Otitis

Birds do not have an outer ear like mammals, so an ear infection is rarely considered. But the ear is there: it is a small opening hidden under the feathers, behind and slightly below the eye. Ear inflammation (otitis) is not common, but when it occurs it can upset the bird's balance and cause it serious trouble.

The ear opening is covered by special, sparser feathers that protect the entrance but let sound through. Behind the opening is a short ear canal and the middle ear, which in birds is connected to the air spaces of the skull and to the throat. That is why inflammation easily spreads from the airways and sinuses to the ear.

Possible causes:

• Bacterial infections – the most common cause, often as a result of inflammation of the upper airways or sinuses.
• Fungal infections – especially in weakened birds or after long-term antibiotic treatment.
• Injuries – a bite or peck from another bird, an injury from a collision, scratching with the claws.
• A foreign body or dirt – rare, e.g. in birds that bathe in dirty water.
• Growths – cysts or tumours in the ear area, rare, mainly in older birds.

Birds with a weakened immune system, due to poor diet, stress or other diseases, are more often affected.

On the ear itself:

• damp, matted or dirty feathers behind the eye
• discharge from the ear, sometimes with an unpleasant smell
• redness or swelling around the ear opening, scabs
• scratching the ear with the foot, rubbing the head on perches

Balance and behaviour:

• tilting the head to one side
• unsteady gait, loss of balance, falling off the perch
• difficulty flying or moving in circles
• lethargy, reduced appetite, weight loss over time

If the inflammation started in the airways, sneezing, nasal discharge and laboured or rapid breathing may appear at the same time.

Important: head tilting and loss of balance are not always a sign of an ear infection. They can also be caused by a head injury, poisoning or diseases of the nervous system. In pigeons, a twisted neck and turning of the head are a common sign of paramyxovirus, and Newcastle disease (paramyxovirus type 1) is a notifiable disease in Croatia that must be reported to the veterinary service.

• the bird suddenly tilts its head, falls or cannot stay on the perch
• pus or bloody discharge from the ear
• a growing swelling behind the eye
• the bird is not eating or is fluffed up and sleepy
• along with balance problems there are seizures, trembling or difficulty breathing
• several birds in the flock show similar signs

The vet parts the feathers and examines the ear opening, using an otoscope if necessary. They take a swab of the discharge to find out whether bacteria or fungi are involved. If the bird has balance problems without a visible ear infection, further tests (blood, X-ray) may be needed to rule out other causes.

After treatment the vet often asks for a follow-up check to make sure the inflammation has completely cleared.

• The vet cleans the ear and removes discharge or scabs.
• Depending on the swab result, they prescribe topical preparations and/or antibiotics or antifungal medication by mouth.
• If the cause is an infection of the airways or sinuses, that is treated too, otherwise the otitis comes back.
• Growths and cysts sometimes need to be removed surgically.

Do not put human ear drops, oil or alcohol into the ear yourself, and do not clean it with cotton buds: the ear canal is very small and easily injured.

• Place a bird with a balance disorder in a low box or cage without high perches, with soft bedding (a towel or paper towels).
• Put food and water in shallow dishes on the floor, within easy reach.
• Keep it in a warm, quiet, dimly lit place, away from draughts.
• Keep it apart from other birds.
• Do not force-feed it or force it to drink, and do not pour water into its beak.

Hand over a wild bird with a tilted head or balance problems to a rescue centre or a vet. Do not touch sick wild birds with bare hands.

• A balanced diet and a clean, dry cage away from draughts.
• Prompt treatment of colds, sneezing and sinus infections.
• Clean bathing water, changed regularly.
• Enough space so that birds do not injure each other.

In birds recovering from a respiratory infection, check the area behind the eye from time to time. Damp or matted feathers there are an early sign worth acting on before balance problems appear.

Otitis in birds is rare, but it needs to be recognised because it affects the bird's balance and general condition. If you notice discharge behind the eye or head tilting, see a vet, as the same signs can also have more serious causes.