In other birds, since the blisters seem to occur seasonally, it might be related to allergens in the environment, such as oak pollen. Allergies are poorly described in pet birds, but probably do occur.While this condition has a name, that doesn't explain why it occurs. What we know is that it seems to be cyclic in nature, that it is more likely to occur seasonally in some birds.
Often, the blisters form on the skin of the feet and legs initially. Then the bird begins to chew on the affected skin, resulting in wounds that crust over. What causes the blisters initially is the mystery, and probably varies from bird to bird. One cause is from owners that smoke cigarettes. The tar, nicotine and other toxins from the cigarettes get on a smoker's hands, and these irritants are then transferred to the parrot's feet when it is handled. For this reason, it is very important for bird owners who smoke get into the habit of consistently washing their hands after smoking prior to handling their birds.
Other topical lotions, creams or soaps should be thoroughly washed from the hands, as well, prior to handling any birds. This is especially important if the owner uses any type of topical steroid cream, as the creams may be absorbed through the skin, or they may be ingested if the bird grooms its feet, and steroids can be very dangerous to pet birds, causing suppression of the immune system, elevation of blood sugar levels, excess water consumption and increased urination.
In other birds, since the blisters seem to occur seasonally, it might be related to allergens in the environment, such as oak pollen. Allergies are poorly described in pet birds, but probably do occur.
It is very important that any Amazon that develops foot and leg lesions be given a thorough work-up by an avian veterinarian, including a CBC, blood chemistry panel, and any other diagnostics deemed necessary. It might be important, from a diagnostic standpoint, to have skin biopsies performed, cytology of the fluid from a fresh blister, bacterial cultures from the lesions, Gram's stains of the lesion and/or fluid from a blister, and perhaps DNA PCR tests on the fluid, as well. Without a diagnostic work-up, it may be impossible to determine the cause of the lesions, and therefore impossible to prevent them in the future (or minimize the outbreak).
During an outbreak, most birds will require systemic antibiotics, as most will have either a primary or secondary bacterial infection. Others may require antifungal therapy, if fungal organisms are diagnosed. Many Amazons benefit from topical medications, as well, which are applied directly to the foot or leg lesions, and to prevent mutilation by the bird, bandages may be applied to the feet and legs. It would probably be beneficial to run an air purifier with a HEPA filter to minimize pollen, mold and dust in the environment. Since Amazons are particularly prone to sinusitis due to low humidity, finding ways to humidify the environment where it lives is often very important, as well.
Vets unfamiliar with this condition, and those who don't usually treat birds, may attempt topical therapy with salves, lotions, creams or ointments that contain various preparations of steroids (betamethasone, dexamethasone, cortisone, hydrocortisone). These preparations (usually not labeled for birds) should NOT be used in avian species, as they can prove very dangerous. Steroids applied topically, especially to inflamed follicles, will be absorbed systemically, and can be ingested when a bird preens. Steroids can cause the suppression of the immune system, which can have disastrous results, including aspergillus infections (a dangerous fungal infection) and serious, even life-threatening bacterial infections. Steroids can also cause elevated blood glucose levels, increased thirst and appetite, weight loss and other problems. Steroids should only be used when absolutely necessary, and should not be administered to birds topically without medical necessity.
In some cases, it may be possible to prevent outbreaks by avoiding contact with allergens or toxins. Wash your hands before handling any bird, and prevent your bird from contacting any chemicals used for washing the cage, perches or cage equipment. If your bird has foot or leg lesions, it is important to work with your avian vet to try to identify the source of the problems, so that hopefully, in the future, additional lesions and outbreaks can be prevented.
Copyright © 2006 Margaret A. Wissman, D.V.M., D.A.B.V.P.
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