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Urgent Foot, Yuzu is not putting ANY weight on it.

Deerhall

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Hello!
I'm new to the forum but hope I can get support anyway...

Yuzu's a ~6 month old tiel (pretty sure female) that has been diagnosed with fatty liver.
She's having a 99% pellet diet since all seeds have been forbidden and vegetables are not acceptable.
She gets some milkthistle seeds that I pre-crack since she doesn't crack them herself and barely taste.

Since she requires a lot of resting and sits on her different perches mostly, she has gotten problems with her feet.
I don't know what happened or what's wrong, but I contacted my VET which said 'it's probably from all her resting, we should start discussing QOL and maybe put her down'.
Neither me or my GF want's to give up on her yet, even though we have accepted the risk of losing her.
The VET was contacted a few days after the first images was taken.

Here's a video of the foot's current state.
(458) YUZU's swollen foot - YouTube

The state the foot is currently in she's not putting ANY weight on it and limps around when eating / drinking.
Most surfaces she's walking on has been dressed in cloth to soften and widen the area of contact.

Yuzu - 13 May.png
Yuzu - 4 June.png
 

Tiel Feathers

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That looks like it might be gout or the beginning of bumble foot. What type of perches does she have? I would make sure everything is all soft, and it’s good you padded her perches. Milk thistle in the form of drops would be more effective in helping with liver issues, just make sure there is no alcohol added. 6 months is awfully young for fatty liver. How did the vet diagnose her? You could look into getting a second opinion.
 

Peachfaced

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Was this an avian vet? I'm also wondering how they came to that diagnoses -- was your bird seen in person? Bumblefoot is treatable if you catch it early, and it certainly sounds like you've been diligent about her care.

There's nothing wrong with a pellet diet, so long as she's eating it consistently. I'd still continue to offer her sprouts and veggies as well. You may have to offer veggies in different ways (cooked, steamed, mashed, or chopped very fine, for example), or pretend to eat it to coax her in to trying it for herself.
 

Deerhall

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That looks like it might be gout or the beginning of bumble foot. What type of perches does she have? I would make sure everything is all soft, and it’s good you padded her perches. Milk thistle in the form of drops would be more effective in helping with liver issues, just make sure there is no alcohol added. 6 months is awfully young for fatty liver. How did the vet diagnose her? You could look into getting a second opinion.
She have had multiple sandpaper ones but now they are all covered up in cloth (except a small one). She has a tree to climb in that she doesn't use with her sore foot. Yesterday she stopped sleeping/standing on one foot and laid down on the perch instead. I have milk thistle in drop form (alcohol free) that I add to their water but I'm not too sure about dosage (3-4 drops in 1 litre?).

I will try to get in contact with my vet again after the weekend to get some antibiotics prescribed if possible, last time I talked to her she wasn't very keen on helping. Their best bird vet will call me on Monday...

I have 3 documented weights of Yuzu:

210409 - 106g
210427 - 110g
210603 - 101g

X-ray images:



\----- 3'd party review of xray ---

The most obvious thing about Yuzu is that the liver silhouette is greatly widened on the v / d image and there is no triangular air space between the lung field and the intestinal package on the lateral image. I guess Yuzu is a female because she is too

has patchy densified bone structure in both femurs, indicating estrogen supplementation.

I dare not say for sure if it is the liver that is enlarged. It could also be the ovary and

the fallopian tube that presses. Or a combination. Constant estrogen replenishment is common on nymph parakeet females and it can cause a sharp and abnormal enlargement of the ovary and fallopian tubes.

If it is the urates in the stool that are yellow, it is a strong indicator of liver disease, which is true consistent with a presumed liver enlargement.

\---

\----- Mail from Vet after sending images of feet -----

She is probably sitting more because of the chronic liver problem, and has now got sores because of this. If she does not get better at supportive treatment with milk thistle seeds, we need to talk about quality of life and further steps for Yuzy, as she has probably come to you with existing problems.

\---

Was this an avian vet? I'm also wondering how they came to that diagnoses -- was your bird seen in person? Bumblefoot is treatable if you catch it early, and it certainly sounds like you've been diligent about her care.

There's nothing wrong with a pellet diet, so long as she's eating it consistently. I'd still continue to offer her sprouts and veggies as well. You may have to offer veggies in different ways (cooked, steamed, mashed, or chopped very fine, for example), or pretend to eat it to coax her in to trying it for herself.
They have not put any diagnose on the feet. I'll try to find something she wants. She did like sprouts for a while but stopped eating then when she wasn't allowed to eat seeds anymore.
 

sunnysmom

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Definitely no sand perches. Can you do some natural wood or rope perches? So did your vet diagnosis fatty liver disease? She seems really young to have that. Milk thistle is helpful for that. Is she actually eating the pellets? You can try giving her some cooked grains- like quinoa and can add some chopped vegetables to that. Also maybe some mashed cook sweet potato.

@Hankmacaw
 

Hankmacaw

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Deerhall

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Definitely no sand perches.
Can you do some natural wood or rope perches?
So did your vet diagnosis fatty liver disease? She seems really young to have that. Milk thistle is helpful for that.
Is she actually eating the pellets?
You can try giving her some cooked grains- like quinoa and can add some chopped vegetables to that. Also maybe some mashed cook sweet potato.

@Hankmacaw
She's not sitting any any sand perches for the last 3 weeks.
She has a rope perch that she find uncomfortable, she prefers only the cloth perches I've made (by wrapping thick shirts or hats). She do have natural wood perches she no longer can stand on.
The Vet has not established a diagnosis, it's simply what they think is wrong after the mentioned xray and her yellow poops.
She eats pellets like crazy. Doesn't eat milk thistle seeds in seed form so I crush them and mix with crushed pellets so she gets SOME (+ we add drops to water).

Today she basically doesn't want to put any weight on the foot, I tried bathing the foot in epsom salt solution yesterday but she didn't like it and only lasted 3 - 5 minutes (she dislikes water any other way than drinking it).
 

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Has the vet prescribed medication?
 

Deerhall

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Has the vet prescribed medication?
I asked to talk to their bird specialist, we talked for about 10 minutes and by his judgement we should put her down. Apparently they are not sure what kind of liver disease but probably fatty liver. The vet said he would not prescribe any medication of the risk of increasing resistant bacteria, since he's had some similar cases ending up not making it. He said the problem with the feet is a sign of weak immune system and that she's too weak to get healthy. The vet also said that if we don't want to put her down ourselves they could do it for us. :depressed:

Also just got mail that the insurance company will not stand for any bills regarding the liver issue since the vet wrote in the journal that she probably had the liver problem since birth. So now, as a student, I also have $600 medical bills stacking up.:depressed:
 

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That sounds like a very poor vet. I've never heard of a vet telling a person to put their bird down because it has fatty liver disease. Fatty liver disease is controllable with medications and the correct diet. Meantime if your vet doesn't want to treat the bumblefoot you can do it yourself. Get a second opinion now.
 

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Wow, awful vet. My macaw spent over a decade being neglected by previous owners with his mouth/beak/nares rotting from the inside out. He was in seriously bad shape, and even still he was treated. He’s just now starting to show improvement.

Your little ones condition is serious, but no where near where I’d even begin to start thinking of euthanizing. I’ve not heard of either bumble foot or gout ever being considered worthy of that, even as secondary infections to something else. That just happens sometimes and can be treated appropriately. I find it very odd this vet is so eager to call it quits.

There are also effective meds that can be given to ease pain and inflammation, despite potential liver issues. The fact those weren’t even offered would make me look for a new vet.
 

Deerhall

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Is there any possibility you can get a second opinion?
I hoped this guy (who is their bird specialist) would give me the second opinion.
I asked if he couldn't just prescribe some antibiotics for the foot and let me try treating her, cold no for an answer.

That sounds like a very poor vet. I've never heard of a vet telling a person to put their bird down because it has fatty liver disease. Fatty liver disease is controllable with medications and the correct diet. Meantime if your vet doesn't want to treat the bumblefoot you can do it yourself. Get a second opinion now.
The 'second opinion vet' referred to it as "the chronic liver disease". We've fed her only pellets and milk thistle as per first doctors orders. I saw a video on YT where treating bumblefoot in chicken meant 'soak in water', 'cut and pull out scab', 'antibacterial gel and wrap foot'. Problem is I've tried wrapping her 'healthy' foot since she's starting to get wear it down (she has 2 small wounds now) but she instantly tried to tear it off for an hour straight so I removed it.

She is no longer standing on the healthy foot, instead she's laying down on her chest on her cloth perches.

IMG_20210611_155900.jpg IMG_20210611_155920.jpg

Wow, awful vet. My macaw spent over a decade being neglected by previous owners with his mouth/beak/nares rotting from the inside out. He was in seriously bad shape, and even still he was treated. He’s just now starting to show improvement.

Your little ones condition is serious, but no where near where I’d even begin to start thinking of euthanizing. I’ve not heard of either bumble foot or gout ever being considered worthy of that, even as secondary infections to something else. That just happens sometimes and can be treated appropriately. I find it very odd this vet is so eager to call it quits.

There are also effective meds that can be given to ease pain and inflammation, despite potential liver issues. The fact those weren’t even offered would make me look for a new vet.
Problem is this vet is the only one that I have available. There's about 6 vets in my county, no other accept birds. The closest one except the current one is +6h drive and I don't have the money for more vet bills or means of transportation (since the insurance company declined any compensation related to the liver or gastronomic issues). :depressed:
Yuzu is still eating and fly around occasionally so I will have to try treating her myself. Problem is the vet (that wants to put her down) didn't want / have time to discuss how I would go about treating her and from what I read online she needs medications not available in Sweden. I have given her 2-3 epsom salt baths for the feet but haven't tried poking at the infected area too much. She doesn't like hands or to be held down, fortunately she doesn't bite to kill like our other bird can do (she has strong jaws when breaking pellets).
 

sunnysmom

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I hoped this guy (who is their bird specialist) would give me the second opinion.
I asked if he couldn't just prescribe some antibiotics for the foot and let me try treating her, cold no for an answer.


The 'second opinion vet' referred to it as "the chronic liver disease". We've fed her only pellets and milk thistle as per first doctors orders. I saw a video on YT where treating bumblefoot in chicken meant 'soak in water', 'cut and pull out scab', 'antibacterial gel and wrap foot'. Problem is I've tried wrapping her 'healthy' foot since she's starting to get wear it down (she has 2 small wounds now) but she instantly tried to tear it off for an hour straight so I removed it.

She is no longer standing on the healthy foot, instead she's laying down on her chest on her cloth perches.

View attachment 385688 View attachment 385689



Problem is this vet is the only one that I have available. There's about 6 vets in my county, no other accept birds. The closest one except the current one is +6h drive and I don't have the money for more vet bills or means of transportation (since the insurance company declined any compensation related to the liver or gastronomic issues). :depressed:
Yuzu is still eating and fly around occasionally so I will have to try treating her myself. Problem is the vet (that wants to put her down) didn't want / have time to discuss how I would go about treating her and from what I read online she needs medications not available in Sweden. I have given her 2-3 epsom salt baths for the feet but haven't tried poking at the infected area too much. She doesn't like hands or to be held down, fortunately she doesn't bite to kill like our other bird can do (she has strong jaws when breaking pellets).
Can you do an online vet consult? Since Covid, there seem to be a lot of online places now. I haven't tried them but it might be worth doing.
 

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@Deerhall
Here is an excerpt from Dr. Wissmans paper on hepatic lipidosis. She is a highly respected vet. I advise that you read the whole article, but below is the portion that applies to treatment. I just wanted to mention that depending on what country you live in, many drugs and medications that are not available to us in the US without a prescription may be available to you over the counter. Check it out.

Keep soaking your baby's feet in Epson's salt and the scabs will eventually fall off. Get a tube of triple antibiotic - such as one of these; https://smile.amazon.com/sk=triple+...antibiotic,aps,233&ref=nb_sb_ss_ts-doa-p_1_17

Keep her perches immaculately clean. and disinfected (bumblefoot is an infection). Replace any rods used for perches with natural branches and wrap with vet wrap; https://smile.amazon.com/Self-Adher...jbGlja1JlZGlyZWN0JmRvTm90TG9nQ2xpY2s9dHJ1ZQ==

"So what can be done to treat a bird with hepatic lipidosis? First, with the help of your avian veterinarian, the bird should be put on a diet and exercise program. It is very important that a bird with hepatic lipidosis be placed on a lower fat diet to minimize impact to the liver. Your veterinarian will tailor a diet plan specifically for your bird. High quality pellets that are low in fat and perhaps lower in protein are an excellent base for birds with fatty liver problems.

If your bird is a die-hard seed eater, it will need to be switched over to a pelleted diet, but in some cases, this is easier said than done. Some birds may be persuaded to start consuming sprouted seed, instead of dry seed. The process of sprouting uses the fat stored in the seed to start the growing process. So, sprouted seed will be lower in fat. Also, the texture will be different, more vegetable-like, so this may encourage a bird to begin consuming some veggies. There are seed-sprouting kits available, or if you choose, you may sprout fresh seed mix yourself. Information is available from many sources. The bird should not be offered any peanuts or food items that could possibly contain any mycotoxins that could further damage the liver.

Any infectious or metabolic problems identified should be treated, taking into consideration that many medications are removed or changed by the liver, so dosages may need to be adjusted.

A bird that is having problems with excessive bleeding may benefit from the administration of vitamin K. I always recommend that the owner of a bird with bleeding tendencies have on hand a type of clotting gel or liquid to be used in an emergency bleeding situation. Ask your avian vet what product would be best for your bird.

Nutritional supplements are often helpful, especially those that are known to support liver function. Biotin and choline (B vitamins) are important and may be supplemented. Methionine is an amino acid that is important in transporting fats from cells. This amino acid is not available from plant sources, but is found in eggs, fish, meat and milk. I do not recommend offering any milk products containing lactose, as birds cannot digest this sugar; however, lactose is almost entirely removed in the process of the manufacturing of cheese, cottage cheese and yogurt, so these products are safe to offer to your bird. If you have any questions, discuss your bird's diet with your avian veterinarian.

Milk thistle is very good support for a damaged liver. Your avian veterinarian will decide if this is an appropriate therapeutic for your bird. Make sure that any milk thistle supplement does not contain ethyl alcohol as a base, as that can potentially intoxicate a small bird and alcohol can also further damage the liver. Another nutritional supplement is dimethylglycine (DMG), which is an antioxidant. DMG is also a very good supplement for birds with liver damage, and I put all hepatic lipidosis birds on this nutrient. Other nutritional supplements, such as aloe or dandelion, may also be helpful. Other amino acids, rare essential micronutrients and probiotics are also all beneficial to the recovering bird.

It is important to set up an exercise program for a bird suffering from hepatic lipidosis. Your avian veterinarian will help you put together an exercise routine that will be safe for your bird. In all cases, when dealing with a sedentary bird, the exercises will need to begin slowly and progress gradually in intensity. Wing flapping exercises, ladder-climbing exercises and walking are safe; however the bird should be monitored closely to ensure that it is not becoming over-exerted at any time or injuring itself."

With diligent care, veterinary supervision, exercise, correct nutritional support and appropriate medications, it is possible to reverse the affects of hepatic lipidosis, but some permanent liver damage may occur. The liver does have a remarkable ability to heal itself and reverse damage, but once liver tissue has been destroyed and all that remains is fibrous connective tissue (scar tissue) that portion of the liver will be gone for good. So, the sooner that hepatic lipidosis is diagnosed, the better the prognosis for a return to good health and normal function. It is possible for a bird diagnosed with hepatic lipidosis that has been successfully treated to live a long, healthy life, as long as it doesn't return to its old ways that caused it to develop hepatic lipidosis in the first place.
 
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