Diarrhea in Birds

Diarrhea is an increase in frequency and liquid content of the fecal component of the droppings. In birds, the droppings are composed of three elements: feces, urates and urine. The droppings are stored in the cloaca, the common emptying chamber for the gastrointestinal, urinary and reproductive tracts.

Feces are produced in the intestinal tract, and are normally green or brown in color. Urine and urates are produced in the kidneys. Usually, birds only produce a very small volume of liquid urine, and the majority of the waste from the kidneys is in the form of semi-solid, white/beige urates.

Occasionally, a larger volume of urine is produced (polyuria), which is often mistaken for diarrhea. Birds that are polyuric have a more liquid dropping, but the fecal component remains solid and formed. Birds with diarrhea have a more liquid consistency to the fecal component.

General Causes

• Bacterial infections
• Fungal infections
• Viral infections
• Dietary changes
• Toxins
• Foreign bodies lodged in the intestinal tract
• Your veterinarian will recommend specific diagnostic tests depending on how severe the diarrhea is, how long the bird has had diarrhea, and if other symptoms are present. Birds that are showing other symptoms, such as vomiting, anorexia or lethargy may require extensive diagnostic testing.
• If your bird occasionally has a few droppings with a liquid or loosely formed fecal component and has no other symptoms, it may be normal. If, however, the diarrhea is persistent (lasts more than a day), recurrent (returns frequently) or other symptoms occur, medical attention is needed.

What to Watch For

• Lethargy
• Ruffled feathers
• Tucking the head under the wing
• Loss of appetite
• Vomiting or regurgitation
• Blood in the stool, which appears as dark, green-black tarry stool
• Lack of feces in the dropping

Diagnosis

Your veterinarian will recommend specific diagnostic tests depending on the severity of diarrhea, or if other symptoms are present.

A complete history is extremely helpful in reaching a diagnosis. Be prepared to tell your veterinarian when diarrhea began, the consistency of diarrhea, and if it contains blood. Additionally, tell your veterinarian the type of diet your bird is on, describe his chewing habits and note any potential exposure to other birds.

Diagnostic testing your veterinarian may perform include:

• A thorough physical examination
• A complete blood count (CBC) and serum biochemistry panel
• Sampling the crop and/or feces for bacterial culture and cytology
• Radiography (X-Rays) to look for evidence of intestinal disease
• Endoscopy to view the intestinal tract or body cavity

Treatment

Treatment for diarrhea may include any combination of:

• Hospitalization for fluids and injectable medications
• Antibiotics or antifungal medications
• Surgery or endoscopy to relieve intestinal obstructions
• Medications to protect the intestinal tract or alter the motility of the intestinal tract

Home Care

If only one or two of the droppings appear to be diarrhea and your bird has no other symptoms, return him to his usual diet, without fruits and vegetables, for 24 hours. Be sure that plenty of fresh water is available, and that the bird is drinking.

Use only paper (no litter of any type) on the cage bottom, and change the paper daily so that you can monitor the droppings. If droppings do not return to normal within 24 hours, diarrhea worsens, or any other symptoms develop, contact your veterinarian.

If your bird was treated for diarrhea, make sure to give all medication as directed, for as long as directed, even after the symptoms appear to be gone. Watch for a change in the droppings, and report any changes to your veterinarian.

If improvement is not seen, the discharge is worsening or the bird develops other symptoms, alert your veterinarian immediately.

Diarrhea occurs when the intestinal tract is unable to absorb fluid or when the cells lining the intestines secrete excessive amounts of fluid. Many factors can alter the intestinal tract’s ability to absorb or secrete fluids properly. For example, if food is not properly digested, it will tend to pull fluid into the intestines. Or, if the lining of the intestinal tract is irritated by a toxin, infection or irritation, cellular changes will cause an increase in secretion of fluid into the intestines.

Peristaltic waves, which are rhythmic contractions of the intestinal tract that serve to push digested food forward, occur at regular controlled intervals in normal birds. In some birds with diarrhea, these waves lack coordination, so that food moves through the intestinal tract too quickly. This results in an increase in frequency of defecation, and an increase in the liquid content since fluid does not have a chance to be absorbed.

Birds may normally have an occasional dropping in which the fecal component is not well formed. This can occur due to excitement or stress, or be due to sudden changes in the diet. For example, if a bird is fed a large quantity of fruits (and sometimes vegetables) and fruits are not normally a regular part of his diet, he may temporarily develop a loose appearing dropping. This is due in part to the increase in fluid content of the diet, but a similar type of temporary diarrhea may occur with any sudden diet change. This should resolve after all of the fruit or new food is digested, and should not last more than 12 hours after new food has been removed from the diet. If the diarrhea persists, or if the bird develops any other symptoms such as vomiting, lethargy or a change in appetite, veterinary attention is required immediately.

The color of the feces can also change due to alterations in the diet. For example, if birds are fed heavily pigmented foods, such as berries, tomato products or colored pellets, the stool may turn the color of the food. If the stool ever appears to be a very dark green-black color, however, your veterinarian should be notified immediately, since this color may be caused by digested blood (melena).

There are many causes of diarrhea in birds. The cause may be very simple, such as a dietary change or yeast overgrowth, or may be due to a number of complex disease processes. Many contagious diseases cause diarrhea, so it is important to inform your veterinarian of any potential contact – direct or indirect – with other birds.

• Bacterial infection. Bacterial infections may come from other birds, from an overgrowth of dangerous bacteria on dirty food or water bowls, or spoiled foods. Often, small amounts of potentially dangerous bacteria live in the intestinal tract without causing harm. This population of bacteria can overgrow and cause disease if the bird’s immune system is not functioning properly, as may occur during times of stress. An overgrowth of harmful bacteria may also occur when antibiotics are used improperly.
• Viral infection. Several different avian viruses may cause diarrhea. In most cases, diarrhea is only one of several symptoms. Viruses can be transmitted by direct exposure to another bird, shared food or water dishes, or on your hands or clothing, depending on the type of virus.
• Yeast infection. Candida is a type of yeast that normally lives in small quantities in the intestinal tract. Stress or antibiotic use can also cause an overgrowth of Candida, leading to diarrhea.
• Parasites. One of the more common intestinal parasites of pet birds is Giardia, a microscopic organism that lives in the small intestine. Giardia can cause severe diarrhea and weight loss, and is potentially transmissible to people. Other microscopic parasites, such as heximita and coccida are less common causes of diarrhea in pet birds. Intestinal worms, such as roundworms and tapeworms, may occasionally be a cause. These worms are specific to avian species and do not cause disease in mammals.
• Cloacal papillomas. Papillomas are wart-like structures. They appear most commonly in the cloaca, but may occur anywhere along the gastrointestinal tract. Papillomas may be a cause of diarrhea. There is also a higher incidence of gastrointestinal tract cancer in birds with cloacal papillomas.
• Obstruction. Tumors or foreign objects may block the intestinal tract. Occasionally, an intestinal intussusception (telescoping of one part of the intestinal tract into another) may cause diarrhea initially, then a lack of feces later in the course of disease.
• Antibiotic use. Birds may develop diarrhea following treatment with antibiotics due to changes in the normal bacteria found in the intestinal tract.

Other Causes

• Cancer
• Toxins, such as heavy metals and plant toxins
• Stress-induced, such as changes in environment
• Metabolic disorders like liver or kidney disease, diabetes mellitus
• Dietary causes like diet changes, eating spoiled food, dietary intolerance
• Maldigestion, such as liver disease, inflammation or infection in the pancreas

Your veterinarian will do a thorough history to help in the diagnosis of diarrhea. Be able to answer the following questions:

• When did the problem begin?
• Is the diarrhea intermittent?
• Are all of the droppings abnormal?
• Is there a change in the number and frequency of droppings?
• Has the character of the diarrhea changed?
• Is there an increase in the amount of liquid urine in the dropping?
• Is there fresh blood in the dropping?
• Has the diet changed?
• Are fresh foods, such as fruits and vegetables, fed regularly?
• Is the bird still eating a normal amount of food?
• What are the bird’s chewing habits?
• Does he have access to metal objects or plants?
• Does the bird chew apart wood, rubber or string toys?
• Are any other symptoms such as lethargy or vomiting present?
• Has the bird been exposed to other birds?
• How often is the cage, the food and water dishes cleaned, and how are they cleaned?
• Your veterinarian will recommend specific diagnostic tests depending on how severe the diarrhea is, whether other symptoms are present or how long the problem has been going on. Birds that have other symptoms or have had chronic diarrhea (lasting for days to weeks) or recurrent diarrhea may require extensive diagnostic testing. Any combination of the following may be recommended:
• A thorough physical examination
• Sampling of the feces or cloaca for bacterial culture and cytology (looking at cell types for evidence of infection or inflammation)
• Sampling of the feces, sometimes over a period of several days, to look for intestinal parasites
• A complete blood count (CBC) will determine the number of circulating white blood cells. This may be helpful in distinguishing between infectious and non-infectious causes of diarrhea. The number of red blood cells may be diminished if bleeding in the intestinal tract is present
• A serum biochemistry panel is needed to look for evidence of metabolic problems, such as diseases of the liver, kidney or pancreas
• Plasma protein electrophoresis looks at the types of proteins present in the circulation. For example, birds with chronic diseases, especially infectious or inflammatory diseases, will produce antibodies, and an increase in one class of proteins (gammaglobulins) will occur. Birds with liver disease or severe intestinal disease usually have low concentrations of another class of protein (albumin).
• Blood tests or other samples for Chlamydiosis (Psittacosis)
• Blood tests that measure the amount of heavy metals, such as lead or zinc in circulation
• Radiography (X-Rays) to look for evidence of intestinal disease, size and density of the liver, kidneys or other organs
• Contrast radiographs, such as barium studies, to look for tumors or foreign bodies, ulcerations or thickening of the lining of the intestinal tract. This test will also determine how quickly ingested material is moved through the intestinal tract
• Fluoroscopy (a video or moving X-ray) to determine if the coordination of peristaltic waves is normal. It is useful in the diagnosis of toxicity (lead or zinc) or viral diseases (proventricular dilatation disease)
• Abdominal ultrasound is only possible in birds with enlargement of the liver or fluid in the abdomen. It allows visualization of the intestinal tract for evidence of intestinal wall thickening, gastrointestinal masses and foreign bodies. A specialist usually performs this test
• Endoscopy is a procedure that allows viewing of the intestinal tract or body cavity to collect samples for biopsy or culture. A specialist usually performs this test.
• Exploratory surgery (laparotomy) may need to be performed to obtain segments of the intestinal tract for biopsy in order to determine the cause of diarrhea
• While waiting for a diagnosis, treatment of the symptoms might be necessary, especially if the problem is severe. The following treatments may be applicable to some, but not all birds with diarrhea. These treatments may reduce the severity of symptoms or provide relief for your bird. However, nonspecific therapy is not a substitute for definite treatment of the underlying disease responsible for your bird’s condition.
• Hospitalization. Birds with moderate-to-severe diarrhea and other symptoms such as lethargy and anorexia usually require hospitalization and 24-hour care.
• Fluid therapy. Many birds with diarrhea become dehydrated and require fluids. Fluids may be given by an intravenous catheter, an interosseous catheter (into the bone marrow) or subcutaneously (under the skin). The route of administration will depend on the severity of the dehydration.
• Dietary change. Birds that are still willing to eat will often benefit from a diet that is low in fat and easy to digest. Usually, food is not withheld from birds with diarrhea. Birds have a very high metabolic rate and require a constant source of energy.
• Forced feeding. Birds which refuse food may require forced-feeding of an easily digestible liquid food. Your veterinarian may pass a tube into the bird’s crop to deliver this food.
• Medication. Antibiotics or antifungal medications may be needed to treat or prevent an overgrowth of bacteria or yeast.