Introduction

A cloacal prolapse is a serious problem requiring immediate veterinary care. Trauma to the internal organs that are prolapsed through the opening can seriously affect the bird. It is seen in cockatoos and the smaller breed birds like budgies and cockatiels. It requires immediate replacement of the prolapsed organs.

Sick bird wrapped in a towel

Birds with a cloacal prolapse can be quite ill, and even in shock. We consider it an emergency.

Nurse gently holding a sick bird with a towel

They are handled gently at all stages

Cause

Straining due to parasites, abdominal masses or tumors, chronic egg laying, abnormal eggs and poor nutrition are all predisposing factors. Determining the exact cause can be difficult.

Xray of a parakeet that is egg bound

That is a big egg for a little budgie, and chronic egg production, especially in cockatiels, can lead to a prolapse

Symptoms

Birds that have this problem might exhibit depression, straining, lack of droppings, fluffed appearance, and poor appetite. Sometimes the only symptom you notice at home is blood in the droppings. These symptoms occur in other diseases, so the diagnostic approach has to be thorough.

A bird that has fluffed feathers due to illness

Birds are masters at hiding illness, and any time your bird shows any signs of a problem, like this fluffed parrot, it should be brought to us for an exam and diagnostic tests

Diagnosis

In many prolapsed birds there is a history of recent egg laying. During the physical exam internal organs (intestines or reproductive usually) are apparent at the cloaca.

Severe prolapsed cloaca with inflamed tissue

This is a severe prolapse and requires immediate emergency care if we are to save this organ, let along the bird’s life

When diagnostic tests are used their main indication is to find the underlying cause to the problem in order to prevent recurrence. These tests include fecal exams for parasites, x-rays for abdominal masses pushing on the abdominal contents, and blood panels to determine general health and organ function.

Avian blood panel with elevated liver tests

This blood panel shows elevated liver enzymes, a potential liver problem that could lead to a prolapse

Avian CBC showing elevated white blood cells

This CBC shows elevated WBC’s. An infection can be the cause of this elevation, leading to a prolapse. 

Treatment

Birds with prolapsed cloaca’s require emergency care. Many are hypothermic and require immediate warming. Others can be dehydrated so warm fluids are also administered. Antibiotics are usually administered to prevent infection in the affected organs.

Ill bird being treated with warmth and oxygen

Ill birds like this parrot are immediately put into a warm room and given fluids and oxygen. Only once they are stable to we perform any diagnostic tests or treatment. 

Sick bird being given IV fluids

Fluids are a crucial part of therapy. This parrot is being given fluids intravenously (IV). We have a page dedicated to this life-saving treatment- click here to learn more. 

Once a bird is stabilized the prolapse is replaced back into the abdomen. The sooner the better because internal organs that are exposed to the environment are easily traumatized and infected. Amputation could be needed on infected tissue or tissue that has inadequate blood supply.

In some cases we anesthetize the bird to allow muscle relaxation and subsequent easier replacement of the affected organs.

Anesthetic monitor showing heart rate and respiratory rate

We closely monitor heart rate and respiratory rate, along with other important parameters, when anesthetize animals

Nurse anesthetist monitoring a bird under anesthesia

In addition to the above monitor, they are constantly monitored by our nurse anesthetist 

Sterile surgery pack showing gauze and instruments

Sterile instruments are used for any surgical repair. You can learn much more about surgery at our Surgery page

Prolapsed cloaca in a bird

This is one way a prolapsed cloaca might look

Prolapsed cloaca in a cockatiel

The prolapse in this cockatiel has been present for several hours. The coloration tells us it is healthy enough to allow replacement back into the abdomen. It will be gently cleansed and flushed with sterile saline. It is an internal organ and requires delicate handling.

Repaired prolapsed cloaca

The area is lubricated copiously with K-Y jelly and the prolapse is gently manipulated back into the abdomen using Q-tips. This process takes several minutes because the organ is swollen and predisposed to tearing.

After it is replaced special sutures (at the arrows) are used to prevent it from coming out again. They are put in tight enough to keep the organs inside but loose enough to allow droppings to pass. These sutures will be kept in for at least several days to allow the prolapsed tissue to heal.

Prevention

There are factors involved with this problem that we have no control over. Factors we can control are good nutrition, a clean environment, spaying birds that are predisposed to egg binding or are excessive egg layers, minimizing obesity and stimulating exercise.

Careful daily observation of your pets daily habits will help you recognize the early symptoms of this disease. No matter what the problem, any time your pet bird shows any symptoms of a disease, no matter how subtle, it is considered significant and requires immediate veterinary care.

This is because birds are masters at hiding illness, and we are all too often presented with sick birds in advanced stages of disease. Our ability to return these birds to normal health is diminished because proper care has not been given early on in the disease process where it is most beneficial.

Return to Avian Diseases page.