A: The cause of cloacal prolapse in cockatoos has not yet been officially studied. Thus, at this time it is unclear whether it tends to occur more in males or females. It does seem to occur in cockatoos which are closely bonded to their owners and have been displaying sexual behaviors such as soliciting their owners (or other birds/animals/objects in the household) and masturbation. Masturbation behaviors can range anywhere from rubbing on the owner or other objects or simply apparently standing still and breathing in and out rapidly. This chronic straining can weaken the integrity of the cloaca and lead to loosening of the vent, expansion of the tissue of the cloaca and even finally eversion prolapse of the tissue of the cloaca out past the vent. Owners will notice a pink object of varying size protruding between the lips of the vent. Severe prolapses will consist of a large amount of tissue that cant be pushed back easily in through the vent: this tissue can dry out and become necrotic (i.e. decayed and infected). At this point, the condition is a surgical emergency to replace that tissue as soon as possible.

Unfortunately, there has been no easy way to fix this problem once it has occurred. Surgery can be attempted, but the success rate is variable and highly dependent on the skill of the surgeon, the post-op care provided by the owner, and the individual bird. As many as four different surgical procedures may be required at one time in the prolapsed male cockatoo: a ventplasty (reduction of tissue in a flaccid vent), a cloacoplasty (reduction of tissue of the cloaca), a cloacalpexy (securing a portion of the cloaca to one of the ribs), and a castration. Castrations in birds are not as simple or as routine in psittacines as they are in dogs and cats. The testicles are close to the aorta (the major blood vessel in the birds coelom), thus surgery in that area requires special surgery instruments, not to mention skill. Ideally, these four procedures will work to prevent reprolapse of the tissue and decrease sexual behaviors that led to the prolapse in the first place. Unfortunately, reports of successful outcomes of these surgeries have been inconsistent. Some clinicians feel that once the behaviors have been established, neutering does little to change them. The surgery itself is risky and not always successful, even in the hands of the best surgeons.

Cloacal prolapse may also occur in females due to straining secondary to sexual behaviors or egg-laying behaviors. The latter can lead to prolapse of oviductal tissue, also a surgical emergency. Removal of the ovaries is extremely difficult, if not impossible, in females since they are adhered to the aorta. Thus, a salpingectomy (removal of the oviduct and uterus) can be performed which will remove the possibility of an egg being formed from an ovarian follicle and ideally reduce reproductive behaviors that have led to the prolapse in the first place. Again, a salpingectomy combined with the other procedures described previously is not a simple surgical procedure.

Finally, there may also be a primary intestinal problem which is causing chronic straining that can lead to prolapse. The bird should be thoroughly worked-up to rule out such causes as clostridial overgrowth or PDD.

The cost for the above-mentioned surgical procedures can range anywhere from $1000 to $2000, depending on length of hospital stay and time in surgery. Post-operative complications, including obstruction of the cloaca (i.e. preventing the elimination of droppings), infection, and reprolapsing of the cloaca can rapidly and easily increase the initial costs to the owner. A work-up to rule out other causes of straining can cost anywhere from $800 to $2000, depending on what is required.

At this time, given the varied success of surgical repair, it definitely seems easier to focus on preventing this condition in the first place. Sexual behaviors tend to occur in birds that are mate-bonded with their owners. The birds sexual frustration is easy to understand when one considers that the bird has spent its entire life receiving signals from his owner that the owner is his mate. Signals can be mutual grooming, constant petting of areas over the back and rear of the bird, hand-feeding of treats (particularly from the owners mouth), and even just providing constant attention and remaining in close proximity to the bird throughout the day. Cockatoos especially must have their independence encouraged. Time out of the cage should consist of positive interactions between the owner and bird that cant be misconstrued as mate-bonded activities. Instead of prolonged mutual grooming sessions, interaction can be focused on teaching the bird tricks (clicker training works great with birds), encouraging the bird to play with novel toys (cockatoos love puzzle toys) and food items. This is not to say that cuddling with the bird is completely off-limits. Rather, it should be balanced with healthy, fun activities that are mentally challenging to the bird and encourage independence from the owner. Scritching and grooming should be limited to areas above the neck.

Annual to semi-annual examinations by a veterinarian are also essential to keeping track of the health of the bird. A veterinarian may notice symptoms of sexual or reproductive behaviors in the bird before the owner does. Reproductively active females may have changes in their blood work, such as an elevated calcium and/or cholesterol. Males may be displaying sexual behaviors toward the owner that are too subtle for the owner to notice; these behaviors may become exaggerated in a stressful situation such as a veterinary visit. Forming a good relationship with a veterinarian who is comfortable with birds is essential to prevention of disease, maintenance of a healthy pet, and nurturing of the human-animal bond.