Heart Disease: A cautionary tale.

Last Sunday I observed Angel, my 28 yr old female Eclectus acting lethargic. She seems to have gained a bit of weight recently, but I was shocked as I picked her up to do a cursory exam and plop her on the scale. She had gained 30 grams since her exam 3 months ago, and the reason was immediately clear. The region from bottom of the breastbone to the vent was swollen, and immediately rebounded to a gentle touch - not a solid mass or egg related. My preferred board-certified AV was not in until Tuesday, and she seemed outwardly normal with great appetite and normal droppings. An ultrasound coupled with a rapid and slightly irregular heartbeat quickly led to a diagnosis of heart disease. He drained 18g of fluid and sent a sample for analysis. The results confirmed his judgment and essentially ruled out cancer or other organ involvement.

What? How did that happen so fast? Her blood panel from 3 months ago was absolutely normal, excellent considering her age. He stated the clinical and outward signs of heart disease come on quickly and eventually cannot be masked as it trademark for parrots. Fortunately there is a drug now widely used to treat heart disease with much success: Pimobendan. Primarily a veterinary drug, though certified for humans in Japan, it is therapeutic and strengthens heart muscle contraction with few if any side effects. I asked if it is simply a "caretaker" drug to prolong life, but he believes it improves overall heart strength with time. His "star" patient is a Grey that presented with heart failure 6 1/2 years ago with little hope, but is now doing well.

Angel seems much improved, but with just a few days of dosage it is hard to tell whether the primary impact is from having so much fluid removed. (some remained because he didn't want the probe to nick her liver. The rest should be naturally eliminated)

Interestingly, my vet mentioned parrot heart disease has been increasing in his practice. In his opinion, Pimobendan has been a game-changer for an illness traditionally difficult to treat.

Scott, I am so sorry to hear this! I am so glad you caught it so quickly.
Poor Angel, does your vet have any idea what caused this? Is it something that just happens? You are one of the best parronts I know, and I know how well you take care of your Fids, so if it could happen to Angel, it could happen to any of our babies.
I am so glad to hear there is a drug to help with her condition, please keep us updated on how she is doing on it.
Sending you and Angel many gentle hugs and prayers.

Yessssss, all that Terry said...and asked.

So sorry.
Good for you and your vigilance, though!

Scott said:

Last Sunday I observed Angel, my 28 yr old female Eclectus acting lethargic. She seems to have gained a bit of weight recently, but I was shocked as I picked her up to do a cursory exam and plop her on the scale. She had gained 30 grams since her exam 3 months ago, and the reason was immediately clear. The region from bottom of the breastbone to the vent was swollen, and immediately rebounded to a gentle touch - not a solid mass or egg related. My preferred board-certified AV was not in until Tuesday, and she seemed outwardly normal with great appetite and normal droppings. An ultrasound coupled with a rapid and slightly irregular heartbeat quickly led to a diagnosis of heart disease. He drained 18g of fluid and sent a sample for analysis. The results confirmed his judgment and essentially ruled out cancer or other organ involvement.

What? How did that happen so fast? Her blood panel from 3 months ago was absolutely normal, excellent considering her age. He stated the clinical and outward signs of heart disease come on quickly and eventually cannot be masked as it trademark for parrots. Fortunately there is a drug now widely used to treat heart disease with much success: Pimobendan. Primarily a veterinary drug, though certified for humans in Japan, it is therapeutic and strengthens heart muscle contraction with few if any side effects. I asked if it is simply a "caretaker" drug to prolong life, but he believes it improves overall heart strength with time. His "star" patient is a Grey that presented with heart failure 6 1/2 years ago with little hope, but is now doing well.

Angel seems much improved, but with just a few days of dosage it is hard to tell whether the primary impact is from having so much fluid removed. (some remained because he didn't want the probe to nick her liver. The rest should be naturally eliminated)

Interestingly, my vet mentioned parrot heart disease has been increasing in his practice. In his opinion, Pimobendan has been a game-changer for an illness traditionally difficult to treat.

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Scot, so very sorry to hear that your Angel has presented with Heart Disease.

The majority of our Amazon's have passed with either or a combination of Heart Disease and/or Fatty Liver Disease. And, both separately and in combination have been on the rise.

Specific to Heart Disease and its sudden on set. Our Avian Vet stated that historically, unless they are dealing with 'Sick' classified Parrot (mine are always in that classification even when they are doing fairly well), they have not spent much time unless they are either hearing or picking-up a change in the blood testing. In addition, the majority of existing clients 'Well Bird' example rarely includes full spectrum blood testing.

Based on our discussion, look for all of our Avian Vets to (if they have not already started) begin using specific criteria to recommend specific and more detailed testing for what has in the past been classed as a 'Well' Parrots.

Things that would likely trigger a more detailed 'Well' Bird Examination:
Age: Over 20, but clearly over 30 years of age
Non-Flier /Never fledged: Starting point not yet defined, but much younger ages then would normally be considered an issue.
Over Weight /Rapid Weight Gain: Although this item has been on their check list, it has become far more important and at younger ages
Presents with Heart Disease: Test for Fatty Liver Disease
Presents with Fatty Liver Disease; Test for Heart Disease
Diet: The poorer the diet the earlier the Testing for Both
Etc: Other like, Human seen Drivers

Much like our Doctors, our Avian Vets will be using /recommending a wider criteria for what has been classified historically as a 'Sick' Bird Examination. Earlier and more detailed examinations!

Once again, so very sorry to hear that your Angel has presented with Heart Disease. Pimobendan has enter the Avian bag of medications after we had lost our Yellow-Winged Amazon to Heart Failure (a Torn Heart Valve). I am so happy to hear that its available! May Angle be positively effected by this medication!

Prays for you and Angle, good friend!


Possible Cause: Congestive Heart Failure?

OMG, I want to learn more... the Rbird is into the danger zone? 30-plus years?

Scott, I'm very sorry to hear this about Angel! That is so scary that such a thing can come on so quickly out of the blue, even in a well cared for parrot. I wonder if there is any genetic base to this? I'm glad to hear there is an effective drug to treat the condition. Please keep us posted!

I'm very sorry

CherylCali

Scott, I'm so sorry to hear this about your Angel baby. This comes as a real shock after a clean bill of health just three months ago. I know what a vigilant parront you are, I'm so glad you saw the symptoms immediately. Pimobendan sounds very promising, I hope Angel does as well with the treatment as the grey is doing. Hugs to you, Scott, and scratchies for Angel. Tell her she has lots of Uncles, Aunties, fans and friends waiting to hear the best possible news.

Thanks everybody!!! I suspect it is partially genetics, somewhat species-specific, and related to activity. Or in the case of Angel, lack thereof. She doesn't like to fly (she knows how) and would prefer to cuddle. The most action she sees is walking around and exploring the floor in the bird-room. (Bird safe room). I've had Angel since weaning so there are no gaps in her history. She seems to be doing well with a stronger grip, and a bit more urates than normal - probably busy dispersing excess fluid.

Looking back..... She had been spending more time on perches with her side against the cage bars..... Possibly for support and relief from fatigue?

I really hope the medication helps her, Scott. Poor Angel. Please keep us updated as she gets more of the medicine in her system, I pray it helps her long term.

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Scott, I am so sorry to hear this diagnosis for your Angel. I know how hard it is to get such scary news about a beloved fid. And as Terry had mentioned, you take wonderful care of your parrots. So this is a cautionary tale for all of us. Thank you for taking the time to make this thread and get the word out there about the dangers of heart disease and the importance of testing.

It's good that you were so observant and acted so quickly upon noticing a difference in her behavior and weight. That definitely saved her life.

And I know your pain when it comes to a female ekkie who refuses to fly unless she deems it absolutely necessary. It's the same deal with Maya. I try to exercise her to the extent that I can, but there really is no substitute for flight. So I am just a lot more strict with her diet than I am with Jolly's. Mainly in terms of smaller treat portions.

I'm glad that your AV was able to prescribe a medication that has such a good track record with fighting heart disease and strengthening the heart muscles. I hadn't even heard of Pimobendan before reading your post.

And SailBoat, thank you for the detailed post you were able to provide due to the experiences you've had with your amazons. It's always so important that this kind of information is shared, as it is so helpful to the next person.

Scott, you and Angel will be in my thoughts and prayers. I'm fervently hoping her health continues to improve. Please keep us updated about her progress, my friend.

Scott,

I am sorry to hear about Angel, but happy to hear you have an awesome avian vet who keeps up on everything!!

A big part of birds in the home is lack of exercise, but isn't that true of many people too! Has your vet suggested an 'exercise program' for Angel as she gains strength? I know when Max came home he was a pudge bucket, and tho technically healthy, much like a person I worried he was at risk for heart concerns. So, his behind started climbing stairs if he wanted to go with me and I started 'forcing' him to fly. Even, now, he flies voluntarily or is 'encouraged'. We are fortunate to have high ceilings so even in the home, he is able to fly 30-100 feet.

I hope to hear Angel is responding wonderfully and is another star example patient for your vet!!

So very sorry to hear about Angels sudden illness and the diagnosis but it does sound very hopeful with the info you have been given about the drug Pimobendan and I have to say well done for noticing the difference and for acting swiftly you probably saved Angels life with that Vet visit and her introduction to this drug. Get Well soon Angel we are all wishing you well

Thank you all for the continued concern! Angel seems stronger, which is becoming more evident as I strive for creativity administering her medicine! Pimobendan is a liquid suspension that can be mixed with various foods; so far oatmeal is the best tolerated. Since it is a lifetime drug, I am resisting the hated direct administration via syringe (no needle) into her mouth.

Exercise is a struggle, best thing I can do is either let her walk on the bird-room ground or encourage the flapping of wings.

Scott, that's great news that you're seeing positive results from the Pimobendan already ! I'm so glad Angel has agreed to take her meds with oatmeal instead of having to administer it to her daily. Good to hear this positive update already!

Very happy to hear that you are finding an alternative to directly into the month. Although it gets the 'job done' it really can strain the relationship.

Regarding getting Angle more active, that really is a double-edged sword. Its very important to work the larger muscles to increase the needed blood flow. But, at that same time watching that you do not over simulate. I am not aware of any method to monitor a Parrot's Blood Pressure. The best method I am aware of is to listen to the Heart Rate. I have long ago trained my Amazons to allow me to place them on their back in one hand, claws attached to the other and than place their chest to my ear. Yup, can be iffy somethings, but it works. Anyone have a better method please chime in here!

It does not take long to get a 'feel' for where your Parrot's Heart Rate is and adjust activities based on what you're hearing. It become very important to get this 'feeling.' Yes, developing a count against time is the correct method, but since I can't count that fast and keep an eye on the Amazon at the same time, I go for a feeling.

Developing a feeling: Listen to the rate at rest /light play (hold the Amazon to my ear game, in this case). Parrot walks across the room and up on to the cage, pick-up the Amazon and listen to the heart rate. With the Parrot on your hand and doing several hand drops to develop wing flapping, place the Parrot to the ear and listen to the heart rate. On the hand, with a hand drop and wing flapping half trip around the room, place the Parrot to the ear and listen to the heart rate. You get the idea and can proceed from this point.

NOTE: If at any point in this or any other activity, if you hear a racing heart rate: STOP! A racing heart on a Parrot that has a known Heart Disease may result in the dead of the Parrot as a result of induced Heart Failure! The goal is to learn the difference between a rested Heart Rate, an active Heart Rate and more importantly the need to stop before cause damage or death.

Sorry, nothing about the above is easy to say. I have been there and the fear of pushing too far is chilling. And, I had also caught when our Yellow-Winged Amazon's Heart failed and heard the heart race to failure as it tried to make-up for failed valve.

Love your Angle! Learn to listen to her heart and adjust her activities. The goal is to with comfort, extend her happy life with you!

Thanks for posting this. Poor Charlie died a month ago from congestive heart failure (he was ten or so). A week or two before he died, I finally figured out he had "water belly." Neither of the avian vets I took him to realized the fluids in his abdominal cavity were caused by heart disease. Instead, he was prescribed Metacam, which I blame for his death. Charlie should never have been given that drug, which in all likelihood caused his horrific death. I held him for an hour before he died, as he coughed and gasped for air, his legs unable to move, with fear in his eyes.

Thanks again for posting. Angel will probably have to see the vet on a regular basis to have her tummy drained. You and Angel have something Charlie never had—a good avian vet.

Teddscau said:

Thanks for posting this. Poor Charlie died a month ago from congestive heart failure (he was ten or so). A week or two before he died, I finally figured out he had "water belly." Neither of the avian vets I took him to realized the fluids in his abdominal cavity were caused by heart disease. Instead, he was prescribed Metacam, which I blame for his death. Charlie should never have been given that drug, which in all likelihood caused his horrific death. I held him for an hour before he died, as he coughed and gasped for air, his legs unable to move, with fear in his eyes.

Thanks again for posting. Angel will probably have to see the vet on a regular basis to have her tummy drained. You and Angel have something Charlie never had—a good avian vet.

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Thank-you, for your heart felt Post. The lost of a beloved Parrot, especially one that you are doing everything you possibility can is Heart Crushing.

Our Amazons have 'at their will' died in our arms. Although Heart Crushing for us, I know that although not easy, they all past knowing that they where loved and that in some small way helped. Prays for your Charlie.

Teddscau said:

Thanks for posting this. Poor Charlie died a month ago from congestive heart failure (he was ten or so). A week or two before he died, I finally figured out he had "water belly." Neither of the avian vets I took him to realized the fluids in his abdominal cavity were caused by heart disease. Instead, he was prescribed Metacam, which I blame for his death. Charlie should never have been given that drug, which in all likelihood caused his horrific death. I held him for an hour before he died, as he coughed and gasped for air, his legs unable to move, with fear in his eyes.

Thanks again for posting. Angel will probably have to see the vet on a regular basis to have her tummy drained. You and Angel have something Charlie never had—a good avian vet.

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I am so very sorry for your loss. Losing your bird is bad enough, but knowing it was due to a missed diagnosis must be additionally difficult. A post like yours underscores the importance of both threads like these and communities like ours where we can share our experiences and help one another.

Fly free, Charlie. Never forgotten and never gone from the hearts of your human flock.

Thanks so much, you two. I honestly believe he could have lived several more months were it not for the irresponsible prescription of Metacam. Part of the problem was the fact that he was an older budgie. Were he a young cockatoo, the second avian vet would have probably tried harder to figure out what was wrong, rather than chocking it up to old age. I wanted to have more tests run, but she basically talked my dad out of it. Charlie is my boy, but the vet and my dad made me feel guilty about wanting to have some simple tests run on my "old" bird who wouldn't be able to "handle" any treatments.