Case study #1: Hypovitaminosis A (Vitamin A deficiency)
This is probably the number one issue I see in the hospital with pet birds. It typically presents when a bird consumes at least 50% of their daily caloric intake as a Vitamin A deficient food, such as seeds. However, commercial poultry pelleted diets or layer feeds may also be deficient, so make sure you check your bird foods' nutrition facts!
Lack of vitamin A tends to affect the bird's epithelium, the outermost layer found in skin, mucous membranes, and GI, as well as many other places. Changes to the epithelium make the bird vulnerable to infections, especially of the eyes, sinuses, nasal passages, and mouth.
External signs:
These birds may present with ruffled or dull feathers. If female, egg production will likely drop.
Opportunistic infections tend to first occur in the sinuses. As it gets worse, the periorbita (area around the eye) begins to swell. In the picture below, there is a squishy bump between the nares (nostrils) and the eye on both sides of the bird's face. This area is also likely to lack feathers.
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If swelling is present, there will likely be secretions in the eyes as well. Here you can see a dried crust around the eyes, as well as a film covering the globe.
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The beak of a bird with hypovitaminosis A will often overgrow and become brittle. Here you can see the beak is long and broken off in front, and that is has a shaggy, cracked appearance in the second picture.
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The swelling of the periorbita and beak length are also noticeable from the front. The nares are sealed shut by mucus.
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Often, deficient birds have hyperkeratosis of the feet, which may give scales a curled or puffed appearance similar to that of leg mites. This bird had mild hyperkeratosis, but nothing extreme. It's a bit hard to see in the picture, but some of the scales aren't flush with the leg.
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Often, the vent in birds with this condition will appear yellowish and improperly feathered. The yellow can be due to improper shedding of the skin in this area or GI issues, as they typically develop very runny stools as their GI acquires more lesions.
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These birds tend to develop anorexia due to the pain caused by lesions in the upper alimentary tract and oropharynx. Anorexic birds will not eat and tend to lose muscle mass, as seen here by the pronounced keel bone.
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It was hard to get a good picture of this, but you can often spot white lesions in the bird's mouth if they have been deficient for a long time. The most common spot to see them is at the choanae on the roof of the bird's mouth, which are the entry point to the nasal cavity.
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Finally, if you puncture the swellings in front of the eye, a pussy, greenish secretion should come out.
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Internal examination:
There are a few things to note inside the bird's coelomic cavity, mostly signs of anorexia. In this picture, a small window reveals that the bird's ceca (paired digestive organs) are gas-filled, indicating that it likely has not eaten significantly in a day or two.
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The proventriculus (glandular part of the stomach which secretes acid and is found above the gizzard) in this bird has a pockmarked appearance. Any part of the upper GI, proventriculus included, can suffer lesions. My thumb is underneath it in this picture.
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The crop is empty.
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I didn't get a pic, but all follicles (yellow yolk-like structures in ovary) in the hen will likely be small and may even be bloody.
Treatment of these guys is tough. If you catch it early and no infection is present, supplementation with Vitamin A rich foods or a new balanced diet will do the trick. If an infection has already taken hold (as with this guy) the infectious agent needs to be cultured to find out which antibiotic (given IM, not normally in water) will be effective.
Hopefully this is helpful! Might be a little TMI, but if you guys want more I'm happy to put more cases together as I see them!