Polyuria in Birds

Polyuria may be defined as an increase in the amount of the urine component of the droppings. In birds, droppings are composed of three elements: feces, urates and urine. The droppings are stored in the cloaca, the common emptying chamber for the gastrointestinal, urinary and reproductive tract.

  • Feces are produced in the intestinal tract and are normally green or brown in color.
  • Urine and urates are produced in the kidneys.

    Usually, birds only produce a very small volume of liquid urine, and the majority of the waste from the kidneys will be in the form of semi-solid, white/beige urates. Occasionally, a larger volume of urine is produced (polyuria), which is often mistaken for diarrhea. Birds that are polyuric will have a more liquid dropping, but the fecal component remains solid and formed. Birds with diarrhea have a more liquid consistency to the fecal component.

    There are many causes of polyuria in birds. A few of the more common causes include:

  • Gastrointestinal tract disease
  • Kidney disease
  • Diabetes mellitus
  • Dietary changes – increased amount of fruit or vegetables in the diet
  • Behavioral – increased amount of drinking
  • Toxins

    Your veterinarian will recommend specific diagnostic tests depending on how severely your bird is affected, how long he has been polyuric, and whether other symptoms are present. Birds that exhibit other symptoms, such as anorexia or lethargy, may require extensive diagnostic testing.

    If your bird occasionally has a few droppings with a clear, colorless liquid component and has no other symptoms, it may be normal. This is especially true if the diet has recently changed, or if increased amounts of fruits and vegetables have recently been fed, since these foods contain a large amount of water. If, however, polyuria is persistent (lasts more than a day), recurrent (returns frequently) or other symptoms occur, medical attention is needed.

    What to Watch For

  • Lethargy. Excessive sleepiness, ruffled feathers, tucking the head under the wing are symptoms that warrant an immediate visit to the veterinarian. Birds that are too weak to stay on a perch are in critical condition.
  • Loss of appetite. Monitor the amount of food the bird is eating. If the amount declines over time, or the bird stops eating entirely, seek a medical evaluation.
  • Vomiting, regurgitation or diarrhea
  • Blood in the stool or digested blood (melena), which appears as dark, green-black tarry stool
  • Lack of feces in the dropping. These droppings appear as only urates and urine. When they appear following an episode of diarrhea, it may indicate an obstruction in the intestinal tract.

    Diagnosis

    Your veterinarian will recommend specific diagnostic tests depending on how severely your bird is affected, or how long the problem has been going on. Chronic polyuria (polyuria lasting for several days to weeks), or polyuria along with other symptoms, usually requires extensive diagnostic testing.

    Your veterinarian may recommend the following:

  • A complete history. Be prepared to tell your veterinarian when the polyuria began, how much water the bird is drinking, whether the droppings have changed or vary in consistency or color, the type of diet your bird is on, and of any potential exposure to other birds.
  • A thorough physical examination
  • Sampling the feces or cloaca for bacterial culture and cytology (looking at cell types for evidence of infection or inflammation)
  • A urinalysis, if the bird is severely polyuric
  • A complete blood count (CBC) and serum biochemistry panel
  • Blood tests for heavy metal toxicity
  • Radiography (X-Rays) to look for evidence of intestinal disease, size and density of the liver, kidneys or other organs
  • Endoscopy for viewing the kidneys, liver and pancreas directly with a rigid endoscope to collect samples for biopsy or culture.

    Treatment

    Treatment for polyuria may include any combination of:

  • Hospitalization for intravenous or subcutaneous (under the skin) fluids and injectable medications for critically ill or dehydrated birds.
  • Dietary change or forced-feeding
  • Antibiotics or antifungal medications

    Home Care

    There are several circumstances under which polyuria may be normal. Some birds will become consistently polyuric after switching to commercially formulated pelleted diets. This will also happen if large amounts of fruits and vegetables are fed, as these foods have a larger water content.

    Baby birds that are being hand-fed formula usually have more urine in the droppings as compared to adult birds. Adult birds feeding babies drink more water and will therefore produce more urine. Birds that are stressed, such as may occur with a change in environment, may temporarily become polyuric.

    If only one or two of the droppings appear polyuric and the bird has no other symptoms:

  • Return the bird his old diet without fruits and vegetables for 24 hours.
  • Return the bird to a familiar environment.
  • Be sure that plenty of fresh water is available, and that the bird is drinking.
  • Use only paper (no litter of any type) on the cage bottom, and change the paper daily so that you can monitor the droppings.
  • If droppings do not return to normal within 24 hours, if polyuria worsens or if any other symptoms develop, contact your veterinarian.
  • If the bird's feathers appear fluffed up, keep him in a warm environment.

    After seeing your veterinarian, be sure to:

  • Give all medication as directed, for as long as directed, even after the symptoms appear to be gone.
  • Watch for a change in the droppings and report any changes to your veterinarian.
  • If improvement is not seen, report this to your veterinarian.
  • If the polyuria is worsening, or the bird develops other symptoms, alert your veterinarian immediately.

    In birds, droppings are composed of three elements, feces, urates and urine. The droppings are stored in the cloaca, the common emptying chamber for the gastrointestinal, urinary and reproductive tract. Feces are produced in the intestinal tract, and are normally green or brown in color. Urine and urates are produced in the kidneys. Normal birds on a diet that has a low water content only produce a very small volume of liquid urine. The majority of the waste from the kidneys will be in the form of semi-solid, white/beige urates.

    The urates seen in the droppings consist of uric acid, which is the form in which the majority of nitrogenous waste is eliminated. This method is very efficient, since greater amounts of waste can be concentrated in a semi-solid form as compared to a liquid urine. The avian kidney always produces some urine. This urine serves to flush the semi-solid urates out of the kidney and into the cloaca. If a large amount of liquid is ingested, either by drinking or eating foods with a high water content, this liquid is eliminated in the form of urine. Birds often drink excessively with many different diseases, including infections and metabolic diseases, like liver disease and pancreatic disease.

    Normally, the kidneys serve to balance the amount of water retained in the body. If the kidneys are damaged, they may loose the ability to form a concentrated urine. Excessive amounts of water can be lost from the body, resulting in polyuria and dehydration.

    Since the major method of eliminating waste is via the production of uric acid, birds have not developed the ability to form urine that is as concentrated as mammalian urine. To compensate for this, liquid is reabsorbed by the colon. When urine enters the cloaca, it is moved by peristaltic waves into the colon, where water is absorbed.

    Birds with intestinal tract disease often develop intestinal hypermotility. Peristaltic waves (rhythmic contractions of the intestinal tract which serve to push digested food forward) occur at regular controlled intervals in normal birds. In some birds with diarrhea, these waves lack coordination, so that food moves through the intestinal tract too quickly. This results in an increase in frequency of defecation and polyuria since water moved into the colon does not have a chance to be absorbed.

    A small amount of urine in the dropping may be normal. For example, switching to a commercial pelleted diet may cause temporary polyuria in some birds, as these birds may initially drink more water. Also, as mentioned above, birds eating a large amount of fruit and vegetables will become temporarily polyuric since these foods contain a higher water content. Similarly, birds may drink excessively following a bath, or if sweet tasting beverages are offered.

    It is common for birds to become temporarily polyuric when stressed. This may occur when the environment changes, such as the addition of a new bird, new people in the house, or moving the cage. Most birds are polyuric when taken to a strange place, like a veterinarian's office.

    Nesting birds and their offspring are usually slightly polyuric. This is commonly seen before egg laying in female birds. After laying the eggs, however, the droppings should return to normal. Birds that are feeding babies will also be polyuric, since they will drink more water to make a gruel in the crop to feed to the offspring.

    Causes

    There are many causes of polyuria in birds. The cause may be very simple, such as a dietary change, or may be due to a number of complex disease processes. There are many contagious diseases which cause polyuria, so it is important to inform your veterinarian of any potential contact – direct or indirect – with other birds. Possible causes of polyuria in birds include:

  • Bacterial infection. Bacteria infections may come from other birds, from an overgrowth of dangerous bacteria on dirty food or water bowls, or spoiled foods. Often, small amounts of potentially dangerous bacteria live in the intestinal tract without causing harm. This population of bacteria can overgrow and cause disease if the bird's immune system is not functioning properly, as may occur during times of stress.

    An overgrowth of harmful bacteria may also occur when antibiotics are used improperly. Bacteria may cause intestinal disease or move from the intestines directly to the kidneys though a specialized system of veins, call the renal portal system.

  • Viral infection. Several different avian viruses may cause polyuria, either by causing intestinal disease, or by directly infecting the kidneys.
  • Neoplasia (cancer). Neoplastic diseases of the kidneys or portions of the brain may cause polyuria.
  • Toxins. Polyuria is a common symptom of heavy metal toxins (lead and zinc), since these may directly damage the kidneys.
  • Antibiotic use. Birds may develop polyuria following treatment with antibiotics harmful to the kidneys. These include the aminoglycosides and sulfa drugs. Usually, the polyuria ceases once the drug is discontinued.
  • Metabolic disorders. These include liver disease and pancreatitis. Most birds with metabolic diseases will have other symptoms in addition to polyuria. The amount of excessive urine in the droppings is small
  • Diabetes Mellitus. It is common in smaller psittacine birds such as budgerigars and cockatiels, but can be seen in any species. Birds with diabetes drink very large amounts of water and will commonly soak the bottom of the cage with urine.
  • Dietary deficiencies or excess. Deficiency in vitamin A or excessive consumption of calcium and vitamin D can directly damage the kidneys.
  • Localized abscesses or infection. Such a uterine infections in female birds, peritonitis, or abscessed air sacs.
  • Steroid use. Corticosteroids (such as prednisone or dexamethasone) or progesterones.
  • Diet changes. The polyuria seen with diet changes, such as eating fruits and vegetables, is temporary and normal.
  • Stress induced. This is usually the result of a change in environment
  • Reproductive behavior

    A thorough history is extremely important in the diagnosis of diarrhea. Be prepared to tell your veterinarian:

  • When did the problem begin?
  • Is the polyuria intermittent? Are all of the droppings abnormal?
  • Is there an increase (or decrease) in the number and frequency of droppings?
  • Has the diet changed? Are fresh foods, such as fruits and vegetables fed regularly?
  • Is the bird still eating a normal amount of food?
  • What are the birds chewing habits? Does it have access to metal objects or plants? Does the bird chew apart wood, rubber or string toys?
  • Are any other symptoms, such as lethargy or vomiting present?
  • Has the bird been exposed to other birds?
  • How often is the cage and the food and water dishes cleaned? How are they cleaned?

    Your veterinarian will recommend specific diagnostic tests depending on how severely your bird is affected, whether other symptoms are present, or how long the problem has been going on. Birds that have other symptoms or have had chronic polyuria (lasting for days to weeks) or recurrent polyuria may require extensive diagnostic testing. Any combination of the following may be recommended:
            

  • A thorough physical examination
  • A complete blood count (CBC). The number of circulating white blood cells may be helpful in distinguishing between infectious and non-infectious causes of polyuria.
  • Serum biochemistry panel to look for evidence of diabetes mellitus or metabolic problems, such as diseases of the liver, kidney or pancreas.
  • Urinalysis to look for evidence of kidney disease. This test is not as specific as it would be if performed on a mammal. Contamination of the urine by fecal material in the cloaca makes interpretation less precise.
  • Sampling the feces or cloaca for bacterial culture and cytology (looking at cell types for evidence of infection or inflammation)
  • Blood tests that measure the amount of heavy metals, such as lead or zinc in circulation
  • Plasma protein electrophoresis. This blood test looks at the types of proteins present in the circulation. For example, birds with chronic diseases, especially infectious or inflammatory diseases, produce antibodies, and an increase in one class of proteins (gammaglobulins) occurs. Birds with liver disease or severe intestinal disease usually have low concentrations of another class of protein (albumin).
  • Blood tests or other samples for Chlamydiosis (Psittacosis) or Polyomavirus
  • Radiography (X-Rays) to look evidence of intestinal disease, size and density of the liver, kidneys or other organs
  • Contrast radiographs, such a barium studies, to look for tumors, ulcerations or thickening of the lining of the intestinal tract. This test will also determine how quickly ingested material is moved through the intestinal tract.
  • Fluoroscopy. This is a video or moving X ray performed by a specialist that is used to determine if the coordination of peristaltic waves is normal. It is useful in the diagnosis of toxicity (lead or zinc) or viral diseases (proventricular dilatation disease).
  • Abdominal ultrasound. This test is only possible in birds with enlargement of the liver or fluid in the abdomen. It allows visualization of the intestinal tract, liver, uterus and other abdominal organs. A specialist usually performs this test.
  • Endoscopy. This is viewing the body cavity directly (kidneys, liver, pancreas) with a rigid endoscope to collect samples for biopsy or culture. An endoscopic biopsy is often the only way to definitively diagnose the cause of kidney or liver disease. A specialist usually performs this test.

    Therapy In-depth

    Your veterinarian may recommend one or more of the diagnostic tests described above. In the meantime, treatment of the symptoms might be needed, especially of the problem is severe. The following treatments may be applicable to some, but not all birds with polyuria. Theses treatments may reduce the severity of symptoms, or provide relief for your bird. However, nonspecific therapy is not a substitute for definite treatment of the underlying disease responsible for your bird's condition.

  • Birds with moderate to severe polyuria and other symptoms such as lethargy and anorexia usually require hospitalization and 24-hour care.
  • Fluid therapy. Many birds with polyuria become dehydrated and require fluids. Fluids may be given by an intravenous catheter, an interosseous catheter (into the bone marrow) or subcutaneously (under the skin). The route of administration will depend on how severe the level of dehydration is.
  • Dietary change. If the polyuria is a temporary normal response to an increased amount of liquid in the diet, fruits and vegetables may temporarily be withheld.
  • Forced feeding. Birds that refuse food may require forced-feeding of an easily digestible liquid food. Your veterinarian may pass a tube into the bird's crop to deliver this food.
  • Antibiotics or antifungal medications may be needed to treat or prevent an overgrowth of bacteria or yeast.

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