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I’ve been meaning to write this article for several years, now finally after finishing several illustrations I no longer had excuses to put it off. Originally if was just supposed to be just about Peritonitis but I decided to start off with Egg Binding, though not going in depth on it, but to show that both health conditions visually share similar characteristics and how to determine the difference.  Most deaths that are mistakenly assumed to be from Egg Binding are many times from Peritonitis.  While researching the terms used for this are Egg Yolk or Egg Related Peritonitis.
 
Please note, I am not a vet.  What I will be writing about is from my own learned information and experiences in trying to find some of the causes and most importantly how to treat and save the hen. I would strongly suggest that you consult with your vet, especially when it comes to Peritonitis and the vet
removing the fluids from the abdomen.  This is a very important step to resolving this in addition to specific antibiotics which I have listed/illustrated later in this article that after several loses from non effective treatments have worked to save the hen.
 
Egg binding is defined as the failure of an egg to pass through the oviduct at a normal rate. 
 
Most Cockatiels will lay an egg every other day. Individual hens within a species may vary by more than one day from the normal ovulation rate. Variability in egg transit makes it difficult to determine when a problem is occurring.
 
First off, true egg binding will have the bird immobile.  Even a wild bird will allow you to pick it up and not fight you. The bird will be down in the bottom comer of the cage, many times using it’s beak to hold onto the bars while it is straining to pass an egg. You will see labored and, in many case, open mouth breathing.
 
PLEASE NOTE: If the hen is active, then you do not have an egg binding problem. If you see that the abdomen has appears swollen and the birds have been set‑up for a month I would be more inclined to believe the hen could have egg related peritonitis. This can be more life threatening and with a sudden death if the fluid accumulation in the abdomen cavity becomes infected with bacteria and goes systemic (throughout the body/bloodstream) This condition results in more deaths in breeder hens than actual egg binding.
 
The following illustrations are to be used as a VISUAL reference of what to look for.

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This illustration shows the Oviduct and how long in each section

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Notice that at first glance both health conditions may look the same.
Please note: It is very important to daily keep track of the weight of the hen. 

​The distinguishing difference between Egg Binding and Peritonitis IS increasing weight gains. A laying hen will only gain the weight of the egg she will lay, which on an average is 5-6 grams, then stop gaining weight.  With Peritonitis as the abdomen is distended from fluid accumulation this will also increase the weight of the hen.  In extreme cases this could be up to 20-30 grams. In addition an Egg Bound hen will be immobile whereas a hen with Peritonitis may be very active.

 
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​I’ll start off with some FYI info. for Egg Binding and Peritonitis

 
NOTE:  A  Good resource for online reading on hen reproductive problems is: Complications of egg laying http://nilesanimalhospital.com/files/2012/05/Complications-of-Egg-Laying-Activity.pdf

Reproductive Problems http://nilesanimalhospital.com/files/2012/05/Reproductive-Problems-in-Birds.pdf

This article is from a chicken page but has good information/insight into both conditions. 
https://luckyhensrescuenorthwest.weebly.com/egg-bound-henegg-peritonitis-help-sheet.html
 
Even though this article is about a chicken it mentions a simple and non invasive treatment worth doing. 
http://www.apriltellsall.com/2016/04/egg-peritonitis/
 
Very interesting article about Peritonitis.
https://wagwalking.com/bird/condition/egg-yolk-peritonitis

I will start this article off with some causes for Egg Binding which may include:  
1… Stress from temperature extremes
2… Poor muscle tone in the oviduct, uterus or vagina 
3… Hypocalcemia, (not enough calcium), and/or marginal nutrition: deficiencies in Vitamin A, E, Selenium and sodium can contribute to poor muscle tone
4… Lack of proper lighting. Natural sunlight or full spectrum is a natural source of D3 which aids in calcium metabolism
5... Age of hen
6… Large, malformed, soft-shelled eggs (failure of the uterus to lay down shell material)  
7...Oviduct obstruction (Impacted eggs)
8… Excessive egg production
9… Systemic Disease
10... Obesity
11... Lack of exercise
12... Oviductal tumors
13... Oviductal infection
14... Genetics

The most common locations of egg binding:
1… Caudal Uterus
2… Vagina
3… Vaginal-cloacal junction
 
Clinical signs of Egg Binding…
1… Distended abdomen.  An egg may be felt by careful abdominal palpation, unless it is soft-shelled
2… Wide stance
3… Reluctance to fly or perch
4… Dropping stuck to feathers around the vent because the bird is  unable  to lift itself high enough for droppings to clear
5… In advances stages: Depression, fluffed feathers, weakness, dehydration, dyspnea, lameness (caused by nerve compression)
6… Prolapsed oviduct, with or without egg.
7… One or more calcified or partially calcified eggs in the abdominal cavity.
 
Supportive Care until you can seek help or a vet...
Most times Egg binding is a medical emergency  Until you can see a vet, place the hen in a quiet area.  Maintain heat at 85-95 degrees and increase humidity.
 
Some cautions: Never handle a hen if you suspect she is ovulating. It could contribute to the following:
1...An Ectopic egg, also called non-septic egg peritonitis, meaning that the yolk got diverted into the abdominal cavity, which can lead to peritonitis.
 
2...If the forming yolk was ruptured from the movement it could get absorbed into the bloodstream and cause a stroke and/or death. 

3...If the egg was in the upper oviduct it could cause a tear in the thin tissue and get diverted to the abdominal cavity. 

4...If the egg has gotten as far as the shell gland and the disturbance occurred when the shell was being formed it could have broken, but the shell part would be adhered to the uterus and the next developing egg would impact on the matter in the oviduct. Several eggs can get impacted 1 on top of the other (broken soft shells stacked up) and contribute to egg-binding or prolapse. In this case the inside of the egg (yolk and white) would be seen on the cage/flight floor.
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There are two (2) stages of Egg Binding to look for:

Stage 1:  No indications of depression, still able to perch, and eating normally. No signs of prolapse, or any straining in less than 24 hours.

At the vet’s office, what to  expect: 

1… Placed in a warm environment
2… The vent and distal oviduct are lubricated with K-Y Jelly (not petroleum jelly)
3… IM injection of Calcium or Calphosan, and, if needed, a multi-vitamin injection containing: Vitamins A and E with selenium, Vitamin D3
4… IM injection of oxytocin (if no physical obstruction is suspected), or topical Prepidil gel (applied to the opening of the shell gland within the cloaca)
5… Massage the abdomen or cervix may help to stimulate egg passage or relax the cervix so that the egg can be passed.  Placing the hen in a dark, warm, humid environment/container many times results in the passing of the egg within 30 minutes.

Stage 2:  Depression, not able to perch, immobile, straining longer than 24 hours, prolapsed.

At the vets office, what to  expect:

1… In addition to the treatments used in Stage 1, if the egg is not passed, or there are complications.
2… Subcutaneous fluids
3… Dextrose
4… Rapidly acting steroids to combat shock
5… Antibiotics if septicemia (infection traveling through the bloodstream) or peritonitis is suspected.
6... A manual removal of the egg.  If this is needed, then the hen is put under anesthesia. 
 
This is done either of two ways

a…The cloaca is dilated with lubricated, cotton-tipped applicators. Gentle pressure from the back on either side is used to manipulate the egg towards the cloaca. If the opening to the vagina is constricted, gentle dilation with the applicator often allows direct visualization of the egg, which is imploded by suction. The shell fragments are gently removed with forceps.  Or the fragments may be left in the shell gland (uterus), and will usually pass within 24 hours. NOTE: If the oviduct is ruptured or of multiple eggs are present, an abdominal exploratory or salpingectomy (hysterectomy) may be required.
 
b…If the egg cannot be visualized then an 18-gauge needle is inserted (percutaneous ovocentesis) through the abdominal wall from a lateral (the side) direction so that the egg is not pushed dorsally (from the back), to keep from putting excessive pressure on the kidneys and associated vessels. The needle is guided into the egg and the contents are removed by suction when pulling back on the plunger of the syringe. This cause the egg to collapse inwards. The remaining portion of the egg (shell) is passed within 1-2 days.
 
The remaining of this article will be about Peritonitis.

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Please read the above info.  It explains my thoughts of what is going on  with the hen.
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During my first few years of breeding Cockatiels I had encountered this several times. Both with my own hens and those I purchased or traded with other breeders.  Also, during this time ALL hens just suddenly died.  From necropsies I learned that this was caused Egg (also called Related) Yolk Peritonitis.  Fine, I now knew what it was, next was trying to learn all the possible causes and an effective treatment. Regarding antibiotics treatment most failed and the hen was lost.  It was by the  3rd hen, my insistence for a different antibiotic that I was able to save the hen and also when others over the years have contacted or phoned for help I could advise them what to suggest to the vet to do. 
 
As mentioned, there are several causes for Peritonitis.  I have found the number 1 cause is Bondage pairs.  During my early years I did a lot of bird trading.  I also had a reputation of being successful in having very productive birds. Therefore, many of these trades were of hen they breeder could not get to breed. 

The light bulb moment for me was when a breeder wanted to trade one of her hens that looked ready to lay and just won’t and that maybe she will lay for me. At the time I was very confident with my breeding skills and did the trade.  From all I read, since the hen was very alert and active, I ruled out Egg Binding.  She was also a mutation I was breeding for, so I set her up with a compatible mate and they appeared to get along.  Two days later she was dead.  I phoned the breeder and asked for some background of the breeding history of the bird, given she was only 3+ years old.  She said she had tried several times to pair her up but she never appeared to bond with any of the chosen males.  Hmmm…I thought to how I paired my birds up and it was letting them pick their own mates.  In talking with others that have dealt with Peritonitis if was more of a Bondage or Forced pairing.
 
Before I go further, please read. NOTE, this is an archived article I wrote about Bonded and Bondage pairings.
https://web.archive.org/web/20170902121823/http://www.internationalcockatielresource.com/bonded-or-bondage-pair.html
 
Since the above link is archived the first two links won’t worked so I have copied them here.
This is a very excellent article/study conducted on forced pairings of cockatiels. 
https://web.archive.org/web/20191031193851/https://sora.unm.edu/sites/default/files/journals/auk/v106n01/p0086-p0093.pdf

And this is a short article on forced re-paired cockatiels:
https://web.archive.org/web/20191031193733/https://www.sciencedirect.com/science/article/abs/pii/S0168159199000088
 
First, before I cover that these illustrations will show what to look for. Please also note that Ascites (fluid retention) is no exclusive to Peritonitis. Liver disease may also exhibit Ascites.  A vet visit would be in order in either situation. 


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If the cause is from a Bondage pairing the remedy may be simple. Simply removing the hen from the male and the breeding cage in halt further stressors contributing to this, IF there is no obvious changes in abdominal skin color as shown a above.
​ 
The yellowing and color are from the body excreting the yolk matter out of the body through the skin. The degree of color can tell how advanced this is.  Until you can get to a vet, I would suggest that you supply greens and/or herbals to assist the body in fluid removal.  But I would like to stress now that a vet is a must. 
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Before I go further, I’ve done up illustrations that show/explain other probable causes.  
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Okay, not back on topic….
As noted, please go to your vet.  He/She will can to do what is shown in the illustration.

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Shown are the antibiotics that I have found DO WORK and must be used.  Piperacillin is essential to a successful treatment.
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 This is illustration is worth repeating.  Your vet will also prescribe a Diuretic, such as Lasix for fluid removal. In addition I have these items illustrated to be just as effective in addition to adding additional nutrients, minerals and vitamins to the diet. I have also used these items for birds with liver disease.  
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In summary Peritonitis is one of the diseases that gets characterized by breeders and is assumed to be Egg Binding. Therefore, by the time a person realizes there is a problem it is often to late and septicemia takes the life of the hen.  Sadly, too this is a more rampant problem than vets realize because when the hen dies from an assumed Egg Binding the body is not taken to a vet for a necropsy. 
​
I encourage my readers to consult/work with a vet with any problems, especially reproductive problems.  BOTH parties will learn something.  For the breeder (or pet owner) you can take this opportunity to discuss causes and how to resolve them. The vet, especially a beginning vet is learning with you.  And many long practicing vets are always learning to be better informed to help their clients.  It’s a win-win for both parties. 
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