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Papillomatosis in Psittacine Birds

By: Dr. Branson Ritchie

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Diagnosis In-depth

A thorough physical examination with detailed observation of the oral and cloacal mucosa is the most likely way to detect suspicious lesions. The cloaca should be gently turned outward using a gloved finger, moistened cotton-tipped applicator or speculum to facilitate the examination. Papillomatosis should be suspected when cauliflower-like growths are visible.

Papillomatous changes may occur in the oral cavity or esophagus in birds that do or do not have detectable lesions in the cloaca. The fusing, raised bumps characteristic of papillomatosis can be red, pink or white and have a tendency to bleed if damaged. Coating the surface of any suspect lesion with 5 percent acetic acid solution will help identify papillomatous changes. The abnormal tissue will turn white, while the normal mucosa remains pink. Microscopic examination of tissue samples from suspect lesions is required to confirm a diagnosis.

Many internal lesions are not recognized until autopsy. Filling defects (indicating that a mass is present in the lumen of the alimentary tract) may be detected by contrast radiography (Barium series) performed on birds with suspicious clinical signs such as chronic regurgitation or weight loss.

Endoscopy is necessary to identify and obtain diagnostic biopsies of suspect papillomatous lesions in the esophagus, proventriculus or high in the cloaca. A liver biopsy may be helpful in confirming cancerous changes in birds that have a history of cloacal papillomatosis and clinical changes suggestive of liver disease.

Other tests include:

  • CBC and blood chemistry. Most birds with papillomatous lesions in the gastrointestinal tract do not have detectable changes in the complete blood count (CBC) or blood chemistry. However, the white blood cell count may be elevated in birds with internal lesions that are ulcerated and secondarily infected with bacteria or fungi.

  • Viral testing. Testing for antibodies to Pacheco's disease virus or using viral specific DNA probes to determine if a bird is shedding pieces of genetic material (DNA) from this virus may be helpful.

  • Currently, there is no test that can be used to confirm that a bird does not have papillomatosis.

    Therapy In-depth

    Generally, papillomatous lesions that are not causing specific problems can remain untreated. Untreated birds should be carefully and frequently monitored for changes that would suggest more aggressive treatment is necessary. Oral papillomas are frequently localized, easy to remove and may not reoccur after removal. In contrast, cloacal papillomas are typically diffuse, difficult to remove completely and frequently reoccur after treatment. Attempted removal may involve various surgical techniques (lasers, radiosurgery and ligation) or chemical cautery.

    When any technique is used to remove growths mechanically from the cloaca, care should be exercised to prevent excessive tissue damage that may result in severe scarring and reduction in the size of the cloacal lumen. Scarring can result in incontinence, reproductive failure or blockage of the ureters or colon. None of the proposed therapies is consistently effective in all cases, and papillomatous lesions often recur following what may appear to be a successful treatment regime.

    Malnutrition and vitamin A deficiencies have been suggested to potentiate papillomatosis. If true, then providing supplemental vitamin A would be indicated.

    Follow-up Care

    Optimal treatment for your companion bird requires a combination of home and professional veterinary care. Follow-up can be critical, especially if your bird does not rapidly improve.

    Make certain you administer all prescribed medications at the appropriate time intervals. Contact your veterinarian immediately if you are having difficulties treating your bird as prescribed. If you are having problems, it may be best to hospitalize your bird to assure that a proper course of treatment is administered.

    Any bird suspected of having papillomatosis, that has been exposed to birds with papillomatosis or that is being treated for papillomatosis should be isolated from other birds to prevent transmission. The common practice of placing a hospital or "sick" room in the same building or airspace with a psittacine nursery is contrary to good medical practices.

    If this disease is caused by a virus, which is likely, then with most viruses organic debris such as blood, soil, nesting material or feces would be expected to protect the causative agent from disinfectants that do not contain detergents.

    Caretakers should always wear a dust mask when handling the waste of birds. To reduce dust, use a misting bottle filled with disinfectant to moisten excrement and feather debris before handling.

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