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co m/avian-medicine-2/avian-nutritio n/tube-feeding/

Avian Medicine: Avian Nutrition: Tube Feeding Birds

Date: June 19, 2007; Updated Dec 9, 2010.

Key words: Cro p, tube, nutritio n, gavage, bird.

Key Points
Estimated crop volume is 50 ml/kg. Begin f eeding one-third to one-half of estimated crop volume
to the critically ill patient.
Always tube f eed warm f ormula (100-105F or 38 to 41C).
Tube f eeding should always be the last treatment perf ormed.
Most birds are tube f ed between two to f our times daily.

Fo r the best video experience, see o ur Video Clip page fo r advice.

Introduction
Tube f eeding, also known as gavage f eeding, is an essential part of avian supportive care. Sick birds are
of ten presented with a history of anorexia. Glycogen stores may be depleted within hours in the granivore
(including psitacine, passerine and gallif orm species) secondary to a relatively high metabolic rate. Another
important indication f or gavage f eeding is a documented drop in body weight of 5 to 10%.

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Equipment needed
Figure 1. Use an oral speculum to pass f lexible tubing in
psittacines.

Feeding tube

Curved stainless steel ball tipped f eeding tube (Ejay

International, Glendora, CA)
Flexible rubber tubing such as red rubber catheters or
silicone tubes (Sovereign Feeding Tube, Sherwood
Medical, St. Louis, MO) may also be used in parrots when
an oral speculum is in place (Jorgensen Laboratories,
Loveland, CO) (Fig 1).

Curved stainless steel ball tipped f eeding tubes are easiest to use
in parrots.

Contraindications and potential complications

T he most important contraindication f or tube f eeding is lack of experience since improper tube f eeding can
result in:

Aspiration and possible death

 If the tube is passed f orcef ully, it may lacerate the oropharynx. If continued, f ood may be injected
through the laceration and into the surrounding tissue potentially causing lif e-threatening cellulitis.

Restraint and tube passage should be practiced so the technique may be perf ormed ef f iciently, saf ely, and
gently in the clinical patient. Tube f eeding is also contraindicated in birds that are regurgitating, dehydrated,
or those that are not alert, responsive, or able to keep their heads elevated.

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Calculate the volume to be f ed

T he crop may hold up to 5% of body weight, or 50 ml/kg, in the adult bird, although neonatal crops can hold
more proportionally. It is prudent to begin with a f ood volume that is one-third to one-half of estimated
crop volume, especially in the critically ill patient. As long as regurgitation does not occur, increase the
volume f ed over two to three f eedings.

For example, the crop of a debilitated 100-gram bird should hold approximately 5 ml of f luid. For the f irst
f eeding, tube f eed 2 to 3 ml of f ood. As long as this volume is tolerated, increase the next tube f eeding to
3 or 4 ml. By the third f eeding, volume may be increased to 5 ml.

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Step-by-step instructions f or tube f eeding

1. T he bird should be warm and hydrated prior to tube f eeding.
2. It is crucial that hand-f eeding f ormula be warm (100-105F or 38 to 41C) since f ormula that is
too cold may promote regurgitation.
3. Feeding should always be the last treatment perf ormed to minimize the risk of regurgitation
secondary to the stress of restraint.
4. Restrain the patient near its hospital cage so it may be returned promptly. Always restrain the
patient upright f or tube f eeding.
5. Until one is prof icient, tube f eeding should be perf ormed as a two-person procedure. One
person should restrain the patient and monitor its status while the second person passes the
tube. With practice, it is possible f or one person to gavage f eed using a ball-end metal f eeding
tube. Gently yet f irmly stretch the neck thereby straightening out the normal S-shaped curve of
the avian neck and theref ore straightening out the esophagus (Fig 2).

Palpate the thoracic inlet region bef ore passing

the tube to ensure the crop is f ree of f ood or
f luid. Delayed crop emptying is a common f inding
in the ill avian patient.
Pass the tube starting f rom the birds lef t. Direct
the tube towards the right and down into the crop
at the level of the thoracic inlet. You will see
f eathers on the right side of the neck move as
the tube descends into the crop. If using a metal
gavage tube, avoid the f leshy commissure of the
mouth or rictus, which can easily bruise. Pass the
tube f irmly yet gently, slowly, and caref ully. Never
f orce the tube.
Fig ure 2.. Se e
T he large, muscular tongue of the psittacine
prevents easy visualization of the back of the
throat; theref ore correct positioning of the tube must be
 conf irmed by gentle palpation of the neck. (Ball tipped tubes
are also easily seen through the thin skin of the neck in small
birds).
Inf use f ood into the crop using a steady, measured pace
while caref ully watching f or f ormula welling up in the back of
the throat.(If f ood does well up in the back of the throat,
withdraw on the syringe plunger to reduce the volume of
f ood inf used. Next, remove the tube and return the bird to its
enclosure. T he bird may shake its head and expel any excess
f ood).
Return the bird to its cage.
Rinse and clean syringes and tubes immediately af ter use..

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Frequency
Depending on the product used and the clinical condition and caloric needs of the patient, tube f eeding is
of ten perf ormed two to f our times daily. Small birds eat a higher percentage of their body weight on a daily
basis than large birds. For instance, a 100-gram bird may eat up to 25% of its body weight daily while a
1000-gram bird may eat approximately 10% of its body weight per day. T heref ore more f requent f eedings
are of ten indicated in small birds and juveniles.

Table 1. Suggested f requency of f eeding based on species.

Species Frequency of Feedings

Finch 4 hours

Budgie, lovebird, cockatiel, small conure 6 hours

Amazon 8 hours

Large cockatoo, macaw 8 to 12 hours

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Monitoring
Caref ully monitor stool production, and continue to provide the tube f ed patient with f resh f ood and water.
Identif y f oods commonly eaten by the patient at home and of f er these items in the hospital.

Weigh the patient on a gram scale at least once or twice daily to ensure that it is at least maintaining, and
pref erably gaining weight. Weigh the patient at the same time or times each day as weight can normally
f luctuate throughout the day.

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Calculation of caloric requirements

For short-term enteral nutritional support, tube f eeding is of ten more a f unction of the volume that may be
saf ely administered. When patients must be gavage f ed f or an extended period of time, it is prudent to
calculate maintenance or resting energy requirements (MER). See Calculating energy requirements f or
additional inf ormation.

Emeraid products
 Carbo- Emeraid Emeraid Emeraid
Product Boost * Nut ri-Support ** Omnivore*** Carnivore Herbivore***

Initial care Long-term Elemental diet Elemental diet Elemental diet

of the ill nutritional support (readily (readily (readily
birds of the debilitated absorbable, absorbable, absorbable,
providing parrot including easily easily easily
calories patients with digestible) f or digestible) f or digestible) f or
Indicat ions and water hepatic lipidosis. the critically ill the critically ill the critically ill
granivore carnivore herbivore

None High Provided as High; provided Low

Prot ein balanced amino as balanced
acids amino acids

Carbohydrat e High High Normal Normal Moderate

Fat None Low High High Moderate

Fiber None Normal Low Low High

Vit amins/ None High vitamin A Normal Normal Normal

minerals content

19.7% monosaccharides 24.65% 20.0% 37.80% 19.00%

Guarant eed (dextrose) Protein Protein Protein Protein
Analyses

14.4% disaccharides 3.4 9.5% Fat 34.00% Fat 9.50% Fat

(maltose) kcal/gram

11.2% trisaccharides 0.5% Fiber 4.50% Fiber 32.00%

(maltotriose) Fiber

54.7% tetrasaccharides &

higher

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Ref erences
Gelis S. Evaluating and treating the gastrointestinal system. In: Harrison GJ, Lightf oot T L, eds. Clinical avian
medicine. Palm Beach: Spix Publishing, 2006;426.

Jenkins JR. Hospital techniques and supportive care. In: Altman RB, Clubb SL, Dorrestein GM, Quesenberry
K, eds. Avian medicine and surgery. Philadelphia: WB Saunders Co, 1997;244-246.

Jones MP, Pollock CG. Supportive care and shock. In: Olsen GH, Orosz SE, eds. Manual of avian medicine.
St. Louis: Mosby, 2000;24, 40-42.

Laf eber T J. Pet bird care: proper technique f or passing a f eeding tube and administration of Emeraid I and
Emeraid II. 1998.

Related topics
Calculating energy requirements

Parrot handling

Passerine handling

Written by Christal Pollock, DVM, Dipl. ABVP-Avian. Video script reviewed by Drs. Scott Echols and Susan
Orosz.