterial infec
tions, and uric acid deposition in the pericardium can develop as a degenerative
process in association with visceral gout. Clinical signs may include apathy, inabil
ity to fly, and dyspnea, with further symptoms manifested by the underlying dis
ease condition. Radiographs may reveal a partly irregular, increased heart shadow.
The underlying cause should be treated if it can be determined. In some cases,
furosamide can be indicated in the treatment of the pericarditis. There is no effec
tive treatment for visceral gout.144
Hydropericardium/Hemopericardium
A hydropericardium may develop in the process of an infectious pericarditis or
may be due to congestion in the case of cardiac insufficiency. A hemopericardium
is found after trauma due to sclerosis or rupture of vessels/tissue. Clinical signs
include moderate to high-grade dyspnea, weakness, and abdominal distension (due
to a congested liver and/or ascites). Acute deaths are to be expected with hemo
pericardium. Radiographs can provide information about the size of the heart
shadow and alterations in other organs caused by congestion (ascites), but the dif
ferentiation between heart hypertrophy and pericardial fluid accumulation is not
possible. ECG alterations permit only a tentative diagnosis. Echocardiographic
and sometimes endoscopic examinations can provide the only accurate ante
mortem diagnosis of pericardial effusion. The underlying disease conditions
should be treated, and symptomatic treatment with furosamide, as well as digitalis,
may be indicated. In the case of hydropericardium, a pericardiocentesis under
sonographic or endoscopic control may be performed.144
Myocardial Insufficiency
Pulmonary hypertension, valvular insufficiency, and myocardial infections may
cause a decreased contractility of the heartusually a right-sided, rarely an iso
lated left-sided, cardiac insufficiency. Cardiac decompensation occurs signifi
cantly more quickly in birds due to their higher heart load. A right-sided cardiac
insufficiency may arise due to pulmonary congestion or hypertension. Dilatation
of the right ventricle is frequently seen in psittacine birds presenting with sys
temic lung disease (e.g. chronic mycoses). Due to liver congestion combined with
development of ascites, clinical signs of myocardial insufficiency include respi
ratory symptoms, general weakness, the inability to fly, and abdominal disten
sion. Radiography and electrocardiography may give further diagnostic clues.
The underlying disease condition should be treated and supportive care, includ
ing cage rest and dietary management, implemented. Heart glycosides can be
used for chronic idiopathic cardiac insufficiency, but the administration of digi
talis should only be done when clearly indicated. When edema is present, diuret
ics are indicated.144
Myocarditis
This term describes all diseases of the heart muscle that are not due to sclerosis,
hypertension, or congenital heart disease. In addition to idiopathic (primary) car
diomyopathy, secondary heart muscle damage can result from generalized sys
temic disease of infectious, toxic, metabolic, and neoplastic origin. Myocarditis is
seen as a complication of proventricular dilatation disease (PDD) and reovirus in
psittacines. Myocardial degenerations are found regularly as myocardial infarc
tions (sometimes secondary to heavy metal toxicoses). In birds suffering from
hemochromatosis (iron storage disease), iron deposits in the myocardium are seen.
Clinical signs may be manifested as weakness, dyspnea, and other non-specific
signs of cardiac insufficiency. Radiographically, the heart silhouette may be con
solidated and have increased radiodensity. Changes in the ECG and echocardio
gram will be seen. Plasma biochemical analyses will provide additional diagnostic
information and should include AST, CPK, LDH, and electrolytes (Na, K, Cl).
Treatment is directed at treating the underlying disease condition. Other general
measures can include cage rest, electrolyte administration, flushing of metabolic
toxins, and in individual cases, the use of glycosides. A very good prognosis is
expected only with an acute myocarditis.144
Endocardial Disease
Alterations of the endocardium, especially the endocardial lining of the heart
valves, may be idiopathic, but are found more frequently with secondary problems
such as inflammation post infection or after degenerative myocardial compensa
tion. Chronic inflammation or metabolic diseases may lead to stenosis of the semilunar valves. Endocardioses occur more frequently after septicemia caused by
bacteria such as Streptococcus sp., Staphylococcus sp. and Pasteurella multocida.
Resultant endocardial damage to the heart valves or stenosis may lead to severe
myocardial insufficiency. Clinically, weakness, dyspnea, abdominal swelling, and
swelling of the distal extremities may be observed. Radiographs may indicate
increased and/or consolidated organ shadows of the heart, liver, or lung, providing
differential diagnoses. But echocardiography may demonstrate physical changes
in the chambers of the heart or of the large vessels and abnormal movements of the
heart valves. A good prognosis may be given in acute cases through treatment of
the causative agent. In cases of congestion, diuretics such as furosamide, as well
as glycosides in cardiac insufficiency cases, may be indicated.144
Arteriosclerosis/Atherosclerosis
The most frequently discussed etiological causes of these conditions are probably
hyperlipidemia, endothelial inflammation, toxins, immune complexes, hyperten
sion, and/or stress factors. Age and nutritional deficiencies over many years with
a lack of exercise seem to play a role in the development of arteriosclerosis.
Sclerolization can cause plaque-like or diffuse hardening of the larger arteries,
such as the aorta and brachiocephalic trunk. This occurs most frequently in African
grey parrots, macaws, and Amazon parrots over 15 years of age. In earlier stages,
arteriosclerosis is not diagnosed due to the absence of clinical signs, but in
advanced cases, acute deaths occur. As a consequence of arteriosclerosis,
aneurysms have been shown to occur. Clinical signs in the latter stages are wide
ranging and can include neurological symptoms (including lameness), lethargy,
vomiting, dyspnea, and ascites. Clinical findings may lead to a tentative diagnosis.
In advanced cases, radiographic changes, such as increased radiodensity and
widening of the aorta, may be seen, as well as atrial and ventricular dilatation.
Stenotic murmurs may be auscultated during the physical examination, resulting
from the narrowing of the large vessels at the base of the heart. Ultrasonographic
evaluation is a suitable procedure to diagnose arteriosclerotic processes of large
vessels that lie close to the heart. Unfortunately, the diagnosis is most often
reached at the time of necropsy. No effective therapy is known; nutritional man
agement techniques are essential, including a balanced diet and the bird must be
given the opportunity to exercise.144
Cardiovascular Therapy
The therapy of avian cardiac disease is still in its infancy and many drugs used rou
tinely in mammals have not yet been adequately studied in birds. The treatment of
the accompanying disease also limits the use of heart drugs. As more avian cardiac
research is undertaken, more information pertaining to these drugs, dosages, and
efficacy will become available in the future.144
Toxicoses
Toxic Fumes
As noted in Chapter 1, birds are more sensitive to toxic elements in the air than are
many other animals, due to the efficiency of their respiratory tract and their small
size. Thus, some airborne toxins that appear to have no immediate effect on
humans can cause sudden death in birds. Owners should be cautioned to move
birds to an area that is free of fumes and has good ventilation whenever they are
using materials that produce fumes or notice a strange smell.
Sources of airborne toxins include aerosol sprays (the propellant in the spray is
toxic), burning or overheated cooking oil or butter, polymer fumes in spray
starch, fumes from self-cleaning ovens, paint fumes, smoke from burning food,
nonstick plastic sprays used to coat cooking utensils, cigarette smoke, carbon
monoxide (from car exhaust or furnace), cooking gas (natural gas), and over
heated polytetrafluoroethylene (PTFE, commonly known as Teflon). Indeed, any
material that emits fumes should be considered dangerous.
The passive inhalation of cigarette, cigar, and pipe smoke is also dangerous to
birds, having the potential to cause chronic ocular, dermatologic, and respiratory
disease. Birds that live in homes with smokers often show clinical signs that
include coughing, sneezing, sinusitis, and conjunctivitis due to the constant irrita
tion of the respiratory system. Many times, secondary bacterial infections occur in
these birdsthe result of bacteria invading the lining of their smoke-damaged res
piratory tracts. The clinical signs may resolve without treatment if the source of
smoke is eliminated and no secondary infections are present.
PTFE Toxicosis
Polytetrafluoroethylene is a synthetic polymer used on nonstick cooking surfaces.
The most familiar PTFE-coated cookware is marketed under the trade names
Teflon, Silverstone, and Supra, but other PTFE-coated products are also available
under other trade names. Under normal cooking conditions, PTFE-coated cook
ware is stable and safe. However, when PTFE is heated above 530F, it undergoes
pyrolysis and emits caustic fumes that are highly dangerous to pet birds.145,146,147
Although most foods are cooked at much lower temperatures than 530F, empty
PTFE-coated cookware that is left on a burner set on the high setting can reach
temperatures of 750F or greater. Thus, the breakdown of PTFE can occur when,
for example, a pan is being preheated on a burner and forgotten or when all the
water boils out of a pot. In most cases, PTFE-coated cookware has to be abused
to emit toxic fumes, but there have also been reports of toxicosis at lower, more
typical cooking temperatures.
The signs of PTFE toxicity are nonspecific. Birds are usually found dead in the
cage or gasping for air and then dying. On postmortem examination, changes are
seen in the lungs only. The lung tissue will be found to be severely damaged by the
caustic effects of the toxic fumes, with congestion and hemorrhage seen in the air
ways145 (Figure 66).
Diagnosis of PTFE toxicosis is through the signs of respiratory difficulties and
death, coupled with a report of a nonstick cooking surface that was possibly over
heated. Other sources of toxic fumes must be ruled out. Because the changes in the
lungs are nonspecific for PTFE toxicity, the condition cannot be positively identi
fied from postmortem examination alone.145
Lead Toxicosis
Lead toxicosis is surprisingly common in pet birds. In fact, it is one of the most
common toxicoses in avian medicine.148 Quite often, owners will not be aware of a
source of lead in their homes, so a negative history should not rule out this disorder.
Due to their curiosity, birds will often pick up and chew on objects and will occa
sionally swallow small fragments. If the objects contain lead, the lead will be
absorbed from the digestive tract into the bloodstream, from which it will be incor
porated into bone and also carried to the brain. It has been shown to cause nervous
system disorders and eventually lead to death.148
Blood lead analysis will confirm the diagnosis of lead toxicosis and is recom
mended whenever possible, but the results may take several days. Blood levels
between 0.2 ppm and 0.5 ppm are suggestive of lead, may not be associated with
any clinical signs, and usually carry a good prognosis with or without treatment.149
Levels between 0.5 ppm and 1.0 ppm are very supportive of lead, often associated
with clinical signs, and carry a good prognosis with treatment.149As levels exceed
1.0 ppm, clinical signs are usually present, confirming lead toxicosis. Prognosis
worsens with increasing values (greater than 2.0 ppm).149 If birds present with
signs of lead poisoning but have negative blood lead levels, zinc toxicosis should
be considered.
Lead toxicosis can be successfully treated if identified quickly. Treatment is gen
erally started with the injectable chelating agent calcium EDTA. Acutely poisoned
birds often respond very rapidly to chelation treatment. Birds that have chronic
lead toxicosis or zinc toxicosis may take longer to respond. In such birds, treat
ment should be carried out for an extended period of time. Oral chelating agents
such as d-penicillamine (55 mg/kg PO BID for 1 to 2 weeks) or dimercaptosuccinic acid (DMSA), a more recently available heavy metal chelating agent, (15-35
mg/kg PO BID for 5 days), have facilitated at-home treatment by the client.149
DMSA has been shown to be more effective than EDTA at decreasing tissuebound lead.149 Combination therapy with EDTA and DMSA has been shown to be
more effective than single-agent (EDTA alone) chelation.149 Some practitioners
administer feline laxatives, mineral oil, peanut butter, or methylcellulose to try to
move the metal out of the ventriculus. If large fragments of lead are present, sur
gical removal may be required. In all cases, treatment should be continued until
there is no evidence of lead in the GI tract or until clinical signs resolve.
If lead toxicosis is suspected based on clinical signs or possible exposure to lead,
chelation therapy should be immediately initiated. Delaying treatment while
awaiting test results could lead to a worsening of the condition.
Zinc Toxicosis
Over the past few years, there has been an increased awareness among bird own
ers and practicing veterinarians of the potential for zinc toxicosis.68 Zinc is an
essential nutrient for avian species and is present in very low levels in the typical
seed diet.68 Plasma zinc testing has increased and is being frequently included as
a standard part of a diagnostic work-up for various feather damaging (picking) and
self-mutilation disorders.68
Zinc toxicosis, or new wire disease, has emerged as a clinically significant condi
tion in pet birds.150 It results from excessive consumption of, or chronic exposure
to, zinc, which can be found in bird cages in the hardware supplies commonly
used for constructiongalvanized wire, galvanized metal dishes, powder coat
ings, paint, and more. Even the white rust on galvanized metal may be toxic. Many
household items also contain zinc, ranging from painted and varnished surfaces to
common adhesives.150
Especially common sources of zinc for pet birds are the galvanized wire and clips
used to construct cages and galvanized containers and dishes that are not properly
treated.150 Scrubbing the galvanized metal with a brush and a mild acidic solution,
such as vinegar, will remove the loose zinc and reduce the risk but will not
totally eliminate it. Birds eating nectar or acidic, moist foods (fruits) should not be
fed from galvanized dishes, even if they have been treated.150All pet bird owners
should be instructed how to recognize galvanized and zinc-plated objects.150
When birds ingest zinc, either from chewing and swallowing material that contains
zinc or from drinking water or eating food that has absorbed it, the zinc is absorbed
in the proventriculus and small intestine. Clinical signs of zinc toxicosis are non
specific, tend to be dose related, and are similar to signs of lead toxicosis.150 The
signs of zinc toxicosis include GI problems, excessive drinking and urinating,
weight loss, weakness, anemia, cyanosis, and seizures. Pancreatic damage, renal
necrosis, and tubular degeneration can also occur.
In cockatoos, a connection may exist between feather-picking and zinc toxicosis,
and it is often recommended that feather-picking cockatoos be tested for zinc
exposure.150 However, there are no published cases of feather picking associated
with zinc toxicosis in peer reviewed journals at the time of this writing.68 In some
cases, feather-picking birds may have blood zinc levels higher than normal values,
but a correlation between feather picking and zinc toxicosis has not been formally
made.68 The key point centers on the difference between high blood zinc and con
firmed zinc toxicosis, which are two distinct entities.68
Pediatric Problems
Full coverage of the diseases of young psittacines is beyond the scope of this book.
Many of the conditions that are seen result from improper hand feeding and from
the stress that accompanies hand feeding. Management of these valuable and del
icate birds when they present with a problem requires a great deal of expertise, as
many of the problems are true medical emergencies requiring immediate attention.
Practitioners are encouraged to acquire a young bird of an easily managed species,
such as a lovebird or cockatiel, to hand feed, with both professional and technical
staff taking part in the care process. Further, to help prevent some of the problems
commonly seen in pediatric patients, practitioners are highly encouraged to dis
cuss the following basic topics with breeder and retailer clients:
1. General preventive medicine strategies, including disease testing of parent
birds, vaccination programs (e.g., avian polyomavirus vaccination for
neonates), and pathology (necropsy) protocols. Because the cells and tissues
of chicks that have died autolyze quickly, they must be cultured and/or placed
in formalin within a few hours of death (refrigeration may not suffice).
2. Veterinary on-site visits, which are essential for evaluating preventive med
icine strategies, records, and nursery hygiene programs.
3. Equipment suitability, including egg incubators (if used), neonatal units,
housing units for unfeathered and pinfeathered chicks (heat and humidity
considerations), weaning units, and socialization areas. Substrate selection
for neonatal units (e.g., paper towels), units for unweaned chicks (e.g., recy
cled newspaper pellets), and weaning units (e.g., plastic-coated grills sized
to avoid entrapments) should also be discussed. In addition, breeders and
retailers should be instructed to keep neonatal units at 92-94F, units for
unfeathered chicks at 90-92F, those for pinfeathered chicks at 85-90F,
and those for weaning birds at 75-80F. Humidity should be above 50%
(especially for younger birds). Feeding instruments should include syringes
of a safe designthat is, with no sharp ends or attached tubes. Gavage tub
ing and crop flushing should be done only by experienced breeders/retailers
or veterinary personnel.
Table 14
Common Pediatric Problems Seen in
Domestically Raised Large Psittacines
P roblem
S pec ies
A ffec te d
K now n
A g e nt s
T ypical
S ig ns
T reatment
Lateral deviation
of the maxilla
Macaws
Possibly due to
hand feeding, stress
Undershot
mandible
Macaws,
cockatoos
Same as above
Mandibular portion
fits over upper beak tip
Same as above
Cockatiels
Bacterial
Splay leg
Various
Genetics, substrate,
diet (excess protein
or calories)
Outward rotation of
tibiotarsal bone(s)
Macaws
Low humidity
Constrictive defect on
toe, edema, necrosis
Weak neck
African grey
parrots,
cockatiels
Unknown
Supportive bandage or
container
Foreign body
Macaws
Hunger
(shavings,
com cobs)
Aspiration
Various
Improper feeding,
anesthesia
Dyspnea, depression
Oxygen, antibiotics
Pharyngeal
puncture
Various
Improper syringe
feeding
Swelling, anorexia,
death
Crop bums
Various
Crop stasis
(sour crop)
Various
Bacterial, viral,
yeast, chick too
cold, foreign body
Vomiting and
regurgitation
Various
Vomiting
Polyomavirus
New World
species
Polyomavirus
Supportive care
Cockatoos,
others
Psittacine circovirus
Malformation (clubbing,
No treatment
stunting, and pinching off)
and hemorrhages in
developing pinfeathers,
diarrhea, death
Chlamydiosis
Various
Chlamydophila
psittaci
Depression, diarrhea,
jaundice
Doxycycline
Nutritional Problems
With the ready availability of commercial hand-feeding formulas, inadequate diet
in neonates is not as much of a problem today as it once was. However, some
breeders still use homemade diets that are not nutritionally adequate, leading to
nutritional problems in their young birds. (See discussion on nutrition in
Chapter 1 on page 23.)
Another problem related to diet in neonates results from new owners not feeding
their young, hand-fed birds enough formula. All too often, birds waste away and
die due to the inexperience of their owners. New owners should always be taught
proper hand-feeding techniques and proper techniques for effectively weaning a
baby bird. Due to the numerous problems that can occur during hand feeding,
many breeders will not sell unweaned birds.
Nutritional deficiency problems also frequently occur in recently weaned chicks
that are sold to new owners. Due to the stress of being in a new environment, these
birds may revert to wanting to be hand fed and may stop eating on their own. New
bird owners should be counseled on how to determine if their birds are eating on
their own, as well as how to evaluate droppings. Monitoring of weight is impor
tant in weaning or newly weaned birds, so the purchase of a scale should be rec
ommended to the client to protect their investment. If these birds are not carefully
monitored, they can waste away.
Another nutritional problem frequently seen in young birds is oversupplementa
tion. Because most formulated diets require no supplementation and oversupple
mentation has potentially harmful results, there should always be a clear indication
for the use of additives, and care should taken when they are used. Practitioners
should always check with their clients to determine the quality of the diet being
given to their birds, to determine whether additives are being given, and to deter
mine whether the diet and additives are being given appropriately.
An additive that is frequently overused is calcium. Calcium oversupplementa
tion is particularly dangerous when excess amounts of calcium and vitamin D3
are included in the supplement. On numerous occasions, birds have suffered
from vitamin D3 toxicosis with resultant renal mineralization12 (see Figure 31
on page 179).
Aspiration Pneumonia
Aspiration pneumonia can occur any time food is inhaled into the lungs. Most
cases seen in avian practice occur in baby birds during the hand-feeding process.
The most frequent cause is owner carelessnessaccidentally depositing food into
the glottis or overfilling the crop, with resultant backup into the oral cavity. When
the crop is overfilled, the food retropulses into the oral cavity, where it can be
inhaled through the glottis. A neonate with an overfilled crop can regurgitate and
aspirate merely by lying down. Hand-fed birds may also regurgitate and possibly
aspirate if the food is not the right consistency or temperature.
Treatment for aspiration pneumonia can be diff i cult, and the prognosis will depend
upon how much food was inhaled. Aspiration of a large amount of food can lead
to sudden death. Aspiration of small amounts can produce a chronic pneumonia.
Antibiotics coupled with nebulization therapy have proved useful in treatment.
Crop Stasis
Crop stasis, also termed sour crop, is another condition that is frequently seen in
hand-fed birds. It can result from numerous causes, both primary (involving the
crop directly) and secondary, with the result that normal flow of material through
the crop to be slowed or stopped.
Primary Causes
One cause of crop stasis is the presence of foreign bodies in the crop. Because
unweaned birds do not know what is food and what is not, they often pick up and
ingest nonfood items. They should be carefully watched when wood shavings or
corncob is used as the cage substrate material to be certain that they do not ingest
pieces of the substrate. Foods such as whole peanuts in the shell should be
avoided, since weaning birds may pick them up and swallow them whole.
Although these foreign bodies can sometimes be manipulated retrograde out of the
crop and into the oropharynx, surgery may be required. The sooner a bird is seen
after a foreign body is ingested, the better, as the surgical procedure required if the
material passes into the proventriculus is much more difficult than that for remov
ing material from the crop.
Another cause of crop stasis is infection of the crop wall and resultant irritation.
Whereas bacterial infection of the crop can be responsible, most of the time the
condition results from the secondary involvement of systemic or gastrointestinal
bacteria. Candida may also be responsible. Candida can lead to a thickening of the
crop wall, producing a Turkish toweltype appearance and slowing transit. It
sometimes also involves the esophagus
and oropharynx. Candida can affect
any species of bird, but the problem is
especially common in cockatiels.18
In addition, stasis can be caused by an
atonic crop condition. Atony results
from overfilling of the crop with ensu
ing stretching and loss of normal nerve
function or tone. An atonic crop will not
empty properly. Crop supports may be
helpful in this condition, supporting the
crop until nerve function can return and
the crop begins to empty normally
again (Figure 68).
Figure 68
Crop supports often are placed on birds with over
stretched crops or on those with poor emptying action
(in combination with other diagnostic and treatment
strategies). (L. M. Bauck, DVM)
Secondary Causes
One of the many possible secondary causes for crop stasis is dehydration. In dehy
drated birds, gastrointestinal function slows down, and water is often absorbed out
of the food in the crop, leading to an impaction.
Another secondary cause, as discussed earlier, is systemic infection, which will
generally slow overall functioning in the bird. A common mistake made by vet
erinarians when presented with a bird suffering from crop stasis is to perform a
crop wash and crop culture and sensitivity testing, ignoring the possibility that
a systemic illness is occurring. Avian polyomavirus and other systemic viral ill
nesses may also cause delayed crop emptying. In addition, malnutrition and
low environmental temperature can slow crop emptying time.
Further, since the crop is a reservoir, material will often accumulate in it when
there is interference with gastrointestinal motility lower in the tract. Hence,
when the crop wash shows bacteria and yeast, these may be secondary.
Whenever crop stasis is evaluated, it is important to evaluate the whole bird,
including a fecal evaluation.
Treatment
Although the treatment of crop stasis depends upon what is causing the condition,
certain initial steps should be taken no matter what the cause is. First, the fluid
accumulation in the crop should be removed. An effective and safe way to evac
uate the crop is to aspirate it with a feeding tube, such as with a soft rubber ure
thral catheter of the appropriate size. Additional holes can be cut into the tube to
facilitate removal. If the crop material is thick or the crop is impacted, a small
amount of water can be added into the crop and mixed to ease aspiration. Extreme
caution must be used when emptying a dilated crop, since handling can easily
lead to regurgitation and aspiration of the fluid. Some sources advocate turning
the bird downward and quickly emptying the crop by squeezing or milking, pro
pelling the contents through the mouth. This procedure can be effective, but a risk
for aspiration exists.
Once the crop has been emptied, appropriate medical therapy can be initiated.
Parenteral antibiotics are preferred, since drugs given orally may not reach thera
peutic levels quickly enough due to the delayed emptying of the crop. To over
come dehydration, intravenous or subcutaneous fluids can be given. When feeding
is resumed, the solution should be very dilute, and small amounts should be given.
Products such as Pedialyte and Emeraid I are useful. As the crop begins emptying
normally, larger amounts can be given. The solution can then be gradually thick
ened until normal consistency is reached.
Although some minor cases of crop bum may not require surgical correction, such
situations are rare. More typically, surgical intervention will be the only option,
and if the surgery is not done correctly, recurrence is likely. It is imperative that the
edges of both the epithelium and the crop wall be trimmed back to viable tissue,
debrided, and closed. Two-layer closure is essential, for if there is not adequate
separation of the epithelial and crop layers, fistulation may redevelop.
Prevention of this condition is accomplished through the practice of good hus
bandry and good hand-feeding techniques. Owners should be instructed to mix
formula well after warming it and to check the temperature before administration.
Uneven heating by microwave and poor mixing are two frequent causes of crop
bum. Although the formula may appear to be a safe temperature at the surface, it
may be dangerously hot further down, where it would most likely be drawn up
into a syringe.
Infectious Diseases
Young birds are prone to many infectious diseases, since their immune systems are
still developing and they often have little natural immunity. Because many breed
ers raise chicks directly from the egg in as sterile an environment as possible, the
birds have little exposure to the flora with which they would naturally come in
contact if they were parent-raised.
When a bird is transferred from the aviary to its new home, it is exposed to differ
ent bacterial populations against which it has no defense. Further, the new bird
may have a resident population of potential pathogens. Although they may have
caused no problem in the aviary setting, when the bird is placed in its new envi
ronment, its immunity may drop due to stress, making it more vulnerable to the
development of disease from these previously innocuous organisms. In addition,
the bird may shed these organisms, leading to the exposure of the resident popu
lation of birds. Such occurrences reinforce the importance of a quarantine period
whenever a new bird is introduced into a collection.
Due to the susceptibility of young birds to bacterial infections, cultures and sensi
tivities should be performed quickly whenever these birds are ill to determine the
proper therapy. Because chlamydiosis is always a consideration, any newly pur
chased bird brought in for examination should be tested for this condition. Quite
often, aviaries are affected with chlamydiosis, and all too frequently the breeders
are unaware of the problem.
Viral disorders are also common in young birds, with some viruses being espe
cially problematic, such as psittacine beak and feather disease virus and
polyomavirus. Proper screening tools for these and other viruses should always be
employed before new birds are introduced into a collection.
Mycotic Infections
Candida is frequently seen in neonates as either a primary condition (usually in
cockatiels) or a secondary condition. Most mild cases will respond to nystatin.
Because nystatin works by direct contact rather than by being absorbed systemically, it is very safe. More severe cases of candidiasis require systemic antifungals.
Aspergillosis is a disease caused by exposure to the fungal spores in the environ
ment coupled with susceptibility. It typically occurs in immunocompromised birds
subjected to poor husbandry practices. Neonates are at a higher risk than older
birds, since their immune systems are still developing and they are undergoing the
stresses of the hand-feeding process and weaning. Treatment is with systemic anti
fungals. Exposure to large amounts of fungal spores can cause an overwhelming
case of aspergillosis in a neonate, resulting in rapid death.
Orthopedic Problems
Leg Deformities
Splay (or spraddle) legs are commonly seen in neonates. With this condition, there
is a deformity in the legs in which there is a deviation outward. The deformity is
usually related to the stifle; however, hip changes can be seen. There are many
possible causes for this condition, including trauma, inadequate substrate in the
nest or brooder (the condition is especially common in birds kept on hard, slippery
surfaces), metabolic bone disease, and calcium, phosphorus, or vitamin D3 imbal
ances.151 Tarsometatarsus deviation, another type of leg deformity, can be seen in
neonates that are kept in a container with a rounded bottom. In addition, poor
nutrition can lead to greenstick fractures, folding fractures, and other feet and leg
deformities (see Figure 30 on page 178).
Figure 69
Lateral leg deviations may be multifactorial in
etiology. Early intervention with tar
sometatarsal hobbles is usually successful.
Avoid slippery substrates. (L. M. Bauck, DVM)
Figure 71
Prognathism is less common than a lateral beak deviation but may
be seen in species such as macaws and cockatoos.
(L. M. Bauck, DVM)
References
1.
2.
Romagnano, A., Wolf, S., Schubot, S., Cray, C., and Bond, M. Maldigestion and
Hypoproteinemia Syndrome in Palm Cockatoo Chicks. In Proceedings o f the
Annual Conference of the Association o f Avian Veterinarians, Tampa, FL: 1996:
89-90.
3.
4.
Otten, B. A., Quesenberry, K. E., and Jones, M. P. Reference Ranges for Serum
Lipid Levels in Amazon Parrots. In Proceedings of the Annual Conference of the
Association of Avian Veterinarians, Orlando, FL: 2001: 95-97.
5.
6.
Diseases o f Cage and Aviary Birds, 3rd ed., Baltimore, MD: Williams and Wilkins,
1996: 490-500.
7.
Fraser, C. M., Bergeron, J. A., Mays, A., and Aiello, S. eds. The Merck Veterinary
Manual, 7th ed., Rahway, NJ: Merck & Co., 1991: 591.
8.
Avian Medicine: Principles and Application, Lake Worth, FL: Wingers Publishing,
1994: 63-95.
9.
10. Clubb, S. L., Clubb, K. J., Otero, T. D., and Schubot, R. Analysis of Psittacine
Diets Fed at ABRC. In Schubot, R., Clubb, K. J., and Clubb, S. L. eds., Psittacine
Aviculture, Loxahatchee, FL: Avicultural Breeding and Research Center, 1992:5-59.
11. Jenkins, J. Ratite Medicine and Surgery. In Rosskopf, W. J. and Woerpel, R. W.
eds., Diseases of Cage and Aviary Birds, 3rd ed., Baltimore, MD: Williams and
Wilkins, 1996: 1002-1006.
12. Roudybush, T. Nutrition and Avian Kidney Disease. In Proceedings of the Annual
Conference of the Association of Avian Veterinarians, New Orleans, LA: 1999:
109-116.
13. Roset, K., Hassler, K., and Phalen, D. N. Determination of Safe and Adequate
Dietary Calcium and Vitamin D 3 Concentrations in a Companion Parrot. In
Proceedings o f the Annual Conference of the Association o f Avian Veterinarians,
Portland, OR: 2000: 239-242.
14. Brae, R. N. Concepts in Psittacine NutritionNeonatal, Adult, Clinical. In
Proceedings of the North American Veterinary Conference, 2001: 15: 722-724.
15. Lothrop, C., Harrison, G. J., Schultz, D., and Utteridge, T. Miscellaneous
Diseases. In Harrison, G. J. and Harrison, L. R eds., Clinical Avian Medicine and
Surgery, Philadelphia: W. B. Saunders, 1986: 525-536.
16. Harrison, G. J. and Harrison, L. R. Nutritional Diseases. In Harrison, G. J. and
Harrison, L. R eds., Clinical Avian Medicine and Surgery, Philadelphia: W. B.
Saunders, 1986: 397-407.
17. Gamer, M., West, G., and Talcott, P. Five Lorikeets with Hemochromatosis
Associated with High Concentrations of Dietary Iron. In Proceedings of the Annual
Conference o f the Association of Avian Veterinarians, Portland, OR: 2000:215-216.
18. Rosskopf, W. R. and Woerpel, R. W. Pet Avian Diseases and Syndromes. In
Rosskopf, W. J. and Woerpel, R W. eds., Diseases of Cage and Aviary Birds, 3rd ed.,
Baltimore, MD: Williams and Wilkins, 1996: 260-282.
19. Worell, A. B. Phlebotomy for the Treatment of Hemachromatosis in Two Sulfur
breasted Toucans. In Proceedings of the Annual Conference o f the Association of
Avian Veterinarians, Chicago: 1991: 9-14.
20. Dorrestein, G. M., et.al. Hemochromatosis/Iron Storage: New Developments. In
Proceedings o f the Annual Conference of the Association o f Avian Veterinarians,
Portland, OR: 2000: 233-238.
21. Wissman, M. A. Personal communication.
22. Phalen, D. N., et. al. Psittacid Herpesviruses and Herpesvirus Disease in Psittacine
Birds. In Proceedings o f the Annual Conference o f the Association o f Avian
Veterinarians, Portland, OR: 2000: 259-262.
23. Phalen, D. N., et al. Diagnosis of Parrots Infected with Pachecos Disease Viruses.
In Proceedings o f the Annual Conference o f the Association o f Avian Veterinarians,
Orlando, FL: 2001:87-89.
24. Ritchie, B. W. Herpesviridae. In Avian Viruses: Function and Control, Lake
Worth, FL: Wingers Publishing, 1995: 171-222.
25. Ritchie, B. W. Management of Common Avian Infectious Diseases. In Wildlife
Exotic and Zoo Animal Medicine Conference Proceedings, Madison, WI: 2001:
1-19.
26. Ritchie, B. W. An Update on Avian Viral Diseases. In Proceedings of the North
American Veterinary Conference, 2000: 14: 916-919.
40. AnitofF, N. It Isnt Always PDD: Three Cases with Proventricular Enlargement. In
Proceedings of the Annual Conference of the Association o f Avian Veterinarians,
Orlando, FL: 2001:35-37.
41. Taylor, M. New Research in Psittacine Gastrointestinal Motility in Normal and
Disease States. In Proceedings of the Annual Conference of the Association of Avian
Veterinarians, Reno, NV: 1997: 131-132.
42. Taylor, M., Hagen Avicultural Research Institute, Montreal. Unpublished data; 1995.
43. Roudybush Proventricular Dilatation Syndrome Client Education Flyer.
44. Harris, D. J. Clinical Appearance of Avian Viral Disease. In Proceedings of the
North American Veterinary Conference, 2000: 14: 884-887.
45. Ritchie, B. W. Paramyxoviridae. In Avian Viruses: Function and Control, Lake
Worth, FL: Wingers Publishing, 1995: 253-284.
46. Phalen, D. N., et al. Genetic Diversity of Avian Polyomavirus: Clinical
Implications. In Proceedings of the Annual Conference of the Association of Avian
Veterinarians, Orlando, FL: 2001: 171-172.
47. Greiner, E. C. and Ritchie, B. W. Parasites. In Ritchie, B. W., Harrison, G. J., and
Harrison, L. R. eds., Avian Medicine: Principles and Application, Lake Worth, FL:
Wingers Publishing; 1994: 1007-1029.
48. Greve, J. H. Gastrointestinal Parasites. In Rosskopf, W. J. and Woerpel, R. W.
eds., Diseases of Cage and Aviary Birds, 3rd ed., Baltimore, MD: Williams and
Wilkins, 1996: 613-619.
49. Bauck, L. A. Survey of Diseases of the Lady Gouldian Finch. In Proceedings of
the Annual Conference of the Association of Avian Veterinarians, New Orleans, LA:
1999: 204-214.
50. Rosskopf, W. J. and Woerpel, R. W. Respiratory Parasites. In Rosskopf, W. J. and
Woerpel, R. W. eds., Diseases of Cage and Aviary Birds, 3rd ed., Baltimore, MD:
Williams and Wilkins, 1996: 620-622.
51. Dorrestein, G. M., et al. Syngamus trachea: An Unusual Infection in Vinaceous
Amazons (Amazona vinacea). In Proceedings o f the Annual Conference o f the
Association of Avian Veterinarians, Orlando, FL: 2001: 59-65.
52. Pokras, M. A. Trichomoniasis. In Proceedings of the North American Veterinary
Conference, 1998: 12: 778.
53. Murphy, J. Psittacine Trichomoniasis. In Proceedings of the Annual Conference of
the Association of Avian Veterinarians, New Orleans, LA: 1992: 21-24.
54. Stahl, S. J. Avian Dermatology: Two Cases with Actual Answers. In Proceedings
o f the North American Veterinary Conference, 2001: 15: 781-782.
70. Redig, R T., Orosz, S., and Cray, C. The ELISA as a Management Guide for
Aspergillosis in Raptors. In Proceedings o f the Annual Conference o f the
Association o f Avian Veterinarians, Reno, NV: 1997: 99-101.
71. Dahlhausen, B., Lindstrom, J. G., and Radabaugh, C. S. The Use of Terbinafine
Hydrochloride in the Treatment of Avian Fungal Disease. In Proceedings of the
Annual Conference of the Association of Avian Veterinarians, Portland, OR: 2000:
35-39.
72. Tully, Jr., T. N. Update on Chlamydophila psittaci. In Seminars in Avian and
Exotic Pet Medicine, Vol. 10, No. 1 (Jan), 2001: 20-24.
73. Flammer, K. Chlamydiosis Treatment Strategies. In Proceedings o f the North
American Veterinary Conference, 2000: 14: 875-876.
74. Phalen, D. H., Hofle, M., Dahlhausen, B., and Styles, D. Diagnosis of Chlamydia
psittaci Infections in Cockatiels and Columbiformes. In Proceedings of the Annual
Conference o f the Association of Avian Veterinarians, New Orleans, LA: 1999:
13-17.
75. Phalen, D. N. Specific Diagnostic Tests for Infectious Diseases: Combining the
Best from the New and the Old. AAV Student Chapter Newsletter, April 2001.
76. Ritchie, B. W. PCR and Beyond: Advances in Avian Diagnostics. In Proceedings
o f the North American Veterinary Conference, 2000: 14: 910-913.
77. Cray, C. and Zielezienski-Roberts, K. Clinical Comparison of Chlamydiosis
Diagnostic Tests. In Proceedings o f the Annual Conference of the Association of
Avian Veterinarians, St. Paul, MN: 1998: 93-94.
78. Dorrestein, G. M. Avian Chlamydiosis Therapy. In Seminar of Avian Exotic Pet
Medicine, 1993: 2: 23-29.
79. Flammer, K. Preliminary Report on the Use of Doxycycline Medicated Feed in
Psittacine Birds. In Proceedings o f the Annual Conference of the Association of
Avian Veterinarians, Chicago: 1991: 1-4.
80. Flammer, K. Preliminary Notes on Treatment of Chlamydiosis with Doxycycline
Medicated Water. In Proceedings of the Annual Conference of the Association of
Avian Veterinarians, Portland, OR: 2000: 3-5.
81. Compendium o f Psittacosis (Chlamydiosis) Control, 1997. Morbidity and Mortality
Weekly Report, July 18,1997, Vol. 46, No. RR-13. U.S. Department of Health and
Human Services, Centers for Disease Control and Prevention, Atlanta, GA.
82. Van Der Heyden, N. Mycobacteriosis. In Rosskopf, W. J. and Woerpel, R. W. eds.,
Diseases of Cage and Aviary Birds, 3rd ed., Baltimore, MD: Williams and Wilkins,
1996: 568-571.
83. Cray, C., Crim, A., and Clubb, S. Serological and Molecular Diagnosis of
Mycobacteriosis. In Proceedings of the Annual Conference o f the Association of
Avian Veterinarians, Orlando, FL: 2001: 83-85.
84. Echols, M. S. Case Presentation #1. In Proceedings o f the North American
Veterinary Conference, 2001: 15: 734.
85. Johnson-Delaney, C. Alveolitis: Pigeon Breeders Lung in Pet Bird Owners. In
Proceedings of the Annual Conference of the Association o f Avian Veterinarians,
Seattle, WA: 1989: 213-215.
86. Joyner, K. L. Theriogenology: Male Reproductive Disorders. In Ritchie, B. W.,
Harrison, G. J., and Harrison, L. R. eds., Avian Medicine: Principles and
Application, Lake Worth, FL: Wingers Publishing, 1994: 774-777.
87. Macwhirter, P., Mueller, R , and Gill, J. Ongoing Research Report: Allergen Testing
as a Part of Diagnostic Protocol in Self-mutilating Psittaciformes. In Proceedings
of the Annual Conference of the Association o f Avian Veterinarians, New Orleans,
LA: 1999: 125-128.
88. Rosskopf, W. J. and Woerpel, R. W. The Psittacine Mutilation Syndrome:
Management, Incidence, Possible Etiology and Therapy. In Proceedings of the MidAtlantic States Association of Avian Veterinarians, 1992: 104109.
89. McCluggage, D. M. Zoonotic Disorders. In Rosskopf, W. J. and Woerpel, R. W.
eds., Diseases o f Cage and Aviary Birds, 3rd ed., Baltimore, MD: Williams and
Wilkins, 1996: 535-547.
90. Bauck, L. A. Neoplasms. In Rosskopf, W. J., and Woerpel, R. W., eds., Diseases
o f Cage and Aviary Birds, 3rd ed., Baltimore, MD: Williams and Wilkins, 1996:
480-489.
91. Gaskin, J. M., Leonard, J. D., Kimpel, J. A., and Lukert, P. D. A Discussion of the
Avian Polyoma Virus. In Journal of Avian Medicine Surgery, 1996: 10: 100-119.
92. McDonald, S. E. A Selection of Disease Syndromes in Psittacine Birds.
Introduction to Avian Medicine and Surgery. In Proceedings o f the Annual
Conference o f the Association o f Avian Veterinarians, New Orleans, LA: 1992:
111- 121.
93. Lightfoot, T. L. How I Approach the Feather Picking Bird. In Proceedings of the
North American Veterinary Conference, 1998: 12: 758-760.
94. Wilson, C. Non-medical Approach to the Behavioral Feather Plucker. In
Proceedings of the Annual Conference of the Association o f Avian Veterinarians,
Tampa, FL: 1996: 3-9.
95. Wheler, C. W. Avian Anesthetics, Analgesics and Tranquilizers. In Seminar of
Avian Exotic Pet Medicine, 1993: 2: 7-12.
122. Tomaszewski, E. K., Snowden, K. F., and Phalen, D. N. The Whipple Paradox:
Megabacteria Exposed as Fungi. In Proceedings of the Annual Conference of the
Association of Avian Veterinarians, Orlando, FL: 2001: 99-100.
123. Dorrestein, G. M Bacteriology. In Altman, R. B., Clubb, S. L., Dorrestein, G. M.,
and Quesenberry, K. eds., Avian Medicine and Surgery, Philadelphia: W. B.
Saunders, 1997: 255-280.
124. Bauck, L. A. Personal communication.
125. Echols, M. S. Liver Disease in Birds. In Proceedings o f the North American
Veterinary Conference, 2001: 15: 731733.
126. Weber, M. A., et al. Benefits and Complications of Liver Biopsy in Birds. In
Proceedings of the Annual Conference o f the Association o f Avian Veterinarians,
Orlando, FL: 2001: 211-213.
127. Bowles, H. L. Update on the Management of Avian Reproductive Disease with
Leuprolide Acetate. In Proceedings of the Annual Conference o f the Association of
Avian Veterinarians, Orlando, FL: 2001: 7-10.
128. Bowles, H. L. and Zantop, D. W. Management of Chronic Egg Laying Using
Leuprolide Acetate. In Proceedings o f the Annual Conference of the Association of
Avian Veterinarians, Portland, OR: 2000: 105108.
129. Bowles, H. L. and Zantop, D. W. Management of Cystic Ovarian Disease with
Leuprolide Acetate. In Proceedings of the Annual Conference of the Association of
Avian Veterinarians, Portland, OR: 2000: 113117.
130. Smith, R. E. Reproductive Disorders. In Rosskopf, W. J. and Woerpel, R. W. eds.,
Diseases o f Cage and Aviary Birds, 3rd ed., Baltimore, MD: Williams and Wilkins,
1996: 449-457.
131. Bowles, H. L. Diagnosis and Management of Female Avian Reproductive
Diseases. In Proceedings o f the Annual Conference of the Association of Avian
Veterinarians, Orlando, FL: 2001: 349-357.
132. Speer, B. L. Diseases of the Urogenital System. In Altman, R B., Clubb, S. L.,
Dorrestein, G. M., and Quesenberry, K. eds., Avian Medicine and Surgery,
Philadelphia: W. B. Saunders, 1997: 625-644.
133. Hoefer, H. Diseases of the Gastrointestinal Tract. In Altman, R. B., Clubb, S. L.,
Dorrestein, G. M., and Quesenberry, K. eds., Avian Medicine and Surgery,
Philadelphia: W. B. Saunders, 1997:419-453.
134. Rosskopf, W. J., et al. Pet Avian Surgical Procedures: An Overview. Introduction to
Avian Medicine and Surgery. In Proceedings o f the Annual Conference o f the
Association of Avian Veterinarians, New Orleans, LA: 1992: 301-312.
Resources
Professional Association
Association of Avian Veterinarians
Membership, client education handouts
(561)393-8901
www.aav.org
Books
A Technicans Guide to Exotic Animal Care
Tully, Jr., T. N. and Mitchell, M. A., Lakewood, CO: American Animal Hospital
Association Press, 2001.
Raptor Biomedicine
Redig, P. T., et al. eds., Minneapolis, MN: University of Minnesota Press, 1993.
Periodicals
The AFA Watchbird
(602) 484-0931
www.afa.birds.org
Bird Talk/
Birds USA
(949) 855-8822
www.birdtalk.com
Bird Times
(336) 292-4047
www.birdtimes.com
Veterinary Clinics:
Exotic Animal Practice
(800) 325-4177
www.harcourthealth.com
Exotic DVM
(800) 946-4782
(561) 641-6745
www.exoticdvm.com
Equipment
AVID Identification Systems, Inc.
Microchips
(800)336-2843
www.avidid.com
Biomune Company
Avian vaccines
(800)846-0230
Dremel
Grinding tool for beak and nail trims
(800) 437-3635
(262) 554-1390
www.dremel.com
Ellman International
Radiosurgical units, beak repair kits,
tissue glue
(800) 835-5355
(516) 569-1482
www.ellman.com
Jorgensen Laboratories
SAM splint (fracture repair)
(800) 525-5614
(970) 669-2500
www.jorvet.com
Lafeber Company
Specula, magnifying loupe,
feeding tubes
(800) 842-6445
(815) 358-2301
www.lafeber.com
Ohaus Corporation
Triple beam balance scale
(973) 377-9000
www.ohaus.com
Laboratories
ANTECH Diagnostics
Avian diagnostics
(800) 872-1001
www.antechdiagnostics.com
Celera AgGen
Blood sexing, DNA testing, registry
(800) 995-2473
www.celera.com
Comparative Pathology,
University of Miami
Full service diagnostics, Aspergillus
antigen, and antibody testing
(800) 596-7390
(305) 243-6928
Department of Veterinary
Pathology, University of Georgia
Necropsy, histopathology
(706) 542-5837
www.uga.edu
Northwest ZooPath
Necropsy, histopathology
(360) 668-6003
www.zoopath.com
Research Associates
Laboratory, Inc.
Full service diagnostics
(513) 248-4700
Southeast Vetlab
Full service diagnostics
(800) 330-1522
(305) 253-1848
Kaytee
Exact avian diets
(800) KAYTEE-1
www.kaytee.com
Lafeber Company
Lafeber avian diets, Emeraids, treats
(800) 842-6445
(815)358-2301
www.lafeber.com
Purina Mills
Mazuris avian diets
(800) 227-8941
(314) 768-4100
www.purina-mills.com
Roudybush, Inc.
Roudybush avian diets,
medicated pellets
(800) 326-1726
www.roudybush.com
Color Plates
Plate 1
335
Normal (dried) budgerigar droppings and polyuric droppings from a
budgerigar with a diabetes-like condition.
Plate 2
336
Avian dropping discolored by blackberry ingestion.
Plate 3
336
Brown coloration of the fecal portion of a bird fed a formulated diet.
Plate 4
337
Dark brown coloration of cockatiel droppings being fed a medicated
pellet.
Plate5
.....................................................
337
Plate 6
338
Polyuria in a budgerigar with diabetes mellitus.
Plate 7
338
Diarrhea (liquid stool) and stained urates in a Moluccan cockatoo
with PDD and a concurrent E. coli infection.
Plate 8
339
Puffed or popcorn droppings seen with malabsorptive conditions,
commonly in budgerigars and cockatiels.
Plate 9
340
Whole seed pieces in the droppings of a macaw affected with PDD.
Plate 10 ........................................................................................................340
Bile-stained urates and poor fecal quality in an Amazon parrot
affected by hepatic lipidosis.
Plate11
........................................................................................................341
Droppings from an Amazon parrot with chlamydiosis.
Plate 12 ........................................................................................................341
Blood present in the urates of an Amazon parrot affected by chronic
zinc toxicosis.
Plate 13 ........................................................................................................342
Classic hemoglobinuria seen in Amazon parrots with lead toxicosis.
Plate 14 ........................................................................................................342
Blood present in the droppings of a young macaw with avian
polyomavirus infection.
Plate 1
Normal (dried) budgerigar droppings and polyuric droppings from a budgerigar with a diabetes-like
condition. Note the dark green fecal portion seen in seed-eating birds due to the bile pigment
(seed imparts no color to the droppings). (L. M. Bauck, DVM)
Plate 2
Avian dropping discolored by blackberry ingestion. (L. M. Bauck, DVM)
Plate 3
Brown coloration of the fecal portion of a bird fed a formulated diet. Note also the
increased fluid content of the dropping that is sometimes seen with birds eating for
mulated diets due to increased water intake. (P. S. Sakas, DVM)
Plate 4
Dark brown coloration of cockatiel droppings being fed a medicated pellet. The simi
larly colored brown pellets can be seen near the droppings. (L. M. Bauck, DVM)
Plate 5
All-urine droppings indicative of a lack of eating or interference with
the passage of feces because of vomiting or obstruction.
(P. S. Sakas, DVM)
P late 6
Polyuria in a budgerigar with diabetes mellitus. Note the increased amount of urine but
the formed fecal portion. (P. S. Sakas, DVM)
P late 7
Diarrhea (liquid stool) and stained urates in a Moluccan cockatoo with PDD and a con
current E. coli infection. (L. M. Bauck, DVM)
Plate 8
Puffed or popcorn droppings seen with malabsorptive conditions, commonly in budgerigars and
cockatiels. Typically, these droppings are indicative of pancreatic exocrine insufficiency and can be
treated with the addition of pancreatic enzymes in the diet. (P. S. Sakas, DVM)
Plate 9
Whole seed pieces in the droppings of a macaw affected with PDD. Whole seeds in the droppings
can indicate malfunction of the ventriculus. (L. M. Bauck, DVM)
Plate 10
Bile-stained urates and poor fecal quality in an Amazon parrot affected by
hepatic lipidosis. (L. M. Bauck, DVM)
Plate 11
Droppings from an Amazon parrot with chlamydiosis. In general, hepatitis causes a yellow-to-green
discoloration of the urates. However, with chlamydiosis, greenish coloration of the urates is typical.
Note also the poor quality of the droppings, scant fecal material, and polyuria. (P. S. Sakas, DVM)
Plate 12
Blood present in the urates of an Amazon parrot affected by chronic zinc toxicosis.
Hemoglobinuria was also present on occasion. (L. M. Bauck, DVM)
Plate 13
Classic hemoglobinuria seen in Amazon parrots with lead toxicosis. Other varieties of birds affected
by lead toxicosis may show varying degrees of hemoglobinuria. (P. S. Sakas, DVM)
Plate 14
Blood present in the droppings of a young macaw with avian polyomavirus infection. Blood is pres
ent in the fecal and urine portions of the droppings. (L. M. Bauck, DVM)
Index
A
Baylisascaris columnaris
(skunk roundworm), 205
Baylisascaris procyonis
(raccoon roundworm), 205
beak. See physical examination
beak injuries, 251
beak-repairing resin. See avian veterinary
practice; equipment
bile acids, 91
bilirubin, 91
biting lice, 217
blood chemistry, 89-92
blood collection, 76-79
blood transfusion, 120
broken blood feathers, 248
brown hypertrophy of the cere, 237
budgerigar
characteristics of, 4
common budgerigar, 4
English budgie, 4
C
CPK (creatinine phosphokinase), 92
calcium, 90
canary
characteristics of, 3-4
Capillaria, 205-206
capture and restraint, 59-65
cardiovascular conditions, 292-297
arteriosclerosis, 295-296
cardiovascular therapy, 296
congenital heart disease, 293
endocardial disease, 295
D
dental acrylics. See avian veterinary practice;
equipment
Dermanyssus (red mites), 216
dermatologic conditions, 236-240
abscesses/granulomas/tuberculosis
lesions, 239
brown hypertrophy of the cere, 237
dermal cysts/macaw "acne," 240
lipomatosis/lipomas, 237
self-mutilation, 237-238
vaccine reactions, 238
xanthomatosis, 240
diabetes mellitus and diabetes-like conditions,
289-290
diagnostics
hands-off physical exam
cage contents, 51
droppings
coloration, 54, 56
consistency, 54
crystalline urate, 53
fecal portion, 53
liquid urine, 53
quantity, 54
evaluation of bird in cage, 56-59
avian ability to mask illness,
56
feather condition, 57
posture, 56
respiration, 58-59
restlessness, 57
evaluation of nutrition, 52
hands-on examination, 59-76
capture and restraint, 59-65
history taking, 50-51
pre-appointment client instructions, 49
diet. See husbandry; diet
DNA probe assay, 95
droppings, 85-86
abnormal, 259-261
coloration, 54,56
consistency, 54
crystalline urate, 53
fecal portion, 53
liquid urine, 53
quantity, 54
drug dosages, 143-165
drug therapy, 120-123
initiating therapy, 121
intravenous drug administration, 121
nebulization, 123
oral drug administration, 122-123
subcutaneous and intramuscular drug
administration, 121-122
topical drug administration, 123
dyspnea, 58-59
E
ears. See physical examination
eclectus parrot See parrots
E.coli
causing colibacillosis (coliform
diarrhea), 261
egg binding (dystocia), 271-274
treatment with human chorionic
gonadotropin (hCG), 270
electrophoresis, 93-94
endocardial disease, 295
endocrine conditions, 289-291
diabetes mellitus and diabetes-like
conditions, 289-290
hypothyroidism, 290-291
endoscope. See avian veterinary practice;
equipment
epilepsy, 286
equipment See avian veterinary practice;
equipment
eyes. See physical examination
F
feather abnormalities, 241-246
alopecia, 242-243
feather cysts, 241
feather mites, 216-217
feather picking/chewing, 244-246
French molt, 243-244
neonatal feather dystrophy, 243
fecal examination
gram stains, 86
wet mounts, 85
fecal matter, 85-86
feeding. See husbandry; feeding procedures
feeding tubes. See avian veterinary practice;
equipment
feet. See physical examination
fibrosarcomas, 280-281
filarial worms, 206-207
finch
characteristics of, 3
fluid therapy, 116-120
flukes, 204
food See husbandry; diet
force feeding (gavage feeding), 123-126
formulary, 143-165
fractures, 246-248
fumes, toxic, 23,296-298
G
GGT (gamma glutamyltransferase), 92
gapeworms, 206
H
Haemoproteus, 211
head. See physical examination
heart. See physical examination
Hexamita (spironucleus meleagrides), 209
history form, avian, 13,45,50-51
human chorionic gonadotropin (hCG), 270
husbandry, 16-32
cage, 16-17
cage accessories, 17-20
cage covers, 20
cage toys, 19
chew toys, 19
location of, 20
temperature and humidity, 20
diet, 23-29
balanced, 24
combination, 24-25
conversion to formulated, 29-30
formulated, 24
ideal, 28
liquids, 27
poor, 24
seed, 25
supplements, 25-27
table foods, 27-28
feeding procedures, 29-31
free-flight, 21
household dangers, 21-23
hypocalcemia syndrome, 286-287
hypothyroidism, 290-291
hydropericardum/hemopericardum, 293
I
identification
leg bands, 13
microchips, 13
identifying smuggled birds, 12-13
incubator, use of, 115-116 Also see avian
veterinary practice; equipment
infectious diseases, 310-311
interval feeding. See husbandry; feeding
procedures
intramuscular drug administration, 121-122
intravenous drug administration, 121
K
Knemidokoptes (scaly face/scaly leg mite),
214-216
L
LDH (lactate dehydrogenase), 91
laboratory equipment. See avian veterinary
practice; equipment
laparoscopy, 98
lateral deviation of the maxilla, 313
lead, ingestion of, 22-23,259
leg bands, 13
legs. See physical examination
leuprolide acetate therapy
diseases responsive to, 280
lifespan of birds.
See pet bird; characteristics of
lipase, 91
lipomas, 282-283
liver conditions, 265-267
enlarged fatty liver, 174-175
lories. See parrots
lovebird
characteristics of, 5-6
M
macaw. See parrots
macaw "acne," 240
mandibular prognathism or maxillary
brachygnathism, 313
marketing the avian practice, 44-47
mate aggression, 279-280
meyers parrot See parrots
microchip identification, 13
microchips and microchip scanner. See avian
veterinary practice; equipment
mineral supplements, 26-27
miscellaneous agents, drugs and dosages,
157-163
monk parrot See parrots
mouth. See physical examination
mouth specula. See avian veterinary practice;
equipment
N
nares. See physical examination
nebulization, 123
nebulizer. See avian veterinary practice;
equipment
nebulizing agents, 139, 153-154
neck. See physical examination
necropsy, 99-100
neoplasia, 280-284
carcinomas, 282
cutaneous lymphosarcomas, 282
fibrosarcomas, 280-281
lipomas, 282-283
pituitary masses, 284
renal or gonadal masses, 283-284
nesting material, 57
neurological conditions, 284-287
epilepsy, 286
hypocalcemia syndrome, 286-287
stroke syndrome, 285
Newcastle disease, 197-199
nutrition. See husbandry; diet
nutritional diseases, 173-182
calcium, phosphorus and vitamin D3
imbalances, 177-180
goiter/iodine deficiency, 180
hemochromatosis, 181
obesity/hepatic lipidosis, 173
vitamin A imbalances
hypervitaminosis A, 176
hypovitaminosis A, 175-176
0
obesity/hepatic lipidosis, 173
open mouth breathing, 58-59
oral drug administration, 122-123
oropharyngeal smears, 86-87
ovarian cysts, 275-276
ovarian/oviductal tumors, 276
overgrown beak, 67,174
P
PCR (polymerase chain reaction). See DNA
probe assay
PBFD (psittacine beak and feather disease),
186-189
PTFE (Teflon), toxic fumes from, 23,297-298
Pachecos disease, 182-183
pain management, 129
papillomatosis, 191-192
parakeet. See budgerigars
parasitic diseases, 203-217
caused by arthropods, 213-217
air sac mites, 213
biting lice, 217
Dermanyssus (red mites), 216
feather mites, 216-217
Knemidokoptes (scaly face/scaly
leg mite), 214-216
caused by helminths, 204-207
ascarids, 204-205
Baylisascaris columnaris
(skunk roundworm), 205
Baylisascaris procyonis
(raccoon roundworm), 205
Capillaria, 205-206
filarial worms, 206-207
flukes, 204
Q
quinolones, 136
R
radiology, 96-98
radiology equipment. See avian veterinary
practice; equipment
radiosurgical unit. See avian veterinary prac
tice; equipment
red-bellied parrot. See parrots
reference materials, 35-36,327-328
renal conditions, 287-289
gout, 287-289
masses, 283-284
polyuria, 289
S
SGOT (serum glutamic-oxaloacetic
transaminase). See AST
Sarcocystis, 210
sengal parrot. See parrots
sex determination, 73-75
sexual behavior and aggression, 278-279
sick bird care. See treatment
sinusitis/rhinitis, 253-254
smuggled birds, 12-13
specialized laboratory services, 94-95,330
T
table scraps. See diet; table foods
tail bobbing, 58-59
talking ability. See pet birds; characteristics of
Teflon (PTFE), toxic fumes from overheating,
23
Tetracyclines, 137
therapeutics, 133-140
aminoglycosides, 135
antifungal agents, 138
antimicrobal agents, 134-135
antiparasitic agents, 139
cephalosporins, 135-136
corticosteroids, 138-139
nebulizing agents, 139
penicillins, 136-137
psychotropic agents, 140
quinolones, 136
tetracyclines, 137
topical agents, 140
trimethoprim-sulfonamide
combinations, 137-138
topical agents, 140,156-157
topical drug administration, 123
tom pygostyle/tail base laceration, 249
toxic
fumes, 23
houseplants, 23
substances, 22-23,259
toxicoses, 296-302
lead toxicosis, 22-23,259,298-300
PTFE toxicosis, 23,297-298
toxic fumes, 23,296-297
zinc toxicosis, 23,259,300-302
trachea See physical examination
trauma, 246-251
beak injuries, 251
broken blood feathers, 248
cat bites and scratches, 251
fractures, 246-248
split sternum, 249-250
subcutaneous emphysema, 250
tom pygostyle/tail base laceration, 249
treatment, 115-129
air sac cannulation, 128-129
anesthesia, 126-128
blood transfusion, 120
drug therapy, 120-123
initiating therapy, 121
intravenous drug administration,
121
nebulization, 123
oral drug administration, 122-123
subcutaneous and intramuscular
drug administration, 121-122
topical drug administration, 123
fluid therapy, 116-120
gavage feeding (force feeding), 123-126
heat and humidity, 115-116
pain management, 129
Trichomonas, 207
trimethoprim-sulfonamide combinations,
137-138
twice-a-day feeding. See husbandry; feeding
procedures
U
ultrasound, 98
unwanted egg laying, 268-271
upper respiratory infections, 253
uric add, 90
urinalysis, 87
V
vent. See physical examination
veterinary practice. See avian veterinary
practice
viral diseases, 182-203
Newcastle disease, 197-199
Pachecos disease, 182-183
papillomatosis, 191-192
pigeon paramyxovirus, 199-200
polyomavirus, 200-203
poxvirus, 183-186
proventricular dilatation disease,
193-197
psittacine beak and feather disease
(PBFD), 186-189
psittacine circovirus 1,186
psittacine circovirus 2,186
vitamin A imbalances
hypervitaminosis A, 176
hypovitaminosis A, 175-176
vitamin supplements, 26
W
weight, 76
wheezing, 58-59
wings. See physical examination
Z
zinc, ingestion of, 23,259
zoonoses, 225-236
allergies-234
chlamydiosis (psittacosis), 225-231
hypersensitivity pneumonitis
(pigeon breeders lung, bird
keepers lung), 234
acute hypersensitivity
pneumonitis, 235
chronic hypersensitivity
pneumonitis, 235-236
subacute hypersensitivity
pneumonitis, 235
influenza A, 233-234
salmonellosis, 231
tuberculosis, 232-233
handbook.
9 781583 260357