How to Conduct a Parrot Health Examination

A resident at Exotic Avian Sanctuary of Tennessee gets a health exam.

Much like the common advice given to humans, it’s important to regularly check the health of parrots with a routine physical examination rather than waiting until a bird is showing signs of distress or illness. Not only will this help you get to know what all aspects of a healthy bird look and feel like, but regular handling may help in keeping a bird calm in more stressful situations. Be prepared to give them a good assessment once a month, while making daily observations in health and behavior or individual residents. This will help care staff know what is normal for the individual and to intercede when they suspect an issue, catching it early rather than later. For more information on why regular health examinations are important, check out our resource here.

Residents With Challenging Backgrounds
Close daily observation can be difficult with certain individuals or groups who come from challenging backgrounds. They may be more likely to hide signs of illness or injury, or may not allow you to come close enough to them to thoroughly assess their well being on a regular basis. Challenging backgrounds may include individuals who are not properly socialized, have lived wild or feral, or were abused or malnourished. If you care for individuals who came from a challenging background, it is imperative to make time to foster a bond of trust so careful observation is possible. More frequent health examinations may be necessary for these individuals until they exhibit signs that they feel safe and you are confident that close daily observation is possible.

New Resident? Conduct An Intake Examination!
If you are conducting an initial health examination on a new resident, check out our intake examination resource to learn about what you should check for and document!

Problem Signals

Though every parrot is different, they tend to hide their pain if they can. By paying regular attention to the individual and flock, you may see some subtle cues in the event that something is amiss. Many species of parrot are especially susceptible to some ailments that are hard to notice without a thorough examination.

Signs of a sick, injured, or otherwise distressed parrot include:

  • Generally poor in appearance
  • Hiding more often than they used to
  • Change in personality – irritability, docility, confrontational
  • Change in their daily schedule (such as disinterest in bathing)
  • Labored breathing, gurgling sounds, or a constantly open mouth
  • Immobility, inactivity or unresponsiveness to your approach
  • Ruffling feathers
  • Avoiding the rest of the flock
  • Being bullied more by the rest of the flock 
  • A limp in their step or standing on one foot
  • Unusual or abnormal droppings
  • Reduced hunger or thirst, or excessive water drinking
  • Plucking their skin and feathers
  • Fecal matting underneath the vent
  • Swollen sinuses or swelling around eyes
  • One or both wings drooping
  • An abnormally large crop
  • Discharge coming from the eyes or nares
  • Unusual coloring of skin
  • Unusually bad smell

In cases of symptoms such as the ones above, it’s especially important to conduct a health examination of the individual. Generally, the examination should begin at their head and end with their tail. It’s important to keep regular documentation of these checkups, including weight and any abnormal findings, in order to keep an easy-to-follow set of information in case a veterinarian needs the parrot’s history.

Conducting The Exam

Ask An Expert
Prior to regularly conducting parrot health examinations, you should have a veterinarian or compassionate care expert give you hands-on training in order to be the best parrot health advocate possible. Being trained to rapidly distinguish healthy conditions from abnormalities can be crucial in early health problem detection and effective treatment!

Hold Them Safely!
You must be very cognizant of a parrot’s stress levels and breathing when handling them. If a parrot ever seems to be very distressed, breathing heavily, or cannot breathe comfortably, you must put them down and let them rest.

• Minimize tipping a parrot too far onto their side during an examination in case they have an abdominal mass or heart or respiratory issue.

• Be sure to learn proper handling and restraint techniques from an experienced avian veterinarian. Improper handling and restraint can cause serious injury and diminish the bond between parrot and care staff members and cause them to fear future examinations. Parrots that are accustomed to handling and human interaction can be offered a finger or forearm for them to hop onto. After that, they should be brought slowly to your body, staying below your chin. If they enjoy being spoken to or receiving scratches (appropriate to a species behavioral repertoire), it can help keep the experience less stressful.

• Generally speaking, its best to gently restrain their head with a single hand (using thumb and forefinger to encircle their neck without constricting) and support their body and wings. with the other hand. If they are small, they can be gently restrained and supported by a palm while the thumb, pinkie, and next finger contain their wings and the middle and forefinger restrain their head.

• Birds that are fearful will require special techniques, such as the use of a towel to help grasp and hold them, that should remain as gentle and careful as possible so as to minimize stress and fear.

Once you are prepared to perform the health examination, conduct the following observations: 

When In Doubt…
Unless you are a qualified veterinarian or have been trained to handle specific conditions, The Open Sanctuary Project strongly advocates that you promptly report any health concerns you find during the course of an exam to your veterinarian or care expert. Unless they’re in a life-threatening situation, you should be the resident’s advocate, not their doctor.

Behavioral Observations From A Distance
Starting their health exam from a distance allows you to observe and record behaviors you might not have otherwise noticed and helps give you an overall “feel” of the individual’s state. Mental and emotional health is important and can affect physical health and an individual’s quality of life. In addition to any signs of illness or injury, observing their behaviors and overall appearance can give you vital information and insight into whether their current living space, flock, enrichment, diet, and comfort with humans need to be reassessed to better promote health overall.

What are they doing at the time of observation?

Do you see any fearful, confrontational, social, reproductive, or playful behavior(s) or any other behaviors? Are they grooming/preening or bathing? Engaged in pleasant or confrontational behavior with flock-mate(s)? Are they sitting still or sleeping? Are they flying around or perched? On the floor? Do their feathers seem ruffled? Are they exhibiting any stereotypies such as route-tracing or self mutilation or feather plucking? Are they screaming?

Write down a few words describing your general impression of them upon first observation.

Example 1: Happy, engaged, social
Example 2: Depressed, disinterested, sad
Example 3: Confrontational, fearful, overstimulated 

Make an assessment of the individual as you know them. Are any of the behaviors they are engaged in normal or strange for them? Note anything that seems surprising or out of place.
Clinical Observations From A Distance
After observing and recording their behaviors, remain outside of their living space and now note any clinical signs of illness or injury. Note any respiratory distress such as open mouthed breathing, tail bobbing, or any sounds. Note the parrot’s posture and report any signs of a hunched position, wings held out to the side (which can be a sign of heat stress or a lack of oxygen), wing(s) droop, favoring one leg, and abnormal head positions. Additionally, note any signs of straining or sounds of vocalization or flatulence if the individual is defecating. Observe if there is an abnormal or foul odor. Take a look at the individual and see the condition of their feathers overall (a closer look will be a part of the examination later). 

Now that you have observed behaviors and general signs of illness and injury, you can move forward with the exam using the knowledge you have required of the individual to tailor the exam to meet their needs.
Check Weight And Body Condition
It’s important to know the accurate weight of each of the birds in your care, as a healthy adult parrot should maintain weight consistently. If the bird has lost a lot of weight, this could indicate a sickness, malnutrition, worms, or parasites, like giardiasis. If the bird has gained weight, it’s critical to ensure that you aren’t overfeeding them, especially with treats and snacks. Obesity-related complications, like Fatty Liver Disease, regularly can lead to death in parrots. If you need to lower their food intake, you must do it gradually because a quick drop in nutrition could lead to serious health repercussions. In addition to weighing each bird, you should also pay attention to their body condition.  Does a bird feel thin with a prominent keel and little muscle mass, but based on the number on the scale, they have not lost weight or have maybe even gained? A loss in body condition without their actual weight going down could indicate a serious health issue such as abdominal fluid or a tumor. For birds with confirmed health issues that result in fluid build-up or masses in their abdomens, be sure to take that into consideration when weighing them. A parrot with liver disease (or in females with salpingitis or yolk-related peritonitis) and subsequent abdominal fluid, for example, may technically have a “normal” weight, but a large percentage of it could be the fluid. If the fluid is removed, they could likely weigh much less of what they did when the fluid was present.
Check Their Poop
It’s highly recommended to create a dropping board for your flock in order to be able to quickly inspect a parrot’s droppings. This practice makes it easy to recognize what healthy parrot droppings look like, which can be quite diverse.

Change in color – Depending on the species and diet, a range of colors can be considered “normal”, which is why it is important you know what normal looks like for your flocks. Colors to look out for are red (possible fresh internal bleeding), black (signs of old blood), green, and yellow.

Note: certain produce and parrot food can turn droppings into these colors. This is why it is important to know what “typical” looks like for your flock and what the diet consists of for your flocks and individuals. Strawberries, green veggies, and blueberries are examples of foods that can cause otherwise alarming colors. 

Texture – Droppings similar in consistency to toothpaste with a tubular shape are good, while tarry droppings indicate serious health problems and a vet should be called immediately. Watery, lumpy, oily or droppings with undigested seeds can also indicate health issues.

Smell – droppings shouldn’t really smell. If they smell funky, this indicates a problem.

If you’re particularly concerned by a dropping, you can bring it into your veterinarian for a fecal float test for analysis, though you should consider fecal testing healthy-seeming birds once every three or so months to check for internal parasites. Additionally, pay attention to when a bird poops and whether they are struggling or pass gas, as this is indicative of potential health issues.
Check Their Head
How are they holding their head? It’s best if they’re holding it up on their own volition. Is their head properly feathered? Bald patches or abnormal feather growth can indicate disease or loss of feathers through trauma. The skin on their head should be thin and just a little flaky. Too much flakiness can indicate vitamin deficiency. Assess their head for any asymmetries that could reveal sinus, eye, or ear abnormalities or illness. Keep an eye out for discharge and be careful not to put much pressure on the facial patches of macaws or African grey parrots, as they are easily bruised.
Check Their Eyes
The parrot should have wide open, clean, alert eyes. Their eyes should be free of discharge and clear. Cloudy, watery, dry, swollen, or crusty eyes indicate illness or injury. Their pupils should be round, be about the same size, and react properly to bright light (get smaller and then return to normal).  Parrots have a third eyelid (also known as the nictitating membrane). It should be cloudy white and retract when stimulated, rather than red, swollen, or non-retractable.
Check Their Beak
Is the parrot’s beak open or closed? If mostly open, they may be stressed, overheated, or have a respiratory illness. A parrot’s beak should be assessed for any abnormalities like scissor beak, overgrowth, and trauma from injury or illness which can result in grooves in the keratin of the beak or missing parts of the beak. Their beak should be smooth and free of cracks, although a small amount of flakiness can be normal. Signs of extreme flakiness, overgrowth or deformities should be addressed as soon as possible. 

Their nares (parrot nostrils) should be free of scratches, bubbles, discharge, plugs, and general crustiness. Enlarged nares may indicate chronic rhinitis. Staining of facial feathers can indicate discharge. The parrot’s cere (bump above beak) should also be evaluated for any lumps, swellings, or injuries.
Check Their Mouth
The parrot’s mouth should not be foaming or contain discharge. You shouldn’t be able to hear them breathe in ideal circumstances. Their breathing should not be labored, loud, wheezy, rattly, sneezy, whistling, or squeaky. Now look inside their mouth (especially at their tongue). The skin should be smooth. It should not have any ulcers, lesions, lumps, or discoloration. It’s completely normal for their mouth’s roof and upper mandible to have a split in it. This is called the choanal slit, and it should be free of obstruction and discharge and be bordered by sharp distinct papillae. A lack of or blunting of papillae can indicate a health issue. Grayish skin and a bad odor can indicate bacterial infections. Mouth lesions could indicate a number of ailments that will need to be treated, including Vitamin A deficiency, avian pox, or candidiasis. Look out for any abscesses, paying particular attention to the side of their tongues.
Check Their Crop
The crop should feel empty or difficult to feel if they haven’t eaten that day, or if the exam is well after they have eaten. It should feel full after they have eaten. If a parrot has sour-smelling breath and/or the crop feels “doughy”, it could indicate crop issues like crop stasis. If the parrot hasn’t eaten that day yet their crop feels full and hard, they may be suffering from a blockage and require immediate care. If the crop is overly distended with fluid or digesting food, you must be careful you don’t cause aspiration while palpating the crop. If you are concerned about a parrot’s crop, you should consult a veterinarian. It’s important to get to know what a crop feels like in both full and empty states so you can more easily monitor it for abnormalities.
Check Their Breast
A careful examination of a parrot’s pectoral muscles and keelbone are necessary to determine muscle mass, weight loss or gain, or any abnormalities such as growths. Many birds lose weight quickly when they are ill and you will be able to see evidence of this in the loss of muscles. You may not notice without an exam if the parrots ruffles their feathers in order to mask their condition (a common practice among prey species). Routine exams are important so you can learn what is normal for an individual parrot and catch issues early.
Check Their Abdomen
The abdomen of a parrot must be examined for signs of distention which could indicate internal masses or swollen organs, ascites, egg-binding, hernias, liver issues, or ovarian cysts (among other conditions). The abdomen in healthy birds is generally concave between the sternum and pubic bones. That is to say, the abdomen should curve inward somewhat. A distended abdomen, or one that is convex (curves outwards) may be a cause for concern, though it could also be fat or a normal reproductive state. Palpate the abdomen but be careful, especially if the abdomen is distended, as this can cause serious injury (ruptured air sac). Once practiced, you will learn the feel of certain normal and abnormal conditions. If you suspect abnormal distention, you should consult your veterinarian. Diagnosis may require radiology to determine the cause of the distention before it can be properly treated.
Check Their Feathers
Feathers should be full, bright, clean, smoothed, free of debris, flexible, and free from signs of ectoparasites. Exceptions to this are during any period of normal molting. Be sure to thoroughly examine feathers for discoloration, damage and abnormal growth, stress lines, and signs of trauma. A growing feather developing during times of intense stress or illness will often have stress lines or bars (a transverse break in the vane of the feather). This generally indicates stress in the fairly recent past, and care should be taken to identify the source of stress and make necessary adjustments.
Check Their Skin
Part the parrot’s feathers and check out their skin health. Feathers can hide skin illnesses and injuries. This is the time to ensure you are checking and feeling every area of the individual’s body, not just those included in this list. This thorough section of the exam is critical to ensure that nothing that could be addressed early is missed. Their skin should not have lice, mites, lumps, cuts, cysts, bruises, or necrosis. The skin should be clean and soft.
Check Their Wings
Take a look at the parrot’s wings. The wings should be held close to their body, be generally symmetrical, and there should be movement in their wings’ joints when they flex. Carefully extend each wing to check range of motion. The parrot’s wings should be checked for cuts, swelling, and other injuries. The joints and bones in their wings should be evaluated for any signs of swelling or popping sounds (crepitus). Make sure to check the area underneath their wings for lice and mites as well as any injuries. If a parrot presents with wing droop and the cause cannot be determined by the examination, your veterinarian may have to run tests to determine the cause.
Check Their Legs
The parrot’s legs should be checked for signs of fractures, deformities, swelling, and bony calluses, as well as for signs of any cuts, missing or protruding scales, lumps, asymmetry, or any mites on or under the scales. Check any leg feathers for damage as well. Each leg should be carefully extended and flexed to check range of motion and detect any signs of swelling or pain associated with movement. Note any favoring of a single leg.
Check Their Feet And Toes
When assessing feet and toe health, it is important to assess an individual’s grip strength and natural perching reflex. To do this, allow the parrot to grip your finger (or hand), checking strength in both feet. Examine the bottom of the feet for any sores, scabs, redness, or ulcerations. Continue the exam, checking the smoothness/crustiness of their skin. Check toes for swelling, abnormal conformation, missing, twisted, or overgrown nails (or toes!), redness, and evidence of uric acid crystal build up (little white masses). 
If you find a scab covering a swollen and hot or fluid-filled area, or if there is discharge seeping out from the scabbed area, you should have the parrot evaluated by a veterinarian as soon as possible. Carefully check their foot for heat or swelling. If they have red, swollen, or scabby joints, this could be indicative of a serious joint infection that requires a veterinary exam. Check their nails to ensure that they’re normal length and even. You may have to trim or file them if overgrown. 
Check Their Preen Gland
The preen gland (also known as the uropygial gland) is not present in all parrots. For example, a preen gland is absent in hyacinth macaws, but prominent in cockatoos! If the species you are examining has a preen gland, then it needs to be assessed for lumps, asymmetry, parasites, enlargement, hardness, abscesses, impaction, or abnormal discharge. Be sure to familiarize yourself with what a normal preen gland looks like, and if there are any species-specific or individual characteristics to be aware of. Aside from the gland itself, which has small lobes on each side, it should not have any additional lumps, and the lobes should be small, fairly symmetrical, and soft. While an enlarged preen gland could point to impaction, something that may be treatable by staff, it can also be a sign of cancer and should be confirmed by an expert.
Check Their Vent
The parrot’s vent (a fancy way to say their butt), should be clean and moist (but not wet) and should be the same color as the rest of their skin. It shouldn’t have any discharge, excessive accumulations of fecal matter around it, nor should it be crusty, bloody, or dry. Ensure that it doesn’t have any mites, lice, tapeworms, or other parasites. Make sure that it isn’t irritated or prolapsed (protruding). Staining of the vent area could be a symptom of egg-binding, cloacal prolapse, and cloacal papillomas. If it’s prolapsed, you must consult with a veterinarian immediately. Sometimes an enlarged vent may be indicative of normal reproductive states in female birds. 
Note Any Potential Neurological Symptoms
Some signs can be indicative of potential neurological issues, though not necessarily so. Here are a few signs to look out for:

• Head tilt
• Abnormal body posture
• Inability to balance/ stay perched
• Inability to grasp a finger or perch
• Wing droop
• Limb paralysis
• Altered cognitive abilities (you may see them having difficulties performing tasks they usually excel at)
• Marked confusion 
• Loss of awareness (such as flying into walls)
• Hyperresponsivity to normal stimuli (such as a care staff member walking by or entering the living space)
• A decrease in the response of stimuli (such as if a staff member brings breakfast and they remain perched) 
• Arching of the head, neck, and spine caused by muscle spasms
• Change in personality
 
The above signs can indicate either neurological issues or other, non-neurological conditions. If you see the above symptoms, it is always important to obtain a veterinarian’s diagnosis, as any number of the above symptoms could indicate other non-neurological conditions that require completely different treatments. For example, a parrot with an abnormal head position may be suffering from heavy metal poisoning, or a decrease in response to stimuli might be due to feeling extremely sick or unwell for any variety of illnesses. For these reasons, it’s important to document your findings and share them with a veterinarian rather than making any assumptions of what may be going on!
Isolate If Necessary
If you notice that a parrot is unhealthy, it’s crucial to consult with a veterinarian and/or compassionate care expert and prioritize accurately diagnosing the problem. Depending on the health concern, it may be necessary to isolate the parrot in order to protect the rest of the flock from a potentially infectious disease. However, with some illness, such as psittacosis (Parrot Fever), often once a parrot is showing symptoms, the other residents in the flock have already been exposed. In fact, some birds can be asymptomatic carriers. In these instances, you will need to weigh what is in the best interest of all of your residents. A sick parrot who is isolated from their flock may become more stressed, which could delay recovery. However, if the parrot is being bullied or cannot compete with the rest of the flock for food, or if you need to more closely monitor their food and water intake and fecal output, you will likely need to separate them at least temporarily.  You may find that keeping them in a quiet space with a calm parrot companion is a good compromise until they are well enough to rejoin the flock.

Writing It All Down

As you may know, regular documentation is a critical part of responsible sanctuary animal care. In order to maximize the value of your parrot health examinations, we’ve developed a free printable parrot health exam form for sanctuaries and rescues!

We are currently working on a Common Parrot Health Issues resource to help identify what may be amiss, but you should always discuss any potential health issues with a qualified avian veterinarian or expert.

Though it may seem like an overwhelming amount of factors to be aware of, once you’ve gotten to know a parrot and what good parrot health looks like, you’ll be an excellent parrot health ally in no time!

SOURCES:

Common Conditions Of Pet Birds | VCA

The Avian Physical Examination  | Niles Animal Hospital

Physical Examination | Clinical Avian Medicine Volume 1

Poopology | Beauty Of Birds (Non-Compassionate Source)

Non-Compassionate Source?
If a source includes the (Non-Compassionate Source) tag, it means that we do not endorse that particular source’s views about animals, even if some of their insights are valuable from a care perspective. See a more detailed explanation here.

Updated on December 21, 2020

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