AVOCADO/PLANT TOXINS

Basics

Overview
-Toxins found in avocado, onion, leek, chives, garlic and plants such as lily of the valley, foxgloves,
rhododendron, oleander, yew, and Kalanchoe sp affect the cardiovascular system resulting in weakness,
depression, difficulty breathing and collapse.
-Toxins found in umbrella plant, peace lily, dieffenbachia, philodendron, pothos, elephant’s ear, rhubarb,
clematis and poinsettia induce irritation of the oral cavity and GI upset.
-Toxins from crown vetch and plants from the Ericaceae family such as rhododendron cause weakness
and neurological symptoms.

Signalment
-There are no species, age, or sex predispositions to avocado/plant toxins.

Signs
-Healthy bird becoming acutely ill
-Weakness, depression
-Difficulty breathing, rapid breathing
-Swelling of oral mucous membranes
-Pale mucous membranes
-Dysphagia, head shaking
-Ptyalism (increased salivation)
-Regurgitation, vomiting
-Inappetence, anorexia
-Diarrhea
-Incoordination, paralysis, tremors, seizures
-Collapse, coma
-Death

Causes
-Avocado contains a toxin named persin which is found in all parts of the fruit. This toxin induces severe
damage to the heart muscle resulting in heart failure.
- Lily of the valley, foxgloves, rhododendron, oleander, yew, and Kalanchoe sp contain cardiac
glycosides. These substances affect the rhythm and ability of the heart to beat normally.
- Umbrella plant, peace lily, diffenbachia, philodendron, pothos, elephant’s ear, rhubarb contain oxalate
crystals. These components cause inflammation and edema of the lining of the mouth.
-Neurotoxins such as nitrotoxin (crown vetch) and grayanotoxin (rhododendron) affect the function of
nervous cells leading to neurological signs.
-Plants from the Allium family (onion, leek, chives, garlic) contain toxic substances activated by
mechanical manipulation (cutting and crushing of the plant). These compounds destroy red blood cells
leading to various degree of anemia.

Risk Factors
-The presence of avocado or toxic plants in and around the house renders toxic exposure possible.
-Birds allowed to roam freely out of their cage in the house without supervision or birds that are taken
outside to the garden without being directly supervised are at higher risk of plant toxicity.

Treatment

Appropriate Health Care

-Birds exhibiting severe depression, lethargy, difficulty breathing, neurological signs and collapse require
emergency inpatient intensive care management.
-Birds vomiting with/without mouth irritation benefit from inpatient medical management.
-Birds apparently normal with confirmed ingestion of toxic plants may be managed as an outpatient
following a brief hospitalization to administer appropriate treatments.
-Crop lavage should be performed within 2 hours of ingestion of avocado/toxic plants. This procedure
may be performed under sedation or general anesthesia.
-Fluid therapy – replacement or maintenance fluids depending on the clinical state may be required.
Blood transfusion may be considered if severe anemia is present.
-Oxygen therapy – indicated with respiratory distress or anemia
-Warmth – minimize energy spent to maintain body temperature

Activity
-Bird’s activity level should be adjusted according to its general status.
-Birds exhibiting severe illness should be kept in a small, warm environment.
-Birds showing neurological deficits may require an adapted environment with lower perches and
padded surfaces to prevent injury.

Diet
-Birds reluctant to eat may require assisted feeding. Enteral nutrition preparation for birds such as
Emeraid Omnivore (Lafeber company, Cornell, IL) or Exact hand feeding formula (Kaytee, Chilton, WI)
may be offered with a syringe.
-Avoid hard food items if irritation of the oral cavity is present.
-Encourage drinking by offering fresh water, juices, or fresh fruits. Avoid acidic fruits if oral irritation is
present.

Surgical Considerations
-Surgery is not typically indicated for avocado/plant toxicity.

Medications
-Activated charcoal –used to bind toxins and prevent their absorption from the digestive tract
-Cathartics –may be given following or concurrently with activated charcoal; used to improve
elimination of the toxin bound to the activated charcoal; common cathartics include magnesium
hydroxide and sodium sulfate. Adverse reactions to these drugs include diarrhea which can accentuate
dehydration. Alternately, bulking cathartic such as psyllium may be administered.
-Mouth inflammation – coating medication (sucralfate) and nonsteroidal anti-inflammatory medication
(meloxicam) may be administered
-Heart failure –diuretic (furosemide), medication that decrease blood pressure (enalapril) may be
prescribed
-Bronchodilator – indicated if respiratory compromise is present
-Antioxidants such as vitamin E and vitamin C may be given if Allium toxicity is diagnosed.

Follow-Up

Patient Monitoring
-Varies with the toxin ingested and the severity of clinical signs.

Possible Complications
-No response to treatment and progressive deterioration of the bird’s clinical state leading to death
-Aspiration pneumonia
-Chronic cardiac, renal, liver degenerative disease

Expected Course and Prognosis

-Varies with the toxin ingested, the quantity consumed by the bird and the delay between the ingestion
and presentation to a veterinarian.
-Once respiratory signs develop following avocado ingestion, death usually follows quickly.
-Ingestion of calcium oxalate containing plants is generally associated with a good prognosis with no
reported deaths in the avian literature.

Key Points
-There are no tests available to identify various toxins that may be ingested by birds. Diagnosis is
generally based on history provided and the clinical signs exhibited by the bird.
-If a bird is suspected of having ingested avocado or a toxic plant, he should be presented to a
veterinarian within 2 hours following ingestion even if he appears completely normal.
-For all toxin ingestion, initial decontamination treatments include crop lavage and the administration of
activated charcoal. Cathartics may be added to facilitate elimination of toxin bounded to activated
charcoal once dehydration, if present, is addressed.
-Ingestion of toxins affecting only the gastrointestinal system (oxalate crystals) carries a good prognosis
whereas toxins affecting the cardiovascular, neurological, and renal/urinary systems are associated with
a more guarded prognosis if appropriate treatment is not administered promptly following ingestion.

NOTES