Chronic Renal Failure, Kidney Failure, Renal Insufficiency, Disease

Renal Dysfunction or Kidney Disease is fairly common in pet birds, and is one of the more common problems in older birds. Normally functioning kidneys filter waste products from the blood stream into the urine. The kidneys are vital, life-sustaining organs, and kidney failure poses a potential and serious risk to a bird’s well-being.

There are two forms

• Chronic renal failure: Progressive destructive condition affecting both kidneys. The onset may be very slow and the signs fairly non-specific, for example, the bird is just not doing well.
• Acute renal failure: function of the kidneys is rapidly and severely, but often reversibly, compromised. In acute disease, such as a toxicity, the signs occur suddenly and can be very severe.

Common Symptoms

• A bird with poorly functioning kidneys may drink increased amounts of water and urinate more often — in an attempt to flush out those waste products in its blood stream that the kidneys are no longer capable of eliminating into the urine.
• Depending upon the cause of kidney dysfunction, the pet’s owners may notice watery droppings.
• The pet may have an enlarged abdomen, become unable to fly, regurgitate, vomit or become constipated.
• If gout develops due to the kidney disease, lameness and swollen joints may also be seen.
• Depression and lethargy; fluffing of the feathers, general weakness, loss of appetite and weight.
• Dehydration – Birds suffering from dehydration may have crinkly skin around their eyes and produce small, dry droppings.
• Blood in droppings (red bird droppings) are indicative of internal bleeding low in the digestive track. Even though this may be a symptom of kidney disease, it can also be a result of lead poisoning

The usual causes of renal failure in birds include:

• Gout:Since the diseased kidney cannot filter out uric acid, they become deposited in joints or the small tubules of the kidney. This condition in birds is referred to as Gout.
• Infections
   
  • Viral: Several viruses can cause either temporary or permanent kidney damage; for example, the Polyomavirus is the most common, especially in young, hand-fed psittacines. Adenovirus, Poxvirus, proventricular dilatation syndrome (PDD), and herpesvirus have also been associated with renal disease.
  • Bacterial: Usually occur as a result of the spread of an infection from another area of the body to the kidneys via the blood stream or the urinary tract.
  • Fungal: Aspergillus is the most common cause of fungal infections of the kidney in birds, though fungal renal disease is relatively uncommon.
• Toxins:
   
  • Excessive levels of vitamin D (hypervitaminosis D)
  • Reactions to antibiotics (i.e., gentamicin and streptomycin)
  • Heavy metals, including zinc, lead, cadmium and mercury. Patients should be tested for toxic levels of heavy metals known to be associated with renal failure in birds, such as lead and mercury. In addition, toxic or deficient levels of other heavy metals, including arsenic, copper, iron, manganese, molybdenum and zinc should be considered and tested for.
  • One should also look for evidence of acute intoxication by organophosphate, carbamate, or organochlorine pesticides.
  • Less common cause of toxicity is overeating salt that can also damage the kidneys of birds
  • Ingestion of certain plants and some food items have been linked to renal failure.
  • Microscopic renal lesions could be tied to an acute toxic etiology.
• Nutritional deficiencies or excesses
   
  • Vitamin A deficiency – Birds with hypovitaminosis A (usually caused by diets low in vitamin A) may develop kidney disease. This most commonly occurs in birds receiving seed-only diets, unsupplemented with pellets, vegetables, and fruit.
• Cancer: Kidney tumors are particularly common in budgerigars. Tumors can often put pressure on other organs and nerves. If the tumor puts pressure on the nerves going to the legs, the bird may experience weakness, difficulty moving a leg or may not be able to stand. The abdomen may also become distended.
• An obstruction of the urinary tract by a urinary stone or an enlarged egg that can’t pass.
• Metabolic diseases
• Blood Parasites: Microscopic and tape worms

Diagnosis

The vet will initially perform a physical examination, and follow it up with a complete medical history and complete blood count (CBC), blood chemistry tests (including electrolytes, total protein, albumin, uric acid, blood urea nitrogen, and creatinine), and a urinalysis.

Radiographs (x-rays) may be helpful, and cloacal swabs, endoscopy, ultrasound, and sometimes a kidney biopsy may also be indicated.

Treatment

• Supportive care: Fluid therapy, tube feeding, and providing supplemental heat.
• Periodic blood testing may be necessary to monitor the response to treatment and adjust it accordingly.
• The underlying cause of the renal disease needs to be treated.
• Since bacterial infections can be a common cause of renal disease, or can often occur secondarily, antibiotics are usually included in the treatment regimen.
• Antiviral medications, antifungal medications, specific treatments for gout or toxins, vitamin A supplementation or surgery may be necessary.

Supportive Nutrition

• Provide a diet rich on the organic vegetables, greens, fruits, rich in the following nutrients:
  • Vitamin A – helps healing process of urinary tract lining
  • Vitamin B complex – helps fluid metabolism
  • Vitamin C – boosts immunity and elevates urine acidity
  • Vitamin E – elevates immune system
  • Bromelain and Quercetin are most effective when used together. Quercetin is an anti inflammatory and may reduce the production of uric acid. It occurs naturally in apples, pink grapefruit, watermelon, elderberries and green leafy vegetables, as well as black tea, green tea and elderberry juice. Bromelain is another anti-inflammatory that is found in pineapple.
• Reduce dietary protein
• Provide an ample supply of clean / filtered water
• Helpful Greens / Herbs:
  • Dandelion Root (pu gong ying) – aids kidney excretion function of waste
  • Cranberry – acidifies urine and kills bacteria
  • Celery and Parsley – decreases uric acid
  • Devil’s Claw is a natural anti inflammatory that also reduces pain. It also facilitates the elimination of uric acid from the body.
  • Nettle Tea increases the excretion of uric acid from the body and many swear by it for treating gouty joints. Nettle will work both as a tea or a tincture. The teas are fine for milder cases, but the tinctures are usually recommended in more severe cases of gout.
  • Aloe Detox (for example: “Lily of the Desert Aloe Detoxifying Formula” – has shown multiple benefits for gout sufferers – one way to get birds to drink it is to drip it on their favorite soft foods. Adding it to their water may stop from them drinking as they may not like the taste. The manufacturer reports that Aloe Detox needs to be refrigerated (obviously). After opening, it will keep for 7 to 9 months.

    Fresh gel from the leaves are superior to Aloe Vera gel bought commercially. Bird owners will cut off a small section each day and feed that section to their pet birds. The plant is easy to grow in most areas. It needs, however, to be grown organically — without the use of chemical fertilizers, pesticides or herbicides.

    *NOTE: Even though Aloe Vera is helpful for many birds, some rare birds may have a reaction to Aloe Vera. Spray one of your fngers and touch your bird’s foot. Leave for 24 hours and see if an reaction occurs

• Allopathic drugs such as Allupurinol can lower uric acids levels and have been used in birds with varied results.

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

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