If you want to have a pet with whom you can talk for hours, this article can help you. If you’d like to watch this article in a video format, you can visit the following:

So, let’s get started!

1. African Grey Parrots

Taking the number one spot, and no surprises here, is the legendary African Grey Parrot. These birds are widely regarded as the most intelligent talking birds in the world. Studies have shown that African Greys have the cognitive abilities of a five-year-old child, and their ability to understand language, not just mimic it, is truly astounding. 

They can learn over 1,000 words, and some exceptional individuals, like the famous African Grey named Alex, demonstrated the ability to count, identify colors, and understand concepts like size and shape.

Their voices are incredibly human-like, capturing tone, pitch, and even emotional inflection with eerie accuracy. African Greys are also known for their ability to hold contextual conversations, often using words appropriately rather than just repeating random phrases. 

But with great intelligence comes great responsibility—these birds require constant mental stimulation to prevent boredom and stress. Without it, they may resort to destructive behaviors like feather plucking.

African Greys are not just pets; they’re lifelong companions with complex emotional needs and a deep desire to bond with their owners. If you’re ready to provide engagement and stimulation, you’ll have a feathered friend who will talk to you for decades.

2. Amazon Parrots

Coming in at number two are Amazon Parrots, known for their boisterous personality and amazing talking ability. These birds are fantastic mimics. They can develop a vocabulary of around 200–500 words, with some learning entire songs and even replicating accents! 

What sets Amazon Parrots apart is their expressive and enthusiastic delivery. They don’t just repeat words; they engage in conversation with excitement and character, often laughing, whistling, and even scolding their owners with surprising sass.

Amazon parrots love to sing and often mimic music with impressive accuracy. However, they are known to be a bit loud and demanding, and without proper training, they can develop behavioral issues. They require lots of attention and socialization to stay happy.

If you want a talkative, playful bird with a huge personality and the ability to entertain guests, an Amazon Parrot might be perfect for you.

3. Eclectus Parrots

At number three, we have the stunning Eclectus Parrot. These birds have a sweet, melodic voice that is surprisingly soft and clear, making them one of the most pleasant talkers in the parrot world. Unlike the boisterous Amazon parrots, Eclectus parrots have a calm demeanor and tend to speak slowly and thoughtfully. They can surprise you by copying the highs and lows of your voice almost perfectly.

These birds can learn around 250 words, but what’s even more impressive is their ability to use phrases in context. Eclectus parrots are also very observant and sensitive to their environment, making them highly intuitive pets. 

Males and females of this species have very different appearances—males are bright green with candy-corn colored beaks, while females are striking red and purple.

Despite their ability to talk, Eclectus parrots can be a little shy at first, requiring patience and gentle encouragement to bring out their full talking potential. If you prefer a quieter, more thoughtful talker, the Eclectus might be the right bird for you.

4. Indian Ringneck Parakeets

Next on our list is the Indian Ringneck Parakeet, a bird known for its incredible talking ability and cheeky personality. These birds have a high-pitched, clear voice and can speak in full sentences. With enough training and exposure, they can develop a vocabulary of around 200–250 words and enjoy showing off their skills to their favorite humans.

Indian Ringnecks have a curious and mischievous nature, often picking up words they hear frequently and using them in humorous or unexpected ways. They’re known for mimicking tones and sounds with surprising accuracy, sometimes even imitating mechanical noises like doorbells and ringtones.

However, they can be a bit stubborn and independent, so training requires patience and consistency. If you’re looking for a talkative bird that loves to learn and play, the Indian Ringneck is a fantastic choice.

5. Budgerigars (Budgies)

Don’t underestimate the small but mighty Parakeets, also known as budgies. These little birds are amazingly good talkers. Despite their tiny size, they can learn 100 to 300 words, with some budgies known to have been trained with over 1,700 words! 

Their speech is fast, chirpy, and sometimes difficult to understand, but with training, they can mimic human speech surprisingly well.

Budgies are social and love interacting with their owners. They thrive on repetition and enjoy learning new words and phrases. However, their high-pitched voice and rapid speech make them a bit harder to understand compared to larger parrots. 

They also require a lot of mental stimulation to stay happy and healthy. Budgies are prone to obesity if not given enough exercise, so providing them with a spacious cage and time outside of it is crucial. 

Their diet should consist of a variety of seeds, pellets, fresh fruits, and vegetables to ensure proper nutrition. Regular social interaction is essential to prevent loneliness and depression.

If you’re looking for an affordable, low-maintenance talking bird, the budgie is a perfect choice.

6. Cockatoos

Next up is the affectionate and highly expressive Cockatoo. These birds may not have the largest vocabulary, typically learning around 50–150 words, but they make up for it with their charming personalities. 

Cockatoos are emotional, social birds that form deep bonds with their owners. Their speech tends to be gravelly and loud, but their enthusiasm and expressiveness make them great companions.

Cockatoos are also famous for their dancing skills, often bopping to music and showing off their fun-loving attitude. However, they can be quite needy and require a lot of attention to stay happy.

Cockatoos can live for anywhere from 40–60 years, so they are a long-term commitment. Also, you need to keep in mind that without proper mental and physical stimulation, cockatoos can develop destructive behaviors such as feather plucking and excessive screaming very quickly. 

They need large cages and plenty of toys to keep them engaged. A well-balanced diet, regular vet check-ups, and a predictable routine are essential to maintaining their health and happiness. 

7. Quaker Parrots (Monk Parakeets)

At number seven, we have the Quaker Parrot. These small, stocky birds can learn 50 to 200 words and are known for their robotic but clear voices. They love to mimic household sounds and frequently chatter away, making them delightful companions.

Quaker parrots are incredibly intelligent and known for their nest-building abilities, often constructing elaborate structures in their cages. 

However, Quakers can become territorial, so it’s important to set clear boundaries early on.

They require plenty of mental stimulation and can be very noisy if they are bored. They also have a tendency to bond a bit too closely with their owners, which can lead to separation anxiety if left alone for long periods.

If you’re looking for a bird that’s fun, talkative, and full of personality, the Quaker might be a great fit.

8. Macaws

Finally, rounding out our list is the Macaw. While they might not be the best at human speech, they can still learn 50–100 words and have a loud, deep voice that can carry across the house. Macaws are more known for their playful antics and loud squawks than their talking ability, but they do enjoy mimicking sounds and occasionally throwing in a few words.

Macaws are intelligent and need a lot of mental stimulation, so while they may not be the best talkers, they’ll keep you entertained with their antics.

On the flip side, Macaws have very strong beaks that can destroy furniture and cages, so providing them with sturdy, bird-safe toys is important. They are highly social birds and can develop behavioral issues if neglected. Due to their loud calls and long lifespan of up to 80 years, potential owners must be prepared for a lifelong commitment.

So there you have it—8 birds that can mimic human speech almost perfectly. Which one is your favorite? Let us know in the comments! Don’t forget to like, subscribe, and hit that notification bell for more awesome bird content. Thanks for watching, and we’ll see you next time!

Whether it’s their demanding care requirements, strong personalities, or special diets, these birds thrive best under the guidance of seasoned owners. Let’s explore each bird in detail, focusing on why they are uniquely suited for experienced bird parents.

If you’re a visual person like me, you might want to watch this list on video instead of read, so here’s a YouTube link you should check out.

First on our list are Pionus Parrots.

Pionus parrots might seem like calm, easygoing birds at first, but they need an experienced touch. These medium-sized parrots are known for being quiet and shy, but there are layers to their personalities that only come out once you start to interact with them. Beginners might find it hard to understand their uniquely quiet way of bonding.

Unlike cockatiels, cockatoos, and African grays that demand a lot of attention, Pionus parrots need a patient owner who can slowly build trust with them over time.

They enjoy solving puzzles and playing with toys, but they’re equally fine just sitting quietly in their cages. That said, as a pet parent, you have to give them regular interaction and a balanced diet. Without it, they might become nippy and reserved.

Pionus parrots can live 25 to 40 years, so they’re a big commitment to take on. They’re a great fit for people who understand how to balance long-term bird care with other parts of their lives. If you’re looking for a steady, quiet, but meaningful companion, the Pionus Parrot might be perfect for you.

Next up are Eclectus Parrots.

Eclectus parrots are beautiful birds. The males and females come in dramatically different colors. But don’t let their beauty fool you—these birds are not for a first-time bird parent. Eclectus parrots are highly sensitive to their environment and diet, making them one of the most complex species to care for.

Their digestive systems are uniquely designed for fresh fruits, vegetables, and a small amount of pellets. Beginners often struggle to cater to their strict dietary needs and end up causing the birds malnutrition or other health issues. I would never recommend a first timer to take on an Eclectus parrot.

These birds are deeply intelligent. They need regular puzzles, games, enrichment activities, and social engagement to keep their minds busy and sharp. If you aren’t careful and regular with their playtime and social needs, you might easily end up causing stress-induced behaviors such as feather plucking in them.

With a long lifespan of 30 to 40 years, Eclectus parrots are a perfect match for seasoned owners who are ready to dedicate decades to the care and companionship of these remarkable birds.

Third, we have the playful and energetic Caiques.

Third, we have the playful and energetic Caiques. Caiques are adored for their clownish personalities and boundless energy, but they can be overwhelming for anyone who doesn’t know how to manage a high-energy bird. 

These small-to-medium-sized parrots demand constant interaction and thrive on structured play. If you’re new to being a bird parent, you might easily get overwhelmed while trying to match their energy levels or provide them with the consistency they need.

Caiques also require firm, experienced handling. Without proper boundaries and training, they can develop nipping or even aggressive behaviors. Their bold, mischievous nature is endearing to seasoned owners but may frustrate those without a deep understanding of bird behavior.

Their dietary and space needs are relatively straightforward, but their high social demands and strong-willed temperament make them a better fit for owners who have handled challenging birds before. Caiques live for 20–30 years, so they need a dedicated and informed caretaker who thrives on their lively antics.

At number four, we have the colorful and charismatic Conures.

Conures are beloved for their playful and affectionate nature, but their loud, raspy calls and occasional stubbornness make them a poor fit for beginners. These medium-sized parrots are highly social and require daily interaction, which can be overwhelming for someone new to bird care.

Their intelligence allows them to learn tricks and mimic basic sounds, but they can also be destructive if bored. An experienced owner will know how to provide the necessary toys, foraging opportunities, and training to keep them mentally stimulated.

Their noise level is another factor that seasoned owners are better equipped to handle. Beginners might underestimate how disruptive Conures can be, especially in apartment settings. With a lifespan of 10–30 years, depending on the species, Conures thrive with owners who have the patience and expertise to meet their dynamic needs.

Fifth on our list are Lories and Lorikeets.

Lories and Lorikeets are among the most visually striking birds, but their specialized care makes them unsuitable for beginners. Their diet of nectar and soft fruits is unique among parrots and requires meticulous preparation and cleanup. Without proper care, they can develop digestive issues, and their messy eating habits mean frequent cleaning of their cage and surroundings.

These birds are also highly social and playful, but their territorial tendencies and occasional aggression require a skilled owner who knows how to manage such behaviors. If you’re a first-time bird parent, you might struggle to set boundaries with them or recognize early signs of stress in these birds.

Lories and Lorikeets tend to live for 15-30 years. They are a medium-term commitment that need a deep understanding of their unique dietary and social needs. For seasoned bird lovers, their vibrant colors and energetic personalities make the extra effort worthwhile.

Next, we have Indian Ringneck Parakeets.

Indian Ringnecks are stunningly beautiful and exceptionally intelligent, but their independent nature and occasional aloofness can be challenging for beginners. These medium-sized parrots are known for their clear speech and ability to learn complex phrases, but their intelligence comes with high demands.

Ringnecks require consistent socialization and training to prevent them from becoming shy or even aggressive. A beginner bird parent might misinterpret their independence as disinterest or fail to provide the structure these birds need.

Their care includes a balanced diet, plenty of toys for enrichment, and a spacious cage to accommodate their active lifestyle. With a lifespan of 25–30 years, Indian Ringnecks are best suited for experienced owners who can appreciate their curious and sometimes quirky personalities.

At number seven, we have the bold and vocal Amazon Parrots.

Amazon parrots are charismatic and highly intelligent, but their mood swings and potential for aggression make them a challenging choice. These medium-to-large parrots require confident handling and a deep understanding of bird behavior to manage their strong-willed personalities.

Their care involves a varied diet of fresh fruits, vegetables, and high-quality pellets, as well as a spacious, enriched environment. They are social birds that bond strongly with their owners but can become possessive or temperamental without proper boundaries.

With a lifespan of 30–50 years, Amazon parrots are a lifetime commitment. Their loud vocalizations and complex personalities are best managed by seasoned owners who know how to handle their intensity while fostering their remarkable intelligence.

Eighth on our list are African Grey Parrots.

Often considered the most intelligent bird species, African Greys are capable of understanding not only words but context and even human emotions. However, their high intelligence makes them incredibly demanding.

These birds require daily mental stimulation, interactive toys, and a stable environment to prevent stress-induced behaviors like feather plucking. Beginners often struggle to provide the consistency and enrichment African Greys need.

Their space requirements are significant, with a large cage needed to support their medium size and active lifestyle. They also need out-of-cage time for climbing, foraging, and exploring their surroundings. Their sensitivity to changes in their surroundings and strong attachment to their owners make them better suited for experienced bird lovers who understand how to meet their emotional needs. With a lifespan of 40–60 years, African Greys require a long-term commitment from an owner who can match their intellectual depth.

At number nine, we have Cockatoos.

Cockatoos are famous for their affectionate nature, but their intense social needs make them one of the most demanding parrot species. These birds thrive on constant interaction and can develop destructive behaviors like screaming or feather plucking if neglected.

Their care involves daily social engagement, a spacious environment, and a variety of toys to keep them entertained. Cockatoos require large cages to accommodate their active and curious nature, along with a safe space for out-of-cage activities. Beginners might find their neediness overwhelming, while seasoned owners are better equipped to provide the attention they crave.

With a lifespan of 40–60 years, Cockatoos are best suited for experienced handlers who can dedicate time and energy to maintaining their physical and emotional well-being.

Last but not least, we have Macaws.

Macaws are majestic birds that require extensive resources and knowledge to thrive. Their intelligence and strong personalities mean they need regular training, interactive play, and consistent boundaries.

These large parrots have powerful beaks and can be destructive without appropriate toys and enrichment. Their diet must include a variety of fresh fruits, vegetables, nuts, and high-quality pellets. They also need a massive cage—typically 36 x 48 x 60 inches—and several hours of out-of-cage time daily in a bird-safe room or aviary to stretch their wings and stay active.

With lifespans of 30-50 years or even more, Macaws are a lifetime commitment. Their loud calls and demanding nature make them unsuitable for beginners, but for experienced owners with the space, patience, and dedication, they are truly awe-inspiring companions.

That wraps up our list of the top ten birds for experienced owners!
Each of these species has unique challenges and rewards, but they all require the expertise and commitment of a seasoned handler. 

Our latest exploration into the world of bird watching technologies led us to the Gigalumi Smart Bird Feeder, and we’re thoroughly impressed by the features it offers.

With its on-demand bird watching capabilities, this smart feeder allows us to view and capture high-definition videos of our avian visitors directly through our phones.

The included solar panel is a handy addition for eco-conscious users, ensuring the device remains powered without constant maintenance.

At the core of the product is its patent bird-friendly design—durable, weatherproof, and with a spacious food container that draws in a variety of bird species invitingly.

Moreover, our experience with the crystal-clear night vision feature has been nothing short of amazing.

It allows us to observe nocturnal feathers in vivid color, adding a new dimension to our birding experience.

Although we experienced a brief learning curve with the app notifications, once configured, the real-time alerts of visiting birds kept us engaged without being overly intrusive.

Bottom Line

The Gigalumi Smart Bird Feeder brings a new level of interactive enchantment to our garden’s ambiance. For those who cherish nature’s wonders, this smart bird feeder is a substantial investment.

The device’s ease of use, combined with its ability to connect us with a vast community of bird lovers, enhances both our appreciation for wildlife and our family bonding time.

So, if you’re ready to transform your bird watching journey, you can get the Gigalumi Smart Bird Feeder for a closer, real-time look at the array of feathered friends visiting your backyard.

Gigalumi Smart Bird Feeder Overview

We’ve had the pleasure of experiencing a refreshing twist to birdwatching with the Gigalumi Smart Bird Feeder. It’s an innovative gadget that not only serves as a durable home for our feathery friends but brings the action right to our smartphones.

Its effortless setup and reliable solar power feature keep it constantly ready for action.

The high-resolution camera with its night vision capability gave us vibrant, crisp images of nocturnal visits without missing a beat.

The zoom function allowed us to appreciate the intricate details of feathers from a comfortable distance.

We noted its proficiency in maintaining a stable Wi-Fi connection, which means uninterrupted streaming of bird activity.

Its design caters to the welfare of birds, with a large capacity for bird food and protection against the elements.

We noticed a substantial amount of avian traffic thanks to these thoughtful features.

Sharing captivating bird moments with family and friends was not only effortless but also allowed us to connect with a community of bird enthusiasts globally.

Despite these positives, we did experience a slight delay in notifications, which could be a minor setback for those expecting real-time alerts.

But even with that, it’s been a joyful addition to our birdwatching gear, adding a layer of interaction and sharing that traditional feeders can’t match.

Real-Time Bird Watching

We recently had the opportunity to experience the Gigalumi Smart Bird Feeder, and it offered a surprisingly intimate view into the world of our feathered friends.

The device sends instant alerts to your phone when birds visit, ensuring you won’t miss any exciting sightings.

We found the 1080P color night vision to be notably sharp, capturing vivid details of birds under varying light conditions, although occasionally, the notifications seemed to have a slight delay.

One standout feature is the bird-friendly design – an IP65 weatherproof and sturdy structure with a spacious food container, which meant less frequent refills and no worries about food spoilage due to rain.

Admittedly, our excitement was shared; the ability to distribute charming bird captures among ourselves and friends added a layer of joy to bird watching.

While the setup process was straightforward, it’s worth mentioning the Wi-Fi connectivity hinges solely on a 2.4ghz signal, yet the added 5dBi antenna seemed to enhance its stability.

We noticed an increase in avian visitors, perhaps attracted by the feeder’s inviting design, which served as both an ornament and a magnet for wildlife in our backyard.

In sum, the Gigalumi Smart Bird Feeder provides an interactive and delightful way to observe birds, although perfecting your experience might require minor troubleshooting with app notifications and ensuring stable Wi-Fi connectivity.

High-Definition Night Vision

When we set out to experience bird watching with the Gigalumi Smart Bird Feeder, we didn’t expect the crisp clarity of its night vision capabilities.

Witnessing the nocturnal activities of feathered friends in full color is nothing short of remarkable.

Even under the veil of night, the 1080P resolution camera doesn’t miss a beat, capturing the birds in vibrant detail.

It should be mentioned that although it doesn’t directly list specs, this feeder with camera combo excels at picking up those subtle features—the patterns of feathers, the glint in a bird’s eye—thanks to its 8X magnification.

Seamless connection to Wi-Fi ensures that these nocturnal moments are delivered to us without interruption.

However, it’s not all about the technology.

There’s a sense of pure joy when birds visit after dusk and the feeder allows us to observe without disturbing their natural behavior.

Sure, there’s a slight lag in notifications at times, but the anticipation makes the eventual viewing all the more rewarding.

The integration of a stable power source, provided by a solar panel, is an intelligent touch ensuring those intimate night-time interactions aren’t missed.

Witnessing this nighttime ballet of birds has become a highlight for us, offering a new perspective on a cherished pastime.

Design Tailored for Birds

When we consider the Gigalumi Smart Bird Feeder, it’s immediately clear that this isn’t just another birdhouse.

Its patent design is created specifically with our feathered friends in mind.

The feeder’s capacity is generous, reducing the need to frequently refill while ensuring plenty of food for visiting birds.

As an added bonus for birdwatchers like us, the weatherproof nature of the feeder keeps the seeds dry, preventing mold and keeping our bird visitors healthy.

From our experience with the product, we’ve appreciated the thoughtful touches designed to appeal to birds of all kinds.

The Birdfy feeder stands as a sturdy and safe haven against the elements, which is especially reassuring during unpredictable weather.

Seeing birds flock to its welcoming design has been a delight—not just for casual viewing but for those moments captured by the cleverly integrated camera.

Although we’ve adored watching the birds up close with the high-definition camera, we noted that a 2.4ghz Wi-Fi connection is necessary to maintain a stable link to all the action.

For tech-savvy bird lovers, the tech integration is a boon, yet it may present a slight learning curve for others.

Nonetheless, the joy of sharing bird encounters with family and birdwatcher communities is unparalleled, an experience that effortlessly connects us with nature and each other.

Family Bonding and Community Engagement

We’ve found that the Gigalumi Smart Bird Feeder is more than just a gadget; it’s a means to bring families together and engage with a global community of bird lovers.

Watching colorful visitors together turns into a shared hobby, sparking intrigue and conversation among family members.

It’s delightful to see how quickly it can become a central part of family time, where everyone gathers to enjoy nature’s simplicity and beauty.

However, maintaining the feeder can require some commitment, as we’ve noticed that our feathered friends are frequent visitors and we need to refill it quite often.

Despite this, the bird feeder’s large capacity means less frequent refilling, allowing us more uninterrupted bird watching.

Sharing snapshots and videos with friends has never been easier, fostering connections far beyond our own backyard.

On the flip side, the notification delay on the app can sometimes cause us to miss live visits.

Regardless, the Birdfy turns bird watching into a collaborative experience, whether we’re comparing sightings with neighbors or sharing in the excitement of the community’s rare bird sightings.

It’s certainly given us a deeper appreciation for our local ecosystem and the global network of those who cherish it.

Pros and Cons

Having spent ample time observing our feathered friends through the Birdfy feeder’s lens, we’re well-positioned to give you a balanced look at what works well and what could be improved.

Pros

• Real-Time Notifications: We receive instant alerts on our phones whenever a bird visits, making sure we don’t miss any winged guests.
• High-Resolution Observations: The 1080P camera captures birds in incredible detail, even at night, enhancing our bird-watching experiences.
• Ease of Use: From setup to daily enjoyment, the process is straightforward. We particularly appreciate the phone app’s user-friendly interface.
• Large Capacity: The feeder holds a substantial amount of bird food, reducing the frequency of refills.
• Weatherproof and Durable: It’s built to withstand outdoor conditions beautifully, and has a stable mount, giving us peace of mind regardless of the weather.
• Social Sharing: Sharing captured moments with a community of bird enthusiasts has never been easier, which adds a lovely social dimension to our hobby.
• Solar Charging: The included solar panel is efficient and eliminates the hassle of regular battery charging.

Cons

• Signal Dependency: Although the connection is mostly stable, it relies on having a consistent 2.4GHz Wi-Fi signal, which could be a con for some remote locations.
• Notification Delays: We’ve noted some lag between the actual visit and the notification, which can sometimes dampen the immediacy of the experience.
• Attracts Lots of Birds: Surprisingly, this can be a downside as the feeder might require more frequent refills due to its popularity among the birds in our yard.
• Camera Placement: We found that strategic placement is key. If it’s not ideal, we might not get the best viewing angles of the birds.

Conclusion

In our time observing the Gigalumi Smart Bird Feeder, we’ve found it to be a delightful addition to any bird lover’s garden. The camera clarity is impressive, allowing for stunning visuals of our feathered friends.

The device syncs seamlessly with the app, providing a convenient way to share the joys of birdwatching. While the notifications might experience slight delays, the overall functionality remains robust.

The battery life is commendable, further enhanced by the Solar Lite feature, eliminating the frequent need for recharging. Installation is a breeze, and the feeder itself attracts an array of bird species, some of which were pleasantly unexpected visitors to our yard.

Although the feeder requires regular refills due to its popularity among the birds, this is hardly a drawback considering the enjoyment we’ve derived from the vivid images and videos captured. Overall, the Gigalumi Smart Bird Feeder strikes a balance between functionality and pleasure, making it a worthy investment for those passionate about avian life.

Pododermatitis is a disease of the integument of the plantar (bottom) surface of a bird’s foot. It can also spread to the dorsal (top) surface of the foot. It is caused by irritation, trauma, poor perching, or overweight. It will become progressively worse unless it is treated aggressively. There are seven stages of progression of the disease; the last is so severe that the bird’s foot might need to be amputated. Treatments consist of medical intervention in the early stages and surgical intervention in the later stages. The sooner the affliction is addressed, the more likely are the chances of full recovery.

Introduction 

Pododermatitis, commonly known as “bumblefoot,” has become a frequently seen disease in companion and aviary birds. “Pododermatitis” is a general term for any inflammatory or degenerative condition of the avian foot. Many times, birds will come into the clinician’s office for a routine annual examination, and the feet will show signs of subclinical or even more serious disease. The condition may range from very mild redness or swelling to chronic, deep-seated abscesses and bone destruction. If caught in the early stages, the underlying, predisposing factors may be corrected, and the disease will often be reversed.

1. Which species of birds are most at risk for developing pododermatitis?

Pododermatitis has been reported in many species of birds, but on a clinical level, it is particularly problematic in captive birds of prey, Galliformes (chickens and turkeys), Anseriformes (ducks, geese, and swans), waders, penguins, and many Psittaciformes (parrots). Of the psittacines, Amazons, budgerigars, and cockatiels are particularly vulnerable to this disease. The condition is frequently described in captive raptors, but it may occur in any avian species, including canaries and finches⁴. Because footpads are present in psittacines more so than in other species, birds in the parrot family are more likely to suffer from this disease.²²

Figure 1. Pododermatitis at Grade II on the feet of a finch(image courtesy Tamara Lowes; used with permission). Note the length of the nails. Long nails have a tendency to catch on fabric and other things in the environment, thus causing trauma to the sores on the feet and forcing the feet to stand in unnatural positions.

Figure 2. Pododermatitis at Grade IV on the feet of a finch, plantar surface (image courtesy of Tamara Lowes; used with permission).

Figure 3. Stage III Pododermatitis. The bands should always be removed in birds if possible. They can create additional paid and damage to the feet. The sore on the tarsometatarsus (heel) of the foot gets additional stress and has become infected (image courtesy Aquarium Store Depot, https://aquariumstoredepot.com/blogs/news/bumblefoot-in-birds)

The scales on the feet are composed of highly keratinized epidermal (the outermost layer of skin) tissue, and this tissue covers the lower leg (podotheca) and foot. The nails/claws are formed by plates of strong, keratinized tissue that enclose the terminal phalanx (last toe bone) of each digit.  It is this keratinized tissue on the plantar surface of the feet that gets quickly worn away when the foot becomes irritated and sore.²²

Birds most at risk for developing pododermatitis are obese birds having excess pressure placed on the feet; aged, sedentary and disabled birds; birds with limited mobility; chronically ill birds; and those with any kind of immune system weakness.²¹

Figure 4. Grade III pododermatitis in a Ringneck Parakeet. This is a result of inadequate perching. The perch appears to be too large, and the weight has been born by the back toes (image courtesy Pin by Tria Connell on Bubu’s Feet | Parrot, Bird, Animals). https://www.pinterest.com/pin/402509285443794473/https://www.pinterest.com/pin/402509285443794473/

1.1 What are the risk factors for developing pododermatitis?

• Previous foot or leg injury
• Hard, muddy, flooded, uneven, or rough floor surfaces
• Damp or unsanitary bedding litter
• Vitamin A deficiency
• Overweight
• Excessively dry skin
• Lack of activity
• Excessive activity due to fighting among flock members or guarding behavior (Mainly in chickens)
• Leg or conformation abnormality
• Improperly designed perches (plastic, sharp corners, incorrect diameter)
• Excessive accumulation of feces
• Poor diet
• Overgrown toenails

(Poultry DVM Bumblefoot in Chickens 2021 file:///L:/Pododermatitis/Bumblefoot%20in%20Chickens.html)

1.2 Causes or predisposing factors behind the development of bumblefoot

• Obesity and inactivity, which put more weight on the feet than it can handle. (Poultry DVM Bumblefoot in Chickens 2021 file:///L:/Pododermatitis/Bumblefoot%20in%20Chickens.html)
• Improperly designed perches: perches that are too small or too large and have no variety of diameter; those that are hard or uneven; dowel or hardwood surfaces; any rough-textured perches such as warming perches, and all concrete perches, plastic perches, those covered in sandpaper or burlap, perches with sharp corners, perches that are too narrow, and perches or spirals made of sisal. (J. Miesle)
• Hard, coarse floor surfaces, such as cement. These are common in aviaries, zoos, and breeding facilities. In poultry, floors may have hard, muddy, flooded, uneven, or rough surfaces. (Poultry DVM Bumblefoot in Chickens 2021 file:///L:/Pododermatitis/Bumblefoot%20in%20Chickens.html)
• Poor nutrition and Vitamin A deficiency. Birds need vitamins added to their food. (Some vitamins, such as ©Avi-era (Lafeber) may be added to the water.) If they are on a pelleted diet, reduce and eliminate the pellets. Extra vitamins should not be given until the pellets are eliminated. They should be fed natural, non-pelleted diets consisting of fruits, vegetables, greens, some people foods, and seeds. Sunflower and safflower seeds may be given sparingly. They are high in fat and can lead to hepatic lipidosis (Fatty Liver Disease).  (J. Miesle)
• Poor husbandry: damp, unsanitary bedding and all substrates. An accumulation of feces and an overall unsanitary environment caused by substrates will lead to fungal and bacterial diseases and are a haven for parasites. Plain newspapers, paper towels, or other paper sources are the only things that should be used. Rope perches and natural wood perches wrapped in fleece or cohesive bandage tape to prevent sores are best. (J. Miesle)
• Overgrown toenails
• Stress, hypothyroidism,²¹ and poor hepatic (liver) dysfunction ⁵
• Severe poxvirus lesions with secondary bacterial infections ²¹
• Trauma, particularly among poultry:
  • Fighting among flock members,
  • Previous leg or foot injury leading to crippling
  • Frostbite injuries and thermal burns
  • Leg or conformation abnormalities
  • Cracks or worn-away areas and discoloration of the skin
  • Damage to the plantar surface of the foot. Injuries cause lesions to develop on the plantar surface of the phalanges or on the tarsometatarsus. Plantar decubital ulcers (pressure sores) are common. ²⁰

(Poultry DVM Bumblefoot in Chickens 2021 file:///L:/Pododermatitis/Bumblefoot%20in%20Chickens.html)

• Concurrent illnesses or conditions causing an abnormal standing position
  • Arthritis. Pain in the joints causes the bird to walk on the sides of his feet; in this case, the toes bear most of the bird’s weight.
  • Subdermal infiltrate swelling. The bird in Figure 4 suffered from mycoplasmosis as a result of a staphylococcus infection. He was unable to stand due to a nidus (pocket of bacteria) on the planter surface of the foot.
  • Thickened pads on the bottom of the foot due to scar tissue or previous wounds which have been covered with these pads.
  • Walking on the “heel” of the foot or the side of the foot due to swelling on the toes or center of the plantar surface of the foot. (J. Miesle)

2. The importance of providing the correct perching for the birds

The following perches are known to be detrimental to the plantar surface of the feet and cause pododermatitis in the feet and arthritis in the leg joints. Any of these can be wrapped with fleece or cohesive tape/bandage wrap to vary the diameter of the surface; however, most are round and need to be wrapped with high and low placement of the cushioned wrap.

Many people use Vetrap, but the author has found this tape to collect dirt very quickly, and it is so sticky many birds will not stand on it. Cohesive tape and fleece are better choices of products.

For birds with less serious pododermatitis, wrapping the perches with fleece will give the bird soft surfaces to stand on. For more serious cases, the birds should be kept on towels in bins until they have healed sufficiently to return to the cage. Once there, the perches should be wrapped in fleece. Purchase at least half a yard of fleece and cut several 1-inch strips from it. Wrap the perch from the place closest to the cage bars, overlapping the fleece by half the strips. When you have reached the end of the perch, use a twist tie to wrap around the fleece and hold it on. It will need to be washed at least twice a week, so have extra strips ready to replace them. They wash well in the washing machine. (J. Miesle)

2.1 Perches that are harmful to the bird’s feet and leg joints.

Figure 5. Plastic perches. These are usually too small for the bird, causing the bird to grip too tightly to stay balanced; they also create pressure sores (image courtesy ebay.co.uk).

Figure 6. Kroger’s Tender Tape. This is a cohesive tape/bandage that wraps the perch well without being sticky. It will get dirty, so it must be changed at least once a week. It comes in white and tan. Choose the white tape so you can see soiled areas more easily and change the tape. A similar product can be purchased at the pharmacy with the name “cohesive tape” (image courtesy J. Miesle).

Figure 7. Rough-textured perches. These include cement, calcium, sandpaper, or warming perches. They irritate the plantar surface of the foot and cause sores and arthritis; they do nothing to keep nails short because the nails do not touch the perch (image courtesy K&H Pet Products Bird Thermo-Perch).

Figure 8. Concrete perches should never be used. They irritate the plantar surface of the foot and cause cuts and tears (image courtesy Kathson Bird Perch Parrot Stand Cage Accessories Natural Wooden Stick Paw Grinding Rough-surfaced). 

Figure 9 Sandpaper perch covers for dowel perches. Not only do they not keep the nails filed, but they also cause sores on the feet and arthritis in the legs. They irritate the skin on the plantar surface, causing small cuts and sores. The owner can remove the sandpaper covers and wrap the perch with cohesive wrap or fleece, making sure to vary the diameter of the wrapped surface. Sandpaper covers also have a tendency to slip on the perch, causing the bird to grip too tightly to maintain balance, leading to arthritis (image courtesy Penn Plax Sanded Perch Covers for Small Birds).

Figure 10. Round dowel perches. These will place all the bird’s weight in the same place, and, because they are slippery, they are difficult for the bird to grip, forcing him to grip tighter all the time. Any perch that can become slippery puts additional strain on the muscles of the leg and foot to stay balanced (image courtesy Prevue Pet Products Birdie Basics Wood Perch 10 in).

Figure 11. Hardwood and softer natural wood perches and platforms offer a variety of textures and diameters. Even these can be slippery, causing the bird to grip too tightly. And they are too hard for the bird’s feet. They can be wrapped with cohesive tape or fleece strips for birds with pododermatitis (image courtesy Ebay).

2.2 Platform perches made of wire and wood

Platform perches come in a variety of sizes, shapes, and compositions. They can be found in wood, chrome, and coated wire. They can be a problem if they are not covered in fleece or flannel for all birds, but particularly for the bird with bumblefoot. They should be covered with several layers of soft, padded material, such as a towel, flannel, or fleece cut slightly larger than the platform perch and with a stack of paper towels under the fleece for comfort. These coverings may be held down with binder clips for thinner perches or C-clamps for thicker ones  Never let any bird stand on open wire, as on grids on the bottom of the cage. Cover all wire with paper towels or cloth towels.

Figures 12. Flat wood perches. These should be covered with at least 2 layers of fleece. These perches can be secured with binder clips or C-clamps. For birds who do not have pododermatitis, paper towels may be placed on top of the fleece for easy cleanup (image courtesy Pevor Wooden Parrot Bird Cage Perches, Amazon).

Figure 13. Another type of platform perch is the flat wire perch (image 12 courtesy Platform Perches – Just for Pets). These and the wood platform perches are wonderful for the birds, but they too must be covered with flannel or fleece since the wire is very damaging to the feet. The fleece can be secured with binder clips. The owner can put paper towels on the cloths to protect the surface from droppings and make for easy cleanup. Birds with pododermatitis should be standing only on fleece.

The perches should be of various textures, sizes, and shapes so the bird is not standing on the same plantar surface all the time. Natural perches covered in strips of fleece, and rope perches are best. Oval or flat perches attached to the side or corner are better than round ones all the same size.

You can purchase flannel and fleece fabric from any fabric store, places like Walmart, or online. Cut several layers a little larger than the platform to fit and hang over the sides. Do not use paper towels or other types of fabric on perches for birds with bumblefoot due to their rough texture and slipperiness; in addition, both could be easily ingested. When the feet have improved, loose paper towels may be placed on top of the secured ones for easy cleanup. These cloth towels must be laundered daily or whenever soiled, so you will need to cut several. A half-yard or yard of fleece will give you many pieces to work with.

Perches that are both too hard, such as Manzanita perches, and too smooth, such as dowel and plastic perches, sharp-cornered perches, rough pedicure perches, sandpaper and rough-textured/concrete perches should be removed and replaced with rope perches and natural wood perches. Hard perches should be wrapped with a cohesive material such as Kroger’s Tender Tape® or other cohesive tape which can be purchased at a drug store, or wrapped with one-inch strips of fleece. This will provide both padding and changes in diameter when the material is wrapped at varying intervals and thicknesses. Natural perches with different circumferences and textures are good but should be covered with cohesive tape or fleece strips. Birds should be encouraged to perch in different places and varying surfaces. This can be achieved by placing food and water dishes in different areas and changing the position of the favored perches.²

Birds will choose a favorite place within the cage to perch, so whatever perch is in that place is the one they will choose to rest. The place is more important than the kind of perch to a bird; take note of that and put the softest perches there. J. Miesle

2.3 Perches that are beneficial for the birds’ feet and legs.  

Figure 14. Booda rope perches (image courtesy JW Comfy Perches for Birds).

Rope perches are available at some pet stores under different names. These are good for birds who are not afflicted with pododermatitis or have only Grade 1 pododermatitis. These come in various diameters and lengths and also in spirals. They give the feet the soft, comfortable perching they need when they’re on their feet and have minimal flying time. They must be removed and cleaned regularly so the bird is not standing on fecal material or food debris. When they become shredded, they must be replaced. Watch the bird carefully for signs he is chewing and possibly consuming the fibers on the perch. If he is doing that, remove the perch and replace with a natural wood perch covered in fleece. If the bird chews on that, provide only soft, natural wood perches.

Figure 15. Padding perches with foam helps prevent bumblefoot as well as aiding healing in afflicted birds. Be sure to watch for signs of the bird chewing on these. If he is consuming the pieces, remove them and use wood perches (images courtesy Hagen Avicultural Research Institute; used with permission; Burgmann, Symptoms and Treatment of Bumblefoot). 

3. Symptoms of bumblefoot in birds

• Dark, circular scabs on feet
• Redness, shininess, and small, red sores on the plantar surface of the foot
• Abrasions, cuts, tissue damage on the bottom of the foot
• Swelling and thickening of the skin
• Lameness and swollen joints in the feet or toes
• Reluctance to walk, stand, or grasp normally with one or both feet
• Ulcers on the soles of the feet^{2, 21}
• Shifting of weight from one foot to the other
• Picking at the sores on the feet

3.1 Means of infection

There are two ways infection can set it:

• Through a puncture in the skin of the base of the foot (a talon, a thorn, or a foreign object)
• Through pressure sores (decubitus ulcers) on the bottom of the foot.⁹

Figure 16. Healthy tissue in a cockatiel. Note that the nails are being kept short, but not too short. This is important; the bird could catch his nails on fibrous materials and slip and fall (image courtesy J. Miesle).

3.2 Punctures to the skin leading to bacterial infections

Infections may occur when penetrations, such as cuts and sores, happen. Bacteria such as Staphylococcus aureus may enter the skin and cause damage if it has not been observed and treated. ² Once the wound becomes serious, oral antibiotics, anti-inflammatories, and topical antibiotics will be needed.²  Celebrex (celecoxib) is the best medication for birds for pain and inflammation.  (J. Miesle)

Systemic infections that result in decubital lesions or death can occur secondary to bumblefoot and are caused by virulent strains of S. aureus. This bacterium is frequently isolated from the lesions, but the birds will usually not respond to antibiotic therapy alone. These bacterial lesions may quickly lead to digital necrosis and gangrenous dermatitis. Staphylococci are by no means the only bacteria that might be recovered from diseased tissue: E. coli, Corynebacterium species, Pseudomonas species, and yeast are frequently cultured from the lesions.¹⁰

3.3 Decubitus ulcers

Decubital ulcers are open sores on the skin, often covering bony structures. Pressure sores occur because of uneven weight-bearing that leads to damage and devitalization of the skin. Both of these lead to bacterial and/or fungal infections of the skin. Once the process begins, a series of changes is initiated which will eventually damage the tendons of the foot and spread to muscles, joints, and other tissues. It can become a chronic disease, affecting the aortic and mitral valves of the heart and causing endocarditis (inflammation of the heart valves), vascular insufficiency (poor blood flow), lethargy, and dyspnea (labored breathing).⁹
4. Additional factors contributing to the development of pododermatitis

4.1 Malnutrition

In Psittaciformes and Passeriformes (songbirds), most lesions are believed to be the result of malnutrition. Poor nutrition causes the skin of the foot to become dry, flaky, and hyperkeratotic (developing a thick, outer layer of keratin on the skin). It is thought that dry, hyperkeratotic skin on the feet changes the mechanics of weight-bearing on the metatarsal pads. This condition is also precipitated by environmental deficiencies and systemic disease.⁴

Sunflower and safflower seeds have a high-fat content. Too many in the diet can lead to obesity in parrots and other pet birds. Traditionally, parrot diets have consisted of a mixture of seeds, with sunflower seeds being an important part of most diets (50% of the content of a sunflower seed is fat). The increased fat taken on by birds leads to Fatty Liver Disease or Hepatic Lipidosis. Over the last decade, there has been an increase in the number of parrot owners who feed their pets commercial pellets; but this is also not a perfect alternative. Pelleted food contains more fat and protein than the amount most parrots need, and the oils added to the pellets (usually palm and coconut oils) may predispose birds to atherosclerosis (fat deposits in arteries). The heavier the bird, the more weight and pressure it puts on its feet, resulting in the development of pododermatitis. This is aggravated by a lack of flying; birds do not put pressure on their feet while they fly, so birds that do not fly are more predisposed to pododermatitis and obesity.¹⁶

The best diet for birds is one that is high in fruits, vegetables, greens, some people foods, and a moderate number of seeds (except sunflower and safflower.) Seeds contain important Omega 3,6 fatty acids which protect the skin and internal organs. (J.Miesle)

See Appendix B, p.50,  for a list of foods that are nutritious for birds.

4.2 Vitamin A Deficiency

Some forms of pododermatitis are caused or exacerbated by Vitamin A deficiency. Birds that eat only seeds are susceptible to it since seeds are typically low in Vitamin A. This vitamin promotes appetite and digestion and also increases resistance to infection and to some parasites. The most obvious sign of a Vitamin A deficiency is a feather stain above the cere (the fleshy area which contains the nares or nostrils). The staining of the feathers above the cere reflects a discharge from the nostrils. Subtle differences may be seen as far as the color intensity of the cere and feathers and the overall condition of the plumage are concerned. A bird deficient in this vitamin may have pale, rough-looking feathers that lack luster. The cere may look rough instead of smooth, and you may see an accumulation of a yellow, dry scaling on the sides of the beak.²

Vitamin A deficiency weakens the epithelium (the thin, top layer of skin) of affected birds. Pressure sores, pressure ulcers, or decubitus ulcers occur when the bird is in the same position for a long period of time; the result is uneven weight-bearing. The ulcers are localized injuries to the skin and/or underlying tissues that usually aid blood flow to the soft tissue. The constant friction from the wrong types of perches can pull on blood vessels that feed the skin. Decubital ulceration on the plantar surface of the feet is common in older, obese, nutritionally deficient psittacines.²⁰

4.3 Limited flying opportunities

Restricted flight opportunities lead to inactivity and obesity, and these produce excessive pressure on plantar surfaces, the toe pads, and the tarsometatarsus. Erosion occurs, and ulcers and staphylococcal infections develop.²⁰

Figure 17: Grade I lesions. Note the shiny area on the foot pad (image courtesy Hari; used with permission).

4.4 Secondary disease

“Pododermatitis can also take place secondary to infectious or parasitic diseases, penetrating foot wounds or leg injuries that affect normal gait and weight distribution. Epithelial damage that arises secondary to asymmetric weight-bearing on the metatarsal pad causes reduced circulation, microepithelial damage (microcysts: very small, round vesicles containing fluid and cellular debris), local impairment of the immune system, and ultimately, invasion of opportunistic pathogens.”¹⁹

For companion birds, raptors, and other wild birds, pathogenic bacteria introduced at traumatized sites may lead to abscessation (formation of abscesses), osteomyelitis (bone infection), or joint changes.⁹

See Appendix A, p. 42, for more information on the treatment of raptors

4.4.1 Arthritis

Septic arthritis may also play a part in the development of pododermatitis. Joints may become infected through a direct, penetrating wound or through the hematogeneous route (spread through the bloodstream). Although the infection may be controlled, a decrease in the range of motion of the joint usually occurs.¹¹

Figure 18: Grade II lesions. Notice the wearing away of the skin on the back toe, continuing into the central pad of the skin (images courtesy Hagen Avicultural Research Institute; Burgmann: Symptoms and Treatment of Bumblefoot; used with permission).

Figure 19: Grade III lesions. Note that the bird is putting his weight on the outside of the foot, causing stress on that toe. This skin on the other toe is wearing away, and the lump on the side of the foot is thickened and swollen (images courtesy Hagen Avicultural Research Institute; Burgmann: Symptoms and Treatment of Bumblefoot; used with permission).

4.5 Contact with tobacco products

Many affected birds belong to cigarette smokers. Passive inhalation of cigarettes, cigars, pipe smoke, e-cigarettes, marijuana, and other types of airborne drugs not only causes ocular and respiratory disease in birds but also damages the integument. (Marijuana exposure also causes severe depression and regurgitation in birds and should be strictly avoided.) Pododermatitis has been observed in birds handled by smokers as the nicotine residues on the hands of smokers will cause this irritation. If minor, the lesions may spontaneously resolve when the client stops smoking; cleans all the furniture, walls, curtains, and cages; only smokes outside; washes his hands and arms and changes his clothes before handling the bird.⁸

The feet and legs should be uniform in texture and color. The feet should have prominent scale patterns on the dorsal and plantar surfaces. Changes that result in the smoothing of the plantar foot surface can instigate chronic and severe foot and leg lesions. One of the common etiologies of foot abnormalities is contact with nicotine sulfate from the hands of cigarette smokers. The feet are particularly vulnerable to fungal diseases due to smoking toxicity.⁸ Macaws (and other birds with bare cheek patches) may suffer similar dermatitis on their cheek patches following repeated contact with a smoker’s hands and arms and the smoker’s environment.⁸

When toxic particulates and gases in the air assault a bird’s respiratory system, skin, and feathers, feather destruction and plucking result. Heat causes the smoke to rise; then, when it cools, gravity brings it back down. The toxins land on the birds, their perches, their cages and cage bars, toys, and food. It is also on the smoker’s hands, arms, clothes, and any other exposed skin— even the hair. If the smoker’s hands are coated with chemicals from holding the cigarette, it is easily transferred to his bird. In one case, an Amazon, who became very sensitive to chemical exposure, began mutilating his feet. The clinician determined the cause to be his perches which were covered with residue from cigarette smoke.¹⁴ Even if the smoker takes these precautions, his clothes, the furniture, rugs, curtains, and perches inside and outside the cage will be covered in smoke and ash. It is best for the smoker to stop smoking and have his home professionally cleaned. (J. Miesle)

Figure 20. Grade IV bumblefoot in a parakeet (images courtesy Burgmann. Symptoms and Treatment of Bumblefoot, Hagen Avicultural Research Institute; used with permission). 

4.6 Contact with strong cleaners and disinfectants

These may also be responsible for irritation and dermatitis on the feet. Cleaning liquids should always be dry and rinsed before the bird walks on the cleaned surface. Cleaning products should be carefully chosen so that chemical irritants are not used.⁸ Air freshener plug-ins and sprays should never be used around birds. They also damage the respiratory system.¹⁴ (The best cleaner is white vinegar and water: 2.5 cups white vinegar to 1 gallon water.) J. Miesle

4.7 Allergens

The allergy syndrome appears to be more common in the spring, suggesting a seasonal allergy. Seasonal recurrences of the lesions may be prevented by the oral administration of prednisolone about one month prior to the time that lesions typically occur.⁸
5. Avian Veterinary Examination by the Clinician, both at home and at the Physician’s Office

5.1 Physical exam

A bird’s skin is very delicate, and the skin of the foot reflects the condition of the rest of the dermis. The plantar surface of each foot should be checked daily by the owner, and the clinician should inspect the feet at the bird’s visits. Both owner and clinician should note the condition of the metatarsal and digital pads and look for loss of definition of the epidermis (seen as a shiny, reddened surface), swelling, erosions, ulcers, and scabs. Birds that are crippled from an injury or genetic defect are prone to developing sores on one or both feet due to the stance they must assume. The owner and practitioner must be observant for signs of pain or discomfort.⁶

If a bird is lame on one leg, he must bear his weight on the unaffected leg; this, in turn, can lead to pressure necrosis, infection, and subsequent pododermatitis on that foot as well. The clinician should always examine the other leg and foot closely when any lameness occurs. A complete examination, including radiographs, may require that the bird be anesthetized to reduce stress on it.⁶

Figure 21. Grade V lesions on a cockatiel with arthritis (image courtesy of Julie Burge; used with permission). Note that there is fecal matter on the feet; this can cause additional infection in the already infected skin. 

Figure 22. Grade VI pododermatitis in a parakeet. Note that the plantar surface is covered in ulcers, scabs, and pressure sores from being on the wrong kinds of perches. Some areas of the toes are also impacted (image courtesy Burgmann, Symptoms and Treatment of Bumblefoot, Hagen Avicultural Research Institute; used with permission). 

Figure 23. Grade VI pododermatitis in a cockatiel. Fecal matter is visible on the pads of the feet and toes. The areas impacted by the disease are deeply imbedded in the skin and will bleed easily when the bird is trying grip the perch (image courtesy David Perpinon; used with permission).

5.2 Testing of the skin

Bacterial samples will be taken and evaluated at a microbiology lab in order to isolate the offending organism. An antibiotic sensitivity test may help determine the best course of antibiotic treatment to rid the bird of this condition or to manage it in the case of a chronic issue. A blood sample will be taken to check for other possible health conditions. X-rays will reveal signs of infection and will indicate any areas on the joints or bones where there’s been erosion or other damage.²¹ Skin scrapings or fine-needle aspirates may also be performed. (J. Miesle)
6. Clinical Grades of Pododermatitis

Hagen Avicultural Resource Institute definitions: The following classification grades have been lifted directly from the HARI institute website. (All are used with permission from HARI).

“A classification scheme grading from early clinical signs and progressing to severe lesions has been established. The clinical progression of the disease varies based on the species and the factors that contributed to the infection.”

Clinical Grades of Pododermatitis⁵

Grade I: Desquamation (shedding of the epithelial or skin tissue) of small areas of the plantar foot surfaces is represented clinically by the appearance of small, shiny pink areas and peeling or flaking of the skin on the legs and feet. Initial lesions are recognized as hyperemia (excessive amount of blood). Flattening of the skin of the digital and metatarsal pads is visible. These are the sites of maximum weight-bearing. (Thinning of the plantar surface of the foot with some reddening).

Grade II: These lesions progress if untreated, and bacteria invade the subcutis, resulting in a scab and mild swelling. (The subcutis is the deeper layer of the dermis, containing mostly fat and connective tissue). Smooth, thinly surfaced, circumscribed areas appear on the plantar metatarsal pads of one or both feet with the subcutaneous tissue almost visible through the translucent skin. No distinct ulcers are recognized. (The thinning of the plantar surface of the foot has progressed to the point that subcutaneous tissue such as tendons can be seen through the skin).

Grade III:  The sores progress to form a caseous (having a cheese-like texture) abscess with marked swelling and pain. Ulceration of the plantar metatarsal pads occurs, and in some birds, a peripheral callus may form. Ulcers form on the soles of feet with callouses forming around the edges of the lesions. Some pain and mild lameness are present.

Grade IV:  Infection of the tendon sheaths develops. Corresponding cellulitis tracks toward the intertarsal joint and the digits along with flexor tendon rupture. There is a necrotic plug of tissue present in the ulcer. Most species with ulcers and accumulation of necrotic debris exhibit pain and mild lameness. (Necrosis refers to cell death; the tissue turns black).

Grade V:  Swelling and edema (cellulitis) of the tissues surround the necrotic debris. The digits of the foot may also be edematous (holding fluid). Necrotic debris starts to accumulate in the metatarsal area, indicating infection of the tendon sheaths. Severe lameness is common, and the entire metatarsal pad may be affected. This is generally a chronic lesion leading to osteoarthritis and septic arthritis of the tarsometatarsal-phalangeal joints. Cellulitis surrounds the area of necrosis, and the foot can be swollen with fluid. Tendon and metatarsal pads become infected; pain and severe lameness are present.

Grade VI: Necrotic tendons are recognized clinically as the digits swell and the flexor tendons rupture. Ankylosis and nonfunctioning digits are usually present in recovery.  (Ankylosis refers to the stiffness of a joint due to abnormal adhesion and rigidity of the bones of the joint, which is usually the result of injury or disease). The digits are swollen and the necrotic flexor tendons on the plantar surface of the foot rupture. Even with treatment, non-functioning digits and joint fusion will be present.

Grade VII: Osteomyelitis develops. This is a bacterial bone infection leading to the destruction of the bone itself. Bone infection can progress to systemic infection and death.

Figure 24. Comparison of a healthy plantar surface on the right and Grade VII severe case of pododermatitis on the left (image courtesy Lauren Thielen; used with permission).

6.1 Grading discussion

Grades I to III lesions are common in Psittaciformes and Passeriformes that are on all-seed or over-supplemented fruit and vegetable diets, are overweight, have no exposure to sunlight, or are kept on improper perches. With proper husbandry and nutrition, most cases recover with little medical intervention. The type of substrate and the size, shape and covering material of the perches may all influence the bird’s weight distribution on the toes and metatarsal pads. These affect the amount of skin wear on the plantar surface. For example, a perch that is too wide and flat may cause excessive weight-bearing on the toe pads, while one that is too small may cause excessive weight-bearing on the metatarsal pads.⁵

Early grades of pododermatitis show loss of the scale pattern on the foot, redness, and mild swelling. This damage can often be treated with topical softeners, improvement of the diet, and modification of the bird’s environment. Reversal is possible when the disease is at Grades I and II. The earlier the disease is caught, the more effective the treatment will be. The prognosis for the full recovery of lesions of Grade I to III is usually more favorable than Grades IV to VII lesions.⁵

Grade III bumblefoot is common in older, inactive birds that are fed inadequate diets. Early lesions (smoothing of the plantar foot surface) and hyperemia (an excess of blood in the vessels supplying an organ or other part of the body, Wikipedia) are frequently missed, and the birds are often not seen by the clinician until this grade. Some birds are not presented until they exhibit a non-weight-bearing lameness. This disease is dynamic and may move from one grade to the next quickly.⁵

Damage to the feet in Grades IV to VII usually requires surgical intervention since the changes that lead to infection also reduce the ability of antibiotics to be effective. Debridement of the wound, surgical removal of damaged tissues, and wound bandaging are treatments that are frequently used.⁵

Older budgerigars and cockatiels (5-10 years old for budgerigars and 10-20 years old for cockatiels) may have Grade V or VI lesions if precipitating factors are not corrected early. Bone changes and osteomyelitis may be present. Later grades are very serious and life-threatening. Since the development of antibiotic-impregnated beads, veterinarians can treat later grades more successfully than they could before. Amputation is sometimes necessary. Prosthetics may be used for birds such as ducks that cannot survive with only one good foot.⁵

6.2 Case Study: Pododermatitis caused by a parasitic bacterium

The cockatiel, Chico, is one of the author’s birds. In January of 2022, this bird became ill with

several severe symptoms. He developed a yellowish, raised area on the dorsal area of his one foot, and a sore area on the plantar metatarsal surface of the same foot. The bird was diagnosed with Mycoplasma synoviae, “a Gram-negative parasitic bacteria responsible for causing respiratory tract disease and synovitis” (inflammation in the lining of the joints). (Merck Vet. Manual) (J.Miesle)

Figure 25. Spring, 2022. The staphylococcus synoviae infection which began the disease, causing the yellow swelling on the top of the foot and the crusty yellow on the formation of the nidus pocket. “The skin is showing some scabbing and flaking, as though it were irritated. The deeper tissues appear to be mildly hyperemic and there is a yellowish infiltrate in the tarso-metatarsal phalanx joint.” (Bob Dahlhausen) (image courtesy J. Miesle).

Figure 26. Subdermal infiltrates caused a nidus (pocket of infection) on the plantar surface of the foot which made the bird shift his weight onto the side of the foot and the tarsometatarsus (heel). After the nidus was resolved, the skin on the plantar surface barely covered the bones; this led to a pad of tissue developing. Because the pad was so large, he was forced to walk on the side of his foot and toes. Arthritis set in because of his unusual limp and gait (image courtesy J. Miesle).

The nidus pocket formed on the plantar metatarsal surface of the foot. The scab that resulted during treatment is covering the nidus hole. The pocket is deep under the thin scab and will bleed if the scab is disturbed. The nidus goes all the way down to the bone and is the result of the S. aureus infection. Infections and diseases can cause swelling, scabbing, and yellow crusting in the feet resulting in pododermatitis (image courtesy J. Miesle).

Figure 27. There were many ailments due to mycoplasma synoviae. It was very painful for the bird. He had very little appetite, and as a result, he lost weight. In addition to the nidus on the center of the foot, more nidi appeared on the toes. These were the first to be resolved. The skin on the toes became thin and fragile (image courtesy J. Miesle).

Black arrow: previous nidus area in center

Figure 28. Nov. 2023. The nidus area after some healing has taken place. The sore area is divided into three sections and remains that way to this date. In order to reduce the size of the pad, the author has been massaging the area twice a day with Aloe Vera Gel. This will continue as long as the bird lives. The author uses Aloe Vera Gel for Sensitive Skin from Walgreens. A small amount is mixed with water or distilled water and stirred until a thin gel is made. It is stored in a small container on the shelf (image courtesy J. Miesle).

7. Treatments for pododermatitis

Perching, cleanliness, and nutrition need to be addressed.

• The cage must be kept scrupulously clean using an antibacterial cleaner once a week or more often if it needs it. Clean all areas daily and watch for droppings and food debris as these need to be cleaned immediately.
• Nutrition: If the bird is on pellets, reduce and/or eliminate them. Replace them with fresh fruits, vegetables, some seeds (not sunflower or safflower as these are high in fat and can lead to Fatty Liver Disease), people foods, seed supplements. Pellets are hard on the kidneys and contain high levels of fat.

If the owner does not have an avian veterinarian, he may contact the author for recommendations. He may utilize the following instructions. If he does have an avian veterinarian, these instructions may be used in addition to those given by the avian veterinarian.

Figure 29. Grade II on right foot, Grade III on left (image courtesy Maria Molina-Gacal; used with permission

Figure 30. Grade V pododermatitis (image courtesy Maria Molina-Gacal; used with permission).

7.1 Treatment of the lesions for all grades

1. Clean the feet with antibacterial soap and rinse and dry well; apply and massage in the following creams. There are two prescription creams that you can get from your avian veterinarian: Gentamicin Sulfate Cream (©Perigo or ©G&W), and Neomycin and Polymyxin B Sulfates and Bacitracin Zinc Ophthalmic Ointment, USP (©Bausch +Lomb). These may be alternated, and you might eventually find one works better than the other. Alternate these with Aloe Vera Gel for Sensitive Skin from Walgreens. See next paragraph. Ask your veterinarian for recommendations of other ointments or creams you might use. If you are unable to acquire these creams, use the triple antibiotic cream and ointment from the pharmacy.

Alternate or additional topical therapy if the prescription creams cannot be purchased: Aloe Vera Gel for Sensitive Skin from Walgreens (or a similar gel). Put a small amount in a very small container and add a little distilled water; mix until you get a medium-gel consistency. Begin to massage the feet with a small amount of triple antibiotic ointment, such as Neosporin, followed by the Aloe Vera Gel. Do this treatment two or three times a day. It is available online from Walgreens. Do not use aloe vera plant liquid. It is not sterile and is not as effective as the gel. The addition of VetOmega is highly recommended to add strength and healing to the skin of the feet. See Section 9.5.2 for more information on this product.

2. Keep the bird on fleece-covered perches for a long time, at least until the feet are completely healed and possibly longer, since some birds have a relapse of the condition. Make sure you remove the fleece strips twice a week and replace with clean ones. They are washable.

3. If the bird cannot balance well and shows discomfort, place him in a storage bin on several soft towels until his condition improves. Put his food, water, and toys in the bin with him. If he’s flighted, cover with a framed piece of aluminum screening or some other type of open covering. When he’s out of the cage or bin, keep him on soft, clean surfaces at all times. You can put soft towels on the surfaces the bird walks on, such as the top of the cage or on any play areas. Keep him off the floor and all hard surfaces as much as possible.

7.2 Additional information concerning treatment for less severe cases

Less severe cases (Grades I and II) may be treated with a combination of environmental and medical methods. Correction of the underlying predisposing factors will often reverse this disease process.

• Take the bird to the avian veterinarian immediately. More severe lesions (grades III to VII) need to be cared for more aggressively. He will need to determine the extent of the damage to the feet and guide you in their healing. If the veterinarian wraps the feet, find out how often you need to bring him back to have them treated and rewrapped, or ask him to let you change the bandages there so you can do it at home. (If you do not have an avian vet, contact the author so she can help you find one.) Follow the rest of the recommendations below. Do not use a heating pad! Get a prescription for Celebrex (celecoxib). Do not use meloxicam; it is not as effective as Celebrex and can cause digestive difficulties.
• Make needed changes in diet with the addition of vitamins containing Vitamin A.

See Appendix B, p. 50, for advisable food choices for these and all birds.

Less severe cases may go back to rope or natural wood perches when the feet have healed. Perches should be soft. Rope perches are good for general use, and wood perches should be covered with cohesive tape/wrap. Vetrap is undesirable since it is sticky and holds dirt. Cohesive tape/bandage (white) will make it easier for the owner to notice the dirt and change it more often. It is not sticky, and white wrap will show the dirt more easily so the owner will be more likely to change it more often. Never use sisal perches, spirals, toys, or any other type of product. It will damage the feet and can be easily ingested, causing crop impaction.

See Section 2 for descriptions of perches that should not be used for any birds, but especially the bird with pododermatitis.

Figure 31. Stage V Pododermatitis. This lesion bled before it was seen by the avian vet and during treatment (image courtesy Diane Snuggles Hut Larson; used with permission).

7.3 Information for the treatment of more severe cases

• For birds with more severe pododermatitis, the perches should be wrapped with strips of fleece and changed several times a week. Observation will let the owner know when they need to be changed. Be careful to get the right diameter of perch for your species of bird. They will be larger as long as the fleece strips are on them. Buy at least 1 yard of very soft fleece. Wrap all perches with overlapping, 1-inch strips of fleece held down by short pieces of twist ties on the ends of the perch. Rope perches and natural wood perches should also be wrapped in fleece for the more severe cases. You can wrap any rough-textured perches and dowel perches with fleece. Eventually you will want to remove those and replace them with rope and natural wood perches, although for severe cases, all perches should remain covered in fleece strips permanently due to the probability of relapse.
• Remove all rough-textured, plastic, dowel, and warming perches. Platform perches must be covered in at least 2 layers of fleece held down by binder clips for small perches and clamps for the larger ones. The perch will be larger with the addition of the fleece. Change it as you find droppings on it. Have clean ones cut so you can replace them as needed.
• For birds unaffected by pododermatitis: Perches should be soft. Rope perches are good for general use, and wood perches should be covered with cohesive wrap. (Vetrap is undesirable since it is sticky and holds dirt. Cohesive tape/bandage (white) will make it easier for the owner to notice the dirt and change it more often.
• Provide frequent exposure to partially shaded sunlight. Avoid full sunlight for all birds, but especially for birds with pododermatitis and any illnesses; it will worsen their conditions as the bird will become overheated. Healthy birds should only be exposed to full sun for a very short time; then they should be moved to partial sun and shade.
• Improve cleanliness. Change the fleece several times a week and clean the cages twice a day.
• Birds in a bin must be on soft towels and sheets of fleece cut to the dimensions of the bin. They should stay there until the feet are almost completely healed. When they are returned to their cages, all perches should be wrapped in fleece indefinitely.
• Make necessary environmental changes. Keep the bird room cool, not cold. You don’t want him to chill. The bird’s infection will have raised his body temperature. If he shivers and holds his wings close to his body, he’s too cold.
• Never use a heating pad under the towels or cage, and never use UV lamps on the bird or his cage. UV Lamps should not be used on any bird or his cage. They will burn the skin and cause cataracts. Only ceiling lamps should be used, if at all, and they should only be on 2-3 hours a day.
• Apply a topical antibiotic or antimicrobial cream containing steroids to aid in resolving the condition. (See 7.1 for medications used) These should be used with caution to prevent toxicity. Many topical products are available, such as softening agents for dry, scaly feet, topical antibacterial creams for acute inflammation and swelling, and ointments for granulating wounds.²⁰ (Granulated tissue is new connective tissue and microscopic blood vessels that form on the surfaces of a wound during the healing process [Wikipedia]).
• Utilize prescription medication; it may be needed both for healing and pain and inflammation. This should be discussed with the bird’s avian veterinarian. Provide Celebrex (celecoxib) for pain and inflammation. Avoid Metcam (meloxicam); it is a dog and cat medication and causes digestive issues in birds as well as not being as effective as celecoxib.
• For all levels of disease, the owner must be willing to continue with the treatment at home, possibly for months. He needs to be made aware that some individuals are highly susceptible to recurrences. If the bird does not respond to these changes, or the condition continues to deteriorate, more complex medical treatment will be necessary.²⁰ At that point, you must have a discussion about the bird’s prognosis with the veterinarian. It is of greatest importance to discuss all of the above treatments with your avian veterinarian.

7.4 Additional treatment of the lesions, Grades III to VII

If you do not have an avian vet, contact the author so she can help you find one and follow the rest of the instructions below.

2. Prepare the lesions for treatment at home.

To prepare the lesions for the topical antibiotics, they need to be thoroughly cleaned. Washing the feet with antibacterial soap is sufficient for Grades 1 and 2, but for Grades 3-7, preparation is more comprehensive. One recommendation involves soaking the affected foot/feet in a shallow dish filled with warm water with Epsom Salts added to it. The recommended strength is about one teaspoon of Epsom Salts mixed in with one gallon of clean, warm drinking water. The Epsom Salts will draw out any toxins. Soak for as long as the bird will tolerate it, at least 5 minutes per foot. Do this twice a day. Soaking the feet will soften and remove any scabs; this allows the lesion to drain any pus and debris. Do NOT remove the scab or other material without soaking it first. Allow the material to fall off by itself. Finally, flush the cavity with diluted hydrogen peroxide to clean the wound out and destroy any bacteria. ² (Hydrogen peroxide should be diluted at a 1:10 ratio with water. One part HP, 9 parts water.) (J. Miesle)

3. Transfer the bird to a storage bin of the appropriate size for his species. Prepare the bin by laying down at least 2 soft towels on the bottom. Keep the bird in the bin until the feet are healed. Place a cover on the bin which is partially open for air. A piece of aluminum screening, framed, will work. While the bird’s feet are healing, buy at least 1 yard of very soft fleece. Remove all hard or rough-textured perches from the cage and replace them with natural wood or rope perches. Wrap all perches with overlapping, 1-inch strips of fleece held down by a short piece of twist tie at the end that the bird does not stand on. Make sure perches are the appropriate size for your bird’s species. Cut a piece of fleece (or two smaller pieces) to fit the bin and place them on top of the towels. Make extra pieces to replace the large pieces when soiled. They are washable. Place the bird’s food, water, and toys in the bin. Do not use a heating pad!! The tissue is already hot from being inflamed and/or infected. Have the cage ready for the bird by the time he is ready to go back into it. Do not wait. (J. Miesle)

4. Clean the feet with antibacterial soap, rinse and dry well; apply and massage in the creams. There are two prescription creams that you can get from your avian veterinarian: Gentamicin Sulfate Cream (©Perigo or ©G&W, and ©Neomycin and Polymyxin B Sulfates and Bacitracin Zinc Ophthalmic Ointment, (USP Bausch +Lomb). These may be alternated; you may eventually find one works better than the other. If you cannot get the prescriptions for these, use the OTC medications in the following paragraph. Get the Aloe Vera Gel from Walgreens and mix a very small amount with distilled water to make a medium-thin gel. Obtain VetOmega as discussed on p. 37. Begin to massage the feet with a small amount of triple antibiotic ointment, such as Neosporin followed by the Aloe Vera Gel. Use only this gel or a similar brand. Do this treatment 3 times a day. You can reduce this to 2 times a day as the skin heals. It is available in-store and online from Walgreens. Do not use Aloe Vera plant liquid. It is not sterile and not as effective. (J. Miesle)

5. Once the feet have healed, the bird may be returned to his cage. He will have to be on fleece-covered perches for a long time and possibly permanently, since some birds have a relapse of the condition due to the skin having been compromised. Make sure you remove the fleece strips twice weekly and replace them with clean ones. Check the fleece daily for any signs of fecal material on them. You will eventually be able to change them just once a week. Replace the fleece weekly if there are no open sores, blood or fluid coming from the wounds. Replace the fleece as needed if these exist. Keep a close eye on the condition of the fleece strips. (J. Miesle)

7.4.1. Dressings and bandaging

The severity, type, and path of infection will direct treatment. No matter what, the owner should keep the bird’s feet sanitized and tailor the living environment to both promote healing and to eliminate destructive perches and surfaces.²¹ (Installing rope perches and wrapping all perches with fleece are the best ways to provide soft surfaces). Oral antibiotics and antibiotic ointment will control the infection. Bandaging may be recommended in order to reduce the opportunity for pathogens to enter the wounds. In more severe cases, surgery (including debridement of abscesses) will help to save the feet, and life, of the bird. ² Antibiotics will be essential in resolving infection, and the bird can be kept comfortable with pain and anti-inflammatory medication. ²¹ (Celecoxib [Celebrex] is the best anti-inflammatory and pain medication for birds; do not accept meloxicam as it is not meant for birds and is not as effective as celecoxib. It also has gastrointestinal side effects that celecoxib does not have. (J. Miesle)

Medical therapies include the application of topical agents in order to toughen the plantar skin of the foot. Softening agents are also helpful in cases in which the epithelium has become thin. Antimicrobial and anti-inflammatory creams and ointments and hypertonic footbaths provide infection and inflammation control. ⁵ (Hypertonic refers to a solution with higher osmotic pressure than another solution. If a cell is placed in a hypertonic solution, water will leave the cell, and the cell will shrink [Merriam-Webster.])

Once the wound is clean, apply liberal amounts of antibiotic ointment as prescribed by the veterinarian, and then carefully wrap the foot or feet with gauze; this will keep the cavity clean and the ointment in place and prevent the bird from chewing on it. If the pododermatitis is in the very severe category, a ball bandage may need to be adhered to the foot. The lesion needs to be cleaned and ointments reapplied twice a day until the feet appear healthy.²

Figure 32. A ball bandage is one option for the management of a closed-toe fracture or severe pododermatitis (image courtesy Dr. Ariana Finkelstein, Lafebervet). This type of bandage is frequently used for raptors who are in captivity due to their inability to be released in the wild. They develop pododermatitis from being in enclosures which have concrete floors or hardwood and often, poorly designed perches. (J. Miesle)

6. In severe cases, a hydroactive (combined with water) dressing may be used Hydration sometimes helps to reduce the concentration of toxic substances in the tissue’s dressing and can be used to facilitate healing of the wounds [Merriam –Webster]). Hydrophilic dressings mix easily with water. Moisture-vapor, permeable dressings, or hydrocolloids (a substance that forms a gel when mixed with water) dressings should be applied topically to enhance wound healing for open, granulating wounds or post-operative incisions. Applying a topical antibiotic and bandaging to the feet with sufficient padding to reduce and better distribute pressure on the plantar surfaces is required in many cases. The types of bandaging methods may include simple toe bandages, interdigitating (between the toes) bandages, and ball bandages. Bandaging of affected tissues may go on for several months until the bird responds to the new diet and environmental deficits have been corrected.⁵

Initially, the bandage may require daily changing. The frequency of bandage changes can be reduced as the wound becomes less exudative (producing fluid) especially in inflamed tissue. Once granulation tissue forms at the edge of the ulcers, scabs should be removed by the clinician, and the lesions should be kept clean to facilitate healing.⁵

7.4.2 Therapy for severe lesions

Therapy should include:

• Cleansing and treating the wounds daily with multimodal medications and changing the bandages daily
• Treating the wounds locally by using the antibiotic-impregnated matrix; antibiotic-impregnated beads are implanted into the wound
• Administering systemic antibiotics parenterally (other than by mouth) in the beginning followed by oral dosing
• Prescribing anti-inflammatory analgesics to provide pain relief. NSAIDs (non-steroidal anti-inflammatory drugs; e.g., celecoxib) or synthetic opioids may be used as needed. Celecoxib (Celebrex) is the preferred medication for inflammation and pain in birds. (J. Miesle)
• Testing for systemic infection in more advanced cases of decubital ulceration (bedsores or pressure sores)
• Performing a complete blood count at the discretion of the avian veterinarian.
• Taking swabs regularly from within the abscesses for fungal and bacterial cultures. E. Coli, Staphylococcus, and Candida albicans are commonly isolated pathogens.⁵

7.5 Goals for managing advanced pododermatitis

Advanced bumblefoot is diagnosed by analyzing the necrotizing abscess on the plantar surface of the foot. Depending on the location and chronicity of the abscess, infection may or may not extend to neighboring joints, tendon sheaths, and bones.¹⁰

The goals of advanced bumblefoot treatment are:

• To reduce infection, inflammation, and swelling
• To establish drainage as needed
• To begin antibacterial topical and oral therapy to eliminate underlying pathogens
• To manage the wounds in order to promote rapid healing
• To initiate surgical intervention when needed
• To ensure an adequate diet, and
• To address environmental deficiencies.⁵

Figure 33. Grade VII Pododermatitis in a four-year-old budgerigar with a straight perch in his cage for years (image courtesy of K. Gerbaga Özsemir; used with permission).

This will be accomplished by:

• Correcting any perching and bedding issues
• Adjusting nutrition as needed
• Correcting potential husbandry issues; cleaning and disinfecting the bird’s enclosure in order to eliminate injuries and stresses associated with those
• Correcting the bird’s diet when it is found to be lacking sufficient Vitamin A, (Essential Fatty Acids, and other important nutrients). Vitamin A injections are an option. Recommendations will be made by your avian veterinarian or through research to supplement the diet to increase vitamin A.
• Increasing exercise and adjusting the diet of all ill birds; adjusting the diet of obese birds for weight loss as needed.
• Addressing bacterial infections, whether localized in the wound area or systemic. Cephalexin antibiotics have been used successfully in cases that involve infection that has spread through the body.
• Treating and dressing any wounds or ulcerations that are present to encourage healing
• Using surgical treatments, natural healing products, therapeutic lasers, and even acupuncture as needed. These are determined by the extent to which the pododermatitis has progressed and the recommendation of the avian veterinarian.²¹

See Appendix C, p. 55, for information on laser treatments for pododermatitis.

Figure 34: Grade VII bacterial pododermatitis. This lesion usually develops following pressure necrosis with a subsequent bacterial infection (image courtesy Harrison: Clinical Avian Medicine, 2006).

7.6 Surgical treatment of advanced cases

Advanced cases may warrant surgical debridement (cleaning and cutting away of dead tissue) of fibrotic and exudative material as well as attempts to close the wound with sutures. Debridement should be approached cautiously since hemorrhaging can occur. Surgical excision of the abscess or amputation of a severely traumatized digit or even the foot may be indicated.⁵

Surgery is often necessary to repair damage to the tendons and ligaments. This is a long, slow process, and it may take months before the feet are healed. Even after healing is complete, the foot may still be tender for several weeks. Preventing trauma and maintaining the patient on a soft footing is important to avoid recurrence. (Birds should be kept on soft towels in storage bins during this time and not in their cages.) Waterfowl should be returned to the water as soon as possible to prevent further damage.⁵

Treatment for Grades IV to VII should include drainage, irrigation, and closing of the wound when the infection has been resolved. The prognosis is fair. Treatment for the lesions must be vigorous, and the prognosis is guarded.⁵

8. Consequences of neglecting to provide treatment for pododermatitis

If the bird owner notices the formation of these sores, initiates veterinary treatment, and makes positive changes to the bird’s living environment and diet, the prognosis for healing is good. However, without veterinary attention and environmental improvements, the sores typically turn into painful abscesses, which enable opportunistic pathogens (usually S. aureus) to breach the surface of the thinning skin.²¹

8.1 Pain, arthritis, and infection

The pain from these lesions causes increased weight-bearing on the unaffected foot, forcing the bird to bear its weight disproportionately. As a result, many birds suffer from bilateral pododermatitis. The plantar location of the lesion is constantly under forces of pressure, movement, and contusion (bruising); in addition, the bird’s feet are constantly exposed to contaminants.⁹ These birds are prone to arthritis as well, and this disease only worsens with time.²¹

Celecoxib should be provided for any birds experiencing pain and inflammation for any reason. It is far superior to meloxicam and has fewer side effects.

Figure 35. “Infectious pododermatitis with gross swelling of a foot in a snowy owl. The central scab was removed, and a large amount of liquid pus was present within the foot” (image and text courtesy B. Speer: Current Therapy in Avian Medicine and Surgery).

Figure 36. “After debridement and application of a topical ointment and dressing, an interdigital bandage was applied as well as a custom-fitted silicone shoe” (image and text courtesy B. Speer: Current Therapy in Avian Medicine and Surgery).

8.2 Necrosis, lameness, and decreased quality of life

In due time, the infection encroaches upon joints in the feet and bones in the legs, and surrounding tissues become necrotic. Ulcers may form on the feet, and the bird may become progressively lame.²¹ “Birds beset by advanced and untreated bumblefoot can become so systemically infected that their lives are unsustainable.²¹ If left untreated, the lesions lead to crippling deformities, sepsis, and poor quality of life.⁹ Bacterial infections that begin in the pads of the foot can ultimately lead to a bird’s death. Many surviving birds endure chronic abscesses and the amputation of a leg.²¹ Unless the condition is treated, the infection will eventually eat into the bone and travel to other parts of the body. This is a painful condition that can lead to death.²¹

8.3 Osteomyelitis involvement

If systemic infection and pain can be controlled, the above therapy may be attempted. If the disease state becomes extreme, osteomyelitis occurs, and the prognosis for recovery decreases dramatically. The owner must be forewarned that the therapy will be of a long duration, and the prognosis is poor. The owner and practitioner will need to discuss the ethics of such long, continuous treatment when the degree of disease is so advanced that the bird cannot stand without severe pain. Euthanasia will need to be considered under such circumstances.²⁰

8.4 Limb amputation

If a bird has had a pelvic limb amputation, it is possible that pododermatitis will develop in the opposite leg. These birds benefit greatly from having soft, wide, padded perches and platforms provided for them. (Even better, they should be in bins on soft towels so they don’t have to try and perch.) It is also possible that the wounds will be so severe that they do not respond to medical or surgical therapy, and the second foot or leg will need to be amputated. Euthanasia must be discussed if that occurs.⁶
9. Prevention of pododermatitis

Pododermatitis is easier to prevent than it is to treat. Bumblefoot may be prevented by taking the proper steps to ensure that the bird’s living conditions are correctly designed, it is given a nutritious diet, and its cage and all play areas are kept scrupulously clean. Prevention of pododermatitis involves constant vigilance for early signs of hyperkeratosis, baldness, flaking of the skin of feet and legs, redness or swelling. Early correction of the underlying causes will avert future severe disease.¹⁹

Figure 37. If a bird’s case of pododermatitis is severe, it would be helpful to house him in a “flat,” wide cage. (The term “flat” is used by manufacturers and sellers to distinguish it from the square and tall cages.) These are especially nice for handicapped, aged, or ill birds, not just for those with bumblefoot. A small, fleece-wrapped rope perch or natural perch can be placed in one of the front corners, close to the floor of the cage, once the bird’s condition has improved. Yaheetch® and Chewy® carry these cages, among other companies.

9.1 Choosing the right size cage

Cages should be large enough to accommodate several different types of perches. They should be neither too large nor too small. A cage that is too large will find the bird at the top of the cage, at the highest perch, and staying there most of the time, not taking advantage of the other perches, toys, and food and drink in the rest of the cage. Macaws placed in these huge, double-wide cages rarely move around; they are sedentary for the most part. An appropriately sized cage will benefit the bird by giving him a reason to move about the cage in search of toys and food. If the cage is too small, the bird will not be able to open and spread his wings or move around the cage easily. The idea that the cage should be as large as you can afford is not a good one. The bird feels lost in such a large cage. The ideal size is one that is large enough to be roomy and hold several toys, yet small enough for the bird to feel comfortable and not overwhelmed by the additional unnecessary room in a huge cage (J. Miesle).

Cages should contain horizontal bars for climbing; these will help prevent trauma to the foot pads from vertical bars which need to be gripped to slide down. Care should be taken to make sure that the wire is smooth and contains no sharp places which could puncture or scratch the feet. Even powder-coated cages may contain sharp points which could damage the feet. Any rough places should be found and smoothed over with a file¹⁹ (J. Miesle).

The idea that a cage should be as large as one can afford is not a good one. It should be large enough to be roomy and small enough for the bird to feel comfortable and safe.

J. Miesle

For birds housed in wire enclosures, the walls of the enclosure should be designed with horizontal bars or solid barriers to minimize the tendency for hanging from the wire. Never house birds in galvanized wire structures. Birds will chew on that type of wire and fall ill with metal toxicosis. Selection of proper perch size, shape, and covering for a particular species of bird is very important. ¹⁹ (The reader should discuss this with his avian veterinarian (J. Miesle).

.

Figure 38. Another flat or wide cage. As you can see, soft towels are placed on the top, and food and water dishes can be placed close to the bird’s favorite spot on the cage—in this case, the front left corner. There are several larger pieces of fleece inside the cage on the front right corner for extra softness. And there is a small rope perch on the left front corner, close to the floor of the cage. (In this case, the affected bird never stands on the front left perch, so it is not wrapped in fleece; other birds who visit like to stand on that perch.) The bird with pododermatitis should have any perch in the cage he stands on wrapped in fleece. There are three soft towels on the floor of the cage and toys on the sides and back. The cockatiel whose images were used for Figures 24-27 is on the top of the cage. Make sure the towels come all the way to the edges and sides (image and text courtesy J. Miesle).

Figure 39. Another option, especially for a bird that is elderly or compromised with other health conditions, is to place the bird in a bin on soft towels. This will give him the comfort and security he needs to heal. This bird is blind and cannot fly. This is where he sleeps at night to avoid night frights. The cockatiel in Figure 35 and two other handicapped birds sleep in bins as well. During the day they are out and in wide cages for naptime (image and text courtesy J. Miesle).

The author’s bird in a bin with towels layered for softness. When arthritis becomes very painful, foot sores are present, so placing the bird in a bin on towels is preferable to keeping him in the cage. (An alternative to the bin is a wide cage, as in Figure 35.) There are no bars, multiple towels will protect the feet, and the bird will move about much more easily. Food, water, and toys may be placed in the bin with the bird. As long as the bird’s condition is severe, there should not be any perches in the bin or wide cage.

Do not use a lamp or heating pad for these birds. For birds with bumblefoot, the additional heat from a heating pad or lamp is contraindicated because it will aggravate the condition, making any inflammation, infection, or irritation worse. Heat lamps should never be used on any bird’s cage, attached to the cage or shining into the cage. It will damage the eyes and skin and overheat the bird (J. Miesle).

Figure 40. Grades VI pododermatitis; These sores are necrotic and oozing (image courtesy Brisbane Bird Vet; used with permission). (https://www.facebook.com/ParrotTrustScotland). Note that the skin has pulled away on the right foot, back digit.

Figure 41. Grade VII infectious pododermatitis in a chicken. This bird’s staphylococcus infection is destroying the skin, making it impossible for the skin to be sewn together (image courtesy Farmer’s Weekly).

9.3. Sanitation and substrates

These can be a problem. The wire grid, or any other wire, should never be the surface that any bird stands on, whether it be the floor of the cage or aviary or a platform. It can damage the feet and cause cuts and bruises. Hard or wire flooring that the bird with pododermatitis stands on should be covered with soft towels to protect the feet, facilitate a more comfortable surface on the floor, and speed the healing process. The grids on the bottoms of the cages of a bird with bumblefoot should be covered with two layers of soft towels without anything on top of them, even paper towels.

The grids on the bottoms of non-affected birds’ cages should be covered with either a towel covered with paper towels or just several layers of paper towels in order to prevent cuts, scratches and any other types of damage to the feet. 

Birds should never stand on grids or wire. Any surfaces an affected bird touches should be carefully sanitized and kept clean, and they should always be very soft (J. Miesle).

Proper hygiene is of the utmost importance in preventing bumblefoot.

• Cages and perches need to be cleaned and disinfected daily to avoid contamination from fecal matter and bacterial growth on surfaces and in food.
• Soft foods should be removed within two hours to prevent bacterial growth. Soft or fresh food can be placed on paper towels to make cleanup easier.
• Wipe down any surface that fresh foods have been on as soon as the food has been removed to prevent bacterial growth.
• Seed, food, and water cups should be checked frequently during the day for droppings and debris.
• Food and water cups need to be cleaned daily and replaced with fresh food and water as needed.
• The grates and trays of the cage must be cleaned daily since many birds spend time on the bottom of their cages where they may come in contact with the droppings. Soft towels and/or paper towels on top of them on the grates (or trays if there are no grates) will make clean-up easier.
• All play areas must be kept very clean. Any play surface is a potential source of bacterial and fungal pathogens that could invade the surface of the bird’s feet. T-stands, toys, and anything the bird stands on must be kept scrupulously clean
• Be aware of the possibility of parasites in the cage and/or on the birds. These will make the pododermatitis condition worse.
• Droppings, regurgitation, and soft foods should be cleaned up immediately to prevent consumption, reinfection, and transmission of disease.
• Care must be taken to choose a cleaning product that will not harm the healthy or damaged tissue. All cleaning products need to be dry before allowing the bird to stand on them.³
• White vinegar (2 ¼  cups to a gallon of water) is a good cleaning liquid. Make sure it too is dry before the bird walks on it.

Do not use substrates on the bottom of the cages. These include nut shells, wood chips, grains, corn husks, moss, pine cones, soil, and bedding made for reptiles and small mammals—any type of bedding. These not only provide opportunities for bacterial and fungal spores to grow, but they also put dust into the air that harms the bird’s breathing and makes it impossible for the owner to observe the droppings. Substrates are also harmful to the humans and other pets in the house. Use plain newspaper, and place it where the bird cannot reach it. (J. Miesle)

9.4 Proper nutrition

Nutrition is extremely important. Many affected birds are primarily seed-eaters. Feeding a balanced diet of some seeds (very few sunflower and safflower seeds since they are high in fat and can lead to Fatty Liver Disease), fresh fruits and vegetables, greens, and some human foods is critical. Provide fresh water for drinking daily. Proper nutrition often will prevent or even reverse early bumblefoot in Psittaciformes. The diet should be corrected to promote needed weight loss for obese birds and to increase general nutritional balance, with emphasis on the replacement of Vitamin A precursors.^13,20 Providing Vitamin A injections if needed and foods high in Vitamin A will prevent more damage to the feet. A quality vitamin and mineral supplement is very important. Avi-era (Lafeber) and Missing Link are the best ones. Vitamin and mineral supplements should not be given to birds who are on a pelleted diet. These birds should be weaned off the pellets and onto fresh, natural foods. (J. Miesle)

9.4.1 The harmful effects of excess protein

Excess protein, when stored in the body, promotes the growth of internal bacteria which are excreted through the skin. In areas where there are feathers, those feathers will usually absorb the protein. In bare areas, such as the feet–and in some birds, the face– these bacteria will present themselves as pink, red, and then blue “calluses.” These most often show up on the bottom of the feet; however, they may also appear on the top or on the tips of the toes, above or under the bird’s toenails. It is important to reduce the protein in the bird’s diet to stop the progression of this condition. ² Pellets contain a high amount of protein—another good reason to remove pellets from the diet. (J. Miesle)

9.4.2 The benefits of vitamins, minerals, and supplements

Birds require supplemental vitamins and minerals to aid in the prevention of bumblefoot and improve the immune system to prevent other diseases. Birds require Vitamin A and biotin (a B-complex vitamin) supplementation to ensure healthy skin development.  Deficiencies in these vitamins may result in pododermatitis and focal hyperkeratosis (plantar corns). Bird owners should provide multivitamins, minerals, and essential fatty acids/amino acids supplementation to prevent these diseases.¹² VetOmega will provide the essential fatty acids/amino acids to the bird’s diet. (J. Miesle)

For the affected bird with Grades III to VII, initial injections of Vitamins A and the addition of B-complex vitamins and Vitamin D3 are advised; in addition, oral supplementation of multivitamin/mineral/essential fatty acid/amino acid preparations is recommended.

Your avian veterinarian may also want to provide those injections to birds with Grades I and II pododermatitis. ^1,12,16 ©Avi-era Vitamins and ©Missing Link minerals are excellent choices for vitamin and mineral supplements. Avi-era and Missing Link, and all other vitamins and minerals, should be placed on the food. They can also be mixed with a little water and given via oral syringe. Make small amounts as these need to be discarded at the end of the day. You do not want to give too much to the birds; there are health issues for the bird that ingests too many vitamins and minerals. The paper, Nutritional Requirements of Companion Birds, explains the danger of hyper- and hypovitaminosis. Birds with pododermatitis should be given a small amount each day, alternating, until the bumblefoot has healed, then go to the same schedule as non-afflicted birds. For non-affected birds, a small amount 3 days a week is sufficient. If you provide both Avi-era and Missing Link, alternate them.

Omega 3 and 6 essential fatty acids may be added in the form of ©VetOmega, available through your avian veterinarian or directly from Dr. Scott Echols. This product provides all your birds with the oils it needs for healthy skin and feathers and to protect the internal organs. This link will allow you to order it yourself if your veterinarian does not carry it. Encourage him/her to begin to offer it to his clients. (J. Miesle)
https://www.vetomega.com/?fbclid=IwAR330QUDMPrtHY-rzR6AMrMg- vbPWPf_SmcfmA36qt_q4LpjpM5t0K0wYuAet

9.5 Exercise

Exercise will aid in preventing and healing pododermatitis; the bird who is allowed to fly will spend less time on his feet, and that will give the feet some relief from constantly standing. Make sure everything he stands on is soft! Allow the bird out-of-cage or out-of-bin time frequently throughout the day so that he can fly and strengthen his legs; this will take the pressure off the feet. Exercise will also aid in lowering the obese bird’s weight.¹¹ If the bird does not fly, allow him to walk on the floor, but only if the floor has soft coverings like carpeting, towels, blankets, or rugs. Walking on sofas or beds is another good place for him to exercise. Many of these birds have some arthritis, and exercise will benefit them. Many birds with pododermatitis have developed arthritis before the sores on the feet are even discovered (J. Miesle).
Conclusion

Pododermatitis is a disease that is easily preventable with the proper environment and nutrition. In the early grades, it is somewhat easy to control, and reversing the disease process is possible. In later grades, however, it becomes increasingly more problematic to treat and can, eventually, lead to permanent crippling and even death; therefore, the bird owner is advised to be continually vigilant, observing the condition of the bird’s feet on a daily basis. At the first sign of a lesion or bruise on the foot, the diligent owner should take the bird to the avian veterinarian for diagnosis and treatment. When treatment and changes in diet and husbandry are initiated early in the disease, the chance of recovery is very good. The owner should change or cover the perches immediately so the disease does not become progressively worse. It is essential that the owner be attentive in caring for his birds.

References:

1. Axelson D. Avian Dermatology. In: Practical Avian Medicine: The Compendium Collection. Ed: Heidi Hoefer. Veterinary Learning Systems, 1997. p. 200
2 Beauty of Birds. Bumblefoot. https://www.beautyofbirds.com/bumblefoot.html
3. Clubb S, Flammer, K. The Avian Flock. In: Avian Medicine: Principles and Application SPIX Pub., Inc. p. 50, 56-58
4. Cooper J.E., Harrison G. Dermatology. In: Avian Medicine, Principles and Application. SPIX Pub., Inc. P. 632
5. Degernes L. Trauma Medicine. In: Avian Medicine, Principles and Application. SPIX Pub., Inc. 2006. p. 425, 426
6. Doneley R, Harrison G, Lightfoot T. Maximizing Information from the Physical Examination. In: Clinical Avian Medicine, Spix Pub., Inc. p. 190, 404
7. Doneley R., Smith B., Gibson J. Use of a Vascular Access Port for Antibiotic Administration in the Treatment of Pododermatitis in a Chicken. J Avian Med Surg 29 (2) 130-135, 2015.
8. Dumonceaux G., Harrison G. Toxins. In: Avian Medicine, Principles and Application. SPIX Pub., Inc. 2006. P. 1047, 1048
9. Ford S., Chitty J., Jones M. Raptor Medicine Master Class. Proc Assn Avian Vet 2008 p. 173-190
10. Gerlock H. Bacteria. Avian Medicine: Principles and Applications. SPIX Pub., Inc. p. 967
11. Helmer P., Redig P. Surgical Resolution of Orthopedic Disorders. In: Clinical Avian Medicine. SPIX Pub., Inc. p. 771, 772
12. Koski M. Dermatologic Diseases in Psittacine Birds. In: Seminars in Avian and Exotic Pet Medicine, Vol. 11, No. 3 (July), 2002. p. 120
13. McDonald D, Harrison G. Nutritional Considerations. In: Clinical Avian Medicine. SPIX Pub., Inc., 2006 p. 117
14. Miesle J. The Effects of Tobacco Use on Avian Species. In: Facebook group The Science of Avian Health File, Academia.edu, IVIS website. 2017
15. Olsen J. Anseriformes. In: Avian Medicine, Principles and Application. SPIX Pub., Inc. 2006. p. 923
16. Perpinon D. Obesity in Parrots. The Veterinary expert.  http://www.theveterinaryexpert.com/parrots/obesity-in-parrots/
17. Ritzman T. Therapeutic laser Treatment for Exotic Animal Patients, Round Table Discussion. AAV J Avian Med Surg 29 (1):69-73, 2015
18. Samour J. Management of Raptors. In: Clinical Avian Medicine. SPIX Pub., Inc., 2006, p. 923
19. Sander S, et al. Advancement Flap as a Novel Treatment for a Pododermatitis Lesion in a Red- tailed Hawk. J Avian Med Surg 27(4): 294-300, 2013.
20. Schmidt R, Lightfoot T. Integument. In: Clinical Avian Medicine. SPIX Pub., Inc., 2006, p. 403, 404
21. Turner C. Bumblefoot in Birds. Wagwalking. https://wagwalking.com/bird/condition/bumblefoot
22. Van Sant F. The Integument: The Largest Organ System of Birds. Proc Assn Avian Vet 2014

Appendix A: Treatment of raptors, poultry, and waterfowl

In captive raptors, bumblefoot is a common medical condition, even though it is never seen in the wild. Some raptor species appear to be more susceptible to this condition than others; falcons present with this frequently, but it is rarely seen in hawks. It is a result of poor nutrition, obesity, inadequate perches, lack of exercise, poor blood circulation to the foot, and cardiovascular changes at the end of the hunting season.¹⁸

Penetrating wounds or bruising of the feet may be predisposing factors in raptors and waterfowl. Grades I to III lesions may not be discovered in raptors; most are not seen until they have more severe lesions.⁴

In captivity, raptors are prone to bruising and abrasions on the plantar surface of the feet from jumping from a hard perch onto another hard surface, such as a stone floor and from hanging from cage wire by their feet, or being forced to stand on hard perches or cement. Any soft tissue or orthopedic injury involving one leg or foot may cause excessive weight-bearing and secondary pododermatitis on the contralateral foot (the foot on the other side.) ⁵

Overgrown talons cause improper weight distribution on the plantar surface of the foot, especially in falcons, or self-inflicted puncture wounds of the metatarsal pad. Other traumatic injuries to the foot which can lead to bumblefoot include bite wounds from prey, punctures from thorns or quills, and trap injuries.⁵

From Dr. Bart Huber, Animal Medical Center of Corona, California

https://www.facebook.com/amcofcorona/

Radiographs of a chicken with severe pododermatitis brought on by a fracture which caused the bird to stand in a way which put undue pressure on that foot.

“Once the bone has been invaded, chances of a cure are almost zero. Now, there is a newer product, Kerrier beads – Kerrier.com – where we buy this sterile kit and can make antibiotic impregnated Plaster of Paris beads that we implant into the affected foot (or where the patient has a bone infection.) The issue in the past is that there was not sufficient circulation to get enough antibiotics via the blood stream to the lesion. With these, the lesions are packed with antibiotics, increasing the healing rate. It does not get rid of the arthritis from the damaged bone, but it does give us hope. Sadly, most of these back yard birds end up getting euthanized.”

Figure 42-49. Pododermatitis caused by a fracture in the leg. This is an example of the disease being caused by an injury above the foot, not on the foot directly. Dr. Bart Huber has kindly allowed us to use these images.

The author expresses her gratitude to Dr. Huber for his generous permission to use these images.

A bird’s inactivity in an enclosure, limiting its ability to fly, is a contributing factor. In a study by P.T. Redig (Ford: Raptor Medicine Master Class), raptors that were housed outdoors and were able to exercise did not develop bumblefoot, regardless of their perching surfaces. The group that was maintained indoors on the same diet developed bumblefoot irrespective of the perching material.⁵

For large birds and raptors housed in wire enclosures, the walls of the enclosure should be designed with horizontal bars or solid barriers to minimize the tendency for hanging from the wire. The selection of proper perch size, shape, and covering for a particular species of bird is very important. Perches wrapped with hemp rope or covered with Astroturf work well for most raptors. Falcons do best on flat shelves or block perches covered with short Astroturf or cocoa mats. Strict sanitation of the facilities and feet is important to minimize bacterial infections. Liquid bandage products work well for minor skin cracks or torn talon sheaths in raptors.⁵ The feet should be massaged with a healing product, such as coconut oil or Aloe Vera gel (see 7.1)  (J. Miesle).

Figure 50. Red-tailed hawk at Wild Care in Eastham, MA. “One talon had to be removed due to a serious infection in the feet. He is on ball bandages. The caregivers are optimistic about his ability to be returned to the wild” (image courtesy Cape Cod Capecast). 

In most cases, treatment involves the surgical removal of scabs and adjacent necrotic and purulent (pus-filled) tissue, followed by suturing to achieve healing by first intention (the wound is held together by a blood clot or sutures). Sometimes antibiotic-impregnated beads are placed within the wound cavity to improve the rate of healing. If the opening is larger, sutures are used along with hydrocolloid dressings to promote healing.¹⁸

Figure 51. Grade VII “Bumblefoot infection has spread across both of this bird’s feet. The areas affected look blackened” (image courtesy The Veterinary Expert; used with permission).

Figure 52. Grade VI “A discrete bumblefoot lesion, showing typical positioning at the weight-bearing position on the base of the foot.” (image courtesy The Veterinary Expert; used with permission). (Discrete refers to a single lesion that is localized as opposed to a diffuse lesion in which there are multiple lesions present)

Figure 53. “Chickens cope incredibly well with legs bandaged! This bird has had surgery for bumblefoot. The bandages cover the surgical site as well as allowing pressure relief to the feet whilst the area in question heals” (image courtesy The Veterinary Expert; used with permission).

“Captive waterfowl are also at increased risk for developing this condition because of their heavy-bodied nature and the amount of time they spend standing on rough, hard surfaces around pools or pens. Waterfowl may suffer penetrating wounds and bruises on the feet which lead to pododermatitis.”¹⁵ Caring for waterfowl frequently involves changing the dimension, shape, and surface of the enclosure, adding adequate swimming areas, and keeping everything very clean.²⁰

Figure 54. “A silver gull with a tibiotarsus fracture on its right leg (Larus michahellis) His solid left foot, burdened with more weight than normal, resulted in pododermatitis” (image courtesy Kübra Gerbaga Özsemir).

“Pododermatitis is common in poultry. VAPs (Vascular Access Ports) are more commonly used in mammalian patients but are sometimes used to treat avian patients requiring long-term intravenous therapy or serial blood collection. Vascular Access Ports offer the advantages of ease of access, reduced trauma and handling of the patient, and the accurate delivery of large volumes of tissue-irritating drugs. Although this technique is used for mammals, it is still considered a novel treatment for avian species.” ⁷

Figure 55. Grade VII bumblefoot foot in a buzzard (Buteo buteo). This bird had been shot and had developed severe arthritis of the tibiotarsal joint of the contralateral limb. The wounds oozed blood as well. The bird was emaciated and had a heavy worm burden. Excessive weight bearing on the healthy leg, coupled with malnutrition, is likely to have resulted in the lesions depicted (image courtesy World Wide Wounds).

Figure 56. Grade VII pododermatitis in a chicken (image courtesy Monica Talbett; used with permission).

Figure 57. Grade VI pododermatitis. The chicken’s foot before surgery (image courtesy of The Chicken Chick).

Figure 58. The chicken’s foot four months after surgery (image courtesy The Chicken Chick).

Appendix B: Food choices for affected birds J. Miesle

Vitamins should always be given to birds unless they are on a pelleted diet. These birds should be taken off pellets and put on a more natural diet. Avi-era and Missing Link are good choices for vitamins. They can be purchased online or at some bird shops. If only one is fed, feed 3 times a week on food, not in water. If both are fed, alternate.

These foods are appropriate for other small birds like budgies, lovebirds, and medium and large birds as well. It is recommended to purchase everything separately and make your own mix. Don’t buy from big box stores or dog/cat pet stores. These stores may have had the food sitting in warehouses for months or even years. Even if they sell birds, they buy from the big box stores. With bird-only stores, they buy quality, and you don’t run the risk of having contaminants like mold, animal droppings, and saliva in the food that you would with food from other sources.

Don’t hesitate to eat with your bird. Many birds will start eating good foods if fed at the table with the owner and/or other birds. It’s a great bonding time.

Cereals:

• Sugar-free cereals, like Wheat, Rice, and Corn Chex; some like it moistened with a little rice, almond, or other non-dairy milk.
• Flakes, like Wheaties, Total, and cornflakes; Cheerios and other low-sugar cereals are good. Some may have small amounts of sugar, which is OK, but if sugar is among the first 3 ingredients, the food will have too much sugar in it and should be avoided.
• Flax seed—available at grocery stores, only for small birds.
• Low-sugar granola, e.g., Quaker Puffed Granola, Blueberry-Vanilla Flavor. It has small freeze dried blueberries in it.

Other foods:

• Nutriberries and Avi-cakes; these are labeled as treats, but they are not. They are nutritious foods. They come in three sizes.
• Kaytee parakeet Forti-diet Honey Treat Bars for small to medium size birds. Break them up and give a small amount per day. Don’t just put the whole thing in the cage. Some of these birds will eat nothing else if allowed. Parakeet bars do not have sunflower or safflower in them, but the larger sizes do. https://www.chewy.com/kaytee-forti-diet-pro- health-honey/dp/122876.
  Available at Chewy, Amazon, and Petco, among others.

Seeds

• Parakeet seed instead of cockatiel or other seeds for mid-sized birds. They are the same, except that cockatiel includes a lot of sunflower and safflower, both bad for the liver. Read the ingredients on everything you buy.
• Oat groats: Some grocery stores carry it. Great Companions, Amazon, and Shiloh Farms do. Shiloh farms has good quality and price. Whole Foods or other similar stores may carry it. Amazon carries some good-quality groats. Do not buy anything that is cheap; it isn’t worth it.
• Red and white/yellow proso millet: These are small seeds, so only small birds would eat them.
• Nuts are good for larger birds, but only feed tree nuts. Avoid peanuts and all peanut products. They usually contain mold spores. Those small black spots on the shell and nut are mold spores, and mold can be in the peanut products at the store.

White/yellow proso millet is available at some grocery stores or over the internet. Morning Bird carries red and white proso millet. Red is a particular favorite of cockatiels.

https://morningbirdproducts.com/collections/bird- seed, https://www.morningbirdproducts.com/products/morning-bird-red-proso- millet?_pos=1&_sid=937075e06&_ss=r
https://www.shilohfarmsmarket.com/ https://www.shilohfarms.com/

NEVER BUY SEEDS FROM NON-AVIAN PET SHOPS OR BIG-BOX STORES. THEIR SEEDS ARE STORED FOR MONTHS OR LONGER AND MAY BE CONTAMINATED WITH ANIMAL DROPPINGS OR OTHER DIRT, AND WILD ANIMALS MAY HAVE EATEN FROM THE PACKAGES.

Millet sprays:

• Amazon, Nemeth Farms, has two bluebirds on top of millet. From “Bird Dog” Excellent quality. Available in 1 lb. bags, 5 lb. boxes, and 25 lb. boxes. It’s quite expensive, but you get what you pay for. There is very little waste, and the sprays are full and fresh. It looks like this:

https://www.amazon.com/Nemeth-Farms-Parakeet-Natural- Healthy/dp/B001LK91O4/ref=sr_1_2?keywords=spray+millet+for+birds&qid=1567312878&s=ga teway&sr=8-2
https://www.amazon.com/Nemeth-Farms-Parakeet-Natural- Healthy/dp/B0068RFAFO/ref=sr_1_1?dchild=1&keywords=nemeth+farm+millet&qid=16088633 59&s=pet-supplies&sr=1-1

These websites have changed to offering the millet in 1-pound bags, not the 5 and 25 lb. boxes. Another distributor in Amazon carried it. and found the 5 and 25 lb. boxes. Here is the link: https://www.amazon.com/Pesticide-Nemeth-Supplement-Cockatiels-Finches- 5lbs/dp/B001LK91O4/ref=sxts_rp_s_sp_1_0?content-id=amzn1.sym.497ddbaf-dbdc-4a61-b204- 33f5c59012b2%3Aamzn1.sym.497ddbaf-dbdc-4a61-b204- 33f5c59012b2&crid=2UGGL33HCZTNM&cv_ct_cx=millet%2Bspray%2Bfor%2Bbirds&keywords=millet% 2Bspray%2Bfor%2Bbirds&pd_rd_i=B001LK91O4&pd_rd_r=143c599f-3eb0-442a-a40b- 8c6cb500d950&pd_rd_w=xCxPs&pd_rd_wg=9ywgo&pf_rd_p=497ddbaf-dbdc-4a61-b204- 33f5c59012b2&pf_rd_r=D8V565J9WBVWKQZSVSQK&qid=1669429901&sprefix=millet%2Bspray%2B% 2Caps%2C73&sr=1-1-5985efba-8948-4f09-9122-d605505c9d1e&th=1

• Buckwheat seeds and groats. Meijers sometimes carries it, best price at Shiloh farms. https://www.shilohfarms.com/buckwheat-groats-organic/
• Zupreem fruit-flavored pellets for cockatiels and medium-sized birds, Chewy carries them; a few a day if they like them. It’s not for a nutritional benefit; simply if they like them.
• Kaytee Fruit and Veggie mix and Fruit Mix for Parakeets, and other parakeet mixes. Chewy, Petco, or Amazon.
• NO GRIT, EVER, FOR PSITTACINES BIRDS! Only birds that eat their seeds whole use grit; Psittacines (birds in the parrot family) do not. They shell their seeds. Birds like canaries, doves, and pigeons only need a very small amount; more should only be added when that amount is gone. Otherwise, they can develop crop impaction.

Human foods:

• Rice, pasta, mashed potatoes, sweet potatoes, couscous, scrambled egg, applesauce (a real favorite, and a way to get fruit into them). It’s also a good way to train them to take food and medications from an oral syringe. Human foods are OK as long as they are not fatty, fried, or breaded. For more protein, baked chicken breast, ground beef, roast beef are good, and from the deli, roast beef and chicken slices and low sodium ham are good. Usually, only the larger birds eat meat, but some smaller ones will try it. Some of the author’s cockatiels eat meat.
• Tomato sauce (plain or mildly spicy), for spaghetti or on ground beef, small amounts
• Peas, corn, and other vegetables such as fresh green beans, asparagus, cauliflower, and broccoli, all lightly steamed or cooked are good. Cauliflower and broccoli can be given raw but there’s more nutritional value in them steamed. Even though the “raw diet” is popular right now, it is not always good for them. Most vegetables need to be cooked to release their nutritional value, and some birds have digestive issues when fed raw vegetables.
• No raw sweet potatoes! Serve only the fleshy meat inside; no seeds, stringy parts by the peel, or the peel itself.
• Never feed yams. Don’t confuse yams with sweet potatoes. These are toxic to birds. (This information from T. J. Miesle, Food Chemist.)
• Whole Foods, and similar stores, have different seeds and grains. Some they like; some they don’t. Try different foods with them. They love couscous, and other grains may be found in these types of stores.
• Whole grain bread. Oat-nut is a favorite. Quality white bread is good in small amounts-many like their bread toasted.
• Soft cheese, like American cheese, occasionally. No other types since some have mold on them (like blue cheese).
• No dairy products, or rarely. I know many people like to give yogurt, but yogurt is dairy; if you give it, give small amounts and infrequently. They can’t digest lactobacillus.

Organic: “Organic” is not really different from regular food. Every state has different rules and regulations about what farmers can and can’t use on their crops. And many of the foods we get are imported, where there are no regulations. Finally, once the food leaves the farm, there is no control at all as to what happens to it. It is handled by many middlemen between the farm and your table. (T.J. Miesle)
Appendix C: The use of lasers in the treatment of pododermatitis

In 2014, ten veterinarians met during an Association of Avian Veterinarians conference to discuss the use of therapeutic lasers in treating avian and other exotics patients. Lasers are being used in veterinary medicine with positive clinical results, and low-power therapeutic lasers have proven effective for the treatment of wounds, reduction of inflammation, and modulation of pain. ¹⁷ The results of the discussion are as follows:

• All of the attending clinicians had used therapeutic laser treatment with birds and other exotics in their clinical work.
• These uses included:
  1. Healing wounds that have resisted previous therapies
  2. Painful conditions
  3. Wounds and skin infections
  4. Postsurgical incision treatment
  5. Osteoarthritis
  6. Pododermatitis
  7. Any inflammatory condition or traumatic lesion.⁷

When asked about the kind of response they observed with therapeutic laser treatment compared to routine care, the practitioners responded positively:

Their responses included:

• Improvement in cases of pododermatitis; some with dramatic improvement
• Faster healing time
• Decrease in the severity of wound cases
• Improved mobility in orthopedic cases
• Accelerated healing time, particularly in the dermal wound healing of the foot.
• Improvement in a chicken with bumblefoot, both in improved weight-bearing and decreased inflammation after just one treatment.
• Reduction of the bacterial colony in a wound
• Increased tolerance of the treatment; some are even able to relax a little during the treatment.⁷

Figure 59. “A cockatiel, with a chronic, long-term self-mutilation site, responded to his one session two weeks ago and received another one just in case. We had performed a complete set of appropriate tests on him over the last two years, including bloodwork and radiographs, as well as a removal and biopsy of the affected skin to rule out damaged nerves” (image courtesy Vanessa Rolfe, The Bird and Exotic Hospital; used with permission).

A discussion of the advantages and disadvantages of therapeutic laser treatment in avian patients yielded the following results:

• The benefits:
  1. An increase in the level of healing for pododermatitis patients
  2. An adjunct to medical therapy alone
  3. Improved speed of treatment and response time, leading to less stress on the patient and better recovery and survivability of the patient.¹⁷
• The drawbacks:
  1. Difficulty in objectively determining the effectiveness or success of the laser treatments
  2. The lack of specific protocols for the use of the laser
  3. The large amount of misinformation or disinformation being spread, which serves to confuse the clinician
  4. The lack of scientific studies in the literature about laser use. Those that are published sometimes have limited access, so clinicians may not have been able to read them and thus may not feel comfortable with their use.¹⁷

All concluded that the advantages significantly outweighed the disadvantages. Although lasers have been used for some time by veterinarians, they have not been used as long by avian and exotic veterinarians. All agreed that the differences between avian tissue and mammalian tissue warranted a more careful study of the techniques involved and results gleaned from such use, and far more care needs to be taken when applying laser treatment to birds.¹⁷

Introduction

When people think of bacteria, they consider them just disease-causing organisms, but the vast majority of bacteria don’t cause disease. Rather, they play important roles in the environment and health of all living things, including humans and birds. They contribute to food and oxygen production. Neither plants nor animals could survive without bacteria.

Bacterial pathogens have existed for millennia. In past centuries, many remained in the hilly, forested lands around the world. In the past two centuries, however, as farm land was being developed and forests were torn down to make way for cities and buildings, many of the bacterial and viral pathogens lost their secret homes and went in search of new hosts to inhabit.

As long as these bacteria remained in the hills, forests, waterways, and farmland, they had no need to spread out. Many of the bacterial diseases that once were thought to be long gone and no longer a threat are recurring and persisting. Most occurred in Asia and Africa, where deforestation is rampant. Animals are also subject to illness from these pathogens. Before we delve into the bacteria that are most commonly found in birds, we will explore those frequently used antibiotics administered to avian species since there are references to them in the paper.

Part 1 The Role of Antibiotics in Avian Health

1.1 The Origin of Antibiotics

Bacteria are single-celled microorganisms that appear in many different metabolic types, geometric shapes, and environmental habitats. Some are beneficial for people and animals, and some are not. They can only be seen microscopically, and most have yet to be categorized.⁵

1.1.1 Sir Alexander Fleming and Penicillin

Humans have been using antibiotics for themselves and animals for decades, but these drugs have not been used for birds for nearly that long. Physicians and physicists have known since 1874 that “certain cultures of the mold, Penicillium glaucum, inhibited bacterial

contamination,” ⁶ but it wasn’t until 1928, when Sir Alexander Fleming identified what is known today as penicillin, that it was able to be used commercially. He found that molecules which were produced by certain molds killed or stopped the growth of specific bacteria. Fleming was doing research on a “culture of disease-causing bacteria when he noticed the spores of a green mold, Penicillium chrysogenum, in one of his culture plates.” ⁶ Fleming theorized that the mold must secrete an antibacterial substance, and he named it, “penicillin.” His work won him the Nobel Prize. It was first used during World War II, and soon after the war it was made available to the general public. Understanding the vast world of antibiotics and anti-infectives is no easy task. ^{13, 6}

Image 1. Alexander Fleming, the discoverer of penicillin (image courtesy Biology Corner). https://www.biologycorner.com/worksheets/articles/alexander_fleming.html

Image 2. This mold, identified as Penicillium notatum, had inhibited the growth of a colony of Staphylococcal bacteria in the Petri dish (image courtesy YS journal.com via en.wikipedia.org.)

1.1.2 The Light Microscope

The microscope is the most important tool the avian veterinarian has for discovering the pathogens that are found in birds. It enables him to see the bacteria, fungi, protozoa, parasites, and viral inclusion bodies, many times without or before staining.

The light microscope employs visible light to small samples and is probably the most well-known and well-used research tool in biology. It is used to view samples with the available room light or with a light affixed to the microscope. The smallest objects that are considered to be living are bacteria, and even those may be observed and cell shape recognized at a mere 100x magnification. It is also called “Bright Field Microscopy.” ¹⁴

In optical or light microscopy, visible light is transmitted through or reflected from the sample through a single or multiple lenses to allow for magnification of the sample. This image may be seen directly by the eye, viewed on a photographic plate, or captured as a digital image. ¹⁴

Image 3. A stereo microscope

1.2 Classification of Antibacterial Medications and Their Functions

1.2.1 Antibiotic Classifications

Antimicrobials are medications that kill or stop the action of a bacterial pathogen. Antimicrobials are classified according to their function. Antibiotics are one class of antimicrobials; they fight against bacteria. Another class is anti-mycotic; these will stop fungal diseases. Anti-viral attack viruses, and anti-protozoal drugs fight protozoal diseases. Most antibiotics fall into their individual antibiotic classes. An antibiotic class is a grouping of different drugs that have similar chemical and pharmacologic properties. “Their chemical structures may look comparable, and drugs within the same class may kill the same or related bacteria.” ¹

1.2.2 Broad- and Narrow-spectrum Antibiotics

Not all antibiotics work against all types of bacteria. Narrow-spectrum antibiotics are only effective against a limited range of bacteria; for example, penicillin G is very effective at killing gram-positive bacteria, but not very effective against gram-negative bacteria. Broad-spectrum antibiotics are effective against a wide range of bacteria. ¹⁶

What causes an antibiotic to have a narrow spectrum of antimicrobial activity? “Often, it has to do with the ability of the antibiotic to penetrate inside of the bacterium. Gram-positive bacteria have a relatively loose outer wall that many antibiotics can diffuse through. However, gram-negative bacteria have a complex outer layer that prevents the passage of many larger or fat-soluble molecules.” ¹⁶

Another reason that antibiotics can have a narrow spectrum of activity can be their target molecules. If an antibiotic targets a molecule that is not in the bacterium, it won’t be effective against that bacterium. For example, isoniazid specifically targets mycobacteria, the bacterium that causes tuberculosis. It’s specific because it prevents the synthesis of mycolic acids, which are found in the cell walls of mycobacteria, but not most other types of bacteria. ¹⁶

If the patient is treated with an antibiotic that has a narrow spectrum of activity, the ‘good’ bacteria that normally live inside the body won’t all get destroyed along with the pathogen that caused the infection. However, it is not always clear which microbe is causing the illness; therefore, the patient will be started on a broad-spectrum antibiotic so that the medication can work quickly and the patient can survive until the specific bacterium is determined and the more appropriate antibiotic is prescribed. ¹⁶

1.3 Bactericidal and Bacteriostatic Antibiotics

Antibiotics are generally divided into two groups based on their method of action. They either kill bacteria or prevent them from growing. They are prescribed when there is an infection that the body’s immune system is unable to deal with. Antibiotics that kill bacteria directly are called “bactericidal,” which means “kill bacteria,” and those that stop bacteria from growing are called “bacteriostatic,” or “staying stable.”. ¹⁶

Image 4. The difference between bactericidal and bacteriostatic medications’ effect on bacteria in a laboratory setting (image courtesy Slide Share). https://www.slideshare.net/kyawsanlin25/terminologies-on-anti-infective-agents

1.3.1 The Mechanism of Bactericidal Antibiotics

The different antibiotics have different mechanisms. For example, “the antibiotic polymyxin B injures the plasma membrane of bacteria, allowing their contents to leak out of the cell wall. Under normal circumstances, bacteria and other cells have to keep a perfect balance of ions on both sides of the plasma membrane because of osmosis. Polymyxin B disrupts this balance and also lets other important molecules, like DNA and RNA, leak out, and so the bacterium is destroyed.” ⁷ Other bactericidal antibiotics include vancomycin, metronidazole, aminoglycosides, fluoroquinolones, penicillin, and cephalosporins. ¹⁶ The minimum concentration of a drug that is needed to kill a certain strain of bacteria is called the “minimum bactericidal concentration” or MBC. ¹⁶

1.3.2 The Mechanism of Bacteriostatic Antibiotics

In contrast to bactericidal antibiotics, bacteriostatic antibiotics inhibit the growth of the bacteria. The bacteria don’t die, but neither can they grow or replicate. Unlike the bactericidal agents, when bacteriostatic agents are used, microorganisms remain viable, and their numbers remain the same. Bacteria normally divide really quickly in the body, and their numbers can quickly get out of control. Bacteriostatic antibiotics stop them from growing and dividing, so the host’s immune system will then be able to take over and destroy the harmful bacteria. ¹⁶

Bacteriostatic agents are used to limit the growth and reproduction of microorganisms by interfering with their protein production, DNA replication, or other aspects of bacterial cellular metabolism. Unlike the bactericidal agents, the bacteriostatic agents must work together with the immune system to inhibit the microorganism’s activities. According to drug concentration, the activity may vary. For example, if high concentrations of bacteriostatic agents are used, they may kill the bacteria, whereas low concentration of bactericidal agents may simply inhibit their growth. Tetracycline, sulfonamides, spectinomycin, trimethoprim, chloramphenicol, macrolides and lincosamides are some examples of bacteriostatic agents. Minimum concentration of a drug that is needed to inhibit the growth of a certain strain of bacteria is known as “minimum inhibitory concentration” or MIC. ¹⁶

Tetracycline is an example of a bacteriostatic antibiotic. It inhibits the bacterial ribosomes so that no new proteins can be made. This doesn’t kill the bacteria; they already have the proteins they need to survive for a while. However, they can’t replicate because they would need to make many new proteins in order to make a whole new bacterial cell. Other bacteriostatic antibiotics include chloramphenicol, trimethoprim, clindamycin, sulfamethoxazole, and erythromycin. ¹⁶

1.4 Determining Factors When Choosing an Antibiotic

 In some cases, there may be multiple bacteria present. One antibiotic might kill one strain but only inhibit the growth of another. It is for this reason that the veterinarian may choose to use two different antibiotics. The practitioner needs to know all aspects of the bacteria and the antibiotics he wishes to use before making his choices. He may choose one or both types when treating an infection. His choice depends on:

• The type of infection
• Growth conditions of the microorganisms
• Bacterial density
• Test duration, and the
• Reduction rate of the bacteria.⁴⁸

In most cases of antibiotic use, a doctor must choose an antibiotic based on the most likely cause of the infection. For instance, if the bird has a skin infection, the doctor needs to know which antibiotic to prescribe for skin infections, and he will prescribe the best antibiotic for that type of bacteria. ^{8, 48}

1.4.1 Testing to Determine Antibiotic Sensitivity

Laboratory tests may be required for the veterinarian to choose the proper medication. Gram’s stains can be used to identify bacteria under the microscope; these will also tell him which bacteria are present and provide information he needs to choose the proper antibiotic. Certain bacterial species will take a stain, and others will not. Those that don’t will be examined directly under the microscope. Many times, the veterinarian will do both—direct and stained microscopic analysis. ⁴⁸

Image 5. Bacteriology plate showing the antibiotic sensitivity. “The best antibiotic to use is the one which leaves a clear ring around the antibiotic disk. This is how we choose which drug will work best in a difficult situation” (image courtesy Michael J. Cannon) ¹³

The veterinarian may need to do a culture on a bacterial sample which is allowed to grow in a laboratory. The results may take a few days to come back from the lab. The way bacteria grow or what they look like when they grow will help to identify the bacterial species. Cultures may also be tested to determine antibiotic sensitivities. “A sensitivity list is the roster of antibiotics that kills a particular bacterial type.” ⁴⁸ This list will confirm that the correct antibiotic is being dispensed. Treatment is based on the location of the infection and the results of the culture-and-sensitivity testing. ⁴⁸

1.4.2 Other Considerations When Choosing an Antibiotic

The practitioner must also consider the species he’s dealing with. Songbirds, canaries and finches, poultry, and psittacines all belong to different taxonomic orders. They react differently to medications, and this needs to be taken into consideration by the veterinarian. The practitioner must consider other factors when choosing an antibiotic: medication costs, dosing schedule, and common side effects are often taken into account. He must also consider how the bird reacts to a specific antibiotic; if there is a negative reaction, he will have to change to a different antibiotic. In some aviaries or households with multiple birds, and if the infection is transmittable to other birds, all the birds may need to receive the antibiotic. If it is a zoonotic disease (transmittable to humans), the clinician will advise the owner to see his own physician. ⁴⁸

A very important question the veterinarian must ask the client concerns the owner’s comfort level with giving the bird the medication. Some people are really confident with syringing medications into the bird or giving injections, and others simply can’t bring themselves to do it. For those who feel they are unable to give their bird the needed medication, the veterinarian might choose to give the bird a long-acting injection in the office if the antibiotic comes in an injectable form. This way, the owner might not have to administer medication himself. Sometimes the veterinarian will begin with a fast-acting injection, and the client will need to continue the treatment with oral medication at home. ⁴⁸

1.4.3 Incorrect Antibiotic Usage in Birds

Even though antibiotics are used quite commonly in aviculture, many owners are confused about how they work and how they are used. If they are not used correctly, or the bird develops a resistance to it, the drug may not work at all. This is often a major problem, since if either is the case, the drug may be of no use to the patient. ¹³

The purpose of using an antibiotic is for the bird to develop “strong, adequate levels of the drug in the bloodstream.” ¹³ The blood’s job is to carry the antibiotic to the infected area of the body. If the dose of the antibiotic is too low, or if it is not given frequently enough, it will fail to work. In addition, if the antibiotic is not used correctly, the bird may develop a resistance to the drug, and other birds in the home or aviary may be at risk of contracting the disease. ¹³

Due to the misuse and overuse of antibiotics, some people have a negative opinion about antibiotics, both for themselves and their pets. This negativity is unfounded; antibiotics are extremely valuable medications. Antibiotics have changed medicine for the better, having been instrumental in curing such infectious diseases as pneumonia and tuberculosis. When used correctly, they are a vital tool for the practitioner. ^6.

1.4.4 Correct Use of Antibiotics in Birds

The antibiotic’s purpose is to kill bacteria; however, they do not all work the same way. Some kill gram-positive bacteria, while others kill gram-negative bacteria. Most gram-negative bacteria are harmful, and most gram-positive bacteria are beneficial and are normally in the body; however, there are some very dangerous gram-positive bacteria out there. Since penicillin has come on the market, there have been many new classes of antibiotics created to deal with the different strains of bacteria. For example, fluoroquinolones such as enrofloxacin (Baytril) are used extensively by avian veterinarians. Giving the wrong antibiotic for a specific bacteria will either be ineffective, or worse yet, cause the infection to worsen ⁷

Antibiotics must be given for a prescribed period of time. Doctors and veterinarians prescribe for a specific amount of time because research data supports that it takes this much time to adequately kill an invading pathogen. So, if people do not comply with giving their birds the entire course because the bird seems to be improving, they risk the possibility that some of the more resistant bacteria are still in the bird’s system. Bacteria can mutate and develop a resistance to the antibiotic. Then the veterinarian has to use stronger antibiotics. Sometimes these work and sometimes they don’t. This can result in an even more virulent infection soon after. If none of these stronger drugs works, the bird may succumb to the infection. ⁷

1.5 Antibiotic Drugs and Their Usages

1.5.1 Table of Commonly Used Antibiotic Drugs

1.5.2 Antibiotic Nomenclature and Tradenames

Most antibiotics have two names: the trade or brand name, created by the drug company that manufactures the drug, and a generic name, based on the antibiotic’s chemical structure or chemical class. Each antibiotic is effective only for certain types of infections. Although there are well over 100 antibiotics on the market, the majority come from only a few types of drugs. These are the main classes of antibiotics: ¹

• Penicillins, such as penicillin and amoxicillin
• Cephalosporins, such as cephalexin (Keflex)
• Macrolides, such as erythromycin (E-Mycin), clarithromycin (Biaxin), and azithromycin (Zithromax)
• Fluoroquinolones, such as ciprofolxacin (Cipro), levofloxacin (Levaquin), and ofloxacin (Floxin)
• Sulfonamides, such as co-trimoxazole (Bactrim) and trimethoprim (Proloprim)
• Tetracyclines, such as tetracycline (Sumycin, Panmycin) and doxycycline (Vibramycin)
• Aminoglycosides, such as gentamicin (Garamycin) and tobramycin (Tobrex)
• Carbapenems, such as imipenem and meropenem
• Glycopeptides, such as vancomycin and teicoplanin
• Lyncomycins (such as Lincocin) ^{1, 48}

1.5.3 Over-the-counter Antibiotics

Many owners decide to save money by purchasing antibiotics from a pet store. Since the owner is unable to diagnose his bird properly, these do little to no good. These water-based medications are so broad-spectrum that they are not effective against a specific bacterium. The bird’s illness cannot be diagnosed without a veterinary exam and culture. Giving these medications causes the owner to waste valuable time in getting the bird the proper medical care. The sick bird’s condition deteriorates quickly—within hours even—once the infection takes hold. Time is of the essence when it comes to getting treatment for sick birds. ⁶

1.5.4 Antibiotic Interaction with Other Drugs and Foods

Many humans use home remedies that seem to work for them, but they should not use them on their birds. They are experimenting and that’s never a good idea. Birds are not mammals. What works on us does not necessarily work for them. It is especially important that they not give their bird home remedies during antibiotic therapy. Some foods can inhibit the efficacy of these drugs. Do not add grapefruit seed extract (GSE) to your bird’s water as an extra med when you are giving them antibiotics. Grapefruit is one of the foods that is well known by doctors to interfere with the absorption of some antibiotics. “Natural” is not by definition safe (not that GSE is natural–it is filled with preservatives). And don’t administer apple cider vinegar thinking it’s a cure-all for birds. It is only used for fungal disease, and even then it is just a temporary fix. The illness will not go away because of its use. It must be treated with the correct medication from the avian veterinarian. ⁷

1.6 Bacterial Resistance to Antibiotics

Antibiotics are typically used to treat bacterial infections. However, in recent years, the improper or unnecessary use of antibiotics has promoted the spread of several strains of antibiotic-resistant bacteria. With antibiotic resistance, infectious bacteria have built up a tolerance for antibiotics that had previously been effective. One such problematic bacterial strain is methicillin-resistant S. aureus (MRSA), a gram-positive bacterium, which resists methicillin and other antibiotics used to treat Staphylococcus infections. It has been found in birds and is quickly fatal. It spreads primarily through skin contact and causes skin infections. ⁵⁴

Some pathogenic bacteria become resistant to antibiotics over time due to mutation. They may work for a while then cease to work after a time. As they change, it becomes more and more difficult to destroy them. This image demonstrates the effect the antibiotic has on bacterial cultures in which it has failed to kill the bacteria. ⁵⁴

Image 6. Antibiotic-resistant strains of Staphylococcus aureus bacteria and Methicillin-resistant S. aureus or MRSA have become the most common cause of skin infections and are frequently found in birds (image courtesy Anthony Komaroff). https://www.askdoctork.com/mrsa-dangerous-201502037412

Image 7. An antibiotic’s effect on various bacteria (image courtesy 123rf). https://www.123rf.com/stock-photo/bacteria_culture.html?mediapopup=47047441)

1.7 Antimicrobials/Antibiotics Commonly Used in Pet Birds

These are commonly administered to avian patients:

Amikacin sulfate

Amoxicillin/clavulanate

Azithromycin

Ceftazidime sodium

Ciprofloxacin

Clindamycin

Doxycycline

Doxycycline injectable, 20 mg/mL

Enrofloxacin

Metronidazole

Marbofloxacin

Trimethoprim/sulfamethoxazole ⁶

1.8 The Use of Probiotics for Avian Patients

Although most antibiotics do kill the good bacteria as well as the harmful ones, most healthy birds will rebuild their supply of normal flora once the infection has cleared up and the bird returns to its usual diet. Owners may wish to give their birds probiotics–lactose-based bacteria that are used by humans to rebuild healthy flora. They are for the most part harmless; however, they are also a waste of money unless probiotics without lactose and made specifically for birds can be found. ⁷ “There is only one good probiotic out there, Sivoy, and it is made in Italy. So, most people will not be able to get it.” (However, Visbiome Vet is available here and is related to Sivoy. Ask your avian veterinarian about it) (R. Dahlhausen, personal communication).

Probiotics made for humans are specific for mammalian flora. Research into developing a true probiotic specifically for birds has been too expensive for most drug companies to pursue. It would have to be cultivated from birds, most likely chickens. Research on human probiotics can be translated from other mammals to humans, but not from mammals to birds. Birds are simply too different. ⁷

The development of antibiotics has changed the course of veterinary medicine. Since their use, countless numbers of birds and other animals have been saved from death by previously fatal diseases and infections. Ongoing research and development of new antibiotic drugs to combat these illnesses is vital.

1.9 Administering Medications Orally

Oral medications must be given directly into the mouth with an oral syringe. Putting them in the water is not a good idea. How much is the bird drinking? Is he drinking less because the water tastes unpleasant to him? Is he drinking more because he is overly thirsty and therefore getting too much medication? The only way to truly determine if your bird is getting the exact, correct dosage is to give it orally. As with children, it can be a struggle with some birds, but it is worth the effort to know he is receiving the correct dosage.⁷

Choose the correct size of oral syringe for the bird. Small birds should receive it from a .5 cc. syringe; medium-sized birds should take it from a 1 cc syringe, and larger birds can use a 1 cc to 5 cc syringe, depending on how well they take the medication. Some large birds are very difficult to dose, so a smaller syringe might have a better chance of getting the medication into them without so much waste. Be aware that you cannot skip dosages without jeopardizing the treatment plan. They must be given as directed by the clinician.

Part II What Are Bacteria and How Do They Work?

2.1 What are Bacteria?

Bacteria are microscopic, single-celled organisms with a simple internal structure that thrive in diverse environments. They can live within soil, in the ocean, and inside the human intestinal system. They contain ribosomes, spherical units within the cell where proteins are assembled from individual amino acids. ⁵⁴

They can be beneficial, as in aiding in digestion, or harmful, causing disease, and they can survive in extreme environments due to their diverse metabolisms. Their ways of obtaining energy for growth and life have allowed them to colonize nearly every environment on earth.³¹ Not all bacteria are capable of causing disease, but each group has at least some disease-causing representatives. ³⁹

Image 8. Ribosomes within the cell (image courtesy Billy Cell City). http://billycellcity.blogspot.com/2009/11/ribosomes-brick-factory.html

2.2 The Difference Between Aerobic and Anaerobic Bacteria

Bacteria may be divided into those which are aerobic and those which are anaerobic.

(Table courtesy Jilani) ²⁹

2.3 Bacterial Structure

Bacteria range in size from 1 to 10 micrometers in length and cannot be seen without a microscope. They have no nucleus, and their genomes are a single circle of DNA.³ On the outside, bacterial cells are usually surrounded by two protective coverings: an outer cell wall and an inner cell membrane. However, some bacteria do not have a cell wall at all, and others may even have a third, outermost protective layer called the “capsule.” ⁵⁴

Bacteria can move in a variety of ways. A number of them move about by secreting a slime that allows them to glide over the cell’s surface so that they slide through their environment. Others have flagella—small, whip-like appendages made of protein which move the bacterium along in a swimming motion. There are those that use pili, hair-like structures, which help the bacterium attach to the host surface. These aid them in “swishing through their watery environments.” ³¹

Image 9. Structure of a bacterium cell (image courtesy Montana Science Partnership). Science Partners.info, http://www.sciencepartners.info/module-3-soils/the-tree-of-life-part-1/bacteria

2.4 Bacterial Reproduction

Most bacteria multiply by binary fission. A single bacterial cell, the “parent,” makes a copy of its DNA and grows large in size by doubling its cellular content. The doubled contents are pushed out to either end of the cell. Then a small fissure emerges at the center of the parent, eventually splitting it into two identical “daughter” cells. Some bacterial species reproduce by budding. During budding, the daughter cell grows as an offshoot of the parent. It starts off as a small nub, grows until it is the same size as its parent, and splits off.³¹

Image 10. Pseudomonas fluoresences reproduces through binary fission. The bacteria splits apart, making almost an exact replica of the parent. Depending on the bacteria’s reproduction rate, there could be  thousands of that bacteria produced in a day (image courtesy Site for Science). https://sites.google.com/site/sassiteforscience/standard-2/objective-d

Image 11. Reproduction by budding (image courtesy mr-roes in Wikispaces).

http://mr-roes.wikispaces.com/Asexual+Reproduction+Webquest

http://fpgeetutor.blogspot.com/2015/02/microbiology-principles-of-microbial.html

Image 12. Reproduction through binary fission (image credit mr-roes). http://mr-roes.wikispaces.com/Asexual+Reproduction+Webquest

2.5 Bacterial Classification and Shape

Bacteria come in many different sizes and shapes, and they are classified by their morphology, or shape and appearance. They can also be distinguished by the nature of their cell walls and by differences in their genetic makeup. ^{4, 7} The three basic shapes of bacteria are: ^{39, 54}

Image 13. Normal cocci and fungal spores in a Gram’s stain swab; the small dots (black arrow) are the cocci and the large smears (red arrow) are fungal spores (image courtesy Bob Dahlhausen; used with permission)

2.5.1 Spherical or Round.

Round bacteria are referred to as cocci (singular, coccus). Cocci can also take their form in different configurations depending on the bacterium and environmental conditions. They can appear as:

• a single bacterium
• combinations of two (diplococcus);
• a linear chain, as in streptococcus;
• a cluster, such as in staphylococcus.

Cocci cause many illnesses Among the more common cocci is Staphylococcus aureus, which appears as a cluster of cocci. S. aureus often grows harmlessly on the skin, but given a chance, can do great damage to the bird’s skin or respiratory system. ^{39, 54}

Image 14. Staphylococcus aureus

Staphylococcus (pl. Staphylococci) is a genus of spherical, gram-positive bacteria which occur in grape-like clusters (image courtesy “Go Pets America”). http://www.gopetsamerica.com/bio/bacteria/staphylococcus.aspx

2.5.2 Rod-shaped or Cylindrical

Cylindrical, rod-shaped bacteria are called bacilli (singular, bacillus). They occur singly or in linked chains. Escherichia coli is a rod-shaped bacterium that normally lives in the intestinal tract without causing disease; however, it can be harmful at other sites, such as in the urinary tract or on the skin. Some strains of E. coli are spread by contaminated food or water. ^{39 54 56}

Image 15. Rod-shaped bacteria. A stylized scanning electron microscopic image of rod shaped bacteria (bacilli). Tetanus, anthrax and botulism are all caused by such bacteria.. (image courtesy Science Photo Library). https://www.sciencephoto.com/keyword/landscape).

2.5.3 Spiral

Spiral or spirilla (singular, spirillum) are rigid, corkscrew-like, spiral-shaped bacteria which can be further categorized depending on how much spiraling they show.³⁹ One such bacterium is Campylobacter which is commonly found in raw poultry. Spiral bacteria can be sub-classified by the number of twists per cell, cell thickness, cell flexibility, and motility. The two types of spiral cells are spirillum and spirochete, with spirillum being rigid with external flagella, and spirochetes being flexible with internal flagella. ^{39, 47, 54}

Image 16. Spiral-shaped campylobacter bacteria (image courtesy “Food Safety Magazine”). https://www.foodsafetymagazine.com/magazine-archive1/aprilmay-2010/control-of-salmonella-campylobacter-and-other-bacteria-in-raw-poultry/

The shapes and configurations of bacteria are often reflected in their names. For example, the milk-curdling Lactobacillus acidophilus are bacilli, and pneumonia-causing Streptococcus pneumoniae are a chain of cocci. ⁵⁴

Image 17: The shapes of bacteria (image courtesy “Slideshare.net”). https://www.bing.com/images/search?view=detailV2&ccid=tw7N4wfv&id=3C37A9DE538B98626059F8943E8F8B6CC56DC8C4&thid=OIP.tw7N4wfvzpPcJcsy2Khu7AEsDh&q=different+types+of+bacteria&simid=608030189621480002&selectedIndex=9&ajaxhist=0

Part III Beneficial and Harmful Bacteria

3.1 Commensal Bacteria: Beneficial

There are many bacteria in the body that are important to health; they protect the host from disease-causing pathogens. ³¹

Commensal bacteria, which are Gram-positive, are usually beneficial. These are commonly found microflora which consist of those microorganisms which live on body parts covered by epithelial cells and are exposed to the external environment, such as the skin and gastrointestinal and respiratory tracts. Some of these bacteria, given the right conditions, can multiply so quickly that they overpower the immune system and become pathogenic, even though ordinarily they are beneficial. The most abundant bacteria are present in the lower part of the intestinal system, and most intestinal bacteria are Gram-negative anaerobes (organisms that live without oxygen). If allowed to multiply to high numbers, these can become pathogenic and will activate the immune system. If the immune system overreacts to these bacteria, there is the risk of inflammation.⁵²

3.1.1 Normal Flora in the Bird’s Body

Any time a bird is ill, bacterial disease should be considered in the list of differential diagnoses (DDx). They are common in pet birds, and almost always due to poor husbandry and nutrition. Neonates and young birds are especially vulnerable. The most commonly found infections are gastrointestinal (GI) and respiratory. These can lead to systemic disease. Normal bacterial flora exist in all companion birds; in small numbers they do not produce disease, but when allowed to grow, they are very dangerous. ²⁶

Image 18. Normal flora in choanal Gram’s stain in author’s cockatiel #1 (image courtesy Bob Dahlhausen; used with permission).

Image 19. Normal flora in choanal Gram’s stain author’s cockatiel #2 (image courtesy Bob Dahlhausen; used with permission).

Image 20. On the fecal Gram stain, author’s cockatiel #1 exhibited an overgrowth of normal bacterial flora. This is indicative of an intestinal imbalance and indigestion (image courtesy Bob Dahlhausen; used with permission).

Image 21. On the fecal gram stain, the author’s cockatiel #2 exhibited a normal number of gram-negative rods; see black arrows (image courtesy Bob Dahlhausen; used with permission).

Normal gut flora in adult psittacines is about 80-100% Gram-positive bacteria, and 0-25% of that is E. coli. Other Gram-positive bacteria found in the psittacine intestine consist of fecal Streptococcus, Staphylococcus, Lactobacillus, and Corynebacterium, to name a few. ⁴⁹

Bacterial infections are common in pet birds, and clinicians should consider them when encountering illness in a bird. Gastrointestinal and respiratory infections are the most frequently seen and can lead to systemic disease. ²⁶.

3.2 General Overview of Pathogenic Bacteria

Bacteria are single-celled microorganisms that lack a nuclear membrane, are metabolically active, and divide by binary fission. They are a major cause of disease in birds. Bacteria may seem to be simple forms of life, but in fact they are “sophisticated and highly adaptable.” ³⁵

Most bacteria are able to multiply very quickly and can live for a long time on a wide variety of surfaces. These organisms exist in everywhere in both parasitic and free-living forms. ²⁶

In general, the bacteria which invade bird species and cause disease are related to the feeding habits of that species. Since most psittacine species are primarily granivorous, their intestinal flora is predominantly Gram-positive. When bacterial disease is observed in parrots and other genera, it is usually, but not always, Gram-negative in nature. ⁴⁴

The intestinal tracts of most healthy birds will contain potentially harmful bacteria. As long as these are small in number, they do not present a problem. But they can grow to larger numbers and create illness when the bird is stressed or immune-compromised, particularly if it is already fighting a concurrent illness.³² The droppings may change from normal color to very green (biliverdinuria) and become watery due to damage to the digestive tract, kidneys and liver. ³⁴

Bacterial inhalation from dust in the air may produce sneezing, eye rubbing, excessive swallowing, yawning and gaping, coughing, and loss or change in vocalizations. Both inhaled and ingested bacterial infections are potentially life-threatening when left unattended. ³⁴.

3.2.1 Obligate, Opportunistic, and Accidental Pathogens

In order to understand the means of identifying pathogens, one must know the types of pathogens that exist. The three categories of bacterial pathogens are:

• Obligate bacteria. This type must cause disease in order to be transmitted from one host to another. They must also infect a host in order to survive, in contrast to other bacteria that are capable of survival outside of a host. Examples of obligate bacterial pathogens include Mycobacterium tuberculosis and Treponema pallidum. ¹⁹
• Opportunistic bacteria. These takes advantage of an opportunity to cause disease. Opportunistic conditions allow the microorganism to activate, begin to multiply, and overwhelm the body’s weakened immune system.¹⁹ Opportunistic bacteria can be transmitted from one host to another without having to cause disease. However, in a host whose immune system is not functioning properly, the bacteria can cause an infection that leads to a disease. In those cases, the disease can help the bacteria spread to another host. Examples of opportunistic bacteria include Vibrio cholerae and Pseudomonas aeruginosa. ¹⁹
• Accidental bacteria. Some bacterial pathogens cause disease only accidentally. Indeed, the disease actually limits the spread of the bacteria to another host. Examples of these “accidental” pathogens include Neisseria meningitides and Bacteroides fragilis. ¹⁹

Most pathogens are Gram-negative, although some are Gram positive. Many pathogens, or harmful bacteria, can exist without causing disease if the numbers are low enough. However, if the numbers increase, they can cause serious diseases and infections such as meningitis, encephalitis, and myelitis. These bacteria include Salmonella, Listeria, S. aureus, Pseudomonas, Klebsiella, Mycobacterium, Streptococcus, Clostridium, and E. coli. These microbes are found everywhere in the environment. ¹⁸

3.2.2 Pathogenic Bacteria Must Be Able to Perform Three Actions:

• They must be able to enter and colonize the body. This happens when the person or animal breaths, eats, or drinks. They can enter through a wound or be passed on through sexual contact. They can also be passed on by parasites which bite an infected individual and then bite another, causing the same disease. ³¹
• They must overcome the body’s defenses. An immune-competent individual is usually able to throw them off, but if a person or animal is immune-compromised, the bacteria will be able to take over. Weakened immunity allows pathogens to reproduce rapidly and thus lead to any number of infections. ³¹
• They must damage the body. Pathogens produce toxins and enzymes that damage the body’s tissues. If food is improperly processed or cooked, or allowed to be out of the refrigerator too long, bacterial toxins can be become part of the food. Clostridium botulinum (botulism) is one such bacteria, often caused by improper canning methods. The toxins, not the bacteria, are what cause disease. ³¹

Image 22. Clostridia bacteria. These are the lines appearing on the image (black arrow) (image courtesy Sandhill Veterinary Services; used with permission). http://www.sandhillvet.co.uk/html/pigeon_service_management_diseases.html

3.3 Causes of Some Bacterial Infections

E.coli Contaminated food old fruit, fluctuating temperatures, draught, stress, wet areas, fungus infection, dirty cages

Streptococcus Cold stress, underlying viral infection, dusty environment, poor seed, stress

Staphylococcus Dust, mice, stress, poor seed, contaminated air conditioning, or dusty environment

Diplococcus Mice, stress

Citrobacter Poor water hygiene

Pseudomonas Poor water hygiene (e.g. bathroom grout and seal around sink) ⁵⁶

3.4 Transmission of Bacterial Infection.

Droplet infection occurs when the person with a cold coughs and sneezes and large numbers of the particles become airborne. The particles contaminate everything they touch, including the bird itself and its surroundings. Infection is due to inhalation or ingestion of the bacteria. Many people allow the bird to come in contact with their mouths; this is dangerous as we carry many bacteria in our mouths that are normal for us but harmful to the bird, such as E. coli. ¹⁹

3.5 Symptoms of Bacterial Infection

“The trachea of a bird connects and seals to the sinuses through the choanal slit when the bird closes its mouth. Signs of upper respiratory or sinus infection are sneezing and nasal discharge. Tail-bobbing and difficulty breathing are due to either middle airway (trachea) or lower airway (lungs or air sac) disease. Birds with a severe upper (sinus) airway disease rarely show much difficulty in getting air in and out of the air sacs and through the lungs. They also don’t usually show systemic signs of illness until and unless the infection extends down into the middle or lower parts of the respiratory system. Their sinuses produce a wet, gurgly sound when their mouths are closed.” ¹⁹

3.6 Types of Bacterial infections

Symptoms depend on the part of the body infected and the severity of the infection. The disease can be peracute or chronic.

• Peracute infection: a sudden, overwhelming illness. The bird sits fluffed up and quiet, and death occurs within 2 – 3 days.
• Chronic infection: The bird fails to thrive for as long as 6 – 8 weeks. With treatment, some birds may recover; others will relapse and die. Some can live indefinitely with treatment, and the disease become transient and mild. ⁵⁵

Part IV Pathogenicity and Etiology of Bacterial Disease

4.1 Classification Based on Pathogenicity

Pathogenicity is the capacity of an organism to cause disease. On this basis, bacteria which have been identified in a patient can be organized into three major groups:

• Primary pathogens. These are considered to be probable agents of disease (e.g., feces are tested and Salmonella spp. is identified as the cause of diarrheal disease).
• Opportunistic pathogens. These enter a host whose immune system has been compromised due to another disease. Bacterial infections can and do occur secondarily to other illnesses or pathogen infections. Viral infections, for example, cause a weakening of the immune system; this permits pathogenic bacteria to enter the body. ³⁴
• Non-pathogens. Some bacteria are considered to be non-pathogenic because they rarely or never cause disease. Pathogenic bacteria constitute only a small proportion of bacterial species, and many non-pathogenic bacteria are beneficial to birds. However, it is possible for non-pathogenic bacteria to adapt and become harmful due to the effects of other therapies on resistance mechanisms. In fact, some bacteria previously considered to be non-pathogens are now known to cause disease.” ³⁵

4.2 How Bacteria are Able to Cause Infection:

• Some bacterial species are extremely virulent and are able to attack a strong, healthy system.
• The bird encounters overwhelming or large-dose exposure to opportunistic bacteria.

Opportunistic bacteria are able to enter the system because of reduced immune response. This occurs during times of stress, poor nutrition, or concurrent disease conditions. Birds experience a great deal of stress some or even all the time. ¹⁹

Image 23: Fecal gram stain from a normal psittacine bird. (Image courtesy G. Kaufman) ³¹

4.3 Septicemia

Image 24: How sepsis takes over the body systems (image courtesy Dr. Warraich Health Channel) https://www.youtube.com/watch?v=qinhrQDtc_I&ab_channel=Dr.WarraichHealthChannel

Septicemia (sepsis or blood poisoning) is a systemic disease which results when pathogenic microorganisms and their toxins enter and remain in the blood. The signs seen by the clinician are a combination of those seen with toxemia and hyperthermia: fever and mucosal and conjunctival petechiation found in the joints, eyes, meninges (membranes around the brain and spinal cord), and heart valves. (Petechiae are minute reddish or purplish spots containing blood that appear in the skin or mucous membrane as a result of localized hemorrhage). Proof is by positive blood culture or smear.⁸

Sepsis, a life-threatening illness, is brought about by the presence of numerous pathological bacteria in the blood which cause the body to respond in organ dysfunction. ³⁵

Image 25. Infection from bite wounds which can let to septicemia. Treatment needs to be aggressive (image courtesy N. Forbes). ²³

4.4 Sources of Infection and Prevention

4.4.1 Bite Wounds from Cats and Other Animals

Bite wounds very often lead to a fatal septicemia if not treated aggressively. The patient should be evaluated for its overall condition and treated appropriately for blood loss or hypotension. The extent of wounds should be evaluated. If the patient’s condition allows, wounds should be thoroughly flushed and fractures stabilized. Aggressive antibiotics should be started early in the treatment. Piperacillin or cefotaxime combined with amikacin or tobramycin are a good choice and should be continued for up to 14 days. If septicemia is suspected, treatment for septic shock should be instituted, i.e., intravenous fluids, rapidly acting steroids, and intravenous bactericidal antibiotics.²³

Image 26. Biliverdinuria and polyuria (excessive urination) in a cockatoo with bacterial septicemia and hepatitis (image courtesy Harrison and Ritchie: Making Distinctions in the Physical Exam, Section 2, Patient Evaluation in: Avian Medicine: Principles and Application, figure 8.41, p. 174, 1994

These are emergency cases which usually require that medications be delivered by parenteral means (other than by mouth) since the bird is unable to swallow them. “Treatment consists of administration of broad-spectrum antibiotics, parenteral fluid therapy, and corticosteroid administration to prevent endotoxic shock due to degenerating gram-negative bacteria.” ²²

Pasteurella bacteria have been reported as possible septicemic agents in birds attacked by pet cats or rats. ³⁰

4.4.1.1 Bartonellosis or Cat Scratch Disease

“Cat-Scratch Fever” is caused by a Gram-negative bacteria known as Bartonella henselae. It is spread through cat scratches and bites. The saliva penetrates the broken skin or mucosal areas such as the nose, mouth, and eyes. Licking by the cat will also transmit this disease. The wound is a puncture wound and it inoculates the bacteria into the skin, and because of the feathers, the owner doesn’t see it, then a few days later the bird is dead. ³⁷

Cats use this toxic bacteria to kill in the wild; the instinct to attack, scratch, bite and claw are built into them. Infants, children, and adults can contract this disease from cats, even young ones. ³⁷

The symptoms include:

• Blisters or papules at the site of the scratch/bite
• Fever, headache, sore muscles, poor appetite
• Heart, eye, brain, intestinal, and skin ailments
• Hyperplasic or swollen lymph nodes, particularly in the armpits and groin
• Malaise
• An enlarged spleen
• Fever, headache, fatigue, muscle soreness and poor appetite.

The diagnosis is often difficult to attain unless the parent is aware of the cat scratch/bite. A biopsy is required to establish a definitive diagnosis. Antibiotics such as Azithromycin are required to destroy the bacteria. Some pathogens are resistant to antibiotics, and this is becoming a serious problem. Most people recover in just a few weeks. In about 5-15% of cases, other, more serious conditions may develop, including heart, eye, brain, intestinal, and skin afflictions. ³⁷

4.4.1.2 Toxoplasmosis

There has been some question about the incidence and potential for toxoplasmosis infection in birds, particularly in pet birds. For the most part, the possibility of pet birds kept in an indoor, hygienic, safe environment is low; however, there are some ways in which even these birds might contract the disease if cats are a part of the household. Many people now keep chickens and other poultry, and these birds are at risk of contracting Toxoplasmosis gonii infection as well. ³⁷

Image 27. A new study reveals that the Toxoplasma gondii parasite acts through the IRE1 protein to cause infected cells to migrate through the body, spreading the parasite (image courtesy Drug Target Review). https://www.drugtargetreview.com/news/65528/toxoplasma-gondii-hijacks-host-stress-mechanisms-to-spread-through-the-body/

4.4.1.3 Toxoplasmosis Symptoms

Toxoplasmosis is a zoonotic (can be transmitted from animals to humans), parasitic, protozoan disease. It is more common in aviaries and backyard poultry than commercial producers. It is characterized by disorders of the central nervous system, but it can also affect reproductive, musculoskeletal and visceral organs (internal organs of the chest and abdomen). Clinical signs include:

• Weight loss and inappetence
• Shrunken comb (in poultry)
• Drop in egg production, whitish diarrhea
• Incoordination and trembling
• Opisthotonos (severe spasm in which the back arches; head is back and tail is up)
• Torticollis or Star-gazing (twisting of the neck)
• Blindness. All chickens infected before eight weeks of age develop clinical signs. In older birds, infection can be asymptomatic (infected hosts show no symptoms) or latent (symptoms only develop under certain conditions). ³⁷

4.4.2 The Growth of Bacteria in Foods

Fruits, vegetables and other soft, moist foods can spoil rapidly, promoting the growth of bacteria (particularly Pseudomonas spp. and E. coli) Clean water with no additives should be provided daily. Vitamins added to the water oxidize quickly (become inactive) and provide an excellent growth media for bacteria. ²⁴ Owners are advised not to add vitamins to water as there can be a 100-fold increase in the bacterial count in 24 hours. Changing the water and rinsing the container will obviously decrease the bacterial load, but an active biofilm remains on the container walls unless it is disinfected or washed thoroughly.³⁸ Pseudomonas leaves a biofilm which is easy to detect and can be extremely harmful. Others, like Staphylococcus aureus, are difficult to detect and can be deadly. ^{24, 38}

Salted, pickled, or cured foods will spoil more slowly and are less likely to grow bacteria.  Remember your temperature guidelines: Keep it hot or cold. Storage in the refrigerator doesn’t prevent spoilage; it merely slows it down.  Porous surfaces promote bacterial growth since they retain moisture.³⁸ Soft foods can become contaminated with high concentrations of bacteria in as little as two to four hours, depending on the food, room temperature, and how old the food is. Food and water containers that have been contaminated with fecal matter will also grow bacteria in a short time. Utensils, storage containers, and towels can all be reservoirs for microorganisms. Don’t keep cooked grains such as pasta for more than a day or two. Freezing smaller portions is a good idea.^{11 38}

Gram-negative bacteria can contaminate seeds, seed mixes, unwashed fruits and vegetables, and even tap water. ⁴⁴ These bacteria are usually associated with water, sand, grit, seed, old food, humid areas, dusty spots and wet cages. Bacterial infections also occur in birds that have a poor level of natural resistance or a damaged immune system. ^{34, 44.}

4.4.3 The Home Environment

Bacterial infections are always related to the environment in which the bird is kept. They usually result from ingestion of the pathogen or contamination in the location. Extra care must be taken to prevent recurrence. From the results of the culture tests, the veterinarian is able to explain the origins of each infection and can advise the client on ways to prevent recurrence. ³⁴

Air conditioners and ventilation systems may serve as foci for bacterial or fungal growth in an indoor facility. In a finch breeding facility, recurrent bacterial infections were traced to an air conditioner filter that supported the growth of Aeromonas sp. ^{14, 22}

Image 28. Contaminated food and water dishes on the bottom of the cage; filthy perches, cage and environment; perfect conditions for bacterial overgrowth (image courtesy Carla Treece Jackson; used with permission).

4.4.4 The Cage Environment

Food and water containers should be positioned away from perches or nest box openings to reduce excrement contamination. In Image 24, the feeding alcove was placed directly under the nest box, resulting in continuous excrement contamination of the food and water. Note also that these birds were on an all-seed diet. The incidence of recurrent enteritis in the breeding adults and Gram-negative bacterial septicemia in the neonates was high in this breeding facility. ^{14, 22}

4.4.5 The Sick Bird

Sick birds should not be left out of the cage unattended; they should be either in their cages or with the owner until they are fully recovered. If allowed to wander around the house and on the floor, they could easily pick up other pathogens. This will protect them from becoming reinfected by bacteria in the environment. They can also pass the illness on to other birds when they are free-roaming. Ill birds are more susceptible to secondary infections. Birds already ill have little cell membrane resistance. ³⁴

4.4.6 The Pet Bird’s Owner and His Family

Pet birds are at significant risk of infection by contact with their owners’ mouths. Most owners are not aware of all the bacteria in their mouths, and most of the time busy veterinarians don’t mention it in the birds’ annual exams.

4.4.6.1 Bacteria Found in the Human Mouth: E. coli

Current research shows that there can be over 600 different bacterial species found in a healthy human’s mouth. The bacteria most commonly found which can cause disease in birds are:

1. Lactobacillus

2. Clostridium

3. Corynebacteria

4. Proteus

5. Prevotella

6. Haemosphilus

7. Pseudomonas

8. Staphylococcus

9. Streptococcus

10. E. coli

11. Enterococcus

12. Mycoplasma

13. Neisseria

14. Actinomyces ⁶¹

Of all the bacteria found in the human mouth, E. coli is the most dangerous. It can be responsible for causing infections in psittacine birds, and it can even penetrate through the pores in egg shells, resulting in dead-in-shell embryos or death of recently hatched chicks. E. coli is identified as one of the most common causes of infection of the oviduct and reproductive tract in parrots.⁶¹

Because of the dangers present in the human mouth, it is crucial that everyone who handles the bird be made aware that kissing the bird on the beak and allowing the bird to kiss and tongue the human’s mouth allows transmission of bacteria to the bird’s mouth, thus providing entry of dangerous bacteria to the bird’s respiratory and gastrointestinal systems. The author has seen multiple videos and images of small birds being allowed to pick the teeth of a human. This practice invites serious bacterial infections in their avian companions. ⁶¹

“E. coli is a very common bacterial organism, found in human mouths at least 25% of the time, and it is also found in dog and cat feces, manure used to fertilize produce and flowers, and in the gastrointestinal tract of many animals we interact with on a daily basis. E. coli has the ability to proliferate uncontrollably outside of its normal home territory of the GI tract. But some strains of E. coli can also cause gastrointestinal disease and diarrhea, often dangerous and potentially fatal, if not identified and treated in time.” ⁶¹ It is diagnosed through cultures, lab tests, and DNA PCR. Blood chemistry tests and complete blood counts will help determine if this bacterium is present and causing the infection. Since this bacterium can survive in dried droppings and dander for a long time, constant cleaning and disinfecting of the environment is mandatory ⁶¹

4.4.7 T. gondii Parasitic Infection

Although this is not a bacterium, it is worth mentioning here as it is a danger to birds and humans. And since it’s a parasite, and can do considerable damage to the skin, bacterial infections can begin to form from the wounds on the bird’s tissues.

“Toxoplasma gondii (T. gondii) is a single-celled parasitic organism that can infect most animals and birds. Because it reproduces only in cats, wild and domestic felines are the parasite’s ultimate host. ¹¹

“The only known definitive hosts for Toxoplasma gondii are domestic cats and their relatives. Unsporulated oocysts (eggs) are shed in the cat’s feces. Although oocysts are usually only shed for 1-2 weeks, large numbers may be shed during that time. Oocysts take 1-5 days to sporulate in the environment and become infective. Intermediate hosts in nature (including birds and rodents) become infected after ingesting soil, water or plant material contaminated with oocysts Cat litter boxes are the primary source of the infection in homes. ¹¹

When a person becomes infected with T. gondii, the parasite forms cysts that can affect almost any part of the body — often the brain and muscles, including the heart. If a person is generally healthy, his immune system keeps the parasites in check. They remain in the body in an inactive state, providing the person with lifelong immunity so that he can’t become infected with the parasite again. But if his resistance is weakened by illness or certain medications, the infection can be reactivated, leading to serious complications. Women who are pregnant should have another person handle all cat droppings. ¹¹

Although an adult can’t “catch” toxoplasmosis from an infected child or another adult, he can become infected if he comes into contact with cat feces that contain the parasite. The person may accidentally ingest the parasites if he touches his mouth after gardening, cleaning a litter box, or touching anything that has come in contact with infected cat feces. Cats who hunt or who are fed raw meat are most likely to harbor T. gondii.” Anti-parasitic drugs are used to counteract the disease. ¹¹

4.5 Disinfection: The Key to Preventing Disease

Clean all food and water dishes daily; this is particularly important if the bird has an infection, but it should be part of the daily cage-cleaning routine. Lysol and dilute bleach are very good at disinfecting. It’s best not to clean with these solutions; just use them as disinfectants after cleaning with detergent or soap and water. The Lysol and bleach have instructions for how long the liquid is supposed to remain on a surface.  And proper dilution is key—straight bleach is very corrosive.   When cleaning bird-occupied surfaces, use 1 part bleach to 10 parts water. Disinfectants and cleaning products all work by different methods, although bleach is pretty much toxic to everything. The owner should wear gloves; inexpensive neoprene gloves are available at hardware stores. ³⁸

Clean and disinfect perches often. Keep the birds away from the cages when you are cleaning them until the cages are completely dry.

Part V: Bacterial Pathogens Commonly Found in Companion Birds

Explanation of Gram’s stains and Gram positive and negative bacteria and other tests will be found in Part VI

5.1 Commonly Found Gram-positive Bacteria

• Staphylococcus, including Staphylococcus epidermidis.
• Streptococcus and Streptococcus intermedius
• Clostridium
• Enterococcus
• Mycoplasma spp (has been implicated in chronic sinusitis and often found in cockatiels)
• Lactobacillus
• Corynebacterium. ^{26, 34}

5.2 Commonly Found Gram-Negative Bacteria

• Klebsiella
• Aeromonas
• Enterobacter
• Proteus
• Citrobacter
• Pseudomonas
• Campylobacter
• Escherichia coli,
• Pasteurella spp
• Mycobacterium and Chlamydia
• Salmonella spp.^{18, 23}

Image 29. Fig 39.24 | A canary with Mycoplasma conjunctivitis CAM: Bacterial Diseases 895-897 Bacterial disease in Passeriformes (songbirds, canaries, finches)

5.3 The Most Dangerous Gram-Positive Bacteria: Staphylococcus and Streptococcus

Staphylococcus (plural staphylococci) and streptococcus (plural streptococci) infections are commonly found in many pet birds and often discussed together. They both will produce severe illnesses that will lead to death. These bacteria are responsible for a wide variety of symptoms, including

• dermatitis,
• pododermatitis (bumblefoot),
• conjunctivitis (red, inflamed eyes),
• sinusitis,
• arthritis, and
• pneumonia

Initial testing is usually with Gram’s stains and cytology, and confirmation of the disease is provided with culture-and-sensitivity testing. ²⁸ Staphylococci, streptococci (especially hemolytic strains), and Bacillus spp are thought to be responsible for several dermatologic conditions in psittacine birds. ²⁶

Image 30. S. aureus with pyloderma grown in a culture (image courtesy Galabin Mladinov гълъбин младенов‎; used with permission)

Image 31. Sinus infection in a cockatiel due to a bacterial infection, probably S. aureus. A scab has formed over the eye and it is likely the orbit has collapsed, rendering the bird blind in that eye (image courtesy Bob Doneley; used with permission). ¹⁸

5.3.1 Staphylococcus aureus and MRSA

Staphylococcus is a genus of spherical, gram-positive bacteria which occur in grape-like clusters. They are a natural part of skin flora in most mammals and birds, and they normally colonize the upper respiratory, alimentary, and urogenital tracts. They are also the most common cause in pus-forming (pruritic) skin infections. S. aureus, commonly found in the nares, and S. epidermidis, found in both the nares and on the skin, have the greatest pathogenic potential. ⁴⁵

Staphylococci are often isolated from lesions of pododermatitis in many avian species. Methicillin-resistant S. aureus (MRSA), previously thought of as rare, is becoming increasingly documented in birds. This bacterium is found in dust, poor seed, contaminated air conditioning, and is carried by mice. It is exacerbated by stress. ²⁶

For a comparison of S. aureus and MRSA, please see Appendix A, p. 75

Image 32. Bumblefoot Caused by S. aureus usually in birds. A pyogranulomatous, chronic infection of subcutaneous tissue on feet. S. aureus is usually introduced via skin lesion on foot (image courtesy Study Blue, Gram positive Bacteria Flashcards | Chegg.com). https://www.chegg.com/flashcards/staphylococcus-c38dfd0f-1879-4025-bc55-d3167c8935da/deck

5.3.1.1 Antimicrobial Resistance of S. aureus

Staphylococcus aureus is resistant to most antibiotics.^{26 “}S. Aureus and Streptococcus have acquired resistance through genetic mechanisms. Many strains of S. aureus are resistant to all clinically useful drugs.” ⁴⁵

Staphylococcus infections generally result in very pruritic (red, itching and pus-filled), often erythematous (red blood cell) infections of the skin. Skin biopsy—including that of feather follicles—and cultures are required to diagnose the illness. ¹⁸

Image 33. Dermatitis in a cockatoo due to staphylococcal infection following a dog ‘mouthing’ the bird (image Courtesy B. Doneley; used with permission).¹⁸

5.3.1.2 Case Study Involving S. aureus

A 2-year-old female Congo African Grey parrot (Psittacus erithacus erithacus) was evaluated for long-standing self-trauma of the feathers and skin of the tail base. All tail feathers and tail coverts were missing, the skin of the tail base was thickened and ulcerated, and the uropygial gland was swollen. There was increased white blood cell count, and x-rays showed shortened caudal vertebrae and pygostyle. Test results of affected areas “revealed ulcerative bacterial dermatitis positive for methicillin-resistant Staphylococcus aureus (MRSA).” ⁹

The bird was treated with multiple medications, topical gel, and hydrotherapy for a month, and there was some tail feather regrowth; however, even though the bacterial infection was resolved, the bird continued to traumatize the area for the next two years. ⁹

Image 34. Staphylococcus aureus (image courtesy Food Science Avenue). https://www.foodscience-avenue.com/2018/01/staphylococcus-aureus-toxin.html

5.3.2 Streptococcus Bacteria

Streptococcus (plural Streptococci), is a disease-causing, Gram-positive bacteria frequently seen in birds. It is found everywhere in the environment, mainly in the dust and air. Many species have been isolated from birds, and they are considered part of the normal bacteria found on the skin and the lining of the digestive, respiratory, and reproductive tracts. ¹⁹

The immune competency of the bird will determine whether or not the bacterial growth increases sufficiently to become a disease agent. ⁵⁵

Some species of Streptococcus are zoonotic. It can be found in humans’ mouths, sinuses, and eyes. ¹⁹

Image 35. Streptococcus pyogenes (image courtesy WikiMili).

Streptococcal infection in poultry – WikiMili, The Best Wikipedia Reader

Group A streptococcal infection – WikiMili, The Best Wikipedia Reader

5.3.2.1 Streptococcus Bacterial Invasion

The streptococcus organism invades the body of a susceptible bird and spreads, first invading the bloodstream from the intestines or skin and then traveling to the other areas of the body. It usually localizes in one specific area initially and then continues to spread. Some of the possible entry areas of the body are:

• The respiratory system, leading to red, watery eyes, nasal discharge, and difficulty breathing.
• The liver, with green diarrhea (biliverdinuria) and weight loss.
• The heart, with long-term cardiac issues and chronic shortness of breath.
• The meninges of the brain, leading to poor coordination, loss of balance, or head tilt.
• The muscles, leading to bleeding and inflammation
• The joints, leading to redness and pain, especially in the wings and legs.
• The kidneys, with increased thirst and urination.
• The intestines, leading to diarrhea
• The abdominal cavity, leading to ascites (fluid buildup) and swelling in the abdomen.
• The reproductive system
  • Young males might experience premature infertility.
  • Hens may experience poor egg formation, leading to embryonic death and weakened chicks that die during or shortly after hatching.

The organism is found in birds’ droppings and can contaminate the nest box and infect the healing navel of recent hatchlings.” ⁵⁵

5.3.2.2 Diagnosis and Treatment of Streptococcal Bacteria

Diagnosis is based on the patient’s history and clinical signs. It depends on the isolation of the bacteria from lesions and cytology findings of streptococcus bacteria in blood films or impression smears of affected tissues. ⁴⁰

Image 36. Streptococci and Enterococci bacteria. Oval cells are arranged in chains end-to-end (image courtesy Medical Microbiology).

Sherris Medical Microbiology, 6e | AccessMedicine | McGraw Hill Medical (mhmedical.com)

Healthy birds living in well-kept environments will be able to resist the disease, and those who do become ill will be able to recover with medication. In an aviary or breeding situation, once the streptococcal disease is diagnosed, the owner must identify and correct the cause of the disease outbreak; otherwise, the medication will not be successful. ⁵⁵

S. aureus will respond to antibiotic treatment. Identification of the organism through culture and sensitivity testing enables the veterinarian to prescribe the most effective antibiotic for that particular strain. Studies show that doxycycline has become the drug-of-choice for most practitioners. It is as effective as synthetic penicillins and more economical. According to Walter, 80% of organisms are controlled by the antibiotics ampicillin (a synthetic penicillin) and doxycycline. ⁵⁵

Image 37. Streptococcal infection in the patagium of the wing of the author’s bird. The bird died from this infection (image courtesy J. Miesle)

5.3.2.3 Preventing the Spread of a Streptococcal infection.

“Streptococcal infections will spread slowly through the flock, resulting in the deaths of some of the birds. Once the disease is confirmed, follow the recommendations below:

• Separate ill birds and treat them in a hospital cage environment (heat, fed and medicated by crop tube, etc.) or euthanize them.
• Keep the aviary clean and disinfected at all times.
• Identify and correct any trigger factors, such as overcrowding, poor diet, poor hygiene, inadequate parasite control, cold or damp conditions.
• Start healthy birds on probiotics. If further birds continue to become unwell while on the probiotic treatment, then treat the entire flock with an antibiotic such as doxycycline.” ^55. “Probiotics will help to minimize the streptococcal invasion during stressful times when normal intestinal bacteria are disrupted; in addition, they may prevent transmission of the infection to other birds.” ⁵⁵

Image 38. A rescued cockatiel taken in by the author. This bird was suffering with a severe sinus infection involving S. aureus.

To view the case study of this cockatiel, please see Appendix B, p. 75

5.4 Enterococcus faecalis

E. faecalis was known as Streptococcus faecalis until 1984 since it was previously categorized by scientists as a bacteria that forms part of the Streptococcus genus. Passerines, or songbirds, such as finches and canaries, are often found with Enterococcus faecalis (formerly Streptococcus bovis) which resides in the alimentary tract. “Birds with this bacteria will present with chronic tracheitis, pneumonia, and air sacculitis, increased respiratory sounds, voice changes, and dyspnea (labored breathing).” ²⁸

Canaries are especially sensitive. Although antibiotics will provide improvement in the clinical signs, many birds never heal completely. ²⁰

Image 39. Enterococcus faecalis (image courtesy Px Pixels). https://pixels.com/featured/9-enterococcus-faecalis-dennis-kunkel-microscopyscience-photo-library.html

5.5 Mycobacterium Avium, or Avian Tuberculosis

Mycobacteria are straight or slightly curved, non-motile, Gram-positive rods. Most birds, including psittacines, are susceptible to M. avium. It is mostly found in high-density populations, such as zoos, breeding facilities, and larger collections. ³ “Mycobacteriosis is an infectious, systemic disease which is chronic and debilitating.” ¹⁵

In the past, antemortem (before death) diagnosis had been challenging, so clinicians had only tests and history to diagnose it. Today, however, clinicians use molecular diagnostic testing since it will afford a definitive diagnosis. ¹⁵ For some birds, diagnosis will not be obtained until the postmortem is performed. ⁴⁹ “Mycobacteria infection leads to a chronic wasting disease. Granulomatous, inflamed lesions on the skin develop that are easily confused with tumor masses.” ²¹

It may be difficult to determine if birds in large collections are infected. The clinician and owner will need to work together to assess the husbandry and sanitation levels in the aviary. It is important to isolate the birds who have the disease or are at risk of contracting this disease. Their weights should be monitored, and CBCs and fecal, acid-fast stains or PCR testing should be performed. ²⁶

Image 40. Cutaneous form of avian tuberculosis in collared dove (image courtesy Datashare).

Image 41. Avian tuberculosis in a woodpigeon. Large, cream, raised nodules throughout liver (image courtesy Datashare).

5.5.1 Vulnerability

Several species of birds are highly susceptible to the disease: gray-cheeked and canary-winged parakeets (Brotogeris pyrrhoptera), Amazon parrots, pionus, finches and canaries, and some species of Forpus parrots (parrotlets). This disease is endemic in these populations, making the birds predisposed to acquiring it; for them it can be quite debilitating. Softbills and passerines are highly susceptible to mycobacterial infections as well. ^{21, 26, 49}

Image 42. Avian mycobacteriosis (image courtesy N. Forbes). ²³

Image 43, Mycobacteriosis in the lung (image courtesy VMD labs; used with permission). http://www.vmdlabs.com/ada-Mbac.html

Image 44. Mycobacteriosis in the duodenum (image courtesy VMD labs; used with permission). http://www.vmdlabs.com/ada-Mbac.html

Mycobacteriosis is one of the most common diseases of various species of birds including domestic poultry, pet and exotic birds such as psittacines and canaries, and free-living and captive wild birds. The disease in birds is generally caused by Mycobacterium avium, but more than 10 other species of mycobacteria have been known to infect birds. These include M genavense, M. tuberculosis, M. bovis, M. gordonae, M. nonchromogenicum, M. fortuitum subsp fortuitum, M. avium subsp hominissuis, M. peregrinum, M. intermedium, M. celatum, M. intracellulare, M. avium subsp paratuberculosis, M. africanum, and M. simiae.

5.5.2 Transmission

M. avium-infected fecal matter, once aerosolized, will be put into the air in large amounts. The infected birds will shed this, and it is then transmitted by ingestion and inhalation. ³

The organism enters the body through the oral, respiratory, and dermal routes. “If the organism enters by ingestion, in will invade the intestinal tract, causing bacteremia, and spread to the liver and other organs.” ¹⁵ Ingestion of the bacteria through contaminated food or water and fecal matter is the most common mode of transmission. ¹⁵

The incubation period for birds is weeks-to-years. The bird will develop pulmonary lesions if the bacterium is inhaled, and skin disease may also develop. It is possible that the bacterium is spread vertically, from hen to egg, but that mode of transmission is not common. ³

5.5.3 Symptoms

Since Mycobacteriosis is difficult to diagnose in its early stages, it should be considered as part of the differential diagnoses when these symptoms are observed:

• Weight loss in spite of good appetite
• Emaciation and muscle wasting
• Loss of subcutaneous and intracoelomic (internal) fat
• Poor-quality integument and skin
• Diarrhea and green urine
• Dyspnea
• Seizures
• Lesions in the lungs and air sacs from inhalation
• Paralysis and lameness
• Depression
• Increased thirst and urination
• Abdominal distention
• Respiratory distress
• Decreased egg production. ^{3, 15}

“Strong indicators of the disease are:

• Subcutaneous granulomas (small, inflamed growths under the skin)
• Organomegaly (enlarged organs)
• A profound leukocytosis (elevated number inflamed white blood cells)
• The cytologic presence of acid-fast bacteria
• Masses and ulcers with enlargement of joints, especially for those with negative results for fungal and aerobic/anaerobic bacteriologic cultures.” ¹⁵

5.5.4 Testing

Several tests may be performed to determine the bacterium. “PCR assays will detect the actual disease-causing organism, and ELISA assays will detect specific antibodies for M. avium. PCR assays are considered to be the fastest, most sensitive method for detecting M. avium, while ELISA assays help determine exposure to M. avium.”³ Molecular methods are highly sensitive and specific for confirming the disease in a short amount of time. ¹⁵

“Endoscopy allows for direct visualization of infiltrative lesions in the abdominal cavity and respiratory tract.”^3,15 With it, clinicians are able to:

• “Identify lesions on the serosal surface of the liver, spleen, intestine, lung, and air sacs.
• Visualize granulomas as white, yellow, or tan, round masses which are soft and easily biopsied. Visualize enlargement of the liver, kidneys, and spleen.
• Take samples of abnormal tissues or granulomas to confirm the diagnosis of mycobacteriosis.
• Remove samples of lesions for cytologic or histopathologic examination, acid-resistant staining, culture, and molecular tests. Examination of the liver is crucial when diagnosing avian mycobacteriosis.” ¹⁵

5.5.5 Treatment

The antibiotic used is determined by the bird’s age, species, and bacterium found. Azithromycin is the drug of choice. It can take six to twelve months to resolve the disease, and relapses are common. Owner commitment is essential since the bird will need daily dosing. Keeping the flock size low and the stress levels reduced will minimize the impact on the collection. Young birds still hand-feeding respond well with oral medications, whereas adult birds respond better to injectable therapy. Combinations of antibiotics (typically three) are recommended because many mycobacterial organisms develop antibiotic resistance. Birds with advanced disease and granuloma formation have a poor prognosis. ^{26, 49}

5.5.6 Prevention

Preventing M. avium is best done by minimizing stress and overcrowding and by providing proper ventilation and nutrition. M. avium outbreak in zoos, bird gardens, and private aviaries can be especially difficult to eradicate. New additions to the aviary should be quarantined for a minimum of 1-2 months. New additions to the flock should be tested to prevent outbreaks^{. 3}

5.5.7 Necropsy and Pathology

Although rare, sudden death might be an indication of mycobacteriosis. Generally, though, “acute death from mycobacteriosis is unusual.”¹⁵ Biopsies of the liver, GI tract, spleen, and lungs will diagnose the disease at necropsy ³

Pathology results include:

• “Emaciation
• Absence of subcutaneous and internal fat
• Severe atrophy of the pectoral muscles
• Hepatomegaly and splenomegaly (enlarged liver and spleen)
• White or yellowish nodules in the lungs, spleen, intestine, air sac, bone marrow, and more rarely, the heart, gonads, central nervous system, skin, and joints.

Hematologic (blood) changes reflecting chronic inflammation and anemia. ¹⁵

5.6 Yersinia pseudotuberculosis

Yersinia pseudotuberculosis is a common cause of outbreaks of acute illness and mortality, usually in aviary parakeets. It is transmitted via feces from infected rodents and wild birds. The majority of affected birds die within a few days, having shown signs of pneumonia, enteritis with wet diarrheic droppings, and general ill health. At post-mortem examination, the most acute cases have an enlarged, patchily discolored liver, and more chronic cases have miliary white spots throughout the liver, kidneys and spleen. ⁵³

In a living bird, confirmation by bacteriology is needed, and antibiotic treatment is required. The drinking water must be kept uncontaminated, and the water should contain either the appropriate antibiotic or a disinfectant, such as 5–6 mg/L of free iodine or chlorhexidine. Prompt treatment will limit, but not completely prevent, deaths in the affected birds. The organ damage in some individuals will cause their deaths even in the absence of the organism. ⁵³

Image 45. Miliary granulomas as seen on this canary’s dark and swollen spleen are indicative of Yersinia pseudotuberculosis (image courtesy Clinical Avian Medicine, Chapter 39, p. 897 figure 39.26

Canaries and finches, particularly in Europe in the winter, may be found with the infection. Signs include ruffled feathers, debilitation, and high mortality. At necropsy, a dark, swollen, congested liver and spleen with small, yellow, focal bacterial granulomata are often found. Diagnosis is confirmed after culturing the microorganisms. Amoxicillin via drinking water is the antibiotic of choice. Soft foods are recommended. ⁵³

Mynahs are very susceptible to yersiniosis, and mortality can be high due to a peracute pneumonia. Post-mortem examination demonstrates hepatomegaly, sometimes with small white foci, splenomegaly, and an acute-to-peracute pneumonia. In Europe, a formalin vaccine is available that appears to be clinically effective in reducing the prevalence of infections. ⁵³

5.7 Escherichia coli

Image 46. E. coli bacteria (image courtesy S. Weir) ⁵⁶

Escherichia coli exists in small numbers in the intestinal tracts of many species of birds, and only if the numbers rise is there a problem. Symptoms vary from species to species. E. coli infections are classified as primary or secondary: A primary infection causes disease by itself, and a secondary infection has an underlying cause. “Most infections are secondary to such stressors as a heavy molt, coccidia, adenovirus, canker, intestinal worms, crowding, stressful home conditions, and poor nutrition.” ⁵⁶

Contaminated food, fluctuating temperatures, drafts, stress, wet areas, fungal infection, and dirty cages are some of the most common causes. ^{26, 34}

5.7.1 E. coli Diagnosis and Treatment

Diagnosis of E. coli infection is based on the symptoms. These are:

• Enteritis and necrotic enteritis
• Loose, green droppings (biliverdinuria)
• Crop stasis
• Vomiting and weight loss
• Sudden death due to septicemia

E. coli, like salmonella, may result in joint infections which present with lameness, swelling, or a drooped wing. Immediate attention to these signs is necessary to prevent further joint damage from occurring. ⁵⁵

Gram-negative bacteria are usually associated with disease in birds; however, the number of bacteria in the intestines differs among species, and some are not pathogenic. Neotropical birds, such as amazons, “may have little to no E. coli in their systems, while some species, such as cockatoos, lories, and eclectus parrots, may have as much as one-fourth of their total flora comprised of E. coli.” ³⁵ As long as the number of bacteria is low, most clinicians believe there is no need for treatment if the bird is not showing clinical signs, but if the bacteria are found in chicks and juveniles, the clinician should perform more tests and begin treatment. ⁴⁹

Image 47. Dropping from a bird with hemorrhagic enteritis, cultured E. coli. Bleeding from an infection/inflammation in the lower intestinal tract (image courtesy M. McMillan: In: Diseases of Cage and Aviary Birds. Ed. Margaret Petrak.1982)

Some strains of E. coli are quite resistant to antibiotics. Commonly used medications are azithromycin, Baytril, Cipro, or Bactrim. These are not to be used on birds that are breeding. The underlying cause of E. coli must be found and treated or the bacteria will return. ⁵⁶

5.8 Campylobacter

Campylobacter is a genus of bacteria of the family Spirillaceae. It is a spirally curved, motile, Gram-negative, rod-shaped bacterium which is pathogenic in domestic animals and humans. Wild and domestic birds are considered major reservoirs of Campylobacter bacteria. It has been found in 35% of migratory birds, 50% of town-dwelling pigeons, and 20%-70% of gulls. It is most commonly found in poultry; therefore, eating undercooked or raw chicken will cause illness in humans and animals.^{12, 40}

Image 48. This shows the curved shape of Campylobacter species (arrow A showing curved gram negative bacteria, arrow B showing white blood cell) stained by gram stain using 0.3% as counter stain. Original magnification X100 (image courtesy Jeremiah Seni, Research Gate). https://www.researchgate.net/publication/271214444_Evaluation_of_detection_methods_for_Campylobacter_infections_among_under-fives_in_Mwanza_City_Tanzania/figures?lo=1

.
Image 49. Campylobacter jejuni (image courtesy Go Pets America). http://www.gopetsamerica.com/bio/bacteria/campylobacter.aspx

The species most often seen in enteric disease in avian species is C. jejuni. Infected birds may be asymptomatic or show the following signs:

• Anorexia
• Somnolence
• Diarrhea
• Emaciation ⁴³

5.8.1 Transmission and Diagnosis

This bacterium is fatal in very young birds. Transmission is by direct fecal or aerosol contact, contaminated fomites (things which other birds have touched), or infected vectors (an organism such as an insect that transfers the bacteria from one animal to another). Diagnosis is made by microscopic examination of the droppings using Gram’s stains. ³¹

5.9 Clostridium

Clostridia are anaerobic, gram positive, spore-forming bacteria. Members of this genus resemble large, straight, or slightly curved rods with rounded ends. Clostridial organisms are common secondary invaders of damaged cloacal tissue in birds with cloacal prolapse or papillomatosis. Different species of clostridia can cause specific disease syndromes. ²⁶

Image 50. Clostridium perfringens (image courtesy University of Arizona, College of Agriculture). https://cals.arizona.edu/pubs/general/resrpt1998/clostridium.html

Image 51. Gram positive clostridium botulinum, or bacillus botulinus (image courtesy Pixnio.com) https://pixnio.com/science/microscopy-images/botulism-clostridium-botulinum/gram-positive-clostridium-botulinum-formerly-known-as-bacillus-botulinus

Image 52. Clostridium in a 7-year-old Moluccan cockatoo presented for smelly stool. In the bacteria field there were 90% gram-positive rods, 10% gram-positive cocci, and 30 Clostridium sp. organisms (image courtesy Merck Veterinary Manual). http://www.merckvetmanual.com/exotic-and-laboratory-animals/pet-birds/bacterial-diseases-of-pet-birds#v4631674

Image 53. Microscopic illustration of rod-shaped bacteria such as Clostridium (image courtesy 123rf) https://www.123rf.com

5.9.1 Endotoxin Release

Clostridium perfringens is the species most often seen in psittacine birds. C. perfringens secretes strong exotoxins that can cause necrosis (cell death) of the surrounding tissue, including muscular tissue. The bacteria “produces gas that leads to bubbly deformations of the infected tissue.” C. perfringens will destroy intestinal tissue, and the enterotoxins lead to severe diarrhea. ²

Image 54. Gas in a bird’s droppings is never normal. Here, diarrhea is caused by gas-producing bacteria (image courtesy Avian Biotech). ²

The clostridia toxins in the small intestines produce these symptoms:

• Decreased appetite and rapid weight loss
• Loss of body condition
• Lethargy
• Blood-stained or undigested food. ²

The toxin and its effects may continue to be in the bird’s system for quite some time, even after the infection has been resolved. ²

Image 55. Clostridial Enteritis (image courtesy Todd Driggers; used with permission).

Yellow blotches: slide artifacts; Purple blotches: degenerating white blood cells; Blue rods: non-sporulated clostridial rods; oval green blotches with black centers: red blood cells

5.9.2 Transmission

Transmission is by ingestion and wound infection from spores found on contaminated surfaces. The spores may also be inhaled or be on contaminated feed, water, fecal material, air, soil, and nesting material. ² Infection may be avoided by:

• Minimizing stress and overcrowding
• Providing proper ventilation
• Preventing malnutrition with a proper diet. ²

Storing food properly in containers will prevent bacterial growth. Corn and grain products, and even pellets or extruded food, may be contaminated by bacterial spores if conditions are favorable. It is wise to freeze all food coming into the house until it is used. ²

5.9.3 Diagnosis and Treatment

Gram’s-stained smears and anaerobic cultures are used to identify clostridial organisms. Samples from affected tissue are used, “including the greenish-brown focal areas of necrosis in the liver. Large, gram-positive cells are almost certain to be clostridia, especially if spores are seen.” ²⁶

Antitoxins and antibiotics, such as Guanidine, zinc bacitracin, penicillin, and tetracyclines are used to treat this bacterium. ²

5.10 Salmonella typhimurium

Image 56: Salmonella bacteria (image courtesy Avian Biotech). ²

Image 57. Salmonella growing on XLD agar (image courtesy Nathan Reading on Flickr [CC-BY-2.0], via Wikimedia Commons.https://www.yourgenome.org/facts/what-is-salmonella

Salmonella species are gram negative, aerobic, rod-shaped, zoonotic bacteria that can infect people, birds, reptiles, and other animals. ⁴

Salmonella typhimurium is the organism most frequently seen in psittacines. Clinical signs are severe illness followed by acute death from septicemia. Rodent feces are a source of contamination in the aviary, and rodents will contaminate food supplies and nest boxes; they will carry contaminants from their own nests to the aviary. ⁴⁹

5.10.1 Infection and Transmission

Infection from S. typhimurium can result in high mortality of young birds. Transmission among birds is primarily through the air. “The organism remains stable outside the host body and dries as a dusty substance.” ⁴ This contaminated dust becomes airborne and enters other birds’ respiratory systems by direct contact of aerosolized fecal matter or feather dust. Affected birds may become symptomatic or be carriers. Transmission is also by ingestion of contaminated food or water, or through shedding the organism in nasal and ocular secretions. Degree of infection depends on the bacteria levels, their serotype, and the age, species, and condition of the host. Birds may have peracute, acute, chronic, or subclinical infection. ²¹

The susceptibility of the bird and number of spores in the environment determine whether or not the bird will become infected. The young may become infected through regurgitation from the hen’s crop during feeding.²¹

5.10.2 Clinical Signs and Susceptibility

• Depression
• Lethargy
• Anorexia, diarrhea, and weight loss
• Conjunctivitis
• Pasty vents
• Lameness
• Abscess formation
• Convulsions
• Poor hatching or excessive fledgling mortality
• Dehydration and crop stasis
• Meningitis
• Liver, kidney, spleen and heart damage and lesions
• Osteoarthritis
• Sudden death.
• Pneumonia and excessive mucus in the nose or throat with inflammation of the mucous membrane.
• Hemorrhagic enteritis ^{4, 21}

Some avian species have specific clinical symptoms. Lories (Loriidae) suffer acute disease and high flock mortality. African Greys tend to develop chronic disease, and their symptoms are mucus discharge from the beak/nasal area, arthritis, excessive thirst, and dermatitis. “Droppings are colored a sulphur yellowish green which is very much a diagnostic sign for this microorganism.”  ⁴

5.10.3 Transmission and Diagnosis

Transmission from hen to egg (vertically) is possible. If this occurs, chicks will hatch and spread salmonella by direct contact with other birds. If the bacteria level is high, the embryo will die. “The disease has a greater chance of spreading in overcrowded conditions, stale air environments, nest-boxes, and brooders. Pet shops, bird marts, and quarantine stations are also high-risk areas.”  ²

In the past, fecal and affected organ culture-and-sensitivity testing have been used to diagnose and treat salmonella. Antemortem diagnosis by fecal cultures is difficult because the bacteria is shed intermittently. ²¹ Today, these assays have been replaced by PCR and sequence assays which are more reliable and identify the strains more precisely.⁴ Even with prolonged treatment (3–8 weeks), the organism might not be eliminated. This disease is controlled only with “strict isolation, vector control, and appropriate disinfection.” ^{4, 21}

Image 58. Salmonella typhimurium (image courtesy Pathogen Profile Dictionary). http://www.ppdictionary.com/bacteria/gnbac/typhimurium.htm

5.10.4 Prevention and Treatment

To prevent outbreaks of salmonella, it is important to keep the birds’ environment meticulously clean. Effective control of flies, rodents and other vermin is essential to eliminate and prevent salmonella outbreaks. Companion birds may be infected by humans who carry the bacteria. African greys, Amazons, cockatoos, and macaws are especially at risk. ⁴ Hanamycin, Gentamycin, and trimethoprem/sulfamethoxazole are used to treat this disease.

5.11 Chlamydiosis. (Ornithosis or Parrot Fever in Birds, Psittacosis in Humans)

Chlamydiosis is the most important zoonotic disease of psittacines. It is endemic to the U.S. and in the wild population.³⁰ Macaws, cockatoos and Amazons are particularly vulnerable to this bacterium. It is also found in cockatiels, budgerigars, and parrots. ^{26, 33}

Chlamydia psittaci is an obligate, intracellular bacterium that can infect all companion birds. The incubation period of C psittaci is from three days to several weeks. The organism can remain infectious in organic pus for about one month. ²⁶ The severity of the disease in the bird depends on the virulence of the organism and the competency of the bird’s immune system. ^30.

“Chlamydophyla depends on amino acids and the host’s cells for its energy supply. The bacterium targets epithelial cells of the mucus membranes of the respiratory system and digestive tract.” ⁴⁶

Image 59. Chlamydia psittici in the air sacs (image courtesy Veterinary Molecular Diagnostic Labs; used with permission). http://www.vmdlabs.com/ada-Chlam.html

5.11.1 Diagnosis

Diagnosis of C. psittaci is difficult, particularly if the bird is asymptomatic. History, clinical signs, radiographs, CBC’s, chemistry panels, and cloacal and choanal cultures have been used in the past, but now serology and PCR testing have proven more reliable. ^{26, 30}

5.11.2 Transmission

For now, there is not a test to show if a previously infected bird is free of the disease. It is transmitted through aerosol inhalation and ingestion for the most part. ²¹ Birds may initially be asymptomatic, but stress can cause acute illness. These birds will infect other birds and humans by shedding the organism. Cockatiels are thought to be one of the most common asymptomatic carriers of C. psittaci. ³⁰ Because it is a zoonotic disease, federal regulations require it to be reported. ²⁶

5.11.3 Symptoms

Birds may be asymptomatic carriers, or they may have severe disease. Clinical signs may include:

• Chronic ocular, nasal, or conjunctival irritation and discharge
• Anorexia, dyspnea, dehydration and polyuria
• Depression
• Biliverdinuria (dark green stools and urine) (hepatitis)
• Hepatomegaly, splenomegaly (enlarged liver and spleen), or air sacculitis.
• Upper respiratory signs (conjunctivitis/sinusitis/rhinitis, often seen in cockatiels)
• Vomiting, lethargy, chronic diarrhea, weight loss
• CNS signs at late stages of the disease which include opisthotonos (arched back), tremors, and convulsive movements
• Leg paresis or paralysis
• Sickly, unthrifty bird with repeated episodes of illness.
• Poor feather coat ^{21, 26, 30, 33}

Image 60. Chlamydia – Direct imprint from air sac with DifQuik stain showing an initial body (image courtesy G. Kaufman) ³⁰

Image 61. This impression smear, made from the exudate of infected tissues, shows intracytoplasmic inclusions associated with Chlamydophila psittaci. Histopathology image from a turkey (image courtesy Cornell University). http://cidc.library.cornell.edu/vet_avian/images/Chlam-Adjusted/CHLAM-022A.jpg.infection. https://partnersah.vet.cornell.edu/content/chlam-022ajpg

Image 62. Chlamydia Psittici in a cockatiel (image courtesy Edgeworth Animal Medical Center). https://www.edgeworthanimalmedical.com.au/2017/05/05/avian-chlamydiosis-and-psittacosis/

Image 63. Photomicrograph of Chlamydophila inclusions in macrophages (arrow) in an Amazon parrot.. Giemsa Stain was used (image courtesy Brazilian Journal of Veterinary Pathology).

5.11.4 Treatment

Doxycycline and azithromycin are the drugs of choice for Chlamydia infection. It is unknown exactly how long it takes to eliminate the organism from the body; therefore, it is recommended that the bird be treated for 45 days. ²⁶

Image 64. Dropping from a cockatoo with psittacosis (image courtesy Cockatoo Info.) http://cockatoo-info.com/health/chlamydia-psittacosis/

Image 65. A Bourke parrot with conjunctivitis caused by Chlamydiosis (image courtesy Melbourne Bird Vet; used with permission). http://birdvetmelbourne.com/chlamydiosis/

Other drugs that have been used to treat Chlamydia in birds are:

• Tetracyclines. They are very effective but work only during the active dividing stage of the organism. For this reason, prolonged therapy for 45 days is required. Even after successful treatment, you can never guarantee a bird free of the organism.
• Chlortetracycline. Treatment through the drinking water is not acceptable.
• Fluoroquinolones are very effective against this organism. ³⁰

For more information, see https://www.beautyofbirds.com/psittacosis.html

5.12 Bordetella avium

Bordetella is a gram-negative, aerobic, coccobacillus bacterium of the Bordetella genus. This rod-shaped bacterium is non-motile and non-spore-forming. B. avian causes the avian disease, bordetellosis, which is responsible for respiratory tract infections in turkeys and in wild and domesticated birds. ³⁶ It is most commonly seen in birds between the age of 2-8 weeks. Turkeys are thought to be the natural host, however; the disease has also been seen in chickens and ducks. ⁶⁰

Image 66. Bordetella avium in a cockatiel (image courtesy Veterinary Molecular Diagnostic Labs; used with permission). http://www.vmdlabs.com/ada-Bord.html

“B. avium colonizes the epithelium of the cockatiel’s tracheal mucosa. As the disease progresses, it will destroy this outer layer of tissue along the respiratory tract and produce toxins that can affect other groups of tissue in the body. It is not zoonotic to humans.” ⁶⁰

As it damages the upper respiratory tract of the bird, it leads to secondary infections from E. coli or other bacteria, causing a more severe infection. If the bird is infected solely with B. avium, he may recover in 4-6 weeks with treatment. Without treatment, the disease will destroy the epithelial tissue in the trachea, causing the bird to die from suffocation. ²⁷

5.12.1 Transmission

Bordetella is highly contagious and easily transmitted by direct contact. It is doubtful that it is airborne because birds near an infected bird will not get the disease. ²¹ It can also be transmitted through contaminated drinking water, feed, bedding, housing, and litter and can remain infectious for 1–6 months in contaminated litter. ²⁷

Image 67. Bordetella avian (image courtesy Look for Diagnosis). https://lookfordiagnosis.com/mesh_info.php?term=bordetella%20avium&lang=3

5.12.2 Symptoms

Signs appear suddenly and include:

• Sneezing and coughing, mouth breathing and dyspnea
• Foamy conjunctivitis around the medial canthus (where the tear duct is) of the eye .
• Sinusitis with a clear nasal discharge that can be observed when pressure is applied to the nares
• Tracheal rales (rattling sounds) and altered vocalization
• Air-sacculitis in advanced disease

In a study of B. avium in cockatiels, it was reported that the bacteria does not appear to cause disease in adult cockatiels; however, it has a severe effect on the very young cockatiel ⁶⁰Symptoms of this disease that are specific only to the young and unweaned cockatiel are:

• “Sneezing with significant mucoid exudates (serious nasal discharge)
• Lethargic behavior and pasty, pale appearance
• Inflammation of the skeletal muscle responsible for opening the beak; this creates the ‘lock-jaw’ condition as the beak gradually closes over a period of 12-24 hours to a point of being ‘locked’ shut (temporomandibular rigidity)
• Constant begging for food, dehydration, and weight loss
• Protruding eyes that appear glassy and half-shut. This is due to swelling of the suborbital chamber of the infraorbital sinus, which forces the lower eyelid upward.
• Swollen appearance of the head due to inflammation of the skeletal (voluntary) muscles adjacent to the inflamed nasal cavity and infraorbital sinus.” ⁶⁰

Birds may exhibit symptoms from three days to four weeks old. Breeders with these signs are considered carriers. Testing is the only way to know if a bird is a carrier. Cockatiels suffer a higher mortality rate from bordetellosis than any other species so far studied and reported. ⁶⁰

At necropsy, birds have watery eyes and extensive mucus in the sinuses and trachea. There may be some hemorrhaging in the lining of the trachea. Signs of the disease usually occur seven to ten days after infection. ²⁷

5.12.3 Testing and Treatment

Serology tests such as ELISA and PCR will provide an antemortem diagnosis. ³⁹ Antimicrobial agents by aerosol, injection, or in the water have not generally been effective, even though B. avium appears to be highly sensitive. “The respiratory area is difficult to medicate, and some strains of B. avium are resistant to antibiotics.” ¹⁹ A necropsy will identify lesions in upper respiratory tract, and this will confirm the diagnosis. ⁶⁰

Image 68. Bordetella avium in the trachea, 7 days after infection (image courtesy M. Jackwood). ²⁷

5.13 Pseudomonas aeruginosa

“Pseudomonas infection is one of the most stubborn and elusive causes of respiratory problems in birds.” ³² It is a mucoid infection, and its causes are malnutrition and poor water hygiene. It is a gram-negative, rod-like organism that is not normally found in healthy birds, but when it is, it is highly resistant to many antibiotics. The body’s warm, moist respiratory system is the perfect place for the spores to grow. This bacterium is frequently found in bathrooms, around the sink, and on the tile grout. ³²

5.13.1 Testing

P. aeruginosa can usually be found in both choanal and cloacal cultures. If the numbers are low, and the bird is not showing clinical signs, treatment is usually not necessary; however, if it is found outside the GI tract, or in the choana/oropharynx, it can cause serious disease. ³²

Other forms of P. aeruginosa infection are conjunctivitis and consequent keratitis and panophthalmites (inflammation involving all the tissues of the eyeball). ¹⁷

Image 69. P. aeruginosa in a chicken (image courtesy I. Dinev). ¹⁷

Pseudomonas is found in water supplies and can cause illness if it is present in high concentrations. Swamp-coolers and hoses that are allowed to sit for prolonged periods without flushing before water is dispensed can aerosolize the bacteria and be sources of contamination.⁴⁹ Other sources are dirty water, dirty bowls, sipper tubes, water systems, misters, spray bottles, baths, sprouted seed, and filters that purify aviary water Cultures must be performed on taps, surfaces, and other areas that the water may contact. Even if bottled water is used, the inside of the cap may contain the bacteria. ³²

The rate of recurrence of the infection is very high, making constant retesting necessary. The bacterium becomes stronger and “more resistant to antibiotics with each subsequent generation.” ³²

5.13.2 Symptoms

• “Sneezing and clear or yellowish discharge from one or both nostrils
• Scratching at the nares and ears
• Conjunctivitis
• In psittacine chicks, it is often associated with chronic sinusitis and usually related to an initial aspiration event.
• Swollen sinuses around the eyes and complete obstruction of the nostrils in severe cases
• Crusty feathers around the nostrils—an early sign
• Foul-smelling diarrhea
• Necro-purulent pneumonia (pneumonia producing inflammation and pus)” ³²

Image 70. Scanning electron micrograph of Pseudomonas aeruginosa bacteria (image courtesy T. Margolin) ³²

5.13.3 Treatment

The preferred treatment is with injectable antibiotics. Most adult birds have competent immune systems and can fight off the infection; however, juvenile psittacines are at greater risk of developing the infection when exposed. They are unable to contain the bacteria to the respiratory tract; therefore, “their systems may be overwhelmed and become septicemic. Hand-fed chicks will succumb to the disease if their formula water is contaminated. Water must be boiled before use and utensils must be disinfected.” ²²

5.14 Bacterial Sinusitis

Bacterial sinusitis causes a collapse of the sinuses. This condition occurs most often with Pseudomonas or Bordetella sp. infections. It responds well to antibiotic therapy based on culture-and-sensitivity testing. Symptoms include “copious amounts of mucous exudate in the sinuses and requires vigorous flushing with large quantities of saline through the sinuses to dislodge the exudate.” ²³ Treatment for these birds includes flushing with 60 ml of saline through each naris daily; this continues until the sinuses returned to normal. The exudate will be flushed out of the choana. The condition is most often seen in recently imported macaws. This condition may also occur if the nares become plugged with a rhinolith and the bird is prevented from breathing normally. ²³

Image 71. Distended infraorbital sinus infection in a parakeet (image courtesy Louise Bauck). ²⁶

Image 72. Sinusitis/conjunctivitis in a cockatiel with Chlamydia sinus infection (image courtesy Melbourne Bird Vet; used with permission).

Bacterial diseases are common in pet birds and should be considered in the differential list of any sick bird. Inappropriate husbandry and nutrition are often contributing factors; neonates and young birds are especially susceptible. GI and respiratory infections are most common and can lead to systemic disease. Normal bacterial flora of companion birds includes Lactobacillus, Corynebacterium, non-hemolytic Streptococcus, Micrococcus spp, and Staphylococcus epidermidis. ²³

“The most commonly reported pathogens are gram-negative bacteria: Klebsiella, Pseudomonas, Aeromonas, Enterobacter, Proteus, and Citrobacter spp, E. coli, and Serratia marcescens). Pasteurella spp have been reported as possible septicemic agents in birds attacked by pet cats or rats. Mycobacterium and Chlamydia are common intracellular bacterial pathogens. Infections with Salmonella spp are occasionally seen. ²³

Image 73. Serratia Marsecens on MacConkey agar (image courtesy Kayleigh Griffin; used with permission).

“The most common gram-positive bacterial pathogens are S. aureus, S intermedius, Clostridium, Enterococcus, Streptococcus, and other Staphylococcus spp. Methicillin-resistant S. aureus (MRSA) is rare but has been documented. Mycoplasma spp have been implicated in chronic sinusitis, often found in cockatiels. This organism is difficult to culture, and the true incidence is unknown. Staphylococcus and streptococcus (especially hemolytic strains) and Bacillus spp are thought to be responsible for several dermatologic conditions in psittacine birds. Staphylococci are often isolated from lesions of pododermatitis (bumblefoot) in many avian species.²⁶

Image 74. Streptococcus in a Gram’s stain; the red arrow is pointing to the orange-colored white blood cells, and the black arrow is pointing to streptococcus chains (image courtesy Kayleigh Griffin; used with permission).

“Clostridial organisms are common secondary invaders of damaged cloacal tissue in birds with cloacal prolapse or papillomatosis. Several specific syndromes of birds can arise from various species of clostridia. A Gram’s stain or anaerobic culture is necessary to identify these organisms. ²⁶

5.14.1 Diagnosis and Testing

“Diagnosis is based on clinical signs and results of cytologic examination and culture of tissue or swab samples. A Gram’s stain is used to identify normal flora, yeast, and spore-forming bacteria. Culture is needed to identify specific organisms and their sensitivity to antibiotics. Samples can be obtained from the respiratory, GI, urinary, and reproductive tracts. Sample sites for culture and cytology include the choanal slit, sinuses, cloaca, wounds, conjunctiva, internal organs (via ultrasound-guided, fine-needle aspirates, endoscopic examination, or surgery), and blood.” ²⁶

5.15 Bacterial Respiratory Disease

Bacterial respiratory disease is often a stress-related phenomenon resulting from a cold environment. It may also develop secondarily to an underlying Vitamin A deficiency.

The most common pathogens involved in psittacine bacterial respiratory diseases are:

• Klebsiella
• E. coli
• Enterobacter
• Pseudomonas
• Pasteurella
• Mycoplasma
• Salmonella
• Proteus
• Serratia
• Hemophilus
• Actinobacillus ³⁰

Image 75. Damage to the skin from mycoplasmosis (image courtesy Sofia Sangushko; used with permission)

5.15.1 Symptoms, Diagnosis, and Treatment

Clinical signs of bacterial respiratory disease may include sneezing, nasal discharge, dyspnea, lethargy, anorexia, exercise intolerance, wasting, and rarely, coughing. The clinical signs will vary according to the location of the infection, from the sinuses (upper respiratory), to the air sacs or the lungs. Tests used to diagnose bacterial respiratory disease are choanal

culture-and-sensitivity tests and radiographs. “Radiographs are extremely important in locating and characterizing the infection. ³⁰

Important differential diagnoses include:

• Viral respiratory diseases (Amazon tracheitis virus)
• Chlamydia
• Toxic inhalants (Teflon, smoke)
• Allergies
• Fungal disease
• Dyspnea caused by abdominal distention (non-respiratory cause).” ³⁰

Treatment involves the use of appropriate antibiotics (delivered by local application), systemic administration, and nebulization. Additional therapies include fluid therapy, Vitamin A therapy, and oxygen therapy if necessary. ³⁰

5.16 Spontaneous Bacterial Enteritis in Psittacines

Bacterial enteritis, including necrotic bacterial enteritis, is usually associated with stress, such as transportation, relocation, introduction of a new bird or person to the home, molting, breeding/egg-laying, and weaning. Sometimes the cause is unknown. ^{13, 20}

5.16.1 Symptoms

Clinical signs include diarrhea, dehydration, anorexia, weight loss, septicemia, and sudden death. The diagnosis is based on history, clinical signs, fecal gram stain, and cloacal culture-and-sensitivity. The fecal Gram’s stain will determine the number and type of gram-negative organisms in the feces. Other possible causes are poor diet, chlamydiosis, and hepatitis. Treatment for bacterial enteritis requires the use of appropriate antibiotics based on culture-and-sensitivity testing and fluid therapy. ²⁰

Image 76. Digitally-colorized scanning electron micrograph of Klebsiella bacteria (image courtesy Go Pets America), http://www.gopetsamerica.com/bio/bacteria/index.aspx

The most common pathogens involved in psittacine bacterial enteritis are:

• E. coli
• Klebsiella
• Salmonella
• Pasteurella
• Pseudomonas
• Aeromonas
• Citrobacter (caused by poor water hygiene)

Other, less common organisms include:

• Enterobacter
• Proteus
• Serratia
• Yersinia
• Mycobacterium
• Chlamydophila ^2O

Part VI Diagnostic Testing of Bacterial Samples

The two methods most used for identification of pathogens are Gram’s stains and cultures. Other methods are also used, but usually they are required after the sample has been tested by one or both of these methods and more information is needed about the pathogen. Today’s practitioners have at their disposal a wide variety of testing methods, from simple visual microscopic examination of impressions and unstained samples to state-of-the-art molecular diagnostic testing. These modern methods enable the clinician to identify and treat a wide range of pathogenic bacteria.

6.1 Observing the Bird for Illness

It is important that the owner pays close attention to the bird’s physical appearance so he may be able to detect early signs of bacterial or other pathogenic infections. There may be a change in the consistence of the bird’s droppings, loss of appetite, increased need for attention, increased sleeping, or other more subtle signs. If the owner waits until the bird is sitting on the bottom of the cage, he may find the is extremely ill and the situation is dire. If the owner observes any unusual signs, he needs to get the bird to the avian veterinarian immediately. He may do any number of tests, including Gram’s stains (oral and fecal smears studied under the microscope), blood samples to be sent to a lab for culture, and any other tests he deems necessary. ⁷

Ideally, the practitioner would wait for the results of the culture or other tests to come back from the lab, but when a bird is extremely ill, he must be treated with some medications right away, and test results often take a week or more. When the tests do come back, he may begin other treatments. The veterinarian may wish to do “antibiotic-sensitivity testing to determine the best antibiotic for that particular strain of bacteria present in the bird.” ⁷ The test results may mean a change to a more effective antibiotic.⁷

6.2 Brief Overview of Testing, Diagnosis, and Treatment

Diagnosis of bacterial disease is based on clinical signs and the results of cytology tests such as Gram’s stains and culture-and-sensitivity tests. Samples may be taken from the respiratory, GI, urinary, reproductive tracts, the choanal slit, sinus, cloaca, wounds, blood, conjunctiva, and internal organs (via ultrasound-guided, fine-needle aspirates, endoscopic examination, or surgery). ³⁴ A Gram stain is used to identify normal flora, yeast, and spore-forming bacteria. Culture is needed to identify specific organisms and their sensitivity to antibiotics. ^{26 34}

Antibiotics are chosen based on the results of Gram’s stains and culture tests. They should be delivered by mouth with an oral syringe since putting them in the drinking water is not a reliable method of delivery.³⁴ Antibiotics and other medications may also be delivered via nebulization directly into a bird’s respiratory tract; this is particularly useful in cases of respiratory diseases. ⁵⁰

Most bacterial infections are contagious from bird-to-bird by the droppings and water, but only a few are zoonotic to humans. ³⁴

6.3 The Gram’s Stain Diagnostic Test

The Gram’s stain is an easy-to-use diagnostic test that has long been used in avian medicine to look for pathogens. It is quick, easy, convenient, and affordable to most clients. When combined with the physical examination and a good knowledge of avian medicine, this test is helpful in identifying early stages of many diseases. With it, the clinician is able to identify a particular pathogen or disease process before clinical signs occur. It may be used along with other clinical data gleaned from the bird’s history, the physical examination, cytological stains, cultures, and PCR tests. ¹⁵

6.3.1 Hans Christian Gram

The Gram’s stain method is named after its inventor, the Danish scientist, Hans Christian Gram (1853–1938), who developed the technique in Berlin in 1884. Gram devised his technique, not for the purpose of distinguishing one type of bacterium from another, but to make bacteria more visible in stained sections of lung tissue in humans. ⁴¹

Image 77. Hans Christian Gram, developer of the Gram’s stain (image courtesy Wikipedia: Hans Christian Gram) https://en.wikipedia.org/wiki/Gram_staining

6.3.2 The Gram’s Stain’s Function$

Gram’s staining is used to determine the presence of pathogenic bacteria in terms of their reaction to the Gram’s stain. They will be either Gram-positive and Gram-negative. The differences in staining occur due to variations in the cell-wall structures that bind the stains differently. This test is used to distinguished whether the bacteria present under the microscope are pathogens or normal, resident, beneficial bacteria. This varies among species, and interpretation requires considerable experience.¹⁰

6.3.3 Body Locations of Samples Taken for Gram’s stains

Normally, the stain is performed on samples from the gastrointestinal tract—from the choana, oral cavity, cloaca, and feces. This test is recommended for both healthy and sick birds at their annual exams. Any abnormalities warrant further diagnostic testing, including cultures and PCR tests. Other samples that may be tested with the Gram’s stain are of upper respiratory tissue, including the nares, oral cavity, sinus cavity, choanal lesions and naso-ocular discharge. Lower respiratory samples may be collected from air-sac fluids and swabs collected by endoscopic exam.¹⁵

Image 78. Gram’s staining is a method of differentiating bacterial species into two large groups: Gram-negative (red stain) and Gram-positive (blue/purple stain) (image courtesy 123rf)

Most abnormal bacteria enter through the oral cavity. Bloody mucosa or excessive mucus are reasons to perform the cytological test. The oral cavity, including the commissure (corners of the mouth) and undersides of the tongue, should be swabbed for samples and may reveal important information when tested. The gastrointestinal tract may be sampled in several different places. The oral cavity and crop may be swabbed, along with resulting fluid derived from it, and the cloaca may be swabbed to obtain fecal material. Fresh fecal samples from droppings may also be utilized. Crop, oral cavity, and cloacal swabs need to be collected carefully so that the highly vascular and friable (flaky and dry) tissues are not irritated, which can lead to bleeding. ¹⁵

Fecal samples may be viewed directly before they are stained. Motile bacteria, bacterial density, parasitic ova and cysts, urates, and undigested material are all able to be identified. With granulomas (a mass or nodule of inflamed or infected tissue) and skin lesions, the tissue under the wounds can be sampled and stained. Other areas that can be tested and analyzed are the feather pulp (inside of a blood feather) and feather follicles. ¹⁵

Image 79. This picture is showing a negative gram stain test and a positive Gram’s stain test. A Gram’s stain test is performed by putting alcohol on the bacteria. It will either turn a violet color or a pink red color. If it’s violet, the test is positive; if it’s a red-pink color, the test is negative. A positive result means the bacteria will have a thick cell wall, a negative result that means the bacteria has a thinner cell wall. Pseudomonas fluorescens will be negative if a Gram’s stain test is performed (image courtesy SA Site for Science).

6.3.4 Further Testing Determined by the Results of the Gram’s Stain

One benefit of the Gram’s stain is to prompt the clinician to pursue other diagnostic assays if he is not satisfied with the results of the Gram’s stain.¹⁵ For example, if inflammatory cells, abnormal red blood cells, or other abnormal cells are suspected from the Gram’s stain, the practitioner will want to perform another cytological stain or possibly a culture-and-sensitivity test. Further tests may include a Polymerase Chain Reaction (PCR), a molecular diagnostic test. ¹⁵

Image 80. Gram’s Staining. A Gram’s stain of mixed Staphylococcus aureus (S. aureus, Gram-positive cocci, in purple) and Escherichia coli (E. coli, Gram-negative bacilli, in red), the most common Gram-stain-reference bacteria (image courtesy Wikipedia). https://en.wikipedia.org/wiki/Gram_staining)

6.3.5 What information does the practitioner glean from the Gram’s stain that cultures cannot provide?

“Cultures alone cannot identify many important aspects in a sample that the Gram’s stain may reveal. The culture cannot identify:

• Numbers of yeast, fungal hyphae, and budding yeast
• Sporulated rods, spirochetes, megabacteria (Macrorhabdus ornithogaster, a fungus), protozoa, and the relative number and percentages of bacteria
• Pathogenic bacteria which have special growth requirements, e.g., Pasturella species.” ¹⁵

6.3.6 Gram-negative Smears

If the bacterial population fails to take up the blue-purple part of the Gram’s stain, it will only retain the red counterstain and therefore appear red or Gram-negative. Gram-negative organisms are more likely to be pathogenic in birds, but not always.10Brown

Image 81. This Gram-negative smear (1000x magnificaion) was taken from a cultured sample of a sinus swab in a cockatiel with sinusitis (sinus infection) and shows both characteristic red Gram-negative bacilli (rod shaped) and cocci (round) bacterial organisms (image courtesy D. Brown). ¹⁰

6.3.7 Gram-positive Smears

Bacteria can be identified as being pathogenic based on their staining characteristics by using a Gram’s stain. Since these bacteria have taken up the blue-purple part of the stain, they are Gram-positive. Most Gram-positive organisms are beneficial and normal in most parrots, but some cause disease. ¹⁰

Image 82. This is a Gram-positive smear at 1000x magnification. It was taken from a cultured sample of a routine sinus swab in a cockatiel and shows both characteristic blue-purple, Gram-positive bacilli (rod-shaped) and cocci (round) bacterial organisms (image courtesy D. Brown).10

6.3.8 Images of Various Bacteria after Gram’s staining

6.3.8.1 Appearance of Mycobacterium organism. Some Gram-positive bacteria can be pathogenic, such as the Mycobacterium organism, a rod-shaped bacterium.

Image 83. This image shows liver tissue with avian tuberculosis bacterial organisms, specifically Mycobacterium spp (a Gram-positive, aerobic bacteria, occurring as slightly curved or straight rods.) The sample has been stained red-purple and viewed at 400x magnification. It is from a long-tailed finch (image courtesy D. Brown)10 Brown

6.3.8.2 Appearance of the Spiral and Spirillum Bacterium

Image 84. Spirillum bacteria, a variation of the spiral bacteria as it appears in a Gram’s stain. They have a corkscrew appearance (image courtesy Imarcade).

Imarcade.com http://imgarcade.com/spirillum-bacteria-under-microscope.html)

6.3.8.3 Appearance of the Coccus Bacterium

Image 85. Cocci, or round-shaped bacteria in a Gram’s stain (image courtesy Imarcade). http://imgarcade.com/coccus-bacteria-under-microscope.html

6.3.8.4 Appearance of Cocci in a Gram’s Stain.

In Some Cocci Infections, the Bacteria Form Chains

Image 86. Streptococcus pneumoniae, a Gram-positive bacterium (image courtesy Imarcade). http://imgarcade.com/cocci-bacteria-under-microscope.html

6.3.8.5 Appearance of Rod-shaped Bacteria

Image 87. Rod-shaped Bacteria. Colored scanning electron micrograph (SEM) of rod-shaped (bacillus) bacteria. The tubes connecting the bacteria are pili, which are used to transfer genetic material between bacteria in a process known as conjunction (Image courtesy Science Photo Library)

6.3.9 The Gram’s Stain Method of Bacteria Identification

The Gram’s stain is a test used to identify bacteria by the composition of their cell walls. Oral and fecal samples are put through a staining process after which the practitioner looks for the distribution of various bacteria. Bacteria are first stained with a purple dye called “crystal violet” which specifically binds to peptidoglycan, a complex structure of amino acids and sugars found in the cell wall. This is followed by a series of steps that ultimately removes any unbound or loosely bound crystal violet.  ^{51, 54.}

Then the cells are stained with a second red-colored dye called safranin. Gram-positive bacteria stain purple because their cell walls are rich in peptidoglycan. Gram-negative bacteria, whose cells walls have two layers, take on a red coloring. The outer layer of lipids does not bind strongly to crystal violet, and the dye is easily washed away during the staining process. For example, Streptococcus pneumoniae, which causes pneumonia, is a Gram-positive bacterium, while  E.coli and Vibrio cholerae (which causes cholera), are Gram-negative bacteria. ¹¹

Sometimes, while the clinician is performing the Gram’s-staining technique, there will be errors in the process, making interpretation difficult. The slide may be overheated, or the sample may be decolorized; these are the most commonly found errors. The technique must be uniform, and fresh samples must be used.¹⁵

Certain factors influence the interpretation and effectiveness of the Gram’s stain:

• Age and species of the bird
• Diet
• Cage hygiene
• Husbandry practices. ¹⁵

6.3.10 Discerning Normal from Abnormal Bacteria in a Gram’s stain.

Clinicians need to be able to judge normal from abnormal bacteria and know the number and ratios of normal bacteria for a particular species. Normal oral and GI flora from psittacine birds consist primarily of Gram-positive rods and cocci. An occasional Gram-negative rod or fungal organism (yeast) is normal, but if there is an abundance of these, or they are frequently seen in successive stains, they are considered abnormal. ¹⁵

Normally, the choanal slit (narrow opening in the top of the mouth) of birds contains squamous epithelial cells and a slight-to-moderate number of bacteria. They usually stain Gram-positive. Abnormal stains may contain inflammatory cells, yeasts, fungal hyphae (long, branching filamentous structures of a fungus), or a large number of Gram-negative rods or cocci. ¹⁵

“Epithelial cells form the epithelium, which is a membranous tissue that covers the internal area of organs and other internal surfaces of the body and also covers the external skin. If the stained sample contains few epithelial cells and fewer-than-normal numbers of bacteria, that is a cause for concern. Ideally, there should be no more than 10% of Gram-negative bacteria in psittacines. An increase of more than 10% of Gram-negative bacteria is not normal. The more Gram-negative bacteria found, the more pathogenic the situation. Just because there are no Gram-negative bacteria in a sample does not mean they are not present elsewhere in the area of the body from which the sample was taken. Any abnormal findings are cause for additional testing, such as culture-and-sensitivity tests and a complete blood count (CBC), especially the white-blood-cell count (WBC).” ¹⁵

Once he gets the results of the Gram’s stain back, the practitioner will record the results of the test.

Blood tests can be used to check for serum antibody levels to certain organisms, including bacteria. PCR can also be used but is generally run on tissue swabs, not blood. Bacteria in the blood indicates sepsis. About 50% of septic cases die.

The feather pulp and skin swabs are performed to check to see what kinds of organisms are present in that area. They may or may not represent the cause of a skin or feather pulp problem. R. Dahlhausen

6.3.11 Diagnosing from the Gram’s Stain

Gram’s stains provide valuable information to the clinician; however, they do not constitute a diagnosis; neither can they assist in the diagnosis of other difficulties the bird may have, such as a respiratory problem or injury. ¹⁸

Diagnosis depends on other screenings in addition to the Gram’s stain. The Gram’s stain is a valuable diagnostic screening test in both well and sick birds, but other factors need to be taken into consideration, such as the bird’s history and the results of the culture and CBC tests.¹⁵

The bird owner needs to pay close attention to the bird’s physical appearance. If the bird shows signs of illness, the owner needs to make an appointment with the veterinarian and have these tests performed. It takes a while for the results to come in many instances; meanwhile, as the clinician and owner wait, the bird continues to become more and more ill. Before he even knows the information gleaned from the tests, he must prescribe medication to treat the symptoms at that time, based on his differential diagnoses (possible reasons for illness). He may prescribe a broad-spectrum antibiotic that will aid in recovery until he is able to do sensitivity testing and prescribe the correct antibiotic for the illness.

6.3.12 Interpretation of Gram’s Stain Results

Interpretation of what is visible on the Gram’s stains is not easy; it takes experience to sort through all that is there and find the pathogen responsible for the bird’s illness. Many other areas must be explored as well; the bird’s history and symptoms are of great importance. The following images and their explanations are examples of documentation of the results of the Gram’s stains.

KEY: Hx = History, CS = Clinical Signs, GS = Gram’s stain results Rx = Therapy

I

Image 88. Four-year-old male Budgerigar, Apparently healthy bird, fed a pelleted diet. CS = none. Gram Stain results = Normal distribution of organisms: 157 total bacteria per field, 70% gram-positive rods, 30% gram-positive cocci, 0 gram-negative bacteria, 0 yeast. Digestion of food is complete (image courtesy Clinical Avian Medicine, Harrison-Lightfoot).

Image 89. African grey parrot, 4 years old, sex unknown: Hx = Intermittent vomiting or loose stool, not as playful. GS = 400 bacteria per oil field, 95% Gram-positive short rods, 5% Gram-positive rods, 0 yeast. Overgrowth of intestinal bacteria, enterotoxaemia (a condition induced by the absorption of large volumes of toxins produced by Clostridium perfringens from the intestines), malnutrition. Rx = Aggressive (image courtesy Clinical Avian Medicine, Harrison-Lightfoot).

Image 90. Severe macaw, 7 years old, sex unknown: Hx = Depressed, not eating, weak. CS = underweight, scant feces, dark yellow urine and urates, malcolored feathers. GS = 200 bacteria per field, 1% gram-positive rods, 0% gram-positive cocci, 98% gram-negative rods. Rx = Aggressive (image courtesy Clinical Avian Medicine, Harrison-Lightfoot).

Image 91. Umbrella cockatoo, 6-year-old female: Hx = Exposure to carnivorous pets, seed only diet. CS = Fetid stool, weight loss, passing undigested food. GS = 200 bacteria per field, 10% gram-positive rods, 90% gram-negative rods, of which 50% are Clostridium sp. Rx = Aggressive (image courtesy Clinical Avian Medicine, Harrison-Lightfoot).

Cultures are done along with the analysis of growth on certain media plates and certain biochemical tests and morphology to identify the bacteria involved. The organism can be grown on a special media plate with multiple discs, each containing a certain antibiotic. This is the sensitivity part of the test. The Zone of Inhibition of growth around the disc determines if the organism is sensitive or not to that antibiotic.

Bob Dahlhausen

Sensitivity testing

Image 92. Moluccan cockatoo, 7-year-old male: CS = smelly stool. GS = 50 bacteria per field, 90% gram-positive rods, 10% gram-positive cocci, 30 Clostridium sp. organisms. Rx = Aggressive (image courtesy Clinical Avian Medicine, Harrison-Lightfoot).

Image 93. “Zone of Inhibition” assay on a culture plate to define which antibiotic works the best. The size of the zone is relative to the potency of the antibiotic. The “Zone of Inhibition” means that the bactericidal or bacteriostatic agent has either inhibited or killed the organisms that were spread on the plate, and that those organisms are susceptible to that agent

(image courtesy Toxikon Services). http://www.toxikon.be/services/Microbiology_Pharma_Biotech.cfm)

6.4 Other Stains Used in the Diagnostic Process

These are the routine stains used in avian cytology, histopathology, and histology. Each of these stains is used for a particular purpose, depending on what the bird is being tested for.

• Wright’s stain
• Wright-Giemsa stain
• Giemsa Stains
• Quick or Stat Stains
• New Methylene blue stain
• Special stains
• Acid-fast stain
• Gram’s stain
• Macchiavello’s stain
• Modified Gimenez stain
• Natt and Herrick’s solution
• Sudan III and Sudan IV stains

“Most of these stains have been in use for many years. The cytology and histopathology stains for birds are going to be the same as for animals and people. The same is true for hematology. Wright-Giemsa stain or a Quick or Stat stain like Dif-Qwik are most commonly used in the clinic setting. Most of the others are special stains and are used by laboratories for special purposes. New Methylene Blue stain is used in cytology and histopathology, typically for staining immature red blood cells. ¹⁵

“Hematologic stains. There are a number of special stains employed to identify specific inflammatory cells seen in peripheral blood and tissues. These include the all-purpose Wright-Giemas and Giemsa stains, leukocyte alkaline phosphatase (LAP), tartrate-resistant acid phosphatase (TRAP), and myeloperoxidase (MPO). ¹⁵

“There are a variety of “Romanowsky-type” stains with mixtures of methylene blue, azure, and eosin compounds. Among these are the giemsa stain and the Wright’s stain (or Wright-Giemsa stain). The latter is utilized to stain peripheral blood smears. The giemsa stain can be helpful for identifying components in a variety of tissues.¹⁵

“One property of methylene blue and toluidine blue dyes is metachromasia. This means that a tissue component stains a different color than the dye itself. For example, mast cell granules, cartilage, mucin, and amyloid will stain purple and not blue, which is helpful in identifying these components. ¹⁵

“Fat Stains: Lipids cannot be demonstrated in routine tissue sections, as during processing the tissue and clearing, lipids will be dissolved. Lipids are routinely demonstrated in frozen sections or cryostat sections. ¹⁵

“Special fat stains used are:

• Oil Red O
• Sudan III
• Sudan IV
• Sudan Black
• Osmium tetroxide

“For more information on stains, the reader may research the individual stain on Wikipedia. There are sites which contain specifics about the individual stains.

“Other sites which offer information about stains are::

• https://webpath.med.utah.edu/HISTHTML/STAINS/STAINS.html
• https://www.histopathology.guru/?s=stains”

(All information on stains from Bob Dahlhausen, personal communication.)

6.5 Culture-and-Sensitivity Diagnostic Testing

A culture refers to the propagation of living organisms or the living tissue cells in special media conducive to their growth. It is also the product of such propagation. It is used when birds are suspected of having a bacterial infection and the Gram’s stain does not yield sufficient information. ⁸

6.5.1 Culture-and-Sensitivity Testing Methodology

To perform the test, a sterile swab of the body fluid in question is obtained and streaked on a laboratory plate. These samples can be from sinus drainage, fecal and oral material, or pus. The plate is a shallow, flat receptacle filled with agar; this provides the nourishment that allows the suspected bacteria to grow. The culture plate is then placed in an incubator overnight. By the next day, bacterial growth is usually visible. If insufficient growth has occurred, the organism may be placed onto a different growth medium and incubated for another twenty-four-hour period. This way, the culture process allows the specific bacteria infecting the bird to be identified. ²⁵

Once the pathogenic organism has been identified, the clinician will perform sensitivity testing to determine the sample’s response to different antibiotics. “Sensitivity” refers to the ability of the one or more of the antibiotics to kill the bacterium. If the bacterium is killed by the antibiotic, it is “sensitive” to it.²⁵

“To test for sensitivity, antibiotic-impregnated paper discs are placed on the surface of the culture plate on which the bacteria are growing. After a period of time, the plates are observed for bacterial ‘kill off.’ This is manifested by a clear zone (Zone of Inhibition) around one or more the antibiotic discs, indicating that the bacteria are unable to live and grow in the presence of that particular antibiotic.” ²⁵

Not all bacteria are killed by all antibiotics. The veterinarian will choose the most effective antibiotic for the bird’s infection, based on the results of the culture-and-sensitivity testing. ²⁵

Image 94. Bacterial growth on a petri dish (image courtesy https://uk.vwr.com/store/content/externalContentPage.jsp?path=/uk.vwr.com/en_GB/microbiology_segment.jsp).

Image 95. Colony of bacteria in culture medium plate (image courtesy 123rf). https://www.123rf.com/stock-photo/bacteria_culture.html

Image 96. Agar as a medium for bacterial growth

(image courtesy Just We Diminute). http://www.justwedeminute.com/2010/04/ewww-growing-bacteria-for-science.html)

6.5.2 Commonly Found Bacteria in Cultures

Normal fecal bacteria cultured from healthy birds include:

• Gram-positive bacilli (Lactobacillus spp., Bacillus spp., Corynebacterium spp., and Streptomyces) Older birds tend to have more Corynebacterium and less Lactobacillus than juvenile birds.
• Gram-positive cocci (Staphylococcus epidermidis, Streptococcus spp., Aerococcus spp., and Micrococcus spp.)
• Escherichia coli is commonly recovered from cockatoos, but less commonly in other species.
• Gram-negative bacteria occasionally found in clinically normal birds include: Enterobacter, Klebsiella, Citrobacter, Pasteurella, and Moraxella spp.
• While some Pseudomonas spp. have been recovered from healthy birds, P. aeruginosa is rarely found in healthy birds.
• Isolation of Proteus, Salmonella, Pseudomonas, Klebsiella, Listeria, Erysipelothrix, and hemolytic Staphylococcus aureus is clinically significant in sick birds.”

Cultures from other sites such as the eyes, ears, and choana usually show similar results. Any heavy overgrowth of bacteria warrants further investigation.” ¹⁸

6.6 Identifying the Pathogens Using Cytology and Histopathology

There are some differences between cytology and histopathology. “Cytology is done with a swab or fluid from a fine-needle aspirate (FNA).  It does not contain solid tissue, so it cannot assess tissue architecture, just cell types present.  Histopathology is tissue collected by biopsy or necropsy.   For example, a crop swab or crop wash yields cytology and culture samples but cannot evaluate the health of the crop tissue.  Histopathology of the crop evaluates the crop wall itself.  Histopathology is not used for culture as it is placed in formaldehyde (Formalin), but one can culture the sample before placing it in Formalin.  Both can see bacteria and cells. Cytology images consist of the whole organism spread out across a slide, while histopathology uses cut samples, usually tissue blocks, so they will look a little different.  Histopathology is not always of disease samples, but it is some form of tissue, so any bacteria may be embedded in it (typically).   The results will also depend on which stain is used.” (Bart Huber, personal communication; used with permission).  

6.6.1 Cytology

Cytology is the study of the structure, function and chemistry of cells. It deals directly with the structural and functional organization of cells and also with metabolism, ontogenetic differentiation (the development of an individual organism from inception to maturity and comparing it to that of another organism), heredity, and phylogeny (the evolutionary history of an organism). ²⁰

Cytology is the study of cellular anatomy, physiology, pathology, and chemistry, and it provides valuable information about the disease process being examined. Only a very small sampling of cells is required so it doesn’t further traumatize the already-compromised tissue. ⁸

Cytological tests can be used to identify cancer cells, the sex of birds, and to give information on the nature of infectious processes, particularly whether they are acute or chronic. Cells from any part of the body may be examined, e.g., the digestive and respiratory tracts, oral and fecal areas, skin, and joints. ⁸

Image 97. Cytology of normal bacterial microflora in a cloacal sample from a Yellow-fronted Amazon parrot using Gram’s stain (image courtesy Terry Campbell: Avian Hematology and Cytology. Iowa State Univ. Press, 1988, p. 50).

Image 98. Chronic active sinusitis in a Scarlet-chested Parrot. Small, round purple intracytoplasmic inclusions (center) are seen in many of the cells. A presumptive diagnosis of chlamydiosis was made based on these findings and the clinical signs. Chlamydiae were isolated from the sample. The sample was stained with Diff Quick (image courtesy Terry Campbell: Avian Hematology and Cytology. Iowa State Univ. Press, 1988, p. 50).

6.6.2 Histopathology

Histopathology is the microscopic examination of tissue changes caused by disease. It refers to the examination of a biopsy or surgical specimen by a pathologist after the specimen has been processed and histological sections have been placed onto glass slides.. ^{3, 21}

Many diseases cannot be identified by simple light microscopy of organ contents. They may require histopathology. This is a process by which very fine sections of suspect tissue are sliced, stained, and prepared for examination. They may be stained and examined immediately; other times, they may need to be cultured before they can be stained and examined. Gram’s stains are usually performed first, then, if necessary, other methods of testing may be utilized. ⁹

6.6.3 Methods of Obtaining Cell Samples for Cytology and Histopathology:

• Swab: In an exposed area of the body, such as an open wound, a swab or scraping of the area will be taken and its contents spread on a slide. ⁸
• Impression smears, also called “contact smears” from skin and internal organs. The slide will be pressed directly onto the affected area to obtain the needed cells. ⁸
• Fine-needle aspirate of masses or organs: If a sample is needed from an internal area of the body (e.g., fluid in the abdomen), a sterile needle and syringe will be utilized to remove the necessary sample. ⁹
• Saline wash: “If samples are needed from the crop, air-sac, or trachea, sterile saline will be instilled into these areas and then removed by sterile syringe and tubing. The saline solution will then contain numbers of cells that can be examined.” ^{4, 7}
• Sinus aspirates, often performed with saline washes. ⁷
• Abdominocentesis: introduction of a needle into the abdominal cavity in order to reach fluid. ⁷
• Arthrocentesis: using a syringe to collect synovial fluid from a joint capsule. It is also known as joint aspiration ⁷
• Scrapings from the palpebral conjunctiva or cornea of the eyes, from the oral cavity, or tissues that normally yield poor cellular samples. ⁷

6.7 Other Testing Methods

Many types of tests will indicate the presence of bacteria. Lab tests for avian species are divided into several basic groups:

• Indicators of immune system activity: the CBC and EPH (electrophoresis: A method of separating substances, especially proteins, and analyzing molecular structure based on the rate of movement of each component while under the influence of an electric field.) ⁴²
• Serum biochemistries (blood tests): indicate the condition or function of various organ systems.
• Serology (Gram’s stains and cultures): tests for antibodies to various diseases. Antibodies are small proteins that circulate in the bloodstream. They are part of the body’s immune system and are made by B lymphocyte while blood cells. Antibodies attach to proteins and other foreign chemicals in the body which they recognize as abnormal. The foreign proteins and chemicals that antibodies attach to are called “antigens.” ⁴²
• Antigen-detection tests: tests for the antigens specific to infectious agents. Some tests can identify the antigen on the surface of some bacteria. ²⁵
• Miscellaneous: randomly utilized tests such as urinalysis. ²⁵

Conclusion

The devastating effects of bacterial diseases on avian populations are enormous. As science continues to explore and understand the number and function of current bacterial pathogens, newly discovered bacteria await analysis and description. Bacteria that are harmful to birds, both pet and wild, are unable to be identified without cytology and histopathology to define them.

Care must be taken by owners to keep the aviaries scrupulously clean, watch for signs of infection, and obtain proper diagnoses and treatments from avian veterinarians as soon as possible. Therapeutics provide the optimum chance of eliminating the disease if it is caught early. Bacteria travel and reproduce quickly, so there is no time to waste. Constant observation of the bird and his environment is of utmost importance.

References

1. Anderson L. Antibiotics Guide. Drugs.com. https://www.drugs.com/article/antibiotics.html x

2. Avian Biotech. Clostridium. Avianbiotech.com. 1995

http://www.avianbiotech.com/diseases/clostridium.htm

3. Avian Biotech. Mycobacterium avium, or Avian Tuberculosis.

Avianbiotech.com http://www.avianbiotech.com/Diseases/AvianTuberculosis.htm

4. Avian Biotech. Salmonella. http://www.avianbiotech.com/diseases/salmonella.htm

5. Bacteria. The Encyclopedia of Life. http://www.eol.org/info/455

6. Bacterial Diseases of Pet Birds. Merck Veterinary Manual.

http://www.merckvetmanual.com/exotic-and-laboratory-animals/pet-birds/bacterial-diseases-of-pet-birds#v4631675

7 Birds and Antibiotics. Parrot Parrot

Birds and Antibiotics

8. Blood D. et al. Saunders Comprehensive Veterinary Dictionary, Third Ed. Saunders/Elsevier 2007

9. Briscoe JA, et al. Methicillin-Resistant Staphylococcus aureus–Associated Dermatitis in a Congo African Grey Parrot (Psittacus erithacus erithacus) (Abstract). Journal Avian Med and Surgery December, 2008: Vol. 22, Issue 4 (Dec 2008), pp. 336-343

10. Brown D. Histopathology. Under the Microscope. ABK Pub. 2003

11. Brue R. Nutrition. In: Avian Medicine: Principles and Application, Ritchie, Harrison, p. 65

12. Campylobacter. Go Pets America. http://www.gopetsamerica.com/bio/bacteria/campylobacter.aspx

13. Cannon MJ, A Guide to Basic Health & Disease in Birds. ABK Publications. 2002

14. Clubb S. and Flammer K. Preventing Bacterial Disease in the Home. In: Avian Medicine: Principles and Application. Ed. Harrison. Spix Pub. Co. 2006, pp. 54-58

15. Dahlhausen Bob, et. al. Diagnosis of Mycobacterial Infections in the Exotic Pet Patient with Emphasis on Birds. Vet Clin Exot Anim These are the routine stains used in avian cytology, histopathology, and histology. Each of these stains is used for a particular purpose, depending on what the bird is being tested for. Vol.15 (2012) 71–83, vetexotic.theclinics.com © 2012 Pub Elsevier, Inc.

16. Difference Between Bactericidal and Bacteriostatic. Differencebetween.com. 2013

Difference Between Bactericidal and Bacteriostatic

17. Dinev I. Diseases of Poultry. http://kenanaonline.com/files/0032/32316/paratyphoid-infections.htm)

18. Doneley B. Central Nervous System Disorders. Avian Medicine and Surgery in Practice. Manson Pub. Inc. 2011 p. 205, 209, 211

19. Doolan M. Zoonotic Bacterial Infections from Human to Bird. Cockatoo Message Board. www.mytoos.com

20. Durairaj V. and Clark D. Necrotic Enteritis. Avian Advice Newsletter In: The Poultry Site, 2007 http://www.thepoultrysite.com/articles/846/necrotic-enteritis/

21. Fiskett RA, Reavill DR. Disease Conditions and Clinical Signs of Pet Birds. Proc Assn Avian Vet 2004, pp.245-266

22. Flammer K. Treatment regimens. In: Avian Medicine: Principles and Application. Ritchie, Harrison, and Harrison Ed. Harrison. Spix Pub. Co. 2006 p. 437

23. Forbes N, Altman R. Self-assessment Color Review of Avian Medicine. Manson Publ./The Veterinary Press. 1998

24. Gerloch H. Defense Mechanisms of the Avian Host. In: Avian Medicine: Principles and Applications. Ritchie, Harrison, and Harrison Ed. Harrison. Spix Pub. Co. 2006 p. 149

25. Harris D. Clinical tests. Handbook of Avian Medicine, 2^nd Ed., Ed. T. Tully. Saunders/Elsevier Pub. 2009

26. Hoppes SM. Bacterial Diseases of Pet Birds, In: Merck Veterinary Manual. Pub: Merck, Share, and Dohme. 2016 p. 14, http://www.merckvetmanual.com/exotic-and-laboratory-animals/pet-birds/bacterial-diseases-of-pet-birds.

27. Jackwood M. Overview of Bordetellosis in Poultry. In: Merck Vet Manual. Pub: Merck, Share, and Dohme. 2016. http://www.merckvetmanual.com/poultry/bordetellosis/overview-of-bordetellosis-in-poultry

28. Jenkins J. Diseases of Small Passerine Birds. Avian and Exotic Animal Hospital. http://www.drexotic.com/diseases-of-small-passerine-birds/

29. Jilani. Difference Between Aerobic and Anaerobic Bacteria. DifferenceBetween.net. April 18, 2010 < http://www.differencebetween.net/science/difference-between-aerobic-and-anaerobic-bacteria/

30. Kaufman G. Bacterial Diseases. Lectures Zoo Med: Psittacine Medicine (2008)

http://ocw.tufts.edu/Content/60/lecturenotes/832349

31. Kratz R, Siegried D. Biodiversity and Classification, and Fighting Back: Human Defenses. Biology for Dummies, 2^nd Ed. Pub. John Wiley & Sons, Inc. 2010 p. 148-149, 260-261

32. Margolin T. Pseudomonas. In: Hot Spot for Birds. http://www.multiscope.com/hotspot/articles/pseudomonas.htm

33. Marshall R. Psittacosis. In: Beauty of Birds website. https://www.beautyofbirds.com/psittacosis.html

34. Marshall R. What is a bacterial infection? In: Beauty of Birds. https://www.beautyofbirds.com/bacterialinfection.html

35. Medical Importance of Bacteria. Go Pets America http://www.gopetsamerica.com/bio/bacteria/index.aspx

36. Microbewiki. Bordatella. https://microbewiki.kenyon.edu/index.php/Bordetella

37. Miesle, J. The danger of cats, in the files of “The Science of Avian Health.”

38. Miesle Terrence.J., M.S. Senior Chemist, Sensient Foods, personal communication

39. Mikesh L. Five different types of bacteria. Livestrong 2017 http://www.livestrong.com/article/117677-five-different-types-bacteria/

40. Morishita T. Overview of Streptococcosis in Poultry. Merck Veterinary Manual, 2018 © 2018 Merck Sharp & Dohme Corp. http://www.merckvetmanual.com/poultry/streptococcosis/overview-of-streptococcosis-in-poultry

41. Optical Microscopy. Wikipedia https://en.wikipedia.org/wiki/Microscopy

42. Payne J. Antibody and Antigen tests. Patient. 2015 https://patient.info/health/antibody-and-antigen-tests

43. Ritchie B, Dreesen D. Avian Zoonoses: Proven and Potential Diseases, Part I: Bacterial and Parasitic Diseases. In: Practical Avian Medicine, The Compendium Collection. Ed: Heidi L. Hoefer. Pub: Veterinary Learning Systems, 1997.

44. Rodgers W. Bacterial Contamination of Food, Animal Hospitals USA. http://www.animalhospitals-usa.com/birds/bird-diseases/bacterial-culture.html

45. Staphylococcus. Go Pets America. http://www.gopetsamerica.com/bio/bacteria/staphylococcus.aspx

46. Speer B. Diagnosis and Management of Key Infectious Diseases. Proc Latin Am Vet Conf. Reprinted in the IVIS website with the permission of the LAVC, http://www.ivis.org/ 2009, p. 330-339

47. Spiral Bacteria. Wikipedia https://en.wikipedia.org/wiki/Spiral_bacteria

48. Stephens E., Antibiotics. E Medicine Health 2016

http://www.emedicinehealth.com/antibiotics/page2_em.htm

49. Styles D. Bacterial Disease And Antimicrobial Therapy In Avian Species. Proc N. Am Vet. Community. Reprinted in the IVIS website with the permission of the NAVC 2005

50. Sweat R. Treatments Recommended For Avian Respiratory Problems. Veterinary Practice News 2009 http://www.veterinarypracticenews.com/Vet-Dept/Avian-Exotic-Dept/Avian-Respiratory-Problem-Treatments/

51. The Light Microscope. Experimental Biosciences, Rice University Press. (http://www.ruf.rice.edu/~bioslabs/methods/microscopy/microscopy.html)

52. Tlaskalova-Hogenova H. Commensal bacteria (normal microflora), mucosal immunity and chronic inflammatory and autoimmune diseases. Abstract In: Immunology Letters, Volume 93, Issues 2–3, 15 May 2004, Elsevier Pub. Co. Pages 97-108 http://www.sciencedirect.com/science/article/pii/S0165247804000379

53. Todd E.C.D. History, Science and Methods. In: Encyclopedia of Food Safety, Science Direct, 2014

54. Vidyasagar A. What are Bacteria? Live Science. https://www.livescience.com/51641-bacteria.html 2015

55. Walker C. Streptococcal Infections in birds. Melbourne Bird Vet Clinic. 2015 http://www.melbournebirdvet.com/streptococcus-infections-in-birds.aspx

56. Weir S. E. Coli Infection in Pigeons. The Pigeon Insider. 2002

E. Coli Infection in Pigeons

57. What is the difference between cytology and histology? DifferenceBetween.Com. June 7, 2012. http://www.differencebetween.com/differences-between-histology-and-vs-cytology/

58. What is the difference between true and opportunistic pathogens? Answers.com (http://www.answers.com/topic/opportunistic)

59. Wikipedia. Histopathology. 2017 https://en.wikipedia.org/wiki/Histopathology

60. Wikivet. Bordetella Avium. https://en.wikivet.net/Bordetella_avium

61. Wissman M. Bacterial Issues In Pet Birds. www.exoticpetvet.net. 2009

Appendix A, from p. 31

Staph vs MRSA – What’s the Difference?

Staph vs MRSA – What’s the Difference? (staph-infection-resources.com) Image courtesy Staph Infection Resources

The differences between MRSA versus S. aureus are significant when it comes to antibiotics and infection control. The key differences listed below play a big role in treatment effectiveness and how quickly a person recovers. In many other ways, however, the differences can be minimal between these two infections.

How they are alike

• The symptoms of MRSA vs S. aureus are very similar. MRSA can be more virulent and more invasive than S. aureus. The rare and deadly form of these infections, called “flesh eating disease” (necrotizing fasciitis,) is more commonly caused by MRSA rather than S. aureus.
• In photos, MRSA and S. aureus look nearly identical. Because they look so alike, the best way to tell them apart is to get tested.
• Both of these infections are also contagious and can easily spread from person-to-person or from contaminated surfaces.
• The most effectively used alternative remedies can work equally well for both S. aureus and MRSA. The lack of resistance issues with most natural and alternative therapies is one of their big benefits.
• MRSA and S. aureus are the same species of bacteria. MRSA (short for Methicillin Resistant Staphylococcus Aureus) is just a special kind of Staph (short for Staphylococcus aureus, or more commonly Staph aureus). The main differences between the two are listed below.

Key differences

• The big difference between S. aureus and MRSA is with antibiotic treatments. MRSA is resistant to most commonly used drugs, but S. aureus is much less resistant. This is an important difference when it comes to choosing the right antibiotic for an infection. MRSA also tends to result in longer, more expensive hospital stays than S. aureus.
• S. aureus is more common than MRSA. Around a third of the people in the U.S. are carriers of S. aureus bacteria on their skin, while fewer than 5% carry MRSA. S. aureus bacteria are extant and a natural part of the environment. Thankfully, MRSA is still mostly confined to hospitals and healthcare environments, but it has been growing rapidly in the community over the last decade or so.
• MRSA can be harder to kill on surfaces than S. aureus. For some disinfectants, such as silver-based products, the kill time for MRSA can be two or three times the kill time for S. aureus.

S. aureus as MRSA (image courtesy CDC) https://www.cdc.gov/mrsa/community/photos/photo-mrsa-1.html).

Appendix B: from p. 34

Case Study: Author’s rescued cockatiel, Boots. Severe sinus and eye bacterial infection.

The attending veterinarian is Dr. Bob Dahlhausen.

May 25, 2021. The bird arrived at the author’s home. Weight: 100 g. There was a heavy scab over the right eye, pushing skin and bone out, away from the eye. I removed the scab and blood and other fluids emerged from the eye. The next day I took him to the avian veterinarian. He had had sinusitis for a long period of time, and this led to the globe collapsing and the lens beginning to calcify. Dr. Dahlhausen injected an antibiotic directly into the bulbar conjunctiva under the globe. The antibodies had infused deposits in the lens.

Severe sinus infection in the author’s cockatiel. The bacteria was Streptococcus aureus. The image was taken after the scab was removed; the orbit had collapsed, and the eye had sunk down under the skin. For several days, the tissue leaked blood and fluid. The scab had pushed the skin and feathers away from the eye in a circular manner, and a hard ring of the forced tissue remains (see black arrow) (image courtesy J. Miesle).

Severe sinus infection in a cockatiel. This is a bird with a similar condition. The scab is still on this bird’s eye, and it gives you an idea of what the author’s bird looked like when she took him in (image courtesy Melbourne Bird Vet; used with permission).

He was to be kept separated until the results of chlamydia test came back. Everything in the respiratory tract was inflamed, and there was undigested fiber in the stool. Gram’s stains showed pus and gram-positive bacteria. The eye could not be removed because the optic nerve is short, and any pressure or tension would kill the bird. He would manage it medically. Boots has no vision in the eye. I was to put warm compresses on it to sooth it and prevent a recurrence of it scabbing over. I was also to put drops of saline solution in the eye 3-4 times a day for at least 2 weeks, probably much longer, to prevent the eye from closing up. If that happened, the infection could start up again since the fluid would not be able to drain. He also gave me an antibiotic cream to put on the eye daily. Boots was started on Azithromycin and that continued for several weeks. His weight was 100 g. when he was taken in. I had begun giving him Emeraid Nutritional Supplement, both Omnivore and Carnivore, plus vitamins, several times a day from the first day on. He continues to receive this to the present day and it will continue indefinitely. His left eye has a large cataract on it, preventing sight. He is, for the most part, blind.

The chlamydia test was negative. By the 31^st, his weight had plummeted to 80 grams and he was losing more each day. He had no appetite.

June 4: Boots’ weight was down to 73 g. We made an emergency visit to Dr. Dahlhausen at 8 a.m. He gave Boots two injections: Robenacoxib and Doxycycline. He said they would begin to work in a few hours. He also said there’s a pocket of pus in the right eye which is causing the infection to remain.

Ball of pus in the conjunctiva (image courtesy J. Miesle).

I’m to put the antibiotic cream he gave me into it four times a day and to continue giving the Emeraid mixture as often as possible. It’s touch and go now to see if we can turn this infection around. I continued to put either thin mashed potato or dampened Rice Krispies in his beak and syringe the Emeraid Omnivore and Carnivore with vitamins mix into the mouth to help it go down. I give him the Emeraid every 2 hours and the food every 2-3 hours, and I get him up every night around 12 to do this again.

June 7: His appetite has improved and he is up to 78 g. He received more azithromycin from Dr. Dahlhausen and another tube of ophthalmic antibiotic ointment for his eye.

June 14: Every attempt to save his life is being made. We returned to the doctor. The left eye with the cataract is not as red, and the oral tissues are also not as red. He can see a little out of it; I suspect he sees light, and is seeing a little out of the peripheral vision. The ocular bulb will eventually coalesce down till there’s nothing left. The little ball of pus and bacteria is under the bulbar conjunctive tissue, so there will always be something there. Hopefully, it will eventually be absorbed by the body. The doctor just wants to be sure it doesn’t start up the infection once we finish the Azithromycin. He will be on the Azithromycin for 3-8 more weeks. I am to watch the redness in his oral cavity and eyes daily. They seem to be clearing up. He gave me more Azithromycin, and I’m to bring him in every week for the next 3 weeks.

June 21. In for another checkup and more Azithromycin.

June 28. In for another injection of Robenacoxib and Doxycycline

July 6. In for checkup. More eye ointment and another doxy injection. Weight: 89 g. He is stable and continues to eat well. The eye is looking much better.

July 22. The eye is less red and watery. I’m to keep it from closing up by using the antibiotic drops and ointment.

Aug 19. I am to continue putting antibiotic drops and/or eye antibiotic cream into the eye daily. Weight is stable at 89. He is enjoying his food and finding his way around the areas in which he was placed. He can see a little out of the left eye. The circular ridge around the eye is permanent; it is result of the scab pushing the skin away from the eye and impaling the skin.

Oct 22. The eye continues to be in the same condition; however, the tissue in and around the orbit tends to get red when touched. It is extremely thin and fragile. This past week I have noticed very tiny pieces of matter coming out of the orbital area. I remove them with a Q-tip and I notice some moisture coming with them; this makes me sure they are coming out of the orbit. I am continuing to put the sterile drops and ointment on the eye. I believe that little ball of pus in the orbit is breaking down as it appears to be getting smaller. Tiny feathers are beginning to grow on the skin around the circular area.

Nov. 3. Boots’ feather coat is very heavy, and he is beginning to preen more than he had. He is flapping his wings when held out a little better than before. He still doesn’t seem to know how to do this, but we keep working on it. He seems to be seeing a little more than he had with his good eye.

An important part of their dietary regimen is nuts and seeds, which play a significant role in providing essential nutrients.

However, it’s important to understand that while these items are beneficial, they should be given in moderation as part of a well-rounded diet.

Nuts and seeds offer vital fats, proteins, and other nutrients.

In the following sections, I will delve into what types of nuts and seeds are most beneficial for African Greys, those that should be avoided, and guidelines for incorporating them into their diet effectively.

Best Nuts and Seeds for African Greys

Here is a list of recommended nuts and seeds, along with their specific nutrients and benefits.

Nuts

• Almonds: Almonds are a great source of vitaminn E, magnesium, and calcium. Vitamin E supports skin and feather health, magnesium aids in nerve and muscle function, and calcium is crucial for bone strength and beak health.
• Walnuts: Rich in omega-3 fatty acids, walnuts support brain health and cognitive function in African Greys. They also contain antioxidants that help combat oxidative stress in the bird’s body.
• Pecans: Pecans are another excellent source of healthy fats and protein. They provide energy and are beneficial for maintaining healthy plumage.
• Pistachios: These nuts are not only a good protein source but also contain antioxidants and essential fatty acids. They contribute to a healthy cardiovascular system and robust immune function.
• Other nuts: African Grey Parrots can also be offered Macadamia nuts, Brazil nuts, pine nuts, hazelnuts, and cashews

Seeds

• Sunflower Seeds: While high in fat, sunflower seeds are a good source of vitamin E, B vitamins, and minerals like selenium and magnesium. They should be given in moderation due to their high fat content.
• Pumpkin Seeds: Pumpkin seeds are known for their zinc content, which is vital for immune health. They also provide magnesium and other trace minerals.
• Safflower Seeds: Lower in fat compared to sunflower seeds, safflower seeds are a good alternative. They provide essential fatty acids and can help maintain a healthy weight.
• Hemp Seeds: Hemp seeds are a powerhouse of nutrition, offering a perfect balance of omega-3 and omega-6 fatty acids. They are also a good protein source and contain various vitamins and minerals.
• Flax Seeds: High in omega-3 fatty acids, flax seeds are beneficial for skin and feather health. They also have anti-inflammatory properties.
• Chia Seeds: Chia seeds are rich in omega-3 fatty acids and fiber. They are excellent for digestive health and also provide calcium and antioxidants.

Each of these nuts and seeds brings unique nutritional benefits to an African Grey’s diet.

However, it’s important to remember that they should be fed in moderation as part of a balanced diet.

The high fat content of some nuts and seeds means they should be given as part of a varied diet that includes other food groups to ensure overall health and well-being.

Nuts and Seeds to Avoid

While many nuts and seeds are beneficial for African Grey parrots, there are certain types that should be strictly avoided due to their potential toxicity or harmful effects. 

Here is a list of nuts and seeds that are not safe for African Greys, along with the reasons why they should be excluded from their diet:

• Avocado Pits: The pit and skin of avocados contain persin, a fungicidal toxin that can be fatal to birds. Even small amounts can cause cardiac distress and respiratory difficulty.
• Apple Seeds: Apple seeds contain amygdalin, a compound that releases cyanide when digested. While a small amount may not be harmful, it’s best to avoid the risk and remove the seeds before offering apples to your parrot.
• Cherry Pits: Like apple seeds, cherry pits also contain cyanide-producing compounds. It’s crucial to remove these pits before feeding cherries to African Greys.

• Fruit Pits and Seeds from Stone Fruits: Pits from fruits like peaches, plums, and apricots also contain cyanide precursors and should be avoided.
• Unshelled Peanuts: While peanuts themselves are not toxic, the shells can harbor Aspergillus mold, which produces aflatoxins. These toxins can lead to liver damage and other health issues in birds.
• Salted Nuts: Salted nuts can lead to excessive sodium intake, which is harmful to African Greys. High salt levels can cause dehydration, kidney damage, and other health problems.
• Chocolate-Covered Nuts: Chocolate is toxic to birds due to the presence of theobromine and caffeine. Any nuts coated with or containing chocolate should be avoided.
• Processed or Flavored Nuts: Nuts that are processed or flavored often contain additives, preservatives, and other ingredients that are not safe for African Grey parrots.

It’s important to ensure that any nuts or seeds fed to African Greys are fresh, raw, and free from these harmful substances.

Always err on the side of caution and avoid feeding any nuts or seeds that you are unsure about.

A good rule of thumb is to offer only those foods that are known to be safe and healthy for your bird.

Proportion of Nuts and Seeds in the Diet

For African Grey parrots, the proportion of nuts and seeds in their diet should be carefully managed to maintain optimal health.

Nuts and seeds, while nutritious, are high in fat and should not constitute the majority of their diet.

• Nuts and seeds: These should make up about 10% of the African Grey’s total diet. This percentage ensures that the birds receive the benefits of these foods without the risks associated with overconsumption, such as obesity or nutritional imbalances.
• Pellets: Formulated pellets should be the staple of an African Grey’s diet, comprising about 60% to 70%.
• Fruits and vegetables: Around 20% to 25% of the diet should consist of fresh fruits and vegetables. These provide essential vitamins, minerals, and fiber, contributing to digestive health and overall well-being.
• Occasional Treats: Treats, including certain human foods that are safe for birds, can be offered sparingly and should not exceed 5% of the diet.

It’s important to note that the dietary needs of African Grey parrots can vary based on factors like age, health status, and activity level.

Therefore, it’s advisable to consult with a veterinarian or an avian nutritionist to tailor the diet to the specific needs of your bird.

Regular monitoring of the bird’s weight and health is also crucial to ensuring that the diet remains appropriate and beneficial.

Preparing Nuts and Seeds for African Greys

Proper preparation of nuts and seeds is essential for the safety and health of African Grey parrots.

Raw vs. Cooked

Generally, raw nuts and seeds are preferable, as cooking can destroy some of the essential nutrients.

However, ensure they are fresh and free from mold or spoilage.

Shelled vs. Unshelled

Offering both shelled and unshelled nuts and seeds can be beneficial.

Unshelled varieties provide a foraging activity and help in beak conditioning, but shelled ones are easier to eat and portion.

As mentioned earlier, unshelled peanuts are an exception to this.

Other Tips

• Always wash and clean nuts and seeds thoroughly to remove any pesticides or contaminants. Organic options are ideal to minimize exposure to harmful chemicals.
• Ensure that the nuts and seeds are free from salt, sugar, or other additives. These substances can be harmful to African Greys.
• Store nuts and seeds in a cool, dry place to prevent spoilage. Refrigeration can help preserve their freshness, especially in warmer climates.

By following these guidelines, you can safely incorporate nuts and seeds into your African Grey’s diet, providing them with the nutritional benefits these foods offer while minimizing any potential risks.

How to Feed Nuts and Seeds to Your African Grey Parrot

Introducing nuts and seeds into the diet of African Grey parrots should be done thoughtfully to ensure they are a beneficial part of their overall nutrition.

Start by introducing small quantities of nuts and seeds into their diet.

This allows you to monitor their reactions and preferences, and it also gives their digestive system time to adjust.

Given the high-fat content in nuts and seeds, it’s crucial to control the portion sizes.

As a general guideline, a couple of nuts and a small handful of seeds per day are sufficient for an African Grey.

Remember, nuts and seeds should not be a constant part of their daily diet. Instead, they should be given as treats or mixed with other foods a few times a week.

This frequency ensures they get the benefits without the risk of overconsumption.

Offer a variety of nuts and seeds to provide a range of nutrients. However, ensure that all types are safe for African Greys and avoid those that are toxic or harmful.

Lastly, pay close attention to your bird’s response to different nuts and seeds. This will help you determine their preferences and any adverse reactions.

Risks of Too Much Focus on Seeds in an African Grey Diet

The high-fat content in seeds can easily lead to obesity in African Greys.

Obesity in birds is a serious health concern and can lead to other complications such as fatty liver disease, heart disease, and a reduced lifespan.

Moreover, seeds, while rich in fats, generally lack essential nutrients like certain vitamins and minerals.

A diet with a high concentration of seeds can lead to deficiencies in vitamin A, calcium, and other nutrients, which are crucial for maintaining good health.

Conclusion

In conclusion, nuts and seeds are a valuable part of an African Grey parrot’s diet, offering essential nutrients like fats, proteins, vitamins, and minerals.

However, they should only constitute a small portion of the diet, ideally around 10%, with the rest being balanced with pellets, fruits, and vegetables.

It’s crucial to avoid certain harmful nuts and seeds and to introduce and prepare them correctly. Portion control and variety are key to ensuring these foods contribute positively to the bird’s health.

By adhering to these guidelines, owners can ensure their African Grey parrots enjoy a nutritious, balanced diet that supports their overall well-being.

The most important thing to know is what to give and specifically what not to offer to your African Grey.

In this article, I explore the natural and captive dietary habits of African Grey Parrots, their nutritional needs, and address the key question: are African Greys herbivores?

African Grey Diet in the Wild

In the wild forests of West Africa, African Grey Parrots (Psittacus erithacus) primarily feed on a variety of seeds, nuts, fruits, and berries.

Like most wild birds, their diet is seasonally influenced, with the types of seeds and fruits they consume varying throughout the year.

A significant component of their diet includes the fruits of the African oil palm, which is native to their environment.

These fruits are a vital source of calories and nutrients, especially during the dry season when other food sources might be less abundant.

Additionally, African Greys in the wild also feed on leafy matter, tree bark, and occasionally on insects, which means that they are omnivorous in the wild.

Dietary Needs in Captivity

In captivity, African Grey Parrots require a carefully balanced diet to maintain their health and longevity.

A common misconception is that these parrots can thrive on a purely pellet-based diet.

However, pellets alone do not provide all the necessary nutrients and can lead to health issues. Instead, a combination of pellets, fruits, and vegetables is recommended for a well-rounded diet.

Pellets should form the cornerstone of an African Grey’s diet, constituting about 75-80% of their daily food intake.

These pellets are specially formulated to meet the nutritional needs of parrots, providing a balanced mix of vitamins, minerals, and amino acids.

This high proportion of pellets helps prevent nutritional deficiencies that can arise from a diet overly reliant on seeds.

Fruits and vegetables are also crucial, making up about 20-25% of the African Grey’s diet. It’s important to offer a variety of these to ensure a range of vitamins and minerals.

Fruits should be given in moderation due to their sugar content, ideally not exceeding 10% of the daily diet.

Vegetables, on the other hand, can be more liberally included. They provide essential nutrients and can be offered both cooked and raw, depending on the type.

While seeds and nuts are a natural part of an African Grey’s diet, they should be given sparingly.

These are high in fat and, if overconsumed, can lead to obesity and related health issues. A variety of seeds and a couple of nuts daily is sufficient.

In summary, the dietary needs of African Grey Parrots in captivity are best met with a balanced mix of pellets, fruits, and vegetables, with a limited intake of seeds and nuts.

So, Are African Grey Parrots Herbivores?

African Grey Parrots, both in the wild and in captivity, are not strictly herbivores. In their natural habitat, their diet mainly consists of seeds, nuts, fruits, and berries.

However, they occasionally consume insects and snails, particularly during breeding seasons, which means they are opportunistic omnivores.

In captivity, their diet is primarily plant-based, comprising pellets, fruits, and vegetables.

The pellets, which form the bulk of their diet, are designed to be nutritionally complete and may contain animal-derived ingredients.

Therefore, while predominantly herbivorous, African Grey Parrots are strictly omnivorous, consuming both plant and animal matter as part of their diet.

Frequently Asked Questions

Conclusion

To summarize, these intelligent birds are not strictly herbivores; rather, they are opportunistic omnivores.

In the wild, their diet is rich in seeds, nuts, fruits, and berries, supplemented occasionally with insects and snails, especially during breeding seasons.

This omnivorous tendency is crucial for meeting their nutritional requirements in various environments.

In captivity, maintaining a balanced diet is essential for the health and longevity of African Grey Parrots.

A diet solely based on pellets is insufficient. Instead, a combination of pellets, fruits, and vegetables is necessary to provide a comprehensive range of nutrients.

Pellets should form the majority of their diet, complemented by a variety of fruits and vegetables and a limited intake of seeds and nuts to prevent nutritional deficiencies and health issues related to obesity.

Feeding frequency directly impacts their physical health, mental well-being, and overall lifespan.

In this article, I will go into the specifics of how often these birds should be fed, taking into account various life stages—from hatchlings to seniors—and special conditions like breeding and health issues.

A good feeding schedule can ensure that African Grey Parrots can thrive in a domestic environment.

Feeding Frequency Basics

When it comes to African Grey Parrots, there is no one-size-fits-all answer for how often they should be fed.

However, general guidelines suggest that adult African Greys typically require feeding twice a day.

This routine aligns with their natural foraging behavior as well as satisfying their nutritional needs.

Several key factors influence the ideal feeding frequency for these parrots:

• Age: The age of the parrot plays a pivotal role in determining feeding frequency. Younger birds, especially those still weaning, need more frequent feedings compared to adults. As they grow, the frequency gradually decreases until it stabilizes in adulthood.
• Activity Level: Active birds may require more frequent feedings or larger portions to meet their energy needs. Conversely, less active or sedentary parrots might need fewer calories, impacting the amount and frequency of their feedings.
• Health Status: A parrot’s health significantly influences its dietary needs. Birds with certain health conditions or those recovering from illness may have different feeding requirements. Consulting with a veterinarian is crucial in these cases to tailor the diet appropriately.
• Environmental Conditions: The parrot’s environment, including temperature and lighting, can affect its metabolism and, consequently, its feeding needs. Birds in cooler environments, for instance, might require more energy to maintain body heat, influencing their feeding frequency and portion sizes.

I will discuss all of this in more detail in the sections that follow.

How Many Times to Feed African Grey Parrot for Different Life Stages

Young and Weaning African Greys

• Frequency and Type of Feed: Hatchlings and birds under 12 weeks require frequent feedings with a specialized hand-rearing formula. These young birds typically need feeding every few hours.
• Transitioning to Solid Foods: As they approach 12 weeks, the frequency of hand-feeding decreases as they gradually transition to solid foods. This phase involves introducing a mix of pellets, seeds, and soft fruits and vegetables.

Juvenile African Greys

• Adjusting Feeding Frequency: As African Greys grow into juveniles, their feeding frequency can be reduced. They start to eat more solid food per feeding session, reducing the need for frequent feedings.
• Introduction to a Varied Diet: Introducing a variety of foods at this stage is crucial for their development and can affect how often they need to be fed. A variety of foods, including pellets, seeds, fruits, and vegetables, are recommended.

Adult African Greys

• Standard Feeding Frequency: Healthy adult African Grey Parrots typically do well with a well-balanced diet of two meals per day. This schedule aligns with their natural foraging instincts and helps them maintain a healthy weight.
• Active vs. Less Active Birds: Active birds may require slightly more food or more frequent feedings, while less active birds might need less to avoid weight gain.

Breeding African Greys and Those Laying Eggs

• Increased Nutritional Needs: Breeding birds and those laying eggs have higher nutritional requirements. This may necessitate more frequent feedings or increased food portions to meet their energy needs.
• Special Dietary Considerations: Breeding females, in particular, need a diet rich in calcium and other nutrients to support egg production and their overall health.

Senior African Greys

• Adjusting Feeding Frequency for Older Birds: As African Greys age, their metabolism slows down. This change might require adjustments in feeding frequency and portion size to prevent obesity.
• Addressing Dietary Needs: Senior birds may also have specific dietary needs due to age-related health issues. Regular veterinary check-ups can help tailor their daily diet to these changing needs.

Special Considerations

Impact of Health Issues on Feeding Frequency

African Grey Parrots are prone to obesity, especially in captivity, due to reduced activity levels.

If a parrot is overweight, it may require a reduction in feeding frequency or portion size, along with a diet lower in fat.

Similarly, birds with liver disease or other metabolic disorders may need a specialized diet.

The frequency and type of feeding might change to include more liver-friendly foods and supplements, as recommended by a veterinarian.

Seasonal Changes and Their Effect on Feeding Routines

Like many birds, African Greys can be affected by seasonal changes. During colder months, they might require more calories to maintain body heat, leading to slight increases in food quantity or frequency.

Conversely, in warmer months, their metabolic rate might decrease, necessitating a reduction in feeding frequency or portion size to prevent weight gain.

Practical Feeding Tips

Best Practices for Feeding African Greys at Different Life Stages

• Consistency: Maintain a consistent feeding schedule to help regulate the bird’s metabolism and digestive system.
• Variety: Ensure a varied diet at all life stages to provide a range of nutrients and prevent boredom.
• Quality: Choose high-quality pellets and fresh produce. Avoid processed foods and those high in sugar and fat.

Monitoring Weight and Health to Adjust Feeding Frequency as Needed

• Regular Weigh-Ins: Regularly weigh your African Grey to monitor for any significant weight gain or loss, which can be indicators of health issues or dietary imbalances.
• Health Checks: Regular health check-ups with an avian veterinarian can help identify any underlying issues that might affect feeding requirements.
• Responsive Adjustments: Be prepared to adjust the feeding frequency and portion sizes based on the bird’s health, weight, and activity level. This approach ensures that the bird receives the right amount of nutrition without overfeeding or underfeeding.

How Many Times a Day Should You Give Water to an African Grey Parrot?

African Grey Parrots should always have access to fresh, clean water. It’s essential to provide them with a constant supply of water, rather than limiting it to certain times of the day.

Their water should be changed at least once daily to ensure it remains clean and free from contaminants.

Additionally, it’s a good practice to regularly clean their water dishes to prevent the growth of bacteria and algae.

Conclusion

There is no static guideline on feeding frequency. How often African Greys need to be fed depends on their individual life stage, health, and environmental conditions.

From the attentive and frequent feedings required for hatchlings and weaning birds to the more regulated schedules for adults and seniors, each phase of an African Grey’s life demands a unique approach to feeding.

Special considerations, such as health issues like obesity or liver disease and the impact of seasonal changes also need to be incorporated in their daily dietary management.African Grey caregivers must ensure that they discuss their bird’s specific needs with avian veterinarians, who can offer the right insight and adjustments to feeding.

This is because of their distinct physiological and metabolic requirements as compared to humans. Their bodies process and react to certain substances in ways that are vastly different from ours, making some of our common foods dangerous for them.

Understanding and respecting these dietary differences is key to ensuring the health and safety of these intelligent birds.

Feeding them inappropriate human foods can lead to serious health complications, including toxicity and nutritional imbalances. In some cases, consumption of certain foods can be fatal to African Greys. Therefore, it’s not just a matter of what is nutritious but also what is safe.

This article aims to provide a clear and concise guide on what foods to avoid feeding African Grey Parrots. I will also try to summarize what constitutes a well-balanced diet for them and the right proportions in which to feed them.

Unsafe Foods for African Grey Parrots

Avocado

Avocado is highly toxic to African Grey Parrots due to the presence of a substance called persin.

Found in all parts of the avocado, including the flesh, persin can cause severe respiratory distress, congestion, and fluid accumulation around the heart in birds.

Ingestion of even a small amount can be fatal, making it imperative to keep avocados away from African Greys.

Chocolate and Caffeine

Both chocolate and caffeine are extremely harmful to African Grey Parrots. These substances contain theobromine and caffeine, respectively, which can overstimulate a parrot’s cardiovascular and nervous systems.

Symptoms of poisoning include vomiting, diarrhea, rapid heart rate, and in severe cases, seizures or death. Therefore, any food or drink containing chocolate or caffeine should be strictly avoided.

Alcohol

Alcohol has a profoundly negative effect on African Grey Parrots. Their small size and unique metabolism make them highly susceptible to alcohol poisoning.

Consumption can lead to disorientation, liver damage, and, in severe cases, respiratory failure. It’s crucial to ensure that these birds are never exposed to alcoholic beverages.

Fruit Seeds and Pits

Many fruit seeds and pits, such as those in apples, cherries, and peaches, contain cyanogenic glycosides, which can release cyanide when ingested.

This can lead to cyanide poisoning in African Grey Parrots, characterized by difficulty breathing, panting, and dilated pupils, and can be lethal.

While the flesh of these fruits is safe, the seeds and pits must be meticulously removed.

Onions and Garlic

Onions and garlic can cause digestive upset in African Grey Parrots and, in larger quantities, can lead to anemia or other health issues.

These foods contain sulfur compounds that can damage red blood cells in birds, leading to weakness and illness.

It’s best to avoid feeding any food containing onions or garlic to these parrots.

Mushrooms

Mushrooms can be toxic to African Grey Parrots. Some varieties of mushrooms contain substances that can cause liver failure or digestive distress in birds.

Additionally, mushrooms offer little nutritional value to parrots, making them an unnecessary risk in their diet.

Salt and Sugar

Excessive consumption of salt and sugar can lead to significant health problems in African Grey Parrots.

High salt intake can cause dehydration, kidney dysfunction, and electrolyte imbalances.

Similarly, too much sugar can lead to obesity, and diabetes. Foods high in salt or sugar should be avoided.

Fatty Foods

Fatty foods pose a risk of obesity and related health issues in African Grey Parrots.

These birds do not require high-fat diets, and excessive fat can lead to liver disease and other health complications.

It’s important to limit the intake of fatty foods to maintain their optimal health.

Tomatoes and Nightshade Plants

Tomatoes and other nightshade plants (like potatoes and eggplants) can be harmful to African Grey Parrots.

These plants contain solanine, a substance that can be toxic to birds. While ripe tomatoes are less harmful, it’s generally safer to avoid feeding them to your parrot.

Dairy Products

African Grey Parrots lack the enzyme necessary to digest lactose, which is found in dairy products.

Feeding them milk, cheese, or other dairy can lead to digestive upset and diarrhea. It’s best to avoid giving any dairy products to these birds.

Raw Rhubarb

Raw rhubarb is another food that is unsafe for African Grey Parrots. This plant contains oxalic acid, particularly in its leaves, which can be toxic to birds.

Oxalic acid can bind with calcium in the body, leading to a deficiency that affects bone health and overall well-being.

Ingestion of rhubarb can also cause irritation in the mouth and digestive tract of African Greys. Given these risks, it’s advisable to keep rhubarb, especially in its raw form, away from these parrots.

Uncooked Beans

Uncooked beans are not safe for African Grey Parrots. They contain a poison called hemagglutinin, which is very toxic to birds.

This substance can cause severe digestive issues and be potentially fatal. It is recommended to thoroughly cook any beans before offering them to your parrot to neutralize this toxin.

Kidney beans, in particular, may be toxic and require careful preparation.

Peanuts

Peanuts can be a controversial topic when it comes to feeding African Grey Parrots.

While peanuts themselves are not inherently toxic to parrots, they can harbor a fungus known as Aspergillus, which can cause a respiratory infection called aspergillosis.

This infection is difficult to treat and can be very harmful to birds. Additionally, peanuts can contain aflatoxins, which are harmful toxins produced by certain molds.

It’s important to ensure that any peanuts fed to African Grey Parrots are fresh, high-quality, and free from mold. Peanuts should be given in moderation due to their high fat content.

Xylitol

Xylitol is a sugar alcohol used as a sweetener in many human foods. It poses a significant risk to African Grey Parrots and all birds.

While it’s a popular sugar substitute in products like sugar-free gum, candies, and some baked goods due to its lower glycemic index for humans, it can be extremely harmful to birds.

Xylitol can cause a rapid release of insulin in many animals, leading to a dangerous drop in blood sugar levels (hypoglycemia).

There is also a risk of liver damage with xylitol ingestion. The liver can be overwhelmed by the toxic effects of xylitol, leading to liver failure, which is a serious condition requiring immediate veterinary attention.

What Constitutes an Optimal Diet for African Grey Parrots?

A balanced diet for African Grey Parrots should include a variety of fruits, vegetables, pellets, seeds, and nuts. This combination ensures they receive the necessary vitamins, minerals, and other nutrients essential for their health.

Specific Beneficial Fruits

• Apples (without seeds): A great source of vitamins but ensure to remove the seeds.
• Bananas: Easily digestible and rich in potassium.
• Berries: Such as blueberries and strawberries, are high in antioxidants.
• Melons: Provide hydration and vitamins.
• Pears: Offer fiber and vitamins, but remember to remove the seeds.

Important Vegetables

• Celery: Low in calories and provides hydration.
• Spinach: A nutrient powerhouse, but in moderation due to oxalic acid content.
• Carrots: High in beta-carotene, which is good for their vision.
• Broccoli: Offers vitamins and minerals.
• Peas: Can be given fresh or frozen for protein and vitamins.

Role of Pellets and Seeds

• Pellets: Formulated to provide a balanced diet and should make up about 50-60% of their diet. Remember that pellets alone are not sufficient.
• Seeds: Should be given in moderation as they are high in fat. Sunflower and pumpkin seeds are good options.

Foods to Use Cautiously

• Citrus fruits: In small amounts due to high acidity.
• Lettuce: Low nutritional value and can cause diarrhea in excess.
• Tomatoes: Only ripe and in moderation, as they belong to the nightshade family.
• Grapes: In moderation due to high sugar content.

This diet, rich in variety and balanced in nutrients, will help ensure your African Grey Parrot remains healthy, active, and vibrant.

What About Food Preparations Available in the Market?

While the above is a list of foods that can be prepared and provided to your African Grey, many complete diet foods are already available in pet food stores.

These foods are formulated to provide balanced nutrition, containing a variety of vitamins, minerals, and antioxidants.

However, when using these foods, remember that variety is key to keeping your parrot interested in its meals.

Different toppings and treats should regularly be added to their diet to maintain excitement and engagement during mealtime​​.

You can also find pellets tailored for African Grey Parrots on the market, loaded with essential vitamins, minerals, amino acids, and a blend of vegetables, seeds, grains, and fruits.

These formulations also include omega-3 fatty acids for brain and heart health, antioxidants for immune support, and prebiotics and probiotics for digestion​​​​​​.

Can African Greys Eat Meat?

In the wild, African Greys are opportunistic omnivores, feeding on small snails and insects when necessary.

In captivity, they may occasionally be given worms, but in general, it is not necessary to do so.

Feeding Practices and Portions

Avoiding toxic foods is important, but just as important are the frequency of feeding, portion sizes, and contents of each portion.

Guidelines on Portion Sizes and Frequency of Feeding

• Pellets: Should constitute about 50-60% of the daily diet. For an average-sized African Grey, approximately 1/4 to 1/2 cup of pellets per day is sufficient.
• Fruits and Vegetables: These should make up about 20-25% of their daily intake. Offer about 1/4 cup of chopped fruits and vegetables each day.
• Seeds and Nuts: Limit to a small handful as treats or part of a foraging activity, not exceeding 10% of their daily diet.

Typically, food should be kept in their feeding bowl once in the morning, and if necessary, it can be replenished once again during the day.

Tips for Preparing and Serving Fruits and Vegetables

1. Always wash fruits and vegetables to remove pesticides and chemicals.
2. Cut into small, manageable pieces to prevent choking and encourage eating.
3. Rotate different fruits and vegetables throughout the week to provide a range of nutrients.
4. Discard any uneaten fresh food after a few hours to prevent spoilage and bacterial growth.

Remember, a varied diet prevents nutritional deficiencies and keeps mealtime interesting for your parrot.

Make sure that you monitor your parrot’s weight regularly to ensure they are not under or overeating. Sudden weight changes can indicate health issues.

Finally, based on activity level, age, and health, adjust food portions. Less active or older pet birds may require fewer calories.

Conclusion

In summary, the health and longevity of African Grey Parrots are heavily influenced by their diet. As I have shared, certain foods that are harmless to humans can be extremely dangerous, even lethal, to these birds.

It is crucial to avoid toxic foods such as avocado, chocolate, caffeine, and others discussed earlier. Awareness and caution in feeding practices play a vital role in preventing accidental poisoning and ensuring the safety of your feathered companion.

Equally important is providing a balanced diet that caters to the unique nutritional needs of African Grey Parrots.

A mix of high-quality pellets, a variety of fruits and vegetables, and a limited amount of seeds and nuts will help in maintaining their overall health.

Lastly, regular veterinary consultations are indispensable. Regular check-ups with an avian vet can help monitor your parrot’s health and adjust their diet as needed.

A balanced diet is crucial for these birds, not just for their physical health but also for their mental well-being.

African Greys are prone to various health issues, including vitamin deficiencies, obesity, and psychological problems, all of which can be mitigated with proper nutrition.

A balanced diet that closely mimics what they would eat in the wild is essential for their physical health, and the variety it offers can also provide mental stimulation, preventing boredom and behavioral issues.

In this article, I will look at one often overlooked component of their diet in their natural habitat: fresh fruits.

I will explain which fruits can be given to them and which ones should be avoided. I will also share tips on how to feed fruits to your pet.

Why African Grey’s Need Fruits?

In their natural habitat, African Greys feed on a variety of fruits, nuts, seeds, and even some protein sources like insects.

Moreover, foraging for food also contributes to their mental and physical health.

Fruits play a significant role in the diet of African Grey parrots.

They are not only a source of essential vitamins and minerals but also provide hydration and fiber, which are crucial for the bird’s digestive health.

Fruits like apples (without seeds), bananas, and berries offer a range of nutrients, including vitamins A and C, antioxidants, and essential minerals.

However, it’s important to note that while fruits are beneficial, they should only form a small portion of the diet.

Overfeeding fruits can lead to health issues due to their sugar content.

Therefore, fruits should be given as part of a balanced diet, complementing other food items like vegetables, pellets, and seeds.

What Fruits Are Good for an African Grey?

African Grey parrots can benefit significantly from a variety of fruits in their diet.

Here’s a list of safe and nutritious fruits for African Greys, along with the specific nutrients they provide and the role these nutrients play in a bird’s health.

Apples (without seeds)

• Nutrients: Apples are a good source of vitamins A and C, as well as fiber.
• Health Benefits: Vitamin A is crucial for maintaining good vision and a healthy immune system. Vitamin C acts as an antioxidant, helping to protect cells from damage. The fiber in apples aids in digestion.

Bananas

• Nutrients: Rich in potassium, vitamins C and B6, and dietary fiber.
• Health Benefits: Potassium is vital for muscle function and maintaining a healthy heart. Vitamin B6 is important for protein metabolism and cognitive development. The fiber content helps in digestive health.

Berries (like strawberries and blueberries)

• Nutrients: Berries are packed with antioxidants, vitamins C and K, and manganese.
• Health Benefits: Antioxidants help in combating oxidative stress in the body. Vitamin K is essential for proper blood clotting and bone metabolism. Manganese plays a role in bone formation and nutrient metabolism.

Melons

• Nutrients: Melons provide vitamins A and C, potassium, and water content.
• Health Benefits: High water content in melons aids in hydration. Vitamin A supports vision and immune health, while potassium is crucial for heart and muscle function.

Pears

• Nutrients: Pears offer vitamins C and K, copper, and fiber.
• Health Benefits: Vitamin C boosts the immune system and acts as an antioxidant. Copper is important for iron absorption and red blood cell formation. The fiber in pears promotes digestive health.

Oranges and other Citrus Fruits (in moderation)

• Nutrients: High in vitamin C, fiber, and flavonoids.
• Health Benefits: Vitamin C is essential for immune function and skin health. Flavonoids have anti-inflammatory and antioxidant properties. Fiber aids in digestion.

Incorporating these fruits into an African Grey’s diet can significantly contribute to their overall health.

However, it’s important to serve these fruits in moderation and as part of a balanced diet, ensuring the birds get a variety of nutrients without overconsumption of any particular one.

Always remember to remove any seeds or pits from fruits, as they can be toxic to birds.

Additionally, consulting with a veterinarian for personalized dietary advice is always recommended to cater to the specific needs of each bird.

Fruits to Avoid

While many fruits are beneficial for African Grey parrots, there are certain fruits and parts of fruits that are harmful or even toxic to them.

It’s crucial for pet owners to be aware of these to ensure the safety and health of their birds.

Avocado

Avocado contains a fungicidal toxin called persin, which is found in all parts of the avocado, including the flesh.

Persin is highly toxic to birds, including African Greys.

Ingestion can lead to respiratory distress, congestion, fluid accumulation around the heart, and even death.

Fruit Seeds and Pits

Many fruit seeds and pits, such as those found in apples, cherries, peaches, and apricots, contain cyanogenic glycosides, which can release cyanide when metabolized.

Even small amounts of these seeds or pits can be lethal to a bird.

Symptoms of cyanide poisoning in birds include difficulty breathing, panting, and dilated pupils, leading to respiratory failure and death.

It’s important to note that the flesh of these fruits (e.g., apple flesh, cherry flesh) is safe for African Greys, but the seeds and pits must be meticulously removed before offering these fruits to your bird.

The risks associated with these toxic substances are severe and can lead to serious health issues or fatalities.

Other Dietary Considerations

While fruits are an important part of an African Grey parrot’s diet, other food types also play crucial roles.

Fresh foods, such as vegetables, pellets, seeds, nuts, and certain foods to avoid or use cautiously, are all key components of a well-rounded daily diet for these birds.

Role of Vegetables in African Grey’s Diet

Vegetables are essential in providing a range of vitamins, minerals, and fiber, which are vital for the bird’s health.

They offer nutritional variety and can help prevent obesity, a common issue in pet birds due to high-calorie diets.

Some vegetables that can be offered to African Grey’s include:

• Celery: Offers hydration and is a good source of vitamins A, C, and K.
• Spinach: Rich in iron, calcium, and vitamins A, C, and K. However, it should be given in moderation due to its high oxalic acid content, which can inhibit calcium absorption.
• Carrots: High in beta-carotene, which is converted into vitamin A, essential for good vision and immune function.
• Other vegetables like broccoli, bell peppers, and leafy greens can also be included. They provide essential nutrients and add variety to the diet.

Importance of a Varied Diet, Including Pellets, Seeds, and Nuts

A varied diet is crucial for meeting all nutritional needs.

Pellets should form the basis of the diet, as they are formulated to be nutritionally complete.

Seeds and nuts should be given in moderation due to their high fat content. Seeds and nuts are good for occasional treats or as part of foraging activities.

Always ensure to keep fresh water in their cage to keep your birds hydrated.

Foods to Avoid or Use Cautiously

Here are some food that should be avoided.

• Mushrooms: Some types can be toxic to birds, and they offer little nutritional value.
• Garlic and Onions: These can cause digestive upset and may lead to anemia or other health issues in birds.
• Chocolate and Caffeine: Highly toxic to birds and should be completely avoided.
• Salt and Sugar: Should be limited as they can lead to health problems.
• Fatty Foods: High-fat foods can lead to obesity and related health issues.

Feeding Practices and Portions

Proper feeding practices and portion control are essential for maintaining the health of an African Grey parrot.

Here are some guidelines on how much and how often to feed fruits, along with tips for preparing and serving them.

How Much and How Often to Feed Fruits

• Portion Size: Fruits should be a part of a well-balanced diet but not the main component. As a general guideline, fruits can make up about 10% of the daily food intake.
• Frequency: Offering fruits daily is fine, but it’s important to vary the types of fruits given to ensure a range of nutrients.

Make sure to regularly monitor your bird’s weight to ensure they are not overeating and gaining excessive weight.

Always use fresh fruits, as they retain more nutrients than canned or processed alternatives. Avoid fruits that are overripe or spoiled.

Thoroughly wash all fruits to remove pesticides and other contaminants. Organic fruits are a preferable choice to reduce the risk of chemical exposure.

Tips for Preparing and Serving Fruits

• Sizing: Cut fruits into small, manageable pieces that are easy for the bird to eat.
• Seed Removal: Ensure all harmful seeds and pits are removed, as these can be toxic.
• Variety: Rotate different fruits to provide a range of flavors and nutrients. This also helps keep the bird interested in their food.
• Serving: Fruits can be served raw. Some birds may prefer certain fruits at room temperature rather than cold from the refrigerator.
• Mixing with Other Foods: You can mix fruits with fresh vegetables or add them to a bowl of pellets to make meals more appealing.
• Observation: Observe your bird’s reaction to different fruits. Some may have preferences or show intolerance to certain types.

By following these guidelines, you can ensure that your African Grey parrot enjoys a healthy and varied diet that includes the right amount of fruits.

Remember, every bird is unique, so it’s important to adjust feeding practices based on individual preferences and health needs.

Regular consultation with a veterinarian can also help tailor the diet to your bird’s specific requirements.

Conclusion

In summary, the importance of a balanced diet for African Grey parrots cannot be overstated.

Fruits, as part of this balanced diet, play a crucial role in providing essential vitamins, minerals, and hydration, contributing significantly to the overall health and well-being of these intelligent birds.

While fruits are beneficial, they should be given in moderation and as part of a diet that also includes vegetables, pellets, seeds, and nuts.

Given the unique dietary needs of each African Grey, I highly recommend consulting with a veterinarian for personalized dietary advice.

A veterinarian can provide guidance tailored to the specific health requirements, age, and lifestyle of your bird, ensuring that their diet supports their health in the best possible way.