Vet AI Scribe for Avian

Pip

Tuesday, May 6, 2025 at 2:40 PM

Subjective

Chief Complaint

Owner reports three weeks of intermittent sneezing, a clicking sound on breathing, and swelling around the right eye in a 9-year-old male cockatiel.

History

• Diet approximately 90% seed mix (millet, sunflower) with occasional table food; no formulated pellet.
• Cage housed in the kitchen; household uses non-stick cookware; no smokers.
• Sole bird for seven years; no new birds introduced.
• Tail-bobbing at rest noted by owner over the past five days.
• Last veterinary visit four years ago for a wing trim; weight then 92 g.

Objective

Vitals

• Weight: 84 g (down 8.7% from 92 g)
• Body condition: 2/5; keel prominent
• Respiratory rate: 62 breaths/min at rest
• Heart rate: approximately 250 bpm on auscultation

Physical Exam

• Mentation: Alert, mildly fluffed
• Periorbital: Right infraorbital sinus distended, firm, non-painful; no discharge expressed
• Nares: Right naris partially occluded with dry debris; left patent
• Oral cavity: Blunted choanal papillae; small white plaque on the palate
• Respiratory: Audible click on inspiration; increased sternal excursion; no wheeze over air sacs
• Crop: Empty; no thickening
• Coelom: Soft; no organomegaly palpated
• Feathering: Dull with poor barb integrity; no stress bars
• Feet: Mild plantar hyperkeratosis bilaterally

Assessment

Primary Problem List

1. Chronic sinusitis, right infraorbital
2. Hypovitaminosis A — squamous metaplasia evident at choanae, plantar surfaces and feathering
3. Weight loss (8.7%) with poor body condition
4. Nutritional imbalance — all-seed diet

Differentials

• Bacterial sinusitis secondary to squamous metaplasia
• Chlamydia psittaci infection
• Aspergillosis
• Mycoplasma sp.
• Inhaled irritant, including PTFE off-gassing
• Neoplasia — less likely given concurrent nutritional signs

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Plan

Diagnostics

• CBC and plasma biochemistry
• Chlamydia psittaci PCR on a combined choanal and cloacal swab
• Sinus aspirate for cytology, Gram stain, aerobic culture and sensitivity
• Whole-body radiographs, two views, to assess air sacs and coelomic organs
• Aspergillus galactomannan if radiographs support it

Treatment / Management

• Nutrition: Begin conversion to a formulated pellet over four to six weeks; do not withdraw seed abruptly. Add dark leafy greens and orange vegetables daily.
• Vitamin A: Supplied through diet conversion; parenteral supplementation reserved for birds that are not eating.
• Antimicrobial: Withhold pending culture unless the patient declines. If empiric therapy becomes necessary, doxycycline 25 mg/kg PO q24h pending the C. psittaci result.
• Supportive: Supplemental warmth; nebulisation with sterile saline 15 minutes BID.
• Environment: Move the cage out of the kitchen; discuss PTFE risk.

Follow-Up

• Weight recheck in 7 days; owner to weigh daily on a gram scale and record
• Culture and PCR reviewed at 3-5 days
• Recheck exam at 4 weeks to reassess the choanal papillae and sinus

Client Communication:
Explained that the sinus swelling and the dull feathering are two expressions of the same nutritional problem, and that antibiotics alone will not resolve a sinus that keeps reinfecting. Discussed that Chlamydia psittaci is transmissible to people and that handling precautions stay in place until the result is back. Diet conversion handout provided, along with a recommendation to buy a gram scale.

— Dr. Marcus Hale, DVM