African Grey's Poor Health

[kaitlyn_thompson66]

For some bird health background, Sappho my African Grey has been through the ringer when it comes to health, and she's only about 3-4 years old.

The big event is I had come home one day and say she had vomited, it took me awhile to realize what it actually was and she was ACTING sick, which I took as a terrible sign and had to wait until the next day to get her to a vet that can actually treat birds. In Kentucky, unless you all can point me elsewhere, I only know of one Vet Office that can work with birds past cutting their nails and wings.
They were very compassionate and took the issue extremely seriously and managed to find the issue. I still don't know what it was exactly, but she had ingested a small piece of metal and this caused a series of bacterial and fungal issues. She managed to push past this, shows little sign that experience ever happened. Then jumping to her 6 month vet visit, it was noticed she again had a bacterial infection, which she at least wasn't severe like last time. So that got squared away after some medicine.
The most recent visit was again rushed, while relaxing at home, my friend noticed Sappho vomiting, it was a very small amount, but still I took it seriously and went to the vet the next day.
She has shown no other signs or symptoms of being ill, which I know they tend to hide that anyway. She's energetic, she's talkative, she's eating, she's drinking. The vet gave us some medicine to stop anymore vomiting until they could figure out the solution.
So far, the x-rays found nothing, her droppings showed nothing, her blood showed nothing BUT she was anemic, and right now we're at a loss of what could be happening.
The vomit had been small, brown liquid around it with full pellets. It was not regurgitation with how she had whipped her head.
The vet has suggested a few things which I've followed and will list off, but I'm willing to take in any other information people are willing to give me or look into for them.
I cleaned the cage carefully, I took out any frayed rope, toys with fur, and anything similar that could be ingested by accident and wouldn't be picked up by the x-ray. The vet said he'd have problems with them before, I'd love your alls two cents.
The vet is worried it might be a bone marrow issue, but we are waiting on one more test on her crop to see if that comes up with anything. I'm hoping its just a crop bacterial infection or something like that and I'm panicking over something we've dealt with before.
Still, because its such a common problem, I would like advise to help stop this from happening in the future, help my bird be healthier, and make her environment safe.

Thank you for the long read, I'm sorry if I rambled in it, I just wanted to make sure you all had enough information and I'm willing to share more if you all need to know it.

 

[Scott]

Welcome to you and Sappho! Sorry to hear your young Grey is plagued with a variety of illnesses.

Something I'd like to clarify, please, is the metal ingestion. Did it pass out of her body normally, or surgically removed? If still in her body, there is a high likelihood of metal toxicity over time.

Is Sappho's vet avian certified? Many vets advertise "exotic" competency, but they lack specialized training and equipment. A second opinion at this point is wise. If interested, this search engine may give you options: https://www.aav.org/search/custom.asp?id=1803

Do you have copies of various lab tests and results? Types of medications given over time?

 

[ChristaNL]

Yup...here they come:


first question: did they ever get the metal out of her?
(metalpoisening will cause anemia, fatigue, nausea, neurological symptoms etc.etc.)


Second question was she (blood)tested for all the regulare scary diseases?

(PBFD, KDD etc. / Feather(dust)testing doen not count, not specific enough.)


Does she gets probiotics every day? (Because that really helps boost not only the good gutbacteria but in that way also boosts the immune-system of the bird)


In case of antibiotics- did you finish the full course (you probably did, but I still have to ask) but also did your vet take a culture so they know exactly *what* type of bacterial-infection she had?

(Not every antibiotic is a match for just any bacteria, that is why there are so many different ones)


Does she still smells the same?
(I can tell my birds are "off" just by sniffing the feathers and the beak.)
Cropissues usually change the way they smell out of their mouths quite a bit.

 

[EllenD]

I'd be highly concerned about the fact that they found metal inside of her (on an X-Ray or by doing a heavy-metal panel by blood?) yet they didn't do any Chelation Therapy to help the metal exit her body. Typically heavy-metal doesn't just pass from their bodies by itself, and even if it does it poisons them on it's way out unless they do Chelation Therapy, which is giving the bird a substance that will bind to the metal in their stomach and carry it out of their body while preventing it from being absorbed into their blood-stream and poisoning them...However, that probably would have killed her by now if it was still in her body, but you never know...

***Has she been tested for any Avian Viral Diseases yet? I hate to say it, but the fact that she is vomiting up undigested food is not a good sign at all, and it's even worse if she's passing any undigested food in her droppings. Has she lost any weight throughout this whole thing? There are a few really nasty Avian Viral Disease that can cause what you're describing, such as PBFD, and specifically ABV, PDD, or both...But she would have to be tested specifically for PBFD and ABV, both are a blood-test, and I would highly suggest you get both of them done...And if the ABV is positive, then you can assume that she also has PDD...

Without knowing exactly what types of tests were run (culture, microscopy/Gram-Stain) to diagnose these reoccuring bacterial infections, as well as exactly what bacteria they are finding, it's hard to comment on what's going on, but obviously the issues seem to have to do with her GI Tract. Bacterial and Fungal infections throughout the GI Tract are common in birds, but not over and over and over again, and that may indicate that she doesn't have enough beneficial bacteria inside of her GI Tract, among a lot of other issues...The fact that she's Anemic is a bit alarming, especially since you said that she's eating normally...

What is her regular, daily diet?

 

[kaitlyn_thompson66]

I do want to apologize how this was typed, I basically opened up a word document and just went down the forum and typed out the answers to things as I saw them, so forgive me if it looks jumbled.

The metal has passed thru, it was small and with amazing luck she managed to pass it with a bit of time. She was x-rayed to check and make sure it was gone and I was shown the x-ray to see the metal piece and what not originally. I was given a good series of medication to give her thru that time with antibiotics, something to help it pass thru, and another to help. I'm sorry I didn't specify that the metal HAS been passed and checked.

When it comes to Kentucky, from what I'm seeing on the Association of Avian Veterinarians, I am going to the only vet that can take care of pet birds, most other places are literally the zoo or wildlife protection. I already live an hour away from that vet, and using that site... even looking 100 miles away from where I live, he is still the only option, but he is at least on there. And he has done everything he could, some family members argued he overtested, but if he hadn't he wouldn't of noticed the metal in the first place.

I am sincerely sorry that I don't have the medicine she had previously been or remember what they were, I just recall it was antibiotics, a fruity smelling medication to help the metal pass, and I believe what she is currently on now to stop vomiting. That's Metocloprimide/Reglan Syrup.

With the most recent visit, what the vet bills says was done was (I'm just typing everything exactly how it is so I don't skip something important):
Six Month Wellness Check-Up
Micro Gram Stain Fecal and/or Crop
OSHA Compliance Fee
Rad-Routine (2 views)
A&E cbc Avian
Metocloprimide/Reglan Syrup 1oz
Iron Dextran Injection (help anemia)
Pcv/Total Protein in House
Aerobic C&S + Fungal

In addition, I can give the exact weight of my bird as 426.0 gm

She has gotten her blood tested a few time, both before and during the most recent illness. I don't know if they would show up or need to be tested on their own.
So an easy question I hope is: “For diseases like PBFD or KDD, does is need to be specifically tested for or would normal blood work and testing test for that as well?”
Her blood has come back as completely normal, both in the vet office and after they sent it out for lab testing to look closer.

I mostly feed her pellets and I'm trying to get her to eat more varied food, but like an actual 3 year old she turns her nose up at anything that isn't a brightly colored pellet. Still, I am trying to implement more into her diet.

Yes I did finish the full course of antibiotics and yes, though I can't remember it he always gave me the exact name of the bacterial or fungal infection and severity. Her last bacterial infection WAS a bad one, he actively warned me it could take longer than normal to treat it and to keep using the antibiotic for the full extent. We had caught it early though, so it was not nearly as dramatic as the metal situation that happened. Absolutely don't quote me fully, but she MIGHT of had Klebsiella bacteria? I just remember it had a K. (I've long realized I need to start a journal of health and exact medication and issues she has, I've started doing this now, sorry its a bit late)

And yes, she does smell the same, I totally understand that question and do check on occasion.

She was x-rayed to find the metal and was x-rayed afterwards to see if it had passed thru (luckily it had). She has also been x-rayed for this new illness just to see if she ingested anything again, but nothing was seen.
Yes, the vet had said much similar about the metal passing and though I can't remember the medicine, which I am very sorry about, I was given something to actively help the passing of the metal and it was explained in a similar way that you just gave. I will not say it WAS Chelation Therapy because I can't say it with absolute certainty, but she did have assistance in the passing process.

Her droppings have been fully digested so far at least.
No, she hasn't lost any weight, when I first got her checked up a year or so ago she was a bit underweight (nothing severe), and has progressively gotten to a healthier weight. Since her last visit 6 months ago, she has gained a bit more weight.
Okay, so those diseases DO need to be specifically tested for? Okay, I can write that down as a question to bring up.

Her diet is mostly Zupreem
Her breeder got her eating pellets, but she's mostly favors colorful pellets and sticks her nose up at others.
Her exact stuff is ZuPreem FruitBlend with Natural Fruit Flavors Parrot & Conure Bird Food
I also try to get her less picky by adding in other stuff from ZuPreem, which I'm totally open to other suggestions of food brands, these are just looked the most like the pellets she's used to and the only ones easily available for me, but I'm picking up I may need to buy some stuff online.
The other ZuPreem food is Natural and Veggie Blend Flavor
I also one special occasions giver her Nutriberries (one with Bell Peppers and one with Carrot, Peas, and Broccoli).
I'm trying to get her to eat more safe veggies but... much like me... if its really good for her she wants nothing to do with it. But still, I'm trying.
My vet mostly uses Harrison's Bird Food, which I'm willing to try to move more towards that, though I would like suggestions on which one exactly I should get because there's too many choices and my eyes cross. Its also not colorful so it'll be a tedious time getting her to eat them, but if everyone agrees its better, I'll make that change.

 

[Flboy]

My opinion, Zupreem and Harrison’s are about equal! (I can hear the beatings starting already!)

 

[ChristaNL]

LOL Flboy- yes, you know me (and my distaste for pellets that contain mostly sugar, like the fruitblend) way to well .




Harrisons is way above my paygrade (seriously, is that stuff made from low grade gold or what? I'd be bankrupt in a month if I started feeding that!) and yes the Zupreem that completely ruined my macaws health and ability to even form feathers ( at her previous home) is *never* coming back in this house.
Just read the ingredientlists and decide what you are comfortable with.
Lost of parrotfoods are mainly 'fillermaterial' pellet or seedmix, it is up to you to find a good one.

(No, sugar is not a healthy ingredient. Idealy it should not even be in there, esp not "added" to the mix.)



(and yes, this is the 4th year in a row I am trying to convince Japie bananaas are nice to eat, but even with the girls chowing down like it is *the* best food in the world *ever*cannot convince him---so I understand stubborn foodbehaviour )

A bird should have a pellet it thrives on, not just 'survives'.

 

[Scott]

Thanks for the wonderfully detailed follow up! Glad the metal is verified as gone.

I fed Zupreem Fruit Blend for many years as it is a favorite with high parrot acceptance rates! Have since switched to Harrison's. Many view it as the best pellet overall, though pricey. Though it is uniform colored and drab, 100% of my flock transitioned using their protocol, and love it.

Many techniques exist to encourage a healthier diet with vegetables and fruits. Trial and error, and a lot of encouragement! This thread may help: http://www.parrotforums.com/parrot-...7-converting-parrots-healthier-diet-tips.html Plenty of other tips in the Parrot Food forum.
The process can be interactive as parrots are flock eaters, and you are part of the "flock." Prepare two identical bowls, give one to your Grey and begin to eat from the other. Make grand gestures and sounds of enjoyment, offer to hand feed pieces from hers if she tolerates.

 

[EllenD]

It's the "Fruit" and "Nut" flavored pellets that are the issue, no matter what the brand they are LOADED with artificial sugars, oils, and fats, and they aren't really any better for them than feeding them a junky seed-mix as their staple diet...Most "Natural" pellets, such as Harrison's, TOPS, and even Zupreem Natural are the way to go...You might buy a small bag of Tropican Granules/Pellets, as they are kind of a happy-medium in that they are flavored with only natural fruit-juice, so they still have some sugar content, but nothing added to them at all as far as sugars, oils, sodium, etc., and otherwise they are right on-par ingredient-wise with the other Natural Pellets, but they tend to like them a bit better if they are unwilling to eat the Natural Pellets...

However I don't think your bird's health issues are diet-related, as her normal Blood-Work such as the CBC, Chem-7, Liver/Kidney Panels, Metabolic Panels, etc. have been normal. If her health issues were related to her diet those routine Blood-Tests would show it. Period.

I'm trying to get an understanding of exactly what your bird's issues are....So if I'm understanding you correctly, basically your bird has been developing chronic bacterial (and fungal? or just bacterial?) infections throughout her GI Tract (or has she also had other bacterial/fungal infections, such as Upper Respiratory, Sinus, Mouth, etc., or have they all been inside of GI Tract somewhere, like Crop, Stomach, Intestinal Tract, Cloaca, etc.?) that typically clear after giving her a course of antibiotics/anti-fungal meds...She also suffers from chronic Vomiting, and the only routine Blood-Work that has been abnormal is that she's Anemic...Does that about sum-up her overall issues?

Yes, any of the Avian Viral Diseases have to be specifically and individually tested for (most are basic ELISA kit-tests that must be run on spun-down blood serum/plasma and are not a part of any routine blood-work or panels)....

***Did her vomiting start before or after she ate the metal?

Quite honestly, I would highly suggest that they do an Endoscopy to take a look at her Crop, Stomach, and upper Intestinal Tract to see if she has something like an Ulcer or another issue of the lining of her Stomach or the internal lining of her Intestines...H-Pylori comes to mind, among other common stomach infections and issues such as ulcers. These types of stomach issues would be the only thing that would account for the vomiting, the chronic GI infections, AND THE ANEMIA, as she may be losing small amounts of blood from either a bleeding ulcer or bleeding of her intestinal lining...And unless that bleeding is pretty bad, it won't show-up in the form of black feces, and it won't kill her, but it will show-up as Anemia...

When a bird is Anemic, is can only be due to 3 causes: They are losing red-blood cells somewhere, their red-blood cells are being destroyed by something, or their body isn't making enough red-blood cells....That's it, those are literally the only 3 possibilities. So when you're a doctor and you're dealing with a patient who has been suffering from chronic Anemia, even if it's not severe, and you cannot find the reason for the Anemia, then you have to look at it from that perspective by combining it with any other signs/symptoms and test results that the patient has had to look for the overall issue...So if you combine mild Anemia with vomiting and chronic GI bacterial infections, your differential diagnoses are Stomach Ulcer, H-Pylori Infection in the Stomach or Upper Small-Intestine, some other type of Stomach and/or Upper Intestinal Infection or Irritation, GI Allergy (usually a problem properly digesting a certain type of food), or if the symptoms such as the vomiting, the chronic GI infections, and the Anemia only started AFTER he ingested the metal, then chances are that there are still particles of whatever he ate still inside of his stomach/intestinal tract that aren't visible on the X-Ray, or more probable is that THE METAL THAT HE ATE ACTUALLY CAUSED INJURY TO HIS STOMACH LINING/UPPER INTESTINAL LINING, AND THIS INJURY HAS BECOME INFECTED AND IS STILL ACTIVELY BLEEDING A BIT!

If I was your bird's Avian Vet, I would be doing a basic Endoscopy to look directly at his Crop, Esophagus, Stomach Lining, and Proximal Small Intestinal Lining to look for an injury/wound, active infection, active bleeding, etc. And then during the Endoscopy I would also take a culture of his stomach to test for H-Pylori and other common Stomach infections that would be causing enough irritation to cause a small bit of active-bleeding and infection...

 

[kaitlyn_thompson66]

I do appreciate everyone's opinion on foods, so I'll be trying to look more into different options just to test. And thank you for the conversion tips.
Tropican Granules/Pellets

Her Crop test came back today and that ALSO came back completely normal. All of her tests have come back normal but the vomiting and anemia.
To specify what the issue is, Sappho had vomited a small bit (brown liquid) and that's all. Her attitude and appetite were still around and she did not continue to vomit up her food or water. Still, I took her to the vet right away, and after several tests, nothing was found to be unusual outside of her anemia. She did not have anemia the vet visit between the metal and this current visit.

More or less, the timeline is:

Metal ingestion
Severe vomiting and illness
Medicated, the metal passed thru
6 months with a recovering bird, putting on weight and eating normally
Gets a bacterial infection that's found at the vet, caught early with no outward symptoms, does not have anemia
Medicated
6 months with normal behavior
A small bit of vomit, goes to the vet
All test come back normal, it is noticed she has anemia though
Currently being medicated, has been acting normal and hasn't vomited again but is under close watch

With the metal the mass majority of the infection was in her crop.
6 months after I believe it was in her digestion
And now we are seeing no bacteria or fungal infection
Her temperament and activity levels are the same. Her vomiting is not “chronic” but I worry about any kind of vomiting. Its only been seen ONCE at this point (though it was undeniably vomit).
I am also nervous about using the word “chronic” to describe her infections, which she's had 2, one with the metal and one 6 months afterwards, but if that is still considered chronic since it is only 6 months apart and I'd hope they wouldn't get infections that back-to-back.

I will bring up endoscopy to the vet as an idea to check for ulcers.
When it comes to her not have infections before the metal... Sappho is 2 years old, she was 1.5 years old when the metal was ingested, or close to that age. So its hard for me to say she would never have an infection before the metal because... she was so young and I can't really judge.

But still, I do like the idea of an endoscopy and I will bring it up to check for active bleeding or anything along the lines of ulcers.

 

[ChristaNL]

if she is om meds again...do not forget the probiotics plze.

 

[EllenD]

Probiotics are a must, actually her GI infections and anemia might be due to simply all the meds as well, so putting her on a daily Probiotic like Benebac or Qwiko is a great idea, no matter what is going on. If he hasn't looked at her feces under a microscope to check to see if she has enough beneficial bacteria throughout her entire GI Tract, then that might also be the actual issue, and the answer is putting her on a daily Avian Probiotic supplement indefinitely, maybe forever. It won't hurt her and can only help...

Again, the metal issue is scary combined with the Anemia, because if it caused any type of injury to her stomach/intestines or even a tiny bit is still in her system which is undetectable on an X-Ray, it could be causing the Anemia and the infections. And if they didn't actually ever do Chelation Therapy then there very well could be some left that isn't visible...You might also mention milk-Chelation to your Avian Vet too, it's an easy and quick way to get any metal particles remaining out of her gut.

Also, have they done a simple test on her feces for occult blood (non-visible blood)? It's usually a dip-test or strip-test, like they use to test if there is blood in the urine that isn't visible...That will give you the source of her Anemia and a lot of answers if she's positive...

You've got an advantage in that a CAG is large enough to be able to do an Endoscopy, and after what she's been through, I highly suggest it...I have done them before and see a bunch on birds who have eaten anything from metal to plastic pieces to chewy candy that won't dissolve in the crop because it's not warm enough but can't pass through either, etc. They can actually do the Endoscopy and then flush the entire contents of the Crop/Stomach out into a white towel, and if there is anything in there that is causing all of these issues it will show-up after the flush...That's the other possiblity, she ate something that won't show-up on an X-Ray...They do that, lol...

Honestly, if she's still on a medication and has been on a bunch of them, it could simply be too many Antibiotics that have killed-off every bit of beneficial bacteria throughout her gut, and that causes all of the issue you're talking about...That's just a matter of making a Fecal Smear on a slide and looking at it under a microscope to see if it contains a lot of beneficial bacteria...When there isn't enough, it's very obvious because it's a blank slide (except for maybe some red-blood cells in the case of your bird, which will also be visible under a microscope, and show where the lost blood is going)...

 

[kaitlyn_thompson66]

I am sorry this is such a late response, to be entirely honest, originally I didn't answer because I didn't see a Page 2 started and I just continued on with the info I had. You're free to make fun of me. I'm responding now with a possibly hilarious update unless you all correct me.

Yes, she was on meds for the time until all the tests were back and the vet gave another examinations and.... nothing, we couldn't find anything. All her tests came back clean, she wasn't acting unusual or showing subtle signs of sickness. We are still constantly watching her but still.

There was no blood outside of her veins that could be found or injuries in her intestines.
With the eating things that won't show up on an x-ray, that was the vet's main idea. So I've started avoiding fluff and straw like material just in case or at least watching her when she plays with them.

I'm working on getting her on a better diet that should help with getting beneficial bacteria back just in case, and still, like I said, everyone's watching her pretty closely.

With that said, being watched so closely, she recently became excited and I BELIEVE tried to regurgitate. I'll describe what it looked like and the circumstance, because its the circumstance that makes me suspicious what may of even happened in the first place was regurgitation. Anemia still a concern, I haven't forgotten, but the “vomiting” may have an answer.

I had put her away for the night, came up to her to say Goodnight before covering her cage before she started bobbing her head and was clearly trying to bring something up. Keeping her mouth open, crop clearly working, and watching me quite intently. After a moment, a bit came up which she chewed, then continued.... several pellets came up, which she promptly shook her head and slung them across the room. What might of happened the first night with the vomiting fear is she... just shakes her head like that with regurgitation because.... she wants to? I don't know why, but looking at what was spit up, it was clearly from her crop, it was a reasonable size for just regurgitation and after walking away she stopped and just grinded her beak comfortably as she started going to bed.

So, to summarize, she may of never vomited in the first place, but the anemia issue is still there and is still being watched for though absolutely nothing was found and she does not seem to be showing even the slightest bit of illness.

 

[Scott]

Don't feel at all squeamish, what most matters is the health of your grey!

Are you able to take a video of what is more likely regurgitation?

 

[ChristaNL]

Thank you for an update always great to hear from/about bird again.

Mine never fling with the regurged food, they just swallow it back down if nobody else wants it.

 

[kaitlyn_thompson66]

Next time she does it, I will do my best to film it.
I have read of others flinging their head with regurgitated food and I though I've never seen her vomit food, I have seen her vomit water (back when she first ingested the metal, it was utterly terrifying) and the body language was completely different.
But still, I will try to film it if she ever does it again... she is also camera shy, but if its vomiting then it wouldn't stop just because a phone appeared.

Nothing stuck to her feathers or beak, and if I hadn't stepped away she looked like she was trying to bring more up but stopped. Her cage was recently cleaned out and her dropping are all completely normal and consistent, her eating habits are normal as is her drinking.

This is not my bird, but this video is extremely close to what she did, and you can see the parrot flick its head like she did and sending the food flying away to some unknown loved one.
[ame="https://www.youtube.com/watch?v=cByWQXPtQUM"]Regurgitation. Part of owning a Parrot who loves you. - YouTube[/ame]