Hepatic lipidosis (pediatric) - The liver in neonates is typically larger relative to the total body weight than in adult birds, so some degree of hepatomegaly is normal in baby birds. However, the baby bird presented with hepatic lipidosis presents a fairly classic picture. It is usually still hand feeding - often with a commercial formula to which the owners have elected to add peanut butter, oil, or some other higher fat food. The baby is generally heavy for its age and exhibiting severe respiratory distress. These birds must be handled gently and minimally. COOL oxygenation, and nothing further, is the best first step. This allows time to discuss the situation with the owner. The first 48 hours with these birds is the most critical. Their lung and air sac capacity is virtually nil, and they have finally presented to you most likely because the stress of feeding and breathing at the same time has exceeded their oxygen reserves. Drastically reducing the quantity of crop food per feeding, adjusting the content of the formula, and adding lactulose to the formula are the general nutritional changes required. Parenteral fluid supplementation, when tolerated, should be added to keep the initially hyperthermic bird hydrated and to help detoxify the body, since the liver is generally not functioning adequately. When possible, bloodwork should be obtained to check for concurrent infection or other diseases.

Hepatic Lipidosis (adult bird) - is most common in Amazon sp. This syndrome is often due to long-standing malnutrition in an obese bird, with secondary septicemia. CBC and serum chemistries will help direct treatment and confirm diagnosis. These birds frequently present with anorexia and a more quiet demeanor. Serum may be very lipemic, with consequent falsely high elevations in total protein. An elevated WBC is often encountered Supportive care with subcutaneous fluids, crop feeding with lactulose, antibiotics, a nutritional injection with Vitamin A, D3, B, E with selenium, and calcium, will pull many of these through. Diet change should not be forced until after the bird has returned to eating its customary food and is stable.

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