Sneezing and Nasal Discharge in Birds

We all sneeze. It is a reflexive response to irritation in the nasal cavity and it’s commonly accompanied by a runny nose. Like people, most normal birds will sneeze occasionally in an attempt to clear dust and debris from their nostrils. But should you ever be concerned when your bird sneezes?

If your bird occasionally sneezes a clear fluid (less than once or twice a day) and has no other symptoms, he is probably just exercising the normal mechanism to clear his nostrils. There are many causes of sneezing and nasal discharge in birds. A few of the most common include:

• Irritation from dust or dander
• Bacterial infections
• Fungal infections
• Nutritional deficiencies
• Foreign bodies in the nose
• If, however, a discharge continues, or if it looks like anything other than a clear, thin fluid, or the sneezing is persistent, or other symptoms are present, then you need to consult your veterinarian.

What To Watch For

• Lethargy – Symptoms such as excessive sleepiness, ruffled feathers, and tucking the head under the wing, warrant an immediate visit to your veterinarian.
• Loss of appetite – If there is a decrease in the amount of food the bird is eating, or if it stops eating entirely, see your veterinarian.
• Difficulty breathing – If your bird leans forward and stretches its neck to breath, breathes with an open mouth, or puffs out the cheeks or bobs the tail with each breath, your bird is having trouble breathing and needs to see a veterinarian immediately.

What Your Vet Might Do

Depending on the severity of the discharge, the sneezing episodes, or how long the problem has been going on, your veterinarian will recommend specific diagnostic tests. But first he or she will want a thorough history of the problem. Be prepared to answer these questions:

• When did the problem begin? Did sneezing and nasal discharge occur together?
• Has the appearance of the discharge changed? Has it changed in color or consistency?
• Is the discharge unilateral (one nostril) or bilateral (both nostrils)? Did it begin this way?
• Is your bird rubbing or shaking its head, or yawning excessively?
• Did the discharge begin when the household heat was turned on? Is the bird kept in a dusty room or with birds that produce a lot of feather dust (cockatiels, cockatoos, African grey parrots)?
• Is the bird on a complete, balanced diet, such as a commercial pelleted diet?
• Since there are many causes of sneezing and nasal discharge, the cause must be identified for proper treatment. One or more of the following diagnostic tests may be recommended:
• Sampling of the choanal (slit in the roof of the mouth) or the nasal cavity for bacteria or cancer
• A complete blood count for evidence of infection, allergies, or inflammation
• Blood serology tests for Chlamydiosis and Aspergillosis and other infectious diseases
• X-rays or CT scans for evidence of sinus infection or destruction of bone
• Endoscopy for direct viewing the choana, ears, or air sacs to allow your veterinarian to assess the severity of the disease, collect more accurate samples, or remove foreign objects

Treatment

If your bird exhibits severe symptoms, especially difficulty breathing, lethargy and loss of appetite, he will require hospitalization and extensive, long-term treatment. On the other hand, birds with mild nasal discharge and no other symptoms can be treated on an outpatient basis. Some of the following treatments may reduce the severity of the symptoms and provide relief for your pet:

• Cleaning dry secretions or removing foreign objects from the nasal cavities or sinuses by flushing with saline solution or with forceps. This process might require anesthesia.
• Antibiotics or antifungal therapy by mouth or injection and by application directly into the nostrils or sinuses. This treatment must often be continued for weeks or even months.
• Flushing the nostrils or sinuses with an antibiotic or antifungal solution may help birds with chronic or recurrent infections.
• Surgical removal of tumors. Small benign tumors can usually be removed resulting in a cure. However, most tumors that occur in the nasal cavities of birds are malignant and invasive.
• Once you take the bird home, follow all directions given by your veterinarian. Be sure to give all medication as directed, for as long as directed, even after the symptoms are gone. You should also report any changes in the character of the discharge. If the discharge worsens or if improvement is not seen, report this immediately.

At Home Care

If your bird’s discharge is a clear, thin fluid and he exhibits no other symptoms, there are a few things you can do to help:

• Your bird’s environment can play a large role. Because the nostrils are located on top of its head, dust and debris can build up in the nostrils. Providing water for bathing can often prevent this. Sensitive birds should not be housed in the same airspace as birds that create a lot of feather dust (cockatoos, cockatiels, or African grey parrots). A high quality air filter, such as a HEPA filter, may also help.
• Tropical birds that are adapted to humid environments, such as Amazon parrots and macaws, often sneeze when the household heat is turned on. Humidifying your bird’s area can alleviate this.
• Most birds are extremely sensitive to cigarette and cigar smoke. Avoid exposure to these irritants.
• Birds that eat a poor diet, especially an all-seed diet, are especially prone to respiratory disease. Dietary deficiencies, especially vitamin A, cause changes in the cells that line the nasal cavity, making it easier for infectious agents to invade more readily and cause infection.

The type of discharge produced will usually vary with the cause. Serous discharges (clear, thin fluid) may be caused by environmental irritants, allergies or early stages of infectious diseases. Purulent (thick, yellowish) discharges or caseous (thick, dry) discharges usually are seen with infectious diseases. With severe disease such a fungal infectious or neoplasia (cancer) the discharge may become blood tinged. These types of destructive processes will often cause erosion or deformation of the nasal cavity.

Possible causes of sneezing and nasal discharge include:

• Bacterial infections
• Chlamydiosis – also known as Psittacosis or parrot fever
• Aspergillosis- a fungus normally found in the environment which can cause severe, life threatening disease in pet birds
• Candidiasis – a yeast infection
• Viral infections
• Hypovitaminosis A – low vitamin A concentration in the diet. Irritation due to low humidity
• Build up of aerosolized dust and debris
• Airborne irritants – such as smoke or aerosol sprays
• Nasal tumors – cancer
• Foreign bodies- objects such as seeds or food lodged in the nasal cavity
• Allergies
• Choanal atresia – a birth defect that prevents the nasal cavity from opening into the roof of the mouth

Diagnosis In-depth

A thorough history is an essential component of the diagnosis. Be prepared to tell your veterinarian:

• When the problem began and whether sneezing and nasal discharge occur together.
• If the character of the discharge has changed. For example, did it begin as a clear, thin fluid and progress to mucus, then pus? Or, is it always a clear discharge with sneezing?
• Is the discharge unilateral (one nostril only) or bilateral (both nostrils)? Did it start in one nostril and progress to both?
• Is your bird rubbing its head, shaking its head or yawning excessively? Birds with sinusitis (infection in the sinuses) will often display these behaviors.
• Did the discharge first begin when the household heat was turned on? Is the bird kept in a dusty room or with birds that produce a lot of feather dust (cockatiels, cockatoos, African grey parrots)?
• Is the bird on a complete, balanced diet, such as a commercial pelleted diet?
  Your veterinarian will recommend specific diagnostic tests depending on how severe the nasal discharge or sneezing episodes are or how long the problem has been going on. Chronic nasal discharge (discharge lasting for months or more) or recurrent discharge may require extensive diagnostic testing.
• Any combination of the following may be recommended:
• Sampling the choanal (slit in the roof of the mouth) for bacterial culture and cytology (looking at cell types for evidence of infection or inflammation).
• Sampling of the nostrils or nasal cavity for bacterial culture or cytology. Samples may be taken directly from the nostril after dried material has been removed or by flushing the nostril out with saline (salt) solution or by removing some cells through a needle (fine needle aspirate).
• A complete blood count (CBC) may be needed to look for evidence of infectious disease, allergies or inflammation. Certain types of white blood cells will be elevated in number with specific diseases. Many types of infectious diseases, such as Chlamydiosis and Aspergillosis have characteristic patterns of white blood cell increases.
• Blood tests (serology) or choanal samples for Chlamydiosis. These tests look for the body’s response to the organism causing Chlamydiosis (antibodies) or for the presence of the organism itself (antigen).
• Serology for Aspergillosis
• Serum protein electrophoresis – Certain protein fractions (gammaglobulins) circulate in the blood with many infectious diseases. Analyzing the types of proteins that are elevated in circulation will aid the veterinarian in the diagnosis of these diseases.
• Radiography (X-Rays) to look evidence of sinus infection or destruction of bone. Many different views of the head are needed for a complete evaluation. The bird must be held completely motionless, so general anesthesia is required.
• CT Scans give much greater detail of the nasal cavity, sinuses and bone. This test may not be available in all areas and referral to an avian specialist is usually required.
• Endoscopy – viewing the choana (opening to the nasal cavities through the mouth), ears or air sacs with a rigid endoscope to collect samples for biopsy or culture. By directly viewing these structures, your veterinarian can assess the severity of disease, collect more accurate samples and remove foreign objects. This procedure is usually performed by an avian specialist.

Treatment In-depth

There are many causes of sneezing and nasal discharge and the cause must be identified for proper treatment. Diseases — which can cause severe destruction of the nasal cavity and sinuses — such as Aspergillosis, many bacterial infections or neoplasia (cancer), will require hospitalization and extensive, long term treatment. On the other hand, birds with mild nasal discharge and no other symptoms can be treated on an outpatient basis.

One or more of the diagnostic tests described above may be recommended by your veterinarian. In the meantime, treatment of symptoms might be needed, especially if the problem is severe. The following treatments may be applicable to some, but not all, birds with nasal discharge. These treatments may reduce severity of symptoms or provide relief for your pet:

• Cleaning dried exudate or secretions from the nasal cavities and/or sinuses. This often may be accomplished by flushing the sinuses with a saline solution. If the material is dried, it may be cleaned out with forceps under magnification. This process sometimes requires general anesthesia.
• Removing any lodged foreign object by flushing the sinuses, or using an endoscope to directly visualize the object and remove it.
• Surgical removal of tumors under general anesthesia. Occasionally, an entire tumor may be removed completely, resulting in a cure. This is only likely to occur with small, benign tumors. Most types of cancer that occur in the nasal cavity of birds, however, are very malignant and invasive. These tumors are very destructive and cannot be entirely removed. Partial removal (debulking) may help to temporarily make the animal more comfortable, and will provide tissue from which a diagnosis may be obtained (biopsy).
• Antibiotics or antifungal therapy is often given both systemically (by mouth or injection) and topically (by instilling antibiotics directly into the nostrils or sinuses. Often, this therapy must be continued for weeks or, in the case of Aspergillosis, months. Many of the medications can only be administered by injection.
• Flushing of the nasal cavity and sinuses with an antibiotic or antifungal solution may be required on multiple occasions in birds with chronic (long-standing) or recurrent infections.
• Diseases, which cause severe destruction of the nostrils and sinuses, such as neoplasia (cancer) or Aspergillosis (fungal infection), may prove to be fatal despite any treatment attempts.
• Birds that are dehydrated may require fluid therapy, administered by injection under the skin (subcutaneous) or intravenously.
• For mild discharges and to prevent future problems, the environment may be modified by:
• Removing environmental irritants, such as dust, cigarette smoke or bird dander
• Humidifying the air in your bird’s environment
• Providing filtration of the air in your bird’s immediate environment (HEPA filter)
• Providing a high-quality diet, rich in vitamins