IN PRACTICE .
JANUARY 1983
Avian Medicine
A practical approach
to cagebirds
by John E. Cooper
MANY veterinary surgeons claim little knowledge of avian dis-
eases and, with the exception of those who work with poultry,
relatively few deal regularly with birds.
Despite this general lack of interest and experience many
practitioners find it necessary to acquaint themselves with the
care and treatment of cagebirds. Large numbers of birds are
kept in captivity in Britain and these may range from pet
budgerigars in cages to extensive aviaries of foreign finches or
free-flying macaws. The actual numbers are difficult to
ascertain but some indication of the popularity of pet birds is
that the readership of a weekly magazine about cagebirds is
approximately 43,000 - four times the number of people on
the Veterinary Register.
Cagebirds are primarily kept as pets but many are also
exhibited at shows. In addition, some aviculturists take a par-
ticular interest in breeding and often contribute substantially
to our knowledge of the biology of the species. This article is
not intended as a catalogue of diseases. Instead it is hoped that
it will provide practical advice on how to examine and handle
cagebirds and encourage colleagues to use both established
and emerging diagnostic techniques.
Types of bird
Some basic knowledge of the different types of bird will
prove useful to the veterinary surgeon, particularly when
taking a clinical history.
Birds are vertebrate animals in the Class Aves. There are
various Orders of birds but the two of most relevance in avi-
culture are the Psittaciformes and the Passeriformes. The
Psittaciformes are the 'psittacine' birds and consist of parrots,
parakeets (including the budgerigar), cockatoos, cockatiels
and allied species. The Passeriformes are the 'perching birds'
and within this order are most of the commonly kept non-
psittacine species such as finches (including the canary),
thrVshes and starlings. Other Orders of birds are also kept in
captivity - for example the Anseriformes (ducks and geese),
the Columbiformes (pigeons and doves), and Falconiformes
(hawks and falcons) - but these will not be covered speci-
fically in this article.
Two words which are commonly used by aviculturists are
'hardbill' and 'softbill'. These are rather imprecise terms but
provide a rough distinction between those birds which feed on
seed, such as canaries and finches (hardbills) and those which
are predominantly fruit or insect eaters. such as mynahs and
tanagers (softbills).
Requirements of the veterinary surgeon
There are three important requirements if a practising veter-
inary surgeon is to play a meaningful part in the care of cage-
29
birds. These are (a) interest and enthusiasm, (b) an ability to
handle and examine birds and (c) some knowledge of avian
diseases and their treatment.
Interest and enthusiasm are of the greatest importance.
Aviculturists are, in general, not satisfied with the service that
they receive from the veterinary profession. Such barriers can
only be broken down if the veterinary surgeon and aviculturist
work together. The individual vet can contribute to this by
getting to know a local bird keeper and by visiting his premises
in order to learn about cagebirds and their care. Better still he
(or she) should keep some birds in the surgery or at home in
order to become familiar with routine management.
At the same time books should be purchased or borrowed
many of those reviewed in The Veterinary Record are con-
cerned with the keeping of birds rather than their diseases -
and the practice should consider subscribing to one of the bird
journals. In this way the veterinary surgeon will develop confi-
dence and begin to feel less daunted when confronted with an
avian patient.
An ability to handle and examine birds is essential if an
accurate diagnosis is to be made. When presented for veter-
inary attention far too many birds are not even taken out of
the cage; aviculturists complain that in most cases the vet
prescribes 'Terramycin in the drinking water' and no proper
attempt is made either to diagnose the problem or to apply
specific treatment.
Such an approach would be unethical when dealing with any
other species but appears to be condoned when the patient is a
cagebird. It is vital that the veterinary surgeon learns how to
handle birds properly and this can only be achieved by experi-
ence. Every opportunity should be taken to handle normal
birds before a sick one is received. This can be readily learnt
when the practitioner visits an aviculturist or keeps his own
birds.
Knowledge of the ailments of birds is important but less
essential than the first two requirements. There are many
excellent books available on the subject and a selection of
these is listed. Colleagues who are already experienced in the
field can also be consulted but are far more likely to be able to
offer sound advice if the veterinarian has already carried out
an initial examination.
Handling and restraint
Before handling a sick bird a full history should be taken.
The bird should then be observed in its cage or aviary - both
at rest, when its general appearance and respiration rate can be
assessed, and on the move (hopping or flying) when any loco-
motory disturbances will become apparent.
It is important to view a bird from more than one direction;
a blind eye or unilateral injury can be easily missed if it is on
the other side of the body. A bird which will perch on its
30 IN PRACTICE JANUARY 1983

A zebra finch (Taeniopygia guttata) is held in the hand for Inhalation agents are commonly used to anaesthetise a
examination. Small birds must be restrained gently bird for diagnostic procedures. The picture shows an
intubated raven (Corvus corax)

owner's hand provides an excellent opportunity for close and quickly before the patient recovers. If anaesthesia needs to be
detailed scrutiny. maintained intubation can be carried out very easily.
A useful aid to observation is subdued lighting. Most birds
become inactive if it is dark and under these circumstances a Injection of ketamine or alphadalone-alphaxalone. The
more careful examination can be performed before handling is author uses ketamine intramuscularly in patients ranging in
attempted. In order to achieve this the cage can be covered size from waxbills to cockatoos. An initial dose of 15 to 20
with a cloth but it may be preferable to carry out the mg/kg bodyweight is usually quite sufficient to sedate the bird
investigation in a darkened room, using a torch to examine the and the effect lasts for about 15 to 20 minutes.
bird in detail. The steroid combination of alphadalone-alphaxalone can be
The ease with which a bird can be grasped and handled given intramuscularly but is generally less satisfactory than
depends upon the species. It may be possible to pick up a small ketamine by this route. The author prefers to administer it
thrush with the ungloved hand but a parrot or macaw will
usually resent this and a different strategy is essential if bite
wounds are to be avoided. Gloves and towels are invaluable
and should be ready before the bird is approached. A cloth bag
should also be available; it too can be used to protect fingers
and, placed over a bird's head, will usually help to quieten the
patient. The beak is often a potential source of danger and an
elastic band can be used to keep it closed. Generally it is best if
two people are involved in the capture of a large bird; one does
the 'catching' while the other must be prepared to grasp and
hold the head. The latter procedure will prevent the bird from
biting and, especially in the case of parrots, will reduce the
noise!
Equipment which may be needed in order to examine the
bird which must be available before the patient is caught
includes a wooden spatula, stethoscope, syringes and needles.
No bird should be removed from its cage unless a prior
check has been made to ensure that all possible escape routes
are blocked. Windows should be closed and doors either
locked or posted with warning notices.
Once a bird has been restrained advantage can again be
taken of its reluctance to move in the dark. The bird's head
must be covered; a towel may be sufficient but it is often better
to use a small cloth bag or even to make a 'hood' similar to
those used by falconers.
Chemical restraint is of the greatest value. The author
routinely sedates or anaesthetises large psittacine birds in order
to carry out clinical examination. So long as this is performed
carefully there is relatively little risk. Birds which are too sick
for an anaesthetic can generally be handled with ease. Two
methods of sedation/anaesthesia are recommended:
Inhalation of halothane or methoxyflurane The bird should
be placed in a jar or chamber and the volatile agent pumped
from a standard anaesthetic machine. Halothane is potent and
a concentration of 2 to 3 per cent in oxygen will usually induce Intramuscular ketamine will sedate a bird so that it can
light anaesthesia within 3 to 4 minutes. Methoxyflurane, on be handled and radiographed with relative ease
the other hand, requires a longer induction period - often 5
to 15 minutes. The bird can be removed as soon as it is These two pictures show possible injection sites -
recumbent; diagnostic procedures must then be carried out pectoral and leg muscles respectively
32 IN PRACTICE . JANUARY 1983

intravenously, in large birds (over 100g) only, at a dose rate of

5 to 10 mg/kg. The effect is shortlived - 5 to 10 minutes
and so again diagnostic procedures must be carried out
promptly.
Sedation or anaesthesia plays an important part in avian
work and is often essential if a full examination is to be
performed. Owners are becoming aware of this and most will
readily accept it. Howver, the veterinary surgeon should
ensure that the client appreciates the slight risks involved and
completes an anaesthetic consent form.

Clinical examination
As with any other species, it is important to have a system
when examining a bird. The author starts at the head and
progresses down the body, checking wings and legs en route. A
full list of procedures will not be given but the following are
important features of the examination which should not be
omitted:
Beak - overgrown or damaged.
Eyes - appearance, pupillary reflexes. Radiography plays an important part in the diagnosis of
Crop - presence of food or palpable lesions. avian disease. This blue jay (Cyanocitta cristata) has an
Body - prominence of sternum ('keel'), presence of palpable infective arthritis of the shoulder
lesions, soiling of plumage or vent area.
Wings and legs - mobility of joints, fractures or dislocations used to investigate the trachea, the crop, the cloaca and the
(compare and contrast with opposite member). body cavity (laparoscopy).
Laboratory tests are available to augment clinical inves-
Following initial examination more detailed investigations tigation and will often provide valuable information. Feathers
may be carried out. The beak should be held open with the aid can be examined microscopically for parasites. Skin scrapings
of a gag. A variety of objects can be used but a clean ice lolly are not easy to obtain from birds. Often it is best to remove a
stick provides a cheap and disposable method for a small bird. small biopsy. Likewise, biopsies can be taken from
Once the mouth is open the mucous membranes can be proliferative lesions on the feet or wings. The swabbing of
examined and lesions of the mouth or pharynx may be infected lesions for microbiological examination should be
detected. routine.
Depending upon the size of the bird either a finger or tube Faecal samples should always be examined since parasites
should be introduced into the oesophagus; this provides a can be common in certain species. Direct smears in saline will
simple test of patency and careful examination after removal usually reveal whether helminth eggs or protozoa are present.
may reveal parasites or pathological material. Similarly a Blood samples are of some value in diagnosis. Blood is best
cloacal examination should be carried out. In a large bird this taken from the brachial vein but small quantities, for smears,
is best achieved by inserting a lubricated finger through the can usually be obtained by short clipping a claw. The author
vent. Careful palpation may yield information on abdominal routinely does a PCV estimation and examines smears for
organs as well as the interior of the cloaca itself. In small birds parasites and cellular abnormalities. If facilities permit other
such digital examination is not possible. Instead, a small investigations, such as total white cell counts, can be carried
lubricated speculum attached to an auriscope can be used. out and may provide additional data.
Relatively little is gained from taking the temperature of
birds and this procedure is not an integral part of the
examination.
Birds submitted for examination should be weighed and
owners should also be encouraged to keep such records. One
reading is of only limited value but weighing at regular
intervals will permit the condition of a bird to be assessed and
assist the veterinarian in computing anaesthetic doses. All
practices should be equipped with suitable weighing
equipment. Scales can be used but those suitable for dogs and
cats may not be satisfactory for small birds. For this reason the
author advocates the use of spring balances - of the type
supplied to bird ringers. Prices of these balances can be
provided by the British Trust for Ornithology, Tring,
Hertfordshire. The bird is weighed in a cloth bag of the same
type as that used during handling.
The main aid to clinical examination is radiography. This
tool is used far too infrequently by veterinary surgeons who
are endeavouring to make a diagnosis. A whole-body radio-
graph can provide a great deal of information about the soft
tissues of a bird as well as its skeleton. However, for the results Laparoscopy is increasingly being used in diagnosis. In
to be at all meaningful the patient must be properly positioned this case a parrot is being sexed; a similar technique can
and this usually necessitates light anaesthesia. be used to examine internal organs for evidence of
The other aid to diagnosis which is assuming increasing disease. (Photo courtesy P. Coffey, Jersey Wildlife Preserva-
importance is endoscopy. Solid or flexible endoscopes can be tion Trust.)
IN PRACTICE . JANUARY 1983
Diagnosis and treatment
Diagnosis in cagebirds requires a logical and systematic
approach. Some veterinary surgeons are familiar with a few
avian diseases such as psittacosis, salmonellosis and
pseudotuberculosis and, erroneously, assume that all cases
must have one or other of these. It is preferable to tabulate the
findings and, if necessary with the aid of a text book, to list the
possible diagnoses. A number of conditions can usually be
excluded and this information alone is of value to the
aviculturist, especially if he has other birds at risk.
Often a definitive diagnosis is not possible immediately and
the veterinary surgeon must offer initial advice. There are two
main aspects to this:
Isolation Affected birds should be kept separate from healthy
individuals and strict hygienic precautions instigated.
Supportive treatment Small birds will die quickly if they stop
feeding, lose weight or develop hypothermia or dehydration.
Conversely, a surprising number of avian patients will recover
if they are given supportive/symptomatic treatment, even if a
specific diagnosis is not made.
The following are the main features of supportive
treatment:
Warmth Maintain sick birds at a constant temperature of at
least 75°F. An aviculturist's hospital cage is ideal for this
purpose and enables the patient to be accommodated and kept
warm and secure with minimum of inconvenience to the vet or
lay staff. Altematively a warm environment can be created
with the aid of an electric lamp or a fan heater.
Fluids A cagebird can rapidly become dehydrated, even if it
appears to be drinking. Birds which have injuries or diarrhoea
should receive fluids (for example, dextrose saline) by
subcutaneous injection. Up to 4 per cent of bodyweight can be
administered daily and it is usually best to use a variety of
injection sites.
Food Small birds have a high metabolic rate and may begin to
deteriorate if they go without food for more than 12 hours.
The sick or injured bird should be offered a suitable diet but if
this is not taken, force-feeding will be necessary. The latter is
best achieved by use of an oesophageal tube, made of a piece
of rubber or plastic tubing attached to a suitable sized syringe.
Various fluids can be given by tube; the author generally uses
Complan (Glaxo). Such force-feeding should be carried out
every 4 to 8 hours until the bird begins to feed itself.
The veterinary surgeon should learn how to tube-feed a
bird. It is best to practise first on a large (normal) bird, such as
An aviculturist's hospital cage. The provision of warmth
is a prerequisite when treating sick cagebirds
33
Birds which refuse to feed may need to be tube-fed. In
this case the patient is a gull (Larus ridibundus) but the
technique is similar in all species
a pigeon, and then to progress to smaller species such as
budgerigars or finches.
Minimum disturbance Although a certain amount of handling
and manipulation is essential, sick birds generally fare better if
they are free from disturbance. For example, a patient in a
hospital cage may refuse to feed if it is constantly under
surveillance. For this reason it is wise to place the cage in a
quiet spot or to cover part of it with a cloth. Care must be
taken to ensure that there is sufficient light for the bird to see
its food; otherwise it may not feed.
The nursing/supportive care of birds is a time-consuming
and exacting task and may need to be continued for several
days. For this reason it is usually best if the patient is
hospitalised and treated on the premises.
Conclusions
Birds do not pose insuperable problems to the veterinary
surgeon. They differ in some ways from the mammals but
there are many similarities. Small birds and small rodents are
alike in a number of respects and the important features of
supportive care are common to both.
The greatest obstacle to successful diagnosis and treatment
in cagebirds is an inability to adapt mentally to a different type
of patient. This can only be overcome if the veterinary surgeon
considers birds as animals and applies basic principles. If this
is coupled with regular practice at handling and techniques he
can become competent in this field.
Further reading
ARNALL, L. and KEYMER, 1. F. (1975) Bird Diseases. Baillire Tindall,
London.
COOPER, J. E. and ELEY, J. T. (1979) Editors First Aid and Care of Wild
Birds. David and Charles, Newton Abbot.
LOW, R. (1980) Parrots: Their Care and Breeding. Blandford Press, Poole,
Dorset.
MEADEN, F. (1979) A Manual of European Bird Keeping. Blandford Press,
Poole, Dorset.
PETRAK, M. L. (1982) Editor. Diseases of Cage and Aviary Birds. 2nd edition.
Lea and Febiger, Philadelphia.