B&G Macaw very ill and in need of help

[Galactus]

Hello, I saw some good information posted on this forum and so I have joined up to see if anyone out there has any added experience and can be of help.

As the heading says, I have a 20 year old Blue and Gold Macaw. About two weeks ago she started exhibiting respiratory issues, heaving breathing, change in voice, not as talkative etc. I took her to my local vet, they took an x-ray, and ran a blood panel, started her on cipro as a precaution. Her x-ray is clear, her blood work is all good except for a slightly elevated PCV count of 58. A few days into the Cipro she was going back and forth between looking better and not. On the fourth day I found her panting and breathing very hard. I was extremely concerned, contacted the Vet again, and they started her on Metacam/meloxican. She is 900 grams and was started on the 1.5 at .25 once a day. My vet recommended that I take her somewhere they could care for her 24/7 as locally they are not equipped and that she also should get a second opinion. I took her to a highly rated facility where they checked her, looked at her x-rays and had her in an oxygen cage. Their opinion is pulmonary hypersensitivity syndrome, they say the husbandry of her with the my Rose Breasted Cockatoo is causing this issue, that her condition is irreversible, and there is no really good treatment for her. They said they did not expect she would make it through the night. We asked where they were keeping her, and how, and what they would do for her if we left her there. At the end the only thing they were going to do for her was keep her in the oxygen cage, and give her an injectable dose of the same drug. I asked about whether they would feed her, give her fluids etc, and whether someone would be there for her as she needs that companionship. They indicated they were afraid to stress her beyond her current condition. I live about 3 hours from their facility so she had traveled a long distance and was already very stressed. I discussed the situation with my wife and we felt that if we were going to lose her we wanted her with us not sealed in a cage papered over so she couldn't see and left with people she didn't know. They gave us a higher dosage of Metacam, and a twice a day dose of .30 for her and we left with her. We took her to a family members home closer to their facility where we tented her cage in plastic, added a vaporizer, and heat, keeping her at 80 degrees and 90% humidity to try and ease her breathing. We stayed up all night with her and tried to get her to eat and drink, she wasn't doing too well, and I spent the night watching her on the floor with my wife. She made it through the night, and looked poorly the next morning. I spent the day with her trying to get her to eat and drink which she did sparingly. We left that night for home, another 3 hour trip she didn't need, but I had no choice. Upon getting her home we weighed her and she had lost about 50 grams and was not looking well, or eating well. I had been feeding her baby food from a syringe the last day and now that I was home I got her pellets, ground them up along with some apple sauce, banana, nuts, fruit juice, etc., I ground it down to a paste and we fed her by syringe. I set her up in the bathroom with the vaporizer, 80 degrees or as close as I could get and 90-100% humidity as controlling the humidity is not easy. She has spent the last three days there in this setup. I am hand feeding her 2-3 times a day, giving her food and water offering treats and anything I can think of. She is taking her Cipro, and her Meticam twice a day as instructed. I am hesitant to say she is getting better but she is now starting to hold her weight, and to possibly even gain some. I am very concerned about her and I am just wondering if anyone else has experienced this situation and if there is anything else I could do for her to get her back on her feet.

I would also welcome anyone's opinion on a B&G being housed with a RB Cockatoo, and an African Grey since she was a chick 20+ years and only now showing these types of symptoms.

In any event, any and all help would be most appreciated.

[Wolf]

I am so sorry for your situation and really wish that someone had informed you much earlier about the hazards of keeping your macaw with dust birds. Both your Grey and your Galah are dust birds, what this means is that they produce a powdery substance to waterproof their feathers instead of using oil. This dust can be a serious health risk, as you found out the hard way, to other birds. I am really surprised that the place that you got them didn't inform you of this.
The only thing that I can think of that might help at all is to get one of those portable oxygen generators for your friend. and continue with what you are doing. Also I would get and run a couple of air purifiers in the room with him.

if someone had spoken up about this to you earlier the air purifiers may have helped prevent this from occurring at all.
There may be someone with more information on this here, but this is all that I know about this.

[Galactus]

Hi Wolf, Thanks for the reply. Amazingly in all the years of bringing them to the vets and having filled out countless forms for them, and the vets and breeders knowing what birds we own, and having visited them, no one ever mentioned this to us. It is truly amazing to me, with all I read and all I have seen, I have never till now stumbled on this. The AG is no longer with us, sadly he passed away of old age about 5 years ago. But she was kept with him, and the RBC. I now have them separated, but I fear it may be too little too late.

I have seen the oxygen generators, and I know there are some on CL and other places. I wondered though if I purchased one, and set it up how I would know how much oxygen to give her, how to set it, and the like. I had mentioned this to the vet a few days back, and I have not heard back as to how to set it up, and I have heard that too much oxygen could be bad for her, not sure if that is true or not but I certainly don't want to make it worse for her.

My other concern now is that at 90-100% humidity and 80+ degrees the bathroom is showing signs of mold growing. I can't spray any anti mildew agents or anything because she is in there, and I don't know what to do or what to clean with to keep her safe. I'm thinking of trying a 50/50 water vinegar mix to clean the walls and things with as I know it will not allow mold to grow, but breathing that in is harsh even on me and with her having issues as it is i'm still concerned.

Thanks again to anyone that may have some advice or help.

[Pajarita]

I am confused as to why the vets said that the situation is irreversible... As far as I know, the condition is perfectly curable because it's simply an extreme inflamatory reaction to long exposure to a certain type of protein UNLESS we are talking about the kind caused by severe aspergillosis with a possible aspergilloma combined with such poor general health that the bird would not survive surgery. So, if all she has is, indeed, bird breeders' disease, the only reason why she is not breathing right is inflammation. Reduce the inflammation and remove the irritant and the respiratory system will get better. Now, if she was also exposed to cigarette smoke for years, the situation is different because although the damage might not be 100% permanent, if the damage is extensive and the bird's general health is deteriorated, it just won't get enough time (it takes 15 years for humans and, most likely, longer in birds) to clean up the lungs.

Hand-feeding and isolating her is fine, but you also have to provide pure oxygen for her to breathe (Wolf gave the right advice, you need an oxygen box where she will spend all day long at the beginning, gradually decreasing the time in it when the lungs become more functional) as well as general support for the body. I don't know what tests and blood work was done and what the results were so, if there was anything 'off' (aside from the increase in total count of white blood cells, the different types that are increased are important because it tells whether it's infection, inflammation, chronic inflammation, immune system failure, etc), it would have to be addressed individually but the general support would be to cleanse liver and kidneys (they 'filter' blood, the medium to move oxygen throughout the entire body), boost the immune system (inflammation is an immune system function) and maximize oxygen utilization.

Now, if there is something else that is quite serious and irreversible (like advanced hepatic failure or congestive heart failure which also causes them to have difficulty breathing) added to the hypersensitivity pneumonitis, or if it's caused by a severe aspergillosis, keeping her alive is not really kind to her because she won't get better.

PS I just read your reply posting and I can tell you the oxygen mix (I know somebody who has been doing it for a macaw with lungs damaged by cigarette smoke). As to the Avian Vet not ever saying anything about the potential problem, what can I tell you? I have learned my lesson the same hard way you are learning yours. People think I am too hard on avian vets but all I am saying is: "Do your own research and don't take their word as the gospel because they don't know that much and they miss A LOT"

[Galactus]

Pajarita thanks for the reply.

The Vet has said the damage is irreversible due to the Macaw breathing in the irritant over the years, the irritant getting into her lungs and damaging them. She has likened this to a smoker who has smoked 15 years and then stops. Any damage done to the lungs is permanent as the lungs unlike the kidneys do not regenerate and so her lung capacity at current and her situation is permanent. The tissue in her lungs has been altered by the Cockatoo dander and now the oxygen exchange is below what it should be so her PCV is slightly elevated as her body tries to compensate. Yes, they can reduce the inflammation (hopefully) with drugs as they are doing, and hopefully her respiration will get better but the damage is done.

As to "bird breeders disease" my understanding is that is a human condition, not the same as what she has, as far as I understand it.

As I stated in my original post, they have done her x-rays and blood work and found no sign of any bacterial, or fungal infection thus ruling out in their opinion Asper and the like. Till now she was a healthy bird and has no other issues I am aware of.

In regards to hand feeding, isolating her, and oxygen; I am hand feeding her to be sure she eats properly and gets enough food, and hydration. It appears her trachea hurts and so she is not happy eating beyond the "smoothie" we are making her, and using the syringe lessens the amount she must manipulate the food helping her throat feel better (I presume based on how she is acting). I am only isolating her to keep her away from the Cockatoo and to insure she gets warmer air and more humidity than normal so she can breathe easier, and use less energy to keep warm. As to oxygen, I am not against building her a sealed cage to give her oxygen. However, as I stated I am unsure as to how much and the rest, if you know please feel free to let me know so I can check and verify it and possibly change her settings.

I have read quite a few of your posts regarding Avian Vets, and your issues with them, etc., I would say just a few things to you on this subject. 1- My motto, one that has served me well, is seen by many to be, "Trust no one". I however refer to it more kindly as "Trust but verify". No matter what it is, Avian Vets, Dog Vets, Personal Doctors, Business, no matter what, I listen and then I always check, and double check, and then try and check again just to be safe. Just like here, even though I posted for help, and I will read and listen, it doesn't mean I will trust it 100% without checking myself. I only trust people or things when they have earned my trust. I must say my current Vet Dr Jodie Santore is an excellent Vet, she is the first to tell you she doesn't know everything, and will tell you Avian medicine is in it's infancy. She is a person I do and would trust, and i am willing to bet had she known me before now she would have said something to me. Sadly we only know each other a few weeks or months as it is. I would recommend her to anyone, at any time without hesitation. She has followed up at every juncture calls and emails me and is an all around great Vet and Human Being. So I'm not sure telling people to not trust their Vets is such great advice. They should trust them to some degree or they should not be using them. But I agree they should also do their own research and check things for themselves as an educated customer can ask better questions note more details and help better than an uneducated one. 2- Remember, doing one's own research is a new thing. Back in the days when I got my first bird there was no internet and what you could learn at groups was limited. Now thanks to the internet the world has changed and information is everywhere. However, you still must know what to look for. It is one thing to research what to and not feed a bird, what cage they need and the basics, but it is still a breeders job, or the professionals job to point out mistakes we can not and would not otherwise know. For example, if I visit a clients site and see their systems and know they are too close together and will eventually overheat and break down it is my obligation to mention it whether they follow my advice or not. When I go to the fish store and say "I have a Moray Eel and I want to add a fish to the tank i expect they will tell me the correct fish to add so the eel doesn't eat them. My Vet in the past was well aware that we owned three birds and what they were and how they were kept and I am quite perturbed that he never mentioned anything. I can only attribute it to the fact that he did not know better. My breeder by the same token knew well that we had a Cockatoo and an AG at the time we were looking for a Baby B&G or Scarlet. He could have easily steered me toward his Scarlet chicks simply by telling me that it was not a good idea to keep a B&G with my other birds. He has all but told me that he was not aware of this disease at the time, and he claims that this is rather new news in the last 8-10 years. I am not able to find when this became news so I don't know if that is factual or not but when he says "If I knew why wouldn't I have told you", I have to believe he didn't know. Finally I would say to you start telling people "Trust but verify" I think you will get much less push back and hurt feelings than telling people "Don't trust them". Just my humble opinion, as you seem to be a genuine caring bird lover with good intentions.

Thank you again for your help, and I hope you will follow up with the oxygen information. If you'd like I can also post her blood work, and x-rays in case you know someone or some people on here would like to review them and see if there is anything they can see that has been missed.

[Pajarita]

OH MY GOD!!! I CAN'T BELIEVE IT! I ADORE DR JODIE!!!! She is the best avian vet I've ever had (as well as regular vet) and I also trust her implicitly. Unfortunately, I had to 'leave her behind' when I moved back to NJ from Pa. Tell her that Bea (ex Waggin' Tails and bird rescuer) sends her love and that I always, always remember her, her husband (excellent vet surgeon) and her lovely children (Ben and Sam) with affection. And, yes, you can trust her because she will always tell you the truth even if it means telling you she doesn't know (but she will find out for you and you can take that to the bank!). Every rule has a few exceptions and she is one of them (and her not even certified!). She is too humble to admit it but she is. And getting a scarlet instead of a b&g would not have made a difference, it's all macaws that are prone to it and not just one species.

I still think that the condition is reversible...at least, up to a point, because hypersensitivity pneumonitis (which is the scientific name for what used to be called 'birds breeders disease' and no, it's not only a human condition, it affects birds too) usually is UNLESS it has progressed to fibrosis but, if this was the case, you would have started noticing symptoms a long time ago. Well, let me elaborate on my last statement, you might not have noticed much if your bird was clipped all her life because the first symptom is shortness of breath after flying but if the bird doesn't fly, you don't notice anything until it's too late. And, of course, when you clip, the respiratory system also atrophies so the oxygenation capacity is greatly diminished which doesn't help at all with a positive prognosis.

I can get you the info on the oxygen but, personally, if Dr. Jodie said there is nothing to be done, I would put her down because she is not one to say this unless there is not a single chance in a hundred million. Dr. Jodie did surgery on one of my parrots which had had a broken leg for over 20 years (and came to the office to do her post operatory check up and Xray THREE DAYS AFTER SHE GAVE BIRTH TO BEN!), she removed a cancerous tumor growing in an old dog's ear which did not have a single chance of getting adopted because he was an old mutt with severe arthritis and neurological damage (17 and 18 years old when she did it and, the second time, she removed the entire hearing system on that ear - no other vet would have even consider it!) and I can give you more examples of her 'never say die' attitude when it comes to helping animals (she treated our animals at the rescue and we specialized on special needs dogs that other rescues did not want) so I know for a fact that, when she recommends an animal be put down, it's because there is no hope and the animal is suffering.

[Galactus]

It's great to know you know her, she is the best I have ever known, and btw she is pregnant currently, looks to be ready soon, though I haven't asked, didn't want to pry. But yes, I love her and told her next time I see her I owe her a hug, and yes honest as could be, all true.

So now just hang on a sec, no one is saying to put her down, they are just saying it is going to be a hard recovery for her, and that if she recovers she will always be susceptible to secondary infections and she will be compromised in certain ways. But no one is suggesting putting her down. They are worried she may not make the recovery (or were worried) and are still worried even if she recovers she will not fully recover. But please, bite your tongue on the put her down thing because no one is suggesting that. They are just trying to prepare me to face the reality that I could lose her.

I really and truly hope that it is reversible even to some extent as I would like to see her get better to where she was before this major outbreak. Also, she has never been clipped but she very rarely flies. She was always a hard breather imho, but she loves to sit on her cage and flap away on her wings and blow my papers everywhere and flap and flap like she was going to fly away with her cage.

I am concerned for her and I came here just looking for other things I might be able to do for her to help her recover, make it easier, and give her the best care I can. o help me do that, but let's not talk about any bad things for her! She is having her troubles but she is fighting so we have to fight with her.

Now not to disagree, but as you suggest, I have done much research, and all I can find on Bird Breeders is human ailments, nothing on the birds. PHS I can find on Macaws. Point me to a link on the bird version if you would so maybe I can get some more research done on it. Also in regards to scarlets vs B&G's my research has shown that the B&G's have no feathers above their nares which make them more susceptible to PHS than any other birds, and that a Scarlet would do better because of the covering on their nares. That is what I have found. Though frankly this is not a major issue for me now, but if someone else should find this thread it may be a concern for them. So if you have a link for all Macaws rather than just B&G's point me there so I can read it as well. I am one of those people that reads everything so feel free to show me anything.

Yes, please do get me the oxygen information as well just so I have it as I am considering building her a new cage/aviary with some added oxygen and a higher heat and humidity environment so going forward as she gets better she could spend a few hours a day in it.

I have also seen some articles indicating that getting her flying and getting her more exercise might help her in building her lung capacity up and overall making her feel better, though I am not certain if this would work. I have also seen mention of cold laser therapy to help with her lungs and again have yet to gather enough information to know for certain.

BTW- Glad to meet you, glad you know Doc Jodie, and glad we agree on so many things, would be nice to get a cup of coffee some day and see your rescue but I don't do NJ, lol.

[cml]

I am so sorry that your bird is ill, but from the looks of it you are doing everything in your power to help her!

I'm thinking of trying a 50/50 water vinegar mix to clean the walls and things with as I know it will not allow mold to grow, but breathing that in is harsh even on me and with her having issues as it is i'm still concerned

You can try using about 20% vinegar and 80% water, scrub away the mold then rinse the walls thorougly with water. Repeat when necessary. I would bring the bird to an other room while doing this, as you wrote, breathing vinegar is quite harsh on you .

Also, the ventilation in your bathroom is inadequate if the mold is gaining a foothold - likely because you've increased the air humidity and your ventilation wasnt built to sustain that. Infact, older bathrooms (a few decades old) are not even meant to sustain daily showering but people using the bath tubs. If you cant or wont lower the humidity, which I assume you've increased to help your bird, then you will have to increase ventilation - at the very least by letting the door remain open all the time.

[Pajarita]

I've been 'disconnected' for a couple of days because I had some many things going on during the weekend so I haven't had a chance to get the oxygen info yet but I will do it today.

Great that Dr Jodie thinks there is a chance! Glad that it was just a misunderstanding on my part! Now, one thing I would do is feed lots of betacarotene rich food because this is what makes them produce the phlegm that cleans out the inside of the lungs which is exactly what she needs (and why high humidity helps). I would supplement her with ubiquinol because it maximizes oxygen absorption at cellular level as well as turmeric, yerba santa and cat's claw to help with the inflammation.

Yes, exercise is good but I would wait until she is stronger and breathing better on her own.

Here are a couple of links on hypersensitivity pneumonitis in birds http://www.birdsnways.com/wisdom/ww47eiv.htm
http://www.birdsnways.com/wisdom/ww24ev.htm
http://bluepearlvet.com/macaw-hypersens ... aw-asthma/

The disease that people get is the same one the birds get as well as other animals like cattle, dogs, cats, etc. Basically, if the animal has lungs and it breathes in an irritant long enough, it will get the inflammation. And that's what the name means, inflammation (the 'itis' part of it) of the air passages ('pneuma') due to extreme sensitivity (the irritant itself could be different things from fungus to proteins so the name only refers to the condition itself and not what causes it). It used to have all kinds of names. The 'common' names were all representative of the group of people that got it like bird breeders, pigeon breeders, bird fanciers, mushroom pickers, farmers' lungs, birds lung, millers lung but there are other 'scientific' ones, like allergic alveolitis and interstitial pneumonia, etc

[Pajarita]

And here we go with the info on how to provide a bird with oxygen therapy:

Both people who are doing it for their macaws use the same machine, a Devilbliss oxygen concentrator . This machine is attached to a large Tupperware container (but it can be any container that the bird can see through, large enough to hold it comfortably and which has a real tight lid that would make it almost hermetically sealed) by punching a hole the exact size of the tube that carries the oxygen. This hole should be above the bird's head (on the top part of the box) as the oxygen rich air is heavier than normal air and would 'sink', thereby providing a more even mix all over. The machine should be turned on about 15 minutes prior putting the bird in the box to 'fill' up the box with the 'good' air. In both cases, they were using level 5 (this is for the oxygen mixture) and putting the bird in for an hour at a time. They started doing it several times a day and, as the lungs got better, they reduced it so the birds are now on two daily sessions. A heating pad under a towel or a blankie provides heat in the winter.

Here it's the box:



Here it's the bird inside the box: