What is Constricted Toe Syndrome?

This condition seems to affect mostly parrots, macaws, cockatoos, and conures. Unfortunately, in some cases, by the time the syndrome is noticed, it is too late to save the toe. If there has been no circulation for a period of time and there is necrosis, the toe will have to be amputated. The syndrome may be so severe that it progresses to avascular necrosis, which is the loss of blood to the bone that causes the bone to die. In this situation, emergency surgery must be performed before the condition spreads to other parts of the body, which is quickly fatal in young birds.

Constricted toe syndrome in birds is not uncommon in young birds and can affect one or more digits. The cause of this syndrome is a band of fibrous tissues that cut off circulation by forming around a joint of any toe or toes. The reason this happens is not known yet, although it is suspected that septicemia or having the humidity too high or low may be the reason. Constricted toe syndrome is most often seen in macaws and parrots, especially those in dry environments. If the problem is found early, the toe can be saved by using a moist bandage after removing the band with debridement. However, in serious cases, the toe can be treated with tiny incisions for better circulation to allow the toe to swell and heal without constriction. Without treatment, it can be fatal due to necrosis and septicemia.

Symptoms of Constricted Toe Syndrome in Birds

The symptoms of constricted toe syndrome are usually pretty obvious, with a circumferential section of the bird’s skin, cutting off the blood supply to one or more of the toes. This closely resembles a condition in which a string or other type of fiber gets wrapped around the toe, stopping the flow of blood to that toe. Some of the symptoms include:

  • Swelling of one or more toes
  • Bleeding of the foot
  • Scabs or other lesions on toes


  • Unilateral includes only one toe
  • Bilateral includes more than one toe

Causes of Constricted Toe Syndrome in Birds

The cause of this syndrome is still not completely understood, but avian veterinary professionals suggest that it may be:

  • Conditions too dry or too humid
  • Nutritional deficiency 
  • Congenital (parrots, macaws, cockatoos, and conures)
  • Untreated fractures
  • Birth defects from egg positioning

Diagnosis of Constricted Toe Syndrome in Birds

Diagnosing constricted toe syndrome in birds is pretty simple, but the veterinarian will do a complete physical examination and history as with any veterinary visit. This is important because the cause of this syndrome may lead the veterinarian to another underlying illness that needs to be treated, such as nutritional issues. Be sure to tell the veterinarian as much as you know about your bird including health issues, behavioral changes, abnormal appetite, and symptoms noticed. This is usually easy because it happens most often to young birds (neonates) within the first few weeks of their birth. 

Also, tell the veterinarian if you have given your bird any medication or supplements because some drugs do not interact well with others. The physical examination most often includes palpation and auscultation, vital signs, and body condition score. The veterinarian will try to do most of the examination while your pet is in the cage or being held by you to reduce stress. Blood will be drawn for some routine tests to look for anything suspicious such as nutritional problems and radiographs to check the bones in the foot. Ultrasound may also be helpful in assessing the damage to the tissues of the toe and surrounding area.

Treatment of Constricted Toe Syndrome in Birds

The first thing you should do is to increase the moisture in your bird’s environment. A warm water compress, massage therapy, and possibly surgery are all treatments that can help constricted toe syndrome.

Warm Water Compress

Because the reason for constriction may be dry skin, the veterinarian will first soak your bird’s feet in warm diluted iodine or saline. Afterward, a hot moist compress may be used and continued indefinitely. If the constriction is not severe, this may be the only treatment needed.

Massage Therapy

Your veterinarian may try massaging your pet’s foot to increase the blood circulation. This is another good treatment for syndromes that are not severe.


Dimethyl sulfoxide (DMSO) ointment and magnesium sulfate soaks can also help.


If necessary, the veterinarian will perform a surgical debridement to remove the skin stricture. If this does not help or if the toe is unable to be saved, surgical amputation will be done to remove the toe.

Recovery of Constricted Toe Syndrome in Birds

If your veterinarian prescribes one of the treatments above besides surgery, you will be given instructions on how to continue the treatment at home. You should also change your bird’s environment to prevent this from recurring. If your bird had surgery, keep the wound clean and follow up with the veterinarian in 7 to 10 days or sooner if needed.

Constricted Toe Syndrome Questions and Advice from Veterinary Professionals

Blue gold macaw
29 Days
Critical condition
0 found helpful
Critical condition

Has Symptoms


45day old Blue Gold Macaw has it on two toes on the some foot. Very severe and the toe is 3 times as big as the other toes. Will my bird die without amputation? There aren't any avian vets available. Should I amputate?

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African Grey
6 Weeks
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

Lame foot

I have a 6 week old African Grey that doesn't seem to be able to grip with one foot. I don't think it is constricted toe, there is no swelling, no lesions, the foot is not hot or cold. the leg seems to work just fine, the foot just seems dead.
Any ideas if this maybe related to Constricted toe syndrome?

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green wing macaw
3 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms

not using foot. swelling

Medication Used

using celebrex now

My macaw may have similar problems but from his leg band which was too tight. The leg band was a steel ring. Initially it had movement but then he grew into it and it did not move. We monitored for a long time but it did not seem to bother him. Then I noticed him favoring the foot so we aimed to remove it. We did this under sedation at a vet, using bolt cutters. They gave him a steroid type injection for inflammation and that helped but now he has pain and discomfort again. Laser treatment is not available where we are.

Dr. Michele King, DVM
Dr. Michele King, DVM
Dr. Michele King DVM
1611 Recommendations
Without seeing Ruby, I'm not sure what might be causing the pain if the band has been removed. Since your veterinarian has seen him, it would be worth calling and asking if they have any ideas on what might be causing the discomfort, and if there is any treatment that they would recommend.

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