Melena in Birds
Dr. Barbara Oglesbee
Is there fresh blood in the droppings?
A thorough history is extremely important in the diagnosis of diarrhea. Be prepared to answer the following questions:
Has the diet changed?
Is the bird still eating a normal amount of food?
What are the birds chewing habits?
Does he have access to metal objects or plants?
Does the bird chew apart wood, rubber or string toys?
Are any other symptoms, such as lethargy, diarrhea or vomiting present?
Has the bird been exposed to other birds?
How often is the cage, the food and water dishes cleaned, and how are they cleaned?
Your veterinarian will recommend specific diagnostic tests depending on other symptoms present and physical examination findings. Most birds with melena have a serious disease that requires extensive diagnostic testing. Any combination of the following may be recommended:
Examination of the nasal cavities and mouth
A fecal occult blood test, to differentiate blood in the feces from dietary pigments
Sampling the crop, feces or cloaca for bacterial culture and cytology (looking at cell types for evidence of infection or inflammation)
A complete blood count (CBC) to determine the number of circulating white blood cells and distinguish between infectious and non-infectious causes of melena
A serum biochemistry panel to look for evidence of metabolic problems, such as diseases of the liver, kidney or pancreas
Plasma protein electrophoresis to look 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 that measure the amount of heavy metals, such as lead or zinc in circulation
Radiography (X-Rays) to look for evidence of intestinal disease, size and density of the liver, kidneys or other organs.
Contrast radiographs, such a barium studies, to look for tumors or foreign bodies, 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 is a video or moving X-ray that is used to determine if the coordination of peristaltic waves is normal. It is useful in the diagnosis of foreign bodies, toxicity (lead or zinc) or viral diseases (proventricular dilatation disease).
Abdominal ultrasound is only possible in birds with enlargement of the liver or fluid in the abdomen. It allows visualization of the intestinal tract for evidence intestinal wall thickening, gastrointestinal masses and foreign bodies. A specialist usually performs this test.
Endoscopy is used to view the intestinal tract or body cavity directly. Samples can be collected for biopsy or culture. A specialist usually performs this test. Some foreign bodies may be removed this way.
Exploratory laporotomy is a surgical procedure that is occasionally necessary to obtain segments of the intestinal tract for biopsy in order to determine the cause of melena.
Before a diagnosis is reached, treatment of the symptoms might be needed, especially if the problem is severe. The following treatments may be applicable to some, but not all birds with melena. These 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 melena and other symptoms such as lethargy and anorexia usually require hospitalization and 24-hour care.
Fluid therapy is often needed since birds can become dehydrated. 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 the severity of the dehydration.
Dietary change may be needed for birds that are still willing to eat. A low fat and easy to digest diet is recommended. Usually, food is not withheld from birds with melena. Birds have a very high metabolic rate and require a constant source of energy.
Forced feeding of an easily digestible liquid food may be necessary in birds that refuse 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.
Intestinal protectants such as sucralfate (Carafate®) and cimetidine (Tagamet®).
Surgery or endoscopy to remove foreign bodies.
Chelation with Calcium EDTA or other chelating agents to bind lead or zinc.