Amarillo decisions

[jmfleish]

So, Ami is doing really well. We went to the UW on Thursday and they took out her staples and stitches and she ditched her cone of shame. While we were there, the most senior vet for exotic species, Dr. Sladky, stopped by and felt the egg and did a small physical of her cloaca and really feels that he can get the egg out through the cloaca.

I got a call from Dr. Parkinson, one of the vets who assisted on the first surgery, last night. She said that Dr. Sladky, Dr. Mans (the vet who did the first surgery), and her got together and talked about the best way to go about it. Sladky and Mans are completely and totally on opposite ends of the spectrum. Mans thinks the egg is way too big to try to remove through the cloaca if it is even in the reproductive tract, which we don't really know for sure. I'm guessing that Sladky would like to try and go through the cloaca because it's less invasive but it doesn't come without its risks. There is no problem with trying to find out if the egg is in there or not other than Ams has to go under anesthesia again and if they find out the egg is not in the reproductive tract, it was unnecessary. If they find the egg, they will drain it and, from what I understand, try to collapse the shell and then remove it. That's where the problem can occur. Because the egg has been in there for so long, it could be adhered to the inside of the reproductive tract which makes it much harder to get out. She's got about two to two and a half hours that she can stay under anesthesia before they feel they need to bring her back out and if they don't get all of the shell out, they watch her and see how she does over time and she can reabsorb it or they may have to go in and remove it. There is also the problem that the shell could have sharp edges that could puncture her organs. There is also the chance that the egg breaks inside her before they drain it completely.

The surgery is really risky for all the original reasons with so many adhesions and the risk of cutting something they shouldn't.

So, I have no idea which one to go with. Dr. Parkinson is on service all weekend and said that I can call her anytime this weekend or stop by to ask questions. They have a slot set up for going through the cloaca on Monday because they didn't want to lose it. If I decide to go with surgery, it would be sometime the week after next.

Opinions, thoughts?

 

[Macawnutz]

Jen, that is not fair. How can they make you choose? You are supposed to trust that your vet knows the best way and does their best. If something goes wrong did you make the wrong choice? OMG!

Which is your vet? Which do you trust more?

 

[jmfleish]

They're all my vets. They work as a team and this time they totally disagree on which way is the best way to go about it. Dr. Parkinson is in the middle and said that she has seen them both do each of these procedures tons of times and have successes but have also seen them lose birds too. I think it's six of one, half dozen of another. We're talking about two vets who are incredibly qualified and one of maybe 150 in their field who totally disagree.

 

[DQTimnehs]

Can you ask Dr Parkinson which way she would go if it were her bird? Let her be the tie breaker.
That is so hard for you! Sounds like both are risky and she'll be under anesthetic either way so there's no avoiding that.
I wish you both luck whichever way you choose.

 

[Hankmacaw]

What a conundrum! There have been these decisions in the past with Dr. Driggers and procedures on Hank. I've always found out as much as I can about the risk/rewards of different procedures and made the decision myself. I have no doubt that Dr. Driggers influenced me in one way or the other, but I always made the decision. Hank was my bird and I sort of felt that it was my responsibility.

 

[DQTimnehs]

I kind of think that since they were already in there and know what they're dealing with that going the natural route through the cloaca isn't likely to work. And also, if the egg were in a position to be pushed out wouldn't it be causing more issues like stopping her from pooping and being in a life threatening situation? I'm certainly not an expert on eggs; in fact I have yet to deal with one (knock on wood)! I'm just weighing the situation as I see it. But of course you should do what you feel is best. And of course even the "best" option is going to be high risk.

 

[Clueless]

I'm so sorry you have to make this decision. I don't know ...... yes I do know what I'd do. I'd go to bed and put the covers over my head and sob.....

Then I'd call Dr Parkinson and maybe make an appointment for a heart to heart talk.

 

[jmfleish]

I have a call in to Dr. Parkinson to ask more questions. My gut seems to tell me that Ami would have passed the egg on her own if it was in the reproductive tract and wasn't adhered to anything but maybe it's just the size. God I just don't know! I need to talk more with Parkinson. What I'd really like to do is get Mans and Sladky in a room together and quiz them both!

 

[jmfleish]

I kind of think that since they were already in there and know what they're dealing with that going the natural route through the cloaca isn't likely to work. And also, if the egg were in a position to be pushed out wouldn't it be causing more issues like stopping her from pooping and being in a life threatening situation? I'm certainly not an expert on eggs; in fact I have yet to deal with one (knock on wood)! I'm just weighing the situation as I see it. But of course you should do what you feel is best. And of course even the "best" option is going to be high risk.

The egg can settle low and cause problems with her pooping so we have to make sure she's pooping. The egg is very mobile. That does not mean it's not adhered to anything, I asked!

 

[WendyN]

When they went in the first tine, why were they not able to see all of the egg and its surrounds?

 

[iamwhoiam]

Hope that you can discuss this with all of your vets more. It's difficult when the vets have differing opinions. I had that happen with one of my birds and it was very confusing. One would prescribe a medication and then the other one would tell me to stop that and use a different one and then back and forth. One suggested certain procedures and the other one suggested something else.
Go with what you feel will be the best for Amarillo after you speak to all of the vets again.

 

[Wasabisaurus]

I have a call in to Dr. Parkinson to ask more questions. My gut seems to tell me that Ami would have passed the egg on her own if it was in the reproductive tract and wasn't adhered to anything but maybe it's just the size. God I just don't know! I need to talk more with Parkinson. What I'd really like to do is get Mans and Sladky in a room together and quiz them both!

I hope you can do this, or maybe a Skype or GoTo Meeting?
What awful choices. Any which way, trust your instincts.

 

[Sarahmoluccan]

Horrible desicion to make. I agree you should go with gut. I'm sorry you and AMI are going through all this

 

[rocky'smom]

can the ultra sound Ami and see what, if , it's is in the right place or whether or not it's attached to her organs???

 

[theocnoob]

Sending you guys positive vibes. I hope your flock makes it through this ok. <3

 

[jmfleish]

When they went in the first tine, why were they not able to see all of the egg and its surrounds?

Dr. Parkinson was the vet assisting the first time and I asked her again what happened the first time. She said that one of two things occurred. Either, while they were making the initial incision, Amarillo took a deep breathe and her intestine pushed up against the knife or it was just an accident that happened due to the adhesions and they cut too far. Either way, they never even had time to go after the egg because they had to fix the intestine and by the time they felt they had that taken care of, she had been under for too long to try to go after the egg. So, they still don't know where it is really. We did do a CT scan which still doesn't tell us a whole lot about where it's located or if it's attached to anything. There was talk of doing an ultrasound but I think they felt that wouldn't tell us any more information than we already had.

 

[WendyN]

Sending a prayer for clarity and knowing what the best next step is.

 

[nu2birds]

Jeeze......... it just makes me cringe when I read what you two have been through. I tend to agree with Jennifer (DQ Timneh's), but like she said only you can make that decision. I would just add, if you can possibly intuit what your gut (heart) is telling you........go with that. Your brain knows the options, has heard the explanations........now your gut (heart) needs to make the decision. I am keeping both of you in m y thoughts!

 

[Clueless]

Sending a prayer for clarity and knowing what the best next step is.

Great thought! And I'll add for skillful hands and knowledge to bring Amarillo through whatever procedure successfully.

 

[Lady Jane]

Ask the docs separately "if this was your bird which way would you go" Wish they could do laparoscopic surgery on her. That way the docs can see what they are doing better.

VetFolio