You should seek the advice of your veterinarian if your pet is ill as only he or she can correctly advise on the diagnosis and recommend the treatment that is most appropriate for your pet.

Liver disease is common in birds, but diagnosis can be a challenge

Diagnosis of liver disease in birds is based upon :

1) History

• Species predisposition - Lories, Mynahs and Toucans are prone to develop haemochromatosis ; show cockatiels are prone to develop hepatic lipidosis
• Imbalanced nutrition - high fat or hypervitaminosis A
• Exposure to toxins - eg mycotoxins on mouldy foods
• Contact with new captive, or wild birds increases the risk of infectious disease
• Previous history of cloacal papilloma (associated with hepatic cancer)
• Obesity - associated with hepatic lipidosis

2) Clinical signs

• Weight loss
• Inappetance
• Lethargy, depression
• Bleeding - eg cut nails
• Polydipsia and polyuria
• Bright green urine due to the presence of urates (called biliverdinuria)
• Overgrowth of the upper beak (rhinotheca)
• Self-trauma to the feet (seen in Amazona spp)
• CNS signs due to hepatic encephalopathy - is rare
• Ascites - rare

3) Laboratory tests

Care is need when interpreting laboratory results of samples taken from laying birds because they often have a hormone-related hepatomegaly and elevated blood results eg cholesterol

• Decreased blood concentrations of : albumin, bile acids, cholesterol, glucose, triglycerides or uric acid
• Increased blood concentrations of : cholesterol, bile acids, globulin
• Increased liver enzymes in blood may be found, but normal levels do not rule out the presence of liver disease:
  • AST - most sensitive indicator
  • GDH and  GGT - less sensitive very specific for liver disease
  • AP and LDH - are occasionally increased.
  • ALT - rarely increased
• Haematology - inflammatory response

4) Other diagnostic aids :

• XRays - liver size, shape, position
• Ultrasound - detects tumours, abnormal tissue density
• Laparoscopy - visualise liver surface
• Liver biopsy - histopathology

Treatment

A variety of treatment regimens have been used in birds with liver disease, including :

• Nutritional and fluid support - force feeding if anorectic
• Low iron ration (less than 100ppm) if the birds have haemochromatosis
• Reduced calorie ration and increased exercise if obese and have hepatic lipidosis
• Phlebotomy to remove about 1% body weight of blood if haemochromatosis and high blood viscosity
• Frusemide - if ascites present
• Lactulose - if hepatic encephalopathy present (rare) - 0.3-1 ml/kg by mouth twice daily.
• Hetastarch - if hypoproteinaemic 10-15ml/kg IV three times daily
• Vitamin K - if coagulopathy is present - 0.2-2.2mg/Kg IM every 4-8 hours
• Antibiotics if infectious disease present

Prognosis

Guarded for most cases. Many diseases that affect the liver can not be adequately treated eg Pacheco's Parrot Disease, tuberculosis (usually caused by Mycobacterium avium, but sometimes others eg M.bovis, and pseudotuberculosis (caused by Yersinia pseudotuberculosis)  and euthanasia is recommended if the disease is diagnosed before death occurs.

Updated January 2016