Case Study: Pica Eating Disorder

It’s fitting that the condition I’ll explore in this post, pica (PYE-kuh) is Latin – not for chicken, but another bird – the magpie, which is known for collecting and eating almost anything.

In people, pica is used to describe compulsive eating of non-food items, such as ashes, clay, and flaking paint. It’s mostly seen in young children or adults with intellectual and developmental disabilities. Pica involving eating dirt may be related to an iron or zinc deficiency.

Our next case is about a hen who was diagnosed with pica. As someone who has had a dog with a penchant for eating the wrong things – hair balls, bits of plastic and the end of a corn cob – I think a more accurate description would be the ingestion of foreign objects out of curiosity. My dog, Simon, probably came across objects of interest and ate them inadvertently. His behaviour was more opportunistic than compulsive.

Chickens explore the world with their beaks and I can see how easy it would be to peck at, and swallow, a shiny object before they knew it. Regardless of the cause, the result can be life-threatening and the remedy expensive. Chickens that eat foreign objects can suffer impaction, perforation of the digestive tract or metal toxicity.

In Simon’s case we forked over a small fortune for five (yes, five) surgeries to remove the things he managed to snarf down without us seeing. In Seleta’s case, her hen Butters was a long-term offender and the surgery to save her resulted in the retrieval of a whole host of interesting objects.

The case study is comprised of reports from the two vet clinics that treated her, as well as conversations with Seleta.

Butters, Buff Orpington, 2 years old

The summer of 2020 was horrible for fires in Northern Colorado. The state suffered a record-breaking fire that burned 208,913 acres and sent ash and black smoke into the air. Since birds have such sensitive respiratory systems, we made the decision to bring our entire flock in the house. The fire burned for 112 days. Combined with extremely high temperatures, the birds ended up being in the house for a majority of the summer. The flock wore diapers through the day and had the run of the house. When the smoke wasn’t too bad and it wasn’t scorching hot outside, we would take them into the backyard for supervised free-ranging time.

Day 1: I actually didn’t see her eat the roofing nail. I was petting her and noticed something felt weird in her crop that felt exactly like the shape of a nail. We had the roof replaced earlier in the year after a hailstorm and though we asked them to be very careful and to magnet roll the yard and around the house after the job was completed, clearly items were missed.

Day 3: When her stool became watery and Butters refused to roost, was more vocal and restless, Seleta took her to the Broomfield Vet hospital. An X-ray revealed the nail had moved down her digestive tract into her ventriculus (gizzard) where it joined another nail, a screw, and a U-nail.

The vet suggested that her “risk of GI perforation was low and zinc levels might be mildly elevated. The pH of the ventriculus may actually dissolve the nails and surgery may not be needed. We can repeat radiographs in a month to see where the foreign bodies have moved (if they have). We recommend base line labs (complete blood count/chemicals/heavy metals) so we can monitor in the future.” – Broomfield Veterinary Clinic

The other risks of leaving metal bits in a chicken’s digestive system is metal toxicity or compaction.

She was given warmed Lactated Ringer Solution (LRS) subcutaneously as part of her supportive care: 120mls (60ml split equally between inguinal folds).

Day 7: The Broomfield Vet did not have endoscopic capabilities for an avian species and was not comfortable doing surgery should it be needed so they referred Seleta to Colorado State University (CSU), which had the more specialized equipment and expertise.

The Veterinary Teaching Hospital did a variety of tests:

Diagnostics:

Complete Blood Count (CBC): This test evaluates red blood cells (which carry oxygen), white blood cells (which fight infection), and platelets (which clot blood). Results showed mild changes related to either stress, or mild inflammation.
Abaxis chemistry: This test evaluates blood levels of proteins, glucose and electrolytes, as well as liver and kidney function. Results were unremarkable.

Explanation of results and clinical findings:

Butters exhibits consistent dietary indiscretion (pica) due to an unknown cause. Possible causes of pica include mineral deficiencies or behavioral issues. As a result, there are several metal and plastic foreign bodies in various portions of the GI tract.
Foreign body surgery in chickens often has a poor outcome due to prolonged healing time and likely dehiscence (splitting open of the incision); therefore an endoscopy procedure to remove the foreign bodies is warranted. There are still significant risks to this procedure such as GI tract perforation as well as the usual anesthetic risk. The foreign bodies may be impossible to remove due to their location. However, the risks of this procedure outweigh the risk of leaving foreign bodies in Butters’ GI tract.
For optimizing visualization of foreign material and success of endoscopy, we recommended starting Butters on a liquid diet.

Medications:

Due to concern of potential perforation or septicemia she was started on an antibiotic: Trimethoprim sulfadiazine (TMS): ¼ of a 480 mg tablet by mouth every 12 hours.
Ominivore care: a critical care powder that can be given in powdered form, made into a liquid diet, or tube fed for ill exotic patients. (50 mls by mouth every 12 hours).

Day 15: Butters underwent surgery at CSU to remove the foreign objects.

Explanation of clinical findings:

Butters was anesthetized for the endoscopy procedure. The liquid diet successfully removed excess material in the GI tract.
Using an endoscope and a camera we entered her esophagus several times, and used different instruments to remove pieces of Lego and other plastic, hairballs and metal hardware.
Moving forward, we recommend that Butters is kept in a cage and has minimal activity for the next two days. She will be discharged today and would like to remind the owner to keep Butters in a pen without small objects on the floor in order to prevent this from happening in the future. However, it is likely that this may reoccur.
The cause of indiscriminate eating is still unknown.
We are hoping that as soon as she is back to her normal diet, she will start laying eggs again.

Post-Surgery Update:

“I’m happy to report that Butters made a full recovery. She went back to laying and hasn’t had a relapse of eating foreign objects.

I think she ate such crazy items because I hadn’t thought to put any grit out for them in the house. In their outdoor run they had free access to both grit and oyster shell to take as they needed it. I’m guessing that in the absence of acceptable grit Legos, staples and screws seemed to be a decent alternative.

Butters is one of our more curious girls and anything that is a brighter colour or shiny is investigated thoroughly, up to and including eating it. As for the Legos, I have a young daughter who, like most kids, leaves much to be desired when asked to pick up toys in her room instead preferring to leave them on the floor as a booby trap for barefoot parents and curious chickens. We re-homed my daughter’s Legos after repeated reminders to keep them picked up, with no improvement. We decided that they would be banned in our house and arranged for her to go to the neighbour’s house to play with her Legos.

We purchased a roller magnet for and scoured the yard for any additional metal that the roofers left behind.

When the flock returned to their outdoor enclosure it was pretty much a non-issue at that point. They live in an enclosed coop and huge run so there wasn’t any access to things that weren’t meant to be eaten. That being said, even after she fully recovered we still have to watch her closely when she is free ranging in the yard. She seems to always be the first to find something questionable to gobble down.”

Seleta Nothnagel: I work in the Clinical Pathology Department at the Colorado State University Veterinary Teaching Hospital as a Medical Laboratory Scientist. We do blood work. urinalysis, coagulation studies and blood banking for all of the animals seen there. Before that I worked in the microbiology department in human medicine at a hospital for 10 years and in veterinary medicine as a Registered Veterinary Technician for 10 years.

Many thanks to Seleta for sharing her story and photos, used with permission.

Butters is not the only bird in Seleta’s flock that has presented with interesting health challenges. Seleta has been kind enough to share her stories of Blue, the first chicken to undergo heart surgery to repair Patent Ductus Arteriosus, and Amethyst whose egg binding led to a spay surgery.