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    How to Conduct a Turkey Health Examination

    A caregiver checks the feathers of a large tom turkey that they are holding in their lap.
    Giving Walter a once-over!

    This resource has been fully reviewed and updated by a member of The Open Sanctuary Project’s staff as of November 30, 2022. It was originally published on March 29, 2018.

    Much like the common advice given to humans, it’s important to regularly check the health of turkeys 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 a healthy turkey looks and feels like, but regular handling may help in keeping individuals calm in more stressful situations. Be prepared to check turkeys over at least once every six to eight weeks*! For more information on why regular health examinations are important, check out our resource here.

    *An Exam Every Six To Eight Weeks Means Daily Observations!
    Our recommendation to conduct routine health examinations every six to eight weeks must be done in conjunction with daily observations. Caregivers should be trained to observe animals both for behaviors that are abnormal for the species and also behaviors that are abnormal for each individual, keeping in mind issues that are common in a particular species or breed and their warning signs. Thoughtful observation plays a crucial role in catching health issues before they progress into more serious situations. You can read more about daily observation for turkey health and well-being 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 socialized, have lived 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.

    green turkey graphic

    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!

    Supplies

    Before conducting a health examination, it’s helpful to gather any supplies you may need and have them arranged nearby for easy access. Having everything you will likely need nearby can make the examination go more smoothly and can reduce the amount of time the turkey needs to be restrained. If you are performing an exam on someone with a known health issue, such as bumblefoot, you may need other supplies, like those needed to wrap a foot. Otherwise, supplies to have on hand during turkey health exams include:

    • Recordkeeping supplies
    • Nail trimmers and/or dremel tool
    • Styptic powder or other blood stop product
    • Gauze squares (​​non-sterile is typically fine, but there may be times when sterile gauze is necessary)
    • Exam gloves
    • Bandage scissors
    • Turkey-safe topical disinfectant (such as dilute chlorhexidine or dilute betadine)
    • Saline flush
    • Turkey-safe ointments or creams such as a triple antibiotic ointment or silver sulfadiazine cream 1% (SSD)
    • Cotton-tipped applicators
    • Tweezers
    • Scale 
    • Headlamp, penlight, or flashlight
    • Towels
    • Antiparasitic treatment for external parasites, per your veterinarian’s recommendations

    Conducting the Exam

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

    Before beginning the actual exam, it’s a good idea to observe the individual without restraining them. Take note of their behavior, activity level, general appearance, how they are standing, and how they are moving. You can read more about “normal” versus potentially concerning turkey resident observations here.

    Before beginning individual exams (and, if possible, before entering your residents’ living space), it’s a good idea to take a few minutes to observe the group. Make note of their behavior, activity level, and general appearance. If residents are up, observe how they are standing and moving. This is also a good time to observe everyone’s breathing, looking to see if anyone is open-mouth breathing. If temperatures are hot, the entire flock may be slightly open-mouth breathing (severe open-mouth breathing is a sign of overheating and immediate steps should be taken to provide residents relief from the heat). However, in addition to being a response to being hot, individuals may open-mouth breathe if they are sick or in pain. If you note open-mouth breathing when temperatures are cool, or if you notice that only one resident is open-mouth breathing or is open-mouth breathing more severely than others, this warrants closer observation (and is some cases, an immediate call to your veterinarian). 

    In addition to paying attention to your residents’ mobility and breathing, during this general observation of the group, watch for anyone who stands out as looking or acting differently from the rest of the flock. While this may not necessarily be an indication of a health concern, it certainly calls for further observation and assessment during the exam. 

    Safe Restraint
    Before attempting to conduct a health examination, make sure you know how to safely hold a turkey. You can read more about safe restraint here. You must be very cognizant of a turkey’s stress levels and breathing when handling them. If a turkey ever seems to be very distressed, breathing heavily, turning dark, or cannot breathe comfortably, you must stop restraining them and give them time to rest. 

    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. You should be the resident’s advocate, not their doctor. Additionally, routine health exams performed by a caregiver are not meant to be a replacement for veterinary assessment. The goal is to catch potential signs of concern as early as possible so you can bring concerns to your veterinarian. If necessary, they can then perform a more in-depth examination of the individual.

    During regularly scheduled health examinations, your goal is to check every inch of the turkey. Some folks like to start at the head, while others may prefer to start at the feet. Either is fine, but it’s helpful to have a general order and routine that you follow each time because this can help ensure you do not miss a step. However, because some areas naturally flow into others, it might not be helpful to think of the exam as a linear list of areas to check. Instead, we think of it more as a choreographed routine, where checking one area flows into checking another area. By checking individual areas or body parts in isolation, you may miss important findings in the gray areas in between. While performing the exam, it’s imperative that you continually monitor how the turkey is doing by watching their breathing and their color and taking a break if they appear overly stressed.

    Up next, we’ll go over important components of a health examination:

    Check Their Feet
    While this part of the exam is important for all turkeys, for large breed turkeys thoroughly checking their feet, especially the bottom of their feet, is one of the most important parts of the health exam. While not a condition limited to large breed turkeys, bumblefoot can be quite common in large breed turkeys and early intervention significantly improves the prognosis. Check for any bumps, lumps, swelling, scabs, cuts, or pressure sores on both the top and bottom of the turkey’s feet and toes. Early signs of bumblefoot include the skin on the foot pad becoming smooth, shiny, and/or red, so look closely for any of these signs. Individuals with heat, swelling, scabbing, or discharge should be evaluated by a veterinarian. Don’t remove scabs unless you have been trained by an expert and are very experienced in evaluating foot conditions in turkeys! 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 turkey evaluated by a veterinarian as soon as possible.

    In cold climates, red and swollen toe tips, blackened skin, or hard black scabby toe tips could be a sign of frostbite. If you suspect frostbite, be sure to move the turkey into a warmer area and consult with your veterinarian. At the very least, the turkey will require pain medications, but may need antibiotics, or even surgical intervention, depending on the extent of the damage. If a turkey shows signs of frostbite, be sure to make changes to their living space to protect the rest of your residents.

    While bulges on the top of the foot, in between the toes, could be a sign of infection, they could also be the result of dirt or mud packed into foot crevices, which is not an uncommon occurrence in large breed turkeys. If you find a resident with a lump in this area, you can start by applying very light pressure to the skin on the top of their foot while watching the bottom of the foot, which should allow you to determine if the cause of the lump is mud pack or not. Remove any mud that has become trapped in this crevice with gentle pressure and the use of wet gauze or cotton-tipped applicators. Be very careful not to damage the skin while attempting to clean this area.

    Make sure that the turkey’s toes are elongated and straight; twisted and folded toes are generally not a good sign, but you’ll need to familiarize yourself with what is normal for each individual. Some turkeys may come in with bent toes when they are rescued, possibly from an old injury, and may never have issues or need any treatment, but if a turkey had straight toes last month and twisted toes this month, then you should consult with a veterinarian. Additionally, some turkeys may arrive missing their nails and toes tips due to the cruel practice of detoeing. 

    The turkey should have smooth, flat scales on their feet. Raised scales could be a sign of scaly leg mites, though sometimes older individuals develop slightly raised scales where their foot and the front of their leg meet.

    You can check a turkey’s natural perching reflex on both feet by placing a finger under their feet and seeing if they grip around it. Additionally, or alternatively, you can gently flex and extend their hock. Their toes should curl (as if gripping around a perch) when the hock is bent and should straighten when the hock is extended.

    Check their nails to ensure that they’re normal length and smooth. You may have to trim or file them if overgrown.
    Check Their Legs
    The turkey’s legs should have smooth, flat scales on their legs. If they’re flaky, crusty, or raised, they might have scaly leg mites. Their legs shouldn’t have any cuts, missing scales, or lumps. If their legs are raw and painful, they might have scald, which is a result of poor housing conditions leading to ammonia burns. This requires medical treatment. 

    Check for any signs of irritation on the hock, which could be the beginning of a pressure sore. This is especially common in large breed turkeys who spend large amounts of time laying down due to mobility issues or obesity. Hock sores can start out as superficial scabs and develop into deep wounds that can become infected. Be sure to seek veterinary care if a resident is developing hock sores.

    Carefully check their range of motion, especially in their hocks, and check for crepitus (creaking, cracking, crunching, popping, or grating), pain, resistance, heat, or swelling. Because of the conformation of their legs, assessing range of motion issues in their knees and hips is difficult. Hot, swollen, or scabby joints could be a sign of infection. Consult with your veterinarian immediately. Never attempt to drain infected joints!

    If the turkey has a leg band, be sure to check that it fits properly and is not causing any issues.
    Check Their Vent
    A turkey’s vent is the external opening of the cloaca and is where both digestive and urinary waste, as well as eggs are released from a turkey’s body. It is located just below the base of the tail. The vent 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 or excessive accumulations of fecal matter around it, nor should it be crusty, bloody, or overly dry. Cysts near the vent could be due to a fluke infection.

    Ensure that there are no mites, lice, or other parasites in this area. Check for wounds, especially rat wounds, as this is where they tend to bite; the presence of rat wounds is a major red flag that you must take immediate steps to control your rodent population and protect your residents before they cause more damage. Read more about compassionate ways to respond to rodent-related issues here. You may need to move turkeys to a new, predator-proof location for the time being in order to keep them safe.

    Make sure the vent isn’t irritated or prolapsed. If you notice that a turkey you are restraining is prolapsing, set them down immediately. If there is just a small amount of prolapsed tissue, it may go back in once the turkey is set down, with no intervention on your part. If this is not the case, contact your veterinarian for guidance. Be aware that other bird residents will likely peck at a flock mate’s prolapsed tissue (especially if there is any sign of blood in the area), causing damage, so a turkey with a prolapsed vent should be kept away from other birds. It is imperative that you do not pick up the turkey, as this could cause them to strain and prolapse further. Read more about how to handle a prolapsed vent here.
    Check Their Abdomen
    The turkey’s abdomen should feel small and soft, and with the exception of possibly the gizzard, you should not be able to feel any defined structures. A turkey with a distended, hard, or fluidy belly should be evaluated by a veterinarian as soon as possible as they could have a number of serious issues including egg binding, egg yolk peritonitis, or heart failure. You should consult a veterinarian if you have concerns about a turkey’s abdomen.

    Anyone with feces-covered feathers should be cleaned and/or have the dirty feathers trimmed using blunt-tipped scissors. This must be done carefully to ensure you do not accidentally cut their skin. Be sure to contact your veterinarian if anyone has excessive fecal matting, diarrhea, or is showing other signs of concern.
    Check Their Preen Gland
    At the base of the turkey’s tail is the preen, or uropygial, gland. Aside from the gland itself, which has small lobes on each side, it should not have any additional lumps, and the lobes should be fairly symmetrical and soft. Orange-tinged oily discharge from the tip of the gland is normal, but there should be no other areas with discharge. It is not uncommon for this area to be a bit dirty if the turkey has access to dirt for dust bathing. Check this area for external parasites.

    An enlarged preen gland could indicate impaction or cancer. Impaction can often be handled with a warm compress periodically applied to their preen gland, but you should have a veterinarian examine the individual before beginning treatment. Using pressure to express a preen gland that appears large can result in damage – this is a technique that should be demonstrated to you and should only be used when a veterinarian has confirmed that the cause of the enlargement is indeed an impaction and not something else.
    Check Their Wings
    Take a look at the turkey’s wings. You can check the wing that is facing away from your body now, and then check the other wing later after you rotate the turkey to their other side. The wings should be held close to their body, be generally symmetrical, and there should be movement in the wings’ joints when they flex. A weak, droopy wing can be a sign of a fracture. Be very careful when checking the wings – if the turkey starts struggling or flapping their wings, set them down/stop handling them to avoid injuring their wings. 

    The turkey’s wings should be checked for cuts, swelling, and other injuries. If their wing tips are scabby or beat up, this could indicate that they have a mobility issue and are using their wings for balance and support. Make sure to check the area underneath their wings for lice, mites, bruising, or injury.
    Check Their Breast And Keel
    The turkey’s breast should be blister-free and firm. Males, as well as some females, have a bristly beard protruding from their chest. In males, these can be quite long, resembling a horse’s tail. In females, they may be so short that they aren’t visible through their feathers, or they may protrude only slightly.

    Check along the keel (also called the breastbone or sternum) for any sores. Keel sores should be treated early on, before they risk infection, and you should investigate the cause. It may be that they need thicker bedding in the areas where they rest, or it may be that they are laying down more often due to arthritis or another health issue that requires veterinary assessment and pain management.

    If a turkey is laying eggs and crushing them, you must be diligent about keeping them clean, as egg-covered feathers will attract flies, which can lead to flystrike.
    Check Their Crop
    The turkey’s crop is located at the base of their neck near the center of their chest. It is where food is stored before entering the proventriculus, or “true stomach.” It should feel empty (or impossible to feel at all) before a turkey eats for the day or after digestion, but will feel full after they have eaten. It’s important to get to know what a crop feels like, both full and empty, so you can more easily monitor it for abnormalities.

    If the crop is hard or filled with fluid, this could indicate a problem. In general, it is best to assess the turkey’s overall well-being in addition to any perceived crop abnormalities. A turkey could have a hard crop because they overate or didn’t drink enough water on a hot day. They could have a fluidy crop because they just drank a bit of water. If the turkey is bright and active and doesn’t have a major abnormality, you can usually plan to check their crop later in the day and, if necessary, again in the morning before they have eaten. If their crop is flat by morning, then most likely either there was never really an issue to begin with or the issue was minor and resolved on its own. If the abnormality does not resolve, becomes more severe, or the turkey begins to display other signs of illness, then you should consult with a veterinarian to diagnose and treat the issue.  

    Be very careful handling a turkey with a large fluid-filled crop, as they can easily regurgitate and then aspirate (inhale the regurgitated fluid into their airways). If the turkey has foul or sour-smelling breath, this also indicates possible crop issues, such as sour crop, which is a fungal yeast infection that requires treatment. If the crop remains full and firm, and they haven’t eaten in a while (or overnight), the crop could be impacted (or blocked). 

    NEVER attempt to empty a turkey’s crop by cutting into the crop or forcing them to regurgitate. These are not safe or appropriate practices. If a crop needs to be emptied, the crop must first be evaluated to determine if surgical intervention is necessary or if the contents can be removed using a feeding tube. All surgical interventions must be done by a licensed veterinarian using proper analgesics and anesthetics. Emptying the crop using a feeding tube and syringe should only be done by a veterinarian or highly trained caregiver. Discuss all crop issues and treatments with your veterinarian – it’s important to determine the underlying cause of the crop issue which often requires a culture and possibly diagnostic imaging.
    Check Their Head And Neck
    When checking their head and neck, keep in mind that turkeys have some very unique characteristics that may be misinterpreted as being abnormal. The skin in this area is covered in caruncles, fleshy protuberances of varying sizes. In males, the caruncles at the base of the neck are quite large. The skin on their head and neck can also change color depending on things like ambient temperature, the individual’s mood, and also the activities they are engaged in. It is also normal for different parts of a turkey’s head and neck to be different colors (rather than having a uniform color to all the skin of their head and neck). This can be especially pronounced in males who may have very red caruncles on the neck, a blue hue around the eyes, and white on the top of their head, for example.

    Scabs or other lesions on the head or neck could be a sign of illness or injury.

    Neck – Observe the position of their head. Any head tilting should be noted. Their neck should be vertical with no kinks. In addition to caruncles, turkeys have a single wattle that is quite different from that of a chicken. Compared to a chicken’s wattles, a turkey’s wattle is less fleshy and more connected to their neck.

    Snood – The snood is the fleshy growth above the beak. Be aware that some agricultural settings remove turkeys’ snoods. In females, the snood is fairly small, but in males it changes size depending on what the turkey is doing – lengthening and hanging down when they are strutting, and becoming quite short and even standing upright at other times. The snood should be supple and free of lesions. Swelling, scabbing, or abnormal discoloration are signs of concern.

    Ears – Their ears are round openings located behind their eyes. A turkey’s ears should have clean feathers covering them and should be free of discharge, debris, or strong odor.

    Eyes – The turkey should have wide open, clean, alert eyes. They should be clear and free of discharge. Cloudy, watery, dry, swollen, or crusty eyes could 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). A cloudy eye could be a cataract or the result of an infection. Turkeys 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. You should have your veterinarian evaluate any eye abnormalities as soon as possible.

    Sinuses – Check the area around the eyes and in front of the eyes for any swelling.

    Beak – Their beak should be smooth and free of cracks. However, turkeys may arrive missing a portion of their upper (and possibly lower) beak due to the cruel practice of debeaking. In individuals who have full beaks, check the length of the top beak. If it begins to grow much longer than their lower beak, you may need to trim or file it down. If the upper beak is allowed to grow too much, it can interfere with eating, pecking, and preening. Check the alignment of their upper mandible (top part of their beak). If the top and bottom beak go in different directions, this may be a common congenital issue known as cross beak (or scissor beak). Turkeys with a crossed beak may need to be offered softer foods, such as soaked pellets, in a wide shallow bowl, because dry pellets and crumble can be difficult for them to eat. They also tend to need their beaks trimmed regularly, and, depending on the severity, may need either or both their upper and lower beak trimmed. If the beak’s alignment is suddenly different, contact your veterinarian for guidance.

    Nares – There shouldn’t be any discharge or crustiness in their nares. If the nares appear clogged at all, you can use a moistened cotton-tipped applicator or a pair of tweezers to gently remove any obstruction. Their breathing should not be labored, loud, wheezy, rattly, whistling, or squeaky.
    Check Inside Their Mouth
    Checking inside their mouth tends to be the turkey’s least favorite part of the exam, and proper technique can be a tricky thing to learn at first. When first learning this skill, it can be easiest if you have a second person restrain the turkey so you can use both hands to open their mouth. When you look inside their mouth, it should not be tacky or have excessive mucus. A sticky or tacky mouth could be a sign that the turkey is dehydrated. Their mouth should not have any ulcers, lesions, or areas of discoloration. Raised yellow lesions could be a sign of wet pox or another disease. 

    It’s completely normal for their mouth’s roof and upper mandible to have a split in it. This is the choanal slit, and it should be free of obstruction and discharge. Their breath shouldn’t have an overly strong odor – a sour smell could be a sign of sour crop. At the center of the back of their throat, you will see the opening to the trachea (windpipe) and depending on the lighting and the angle from which you are looking, you may also be able to see partially down their trachea. If you have a concern about the trachea, in addition to consulting with your veterinarian, you can hold a light against a turkey’s neck while looking down their throat. The light will illuminate their trachea, allowing you to see more clearly for any signs of obstruction, gapeworms, lesions, or other concerns.
    Check Their Feathers And Skin
    The turkey’s feathers typically should look shiny and lay flat against them (with the exception of when strutting). Bloody feathers are a clear sign of a problem. For the most part, feathers should be clean, though you may have residents who have dirty feathers from exploring in the mud or eating a messy treat. Unless the turkey is molting, feathers typically should not be missing or  tattered, which could be due to stress, parasites, flock behavior issues (like bullying or feather pecking), or nutritional deficiencies (especially protein). If their feathers don’t seem to be developing or won’t fold into their normal position, this is also indicative of a problem. 

    Part the turkey’s feathers around their body, being mindful of any pin feathers (new feathers), as these emerging feathers are very sensitive to handling and can be damaged easily. 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 highlighted above. This thorough portion of the exam is critical to ensure that nothing that can be addressed early is missed. Their skin should be soft, pale pink, and translucent. Look for areas of abnormal discoloration, scabbing, swelling, and any signs of injury. Look carefully for signs of external parasites, including clumps of eggs or irritated, scabby skin. 
    Check Their Weight And Body Condition
    It’s important to have an accurate weight for each of the individuals in your care. A healthy adult turkey should maintain weight consistently. If a turkey resident has lost a lot of weight, this could indicate an illness, malnutrition, or parasitic infection. If they have gained weight, it’s critical to ensure that you aren’t overfeeding them, especially with treats and snacks, as obesity can lead to other health issues. Obesity is particularly common in large breed turkeys and can increase their risk of developing a host of health challenges, including mobility issues, pressure sores, and heart issues. Excess weight can not only negatively impact their quality of life, it will also likely shorten their life.

    To weigh turkey residents, it can be helpful to use a scale intended for “dynamic weighing” or “weighing in motion,” as these scales will calculate the average weight for an animal moving around on the scale rather than oscillating indefinitely. Make sure the turkey has adequate traction on the scale (a bath mat or rubber bowl can be used to provide traction) and keep your hands near them to prevent them from slipping or jumping off the scale, which could result in injury. We recommend weighing turkeys in a standing or sitting position rather than placing them on their side. We never recommend placing a turkey on their back. 

    In addition to weighing each individual, you should also pay close attention to their body condition to determine if they are at a healthy weight. A prominent keel is a sign an individual is underweight. In an individual who is overweight, the keel may be difficult to find and the individual may stand with splayed legs. 
    Check Their Poop
    If the individual poops during the exam, be sure to make note of whether or not their stool appears “normal” or potentially concerning. You can read more about turkey poop here. Not every unusual dropping is cause for immediate concern, but be sure to contact your veterinarian right away if anyone has bloody poop; worms in their poop (be aware that the absence of visible worms does not mean the individual does not have parasitic worms or other parasitic infection); or consistently foamy, loose, or abnormally colored stool that cannot be explained by diet.

    When in doubt, grab a fecal sample and connect with your veterinarian.
    Isolate Them If Necessary
    If you notice that a turkey is unhealthy, it’s crucial to consult with a veterinarian to accurately diagnose the problem. Depending on the health concern, it may be necessary to isolate the turkey in order to protect the rest of the flock from a potentially infectious disease. However, with some illnesses, once a turkey is showing symptoms, the other residents in the flock may have already been exposed. In these instances, you will need to weigh what is in the best interest of all of your residents. A sick turkey who is isolated from their flock may become more stressed, which could delay recovery. Also keep in mind that in flocks with more than one male, it can sometimes be difficult to re-introduce a tom back into the flock, so you may only want to separate males in this situation when absolutely necessary. However, if the turkey 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 companion is a good compromise until they are well enough to rejoin the flock.

    To read more about considering alternative living arrangements in response to a health condition, check out our resource here.

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

    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 turkey health examinations, we’ve developed a free printable turkey health exam form for sanctuaries and rescues!

    SOURCES:

    Physical Examination Of Backyard Poultry | Merck Veterinary Manual

    Fluke Infections In Poultry | Merck Veterinary Manual

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