ABSTRACT
Background: Parrot foot necrosis is a poorly understood dermatitis with difficult diagnosis and treatment that has been reported in all species of Amazon parrots. Diagnosis is usually achieved by detailed history and ruling out other causes through evaluation of CBC and biochemical profile. Prolonged crack-cocaine misuse could cause digit or nail lesions in humans. In this report similar clinical manifestations in two African gray parrots owned by crack-cocaine addicted users have been reported. Cases: Two African gray parrots were referred with pruritic foot, discoloration of digits, black and brown patching of the scales on the feet and legs associated with soft tissue swelling. Gross necrosis and self mutilation were also observed. According to the history, both birds had been suffering from the lesions for the past few weeks. A detailed history was obtained for each patient, including environmental condition and their main diet was nuts and fruits. Common causes were ruled out through evaluation of CBC and biochemical profile. Based on gross characteristics and distribution of lesions, foot necrosis was diagnosed. Husbandry recommendations were given and antibiotics were prescribed to prevent possible infections. However, no improvements were seen, following the prescribed medication. Also deterioration of the clinical signs and feet lesions were observed. Typical finger tips showed gangrenous necrosis and very severe dark discoloration. After scrutiny in history taking, and visit of the owner's residence, it was evident that the birds have been exposed to the owner's crack-cocaine smoking area for at least two years. One of the owners accepted the recommendation of amputation of the affected digits and changing either the owner or environment. Follow-up showed no further lesion progression. Discussion: This clinical report presents two cases of parrots exposed to long term crack-cocaine smoke released to the environment. Generally speaking pet birds such as African gray parrots, used to share in many social activities with their owners, and such a behavior makes them more vulnerable to develop lesions in polluted environment. The history of both patients did not show any exposure to external or internal irritant of epithelial tissues except that they were continuously in close contact with crack-cocaine smoke. Clinical manifestations of both cases were similar in the first visit and followup clinical examination. So, according to the history and physical examination fi nding and ruling out other possibilities, it is assumed that foot necrosis may occur following long-term exposure of a bird in a crack-heroin-polluted area. Skin lesions such as burns and blackened hyperkeratosis on hands or digits of human associated with the use of crack have been reported before. Vasoconstriction (due to cocaine exposure) would be able to cause persistent hypoxia at the periphery. Another possible reason for these signs is acute peripheral arterial thrombosis associated with cocaine. Cocaine has also been associated with small vessel vasculitis. It is therefore postulated that, prolonged habitual use of crack-cocaine by parrot owners may result in visible digital changes (caused by multiple prolonged episodes of vasoconstriction, peripheral arterial thrombosis, hypoxia and ischemia) in parrots and could be one of the reasons for foot necrosis.