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Cholesterol & Fatty Liver Disease




Fatty Liver Disease is a common problem amongst pet birds and most frequently seen in desert bird species such as Cockatiels, Galahs and Sulphur Crested Cockatoos. The condition is also common in parrots with their wings clipped as this restricts their flight and ability to exercise. Cholesterol Problems are common in Eclectus parrots as these rainforest birds are unable to process excess fats in their diet.


High cholesterol and associated Fatty Liver Disease are difficult to recognise from outward signs and produce many and varied symptoms associated with poor health. Excessive beak or nail growth is often a signal that there is a cholesterol problem. Poor feather colour and sheen, recurrent sinus infections and large watery droppings are common symptoms of Fatty Liver Disease in cockatiels. A withdrawn or anxious personality and limited desire to interact and learn are other poorly recognised signs of cholesterol and fatty liver disease.

Birds with long standing cholesterol problems are prone to more serious life threatening conditions such as xanthomas. These are common fatty type tumours often seen on the wings of cockatiels and on the body and internal organs of galahs cockatoos.


Blood tests are the best way to check that your bird is free of this disease. Annual blood tests are then recommended in those birds previously diagnosed with the disease.

This article presents Dr Marshall's approach to be diagnosis and management of Fatty Liver Disease. Please contact our hospital for any further advice.


Blood Testing for High Cholesterol & Fatty Liver Disease (FLD)

This information will be reported to Dr Marshall each day.

Blood tests are recommended when Fatty Liver suspected of being involved with an illness or as a routine part of an annual health check for birds with a history of cholesterol, liver or pancreas problems.

A failure of the blood to clot quickly at the venipuncture site (we collect blood from the vein under the wing) following blood collection is a clue that FLD is likely to be present.

Blood test results that show high blood cholesterol indicate a diet that is too high in fat. Other biochemistry blood tests findings are also used to assess the effect of the diet of your bird and possibility of Fatty Liver Disease or associated pancreas problems.


Causes of High Cholesterol & Fatty Liver Disease (FLD)


A diet too high in fat is the most common cause of high cholesterol problems and Fatty Liver Disease.

Although diets of sunflower seeds and nuts are the most common cause of high cholesterol and Fatty Liver Disease, other factors may be involved, for example genetic or family predisposition, hormonal influences, contaminated food and inadequate exercise (i.e. clipped winged birds or fully flighted birds that are not encouraged to fly).

High cholesterol and Fatty Liver Disease is most frequently seen in desert bird species such as Cockatiels, Galahs and Sulphur Crested Cockatoos, although other pet birds such as Eclectus parrots and Green-cheeked Conures often develop the problem.

Australian desert parrots are particularly susceptible to fatty liver disease because they live in an unpredictable and dry environment where food supply is often sparse. Their metabolism has evolved to become extremely efficient at conserving energy enabling them to survive on foods of low nutritional value. They conserve energy by depositing any oversupply as fat. It is this exceptional ability to efficiently conserve excess energy as fat that leads to obesity, fat tumours and fatty liver when cockatiels, galahs and white cockatoos are fed fatty foods.

Lack of exercise is also linked to high cholesterol and Fatty Liver problems. Our pet birds are far less active than wild birds and need less food to sustain them. They often prefer the taste of fatty foods (e.g. sunflower seeds and nuts) above starchy cereal grains and in many instances leave other grains in the seed mix untouched. Unknowing to the owner their sole diet becomes sunflower seeds or nuts as these foods totally satisfy their hunger. It is the protein and other nutritional deficiencies created by this poor diet that produces the many symptoms linked to Fatty Liver Disease.

Several other factors contribute to Fatty Liver Disease. These include damage from toxins, excess dietary carbohydrates, choline and biotin deficiency, excess calories, obesity and thyroid dysfunction. Dr Marshall will assess these components of FLD during a consultation.


Signs of Fatty Liver Disease & High Cholesterol


Obesity, fat tumours, excessively long beak or toenails, unexplained bleeding episodes (e.g. blood quill ruptures, nose, mouth bleeds) and a loss of vocabulary or less inclined to play and talk are the most common symptoms seen with Fatty Liver Disease, although variations do occur between each parrot species.

The most common signs of FLD seen in cockatiels are signs of a delayed moult that is recognised by pin feathers (i.e. unopened quills) on the neck or crest feathers, or a failure to moult old wing flight feathers. Bleeding episodes associated with night frights or involving spontaneous nose or mouth bleeds are other common signs of FLD in cockatiels.

Galahs with FLD develop fat tumours,have bleeding episodes associated with feather picking and self mutilation. Their normal healthy pink feather colour changes to a red hue and often they develop bumble foot ulcers and stiff joints.

White Cockatoos with FLD also develop fat tumours and bumble foot, but are more inclined to abdominal hernias, feather picking over the chest and abdominal areas, and delayed moult (pin feathers on crest and head). Lameness or lifting of the right foot may occur when secondary proventricular or pancreas inflammation cause abdominal discomfort.

Conures with FLD will become anxious, introverted and may start to bite. They commonly feather pluck over the chest and back area as a result of the pain caused by secondary pancreas infections and proventriculus inflammation.

Eclectus parrots with FLD also become anxious, introverted and may start to bite. There will also be beak, feather colour and moult abnormalities. As a result of secondary pancreas infections and proventriculus inflammation Eclectus will stop talking, yawn frequently, toe tap and wing flick.

Across all species a delayed moult and poor quality feathers that occur as a result of protein and other nutritional deficiencies is a constant finding with Fatty Liver Disease. Other less obvious signs include loss of appetite, inactivity, loss of vocabulary, anxiety (more frequent night frights, biting and unsociable behaviour, heavy breathing attacks), recurrent illnesses and xanthomatous wing tumours.

Heart attacks are likely in birds with long standing cholesterol problems. Cholesterol is very insoluble and prolonged high levels in the blood stream result in its deposition on the walls of the blood vessels. These deposits eventually harden to atherosclerotic plaques. This narrows the blood vessels and serves as a site for clot formation and may precipitate myocardial infarction or heart attack. Heart attacks associated with FLD are most prevalent in galahs and cockatiels.


Treatments for Cholesterol & Fatty Liver Problems


Treatment Program


Stop feeding all fatty foods (i.e. no more sunflower seeds, nuts etc.) Provide culture tested millet mix as seed part of diet. Culture tested seed mixes are free of contamination and their sweet fresh taste is readily accepted by birds. Culture tested food is recommended because mould toxins and mould contamination has been linked to Fatty Liver Disease.


Start Cholesterol & Fatty Liver Nutritional Programme


Provide nutrient dense and low GI (glycaemic index) foods as a cooked morning (e.g. rice vegetable recipe mix) for flighted birds or evening meal (cooked bean mix) for clipped birds. See Food and Foraging Article. Beans are recommended as they are rich in the amino acids lysine, methionine and tryptophan that are lacking in the foods commonly fed to birds. White beans and green leafy vegetables (e.g. spinach or swiss chard) are also recommended as they contain choline and biotin, which improve the proper metabolism of fats in the body. Turbobooster is used as part of the FLD Nutritional programme because it contains polyunsaturated fatty acids and good levels of tryptophan and methionine. Herbal medicines such as Milk Thistle may be recommended for those birds with excessively high cholesterol and GLDH blood levels as these indicate advanced fatty liver disease.

Give green leafy vegetables especially swiss chard, which is a green leafy vegetable belonging to the beet family and looking a bit like spinach. Swiss chard has high levels of biotin and many other antioxidants, and is involved in maintaining blood glucose levels. It is also an excellent source of vitamin K and vitamin A. Free vegetables such as red and green peppers, celery, spinach and zucchini should also be fed to help control and treat FLD.

Start Exercise Routine of free flight outside the cage at least once a day. Walking exercise or short flights should be encouraged for clipped birds. Clipped birds should be encouraged to fly as their new flight feathers regrow and not be clipped in the future if at all possible.
Retest blood cholesterol and liver chemistry two weeks after start of this treatment regime. Blood cholesterol levels and liver tests should show a marked improvement within 2 weeks of this programme as most birds will quickly accept their new diet and regain a hearty appetite almost immediately.

Annual check ups are recommended to monitor the disease. This includes an assessment of feather quality and moult progression. Cholesterol and liver chemistry blood tests are also taken to ensure the diet and exercise routine has stabilised the disease.


Recovery Period


Positive changes will be noticed within a week of starting the above treatment plan. An increased appetite, feather colour and more sociable activity will quickly return. Take care to prevent night frights as bleeding episodes may persist for 2-3 months. For birds presented with excessively long beaks and nails, bi-monthly beak trims may be needed for up to a year as it may take this time for the excessive growth rate to return to normal. On our FLD programme blood cholesterol and liver chemistry levels should drop noticeably within two weeks and return to normal within 2-3 months. High liver and pancreas blood chemistry may persist when Fatty Liver Disease is long standing and liver cirrhosis has already occurred.

Quik gel is a broad spectrum first aid treatment that is given whenever you feel your bird is tired or unwell.

Emergency rescue formula is best administered using a crop needle, but it can also be given by spoon or syringe.

Click for information on high cholesterol and fatty liver disease, including causes, symptoms and treatment.

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