Urgent Unusual sneezing behavior from a Senegal/Meyers hybrid

[beccarrot]

Evie is a 3.5 year old DNA female Sennie/Meyers hybrid (whoops!) and we've had some weird happenings with her. In October, she started sneezing miserably for hours, several times a minute. She had lots of clear liquid from her nares. We visited an avian certified vet in the area, and he suctioned some green matter from her nose and sent it off for testing. It didn't come back with anything unusual, and we think it could've been from the dehydrated green beans we give her. While waiting for results, we were on cipro and an antifungal, but what was weird is that she seemed normal the following day after the appointment. We ended up doing the meds for 8 days while waiting for the cultures to return, then stopped. Since then, she's had 2 other short stints (<1 hour) of miserable sneezing and coughing until this week, where she was sneezing and coughing for almost 2 before we took her in again. She stopped sneezing for the most part on our way over but the vet said she sounded very congested and suggested cipro and antifungal again. Since it was really traumatic the first round (syringe training her has been unsuccessful so far since she hates liquid treats) we suggested that we could wait until the next day to start the meds in case it cleared up like the last few times. It did for a day and a half, then she started sneezing again for about 30 minutes. She's been flying, eating, screaming, playing between these attacks. She hasn't lost any weight, no new scents or products in our house, no dietary changes. Humidity in the house sits somewhere around 50* and her room rarely drops below 70.*

I'm perplexed. Something that does seem notable is that she appears to be paying extra attention to a spot on her upper chest, dead-center. When I try to look, I don't see or feel anything notable there, but her concentration on that spot seems unusual. Other than that, she's mostly been herself, maybe a little sleepier.

Does anything here seem familiar to anyone?

 

[beccarrot]

Would you go ahead and do the course of Nystatin and Cipro with these details? I called my vet but they never returned my call...

 

[Shezbug]

Have you checked your home for irritants such as fragrances, cleaning chemicals, personal care items etc? I just noticed you mentioned the bird got better on the way to the vet

 

[Pixiebeak]

I would follow your veterinarian recommendations.
Some types of infection are difficult to culture. Anaerobic bacteria are notoriously difficult to culture, clymadia is difficult to ever culture, instead a blood test is done. Some of the yeasts and fungal are harder to culture..

Green goo would have me lean towards bacterial,

A nasal flush and suction would help improve things , getting that clogging debris out of there , would certainly help. But if root causes wasn't found, would start building back up. Sinus issues can take longer to resolve, or can come back .

You could discuss with your vet the worth of doing the blood test for clymadia. If it was thst infection it takes doxycycline to cure it, other antibiotics don't work against it, but can make seem temporarily improved.

 

[beccarrot]

Thanks for the responses. I will start her meds in the morning since she's already asleep and hasn't shown any issues for the past 12ish hours. It's just so odd how fleeting the symptoms are--solid sneezing for 30-90 minutes, then back to normal. As for irritants, nothing comes to mind. I don't use air fresheners, candles, anything aerosolized. No perfumes or scented things aside from my own body products like shampoo and conditioner, but she's halfway across the house while I use those. I'll do the course of antibiotics and see if we can do a blood panel since she's due for one anyway.

 

[beccarrot]

We are still unresolved with Evie. We finished out the second round of Cipro drops and Nystatin back in December (8 days, I believe.) During that round, the behavior didn't recur while dosing, and she was good for a couple weeks.

On Jan 8th, she had some more minor sneezes but we decided to take her to the vet again. He suggested that it was allergies or some physical abnormality and irritant. Then he sucked a giant lightly tinted glob of snot from her nose again, and decided to do more testing. We sent the snot for culture along with chlamydia and bornavirus tests.

Starting the 8th, we had her taking Sulfamethoxazole/Trimethoprim along with the Cipro nose drops twice a day. She had a bit of a recurrance on Wednesday afternoon, then again on Friday. Because she was continuing to have problems, he switched her to Baytril and Cipro 3x on Friday. We kept that up all this past week, but she would still have random bouts of sneezing and coughing (video: IMG_9339), along with digging in her nose. We got the results of all tests yesterday and all of them were negative.

Tonight, we heard her cough/wheezing in her cage.

I'm at a loss for what to do. She has been more tired recently, tucking her head back between being her normal self (flying, screaming, playing roughly with toys). I thought maybe the tiredness could be due to the constant medicating -- including in the middle of the night. We don't normally listen to her throughout the night since she's in her own room, so maybe she's been having bouts of it in the middle of the night and that's making her tired during the day. Not all days are tired ones. It truly feels random.

I don't know what our next steps are. It's so hard to hear her struggling. Suggestions are welcome.

 

[Mizzely]

I'm sure you've already explored this, but what's her diet like? My Jardine's was very sneezy and raspy when I brought him home. His was due to vitamin A deficiency.

You could try taking her into a steamy bathroom for a bit to help loosen her up some for now.

 

[beccarrot]

In theory, diet is good... in practice, I think she doesn't eat much of the good stuff she's provided... She is provided chop (kale, brocc, carrot, bell peppers, lentil pasta, other bits and bobs), apple and berries, Zupreem naturals pellets, and safflower seeds. Admittedly, I think she gets too many seeds and treats - i.e. she'll get a tiny piece of a graham cracker as a reward for going to her sleeping cage. The poorer eating habits have probably gotten worse since she's been ill, too.

I'm terrified of switching it up on her too much and her losing weight. She's already pretty petite at 100g. Maybe tough love is needed here?

Is there a vitamin I can give her to help while improving the diet overall?

I will make the shower inclusion more routine. I considered getting a humidifier for her room, but it already averages about 50% and doesn't drop below 40% since we're in Florida.

Also: Would you say 'coughing' is an accurate description of what's in that video?

 

[beccarrot]

Given that she can go days or weeks seeming completely normal, along with the lack in anything coming up in cultures, does it seem unlikely that this is an infection of some sort? One other thing I've noticed a couple of times is that she likes to drink warm-to-hot water, and this can exacerbate her when she's already near or in a 'fit.'

 

[Mizzely]

Zupreem Natural is fine, but if it's 50% or less of what she eats everyday, it could be a factor, especially if seeds and treats are the bulk of her diet. Not to say she can't also be sick; it does sound like she is. Some things are cyclical and only present symptoms occasionally.

I would at least try to bump up her orange veggies (sweet potato, carrot etc) for a Vitamin A bump up.

Yes, there's multivitamins you can provide. I personally have used Hagen Prime. Since she's undergoing treatment I would run it past the vet first just in case; we don't want any interactions or overdosing!

https://www.chewy.com/prime-vitamin-bird-supplement-11-oz/dp/784358

The video sounds like she's definitely trying to clear something out of her throat or nose. My Jardine's makes the same noise occasionally.

 

[Pixiebeak]

I'm sorry you guys are still struggling to resolve this.

 

[beccarrot]

Evie had sneezing fits for 3 days in a row this past week, on Tuesday, Wednesday late afternoon, and Thursday. Wednesday she was scheduled for a CBC, so she was seen and was fine during the appointment. On Thursday, her sneezing fit was so severe that her forehead was all wet and clear fluid was going down the side of her beak. We brought her back but she perked up on the way to the vet again -- we ended up leaving her for observation for several hours and she was fine. We moved her to my parents' home and she's been symptom free since Thursday afternoon. Because of this, we're back to environmental issues in my home or some other allergy...

We plan on keeping her here for a few more days to see if there is any symptoms. We eliminated her chop for a couple of days and will give it back to her to see if that spins her back up. Trying to decide what the best path for bringing her home will be, if the chop isn't the culprit.

Her CBC results showed nothing aside from some elevated liver enzymes, which our CAV is attributing to the 3 rounds of antibiotics she went through in the past few months.

 

[beccarrot]

Evie had a 20 minute wet-sneeze fit this afternoon after having no exposure to my home or her chop for several days. She was just hanging out and cleaning herself on me and started yawning a bunch and clearing her crop before breaking out in sneezes. Clear liquid came from both sides. Within 20 minutes, it started and stopped and she was normal on either side.

It seems that the common theme is this happens when she's relaxing and presumably preening. I've seen her start up 2 fits mid-preen/when her head tucks back into her feathers. My best guess is that some of her own dust and fluff gets into her nose and that irritation just spirals into a fit.

She does not do a great job bathing in water -- she mostly only dips her face and chest, then throws around the rest of the water out of the bowl. I'll get some spray on her her in the shower, but it stays pretty surface level -- she doesn't fluff and let the water through to her down, as far as I can tell. Could she really be dirty/dusty enough to have such severe reactions to her own fluff?

In any case, this is our best guess currently and we're going to try to see if we can get her more thoroughly bathed...

 

[orphansparrow]

Gosh, this is so frustrating, I’m so sorry. So it seems, apart from the 20 minute fit, that she’s doing better at your parents house? Or hard to tell?..

 

[Pixiebeak]

That much fluid out of her sinuses is concerning.
I think you need an X-ray .
Are there any other symptoms?
A weird rare thing with people is cerebral fluid draining into sinuses and running out of nose..I had a good friends dad have this in highschool....so long ago I don't remember much ....I think we had a case with a dog also so very long ago
With it being positional also make me wonder...

CSF Rhinorrhea Treatment from Skull Specialists | UVA Health

Have a watery, runny nose? You could have CSF rhinorrhea. This brain fluid leak can lead to dangerous infections. Learn about treatment.

uvahealth.com

There is never trouble breathing? Sudden weakness? No sign of fluid in abdomen?

 

[beccarrot]

She came home after having the fit at my parents' house. We were trying to rule out issues in my home and her chop, and she had issues without both. We still deep cleaned her space before she came home. She did good today, I sprayed her down well and will continue to encourage baths for the next little bit. She's energetic and eating well, flying, and playing. No symptoms outside of the fits, and the CAV always says she appears perfect physically. I did manage to catch the beginning of the last fit on video and sent it to my CAV - he hasn't spoken to me yet, but the vet tech mentioned it appears that it might be starting as throat irritation since it starts with some clearing the crop / regurgitation motions that don't produce anything. Then she starts digging in her nose and dry sneezing for a bit before they turn wet. 10-15 minutes later, back to normal.

If the increased bathing doesn't seem to help, she'll be going up to Gainesville for a CT scan to look for abnormalities.

 

[Pixiebeak]

She came home after having the fit at my parents' house. We were trying to rule out issues in my home and her chop, and she had issues without both. We still deep cleaned her space before she came home. She did good today, I sprayed her down well and will continue to encourage baths for the next little bit. She's energetic and eating well, flying, and playing. No symptoms outside of the fits, and the CAV always says she appears perfect physically. I did manage to catch the beginning of the last fit on video and sent it to my CAV - he hasn't spoken to me yet, but the vet tech mentioned it appears that it might be starting as throat irritation since it starts with some clearing the crop / regurgitation motions that don't produce anything. Then she starts digging in her nose and dry sneezing for a bit before they turn wet. 10-15 minutes later, back to normal.

If the increased bathing doesn't seem to help, she'll be going up to Gainesville for a CT scan to look for abnormalities.

I hope you share images. Wishing you both the best outcome. Such a lucky bird to have you!

 

[beccarrot]

Evie is still having issues. I've been watching her closely on camera when she's not with me and I almost expect her to have a short fit every day. It does seem that I can 'distract' her away from a full blown wet sneezing fit if I intervene early enough into her yawning spells. I wondered if it was behavioral so I let her continue one day and she ended up with wet discharge and the coughing sounds. It's almost always in the late afternoon while she's resting. Her weight, appetite, and behavior outside of her fits remain normal.

We ended up taking her to get a sinus flush and chest X-Ray on a day where she hadn't exhibited symptoms yet. Sinus flush produced a good amount of mucus, according to the vet. It was sent out for culture and sensitivity, but we haven't gotten that back yet -- hopefully on Monday. We were hoping that out would pop some solid irritant, but she was back to her issues just a day or so later.

The X-Ray Findings:
RLAT and VD whole body radiographs (2 images) dated 2/19/24
Both lungs are normally opacified. The caudal (abdominal and caudal thoracic) air sacs are questionably hyperinflated. The proventriculus contains a moderate volume of gas but is otherwise normal. The remainder of the caudal coelomic structures are normal.

Assessment:
1. Questionable hyper-inflation, caudal thoracic and abdominal air sacs
2. Mild, aerophagia
The clinical significance of the hyper-inflation, if real, is unclear, but can be due to compensation from dyspnea and thus may be related to the reported sneezing and nasal discharge. A definitive cause for the reported clinical signs is not determined.



I was not offered any specific treatment recommendations based on these findings, but it's possible they are waiting for the cultures to do so.

I have an appointment at UF to get her a CT on Thursday that I'm very nervous about.

Should the culture and CT produce no findings, I am considering putting her on a very strict food isolation test to suss out allergies... but I'm unsure how I'll go about it. She's going to be mad as hell if I try.

 

[Pixiebeak]

Thank you for sharing this update. I'm sorry it's been frustrating finding a cause for symptoms. You are incredible and so dedicated to helping her.

Did they x-ray skull?

I hope answers are found. That the culture or ct gives answers. Or a treatment is found to help.

I've been thinking about you guys.

 

[beccarrot]

The culture from her sinus flush a couple weeks back was negative.

Evie had her CT scan yesterday and it came back normal along with cytology on a blood draw. The diagnosis for now is chronic sterile sinusitis. They're thinking it was some inflammatory process that hasn't been able to resolve itself on its own, so have prescribed her anti-inflammtatories and benadryl for the next two weeks to see how she responds. Hopefully it will just calm down her tissues long enough for it to fully heal and it won't have to be lifelong treatment

She did have significantly elevated muscle CK enzymes, but she actually came back to me with a significant bald spot on the back of her neck and I'm wondering if that trauma is what caused that jump in enzymes. She was left in holding in her carrier for awhile before her scan and she can be neurotic when in an enclosure like that -- the feathers were found in there. Either she did it herself (though she's never had any sort of self-mutilation patterns) or there was some mishap in handling that they aren't sharing.

She'll also be receiving calcium supplementation since it was low.

I'll keep updating here since it could be useful information to people browsing in the future.