The decision involves a number of factors. In the critically ill patient, parenteral therapy is indicated to assure delivery of bacteriocidal agents. Water medications, even if reported as sensitive, are less reliable when blood or tissue levels are desired. The compliance of the client in administering treatment is another concern. The acid fast stain is currently the only laboratory method readily available for diagnosis of avian tuberculosis.
Hematologic changes can increase suspicion.
Since affected birds often have multi-organ involvement, intestinal shedding is common. Hence, a fecal acid fast stain serves as a useful but insensitive tool, due to intermittent shedding.