Atherosclerosis: The Hidden Killer

Atherosclerosis is a common disease in companion parrots – one we must all take seriously. If you have ever heard of an older parrot who died suddenly, without apparent cause, there is a good chance that this progressive disease was a primary factor in the demise.

What is Atherosclerosis?

Atherosclerosis is one type of arteriosclerosis.  The word atherosclerosis derives from the Greek words athero, which means “gruel or porridge,” and sclerosis, which means “hardness.” This is a fairly descriptive term for the disease itself, in which cholesterol is deposited onto the sides of arteries, creating hard plaques. Once build-up is great enough, plaques can dislodge; these cause blockages, which lead to heart attack.

It is primarily a disease of inflammation. The more inflammation, the greater the risk of atherosclerosis.Blue and Gold by Engin Akyurt

Birds are more susceptible to atherosclerosis than any mammal, with the exception of humans. “The reported incidence rates in avian species range widely from 1.9% to 91.9%.”(Powers, 2015)

A Confusion of Information

While much is known about atherosclerosis in humans, this information cannot be readily transferred with reliability to birds. Reading through scientific papers about the disease causes consternation and befuddlement. Undeniable conclusions are lacking, although more recent research does point to strong correlations.

Much of the research has been done on bird species other than parrots, such as quail, waterfowl, and chickens. Diagnosis on parrot species who have succumbed to this illness has been conducted on a very mixed population, particularly those kept previously in zoos, who have been maintained under a variety of conditions and fed a mix of diets.

Moreover, the studies that are being done on risk factors that exist for parrots are being performed on the known risk factors for humans and other mammals. There may, however, be other risk factors specific to avian species that may take longer to uncover, such as individual species’ genetics.

Thus, I will warn you that what I write today may well be something I will edit extensively in another five years.  The danger is significant and real for our parrots, so an examination now of what we know is important. However, I have every expectation that some of what you read below may be proved wrong in the future, while additional details will in turn come to light.

Which Parrots Are At Risk?

While we have a very good understanding of risk factors in mammals, this is not so with parrots. But, a few things we do know.

Speciesparrot-2005767__340

It is currently agreed that Amazon parrots, African Grey parrots, quaker parakeets, and cockatiels appear to be at greatest risk. While the disease has been seen in cockatoos and macaws, they are not believed to be quite as susceptible. Many avian species, though not all, have been found to develop atherosclerosis in captivity.

Age

Increased age is a significant risk factor. However, while more common in older parrots, Nemeth states that atherosclerosis has been found in birds aged 1 to 42 years. (Nemeth at al, 2016) It is most common in companion parrots over the age of 10.

Gender

Female parrots have been proven statistically to be at greater risk. Female birds in reproductive mode generally have elevated levels of cholesterol, triglycerides and lipoproteins, as well as calcium, creating greater susceptibility.

Diet and Nutrition

“The inclusion of cholesterol in the diet of birds that consume non-animal protein, even as low as 0.25% of the diet, dramatically increases plasma and serum cholesterol levels.” (Petzinger and Bauer, 2013).

Petzinger also mentions a 2003 paper by Bavelaar and Beynen that found that African grey parrots fed a high-fat diet containing palm kernel oil (saturated fatty acids) had increased cholesterol levels.cockatiel-1213758__340

Petzinger also reports on the findings of yet another study from 2012. In this research, a total of 47 cockatiels who were supplemented with fish oil had lower plasma cholesterol than cockatiels fed flaxseed oil. The conclusion? “Thus, dietary fish oil (and possibly dried algae products) may be more beneficial than oils high in A-linolenic acid on reducing risk factors and prevalence of atherosclerosis in avian species.” (Petzinger and Bauer, 2013)

Another nutrient capable of lowering cholesterol levels in birds is pectin. Pectin is the soluble fiber contained in fruit and some vegetables.

The overall amount of food eaten may also contribute to the development of atherosclerosis. Overeating and obesity are proven risk factors for mammals. This correlation has been studied in birds with varying conclusions.

Physical Inactivity

Every research paper I read reported a presumed link between inactivity and the development of atherosclerosis. However, I could find no evidence that any link between exercise and this illness had actually been researched in avian species.Conure2

Since such a strong link exists between the two in mammals, including humans, it would be foolish to ignore it here and the papers I read did include recommendations for exercise in companion parrots.

Inflammation

The literature on human health names inflammation in the body as a primary cause for the development of atherosclerosis. In fact, inflammation is currently being discussed in what is being called “a unifying theory of disease.” (Harvard Health, 2006) In other words, inflammation is now considered as a significant factor in the development of many chronic human illnesses.

Nevertheless, inflammation as a process “remains a mystery.” (Anft, 2016) However, scientists are beginning to agree that lifestyle choices like diet and exercise may increase (or reduce)  inflammation.parrot eating cracker

Common foods that cause inflammation, which are often fed to parrots, are fried foods and those containing refined carbohydrates (white flours and sugars).

Co-Infection with Psittacosis

The disease Psittacosis, also known as Parrot Fever, is more accurately referred to as Chlamydia psittaci. This disease is still relatively common among companion parrots, especially those who have come from large collections. While researchers disagree about whether there is a conclusive correlation between infection with Chlamydia and atherosclerosis, some studies appear to agree on this.

Signs and Symptoms

Sadly, the most common sign of atherosclerosis is sudden death. In the late stages, there may be symptoms such as weakness, lethargy, neurological  signs (including seizure-like activity), trouble breathing and exercise intolerance. However, these may be less observable due to parrots spending long hours in cages. It is easier to identify exercise intolerance, for example, in parrots who fly.

At this point in time, diagnosis is extremely difficult. Most people will never imagine that their parrots are ill until they lose them unexpectedly, well before their time. With better imaging techniques, as well as a better understanding of identifying factors in serum chemistries, this may change in the future.

What Can We Do?

Atherosclerosis in companion parrots is still not well-understood. Direct and specific correlations from the human health field may only be suggestive. Thus, we do not have well-defined risk factors that would allow us to target flawless measures for prevention.

FoodSkewerMoreComplexSuggested lifestyle changes reported in the literature include “increasing physical activity by providing more opportunities for locomotion and foraging behaviors and decreasing the stress level  in their captive environment. Limiting dietary excess and obesity also seem to be a reasonable strategy, but species-specific dietary needs should be considered.”(Beaufrere, 2013)

“Birds should be provided ample opportunities for exercise and activities such as foraging, and even flight, if considered safe for the bird. Excessive energy content in the food should be avoided, such as excess carbohydrates and fats. Birds should receive regular preventative veterinary care with periodic bloodwork monitoring.” (Powers, 2015)

Diets that contain relatively high levels of Omega-3 fatty acids reduce the prevalence of the disease. (Petzinger and Bauer, 2013) Nordic NaturalsNewer research indicates that fish oil may be more effective in this than alpha-linolenic acid, the type of omega-3 found in plants, such as in flax seed oil. Supplementation with fish oil may be an excellent addition to the diets of many companion parrots, but this should not be undertaken without the advice of your veterinarian.

Pectin in the diet has also decreased the occurrence of atherosclerosis. (Petzinger and Bauer, 2013) Pectin is the soluble fiber found in fruit. Too much pectin can result in a decrease in the absorption of nutrients from the intestine, however. Thus, fruit should be fed in moderation for most species.

Reducing the overall amount of food, i.e. not over-feeding, can also decrease the prevalence of atherosclerosis. This  information too, however, could be harmful if implemented to the extreme. Hunger and malnutrition do nothing to improve overall health. It is best to consult with your veterinarian about the quantity of foods to offer.

Suggested Action Steps:

After as thorough a review as I could muster with the research I was able to access, I think the following steps are prudent:

  • Identify an avian vet who specializes in birds and schedule annual visits.
  • If your veterinarian tells you your bird is fat, take this seriously and formulate a plan for gradual weight reduction.
  • Discuss with your veterinarian supplementation with fish oil. (The correct dose is important and should be obtained from your vet.) Nordic Naturals is an excellent choice.
  • If you have a female parrot, do everything you can to minimize triggers for the increased production of reproductive hormones. (You should do this for males too.)
    • Discourage a pair bond
    • Avoid cuddling and other highly affectionate interactions
    • Prevent cavity seeking (getting into closets, boxes, etc.)
    • Feed a low-fat, low-carbohydrate diet013
  • Do not feed foods high in saturated fat (fatty meats, butter, margarine, cheese, coconut oil, palm oil, fried food, or snack foods).
  • Do not feed pasta, white rice, or any foods that contain white flour or sugar and other sweeteners.
  • If your bird eats a seed mix as a dietary staple, convert him to a pelleted diet with supplementation of fresh foods.
  • Avoid overfeeding. Remember the size of the creature you are feeding.
  • Encourage foraging and try to incorporate some physical activity into this.
  • Encourage exercise.
    • Determine whether you and your bird might be a candidate for flight in the home.
    • If not, work to discover ways to encourage as much movement as possible.Green And Red Healthy Food
  • Do feed foods high in pectin, in moderation (apples, pears, plums, peaches, apricots, cherries, strawberries, guava, carrots and peas). Apples are especially high.
  • Do feed foods high in omega-3 fatty acids or that are otherwise known to reduce cholesterol (oats, barley and other grains, walnuts, flax seeds, chia seeds, hemp seeds, edamame, almonds, beans, tofu, salmon)
  • Do feed foods that fight inflammation (green leafy vegetables, blueberries, salmon, broccoli, cauliflower, kale, peppers, grapes, celery, ginger, tumeric)

parrot-2960562__340Atherosclerosis is a scary prospect, given what we now know about the susceptibility of our companion parrots. However, I suspect that we have in our hands the tools for prevention, just as people do. Granted, risk factors outside of our control exist, such as age and gender. However, we do have enough information to take action and keep our parrots as healthy as absolutely possible.

Thank you for reading my blog. I am Pamela Clark, an IAABC Certified Parrot Behavior Consultant. My passion is helping people with parrots by offering behavior consultations and publishing information you can trust. To access free resources, schedule a consultation, or subscribe to my newsletter (which is a different publication from this blog), please visit me at http://www.pamelaclarkonline.com. Until next time!

References:

Anft, M. 2016. “Understanding Inflammation.” Johns Hopkins Health Review. Volume 3, Issue 1. https://www.johnshopkinshealthreview.com/issues/spring-summer-2016/articles/understanding-inflammation

Beaufrere, H.  Dr. Med Vet, PhD, Dip. ECZM, Dip. ABVP. 2013. “Avian Atherosclerosis: Parrots and Beyond. Topics in Medicine and Surgery.http://dx.doi.org/10.1053/j.jepm.2013.10.015https://www.sciencedirect.com/science/article/abs/pii/S1557506313001754?via%3Dihub

Bavelaar F. J. & Beynen, A.C. (2004) “Atherosclerosis in Parrots: A Review. Veterinary Quarterly, 26:2, 50-60. https://doi.org/10.1080/01652176.2004.9695168

Nemeth, N.M. , Gonzaliz-Astudillo, V., Oesterle, P.T. Howerth. E. W.  “A 5-Year Retrospective Review of Avian Diseases Diagnosed at the Department of Pathology, University of Georgia”. Journal of Comparative Pathology. Volume 155, Issues 2–3, August–October 2016, Pages 105-120. https://doi.org/10.1016/j.jcpa.2016.05.006

Harvard Health Publishing. April 2006. Harvard Medical School. “Inflammation: A Unifying Theory of Disease. https://www.health.harvard.edu/newsletter_article/Inflammation_A_unifying_theory_of_disease

Petzinger, C. PhD, Bauer, J, DVM, PhD, Dip. ACVN. 2013. Journal of Exotic Pet Medicine. Volume 22, Issue 4, October 2013, Pages 358-365. “Dietary Considerations for Atherosclerosis in Common Companion Avian Species. https://doi.org/10.1053/j.jepm.2013.10.013

Petzinger,C BS, Heatley, J DVM, MS, DABVP, DACZM, Cornejo,J BS, Brightsmith, D. PhD; Bauer, J DVM, PhD, DACVN. Journal of the American Veterinary Medical Association. March 1, 2010, Vol. 236, No. 5, Pages 523-528. https://doi.org/10.2460/javma.236.5.523

Powers, L. DVM, DABVP. 2015. “The Silent Killer: Atherosclerosis in Pet Birds.” CVC in Washington, D.C. Proceedings.  Published on DVM 360. http://veterinarycalendar.dvm360.com/silent-killer-atherosclerosis-pet-birds-proceedings.

Part Three: The Benefits to Us

I have never read any discussion about living with flighted parrots in which the word “inconvenience” didn’t appear. It’s true. Living with flying birds can be inconvenient, in addition to messy, challenging, and chaotic.

Despite this reality, I would never go back to clipping wings. Most others who have adopted the lifestyle agree. They can’t imagine a scenario that would cause them to clip wings again.

Living with birds who fly is an experience so special …so remarkable …that no amount of inconvenience, chaos or mess will press you to give it up. My last blog episode examined the advantages to the birds of enjoying indoor flight. In this post, I will focus on all of the many advantages to us.

Why I Do It

I initially stopped clipping wings because I thought it was the right thing to do. Preventing their freedom of movement no longer seemed an ethical option. Never, however, could I have imagined the gifts that would accrue to me personally of making this change. I can enumerate them as follows:

  • Greater sensitivity to and skill at reading body language
  • Greater awareness of my surroundings and my animals
  • Knowledge of how behavior works and improved skills at teaching and motivating
  • Deeper commitment to being responsible for the safety of my flock
  • Parrots with no behavior problems
  • The ability to recognize illness earlier
  • The ability to identify discord between individuals earlier
  • A deep sense of pride at how I provide for my birds
  • A deeper, more trusting, relationship with my birds
  • A great deal more fun!

Reading Body Language

We generally gain knowledge on an “as needed” basis – to meet our lowest level of intellectual demand. If our parrots do less because they can’t easily move around, we have less need to develop greater sensitivity. Oh, we usually (but not always) learn how to avoid being bitten. And, if we have a fearful parrot, we may learn which environmental factors scare them and how to avoid those.  We learn to respond to very overt body language.

However, the potential for problems of all types increases when you live with multiple flighted parrots. To avoid conflicts and accidents, as well as to maintain trust and compliance, it’s necessary to become exceptionally more sensitive to and skilled at reading body language.

Bird who enjoy frequent movement are constantly giving us feedback about ourselves. This creates for us greater sensitivity in regards to how our movements affect them. Move too quickly, or use a scary gesture, and they fly away. When we live with clipped birds, this type of subtle feedback is absent. Living with those who can fly makes us more sensitive and considerate caregivers.

Greater Awareness of My Surroundings

Living with flighted birds comes with risks. Managing these risks successfully requires that we cultivate and maintain a greater awareness of our surroundings and our birds from moment to moment. This is simply a skill that develops over time.

Risk management is only one advantage from becoming more aware, however. The real gift is one of living more harmoniously with my flock. I will never forget the reverberation in my heart when I heard Barbara Heidenreich say, “If an animal is aware of you, you must be aware of your animal.”

My birds are infinitely aware of and sensitive to my movements. Thus, because I feel the truth of Barbara’s advice, I have required of myself that I learned to match their awareness with my own. This has created a much deeper connection to them that I struggle to describe.

Acquisition of Knowledge and Skills

Way back when, I taught stepping up through laddering. Because someone said I should. I got a reluctant parrot to step up by scaring him with a washcloth held close by. Because someone said I should. I kept a parrot on my hand by putting pressure on his toes. Because someone said I should.

I only got away with these strategies because at that time, I was also clipping wings and had pretty polite parrots who were willing to go along with my foolishness. Those types of interactions are aversive to parrots and rely on an attitude of force and command.

When you live with birds who fly, the use of force is completely off the table. They simply fly off if they don’t like what’s happening. If you respond to the behavior challenges that occur with a lack of skill, you can quickly lose all control over them. Your only option is to learn the principles that govern how behavior “works” and to use positive reinforcement skillfully in order to get the behavior that you want.

As my friend Leslie Mapes describes her experience:  “Giving my bird the ability to fly means that he is able to act on his environment and go where he wants to and connect with me (or not) when he wants to. His ability to move around on his own also makes me a better caregiver. I wouldn’t have it any other way for this very smart, very gifted flyer of a bird!”

Living Responsibly

Discussions about indoor flight are replete with cautions about the risks. They can land on hot stoves or fly out the door. They can drown in toilets. They can eat toxic houseplants, or fly into ceiling fans. Some of these presumed risks are very real; others are more imagined.

These risks can be handled successfully through skillful management of the environment, coupled with training. Nevertheless, living with birds who fly requires us to become and remain more watchful and responsible. We learn to automatically think ahead to anticipate potential problems and invent solutions before they arise. Rather than relying on the assumption that clipped wings will keep my birds safe, I must accept the responsibility for ensuring their physical safety.

I like how reader Rachel Crooks expressed it: “I think it’s my responsibility as an owner of a flighted creature to maintain an environment where they are safe to fly, rather than trying to adapt the bird to my environment.”

Absence of Behavior Problems

The majority of behavior problems are caused in part by inadequate environmental provisions – not enough choices, learning opportunities, foraging or freedom. A parrot who cannot move around at will is at greater risk for developing behavior problems.

This doesn’t mean that flighted parrots can’t also develop problems. They do. They can be loud. They can be aggressive. They can chew off feathers. However, the incidence of problems is much less among flighted birds.

My birds don’t need to scream for attention. If they need it, they fly to my proximity and indicate this in a quieter manner. They don’t need to bite; they simply fly away if I make a misstep. None of them destroy their feathers. The flying they do encourages normal preening and they are so busy, they aren’t prone to resorting to feather destruction for entertainment.

Recognizing Illness

We all know it – birds tend to hide signs of illness until they are so sick they can no longer do so. Even seriously ill parrots behave normally at times. This leads to their early loss too frequently – we just didn’t realize that something was wrong until it was too late.

Flying takes a lot of energy. If a parrot flies frequently as part of its daily behavior repertoire, an observed decrease in this activity is likely to signify the presence of  a problem. Clipped parrots often display lower levels of interaction with the environment, making it more difficult to identify behavioral signs of illness.

Thus, flight ability acts as an “early warning system.” If a bird begins to fly less, even if he appears normal in all other ways, I am going to get him to the vet without delay.

Recognizing Discord

Parrots have dynamic personalities. They don’t always get along. Some never do, while others can change their relationship dynamics over time. Those who used to be friendly can begin to have issues.

Differences in the expression of body language, along with issues of perceived territory, can cause some pretty consequential discord. Serious injuries and expensive veterinary bills can result.

Since parrots use flight to express themselves, in addition to moving around, peersonality problems become evident quickly. If I see one bird beginning to spend more time in the bedroom, away from the others, I know to look deeper into this behavior change. The likelihood is that someone is harassing her, at least on a subtle level. If I see any chasing happen, I know I’ve got a serious problem to solve.

Those who clip wings don’t have this advantage. Often problems between parrot personalities aren’t recognized until it’s too late.

A Sense of Pride

I believe that most of us feel guilt, on some level and at least some of the time, about keeping parrots at all. It was a blatantly stupid, arrogant, idea to take a creature who can fly, remove that ability, and confine it in a cage for human enjoyment. Those of us who choose to live with birds in our homes now carry the burden of this misuse of power deep in our souls, despite our distance from the original sin.

I contend that this quietly simmering unease causes us to make some really questionable decisions regarding our parrots. We want to make them happy, so feed them things they shouldn’t have, focus on the provision of physical affection, and allow them to hang out in closets for hours at a time. We give them what they want, rather than what they need.

I can’t forget that my birds didn’t evolve to live within four walls. But, by providing for flight, lots of freedom, and time outdoors, I can feel good about the quality of life that they enjoy at my hands. They can’t have it all, But they have enough to enjoy life to the fullest.

As behavior consultant Greg Glendell writes, “Is it a basic tenet of good animal husbandry that all creatures in captivity should be given the opportunity to carry out as many of their natural daily activities in captivity as they would in the wild.”

Relationships of Trust

This one is simple. Training always creates more trust. Clipping wings and training are two sides of the same coin. You either clip or you train. If you live with parrots who possess good flight skills, you don’t have any choice. You must provide training on a daily basis.

This ongoing behavioral guidance creates deep levels of trust in my relationships with my birds. Every interaction that I have with them involves choice for them. They don’t have to step up unless they want to. They don’t have to go back into their cages unless they want to. They don’t have to go outdoors unless they want to. But, they do want to because I have learned to be a good trainer and I know how to motivate them.

A Joyful Lifestyle

Parrots use flight for reasons other than moving around. They also use flight to express themselves. One might suddenly take it into his head to fly in circles, screaming happily. I get to share in that exhilaration.

One might fly to a perch and then flip upside down in silliness. I get to laugh. One might ace an especially complicated landing. I get to admire. I might find one in a completely unexpected place. I get to be surprised.

Birds who fly are simply more fun to be around. They reveal their unique personalities in a manner that sedentary birds cannot.

As reader Rachel Crooks describes, “As her flight feathers have come in over the past year, I have seen a huge growth in her confidence and independence. I love that she is able to explore and find new ways through flight to entertain and stimulate that little brain of hers! Part of her daily routine is to zoom around my apartment for 10 or 15 minutes purely for fun. My experience with her has taught me that flight isn’t a purely functional behaviour – it’s used as a way to communicate, to play, and to explore. I feel lucky to be able to experience this alongside my bird!”

My birds are also less dependent, which pleases me. They don’t need me for entertainment. They can go where they want and do what they want in an environment that provides them with plenty of opportunities.

In Summary

I will leave you with the words of reader Paula Hobson: “I have mixed feelings about keeping companion animals.  On the one hand, I feel most peaceful and happy in the company of my 2 dogs, 2 parrots, and 2 parakeets.  Their beauty, affection, curiosity, attention, and the fact that they are always exactly who they are in the moment helps ground me and keep me sane.  That they aren’t human keeps me alert and curious about what the world is like with their particular senses, abilities, and unique thought processes.  On the other hand, they live mostly indoors, will never mate and raise young, interact naturally with their own kind, or make use of their considerable intelligence and resourcefulness to survive in their natural habitats.  In recognition of their great (involuntary) sacrifice, I try to provide the best diet, environment, and fun/challenge for them.  This includes as much freedom as you can have in a modest 3-bedroom ranch home.  They are out of their cages unless I have visitors or need to have the door open for any length of time.  They have play areas on their cages, java tree, toy tree, parrot stand, and refrigerator top.  They fly to the bathroom when I shower, and to my bedroom when I dress.  Just seeing their grace and beauty during flight lifts my heart, every time.  The physiology of flight, from unique skeleton and respiratory system, and the visual processing of the brain for flight and landing, are integral to the birds’ being.  To cripple them by clipping the wings and forcing them to walk everywhere would so severely limit their experience and freedom that I do not think I could justify it to myself.  Imagine being kidnapped by an alien and having your hamstrings cut so you could only get around in a wheelchair.  For your own safety.  How would this affect your quality of life?  Your mood?  I believe all living beings have pleasure moving in their healthy bodies and in having freedom.  If it increases some risks to the birds, I choose that over depriving them of flight.”

Now that we have examined all of the many benefits of flight, I will in my next episode, get down to the business of discussing how to make this difficult decision. Is my house a suitable one for having birds who fly? Is having flighted birds right for me? Is my bird a good candidate for flight? See you then!

Thank you for reading my blog. I am Pamela Clark, an IAABC Certified Parrot Behavior Consultant. My passion is helping people with parrots, by offering behavior and husbandry consultations and publishing information you can trust. To access free resources or subscribe to my newsletter (which is a different publication from this blog), please visit me at http://www.pamelaclarkonline.com. Until next time!

Resources

McKendry, Jim. Publication date unknown. Wing Clipping vs. Flighted Companion Parrots. World Parrot Trust: Ask an Expert. https://www.parrots.org/ask-an-expert/wing-clipping-vs-flighted-companion-parrots. Accessed 03/29/2019. Accessed 03/30/2019

Sarah and Three Birds and A Cloud. 2012. https://threebirdsandacloud.wordpress.com/2012/08/28/life-with-flighted-parrots. Accessed 04/08/2019.