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A division of Kindred Spirit Kindred Care, LLC

Shannon Fujimoto Nakaya, DVM

 

A website about birds and bird-related services on the island of Hawaii.

Getting a Diagnosis

Written by Shannon Fujimoto Nakaya, DVM

 

Disclaimer: The information provided on this page is not intended as a substitute for veterinary care.

I once did an exercise to determine what conditions could cause vomiting as a symptom and came up with dozens of possibilities.  In order to treat a patient appropriately, it is generally helpful to understand the cause of the problem.  This process is called getting a diagnosis.

Getting a diagnosis is a sleuthing process and it FIRST begins with YOUR familiarity with the bird and YOUR observations about what is not "normal" for that individual. I begin most of my patient evaluations with a question and answer session with the person who attends to the bird from day to day.

SECOND is my (hands off) visual examination.  Here are a some of the things I might be focusing on during my visual examination.

  • What is its overall attitude? Demeanor? Alertness? Posture? Strength?
  • Are its eyes clear? Cloudy? Partially closed? Discharges? Swelling?
  • Are its nares clear? Obstructed?
  • Is its breathing normal? Labored? Audible?
  • Is there abdominal distention?
  • Does it appear thin? Overweight?
  • Is it interactive? Standoffish? Confused? Painful? Too weak to care?
  • Does it have a strong or weak grip on its perch?
  • Is it flighted?
  • Droppings?
  • What is its feather condition? Is it preening?

The reason I wrote this list is because sometimes this all happens very quickly.  This is what I have spent years training to do.  Experience also aids me to pick up on things that are unusual or subtle.  Nevertheless, I don't know that people always realize that I am actually taking in a lot of information just by watching your bird from across the room as I gather information from you.  There may be overlap of my observations and yours. Sometimes I go back and ask more questions as I am doing my visual examination. Everything up to this point is minimally intrusive on the bird itself.

THIRD is the hands on physical examination.  I try to make this as brief and minimally offensive to the patient as possible.  Yet, this is a very important part of getting a diagnosis.  I constantly balance not wanting to harangue and stress a patient with needing to do my job of competently assessing the patient.  Things that are included in this section:

  • What is its body weight? Is that appropriate for its bone structure?
  • Are its ears clear? Swelling? Discharges?
  • Are its oral cavity and choana healthy? Are its choanal papillae sharp or blunted? Plaques? Ulcers? Slime? Odors?
  • Auscultation (with a stethoscope):  What is its heart rate? Rhythm? Regularity? Intensity?
  • Auscultation (with a stethoscope):  Is there appropriate air flow through its sinuses? Trachea? Air sacs? Lungs?
  • Abdominal palpation can provide clues about internal organs. Swellings? Enlargements? Pain?
  • Body condition scoring is a method of evaluating fat and muscle mass relative to bone structure.
  • Closer look at feather condition and uropygeal gland.
  • Evaluate strength, coordination, and mobility of legs and wings.
  • Hydration and blood pressure can also be evaluated during physical examination.

All of this is typically done as efficiently and unobtrusively as possible, typically in less than 5 minutes.  Like detectives who are trained to walk into a crime scene and instantly absorb dozens of details, I have spent years training and cultivating my veterinary skills so as to be able to gather a lot of information in a short period of time.

This is where I pause to give the bird a break and crunch all the data that I have gathered. Sometimes I have all the information that I need at this point to make my diagnosis.  Otherwise, this is when I work out the rest of my diagnostic plan.

Medical technology offers us a variety of diagnostic tests to glean more detailed information about what is right and not right in a body.  Some of the more common diagnostics are summarized below. Not all of these tests will be necessary in every patient. This is just a list of some of the diagnostic aids we have at our disposal.

Bacterial Culture and Sensitivity

A swabbed specimen is obtained from your bird, usually from the respiratory tract if a respiratory problem is suspected, or from feces if a GI problem is suspected.  The specimen is sent to a diagnostic laboratory where it is plated in a petri dish to grow colonies of the bacteria present on the swab.  Bacteria are identified and a determination is made whether they are normal or disease-causing bacteria. If disease-causing bacteria are found, it is tested against different antibiotics to determine which drugs will effectively treat your bird (bacterial sensitivity) and which ones will not (bacterial resistance). Similar cultures can be done when fungal infections are suspected.

Chemistry panel

This is a group of blood tests where specific enzymes (AST, CK, GGT, Amylase), electrolytes (sodium, chloride, potassium), organic molecules (albumin, total protein, blood urea nitrogen, cholesterol, glucose, triglycerides, uric acid, bile acid), and inorganic ions (calcium, phosphorus) are measured. When patient chemistries fall outside of the bell curve, it alerts us to changes in liver, kidney, pancreas, and/or endocrine systems.  It is also a way for us to monitor patient recovery.

Complete Blood Count (CBC)

In the first part of a CBC, white blood cells, red blood cells, and platelet are counted and quantified. In the second part of a CBC, the cells are studied under the microscope. CBC provides insights into the patient's immune system and bone marrow.  The combination of a CBC and chemistry panel gives a fairly broad view of the patient's internal workings.

Cytology or Biopsy

A specimen of abnormal tissue is studied under the microscope by a veterinary pathologist. 

Fecal ova and parasite screen

Fecal specimens are processed and looked at under a microscope checking for ova of different intestinal worms.

Radiograph (X-ray)

Also known as an x-ray, because it is an image taken using x-rays. Nice because it is non-invasive. Size, shape, and position of organs such as heart, liver, kidneys, stomach, spleen, bones, etc. can be evaluated.  Presence of gas, fluids, and solid masses (tumors, foreign objects) inside your pet's body can be detected.

Serology or Titers

These are blood tests that look for antibodies to specific pathogens (disease-causing organisms).  For example, there are titers for Chlamydophila or Psittacosis, Psittacine Beak and Feather Disease (PBFD), Polyomavirus, and Aspergillosis.

Polymerase Chain Reaction or PCR tests

These are tests that look for strands of DNA unique to specific pathogens (disease-causing organisms).  It can be either an alternative or a complementary test to serology. There are PCR test for Chlamydophila, Polyomavirus, Psittacine Beak and Feather Disease (PBFD), and Giardia.

DNA Sexing

Blood test to determine whether a bird is male or female.

 

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