Urgent Foot Mutilation/Lameness Green Cheeked Conure (sad update post #34)

[Elsibetz]

Hi All,

We have posted on this forum before, but we're now again reaching out for help as we're running out of ideas and are being desperate. Please advise if this should be posted elsewhere. Any help is very, very much appreciated as we're running out of ideas/time.

Please help: My husband and I love our little floof and we are out of ideas / cannot handle sleepless night watching our baby anymore. We have ruled out AG, a tumor seems unlikely given that nothing shows up on the xray, we were told Avian Herpesvirus doesn't present this way in conures, fungus/bacteria unlikely as there's no symptoms and normal white blood cell count, heavy metal toxicity unlikely, is currently being ruled out. What could this be? We simply don't understand as it comes and goes unpredictable: Apple seems perfectly healthy and fine for two months, suddenly he mutilates over night / goes lame in the other foot. In the past, after the mutilation, he just went back to normal for months at a time (hormones?). Thanks for any ideas/referrals/notes/observations. We need them badly. Details below

General Situation:

Our green-cheeked conure Apple (DNA sexed male) started mutilating his feet in July 2022. This would almost exclusively occur at night / right after waking up. We took him to 3 different vets since this event happened and got the following results:

In the first x-rays, the vets commented that they're seeing an enlargement of the gonad, couldn't pinpoint whether it was just enlarged from him being extremely hormonal the months leading up to this event, or if there could be a growth/tumor. The vets assumed that this enlargement was pressing on the sciatic nerve and would therefore cause a weird sensation in his feet - hence the mutilation on both feet. At that point, one of his feet also went lame for a couple minutes one day.

We changed up Apple's environment and made sure we wouldn't interact with him in any way that could stimulate his hormones further. We switched up his cage/toys/room and limited interaction to several hours a day as well as giving him enrichment to interact with. We followed up with treatment of three separate Lupron injections (as is indicated to control hormones / treat testicular cancer).The results confused us even more: Apple's hormones would generally seem to cool down after each injection, his behavior and mutilation did however not really correspond with the timing of the injections either. Another point worth mentioning is that he would regurgitate intensely at night and in the morning (on objects) -- the intensity of the regurgitation roughly corresponds with his hormone levels. We assumed it was a mix of the Lupron and our limited interaction with him.

Ever since then, he had his ups and down and mutilated every ~40 days. We decided to go with a hormone implant for a more permanent solution which seems to reduce his hormones and has him molting like crazy for the past two weeks. We were hopeful that we had finally found a way to address the issue as we went for about two months without mutilation -- until three days ago. Out of the blue (usually we see warning signs like irritated grooming during the day), Apple started mutilating again at night and gave himself two wounds on the left foot. Two days later, his right foot went lame for several minutes.

In our most recent Vet visit four days ago, we were told that there testicles do not look bigger, hence they do not suspect a mass. The vet gave an anti-inflammatory (Onsior) that is also used for AG (Avian Ganglioneuritis) which he assumed would help us get through this week until we get the results from heavy metal testing back (Jan 2nd), but it doesn't seem to help. Apple wakes up in the middle of the night and goes straight for his legs. If we don't interrupt him, he will chew bits off, specifically focused between the toes.

(I have read that lameness / toe mutilation can come from kidney issues, however there's nothing on the xray and his uric acid went down between first and second blood test in the summer. In the last visit, the vet mentioned that the pancreas was a little denser, but he said it could be nothing and that also didn't show up in the previous xrays.) We are confused.

Apple's Health:

In-between those frantic attacks on his feet, he appears perfectly healthy, has good/perfect poops, is active and alert, maintains stable weight since July (average of 79grams, muscular build).

1. Radiography shows increased volume in the gonad region
2. Blood Chemistry & CBC show no abnormalities except for slightly elevated uric acid consistent with testicular enlargement placing pressure on the kidney
3. Apple has been cleared for psittacosis and avian ganglioneuritis

He has wings clipped and is not roaming freely outside his cage without supervision. His cage/toys are all vetted. Therefore, we do not believe that the heavy metal test is going to come back positive. Will keep results posted here.

Medications: We have tried different anti-inflammatory medications / pain killers. None of them seemed to make any noticeable difference.

Xray from July 2022 (can provide later ones if necessary, but there is not much change/slightly smaller gonad according to vets



Mutilation:



Thank you All. We appreciate the help.

 

[April]

Oh that looks so painful poor sweet Apple. I'm so sorry that you and he are going through this. @webchirp do you have any ideas?

 

[Pixiebeak]

Im so sorry for you guys. Ouch Apple you poor sweet baby..he is really going after them.

You have been incredible in your dedication to him and seeking answers. You really have done everything and every work up and even seeking second opinions. It's beyond frustrating and scary to not be able to determine the cause, when you have done everything right. Again im so very sorry for him and you.

I've had behavior mutilation of feet in my rescue quaker Penny. When I rescued her her feet wer so bloody and she lost a toe tip. For her this must have been stress related to her horrible living conditions. I soaked her feet daily in warm dilute betadine. And her improved life with me put an end to this behavior.

Unfortunately that doesn't help you. As you are providing a wonderful life and care to Apple.

I had a foster who mutilated his whole body ...again due to unspeakable cruelty to him. But haloperdol helped him through this. While yours is not abused, I wonder if haloperdol would help?

I have no idea the reason for you. But things I can throw out , possibly a food allergy. If he is on pellets , it might be worth switching him to all fresh diet. Look at the ingredients listed on your pellets, it could be he has a rare sensitivity to any colors or primary ingredients like soy, peanut, wheat, or the added vitamin supplements or something....
It would take some effort and research in chop recipes and ways to get fats, carbs, protein, and rich sources of natural vitamins . But many ekkie owners are able to do this as some others also prefer this type of feeding. Using boiled egg, soaked and cooked legume, sprouts, leafy greens, sweet potatoes and such ( not a comprehensive list)

You have tried so much, if this was happening to me its something I would try with haloperdol if veterinarian thought appropriate.

Otherwise I just don't have any ideas. We have many knowledgeable members here, I hope they have ideas for you .

As well as the hope your veterinarians can find a cause.

I have so much empathy for you, and so much respect for the lengths you have gone to to try and help him. You are incredible and loving parronts! Apple is beautiful , outwardly looking so healthy with bright feathers and good weight.

 

[April]

@Peachfaced May have an idea as well since I know sometimes Rupert picks at his little feetsies as well.

 

[Tyrion]

 

[Peachfaced]

How old is Apple? What is his diet like?

Gosh, his little wounds do very much remind me of Rupert's. We have not pinpointed what his issue is, but one of the first things my vet team looked in to was allergies as well. But nothing has made sense. If he were allergic to certain foods or the dyes in his toys/perches, this would be a more prevalent issue, and not something that occurs in a more cyclic fashion, right? Rupert does not get any lameness in his feet.

Apple's mutiliating seem a bit more consistent than Rupert's. I keep a notepad on my phone, and jot down any pertinent info at the time. Sometimes they're closer together, and sometimes they're further apart. I'm pretty sure Rupert's problem has something to do with hormones, but I don't know what the trigger is.

So far, the only thing that's helped is putting on SSD cream (silver sulfadiazine cream 1%) twice daily, as soon as the first wound(s) appear. I make sure to pad his frequented surfaces, to prevent any agitation to his sores. But all the SSD does, is help the healing process.


I adopted Rupert in May 2017, and he was 3 years old at the time. He's 8 years old currently. Here are all of the start dates of his mutilation.

Day/Month/Year
9/16/2017
3/17/2018
11/25/2018
5/6/2019
6/16/2019
12/18/2019
3/2/2020
5/24/2020
11/26/2020
7/22/2021
9/26/2021
3/25/2022
6/24/2022
9/10/2022
12/2/2022 *This most recent one was a weird one. He only had one very small spot, and he never did any further chewing/mutilating. He let it scab over and it was uneventful.

Rupert's diet: Sprouts, fresh and steamed veggies, and Roudybush pellets daily. He does get a small amount of fruit a couple of times a week. I give him a couple of pieces of plain scrambled egg once or twice a month. Treats: Avicakes (original or tropical), millet, and sunflower seeds. The sunflowers are not my favorite, because they're fatty, but he will NOT accept safflower seeds, nor will he accept pre-hulled sunflower seeds (otherwise I'd break them up and give him little morsels instead). He also generally pooh-poohs most nuts, except for the rare nibble of a soaked almond.

 

[Elsibetz]

I had a foster who mutilated his whole body ...again due to unspeakable cruelty to him. But haloperdol helped him through this. While yours is not abused, I wonder if haloperdol would help?

I have no idea the reason for you. But things I can throw out , possibly a food allergy. If he is on pellets , it might be worth switching him to all fresh diet. Look at the ingredients listed on your pellets, it could be he has a rare sensitivity to any colors or primary ingredients like soy, peanut, wheat, or the added vitamin supplements or something....
It would take some effort and research in chop recipes and ways to get fats, carbs, protein, and rich sources of natural vitamins . But many ekkie owners are able to do this as some others also prefer this type of feeding. Using boiled egg, soaked and cooked legume, sprouts, leafy greens, sweet potatoes and such ( not a comprehensive list)

You have tried so much, if this was happening to me its something I would try with haloperdol if veterinarian thought appropriate.

Otherwise I just don't have any ideas. We have many knowledgeable members here, I hope they have ideas for you .

As well as the hope your veterinarians can find a cause.

I have so much empathy for you, and so much respect for the lengths you have gone to to try and help him. You are incredible and loving parronts! Apple is beautiful , outwardly looking so healthy with bright feathers and good weight.

Thank you so much for your response. It's nice to hear supporting words. He is 10 years old and has been on Harrison's Lifetime fine all his life (75%) with some pellet/nutriberries (10%) and occassional dried peas as a treat (5%). The remaining 10% is homemade chop that we consulted with a behaviorist to give him variety/less calory dense food and another foraging opportunity. (We used to give him seed mix every once in a while but we stopped that too.) So we've basically tried everything in terms of food.

We'll keep haloperdol in mind if this really doesn't get better, thanks again for your thoughts.

 

[Pixiebeak]

You really really have covered everything!
You and your vet team are dedicated. Apple is much loved. I hope something can help.
All my love

 

[Pixiebeak]

How old is Apple? What is his diet like?

Gosh, his little wounds do very much remind me of Rupert's. We have not pinpointed what his issue is, but one of the first things my vet team looked in to was allergies as well. But nothing has made sense. If he were allergic to certain foods or the dyes in his toys/perches, this would be a more prevalent issue, and not something that occurs in a more cyclic fashion, right? Rupert does not get any lameness in his feet.

Apple's mutiliating seem a bit more consistent than Rupert's. I keep a notepad on my phone, and jot down any pertinent info at the time. Sometimes they're closer together, and sometimes they're further apart. I'm pretty sure Rupert's problem has something to do with hormones, but I don't know what the trigger is.

So far, the only thing that's helped is putting on SSD cream (silver sulfadiazine cream 1%) twice daily, as soon as the first wound(s) appear. I make sure to pad his frequented surfaces, to prevent any agitation to his sores. But all the SSD does, is help the healing process.


I adopted Rupert in May 2017, and he was 3 years old at the time. He's 8 years old currently. Here are all of the start dates of his mutilation.

Day/Month/Year
9/16/2017
3/17/2018
11/25/2018
5/6/2019
6/16/2019
12/18/2019
3/2/2020
5/24/2020
11/26/2020
7/22/2021
9/26/2021
3/25/2022
6/24/2022
9/10/2022
12/2/2022 *This most recent one was a weird one. He only had one very small spot, and he never did any further chewing/mutilating. He let it scab over and it was uneventful.

Rupert's diet: Sprouts, fresh and steamed veggies, and Roudybush pellets daily. He does get a small amount of fruit a couple of times a week. I give him a couple of pieces of plain scrambled egg once or twice a month. Treats: Avicakes (original or tropical), millet, and sunflower seeds. The sunflowers are not my favorite, because they're fatty, but he will NOT accept safflower seeds, nor will he accept pre-hulled sunflower seeds (otherwise I'd break them up and give him little morsels instead). He also generally pooh-poohs most nuts, except for the rare nibble of a soaked almond.

Darn....I hadn't realized....whst is going on with these little one????

 

[Elsibetz]

How old is Apple? What is his diet like?

Gosh, his little wounds do very much remind me of Rupert's. We have not pinpointed what his issue is, but one of the first things my vet team looked in to was allergies as well. But nothing has made sense. If he were allergic to certain foods or the dyes in his toys/perches, this would be a more prevalent issue, and not something that occurs in a more cyclic fashion, right? Rupert does not get any lameness in his feet.

Apple's mutiliating seem a bit more consistent than Rupert's. I keep a notepad on my phone, and jot down any pertinent info at the time. Sometimes they're closer together, and sometimes they're further apart. I'm pretty sure Rupert's problem has something to do with hormones, but I don't know what the trigger is.

So far, the only thing that's helped is putting on SSD cream (silver sulfadiazine cream 1%) twice daily, as soon as the first wound(s) appear. I make sure to pad his frequented surfaces, to prevent any agitation to his sores. But all the SSD does, is help the healing process.


I adopted Rupert in May 2017, and he was 3 years old at the time. He's 8 years old currently. Here are all of the start dates of his mutilation.

Day/Month/Year
9/16/2017
3/17/2018
11/25/2018
5/6/2019
6/16/2019
12/18/2019
3/2/2020
5/24/2020
11/26/2020
7/22/2021
9/26/2021
3/25/2022
6/24/2022
9/10/2022
12/2/2022 *This most recent one was a weird one. He only had one very small spot, and he never did any further chewing/mutilating. He let it scab over and it was uneventful.

Rupert's diet: Sprouts, fresh and steamed veggies, and Roudybush pellets daily. He does get a small amount of fruit a couple of times a week. I give him a couple of pieces of plain scrambled egg once or twice a month. Treats: Avicakes (original or tropical), millet, and sunflower seeds. The sunflowers are not my favorite, because they're fatty, but he will NOT accept safflower seeds, nor will he accept pre-hulled sunflower seeds (otherwise I'd break them up and give him little morsels instead). He also generally pooh-poohs most nuts, except for the rare nibble of a soaked almond.

Thank you for your detailed response and I am very sorry to hear about Rupert but also a little hopeful that was Apple has might not be fatal. Apple is 10 years old and his diet consists of Harrison's Lifetime fine all his life (75%) with some pellet/nutriberries (10%) and occassional dried peas as a treat (5%). The remaining 10% are made up from homemade chop that we consulted with a behaviorist to give him variety/less calory dense food and another foraging opportunity. (We used to give him seed mix every once in a while but we stopped that too.) He never had issues before this event except for one bacterial infection that cleared up with antibiotics back in 2019, I believe.

He has been going through a very strong hormonal phase, so we thought that enlarged testicles could be the problem but it still wouldn't explain why he's currently molting and stopped regurgitating / displaying hormonal behaviors and the problem persists, or rather returns over night without warning from 0 to 100 intensity.

I am really fascinated by the fact that you kept such a detailed log of his mutilation. Did you spot any other patterns or anything that could trigger it? Did the vets have any other ideas/do any imaging or labs? I wonder if we should test for allergies. For now we're also treating his wounds, but we're just worried one of these nights he'll bleed too much if we're not watching.

 

[Peachfaced]

Darn....I hadn't realized....whst is going on with these little one????

We don't know. Though I do feel like it's been less severe than it has been in the past? Hard to tell.

 

[Peachfaced]

Thank you for your detailed response and I am very sorry to hear about Rupert but also a little hopeful that was Apple has might not be fatal. Apple is 10 years old and his diet consists of Harrison's Lifetime fine all his life (75%) with some pellet/nutriberries (10%) and occassional dried peas as a treat (5%). The remaining 10% are made up from homemade chop that we consulted with a behaviorist to give him variety/less calory dense food and another foraging opportunity. (We used to give him seed mix every once in a while but we stopped that too.) He never had issues before this event except for one bacterial infection that cleared up with antibiotics back in 2019, I believe.

He has been going through a very strong hormonal phase, so we thought that enlarged testicles could be the problem but it still wouldn't explain why he's currently molting and stopped regurgitating / displaying hormonal behaviors and the problem persists, or rather returns over night without warning from 0 to 100 intensity.

I am really fascinated by the fact that you kept such a detailed log of his mutilation. Did you spot any other patterns or anything that could trigger it? Did the vets have any other ideas/do any imaging or labs? I wonder if we should test for allergies. For now we're also treating his wounds, but we're just worried one of these nights he'll bleed too much if we're not watching.

His diet sounds pretty sound. I asked because sometimes warm, mushy food can trigger hormones. I'm glad to hear about the foraging - Rupert loves food and thankfully actively looks for foraging opportunities since we started doing them years ago.

We didn't have anything else to go on. His lab work was coming up inconclusive, and physically, he's in good shape. The vet is just as stumped as we are, so I wanted to see if a pattern emerged. His weight is very consistent at 69-70g. I figured it wouldn't hurt anything to keep a little diary of sorts. He is often in the midst of a molt/extra itchy from growing in pinfeathers, or hormonal (sometimes both) according to my notes. I really want to be able to get this data on a graph, but I haven't figured out how to do it. I thought it would be easy, but I must be doing something incorrectly.

I don't think it would be a bad idea to look further in to allergy testing.

 

[webchirp]

Giggie is very similar. She is currently maintaining on .2 ml paroxetine and between .02 - .05 gabapentin. When she has a flare up, we use hormone injections (swelling makes the feet feel odd and sildenaphil which increases blood flow). She also gets dolorex when she goes full blast…usually once a year. Tuck also mutilated and we lost him to gout. Sometimes all you can do is manage symptoms. I’m so sorry as it is such a stressful thing not being able to control it. You can also massage his tootsies with coconut oil.

 

[webchirp]

She will usually start picking her toes and then move up the legs and under the wings. I hammer her with meds when it cycles. She was high as a kite the one week a few years ago when it was really bad.
Past image

Current

 

[April]

She will usually start picking her toes and then move up the legs and under the wings. I hammer her with meds when it cycles. She was high as a kite the one week a few years ago when it was really bad.
Past image
View attachment 420266
Current
View attachment 420267

Aw baby girl you've gotta stop doing that to yourself.

 

[Peachfaced]

Oh gosh, poor baby girl. Rupert has not gone any further than than the "ankle", and usually it's more focused on the undersides of his toes.

 

[Elsibetz]

Giggie is very similar. She is currently maintaining on .2 ml paroxetine and between .02 - .05 gabapentin. When she has a flare up, we use hormone injections (swelling makes the feet feel odd and sildenaphil which increases blood flow). She also gets dolorex when she goes full blast…usually once a year. Tuck also mutilated and we lost him to gout. Sometimes all you can do is manage symptoms. I’m so sorry as it is such a stressful thing not being able to control it. You can also massage his tootsies with coconut oil.

Thanks for your response. How did they know it was gout? What were the symptoms? Is there a test for it?

 

[Elsibetz]

Oh gosh, poor baby girl. Rupert has not gone any further than than the "ankle", and usually it's more focused on the undersides of his toes.

Yeah that's what we've been observing too. I wonder if that indicates something, I wish our vet would do more diagnostics.

 

[webchirp]

Thanks for your response. How did they know it was gout? What were the symptoms? Is there a test for it?

When he died they did a necropsy and it was all throughout his major organs. He would just mutilate his feet and sometimes a leg or become super aggressive to other birds. He got an eye infection and we put him on meds on a Friday. The meds shut his kidneys down and I lost him that Monday.

 

[Elsibetz]

When he died they did a necropsy and it was all throughout his major organs. He would just mutilate his feet and sometimes a leg or become super aggressive to other birds. He got an eye infection and we put him on meds on a Friday. The meds shut his kidneys down and I lost him that Monday.

I am so sorry for your loss. Poor thing. Did his legs ever go lame?