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Sick bird with GI issues, need advice

owltrees

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Hey everyone. My 10 year old lovebird Tica has come down with something gastrointestinal related. Some background:
Tica has intermittent seizures that started a few months ago. She was put on Keppra long-term and will seize if she misses a dose. It's hard to know if the seizures are related to her current illness, because the only reason I noticed she was napping a lot during the day was because I got a Nest Cam to monitor her seizures while I was at work. She tested negative for lead/zinc my vet is inclined to believe it's a separate issue.

-

Currently: Her poop has been off. It alternates between normal and strange (polyuria + bubbly, diarrhea, and polyuria + squiggly). She naps A LOT during the day, and thus far has had two black stools that were positive for blood (I have a hemoccult at home that I use to test suspicious stools).

About 2 weeks ago we did a contrast dye study and the xrays showed enlarged intestines:

upload_2019-10-9_14-47-41.png
upload_2019-10-9_14-47-51.png

We did a CBC and her white blood cell count was slightly elevated, but that was a bit confounded by how stressed she was at the time (it was a 3 hour car ride). Fecal float, gram stain, anaerobic and aerobic cultures, lead/zinc blood tests all turned out negative. On one fecal 3+ weeks ago, my vet saw a few yeasts hanging around (nothing alarming) so she was put on itraconazole for 14 days - I didn't see any improvement.
She was sick in February (congestion in lungs) and went on one round of antibiotics which cleared it up. She lost weight back then but recently has been gaining weight back despite having gastrointestinal issues right now. Her appetite has been good for now, which is relieving.

We moved to a new city a few months ago and because it wasn't sustainable for me to keep driving 6 hours round trip to my ABVP vet, I went to a new avian vet in my area today (which is always nerve wracking when you don't know if you can trust a new vet!). Fecal smear on-site showed nothing, and we tested for polyomavirus, chlamydia, giardia, and did a gram stain. I will get results back in a week.

I expressed discomfort going home without any sort of medication when she obviously is sick, so the vet prescribed doxy (.16 mL per 10mg/mL) for 30 days, though told me to stop if I see no sign of improvement within 10 days. I have read that doxy is a very robust drug, is it alright to give it to her before starting more holistic antibiotics like metronidazole?
When I expressed concern about doxy and yeast infections I was given some benebac also.

Sorry this is so long and thanks for reading, was wondering if I could get some thoughts on current treatment plan or other tests I could do to help illuminate what's going on.
 
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sunnysmom

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Hi,

I am afraid I don't know but will tag some people. I hope your bird feels better. And you may want to ask your vet about giving her probiotics too.

@enigma731 ? @Hankmacaw ? @Zara ?
 

Hawk12237

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Your bird has an infection some sort going on. Everything you described points to that. Keep an eye on her weight, if your bird is losing weight chances are it's not getting nutrients from food because of the inflammation.
Ask your vet to give you emeraid which you give your bird by syringe. Helps regulate blood sugar. The seizures are in my opinion, secondary to what's actually going on.
Your vet needs to test for the infection, possible fungal infection. I wouldn't wait on asking vet that. So you get the proper meds to deal with appropriate infection.
 

owltrees

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I also forgot to mention the .16 doxy dose is twice a day.

@Hawk12237 As I mentioned, we have already done numerous floats/gram stains, two fecal cultures and still found no solid "proof" of an infection even though she obviously has one. It's so frustrating because whatever it is probably is shedding intermittently. I don't know what other specific tests to do, just made this thread to ask if this new vet and I have missed something to potentially screen for. Is a test for a fungal infection a fecal culture? If so we tried that but I'll keep testing if need be.
And yes, I weigh her twice daily (once in the morning and then before bed) to keep a close eye on it. Luckily she has been gaining weight and keeping up her appetite, and I hope she can at least hang on to her appetite until we get a diagnosis :(

She won't take food from a syringe, so if I went that route I would need to gavage her... which I think would hurt more than help since she reacts so badly to it, but I will definitely do that if I start noticing a decline in her weight.
 
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Hankmacaw

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Doxycycline is a good broad spectrum antibiotic and generally is pretty benign. 30 days seems like a long treatment. My vet has prescribed Doxycycline for two weeks except when my bird had a MRSA infection and then it was four months. Metronidazole is generally used for anerobic bacteria and you haven't identified a bacteria.

Has she been tested for protozoa or other parasites? Has she been tested for the ABV virus?
 

owltrees

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@Hankmacaw
Yeah, that 30 day doxy treatment is also twice a day so I wasn't sure if that was excessive...

We tested for giardia this time. Other protozoa is usually a fecal smear/float right? If so we have done several of those done and haven't seen anything. :( Though I have been wondering if it is parasites via water – she's drank tap water all her life but since I recently moved the water source obviously changed. After having that thought I switched her to bottled instead.

She hasn't been tested for ABV yet, though I have a feeling she probably is a carrier since she was around an ABV+ bird a few years ago. In the past, I was on a wild goose chase trying to piece together a potential PDD diagnosis since it's so murky.. so I really hope this is not the case :(

Is there anything else you recommend trying? I am hoping this round of tests reveals something.. it is always so frustrating when everything turns up negative.
 

Hankmacaw

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There is a new test for PDD. I'm having flat brain waves, but I am going to my vet tomorrow and will get the details from him. About 40% of the parrot population has ABV, so not a lot of sense to test for it - and the test is not all that trustworthy.

She is a Lovebird, so blood based tests are somewhat restricted.

Talk to you Fri. - my vet is a long ways away
 

finchly

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There are protozoa that, if she’s never been treated, may be hanging around; many only shed oocysts intermittently so it’s hard to see them on a slide. It’s worth treating for them in case that’s the problem.

Also - due to all the antibiotics, I strongly recommend probiotics daily. It’s probably useless during the doxy but it wouldn’t hurt anything to try.

I’m not going further with suggestions because it seems you are working closely with a great vet.
 

enigma731

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Unfortunately I agree with everyone else that you've pretty much exhausted the available tests. It sounds like you're at the point of trying to treat empirically, which means giving medications for the most likely causes and watching what happens. If the doxy doesn't work, I'd probably want to do metronidazole next since that covers giardia, which can be very difficult to find on lab tests. But it also sounds like your vet is doing a great job.

Lots of people are recommending probiotics but it sounds like she's already on Benebac? That is a probiotic.
 

Hawk12237

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I also forgot to mention the .16 doxy dose is twice a day.

@Hawk12237 As I mentioned, we have already done numerous floats/gram stains, two fecal cultures and still found no solid "proof" of an infection even though she obviously has one. It's so frustrating because whatever it is probably is shedding intermittently. I don't know what other specific tests to do, just made this thread to ask if this new vet and I have missed something to potentially screen for. Is a test for a fungal infection a fecal culture? If so we tried that but I'll keep testing if need be.
And yes, I weigh her twice daily (once in the morning and then before bed) to keep a close eye on it. Luckily she has been gaining weight and keeping up her appetite, and I hope she can at least hang on to her appetite until we get a diagnosis :(

She won't take food from a syringe, so if I went that route I would need to gavage her... which I think would hurt more than help since she reacts so badly to it, but I will definitely do that if I start noticing a decline in her weight.

Is a test for a fungal infection a fecal culture? You ask...
Usually they swab the inside of mouth, or take a crop sample of food. poop or gram stain doesn't always show that..If it's losing weight, there's something digestive going on. I would add digestive enzymes to her food too, will help in getting proper nutrients. My birds are both spoon and syringe trained.
When my son was seriously sick ( she recovered) she had to have soft food mixes with some enzymes. She's take the syringe easily. My grey is a monkey see monkey do, so he wanted to try it...now he is very used to syringe.
It's a good practice to get birds into, cause When times turn critical, you don't have to stress them out fighting with them to get them to take syringe.
 

webchirp

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There is a new test for PDD. I'm having flat brain waves, but I am going to my vet tomorrow and will get the details from him. About 40% of the parrot population has ABV, so not a lot of sense to test for it - and the test is not all that trustworthy.

She is a Lovebird, so blood based tests are somewhat restricted.

Talk to you Fri. - my vet is a long ways away
Avian Anti-Ganglioside Antibody Test
 

finchly

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Lots of people are recommending probiotics but it sounds like she's already on Benebac? That is a probiotic.
Whoops! Totally missed that. I see it now.
 
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