by Carol Curry DVM (c)1993

As Appeared in Beakers: On The Wing!

More people are starting to hand raise their baby birds from a very young age. One of the most common problems I see is crop stasis and/or vomiting in these unweaned birds. Crop stasis is defined as a crop that just doesn't empty within a reasonable amount of time. It can often precede vomiting/regurgitation. Vomiting is not a disease. It is simply a clinical sign.

There are many causes for this clinical sign so one treatment does not fit all and antibiotics are not always indicated. In fact, they can be counter productive in certain cases. Many cases of vomiting are due to non-infectious problems. Some of the things to consider are changes in diet (formula, temperature, consistency, amount), foreign bodies, gout, or medications. There are many infectious causes as well, but antibiotics are not always the treatment of choice.

We have seen bacterial infections (E.coli, Pseudomonas, Klebsiella, Salmonella), viral infections (polyoma, proventricular dilatation), parasites (Giardia, Trichomonas, roundworms, tapeworms), and fungal infections (Candida).Non-infectious causes are sometimes hard to diagnose. They usually involve the husbandry practices of the hand feeder. Do not expect medication to cover up for shortcomings in management. There are many different types of formulas in the literature, including commercial and homemade diets. Commercial diets are more finely ground than monkey chow homemade diets so be careful the first few days to make them dilute enough. Measure the powder added to the measured amount of water. DON'T GUESS.

This is the only way to provide a consistent diet. Be very clean preparing your formula. Mix it fresh each time. Thoroughly clean all utensils between birds and after each use. Wash your hands frequently, especially between birds. Don't handle adult birds and then go in and feed the babies without washing hands, changing outer coat, wipe shoes, etc. It does not seem likely that one formula fits all types of birds. For example, macaws need a lot more fat than other types of birds. In the wild, a survey showed that one of the most popular foods which macaw parents fed their young was palm oil nuts. These belong to the same family as coconuts, and contain a large amount of fat. The nuts are actually processed as lubricating oil in Brazil. But not all babies are raised in the amazon rain forest with a high fat diet. Cockatoos need much less fat in their diet to avoid problems.

Large amounts of sugar in the diet can promote Candida growth. Both deficiencies and excesses in the diet can cause harm. The temperature of the formula is extremely important and should be measured with a thermometer. It should not be over 110 degrees Fahrenheit or the crop can be burned. Running your finger through the formula breaks strict cleanliness, and it is not very accurate. We have done many surgeries to repair burned holes in crops because the formula was too hot when fed. The formula should be thoroughly stirred before measuring the temperature to ensure there are no hot spots which can occur with the use of microwave ovens.

The bird's environment has a lot to do with the baby's overall health. Humidity and temperature are very important. Once again, different species need different levels of moisture. Macaws and other birds from a tropical climate need a much higher humidity than cockatiels who live in a drier area. Temperatures also vary according to the age of the bird. Chilling can decrease crop motility and allow infectious agents to proliferate. The temperature must be kept steady with no fluctuations which can be very stressful to young birds.

Cleanliness is next to Godliness, especially when raising young birds. They must be cleaned constantly, both the cage and the bird. Dried formula around the mouth and eyes can create sores and promote bacterial growth. The feet must be kept clean to prevent sores or strictures around the toes. Disposable diapers work well. Be very cautious about using any type of particulate bedding such as crushed corn cob. Sometimes hungry babies will ingest this material and it can swell in the digestive tract causing impaction. Hungry babies can also ingest foreign bodies so keep everything out of the bird cage that they could possibly eat or break up into pieces.

String type bedding can allow small fibers to become wrapped around the toes, resulting in stricture and loss of blood supply to that toe. Be very careful when using any sort of fabric as bedding. There is a real art to handfeeding. Experience is very important. Some people have successfully raised one species of bird, but may have problems when switching to another type. Try to find someone who has had success with the type of bird you are hand raising to act as a mentor to help you get through the first time.

Just remember that every bird is different. There are no iron fast rules to handfeeding. The parent birds do not add anything to the food which they feed their babies in the wild except pigeons. Pigeons actually slough some of the surface cells from their crop into the baby's food (crop milk). So basically the parent birds feed the babies whatever they can carry to the nest and the food is not modified in any way. Don't economize on the parent's or baby's food.

Use high quality foods and provide a good diet to the parents. This will be reflected in the babies. It is very important to get a feel for how much to feed the babies and how often. We all lead busy lives and it can be difficult to stay with a set schedule of feedings 3-5 times/day. But the crop can be over-stretched if you try to cut down on the number of feedings and increase the amount too soon. They must be fed smaller amounts more frequently when young just like the parents would do it in the wild. As the babies mature, the number of feedings can be gradually decreased as the amount per feeding is raised.

One problem I have seen with more mature babies is constant crying and restlessness, weight loss, and begging. These birds need to have the formula thickened. You may be feeding them enough volume but they are getting too much water and not enough calories so they are hungry all the time. The formula should be thickened up as the birds mature so they can continue to grow and develop properly.

A gram scale is one of the most important pieces of equipment you can invest in. Weigh the babies every morning after they have defecated but before you have fed them and keep a record of their weight gain. Any decrease can be an early warning sign of impending problems. Gout can cause vomiting in baby birds. This is a metabolic problem which involves the deposition of uric acid crystals in the visceral organs or joints. It is difficult to diagnose except at post mortem because the blood uric acid is not usually elevated.

White gout crystals can be seen on the surface of organs when performing a laparoscopic exam. Gout deposits in the joints do not always occur at the same time as gout deposits in the organs. We are unsure of the cause of gout at this time. Some things which may contribute to this problem are malnutrition, dehydration, secondary infections, or genetic metabolic problems. Clinical signs of gout are not always present. The bird can just die suddenly or there may be a few days of "sick bird" signs (vomiting, ruffled, depressed). Treatment is aimed at preventing new gout crystals from being deposited using medications, treating any other underlying infections, and a low protein diet. Sometimes medications can cause vomiting. Macaws are very prone to problems with Bactrim (Trimethoprim/sulfa).

Other antibiotics can be a problem as well, such as Vibramycin. Sometimes the anti-fungals can cause a digestive upset (ketoconazole). Anything which might affect the normal bacteria process, resulting in a slow emptying time. So it is not a good idea to give every baby bird antibiotics at the first sign of a problem. You may just make things worse. Whenever I see a bird with crop stasis/vomiting, I always perform a Gram stain on the crop contents and the feces. This is a special bacterial/fungal stain. We are looking for signs of abnormal bacteria or yeasts. But sometimes in the early stages, the pathogenic bacteria are present in very small amounts and do not show up well on the slide.

A bacterial culture using selective media will usually help in making a diagnosis and finding which antibiotic will be most suitable to treat the problem. Cultures are most successful when performed before a bird has been started on medication. This should be done before antibiotics have been given or they may prevent the bacteria from being recovered on the plate. Certain bacteria can be very resistant to the commonly used antibiotics. Our cultures are done using 20 different antibiotics so we can find out which is best for treating that particular bird's problem. Viral infections can be passed from the parent birds to the babies. These are much harder to diagnose and new tests are becoming available all the time.

Polyoma virus can be devastating in young hand fed babies, especially at the stressful weaning time. These birds can look normal one day, start vomiting, and be dead in 24 hours. Unfortunately there is no good medication to treat this virus. All you can provide is nursing care, but this is usually unsuccessful and the bird could become a carrier if it survives. Hopefully a vaccine will soon be on the market which can be used to vaccinate the parents and prevent this disease from spreading amongst their babies. Until then, the only way to eliminate this problem is to test the parent birds and do not use any positive birds for breeding.

Another probable viral disease is proventricular dilatation syndrome (previously referred to as macaw wasting disease). Suspicions are very high that this disease is viral in origin. The nerves which regulate gastrointestinal function are destroyed so the birds cannot digest their food properly. The proventriculus (stomach) becomes dilated, the birds regurgitate, lose weight, and eventually die. This has been diagnosed in very young birds soon after weaning. It is not exclusively a macaw disease. Diagnosis is made by barium radiographs and clinical signs. There is no definitive diagnostic test for this disease at this time.

Yeast or fungal infections (Candida) cause a disease commonly referred to as "sour crop". This can be secondary to other infections or can occur if crop motility is compromised in any way. Many birds carry a few Candidal organisms in their digestive tract and we sometimes identify sporadic organisms on our Gram stain. Some diets, especially those containing monkey chow, can show Candida-like organisms, so the Gram stain must be interpreted in light of the bird's diet and condition. Antibiotics can often suppress normal intestinal bacteria, thus allowing Candida organisms to proliferate.

Many times I will put baby birds on a prophylactic dose of medication to prevent secondary yeast growth while the bird is on antibiotics. With Candida infection, the crop motility slows, the contents can become fluid or hard, the crop sags, and the contents take on a foul odor. Emptying the crop manually, decreasing sugar in the diet, and medication will correct the Candida overgrowth, but you must always look very diligently for any other primary problems. Parasitic diseases can and do occur in baby birds. The parents should be examined before breeding to look for parasites in the feces. Unfortunately, they are not always passing eggs in every sample. It is important for the breeder to pay attention to the bird's stools at all times. Tapeworms can look like tiny segments of rice either on the bird's feces or attached to the feathers around the cloacal opening.

Cockatiels especially are prone to Giardia infections, a microscopic protozoal parasite. Direct and floatation techniques are available using fresh feces, but diagnosis can be difficult. Sometimes blood tests can be performed. If a certain type of white blood cell called an eosinophil is present in large numbers, we may suggest treating the adult bird for parasites. As you can see from this short discussion, there are many causes for "slow crop" or vomiting. Diagnostic tests are usually necessary to differentiate the cause and provide appropriate care on an individual bird basis. Successful handfeeding of baby birds is 95% management and only 5% medication.

Beakers Parrot Society and Monica Sudds C.A.S. at :beakers@probe.net