Diabetic Blue and Gold

[missscoot]

I am a new member and I need help please. I have a 26 year old blue and gold macaw female named Mickey that I hand fed as a baby. She was just diagnosed as diabetic. There is very little info that i can find on treatment options and diet information. I am hoping that I can find someone on a forum that has a macaw or parrot that has or had diabetes and what their experience was. Maybe what worked and what didn't. Or possibly anyone who might know where I could go to find any information that will help. Thank you so much.

[Loriusgarrulus]

We have not got a diabetic parrot. My husband is diabetic though.
One of the fruits that is high in glucose my husband can't eat are grapes.

You will need the advice of an exerianced avian vet to balance his diet against exercise and sugar levels.
When your macaw was diagnosed did the vet say whether it could be diet controlled or does he need medication as well.

There are some papers on the web and a thread on here for some info. Links below.

One thing it did mention was a low iron diet was important, this is why breakfast cereals for humans should never be given to parrots.

viewtopic.php?f=8&t=13435

https://www.beautyofbirds.com/diabetes.html

http://dx.doi.org/10.1080/03079450701466093

[missscoot]

Thank you so much for your reply. We have have only one exotic pet vet in our area and he has suggested insulin injections. I am very fearful of this because of the danger of sugar going to low etc. That is why I am searching for others who have dealt with this and hoping for their thoughts or experiences. I do want to try diet and exercise and anything else that might help. I haven't been very successful in finding a lot of information from anyone who has experienced this with their bird. Thanks again. I am going to check out the link.

[Loriusgarrulus]

If you put on here what area you are in someone might know a specialist avian vet who could help.

In humans diabetes can be controlled by diet in the early stages or later by tablets which my husband is on.
My late Mother was on insulin injections, but injections are hard on birds, even the bigger birds.

[Pajarita]

Insulin doesn't really work with birds as well as with humans because the cause of avian diabetes is not the same. In humans, there are two types of diabetes: the one that is caused by the pancreas not making enough insulin (type 1) and the one that is caused by the body not reacting correctly to the insulin (type 2) so while humans diabetes is caused by too little insulin, with birds, insulin is not the problem, it's too much glucagon. It's the overproduction of glucagon that causes the bird's blood to show too much glucose in it because it overwhelms the normal production of insulin. BUT, all other causes of hyperglycemia (too much sugar in the blood) need to be eliminated BEFORE a diagnosis of diabetes is given - things like steroids (even topical ones), infection, liver disease, chronic dehydration (do you, by any chance, feed pellets and offer water in a bottle?), stress... So, the first question to ask yourself is has the bird had all other tests done? Including bile acids and a full body XRay? Have you re-evaluated your husbandry so as to make sure the bird's diet is the right one, that there is no stress, that the bird is drinking enough water (birds with too much sugar show both polydipsia -drinks too much water- and polyuria -produces too much urine), etc.

[missscoot]

Thank you for replies. I live in New Hampshire. There are very very few specialists in my area. Have called several different vets. Some specialists listed on internet are no longer in practice. I have found and read information posted above and my vet explained the difference in diabetes in people vs birds etc. So I understand all that. And I also read about the insulin issues and why it doesn't work yet that is what my vet has recommended. Thus my confusion and search for more information. She had blood work done. He said everything else looked good. She had an ex ray also. He said all organs looked normal. Are you saying that I should question if she is really diabetic? Wouldn't the vet check out other possibilities before stating that she is diabetic. Do I question him? Other then excessive drinking, urinating and weight loss she is active and normal in all other ways. She is on pellets. Kaytee Exact Original. She has been on them her whole life. I hand fed her as a baby and she is 26 now. She does have a water bottle also but has had that for a very long time also. So I don't believe this causes her any stress. She has been healthy with no illness or injury in all the 26 years I have had her until now. This is quite a shock. After searching the internet I asked my vet about trying glipizide and diet change and exercise. He said that we can try them for a couple of weeks and see what happens but he doesn't seem to optimistic. So we started her on the med today. So this is why I am searching out any info I can find. Vet says this is so uncommon no one really knows for sure how to treat it. That everyone just has their own ideas. So I was hoping to find someone who has been through this and their experience and the options they might have tried. Thank you all for the info given.

[~Karen]

Hi, I'm sure you did a search on the board for old posts on this subject but I thought I would post this link in case it was overlooked.

viewtopic.php?f=8&t=13435

[missscoot]

Yes I did but thank you. I believe the article was on Insipidus diabetes and Mickey has been diagnosed with Mellitus diabetes. Thank you though.

[Pajarita]

Well, I would eliminate the pellets and the water bottle ASAP and I'll tell you why. There is a very close relationship between dehydration and high glucose in the blood. Glucose is eliminated through urine BUT when the body cannot eliminate ALL the excess, it goes into the blood. That is one link, then there is the hormone link. If there isn't enough hydrdation, there is reduced urine (the body's way of keeping enough moisture for the internal organs to work) and, when there is reduced urine, you end up with too much of certain things in it and, in the case of glucose, also in the blood. This is because of a hormone called vasopressin (in birds, the equivalent is called vasotocin) which the body produces when it's dehydrated. This hormone makes the kidneys retain urine BUT it also makes the liver produce blood sugar so it's a double-whammy!

Birds kidneys are not like mammals' (they are like a mix between mammal and reptilian organs) and the avian hydration 'mechanism' is different than mammals. Parrots were created by nature to derive most of their hydration needs from the food they eat which is 85-95% water (fruits, buds, green seeds, etc) so they are hard-wired not to drink too much or too often (they usually only drink early in the morning once and then again in the evening -they, as all prey animals, are crepuscular feeders because it's when they are safest from predators). When you feed pellets (a maximum of 10% moisture - WAAAAAY lower than nature meant for them to eat) and offer water from a bottle (which releases a drop at a time), the bird simply does not get enough hydration. And, because their kidneys work differently than mammals (they cannot concentrate the urine they way we do), they can't use this method to avoid mild dehydration. You can't really tell because, first of all, we are talking about a subclinical (mild) dehydration but also because they don't have the symptoms we are used to with mammals (dry skin, dry mouth mucosa, skin without elasticity, etc) so parrots that are fed food too dry (people also give them dehydrated fruit instead of fresh, crackers, etc) and don't have easy access to water (as in big gulps from a nice big bowl deep enough for them to dip their beaks halfway into the water) could end up with a chronic state of mild dehydration. Mild dehydration = vasotocin + not enough urine for the body to get rid of the excess glucose (which could also be dietary -birds should never consume anything with sucrose -sugar- in it) = high glucose in the blood.

Now, I am not saying that giving the bird a good diet (low in carbs and then ONLY complex ones), proper hydration and exercise as well as reducing stress as much as possible (just because a bird has been living a certain way for many years doesn't mean it's not stressed by aspects of it -mind you! I am NOT trying to imply that your bird is stressed out, I am just making a point that most people seem to miss) is going to take care of the problem because they have found that years of mild dehydration will end up causing the body to develop insulin resistance which might not be reversible but, if the bird was mine, I would definitely try it.

I firmly believe in treating the entire body (holistic) and, as much as possible, through the usage of natural ways (meaning not man-made medicines) so, if I took in a bird with high glucose I would make sure it's eating an organic, low carb, VERY moist diet all the time; that it has easy access to lots of water (big -deep enough so the bird can dip half the length of the beak in it- bowl of cold water both at dawn and dusk), regular exercise (flight, of course, as there is no other exercise for a bird) and a VERY strict solar schedule (a healthy endocrine system is essential with sick birds!), with a good FS light (CRI 94+, Ktemp 5000-5500) in the ceiling fixture of the room where the bird spends most of its time (light is a nutrient to birds and a trigger for hormone production).

I am giving you a couple of links for you to read. There are a couple of human-oriented articles but the information can be extrapolated and use for birds, too. And a couple of studies specific to birds - they are a bit hard to understand but the info is there and it's pretty much what I explained to you above.

These two are about the relationship between dehydration and hyperglycemia

http://www.livestrong.com/article/23945 ... se-levels/
http://www.diabetes-book.com/diabetes-dehydration/

These are about the avian kidneys, vasotocin and the relationship between vasotocin, glucagon and stress:

https://www.ncbi.nlm.nih.gov/pubmed/16288753
http://www.exoticpetmedicine.com/article/S1055-937X(05)80007-6/abstract (you need to pay for this one)
https://www.ncbi.nlm.nih.gov/pubmed/23500673
http://www.poulvet.com/poultry/articles/physiology.php
http://www.sciencedirect.com/science/ar ... 2974907348

[missscoot]

Thank you so much for your reply. I really appreciate it. I will read the links as soon as possible. But right now I have so many thoughts, idea's and suggestions coming in at me that i am a little overwhelmed. I have to sort through all of them and see what I can do now, what I need to look into and what I need to do in the future. The more I learn though the more complicated it seems to be. Now I have reason to wonder if Mickey has been misdiagnosed by my vet. I just don't know what to do at this point. As of now she is getting glipizide (SP?) at a dose calculated by vet in her water bottle and I am keeping track of what she is drinking. If I switch to bowl at this time she will be playing splashing and making soup instead and it will be difficult to know what she is drinking. So for now I need to keep her on bottle. As for her pellets it makes sense about moisture etc. But she gets other food besides pellets, fruits and veggies etc too. and believe me Mickey knows how to get more than a drop at a time out of that bottle. She plays with it enough to still find a way to make her little soup at times still If there comes a time when she no longer needs meds in her water I will definitely try switching her over to a bowl for water or at least give her both options. But I don't think the stress of a change in diet at this time would be good as far as the pellets. But again, as soon as possible, I will read the links and speak to my vet re: this. Thank you again for all your help and the information. Debbie