Atherosclerosis (heart disease) in cockatiel?

[aurelius]

I just came back from the vet and my tiel Pepper was diagnosed with atherosclerosis. I got her at 4-ish years old (now 7-8ish) as a rescue from a previous home who didn't care for her well (all seed diet, constant access to mirrors, small cage, trauma with little children...). She had an issue with feather plucking that we thought was behavioral and worsened due to dry skin, and we suspect she had hormonal issues with egg-laying. She is doing great now with only a few bare areas due to some medications, she has a great pellet-only diet (with veggies and sprouts when she'll eat them and seeds as occasional treats), no egg-laying, very few medical issues of concern - but if she were to come off her meds she would start plucking again.

Turns out the plucking was from heart disease (atherosclerosis). Apparently in early stages still, but I'm a little terrified. I couldn't find much information online. She is starting isoxsuprine and will be back in the vet to monitor progress in 7 weeks (it would have been sooner, but my schedule is difficult to work around). She is also currently on haloperidol/haldol for plucking but we will start weaning her off of that at the next vet appointment once isoxuprine starts kicking in. She is also on an omega-3 fatty acid-high oil medication, which was originally for her dry skin but the vet advised that she continue to take because it could help with atherosclerosis.

The only real symptoms I've seen of this are feather plucking and standing on one food more often than the other, more than is normal at least (apparently due to her feet falling asleep). Otherwise she has no obvious symptoms.


This is the information summary from the vet:

Pepper's x-rays we took today demonstrated increased brightness and enlargement of her major vessels, which is consistent with atherosclerosis.

Atherosclerosis in birds results from the accumulation of cholesterols, fats and inflammatory debris on the inside of the blood vessel walls. This creates a narrowing of the blood vessels, forcing the heart to have to work harder to get past this partial blockage. Blood flow to other areas of the body becomes compromised, and can lead to fainting/falling episodes, seizure-like episodes, weakness, panting, decreased exercise tolerance and has been associated with feather destructive behavior.

Although x-rays are highly suggestive of this disease, more complete information can be obtained through a CT scan or echocardiogram. A referral to [location] for a more complete diagnostic workup can be pursued at any time if interested.

Although atherosclerosis is a progressive condition that cannot be reversed, many birds can live years with this condition. Some birds however may not respond to treatment or suddenly worsen, including suddenly passing away overnight. (My note: this is the part that terrifies me the most).


So my questions:
Who else has experienced this?
How else can I help treat and prevent this? What can I do for Pepper?
What is her outlook? With proper treatment, can she live just as long? Is there any real threat of sudden decline?
Has isoxuprine helped?

Also, how expensive is it to treat and monitor atherosclerosis? I shelled out 2.5x of Pepper's average vet cost yesterday and while I am willing to pay anything I can for her, I am still concerned about financing her care (I am currently a student so money doesn't stretch that far.) What were the costs for caring for atherosclerosis in birds? What procedures and tests were needed and how expensive were they? Were there more appointments than 2x/year for checkups (excluding unrelated emergencies like injuries)? How do you pay for emergencies? Would it be better to do pet insurance (though at this point she would be considered as having a preexisting condition) or add to a savings account every paycheck? There is even a vet care credit card advertised on my vet's website (CareCredit) and payment plan options.

I will be asking a lot of this to my vet when I see her next, but it's hard to reach them when I don't have the vet in front of me to ask. So any information you have is appreciated - even if it's a scientific paper (I read biology research papers every day so I'd be glad for any research available as well). Most of what I could find on atherosclerosis in birds was 10+ years old, and my vet said this is more of an emerging bit of knowledge.

Thank you so much and literally anything you recommend is appreciated!!!! I'm worried about Pepper, but glad to know about her condition so I can care for her as best I can. She is my ESA and I can't imagine life without her (though I know I will someday have to... Just hoping not for another 10-15 years!) Thanks for reading this super long post.

 

[Mizzely]

Here's an article: Atherosclerosis: The Hidden Killer

We had a member who is no longer with us that knew a lot about it as her macaw lived with it for 21 years. She said at one point that the biggest challenge was that it left her bird susceptible to other infections.

Here's a search for all her posts that she mentions it by name: Search results for query: atherosclerosis

 

[April]

@AGS @webchirp

 

[AGS]

Thanks for tagging me, April!

I’m going to type up a response but in the meantime, here’s a link to my thread for my bird, Widget: How much hope is there for birds with heart disease?

 

[April]

Thanks for tagging me, April!

I’m going to type up a response but in the meantime, here’s a link to my thread for my bird, Widget: How much hope is there for birds with heart disease?

Of course I knew you'd be the perfect person to help out

 

[AGS]

Who else has experienced this?

My cockatiel Widget was diagnosed with atherosclerosis in August 2020. He’s currently sitting next to me whistling

How else can I help treat and prevent this? What can I do for Pepper?

Different things and different medications work for different birds. For example, the bird mentioned above who lived with this for 20+ years took Sildenafil which helped her a lot. Widget tried the same medicine and it had no effect.

He’s currently on:
Benazepril
Isoxsuprine
Pentoxifylline
Theophylline

You might want to ask your vet about ACE inhibitors, whether it be Benazepril or a different med.

Some other treatments/supplements you can try:

• Garlic/garlic oil
• Red palm oil
• Oxygen therapy (there’s a thread about this somewhere- oxygen machines can be pricy but might be worth it. It didn’t help Widget because he used all his time in the tub to run around playing lol)
• Omega 3’s which you already mentioned
• Reduce stress however possible for your bird
• Encourage exercise (your vet can tell you what a safe amount is for your bird)

What is her outlook? With proper treatment, can she live just as long? Is there any real threat of sudden decline?

It’s impossible to say for sure since each bird is different, but as far as possibilities, there is definitely a chance she can live for many more years. I will say that Widget was extremely sick when diagnosed and still is doing well, so getting diagnosed early can improve your birds chances. Atherosclerosis won’t suddenly worsen but there are other related things like strokes, aneurysms, etc. But you will drive yourself mad wondering at all of the possibilities that likely will never occur. I know from experience, and IMO birds pick up on our stress. Focus on treasuring your time with Pepper as much as possible.

Has isoxuprine helped?

Isoxsuprine was the first medicine Widget tried. It did help slightly but not a huge improvement. Adding benazepril with isoxsuprine is what really helped him. Some birds do well on just Isoxsuprine.

Also, how expensive is it to treat and monitor atherosclerosis? What were the costs for caring for atherosclerosis in birds? What procedures and tests were needed and how expensive were they? Were there more appointments than 2x/year for checkups (excluding unrelated emergencies like injuries)?

I can only speak from personal experience, but for Widget, it was a big chunk upfront but not much for ongoing treatments. His medicine is about $200 every 3 months, but he takes 4 different ones. I order from WedgeWood pharmacy. They give you a good amount of medicine (15mL) and it doesn’t need to be refrigerated. I also paid for some things that weren’t “necessary” like an echocardiogram (I regret putting him through this) and an oxygen machine (didn’t help him). The necessary test to diagnose was an x-ray. He hasn’t needed them since, except for an unrelated issue. Bloodwork can also be a good thing every year or every other year, but I no longer get bloodwork for Widget since it’s too much stress for him. He hasn’t had any kind of procedure. I only do a check up 1x a year, again just due to the stress it causes him. Widget has been lucky (relatively speaking) and hasn’t had any unexpected things related to the disease pop up.

How do you pay for emergencies? Would it be better to do pet insurance (though at this point she would be considered as having a preexisting condition) or add to a savings account every paycheck? There is even a vet care credit card advertised on my vet's website (CareCredit) and payment plan options.

I can’t really comment on this. I don’t know a lot about pet insurance and have never used CareCredit. Saving money is good, but I don’t know how it would compare to insurance. Definitely check with your vet about the payment plans. Better to know in advance what your options are for that.

 

[aurelius]

Who else has experienced this?

My cockatiel Widget was diagnosed with atherosclerosis in August 2020. He’s currently sitting next to me whistling

How else can I help treat and prevent this? What can I do for Pepper?

Different things and different medications work for different birds. For example, the bird mentioned above who lived with this for 20+ years took Sildenafil which helped her a lot. Widget tried the same medicine and it had no effect.

He’s currently on:
Benazepril
Isoxsuprine
Pentoxifylline
Theophylline

You might want to ask your vet about ACE inhibitors, whether it be Benazepril or a different med.

Some other treatments/supplements you can try:

• Garlic/garlic oil
• Red palm oil
• Oxygen therapy (there’s a thread about this somewhere- oxygen machines can be pricy but might be worth it. It didn’t help Widget because he used all his time in the tub to run around playing lol)
• Omega 3’s which you already mentioned
• Reduce stress however possible for your bird
• Encourage exercise (your vet can tell you what a safe amount is for your bird)

What is her outlook? With proper treatment, can she live just as long? Is there any real threat of sudden decline?

It’s impossible to say for sure since each bird is different, but as far as possibilities, there is definitely a chance she can live for many more years. I will say that Widget was extremely sick when diagnosed and still is doing well, so getting diagnosed early can improve your birds chances. Atherosclerosis won’t suddenly worsen but there are other related things like strokes, aneurysms, etc. But you will drive yourself mad wondering at all of the possibilities that likely will never occur. I know from experience, and IMO birds pick up on our stress. Focus on treasuring your time with Pepper as much as possible.

Has isoxuprine helped?

Isoxsuprine was the first medicine Widget tried. It did help slightly but not a huge improvement. Adding benazepril with isoxsuprine is what really helped him. Some birds do well on just Isoxsuprine.

Also, how expensive is it to treat and monitor atherosclerosis? What were the costs for caring for atherosclerosis in birds? What procedures and tests were needed and how expensive were they? Were there more appointments than 2x/year for checkups (excluding unrelated emergencies like injuries)?

I can only speak from personal experience, but for Widget, it was a big chunk upfront but not much for ongoing treatments. His medicine is about $200 every 3 months, but he takes 4 different ones. I order from WedgeWood pharmacy. They give you a good amount of medicine (15mL) and it doesn’t need to be refrigerated. I also paid for some things that weren’t “necessary” like an echocardiogram (I regret putting him through this) and an oxygen machine (didn’t help him). The necessary test to diagnose was an x-ray. He hasn’t needed them since, except for an unrelated issue. Bloodwork can also be a good thing every year or every other year, but I no longer get bloodwork for Widget since it’s too much stress for him. He hasn’t had any kind of procedure. I only do a check up 1x a year, again just due to the stress it causes him. Widget has been lucky (relatively speaking) and hasn’t had any unexpected things related to the disease pop up.

How do you pay for emergencies? Would it be better to do pet insurance (though at this point she would be considered as having a preexisting condition) or add to a savings account every paycheck? There is even a vet care credit card advertised on my vet's website (CareCredit) and payment plan options.

I can’t really comment on this. I don’t know a lot about pet insurance and have never used CareCredit. Saving money is good, but I don’t know how it would compare to insurance. Definitely check with your vet about the payment plans. Better to know in advance what your options are for that.

Thank you SO much! This is so helpful. I'm very glad to know that Widget hasn't needed much extensive care once he found the right medication. I was definitely worried about the cost as well, so it's very helpful to know your experience with it - yearly vet appointments at minimum are a given and bloodwork isn't too much extra so it should be fine. I've been so worried but it sounds like I have little need to as long as she gets her medications and check ups!! Thank you again so much. And I'm so relieved to hear that Widget has been doing well very cute name.