(See also Physical Examination of Mammals (Techniques Overview))

• Physical examination of a bird or birds is a useful part of the investigation of a problem and may also be a part of routine disease control, e.g. annual health checks and examination of new birds entering a collection.
• In carrying out a physical examination it is beneficial to be aware of the normal appearance and anatomical features of the species being examined.
• The results of a physical examination of the bird or birds should be used in conjunction with the history of the bird or birds, consideration of its immediate environment (e.g. cage or enclosure), appearance of droppings and further tests as appropriate. (See History and Documentation - General and Environmental Assessment - General)

(B11.2.w16, B13.8.w20, B14, V.w5)

(B8).

• History and Documentation - General
• Environmental Assessment - General
• Chapter 2 - B36 Field Manual of Wildlife Diseases - Specimen Collection and Preservation
• Chapter 3 - B36 Field Manual of Wildlife Diseases - Specimen shipment
• Chapter 5 - B36 Field Manual of Wildlife Diseases - Euthanasia

Much information may be gained by examining the immediate surroundings of the bird(s).

• Where practical for caged birds (i.e. cage-size permitting) if a bird is brought to a veterinarian for examination the cage should be brought as well, complete with the paper or other cage floor covering, and the droppings produced by the bird.
• For flock problems in particular, examination of the aviary, enclosure or local environment where the problem is occurring may be vital.
• If the normal cage cannot be brought, or the aviary/enclosure/environment visited, details of these should form part of the history, and the owner/caretaker urged to bring a sample of typical droppings.
• Droppings should be examined visibly noting the quantity, colour and consistency of both the faecal and urate components.
• If blood is present, an assessment of the amount of blood should be made, allowing for the ability of a small volume of blood to cover a large area. Blood may come from an external injury (e.g. a laceration or damaged blood feather) or from the cloaca.

(B11.2.w16, B13.8.w20, B14, V.w5)

• Details of the substrate (e.g. concrete, mud, grass), water (pool construction, depth, water flow etc.) and other environmental features in which the bird has been kept or found may be very important in disease diagnosis.
• Bright green droppings are characteristically seen in waterfowl with Lead Poisoning.
• Blood-stained patches may be noted on the ground where waterfowl with Duck Plague have been sitting (B36.16.w16).

(B11.38.w6, B15, B36.16.w16, B36.43.w43, V.w5)

• Environmental Assessment - General

The first stage in the physical examination of a bird is observation of the bird, preferably without the bird knowing it is being observed.

• Birds usually will attempt to hide their illness; this is a survival tactic, as predators may be more likely to target an obviously unfit individual.
• A bird which appears bright and alert when being watched may become huddled and fluffed up when it thinks it is unobserved.
• Subtle changes in appearance which may be noticed by an experienced aviculturist may not be obvious on initial observation: if the owner/caretaker identifies a bird as "not quite right", they are probably correct.
• For flock problems, observation may give an indication of the proportion of birds which are sick, and whether the affected birds are of a particular type (e.g. species, food type, sex, age class).
• General signs of illness include fluffed feathers, a hunched appearance, partially closed eyes, the head tucked under a wing, sitting or standing on the ground rather than a perch (ground-dwelling birds excepted), cloacal straining, shivering.
• Fluffed feathers, huddling and/or shivering may indicate chilling/hypothermia (Chilling/Hypothermia).
• Unilateral wing droop may be observed by comparing the two wings; this may be more difficult in a pinioned or feather-clipped bird. The wing position may indicate the affected portion of the wing - general dropping but with raised wing tip (relative to the other wing) with coracoid or shoulder injury; severe drooping with the primary feathers trailing on the ground with distal wing injuries, drooping but with the primaries off the ground with a humerus or elbow injury.
• Foot or leg problems may cause a bird to shift its weight form one leg to the other repeatedly, weight bear on only one leg constantly, rest on the ground rather than stand, or stand on the metatarsus rather than the foot (hock-sitting). Hock-sitting is normal in some birds, particularly long-legged birds, and in juveniles of these species.
• Note respiratory rate, and effort.
• Increased respiratory effort may be seen as tail-bobbing, excessive chest movement, head-bobbing or mouth-breathing.
• Respiratory noise may indicate a partial blockage of the trachea.
• Acute dyspnoea in an otherwise healthy-appearing bird may indicate exposure to an inhaled toxin, aspiration of a foreign body or a tracheal plaque which has become dislodged and is now blocking the airway (dyspnoea due to chronic disease will usually be accompanied by other signs of ill health, such as weight loss, depression, oculo-nasal discharge).
• N.B.  apparent respiratory distress may be seen with space-occupying masses (egg binding (Egg Binding), hepatomegaly, tumour (Neoplasias)) or anaemia, as well as with respiratory system problems..
• Overheating may be visible as constant open-mouthed breathing and throat fluttering; this may also be seen in some birds as a sign of stress.
• A variety of nervous signs may be seen, including ataxia, paresis, paralysis, torticollis, circling, opisthotonus and fitting.

(B11.2.w16, B13.8.w20, B14, V.w5)

• Healthy waterfowl should appear bright-eyed and alert, with sleek plumage.
• If observed within an enclosure or natural environment, sick waterfowl may be difficult to find, being hidden within vegetation, or may be found sitting motionless near the edge of the water.
• In swans, a distinctive neck-kink may be observed in lead-poisoned birds: a portion of the neck lies flat along the back of the bird (see: Lead Poisoning). Waterfowl with Avian Botulism may be unable to keep their head up; the bill may rest on the ground if they are on land, or droop into the water.
• Waterfowl with Avian Botulism may propel themselves along the ground or water using their wings after their legs have become paralysed, while waterfowl with Lead Poisoning are usually able to walk even though they cannot fly.
• A prominent nictitating membrane (third eyelid) is commonly seen in waterfowl with Avian Botulism.
• Normal respiratory rate may be e.g. 13-40 breaths per minute in geese and swans, or e.g. 30-95 breaths per minute in ducks (B11.33.w1, B13.46.w1).
• Gaping may a sign of Gapeworm Infection, particularly in goslings.
• Hypothermic waterfowl (Chilling/Hypothermia) (e.g. oiled birds - see: Oiling) may be fluffed up and/or shivering.
• Nervous signs are common in the late stages of many waterfowl diseases.

(B11.35.w3, B14, B36.1.w1, B36.38.w38, B36.43.w43, V.w5).

• Chapter 1 - B36 Field Manual of Wildlife Diseases - Recording and submitting specimen history data

• In order to carry out a proper physical examination, the bird must be appropriately restrained. Restraint should avoid injury to the bird, the handler or the person carrying out the examination. Covering the head may assist in keeping most diurnal birds quiet during the examination.
• N.B. small birds, particularly obviously sick birds, but on occasion even apparently healthy birds, may die suddenly from heart failure when caught or held.

(B14, V.w5).

(B11.33.w1, V.w5)

• See: Bird Handling and Movement - General

• Changes in weight (usually weight loss) are common in sick birds.
• Normal weight and body condition may be seen with peracute or acute-onset illness.
• Determination of lost weight requires knowledge of normal weight for the bird/species.
• Very accurate scales are required for weighing small birds.
• Normal weight may vary greatly over the year, particularly in migratory birds.
• Considerable weight loss may be seen e.g. in incubating birds.
• Normal weights for individual birds are likely to be known only if the individual is weighed e.g. as part of a regular health check, or in raptors which are being flown (in which both the usual relatively low "flying weight" and the "fat weight" should be known for the individual bird).
• Body condition may be assessed by palpation of the pectoral (breast) muscles - N.B. variation in "normal" muscle profile between species.

(B11.2.w16, B13.8.w20, B14).

• Waterfowl with chronic diseases such as Avian Tuberculosis, Aspergillosis or Lead Poisoning will usually be thin, with decreased body weight and a prominent keel.
• Waterfowl with peracute or acute diseases suck as Duck Plague or Avian Cholera may be of normal body weight and condition.
• Rapid weight loss may occur with some acute conditions, e.g. Oiling, in which the birds have greatly increased energy requirements to maintain body temperature.
• Severe weight loss may also indicate Starvation.

(B15, B36, V.w5).

When examining a bird, as with any animal, it is important to be systematic. Bilateral structures should always be compared with one another for any asymmetry.

SKIN & PLUMAGE:

• Feathers should be evenly coloured. Note any thin areas (fret marks) on individual feathers, indicative of illness or nutritional problems during feather growth.
• Note any abnormally-growing feathers and missing feathers.
• An area of matted feathers may indicate an underlying injury.
• The presence of small numbers of external parasites may be coincidental. Large numbers of feather lice indicate a debilitated bird.
• Check uropygial gland for redness, swelling, abnormal secretion.

HEAD & NECK:

General:

• Note any flesh wounds - punctures, lacerations, scalping.
• Note any masses which may be neoplastic.
• General pallor of skin and mucous membranes may be seen with blood loss and anaemia.
• Cyanosis may be seen with
• Flaky white thickened skin and feather loss may indicate ringworm infection (Favus).

Bill and mouth:

• Bill should be shiny and meet evenly. May be in poor condition with underlying management problem, nutritional problem parasitic or other disease.
• Note any external crusty lesions around the bill or cere - e.g. white and flaky with Cnemidocoptes mite infection, brown and crusty with avian pox infection (Avian Pox).
• Nostrils should be clean and open; check for discharge, occlusion, rhinolith.
• Mouth should be opened and checked for plaques, discoloration, necrotic area (gently scrape any lesion and prepare smear for examination under the microscope). N.B. check all areas, including under the tongue, the choana, the glottis.

Eye & Periorbital Area:

• Eye should be round and shiny.
• May appear sunken in dehydrated birds.
• Matting around eyes may indicate epiphora.
• Check for inflammation of eyelids and conjunctiva, presence of foreign body
• Check for swelling (unilateral or bilateral) just above/below the eye - sinusitis, seen with e.g. various respiratory infections.
• May be examined for surface lesions using fluorescein dye.
• Note any difference in size between the pupils.
• Parasites (leeches, eye fluke, eye worm) may be present.
• Complete ophthalmic examination may be carried out.

Ear:

• Rarely any problems, but should be checked for polyps, neoplastic lesions, infection.

Neck:

• Palpate carefully for any generalized or localized swelling of the oesophagus.
• Palpate crop (not present as a structure distinguishable from the oesophagus in all species)..
• (Further examination of the oesophagus and crop by endoscopy may be needed - this may require general anaesthesia).
• Localized or generalized emphysematous swelling may be seen with damage to the cervical air sac.

WINGS, LEGS & FEET:

• Palpate and manipulate wings and legs carefully for fractures or dislocations. Check the whole length of each long bone, and palpate and manipulate each joint.
• Wings should be examined one at a time, while the other wing is kept restrained with the body.
• Legs should be palpated and manipulated one at a time, while the other leg is kept restrained, particularly in long-legged birds.
• Legs should also be held out together and compared for symmetry.
• Inspect featherless areas for damage e.g. to scales. Check any leg rings are correctly fitting and there is no associated trauma.
• Note any discoloured areas (pale and cold, reddened and swollen or dry and necrotic) which may indicate e.g. frostbite (Frostbite).
• Carefully inspect plantar surface of feet for bumblefoot lesions (Bumblefoot).
• Check for joint swellings indicative of articular gout (Gout), arthritis etc.

BODY:

• Palpate body gently for any surface masses.
• Check pectoral muscles are symmetrical.
• Examine abdomen for signs of generalized distension (e.g. ascites, obesity) or localized masses (e.g. retained egg, neoplasm, abscess).
• Kidneys and gizzard (proventriculus) may be palpable in a normal bird.
• Enlarged liver (hepatomegaly) may be palpable.
• Palpation of the abdomen via the cloaca may be possible depending on the size of the bird
• Auscultation may be unrewarding. Very rapid heart rate in most birds - detection of abnormalities may require electrocardiogram at 100cm/minute paper speed.
• Short, faint inspiratory noise may be normal.
• Excessive respiratory noise may be associated with a problem affecting the upper respiratory tract (e.g. gapeworm (Gapeworm Infection), tracheal aspergillus granuloma (Aspergillosis)) or severe air sac disease (e.g. Aspergillosis, Chlamydiosis / Psittacosis, bacterial respiratory infection).
• Expect higher respiratory rate in a restrained bird than in the same individual prior to restraint.

BODY TEMPERATURE:

• Normal expected approximately 40-42°C (B14); approximately 39.1-41.6°C in waterfowl (B13.46.w1).
• N.B. diurnal variation in individuals, and wide intraspecific variation.

(B11.2.w16, B11.3.w10, B13.8.w20, B14, V.w5)

• Areas of down loss on the backs and/or heads of downies may indicate Feather Picking, usually in bored birds given insufficient space and e.g. greenfood to peck at.
• Area of feather loss on the back of the head and neck may be seen in female birds related to excessive mating activity (see: Scalping).
• Overall bedraggled plumage may indicate lack of preening (e.g. in ill/debilitated bird) or  Wet Feather. Check for presence of Holomenopon leucoxanthum - Shaft louse (Feather Lice Infection) (use a hand-held magnifying lens), Cladosporium herbarum - Sooty mould (Wet Feather), and any contaminants (oil, mud etc.), also for uropygial gland dysfunction.
• Oil may be very visible, or may not be obvious (with light, transparent oil). Placing a feather from a suspicious area of plumage in a bowl of water will result in a "sheen" of oil over the surface if oil is present (B36.42.w42).
• Feathers should be parted to check for bruising, lacerations and puncture wounds (see: Impact Injury, Lacerations / Punctures), which may not be easily visible. N.B. an area of matted feathers may indicate an underlying injury.
• In individual wild waterfowl casualties, check carefully for fishing line (see: Hook and Line Injuries).
• Singed feathers may be seen in waterfowl which have hit power-lines (Electrocution)or associated with Burns.
• Blood may be seen around the cloaca with Duck Plague.
• Soiling of the feathers around the vent may be seen with diarrhoea (e.g. Salmonellosis, Colibacillosis, other bacterial enteritis, Intestinal coccidiosis, gastro-intestinal parasites) or with Cloacitis (Vent Gleet).
• Keel sores may develop over the sternum, e.g. in diving ducks being maintained out of water, or in heavy birds (particularly geese and swans) which are unable to walk.

HEAD & NECK:

General:

• May be traumatic injuries (Lacerations / Punctures, Impact Injury, Scalping)
• May be neoplastic masses (Neoplasias).
• May see areas of feather loss and flaky white skin with ringworm (Favus).
• Ocular and/or nasal discharge may be seen with a wide variety of diseases.

Bill & Mouth:

• Check for fishing line caught around the bill base or tongue base, or running down into the oesophagus, and for fish hooks ( may be small) caught in mouth. Run a finger down the underside of the bill, along the soft inter-ramal tissue to the throat to feel for fine fishing line. (See: Hook and Line Injuries).
• Look for any bulge under the tongue (Sublingual Impaction).
• Oral and/or oesophageal lesions may be seen with e.g. Vitamin A Deficiency, Streptocariasis, Candidiasis, Avian Pox, Trichomoniasis (Flagellate Infection). Also in Duck Plague (lesion under the tongue may be seen in carriers)
• Nasal leeches may be seen e.g. protruding from the nares (Leech Infection).
• Bill lesions may be seen with Plant-Induced Photosensitisation.
• Bill deformities may be related to injury, or congenital (Congenital Abnormalities), or following e.g.  Plant-Induced Photosensitisation.

Eye & Periorbital Area:

• Check for sunken eye (dehydration).
• Leeches may be found attached to the eye, flukes or nematodes may also be found on the eye (see: Leech Infection, Ocular Fluke Infection, Ocular Nematode Infection).
• Nictitating membrane (third eyelid) may be prominent with Avian Botulism.
• Swelling below the eye may be seen indicating sinusitis (e.g. Mycoplasma Infection, Colibacillosis, Chlamydiosis / Psittacosis, and rarely in waterfowl Avian Influenza, Newcastle Disease).
• Check for Eye Injuries

Ear:

• Rarely any problems, but should be checked for polyps, neoplastic lesions, infection.

Neck:

• Palpate carefully for localized swelling (foreign body - see: Foreign Body Ingestion) or generalized swelling ( Impaction), which may be indicative of Lead Poisoning, Foreign Body Ingestion, Gizzard Worm Infection, Hook and Line Injuries .
• Localized or generalized emphysematous swelling may be seen with damage to cervical air sac (Air Sac Injury).

WINGS, LEGS & FEET:

• Palpate and manipulate wings and legs carefully for fractures or dislocations (see:Impact Injury).
• Frostbite lesions may be seen on the webs or affecting the feet and legs - cold and pale, swollen and inflamed, later necrosis, dry gangrene).
• Lesions on the underside of the feet may be noted, e.g. with Vitamin A Deficiency, Bumblefoot.
• Swollen joints may indicate mechanical damage (e.g. Perosis), infection, or articular gout (Gout).

BODY:

• Normal heart rate may be 80-150bpm (geese, swans) or e.g. 180-230bpm in ducks (B11.33.w1).
• Excess respiratory noise may indicate e.g. Aspergillosis
• Distension of the abdomen may be generalized, e.g. in an obese individual or with ascites (see: Egg Peritonitis, Avian Tuberculosis), or localized e.g. with a retained egg (note if the bird is female, and this is the breeding season), neoplasm, abscess (see: Egg Binding, Neoplasias).
• Cloaca should be examined for signs of prolapse Cloacal Prolapse.
• N. B. in male Anseranas semipalmata - Magpie goose it is normal for tracheal loops to be palpable between the skin and the muscle of the breast.

BODY TEMPERATURE:

• Normal expected approximately 40.5-41.0°C (B11.33.w1); 39.1-41.6°C (101.4-106.9°F) (B13.46.w1)

(B11.34.w2, B11.35.w3, B11.37.w5, B11.39.w7, B13.46.w1, B14, V.w5)

Video Available: Blood Collection Techniques for Birds:
        Internet (Web) Version (Smaller files - quicker to load)
        CD-ROM Version  (Larger files - higher quality images)

• Blood is usually taken from the (right) jugular vein (neck), medial metatarsal (caudal tibial) vein (leg) or the brachial vein (wing) (see: Intravenous Injection of Birds).
• In very small birds (e.g. weighing less than 10g) blood may be taken by clipping a claw and drawing the blood into a capillary (microhaematocrit) tube or allowing the blood to drip into the collection tube; after the sample has been collected, bleeding should be stopped e.g. by applying ferric sulphate or a silver nitrate pencil.
• Cardiac (heart) puncture and the occipital venous sinus are used mainly in research.
• N.B. The minimum amount of blood required should be taken.
• As a (conservative) rule, no more than one percent of the body weight of a bird should be taken at one time (B36.6.w6). N.B. in small birds this may be only a few drops of blood. Example volumes: 0.5ml maximum in a  40g budgerigar, 2ml in a 250-400g African Grey or Amazon parrot) (B14).
• The needle size and sample site chosen should be appropriate for the species and the amount of blood being taken. A 23-25 gauge, five-eighths inch hypodermic needle, slightly bent, may be used for small birds.
• Too great a pressure on the syringe plunger when taking blood may cause the vein to collapse, stopping the blood flow and may damage blood cells (particularly when using a small gauge needle).
• Proper restraint during blood sampling is essential.
• N.B. care should be taken following blood sampling to ensure that the vein has stopped bleeding; pressure should be applied over the vein until this has occurred (see: Intravenous Injection of Birds).
• Blood should be evaluated (e.g. haematology, biochemistry) by a laboratory that is familiar with avian blood characteristics.
• If possible, the laboratory to which the blood is to be sent should be consulted regarding the amount required, anticoagulant to be used etc. prior to any sample being collected.
• N.B. EDTA is commonly used as an anticoagulant for avian blood, but is known to cause haemolysis of the erythrocytes (red blood cells) in some species (e.g. corvids, currasows, crowned cranes (Balearica spp.), hornbills, eagle owl).

(B14, B36.6.w6, V.w6)

• Blood is commonly taken from the medial metatarsal vein in waterfowl.

(B14, V.w6)

• Intravenous Injection of Birds.
• Chapter 2 - B36 Field Manual of Wildlife Diseases - Specimen Collection and Preservation
• Chapter 3 - B36 Field Manual of Wildlife Diseases - Specimen shipment
• Chapter 6 - B36 Field Manual of Wildlife Diseases - Guidelines for the Proper Care and Use of Wildlife in Field Research

Video Available: Blood Collection Techniques for Birds:
        Internet (Web) Version (Smaller files - quicker to load)
        CD-ROM Version  (Larger files - higher quality images)

• Potential hazards to human health of ANY physical examination must be considered before undertaking examinations.
• Personnel undertaking or attending physical examinations must be made aware of the  potential hazards to human health.

FOR BIRDS:

• N.B. consider the potential for transmission of zoonoses, particularly from birds with respiratory or gastro-intestinal disease, also diseases transmitted by arthropod vectors which may be present on the bird.
• Important zoonotic diseases to consider in dealing with birds include Aspergillosis, Avian Tuberculosis, Chlamydiosis / Psittacosis, Erysipelothrix Infection, Salmonellosis and Yersiniosis.
• Some people are allergic to birds.
• External parasites may be transferred from the bird to the holder and/or person examining the bird.
• Care to avoid injury from e.g. bill (particularly in psittacines and long-billed birds) and talons (particularly in raptors and owls), large birds (See: Bird Handling and Movement - General).

(B11.2.w16, B36.6.w6, V.w6)

• All the zoonoses mentioned above occur in waterfowl.
• Care is recommended in handling and examining birds contaminated with e.g. Oil.

(B36.42.w42, V.w5)

• Bird Handling and Movement - General
• Necropsy of Birds - General