Sneezing and Nasal Discharge in Birds
Dr. Barbara Oglesbee
When the problem began and whether sneezing and nasal discharge occur together.
A thorough history is an essential component of the diagnosis. Be prepared to tell your veterinarian:
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.
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