by Lisa Paul DVM
An annual Well Bird Exam is a very important part of monitoring the health of your flock. Birds will often show few signs of illness in the initial stages of disease. Early signs will often be very subtle and may be easily missed. By the time that obvious signs of illness are present ( a fluffed up appearance; obvious lack of appetite; sitting on the floor of the cage), the bird is very ill, and treatment may be difficult or be too late.
It is impossible to know the state of a bird's health unless certain tests are done. At the annual health exam, recommended tests include a Complete Blood Count (CBC), Gram's Stain, mini-serum chemistry, weighing and a complete physical exam. It is appropriate to test for PBFD at this time if the test has not been run previously. It is also appropriate to vaccinate for (or booster the vaccine for) Polyoma. Now is also the time for those wing and nail trims. The costs of these tests will vary from area to area, but the average cost seems to be between $150 and $250 (Costs may be higher in your area).
The cost of the exam can be minimized by omitting some tests. However, without at least a physical exam, Gram's stain, CBC and mini-blood chemistry it is impossible to be sure of the exact state of health (some veterinarians may recommend a chemistry on an every other year basis). Leaving out tests is to be carefully discussed with your veterinarian, as important holes are left in the knowledge obtained about your bird's health.
The veterinarian will begin the annual exam with observation of the bird and the environment. The veterinarian will assess the droppings of the bird and the behavior during this time. A healthy bird will be alert and attentive to the activity going on within the environment. Any abnormal behaviors such as tail bobbing, fluffing, head tucking or dropping off to sleep may indicate illness.
The next stage of the exam will include the weighing of the bird. Charting the weight gain or loss helps to evaluate the general health of the bird as well as the nutritional status. Birds often hide illness and weight change is one of the few methods of recognizing a problem.
Once the weight has been obtained, it is important to do a physical exam. During the physical exam, the veterinarian will look at the mouth, beak, and cere to assure that the tissue there is healthy. Plaques, discharges or the presence of accumulated food particles will be noted as indications of disease. The eyes and ears are examined to assure that they appear healthy. The skin and feathers are examined and abnormalities will be noted on the record as well. Finally, the body is examined, the areas to the right and left of the keel bone are checked to see that the bird is at a good weight, the respiratory rate is noted and the vent is examined for indications of feather matting or possible papilloma. A complete physical exam will take only a few minutes.
A physical exam alone will not give the veterinarian the ability to call a bird healthy or ill. The information gained in the exam will only provide clues as to the condition of the bird. It is impossible to know what is going on internally without doing further tests.
A CBC should be preformed as a minimum part of all exams. The CBC will look at the numbers and condition of all cells within the blood. The CBC consists of the hematocrit (PCV), Hemoglobin ( HB), Total Red blood cell count ( RBC count), and the White blood cell count (WBC count). The hematocrit is a method of measuring the mass and indirectly the number of RBC's. A low hematocrit is an indication of anemia. The lower the number of the hematocrit, the more severe the anemia.
The WBC count will look at the numbers and conditions of the different types of WBC's in the blood. An elevated WBC count is an indication of infection. The different types of WBC's are looked at to help determine possible types of infection as well as the possible severity of the infection. Keep in mind that it is important to interpret what is going on with the white count along with the results of the physical exam and blood chemistry tests before a true diagnosis can be made.
The next test that needs to be done is a blood chemistry profile. The blood chemistry profile will include a number of different tests. The exact tests run will be determined by the individual preference of your veterinarian. These tests will often include a total protein, glucose, uric acid, AST (SGOT), and Calcium (especially for African Greys). Your veterinarian may recommend additional tests if any of these come back outside of normal levels. The total protein is a measure of the total amount of proteins in the serum. A decreased total protein can indicate a chronic disease state (especially kidney or liver disease), starvation, the presence of parasites and stress. An increased total protein level is often seen with dehydration, infection and shock.
The glucose level is the amount of blood sugar found in the serum. Glucose levels can be decreased with liver disease, starvation and/or malnutrition and septicemic infections. If the glucose level drops too far, seizures and death may occur. Increased glucose levels may be seen with diabetes and diets too high in sugars. Some birds will show an increased blood glucose level during the breeding season. A one time sample of blood glucose may not be adequate, as glucose levels can change rapidly. If an abnormal glucose level is found on tests, re-testing should be done to confirm the abnormal result.
Uric Acid is a test of kidney function. Uric acid is excreted by the kidneys as a way of ridding the body of the waste products from proteins. Increased values of uric acid indicate that the kidneys are not filtering this waste product from the blood. The uric acid levels will also be increased in a bird that is dehydrated, and in patients with gout. Lab sampling error can also cause a false increase in these levels as well.
AST ( SGOT) is a test for liver function. Increased ALT levels may be an indication of liver disease. As liver cells die, this enzyme is released into the serum from the dying cells. A high level of ALT in the serum may indicate liver disease. However, this enzyme is not specific for liver disease. It is also found in muscle tissue with small amounts found in the brain and kidney. Large increases in AST are usually tied to liver disease. Other enzymes that may be tested for clues on the health of the liver include ALT ( SGPT), LDH, and ALP.
Calcium is important to test for in African Greys. These birds are often deficient in calcium. If the Calcium level is too low, bones may break as the body will remove calcium from the bones to supply its needs. Low calcium levels will indicate the need for supplementation. You should never randomly supplement your bird with Calcium as over supplementation may lead to serious disease.
The Gram's Stain is the final test that should be run each year. For this test, your veterinarian will take cloacal and choanal swabs and stain these with a special stain. These slides will then be examined under the microscope to determine the types and numbers of bacteria present. Gram negative rod bacteria may be agents of disease. The presence of Gram negative Rods may indicate the need for a bacterial culture and sensitivity so that the bacteria can be accurately typed and the proper antibiotics determined (if needed).
The tests that we have discussed will allow you and your veterinarian to better understand and monitor your bird's health. Baseline normals will allow you to more quickly pick up on abnormal tests. Early detection of disease through wellness testing will allow early treatment to occur. With proper medical testing, your birds can live a longer healthier life.