Sepsis is a potentially life-threatening condition caused by the body’s response to an infection. Sepsis or blood poisoning is usually caused by bacterial invasion and disrupts the bird’s immune response to fight the infection. At times the bacteria can spread quickly through the blood stream and affect any organ system. In human medicine there are three stages of sepsis. This can certainly apply to birds, however it may not be an easy situation to identify by visualization alone. The first phase is a systemic inflammatory response, which may progress to sepsis if there is an infective agent. The second phase is termed severe sepsis, a condition where acute organ dysfunction begins. Septic shock is the final stage with high mortality. The patient is often unable to respond to the infection and mount a response. Just as in humans, birds can die of sepsis within 12 hours, depending on the bacteria causing the problem, often with no advanced warning. Some birds may suffer from a low-grade chronic infection that they have kept marginally under control, only to succumb to the infection if it overwhelms the body.
There are many etiologies for sepsis: trauma with open wounds, viral infections with secondary bacterial infections, gastrointestinal disease, neoplasia and respiratory infections to name a few. An example of a serious situation is an injury or scratch from a cat. Life threatening sepsis can occur within three days of the injury. Clinical signs of sepsis will vary: weakness, anorexia, inability to stand, increased respiratory rate and effort, and increases of the heart rate in the early stages. As the disease progresses, the bird may become moribund and non-responsive. The diagnosis of sepsis involves evaluation of the red and white blood cells and enzymes of the organ systems. The complete blood count with morphology of the cell lines will confirm sepsis, while the chemistries reveal the health of the organ systems. In the early stages, the white blood count will be elevated with toxic cells. A left shift is a typical response to an active infection with an elevated white blood count with elevation of both the immature and mature heterophils. Toxic changes are usually present. As the disease progresses, the white blood cell count decreases and only immature cells are present. This is a degenerative process and carries a grave prognosis. At times bacteria can be seen in the white blood cells or free within the blood sample. Again this is a grave prognosis. Often blood cultures are recommended to identify the type of bacteria present as well as advanced diagnostics to identify the source of the infection such as radiographs, ultrasound or CT scan.
Treatment must be aggressive to save the life of the patient. This will include hospitalizing the bird, providing intravenous fluids, antibiotics, oxygen therapy and target therapy for liver, kidney or heart dysfunction related to the sepsis. Multiple blood tests are often required to monitor the septic patient. A bird suffering from sepsis may need hospitalization for a week or longer depending on the severity.
