Recognizing Illness in Pet Birds
Peter S. Sakas DVM

Introduction
One of the most important responsibilities of pet ownership is to recognize when your animal is sick. Most people can tell when dogs and cats are ill, but sickness in birds is not easily recognized. One of the greatest frustrations that face avian veterinarians is that by the time a pet bird owner brings a sick bird into the veterinarian the disease condition is usually well-advanced, making treatment difficult, if it can be treated at all.

The failure to recognize illness in birds is not due to the negligence of the bird owners but rather the unfamiliarity with the subtle signs of early disease, which when addressed promptly result in effective treatment of the condition. Anyone can tell that a bird on the bottom of the cage, with ruffled feathers and partially closed eyes is indeed very ill. The purpose of this discussion is to describe the early signs of disease in pet birds so that you can better recognize them. Birds hide their illnesses very well as it is part of their natural defenses. A bird that is obviously sick in the wild will be subject to predator attack or harassed by other birds. Therefore, a bird that has been sick and ruffled all day may perk up when someone walks into the room thus appearing normal in an effort to mask their illness. When birds are no longer to effectively conceal their illnesses, they are usually seriously ill.

Many people believe that birds are frail creatures and the slightest draft could prove fatal. Birds are actually very hardy animals and tolerate conditions as well as any other animal. Unfortunately, the bird that "suddenly got sick and died" had probably been sick for some time; the disease changes unrecognized, so that even the healthiest bird would eventually succumb. Outlined below are some basic signs to evaluate in the assessment of a birds condition. The secret of success is to develop a feel for what is "normal" for your bird. After you are familiar with normal activity, attitude, appetite, etc., changes from the norm may serve to indicate early signs of disease.

General Appearance
Feathers - A healthy bird should be bright-eyed, alert and have clean, nicely preened, sleek feathers held closely to the body. Sick birds will usually ruffle (puff up) their feathers for extended periods of time. When a bird ruffles it is chilled and its ruffled feathers trap a layer of warm air around the bird. The bird will also close its eyes in a sleepy fashion. Birds that huddle on the bottom of the cage and are extremely ruffled are critically ill. Dirty tattered feathers may indicate lack of preening due to illness, mechanical damage due to poor housing, or "emotional upset." Staining of the feathers above the nares (nostrils) indicates rhinitis (nasal discharge). Pasting of head feathers is usually seen with vomiting. The feathers around the vent should be clean. If droppings are stuck to the vent it could indicate an intestinal tract infection or abdominal enlargement.

Posture - The bird should maintain an erect position on the perch, weight evenly distributed on the feet, wing tips crossing over the back and the tail feathers maintaining a straight line with the back. Sick birds will sit with either one or both wings drooped and its tail directed downward. A bird that has their tail directed downward may have a respiratory tract disturbance or abdominal discomfort (infection or enlargement). Tail bobbing/flicking also can occur. Unsteadiness on the perch, wobbliness or low posture on the perch are signs of abnormality. Birds with severe respiratory or abdominal disease may maintain a horizontal position on the perch. Restlessness, shifting of body weight or favoring of one leg may indicate pain or dysfunction due to disease or injury. In budgerigars paralysis or weakness in one leg may be due to kidney tumors.

Attitude - Changes in a birds attitude may indicate a problem. A decreased activity level, the bird that is no longer playful, talking less or not singing may be indications of early disease. Personality changes may also provide early clues, such as the aggressive bird, that you could never handle easily, suddenly becoming passive or the normally friendly bird that becomes aggressive/irritable and wants to remain alone.

Beak - The beak grows constantly and with normal activity should wear down, if this does not occur and the beak overgrows it must be trimmed. However, if the beak quality changes or if the beak suddenly grows rapidly and abnormally it could serve to indicate disease. For example, in fatty liver disease (mainly in budgies eating an all seed diet) the beak overgrows, deteriorates and black/brown spots of hemorrhage are noted on the beak and toenails. Therefore, do not be fooled into thinking that an overgrown beak is strictly due to "not using the cuttlebone". Always check for any unusual crustiness, scaling or enlargements around the beak and mouth.

Feet/Legs - Infections of the feet occur despite precautions. Pressure sores on the bottom of the feet may develop from improper perch sizes and could lead to ulcerations/bumblefoot. Keep the perches clean, vary the sizes, and provide a soft or non-rigid type perch. If you notice weight shifting, redness, swellings, sores on the feet/legs or lameness, veterinary care should be sought quickly. The sole purpose of the leg band is for identification, it should be removed to prevent problems. We very often see irritation of the leg due to the band or injury (such as fracture or dislocation) if the band becomes caught on an object. If the leg band is necessary always check the leg for free movement of the band and any unusual irritation.

Unusual crustiness/flakiness on the legs may indicate a nutritional or parasitic condition and should be properly evaluated. One strong caution-care must be taken whenever cream or ointment are applied to a bird. Never apply it to the feathers as it will spread and destroy the insulative properties of the feathers. If it is to be used on the feet or legs, use it sparingly.

Respiratory Tract - When a bird breathes there should be very little effort. Breathing hard while at rest or heavy breathing for prolonged periods after exercise/exertion can indicate a problem. Any noises heard while breathing such as clicking, wheezing or frequent sneezing are signs of sickness; a bird should breathe with no noticeable respiratory sounds.

Upper respiratory tract infections are very frequently seen in birds. A nasal discharge may appear as fluid in the nostrils or staining of the feathers above the nostrils. Conjunctivitis (pink eye) may also be seen with swollen, reddened eyelids and discharge around the eyes. Early signs of conjunctivitis may be indicated by frequent blinking or partial closing of the eyes for prolonged periods. If the condition worsens into a sinusitis there can be swelling around the eyes. Early recognition of respiratory disease in birds is important because pus in birds is not liquid, rather it becomes "cheesy." Thus when the pus builds up in the sinuses and air sacs removal is very difficult.

A bird that is dyspneic (difficult breathing) with mouth open and gasping is extremely ill and must be handled with extreme caution, if at all. Not all dyspneic birds have a respiratory tract infection. One possibility is a space occupying mass in the abdomen that may prevent full expansion of the air sacs so that air flow through the lungs is greatly reduced. Tail bobbing is another sign of an impaired respiratory tract, whether it is a primary respiratory disease or abdominal enlargement. Heart disease in birds can also cause labored breathing.

Extreme breathing difficulty can lead to the development of cyanosis, indicated by a bluish color of the skin, legs and beak. However, do not be fooled by the normal bluish color of the legs of some birds, particularly budgies.

The incessant, high-pitched squeaking sometimes heard in budgies may be due to goiter and pressure of the enlarged thyroid gland on the syrinx (voice box)/trachea (windpipe). The condition responds nicely to iodine therapy.

Digestive Tract
Food Consumption - A bird that is not eating well is at great risk due to its very rapid metabolic rate and its condition can deteriorate rapidly. It is important to check daily that your bird is eating, and if so, how much. A bird may be picking at the food cup and not actually eating. You must determine if the seeds are being hulled or if they are just being scooped out of the dish onto the floor of the cage. Sometimes a bird may hull the seed but not ingest it. Check the seed cup and bottom of the cage for seed hulls as well as making sure there is not an increased amount of hulled seed present.

If there is hulled seed on the bottom of the cage it must be determined if the bird is not ingesting the seed, regurgitating or vomiting. Regurgitation is a normal part of the courtship behavior. During courtship, regurgitated seeds may be seen on or near the mirror or toys. The bird may even begin to regurgitate to you in a courtship gesture. However, vomited seeds can be seen in sticky clusters throughout the cage - often adhering to the bars of the cage. Further evidence of vomiting is that the head feathers of a vomiting bird are pasted together with vomitus, and this can occasionally mixed with seed.

Grit is a controversial subject. It should only be used sparingly as it is not continually required for the replenishment of the gizzard. However, for the purposes of our discussion, sick birds, especially those with gastrointestinal upsets, tend to overeat grit. This could lead to impaction/blockage. Very often it is believed that a sick bird is eating, when in fact it is consuming only grit. Thus excessive consumption of grit could be indicative of a problem. The best means of determining whether or not a bird is eating enough and that food is passing through normally is to check the droppings daily. In an upcoming section we will discuss this in detail.

Water Consumption - Birds may not appear to drink a large amount of water but they do require an adequate fresh, clean source, changed daily. Birds that begin to drink excessive amounts of water may be suffering from a metabolic disorder (such as diabetes), kidney disease or a digestive tract disturbance. You should have a feel for daily water intake. You do not need to determine the exact amount consumed as some will be lost due to evaporation, for example. Rather you would notice that the water cup is half as full as it normally has been and also that the droppings have become more watery.

Evaluation of the Droppings - Droppings are an excellent indicator of a birds condition. Changes in the appearance of the droppings or their number may be early signs of an abnormality. First and foremost develop a feel for what is normal for your birds. Check the cage papers daily. The number of droppings per day should be fairly consistent, a reduction in number indicates reduced food intake (or passage of food material) and should alert you to a potential disease condition. For example, a healthy budgie should have more than 30-40 droppings per day. Also the appearance of the droppings should be roughly similar. Droppings will change depending upon the variety of food consumed, but if the bird has not had any unusual dietary changes and the droppings appear significantly different, a problem may be developing.

We recommend the cage bottoms be lined with paper so that the droppings can be observed easily on a daily basis and the cage papers discarded daily. If wood shavings or corn cobs are used, although convenient, the character and number of droppings cannot be easily determined. Also if these are used in cages they are not changed as often which could increase the possibility of elevated bacterial populations in the cage bottom. Therefore if you do use wood shavings or cob you must make special efforts to check the droppings daily as well as perform frequent cleanings.

A normal dropping consists of three basic parts; a formed fecal portion, an off white urate portion, and a liquid urine portion. The fecal portion is usually green in seed eating birds as seed imparts no color to the droppings so the green bile color predominates. However if the bird would eat foods other than seed the color of the fecal portion would change. For example, a bird eating pellets would have brownish droppings, a bird fed strawberries would have reddish droppings. The consistency of the droppings will vary with the variety of bird and its diet. A bird that eats fruit, vegetables and other succulent foods will have more watery droppings. Pelleted diets, in addition to causing brownish droppings, may also lead to increased water intake and hence more watery droppings with a less formed fecal portion and increased urine.

Droppings that have suddenly changed consistency and color could indicate disease. The amount of fecal portion should be checked. If the bird is not eating, there may be a scant fecal element or a dropping that is mainly urine with a small amount of bile. It is normal for a bird to "urinate" when it will pass only liquid urine and urate crystals with no fecal matter. However, this is an occasional occurrence and if it predominates a problem exists. Remember that although a reduction in the number of droppings or amount of fecal portion indicates reduced food intake, it may also indicate interference with normal passage of fecal matter, such as with vomiting. Watery droppings should be carefully evaluated to determine if they are due to gastrointestinal disturbance or increased urine production (polyuria). A somewhat formed fecal portion with an extremely watery urine portion or excessive urate portion may indicate a kidney problem or metabolic problem such as diabetes.

A more liquid consistency in the fecal portion of the droppings is suggestive of an intestinal tract infection. Occasionally, birds with an intestinal disturbance may have a grayish coating on the fecal portion due to excessive mucous. When a bird has pancreatic disease it has characteristic "popcorn" droppings which are bulky and off white to gray in color. Undigested seed or grit in the droppings are abnormal and could indicate a gizzard malfunction.

Blood in the fecal portion of the droppings is usually from the cloaca or oviduct. Severe inflammation in the cloaca, ulcerations or tumors may be responsible. Blood may also be seen in female birds encountering difficulty passing eggs. In Amazon parrots and macaws, blood in the droppings could be due to cloacal papillomas, which are of viral origin. Other signs of this condition include straining to defecate and the presence of granulation tissue (appears almost like a strawberry) around the vent and in the cloaca.

The urate portion (urine crystals) should be off white in color. If the urates are yellow or neon green it may serve to indicate hepatitis. The neon green urates may be suggestive of psittacosis. Blood in the urine or urates (to be distinguished from blood in the fecal portion) are indicative of a kidney disturbance or toxicity, particularly heavy metal poisoning such as lead.

Unusual Growths/Enlargements
Birds can develop abscesses, feather cysts and tumors, so any unusual swellings should be properly evaluated. Fat deposits may develop on the chest and/or abdomen and should be considered abnormal. Other abdominal enlargements could indicate the presence of a tumor or an egg. Many times these growths are not detected until they are quite large. Early detection may be accomplished by noting irregular displacement of the feathers. Keep a close watch on your bird as the earlier these problems are treated the greater the success rate.

Conclusion
The above discussion provides some basic tips to help you better understand some of the signs of illness in pet birds. If you observe any of these signs or have questions about your birds condition, do not hesitate to notify your veterinarian for aid a sick bird that is treated promptly and properly has a much better chance of recovery. Yearly physical examinations including blood testing and fecal analysis are strongly recommended for all birds. New birds should be examined shortly after purchase so that their state of health can be properly evaluated. Early detection is the key. In conclusion, develop a sense for what is normal with your bird, deviations from the norm could indicate disease. The more you handle and interact with your bird the greater will be your understanding of the bird as well as your ability to detect potential problems.