What are Hepatic Lipidosis?

An excess of fat in the diet of birds can compromise normal body functions. Over time, fat accumulates in the liver and around the heart, where it interferes with their normal processes. As the condition progresses, the liver functions involved with detoxification and blood clotting are compromised, leading to blood poisoning and prolonged bleeding. This can then lead to a severe loss of blood, even from a very minor injury, and could be fatal.

Hepatic lipidosis, also called fatty liver disease, is characterized by obesity and an excess of fat in the liver, and is a common nutritional disease of birds. Pet birds that are fed high fat seed diets, and are often sedentary, can develop an enlarged liver and carry excessive weight, causing problems with energy and flight. Species commonly affected include cockatiels, Amazon parrots, cockatoos, Quakers, budgerigars, and lovebirds.

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Symptoms of Hepatic Lipidosis in Birds

A condition of hepatic lipidosis comes about gradually. If your bird is showing signs, then the disease is becoming advanced. Near the end stages of this condition, the nervous system becomes compromised, resulting in disorientation or seizures. Spots seen on toenails and beaks are signs of internal hemorrhaging, and point to clotting problems. Symptoms of hepatic lipidosis include: 

  • Overweight
  • Excessive fat deposits under the skin 
  • Buxom chest or abdomen from fat deposits
  • Distended abdomen 
  • Enlarged liver seen through moistened skin in small birds
  • Overgrown beak or claws
  • Beak develops soft areas
  • Black spots on toenails and beak 
  • Poor feather quality 
  • White feathers of cockatiels can have a yellowish hue 
  • Unable to fly
  • Tires easily
  • Engage in little to no exercise
  • Diarrhea 
  • Droppings have a more greenish hue 
  • Difficulty breathing 
  • Tendency for prolonged bleeding
  • Lack of blood clotting ability
  • Disorientation
  • Seizures 
  • Sudden death

Types

There are two recognized types of hepatic lipidosis, classified by the age of the affected bird.

Juvenile Hepatic Lipidosis

This condition in young birds is often due to being hand-fed in excess amounts, or past the time of weaning. Owners often feed juveniles calorie dense, high fat foods, such as commercial formulas enriched with oil, peanut butter, or a fatty supplement. This overfeeding, coupled with the fact that juveniles tend to be more sedentary, can create a bird too heavy for its age, and contribute to respiratory distress. A hematoma, or a swelling of clotted blood, can also form on the liver. 

Adult Hepatic Lipidosis

A long history of malnutrition creates this condition in adult birds. Obese birds have often been fed a high fat diet, and eventually develop blood poisoning and an enlarged liver that creates problems in the heart, and respiratory and nervous systems that could become fatal.

Causes of Hepatic Lipidosis in Birds

In normal liver function, lipids (molecules that include fats) are consumed in food, and then are transported to the liver from the gastrointestinal tract, where they are transformed into lipoproteins. These lipoproteins, which carry triglycerides, are then released into plasma so that the body can use them as an energy source. When triglycerides accumulate in the liver faster than they can be released as lipoproteins, hepatic lipidosis, or a fatty liver, can occur. This condition often results from a variety of disruptions to the body’s normal process of lipid metabolism. Situations that can cause a disruption include:

  • An excessive dietary intake of fat or carbohydrates
  • Diet high in seeds
  • Over-eating 
  • Juveniles hand-fed a high fat diet past weaning, or in excessive amounts
  • Amino acid deficiencies, such as biotin, choline and methionine 
  • Long term malnutrition 
  • Sedentary lifestyle
  • Starvation 
  • Endocrine abnormalities
  • Abnormal liver cell function 
  • Metabolic diseases, such as thyroid dysfunction
  • Exposure to toxins, such as drugs, hepatotoxins, or aflatoxins found in peanuts and corn
  • Hereditary factors 
  • Bacterial infections, such as Chlamydophila psittaci

Diagnosis of Hepatic Lipidosis in Birds

A diagnosis begins with symptoms, a physical exam that notes the weight and any medical history, and an evaluation of your bird’s diet. An enlarged liver may not be visible, but your veterinarian will likely feel that area to discover if it is present. 

Blood and serum tests are run, including a CBC and a serum bile essay. Elevated levels of lipids, cholesterol, triglycerides, liver enzymes and bile acids can help lead to a diagnosis.

X-rays or ultrasounds are used to confirm an enlarged liver. In the end stages of liver disease, however, the liver can be smaller and denser. A biopsy is sometimes performed to provide a definitive diagnosis, but it can be dangerous in birds, due to blood clotting issues and the risks from anesthesia. Endoscopic methods for the biopsy can be used, but can still carry these risks. A diagnosis can be made without a biopsy, and is based on other testing and examination results.

In the case of a juvenile bird, there is often further testing to check for other infections or diseases.

Treatment of Hepatic Lipidosis in Birds

The severity of your bird’s condition will dictate the course of treatment. In all cases, though, diet modification is the primary therapy. Your veterinarian will discuss a balanced diet for your bird that includes an appropriate amount of fats. This may include the addition of foods like ground flaxseed, palm kernel oil, safflower seed, or sprouted seeds. Switching to a pelleted diet may also be helpful. Be sure to stay away from peanuts or other foods that contain liver damaging mycotoxins to prevent further injury.

Medication therapy can be prescribed in more severe cases, and can include such liver sparing drugs as colchicine, or antibiotics. Any metabolic problems may also be treated as needed.

Treatment besides dietary management more often comes in the form of supportive care. This can include fluid therapy, blood or plasma transfusions, the use of metabolic aids such as lactulosea, policosanol, milk thistle, or psyllium, or the administration of L-carnitine to promote liver regeneration, L-cysteine, and vitamin K to prevent excessive bleeding. Having a clotting gel or liquid on hand is also useful in birds with clotting problems. Other supplements can include biotin, choline, Methionine, dimethylglycine (DMG), aloe, dandelion, micronutrients, and probiotics. Setting up an exercise regimen is often recommended, but needs to start slow and build gradually for sedentary birds. Exercise needs to be closely monitored to prevent injury.

Juvenile birds affected with hepatic lipidosis need to be handled gently. Dietary changes are recommended, and often include reducing quantities of feed, adjusting fat levels, and adding lactulose. They can also benefit from fluid therapy, cool oxygen treatment, antibiotics, and some metabolic aids.

Recovery of Hepatic Lipidosis in Birds

Your bird can recover, and many of the effects of hepatic lipidosis can be reversed, through proper treatment, diet, and exercise. The liver may return to normal, but there are cases when there is permanent liver damage. The quicker you can begin treatment, the better your bird’s chances of recovery will be. Your veterinarian may need to monitor your bird throughout treatment to alter the diet and exercise if needed. 

Hepatic lipidosis can be prevented through maintaining a properly balanced diet. Taking your bird for regular physical exams can help to discover the disease before it becomes too progressed.