Urgent Need advice/help, Chronic cockatiel respiratory illness, antibiotics not helping

[Keys378]

Hello, I am a first time poster so I apologize if I have messed anything up! Feedback is totally welcome.

My beloved cockatiel sparky is about 4 years old and has been ill. Initially about 6 months ago i took him to the vet because i noticed his left nostril filling up with fluid. He had a slightly elevated bacterial count so we did two weeks of oral antibiotics (smz/tmp solution) and it seemingly cleared it up. He showed no signs of illness except his left nostril continued to fill up with fluid. At his recheck two weeks later, the vet said that everything is great, and it’s likely just a chronic rhinitis issue due to him being more sensitive to things like dry air. Lungs, muscle strength, weight, and everything else she checked was great. He also behaved totally normally through all of it.

Fast forward to about a month and a half ago, i came home to his left eye being completely covered in discharge, and the feathers all around being matted. He was also tucking his upper beak into his lower beak and had slightly audible breathing. No tail bobbing. I immediately took him to our vet for an emergency appointment, during the 20 minute drive the eye had stopped actively watering. The vet said based on the cytology of his mouth and eye swab, there was definitely a bacterial infection.

We again treated with two weeks of oral antibiotic (smz/tmp solution) as well as a topical antibiotic drop (tobramycin) into nostrils and eyes. We also started doing a steamy shower session for about 15 minutes every other day, which really seemed to help.

During the two weeks of meds, his eye never watered/discharged again, and the feathers around his eye were not matting at all. At his recheck, the vet said things were looking great, bacterial level was almost zero in mouth swab. Three days later his eye was discharging again. I booked an appointment for the next morning. She decided to hospitalize him for the day to do a nasal flush and a nebulizer treatment. His bacteria levels in mouth were slightly higher than normal, and she said his eye had a heightened level of inflammatory white blood cells (pus). We continued the smz/tmp solution at a higher dose for another two weeks, and had the same story. At the recheck he was great, a couple days off the antibiotic and it was in full force. We decided to do a (very expensive) fungal culture and psittacosis test. She said in order to do this he needs to be off meds for a few days. We bought a nebulizer for home use and continued spray/misg baths as well as steamy shower sessions to manage symptoms while he was off meds. He made it about three days off meds before he appeared so sick it worried me again. We did the tests after three days off antibiotics but they take quite a bit of time to yield results. He is now on a different antibiotic (Baytril, he was on this once when he was younger) as well as the tobramycin drop in nostrils and left eye.

I do really trust my vet. She seems great and has a long history treating parrots. I love this bird so so so much i can’t help but worry. My biggest anxiety is that the bacterial infections are just a secondary infection to something else. From what i’m reading, if it’s a fungal infection it sounds quite likely he could pass away. Is it possible that this is just an extremely persistent bacterial infection? I severely doubt he has psittacosis because he is never in contact with other birds than my conure who we have had for three years. Even then they do not interact as my conure has aggression issues and can’t be trusted around my cockatiel yet. Only other possibility would be from a new toy? But i don’t think that is possible. I have no idea where he would get a fungal infection. We also discussed doing a referral for a CT Scan at a teaching university about 3 hours away.

Some other info is that his diet is almost all Tops natural pellets, and he gets offered fresh chop in the morning when he is most hungry, although he is very picky with his veggies. I’m extremely careful and we don’t use anything that would be toxic to him in the air like nonstick cookware or perfumes and whatnot. Another question i have is how come it is ENTIRELY on his left side. Extremely rarely his right nostril will fill with some fluid that he sneezes out. His right eye has never once had any sort of discharge.

Has anyone ever dealt with anything similar? Makes me so scared, I want to do what is best and i’m already $2k in on vet bills. I’m happy to answer any clarifying questions. Any thoughts are greatly appreciated!

 

[Shezbug]

Bump

 

[sunnysmom]

Poor little guy. I hope it clears up. I have not dealt with this but just a few general suggestions. I would ask the vet about following up with probiotics. Also what's the humidity level in your house? You can buy a cheap thermostat/humidity reader on Amazon. Humidity should be at least 30% but I have read in 40s or 50 is better. I have a humidifier for my birds. Also do you have an air purifier? I don't think these things are the cause of course, but might help.

 

[Keys378]

Poor little guy. I hope it clears up. I have not dealt with this but just a few general suggestions. I would ask the vet about following up with probiotics. Also what's the humidity level in your house? You can buy a cheap thermostat/humidity reader on Amazon. Humidity should be at least 30% but I have read in 40s or 50 is better. I have a humidifier for my birds. Also do you have an air purifier? I don't think these things are the cause of course, but might help.

Hi, thank you for the advice. I use the levoit core 300 (may not be exact model) and have good luck with it. I do have a humidity/air quality monitor, and the humidity is quite low, usually around 25%. I believe this is from the heating. I’ve been using a humidifier trying to keep up and can usually keep it around 40%. Thank you for the suggestions! I’ve read a tiny bit about probiotics but honestly I don’t fully understand. Are the probiotics to replace good bacteria that the antibiotics are getting rid of?

 

[April]

@Pixiebeak

 

[sunnysmom]

Hi, thank you for the advice. I use the levoit core 300 (may not be exact model) and have good luck with it. I do have a humidity/air quality monitor, and the humidity is quite low, usually around 25%. I believe this is from the heating. I’ve been using a humidifier trying to keep up and can usually keep it around 40%. Thank you for the suggestions! I’ve read a tiny bit about probiotics but honestly I don’t fully understand. Are the probiotics to replace good bacteria that the antibiotics are getting rid of?

Yes, sometimes antibiotics can kill off good bacteria too. I had a cockatiel who suffered from frequent bacterial infections. He would be on probiotics for 30 days and do great and then get sick again. Eventually my vet and I decided to keep him permanently on probiotics, which isn't typically what you should do, and it made a big difference.

 

[Pixiebeak]

Chronic sinus with periorbital sinus infection can be difficult to resolve. I don't think this will be fungal. But with extended antibiotics and most especially with baytril a secondary yeast overgrowth is likely . The simple cheap Nystatin to treat almost assured yeast when taking baytril. Worked great fir me and mine

For primary infection, I think psittacosis is a likely candidate and I would treat for it regardless of tests, culture isn't the way to identify this weird bacteria infection, better results by PCR tests or such done on serum. False negatives are all to common and it can be extremely frustrating and difficult to confirm. So often it it is likely it is treated for regardless of what tests say. ...Because of it's weirdness and dormancy and hiding out. It takes 45 days of doxycycline to clear it and often a second round of 45 days of doxycycline .

Other antibiotics are not effective against AC . Won't clear it. But can temporarily make symptoms and bird better so it seems like the other antibiotics are working, but they are not .

Plus extreme cleaning. Toss out all soft and porous material toys that can't be cleaned. Change AC home filters every two weeks during treatment, and for a month post treatment. Replace vacuum filters weekly. My vet preferred I not use a vacuum during this time , as I dint have carpet that was possible fur me. I bought cheap brooms and replac d weekly. Every other cleaning supplies stuff git bleached.

I have had way to much experience with psittacosis, which I refer to as avian clymadia, or AC for ease if typing it over and over. My whole flock of 7 had this at the same time , and each of their symptoms were different. 2 did develop one sided sinus, and periorbital sinus infection and inflammation. It was very difficult to clear those sinus infections. It took many nasal flushes ,plus steam room ( shower steam ) twice daily for a month I think
and for mine it took 3 rounds of doxycycline 45 days again 45 days a d yet again 45 days . Ugh!!! The good thing is doxycycline is well tolerated, much less likely to lead to secondary yeast or fungal overgrowth . Tho 2 dud develop yeast overgrowth, but had also started out on different antibiotics before vet determined AC( during lockdown so no tests sent out) we ultimately did the doxy water and it worked great. Part of our difficulty in clearing the AC , is that after researching my vet found budgies need 90 days of doxycycline to clear , and originally we didn't know that . They would be the ones to relapse first , ( their relapse symptoms were soft squishy green tinged stool , one would have occasionally sneezed, then the rest of my mixed flock would get sick again. Anyway it was an epic struggle.

I also found feeding plain Greek yogurt very effective for maintaining good flora . I feed daily during any antibiotics treatments. All of my birds including Budgies will kick it up. Fir the non Budgies I often offer from my fingers. The budgies I put a dollop down by their veg and they come eat it.

My remaining parrot that had periorbital sinus swelling, with original AC infection, all these years later occasionally flares and my vet has me do pulses of doxycycline . Those periorbital sinus infection regardless of what cooties cause are a pain to clear ...no real way to flush , probably some anatomical issues, plus birds often make these dry secretions in there that can shift and plug stuff .

I'm thrilled to hear of yours being on a great diet. AA low vitamin A from a poor diet can really play a role in respiratory health.

 

[Keys378]

Chronic sinus with periorbital sinus infection can be difficult to resolve. I don't think this will be fungal. But with extended antibiotics and most especially with baytril a secondary yeast overgrowth is likely . The simple cheap Nystatin to treat almost assured yeast when taking baytril. Worked great fir me and mine

For primary infection, I think psittacosis is a likely candidate and I would treat for it regardless of tests, culture isn't the way to identify this weird bacteria infection, better results by PCR tests or such done on serum. False negatives are all to common and it can be extremely frustrating and difficult to confirm. So often it it is likely it is treated for regardless of what tests say. ...Because of it's weirdness and dormancy and hiding out. It takes 45 days of doxycycline to clear it and often a second round of 45 days of doxycycline .

Other antibiotics are not effective against AC . Won't clear it. But can temporarily make symptoms and bird better so it seems like the other antibiotics are working, but they are not .

Plus extreme cleaning. Toss out all soft and porous material toys that can't be cleaned. Change AC home filters every two weeks during treatment, and for a month post treatment. Replace vacuum filters weekly. My vet preferred I not use a vacuum during this time , as I dint have carpet that was possible fur me. I bought cheap brooms and replac d weekly. Every other cleaning supplies stuff git bleached.

I have had way to much experience with psittacosis, which I refer to as avian clymadia, or AC for ease if typing it over and over. My whole flock of 7 had this at the same time , and each of their symptoms were different. 2 did develop one sided sinus, and periorbital sinus infection and inflammation. It was very difficult to clear those sinus infections. It took many nasal flushes ,plus steam room ( shower steam ) twice daily for a month I think
and for mine it took 3 rounds of doxycycline 45 days again 45 days a d yet again 45 days . Ugh!!! The good thing is doxycycline is well tolerated, much less likely to lead to secondary yeast or fungal overgrowth . Tho 2 dud develop yeast overgrowth, but had also started out on different antibiotics before vet determined AC( during lockdown so no tests sent out) we ultimately did the doxy water and it worked great. Part of our difficulty in clearing the AC , is that after researching my vet found budgies need 90 days of doxycycline to clear , and originally we didn't know that . They would be the ones to relapse first , ( their relapse symptoms were soft squishy green tinged stool , one would have occasionally sneezed, then the rest of my mixed flock would get sick again. Anyway it was an epic struggle.

I also found feeding plain Greek yogurt very effective for maintaining good flora . I feed daily during any antibiotics treatments. All of my birds including Budgies will kick it up. Fir the non Budgies I often offer from my fingers. The budgies I put a dollop down by their veg and they come eat it.

My remaining parrot that had periorbital sinus swelling, with original AC infection, all these years later occasionally flares and my vet has me do pulses of doxycycline . Those periorbital sinus infection regardless of what cooties cause are a pain to clear ...no real way to flush , probably some anatomical issues, plus birds often make these dry secretions in there that can shift and plug stuff .

I'm thrilled to hear of yours being on a great diet. AA low vitamin A from a poor diet can really play a role in respiratory health.

Wow this so helpful thank you SO much. It seems like you have a background. I did look at my vet bill and it lists “Aerobic and fungal cultures” as well as “Lab - Avian (GA) Chlamydia spp. PCR”. Does this sound correct? Honest to god my biggest fear is aspergillosis it sounds nightmarish, but AC also sounds intense. My concern with this is my conure who, as much as we love him, is very far from tame and quite aggressive. We will do what it takes of course but what does administering doxycycline look like? Is it a twice daily syringe like we’ve been doing, or I’ve seen online that it can go in water or be an injectable. Not sure how true or effective those methods are.

Since you seem knowledgeable, I’d like to ask you if anything im doing could be harmful or continue the spread of the disease (assuming it is AC, the test results are supposed to be back this week), any insight is much appreciated!

• Is having an air purifier and humidifier okay?
• How would one go about cleaning the environment in general but especially if we have carpet?
• If AC is the case I will likely replace their cages as they are approaching the end of their life span anyways and I would like to start fresh. Would the F10 I see online be acceptable/effective for AC? I saw you used bleach but I worry about the fumes and whatnot.

Also, are you saying the sinus issue can be long lasting after AC is gone? I don’t fully understand, is the chronic sinus infections separate from AC, and just happen as a result of the AC, or how does it work?

Lastly, I can only imagine struggling with this times SEVEN birds. Madness! Glad everything turned out well for you guys!

 

[Pixiebeak]

Do you have more than one parrot /bird? If you have any other birds, all must be treated at the same time . AA some can be hidden shedders and if one has all have , regardless of the other birds dint have symptoms.

Yes PCR is correct test for avian clymadia.

The doxycycline is a powder you add to water ( comes with directions) and you make up a fresh batch each day and that is the birds sole drinking water . It is effective and no grabbing and dosing. Works great for treating aviary birds .

AC is a weird weird weird bacteria, and it is systemic, so it can affect any systems in the body or multiple systems in the body . So symptoms vary depending on what part of the body it's attacking.
Classic symptoms are nasal and ocular, usually with polyuria and biluria. As the vacter likes to hide in liver and kidneys. It also can be acute , chronic , or carrier . It goes through dormant of periods and thst why long treatment. Most sick birds with ac treated with doxycycline will be almost completely well by day ten but absolutely takes the 45 days to clear the infection. If they don't get uninterrupted 45 days will relapse . If there are other birds in the home that aren't treated with the sick one at the same time , then you will also not clear the infection. It is a pain in the butt , but is completely treatable. It is highly contagious, aerosols ,and can persist in the environment . I don't remember all the facts on how long can last in the environment. But a relapse after the first 45 day round is pretty common , happens about ten days post treatment can vary. And second 45 day round usually enough to get rid of.

I use bleach because I'm old school. I move the birds to a different part of the house and I haven't had issues. Because I haven't used f10 , tho I hear great things about it, you would have to get advice from members that do . Because of aerosol,my vet has me spray dilute bleach on the cage poop paters before rolling them up bagging them and taking outside to help cut down on in aerosol.

As far as pariorbital sinus infection, regardless of what bacteria, AC or other kind, they are just difficult to clear.
I don't know if in my bird Pikachu if it's actually AC ,it could be some other bacteria that collects in there due to scaring from her past infection. But doxycycline is a broad spectrum antibiotic, that is good for most avian respiratory bacteria infections besides avian Chlamydia. And has been successfully keeping down any flare ups she has.