Examination and treatment of both sick and healthy birds requires a systematic, consistent, and thorough evaluation.
Proper Transport & Client Instructions
Prior to the avian patient arriving at the veterinary office, instructions should be provided to the client regarding proper transport of the bird - for safety and for maximized diagnostic information. The owner should bring the cage with the bird for examination and it should not be cleaned for the visit. If the cage cannot be easily transported, the owner should collect droppings on newspaper and bring them to the appointment. Water bowls should be removed for transport. If the bird is weak or severely ill, the owner should remove perches, swings, and toys during transport. Covering the cage during transport can provide warmth and reduce stress; in cold climates, a concerted effort should be made to keep the bird away from extreme cold while en route to the hospital.
Once the bird is in the exam room, but prior to capture and restraint, a complete and thorough history is absolutely essential. Many of the avian diseases seen are a direct result of husbandry/management practices in the home or due to exposure to other birds or toxins.
The history should include the following information at a minimum:
Signalment: species, age, sex
Original source of the bird: pet store, breeder, street market, friend, wild, etc.
Husbandry (caging or lack thereof; exposure to natural sunlight, etc.)
Management practices (food preparation, sanitation, exposure to disease vectors)
Details of current illness
Exposure to infectious disease or toxins
Evaluation of Cage and Cage Contents
When possible, the client should bring the bird and its uncleaned cage to the hospital. Digital photos of the cage are also useful if the cage is not transportable. The cage should be evaluated for size, construction, content, and hygiene. The cage should be large enough for the bird to be comfortable, move around, and stretch its wings. An evaluation can be made for potential sources of trauma or heavy metal ingestion. Perches, accessories, feed, bowls, grit, and the presence of discharge or vomitus can be assessed at this time.
Evaluation of the Droppings
The typical avian dropping is composed of three components: feces, urates, and urine. The feces are the brown or green portion of the dropping. The urates are a white or light tan chalky white substance. The urine is the liquid portion of the dropping. The fecal portion should be evaluated for amount, color, and consistency. Many clients presenting their birds for "diarrhea" are in fact describing polyuria. Feces are typically green or brown, depending on the diet. Pelleted diets containing food dyes can alter the color of the feces and this should be taken into consideration. Fruits and vegetables in the diet can cause an increase in water content of the droppings and some natural food pigments can alter fecal coloration. Blood or undigested food in the droppings or diarrhea is abnormal. A decrease in fecal production or smaller darker droppings can indicate the bird is not eating. A change in the urate color to yellow, brown, or red is abnormal. Urine is normally clear; an increase in urine or a change in the urine color is abnormal.
Observation Before Handling
During the history taking and before handling the bird, an effort should be made to observe the bird at rest in its cage or carrier. Monitor the stance, attitude, and respiration effort. Normal birds should be alert when out of their usual surroundings. Ill birds may sleep, have their eyes closed, or appear with their feathers fluffed. Observe wing and tail position and overall symmetry. Sitting on the cage bottom, open-mouth breathing, and tail bobbing are indicative of a critically ill bird. This information can help the practitioner in determining whether the bird is even fit for the next step of capture/restraint or may be initially more suited to "hands-off" measures (such as placement in an oxygen chamber). Severely ill birds can occasionally die from the stress induced by capture/restraint; owners should be forewarned of this possibility and measures should be taken to avoid this unfortunate outcome.
Capture and Restraint
The type of bird, its anatomy and its demeanor dictate the method of capture and restraint used. Never capture a bird while it is perching on its owner (as the bird may bite or injure the owner). Towels or nets (that are cleaned between animals) work well to catch birds. Gloves are not normally used except when handling raptors. Nets are not commonly used in the hospital setting but are more useful in large aviary situations or for escaped birds. Capture and restrain birds in a safe environment with windows covered, doors closed and fans turned off. All needed examination tools and diagnostic sample collection supplies should be made ready before a bird is captured to minimize restraint time. Birds should be restrained with a firm grip to prevent escape and prevent injury to the handler, but the sternum should be able to move so that the bird can safely breathe.
To catch a psittacine bird in a cage or travel carrier, carefully use a towel to position the bird against one side of the cage. Birds can potentially lunge and attempt to bite, so proceed with caution. With one hand covered by the towel, catch the bird across the back of the head and around the neck with the covered hand. Small psittacines and passerines can be distracted and captured more easily with the lights dimmed or briefly turned off. Small birds can be caught using paper towels; use hand towels or bath towels for catching medium to larger birds. Once the head is restrained, the bird can be removed from the cage and the towel wrapped around the wings and feet. At this point for examination the bird may be restrained in the towel or taken out of the towel and held directly. Restraint in towels makes it easier to control the wings but can make it more difficult to observe some areas of the bird.
Small birds may be restrained by holding the head with the thumb and index finger and cupping the body with the palm and other fingers. Another method for holding small passerine birds that don't inflict a painful bite is the "photographer's grip" which involves holding the top of the bird's tibiotarsi (as close to the body as possible) between the index and middle fingers in a scissor-like grip, and pinching the bird's tarsometatarsi between the thumb and the index and middle fingers. This grip may be used for relatively robust passerines, but is not suitable for those with short or delicate legs. Medium and large psittacines are restrained by holding the head/neck firmly just underneath the base of the mandibles. The feet are controlled with the other hand, and the bird is gently stretched between the holder's two hands to prevent the bird from struggling or reaching around and biting. To prevent the wings from flapping, the bird is wrapped in a towel or held close to the restrainer's body. Owners should never be allowed to pet or touch the bird near the beak while it is being handled.
In raptors, the talons are the major source of injury, and so the feet must be carefully controlled. The bird's view can be temporarily obstructed while the legs and feet are caught with a gloved hand. For smaller raptors, a towel can be placed over the back of the animal, the body grasped, and then the feet quickly immobilized. A hood may be used to calm nervous raptors during restraint. Ball bandages can be placed to protect the handler from the talons if needed. Some raptors can also use their beaks for protection as well, so care is also needed when working around the head.
Other families of birds may require alternate handling methods; it is not possible to cover all possible restraint methods for other families in this discussion.
The physical exam should be routine and comprehensive as it is in other animals. This includes taking an accurate body weight in grams. The physical exam can be stressful for a bird and so it should be performed quickly and efficiently. It is important to monitor respiratory rate, body temperature and attitude as indicators of stress. The bird may need "rest periods" if very stressed, requiring the physical examination to be performed in stages. If necessary, oxygen can be administered by mask during examination or the bird may need to be placed in an oxygen cage before and/or after handling. A systematic approach should be taken and used every time.
Body systems and physical exam findings will be covered during the lecture.