Changes

==Clinical Signs==

==Clinical Signs==

Early clinical signs include '''sneezing''', '''proptosis''' and '''clicking'''. Later, '''swelling''' may develop around the '''eyes''' or between the eyes and beak over the frontal signs. Excessive secretion of serous or mucous material from the respiratory mucous membranes is often reported. It is common for the bird to be suffering from concurrent disease such as pneumonia and air sacculitis. Respiratory distress may be evident, however this should be observed in a quiet stress-free environment for reliable interpretation. Clinical exam is often better performed under general anaesthesia as the cloana should be examined for any spread of infection.

Early clinical signs include '''sneezing''', '''proptosis''' and '''clicking'''. Later, '''swelling''' may develop around the '''eyes''' or between the eyes and beak over the frontal signs. Excessive secretion of serous or mucous material from the respiratory mucous membranes is often reported. It is common for the bird to be suffering from concurrent disease such as pneumonia and [[Air Sacculitis|air sacculitis]]. Respiratory distress may be evident, however this should be observed in a quiet stress-free environment for reliable interpretation. Clinical exam is often better performed under general anaesthesia as the choana should be examined for any spread of infection.

==Diagnosis==

==Diagnosis==

Clinical signs coupled with the history of a vitamin A deficient diet should should be suggestive of sinusitis, however '''needle biopsy''' of the swellings is required to make a '''definitive diagnosis''', as it allows for the differentiation from abscesses. '''Cytology''', '''culture and sensitivity''' should be performed on the aspirated material to determine the presence and nature of infection. The most common infectious organisms are ''Pseudomonas'' and ''Mycoplasma'' species. '''Radiography''' of the skull can also be performed to confirm the presence of sinusitis.  

Clinical signs coupled with the history of a vitamin A deficient diet should be suggestive of sinusitis, however '''needle biopsy''' of the swellings is required to make a '''definitive diagnosis''', as it allows for the differentiation from abscesses. '''Cytology''', '''culture and sensitivity''' should be performed on the aspirated material to determine the presence and nature of infection. The most common infectious organisms are [[:Category:Pseudomonas and Burkholderia species|''Pseudomonas'']] and [[:Category:Mycoplasmas|''Mycoplasma'' species]]. '''Radiography''' of the skull can also be performed to confirm the presence of sinusitis.  

==Treatment==

==Treatment==

Ideally the bird should be treated with the '''antibiotic 'Baytril'''' as it covers the above-mentioned bacteria. Additionally the bird should receive a dose of '''Vitamin A''' by '''intramuscular''' injection. Subsequent dietary supplementation of Vitamin A by feeding '''orange''' and '''dark green vegetables''' is necessary to prevent recurrence of infection<ref name="two">Forbes NA & Altman RB (1998) '''Self-Assessment Colour Review Avian Medicine''' ''Manson Publishing Ltd''<ref> <ref name="one">Lawton, M (1999) '''Management of respiratory disease in psittacine birds''' ''In Practice 1999 21: 76-8''</ref>. Drainage and flushing of the sinus with antibiotics in severe cases is recommended  by some <ref name="three">Stanford, M (2009) '''Respiratory Disease in Birds''' Royal Veterinary College Integrated Course ''RVC''</ref> but due to the anatomy of the sinuses and the nature of the inspissated pus produced, others report that it is normally unsuccessful<ref name="one">Lawton, M (1999) '''Management of respiratory disease in psittacine birds''' ''In Practice 1999 21: 76-8''</ref>. If rhinoliths or choanal abcesses are present they should be removed using a needle or dental instruments.  

Ideally the bird should be treated with the '''antibiotic 'Baytril'''' (enrofloxacin) as it covers the above-mentioned bacteria. Additionally the bird should receive a dose of '''Vitamin A''' by '''intramuscular''' injection. Subsequent dietary supplementation of Vitamin A by feeding '''orange''' and '''dark green vegetables''' is necessary to prevent recurrence of infection<ref name="two">Forbes NA & Altman RB (1998) '''Self-Assessment Colour Review Avian Medicine''' ''Manson Publishing Ltd''<ref> <ref name="one">Lawton, M (1999) '''Management of respiratory disease in psittacine birds''' ''In Practice 1999 21: 76-8''</ref>. Drainage and flushing of the sinus with antibiotics in severe cases is recommended  by some <ref name="three">Stanford, M (2009) '''Respiratory Disease in Birds''' Royal Veterinary College Integrated Course ''RVC''</ref> but due to the anatomy of the sinuses and the nature of the inspissated pus produced, others report that it is normally unsuccessful<ref name="one">Lawton, M (1999) '''Management of respiratory disease in psittacine birds''' ''In Practice 1999 21: 76-8''</ref>. If rhinoliths or choanal abcesses are present they should be removed using a needle or dental instruments.  

==Prognosis==

==Prognosis==

If the dietary deficiencies are addressed long term then infection is unlikely to recurr. Therefore, if the bird recovers well from the original episode of sinusitis the prognosis is '''good'''.

If the dietary deficiencies are addressed long term then infection is unlikely to recur. Therefore, if the bird recovers well from the original episode of sinusitis the prognosis is '''good'''.

==References==

==References==

<references />

<references />

[[Category: To Do - Siobhan Brade]]

[[Category:Respiratory Diseases - Birds]]

[[Category:To Do - Manson review]]

[[Category:Expert Review - Birds]]