Candida / Candidiasis / Thrush Infections in Pet Birds by Dr. Rob Marshall

Article by Dr. Rob Marshall

Thrush (candida) infections are diagnosed by the microscopic examination of a stained (gram stain) dropping or mouth swab. A culture test will confirm the severity of the infection and help to identify an underlying cause.

What is thrush?

Thrush is a common disease of pet and other birds. It is a condition that distresses the bird, causing it to become depressed and lifeless. A bird with thrush often shows dropping changes because the infection irritates the bowel lining.

The dropping of thrush commonly infects the mouth, causing birds to swallow excessively. It may even infect the sinus and cause sneezing. Thrush infections are potentially life threatening when left unattended.

Thrush is always caused by an underlying stress factor. Stress factors include, vitamin and mineral deficiencies, fluctuating temperatures, environmental change, psychological stress and underlying illness.

How is thrush treated?

Thrush infections require a 5-7 day course of Mycostatin treatment. The Mycostatin is best administered directly by mouth. If this is not possible, a drinking water treatment may be effective. Remove all seed, grit, seed bells and fruit, from the cage. Disinfect the cage with a Water Cleanser and start your bird on sterile seed.

Are there any other special instructions?

To accelerate the healing process I recommend that all birds with thrush infections be given Turbobooster, Energy supplement and Fvite on the sterile seed daily for three weeks and then three times a week after this time. Following the antibiotic treatment, Dufoplus and Ioford are given twice weekly in the drinking water. Ensure your bird is actually eating and drinking. If not, it will need special force feeding in hospital (Avianweb Note: or by someone experienced / trained in proper force feeding procedures).

Are there any long term problems?

Thrush infections may leave your bird susceptible to illness in the future. A Water Cleanser is added to the drinking water for two consecutive days. It is then given two days each week, followed by Dufoplus and Ioford to help control recurrence. To further protect your bird from repeat infections follow the health programme in the accompanying brochure.

Is this disease contagious to humans or other birds?

Although thrush infections are not highly contagious, they may be transmitted from bird to human by close contact, especially kissing. It may also be transmitted from bird to bird via the dropping.

Can thrush infections be prevented from recurring?

Thrush infections are always related to stress factors. Special care must be taken to minimize potential stress on the bird. This may be in the form of environmental changes or nutritional adjustments. By following the ongoing health programme your bird is provided with all minerals and nutrients it needs for ongoing health and vitality.

Candidiasis

A disease that is common in hand-fed chicks – is caused by a yeast that most commonly affects the crop and the digestive tract; but it can also affect other organs, including the respiratory system, the beak, the skin, feathers, eyes, reproductive tract and central nervous system.

Cause:

Candidiasis is most common in young birds, especially those on antibiotics, and adult birds with weakened immune systems. Birds on seed-only diets and/or with a Vitamin A deficiency are at risk. Signs of Vitamin A deficiency include feather stains above the cere (fleshy area above the beak) as a result of discharge from the nostrils. The color intensity of the cere and / or plumage may also be noted, as is a deterioration in the condition of the general plumage.

The presence of other infections, such as poxvirus or Trichomonas, smoke inhalation, stress or trauma also predisposes birds to yeast overgrowth.

Vitamin A promotes appetite, digestion, and also increases resistance to infection and to some parasites.

Foods rich in Vitamin A include: dark leafy greens, orange-colored produce (apricots, cantaloupes, carrots, red peppers, pumpkins and sweet potatoes).

Symptoms:

A Candida-infected crop shows cheese-like lesions caused by a greyish-white layer on the inside of the crop. This membrane often becomes inflamed resulting in a puffy-looking crop.

Chicks with a cop infection display swollen or bloated crops, delayed crop emptying (slow crop) and possible crop impaction; they may suffer from anorexia and clear slimy liquid may come out of their mouth. They may regurgitate their foods.

If the mouth and beak are affected, one might note bad breath and raised areas with thick clear or white material inside the mouth; and in the upper and lower beak (most often where they meet).

If the digestive tract is impacted, birds may suffer from loss of appetite, weight loss, vomiting and diarrhea.

If the respiratory tract is infected, nasal discharge, a change in the voice, difficulty breathing and rapid breathing may be noted.

Transmission:

Yeast commonly grows on spoiled food, on cages that are not properly cleaned; it can be on our hands and pass on to our birds as we handle them … For at-risk birds, your veterinarian may advise mixing chlorhexidine into the drinking water.

Treatment: (scroll down to find out how breeders address this problem)

Treatment requires the elimination of any risk factors, such as stress, poor diet, poor sanitation, or the presence of other diseases. Focus should be on quality nutrition and immune function support. The diet should be devoid any sugar and little to no fruit until the yeast is cleared up. A clean environment will help in the resolution of this disease – the quality of the air and the water (steam-distilled).

Antifungal medications commonly prescribed include nystatin, flucytosine, ketoconazole (Nizoral), fluconazole, diflucan, and itraconazole. For treatment of oral or skin infections, ointment containing amphotericin B are usually applied.

Please note that candida may become resistant to Nystatin, especially if administered incorrectly, and/or over a prolonged time.

Nystati is administered by mouth for 5 days or longer. Nystatin could be mixed into the handfeeding formula; however, is more effective if given full strength about half an hour before feeding. Nursery items need to be cleaned and disinfected after use on each bird. To prevent cross-contamination, it is strongly recommended to not use any utensil on two birds without disinfecting in-between. Any left-over formula should be discarded.

Avianbiotech recommends the following:

Nystatin, the most commonly prescribed anti-fungal agent. This yellowish liquid suspension is usually administered by mouth for several 5 days or longer. Nystatin can be mixed directly into the hand-feeding formula but is more effective if given full strength about 1/2 hour before feeding. This will give it time to coat the crop lining and attack the unhealthy Candida organism. Nystatin works by disrupting fungal cell walls. Nystatin is not well absorbed in the gastrointestinal tract. This anti-fungal agent should not be used indiscriminately or as a preventative. Candida may become resistant to Nystatin from continued use, from inadequate or improper dosing regimens. Do not assume that a bird treated with nystatin will be free of Candida. Some resistant yeasts require antifungals other than Nystatin.

Diflucan, one of the newer drugs, has proved to be effective in treating fungal infections. A suspension combining Nystatin and Diflucan has been found to be a safe and effective treatment for Candida. Candida in cockatiels can prove to be extremely difficult to treat. When administered properly Diflucan can clear up Candidiasis within five days.

Ketoconazole (trade name Nizoral) which is dosed orally is sometimes prescribed when Nystatin resistant strains of Candida develop. It is almost insoluble in water, expensive and can be toxic if used improperly. Using Nizoral on a severely ill and physically stressed bird can prove fatal. Nizoral should be used under veterinary supervision, only in physically “healthy” birds, to treat yeast infection, or as a preventative when using antibiotic therapy.

Flucytosine – 250mg/kg PO BID x 21 days

Ketoconazole – 10-30 mg/kg BID x 21 days

Fluconazole – 5mg/kg SID for 7 days

Nystatin – 100,000 units 1ml per 400 gram bird PO BID x 7 days

Natural Treatment / Treating Chicks and Adults with Yeast
(Consult with your vet)

Raw Apple Cider Vinegar:

Some breeders swear by raw apple cider vinegar and their recommendations are to add a drop or two of raw apple cider vinegar to the handfeeding formula to establish a normal pH balance in the gut. Apple cider vinegar naturally promotes acidity in the digestive system thus encouraging the growth of healthy bacterial flora … Vinegar: A Natural Approach to Avian Management (PLEASE NOTE: HEATED vinegar emits toxic fumes similar to carbon dioxide. Bird owners have lost their pets by adding vinegar to their dishwashing cycle, or used it to clean coffee machines. )
Organic apple cider has natural enzymes, minerals vitamins and essential acids that help keep yeast under control. It is frequently referred to as natures ‘antibiotics’ that is more of a probiotic (because its an antiseptic). The dilution that a breeder recommended was approximately 1/4 cup of vinegar to one gallon of distilled or filtered water. (Do not use spring water as it may counteract with some of the enzymes). NOTE: Some birds can be sensitive to vinegar, so make sure you talk to your holistic vet before you start this or any other regimen of natural origin.
One vet recommended the following dosage for early treatment or preventative for candida: 1 tsp of Apple Cider Vinegar per 16 oz water.
For yeast infections on the skin, soak a qtip in vinegar and apply every day for about three weeks. This usually clears things up.

Grapefruit Seed Extract (GSE)

Others (including myself) have been happy with the results gained by adding Grapefruit Seed Extract (GSE) added to hand feeding formula. I am using it as a preventative measure and it literally eliminated this problem. As an additional benefit, GSE also has good anti-parasitic properties.

Probiotics:

Psittacine-specific probiotics (good bacterial normally found in parrots) should be offered to help compete with potentially pathogenic bacteria
Why is Lactobacillus Acidolphilus so Important to your Bird’s Health?

Gentian Violet Treatment:

Gentian Violet is considered a safe and efficient remedy for treating Candida, and was successful when conventional treatment failed. It is available from some drug stores and hand-feeding equipment suppliers. A solution of 1% Gentian Violet is used to swap the mouth, esophagus and crop of bird suffering from the crop disorder. The saturated swab is slowly rotated around the mouth, down the esophagus and into the crop. Make sure to completely wipe the crop interior with the purple Gentian Violet. It helps to place your thumb against the crop and run the swab in circular motions with in the crop while slightly pressing against the thumb. Healthy tissue within the crop will stain purple when swabbed with the Gentian Violet. The unhealthy tissue will show up whitish and mottled. Best results are realized when administered to an empty crop but an empty crop or evacuation of the crop is not absolutely necessary unless crop is more then ½ full. Treatment should be administered every morning or every other morning, depending on severity of infection, over a three-day period. Very rarely is treatment continued for more than three days, except in severe cases. Improvement should be evident by the second treatment. The whitish lesions on the crop wall will begin to disappear. When all lesions are gone, treatment can be discontinued. In cases of crop bloat the crop will deflate noticeably. This proven treatment is very safe, and satisfactory results are often realized almost immediately. If this three-day treatment fails to show improvement a veterinarian visit is highly recommended.

Breeders’ Recommendations:

Make sure to read both Patricia’s and Heike’s views on Nystatin. Use your own judgment as to how to fight yeast. Helena’s and Martie’s Natural Treatment of Yeast, are also worthwhile reading.

Using Nystatin to Fight Yeast by Heike Ewing

Nystatin is one of the safest “drugs” on the market. When administered orally, Nystatin stays in the digestive tract; it does not cross the membrane barrier into the circulatory system and, unlike systemic antifungals such as itranconazole or fluconazole, has no effect on any internal organs or systems. Furthermore, Nystatin is a “contact” drug that interacts with live yeast organisms it comes into direct contact with and kills them. It does nothing to other tissues or cells. I have in the past accidentally given large overdoses of Nystatin to very young chicks with no ill effects whatsoever.

– Consequently, Nystatin is a safe and very effective antifungal for yeast infections of the crop or digestive tract that can safely be given to chicks of any age and to parents that are laying, incubating, or feeding chicks. Correct dosage depends on the strength of the solution, but the dosage I have for the “standard” suspension that most pharmacies and vets have on hand and dispense is 0.3cc per 100gm body weight every 12 hours for 7 – 10 days. For best results, give the dosage when the crop is empty, perform crop massage after the medicine is given, and do not feed the chick for 10 – 15 minutes after giving it.

– I have heard others express concerns about Nystatin in the past and specifically questioned my avian vet about it; she explained that she thinks people get confused between Nystatin and other antifungals, as most of the “azole” antifungals are powerful systemic drugs that can have serious side effects and can cause birth defects and other problems if given to birds that are laying eggs. Nystatin is a totally different type of drug and has none of those problems – in fact, although gentian violet can be more effective on severe candida infections of the crop, it is more dangerous than Nystatin and more likely to kill chicks if administered improperly even though it is a non-prescription product.

– In the 9 years I have been breeding cockatiels, Nystatin has been my FIRST line of defense against yeast infections of the crop and I have never had any trouble with it or lost a chick due to its use. Its only drawbacks are that it is completely ineffective against systemic fungal infections, and that it takes a long time to eliminate severe infections because it kills only the top layer of yeast cells – the ones it comes into direct contact with – each time it is given.

NOTE: Martie Lauster noted: “Nystatin failures are due both to resistant strains and to the fact that it is a topical medication that must come directly in contact with the organisms it is attacking.

If the yeast has gone systemic, and is no longer contained only in the digestive tract, Nystatin will have no effect. Caprylic Acid acts systemically so it can get to yeast that has grown into internal organs.”

Patricia Carter’s Input on Nystatin to fight Yeast

I wouldn’t recommend using Nystatin without knowing if there was actually a yeast problem present. Even if I knew yeast was present I would try probiotics first since it hasn’t any side effects like the chemicals in Nystatin. Gentian violet works well for yeast too. I would use Nystatin as a last line of defense.

Controlling Yeast Naturally by Helena / Totally Tweety

Helena uses non-pasterurized, non-filtered, organic and raw apple cider vinegar. 1 tsp. per pint of water. She uses the brand called “Tree of Life”. Apple Cider Vinegar controls most gram-negative and yeast problems without meds.

She uses it for crop problems, 2 tbsp. to 1 gallon of water. Dr. Harrison says to use for 1 week every 3 months for preventive care. It is a immune stimulator. It also has a number of beneficial vitamins and minerals.

Use of Apple Cider Vinegar effective against Yeast and Bacteria
by Safiyah

A way to combat yeast is to give your parrots apple cider vinegar in their water. I make up a gallon at a time, and keep it in the fridge. Just 2 tablespoons of APPLE CIDER VINEGAR (not white, or any other kind) in the gallon. I have tried Kokomo to see which she prefers, the vinegar- water or plain water. She goes for the vinegar water every time. She loves it, I am not sure why … Something in the vinegar combats yeast and other bad bacteria.

PLEASE NOTE: HEATED vinegar emits toxic fumes similar to carbon dioxide. Bird owners have lost their pets by adding vinegar to their dishwashing cycle, or used it to clean coffee machines.

Another Natural Treatment for Yeast in Baby Birds by:
Martie Lauster

Successfully used Caprylic Acid to save a chick that showed signs of yeast: had been regurgitating its food, had redness around its throat, crop and mouth, and by the tame Martie found the baby was laying on its side — looking as if it was “on its way out”. Anyhow, Martie bought a produced called “Caprylic Acid Combination”.

Martie cobbed together a dosage (kind of 1/8 teaspoon to one dessert spoon of dry formula) and force fed this to the baby. Two hours later, Martie had to force feed once again as the baby was still not showing any interest in eating.

After four hours, the baby was much more responsive and by eight hours it was standing up and yelling to be fed! It was like a miracle. Martie kept the same dosage going for the next three days and the little owl fully recovered and is bouncing around and healthy.

NOTE: Some birds experience stomach upset with caprylic acid. So be aware of that if and when administering it.

Additionally, people advised Martie to give aloe to soothe the effects of the toxins produced by the yeast. Martie found with this baby and with others that the aloe moves a slow crop and seemed to soothe the inflammation from the yeast infection.

Martie will most assuredly be using Caprylic Acid and Aloe in the future to try to get a handle on the best applications.

Some bird owners highly recommended the below Aloe product: Marty uses a product called Herbal Aloe Force, but others have used Aloe Detox with similar results.

The manufacturer reports that Aloe Detox needs to be refrigerated (obviously). After opening, it will keep for 7 to 9 months. One recommended brand is “Lily of the Desert Aloe Detoxifying Formula” – available at better health food stores or online.

Prevention:

The risk of candidiasis can be greatly reduced by providing a sanitary environment and proper nutrition, reducing or eliminating any causes of stress, and preventing contact with any potentially sick bird.

Basic sanitary procedures, include the removal of old food from the flights or cages, clean water, and the provision of immune-enhancing nutrition.

Maintaining a general level of hygiene when handling and hand-rearing neonates will help prevent young birds from contracting the disease. Unnecessary and excessive antibiotic therapy will increase the risk of fungal infections.

Other Relevant Web Resources

NEED A VET?
USA: Find Your Local Avian Veterinarian

Information contained on this website is provided as general reference only. For application to specific circumstances, professional advice should be sought.