Heavy Metal Poisoning (Zinc) - sad update #28

[HRM]

Hi Everyone,
I recently discovered this forum and was wondering if I could get any help/advice/information.
Kiwi, my 12-year old parrotlet, ate a piece of metal. I attached a copy of her x-ray, which was taken early April.
I am not quite sure what she ate but it looks like she ate one piece vs. small doses of zinc.
Kiwi's avian vet put her on DMSA, to treat her her for the zinc toxicity, and we have been giving twice a day since April.
Our second visit to the vet showed that the metal did not shrink or move.
We took her to the vet last weekend because she wasn't showing any signs of improvement. From what I read, on this forum, she was showing neurological damages - sudden inability to walk and losing balance.
I think that we were not administering the medication properly since Kiwi was spitting a great chunk of it out. The vet didn't show us how to properly administer the medication "due to Covid". The clinic here were not allowing us in the examination room and would providing consultation over the phone. During our last visit, I insisted that we be showed the proper way to administer the medication.
The vet suggested to keep giving the DMSA for another two weeks before deciding on whether to perform surgery. I don't think Kiwi will make it through a surgery because she is very weak and, also, due to her small size.
Kiwi looks very tired and sleeps almost all the time. She still has an appetite but eats with her eyes closed.
I tried peanut butter and oyster shells. I tried olive oil but the vet said it was dangerous to give her olive oil since it can go into her lungs and instantly kill her.
I don't really know what else to do. My inability to help her is breaking my heart.
Any help/advice/information is greatly appreciated.
Kiwi and I thank you all in advance

 

[flyzipper]

Welcome to the forum, sorry it's not under better circumstances.

Here's a thread from another individual who went through something similar; it might have some insights...

Urgent - Heavy Metal Poisoning - Please help!

Hello all thank you for reading and responding to my post. It is truly appreciated. Unfortunately two days ago my little baby Lovebird, kiwi, was feeling sick and we quickly realized it was heavy Metal Poisoning. Fortunately we brought him to the vet immediately after we recognized his symptoms...

forums.avianavenue.com

@Hankmacaw any advice based on your experience with heavy metal toxicity?
@Zara any advice about surgery as it relates to small birds?

 

[Zara]

@Zara any advice about surgery as it relates to small birds?

Sorry, none of my birds have had surgery or x-rays. I paid for an on the spot surgery for a young dove with a hole in it´s crop, that was a great success.
Also had an x-ray done for a quaker after a cat attack, the bird was fine for the x-ray but the surgery couldn´t be performed due to declining health.

I have read people feed natural peanut butter to help remove small foreign objects... I wonder if you could ask your vet if that would help?

 

[Mizzely]

Here's my thought.. if the things you are doing aren't helping and her health is declining, then avoiding surgery is just delaying the inevitable. How does your vet feel about the odds of the surgery being successful?

 

[HRM]

Good morning Everyone,
Thank you all for your inputs!! I truly appreciate it.
The vet does not want to do surgery, she thinks the procedure will be very risky.
We are trying to give her all natural, organic and sugar free peanut butter. She spits most of it out and insults us. She liked almond butter and I read that it could also help, so I am giving her that too. Is it to much fat for her liver?
The thing is, I feel like the process of getting accurate and conclusive test results were long and, as a result, her symptoms worsened. The first avian vet even suggested Kiwi has cancer, without performing any tests, and prescribed a bunch of medications. I questioned her since I felt she shouldn't be prescribing any medication to treat cancer and looked for another avian vet.
Also, I am not sure if it really is zinc vs. lead. The vet said it was zinc due to the coloring of the metal but some websites associate her neurological symptoms to lead poisoning. She also lost a lot of feathers from her head and wings. We can see her skin . I think the treatment for zinc and lead is the same.
She is a bit more chirpy this morning . I am trying as much as possible to make sure she takes her medication and now she hates and insults me whenever I walk by her . She also runs and cuddles with my husband, who refuses to administer the meds. I'll keep trying and, hopefully, it's going to be one of those miracles .
Thank you all!! I am very grateful

 

[Hankmacaw]

She has a large chunk of metal in her, from the xrays and that needs to come out or be chelated out. Almond butter is much, much better than peanut butter. Almond butter has much less saturated fats in it - be sure you buy the kind with no sugar and no salt. No peanut butter. She needs both DMSA and almond butter.

Isn't Kiwi being given a chelating agent;

Treatment:

1. Calcium EDTA – Calcium disodium salt of ethylene diaminetetraacetic acid. ...
2. D- penicillamine – This medication, given orally, can be combined with CaEDTA in hospital. ...
3. DMSA – Meso 2,3 – dimercaptosuccinic acid is an oral chelating agent that is very effective in treating both lead and zinc toxicity.

Diagnosing and Treating Heavy Metal Toxicosis in Birds ...
https://www.mspca.org › angell_services › metal-toxico...

She must have good nursing care and that is up to you. She may need to be hand fed (keep track of her weight every morning). She may need to go to the Dr. for hydration. Keep her warm. Keep her quiet. It is common to give a chelation agent for a few weeks the to give a weeks rest from it and then do the treatment again. This round of treatments may need to be repeated several times over several months.

 

[BirbBrain]

Oh no! I hope Kiwi is okay. I think that you should do surgery if it is the last thing you can do, for now just use almond butter.

 

[HRM]

Yes, we have been giving her DMSA, twice a day, since April. We are also giving her almond butter and oyster shells.
When we took her to the vet on the weekend, she treated Kiwi for dehydration and gave us vitamins to give once a week.
I'll ask the vet about the other two elements that you mentioned .
The vet said that she would follow-up with us, by phone, in two weeks. I am thinking it might be to long of a wait and maybe should go again this weekend?

She sits on our computers, while we work, on the part that emits heat. I'm really happy to be able to work from home so I can monitor her.

Thank you so much!!

 

[flyzipper]

I am trying as much as possible to make sure she takes her medication and now she hates and insults me whenever I walk by her . She also runs and cuddles with my husband, who refuses to administer the meds.

It's difficult, but sometimes we have to be the "bad guy" and do what's best for them, and it's also good that Kiwi still has your husband as a safe place to get comfort. Personally, I would keep this separation of duties so all of Kiwi's needs are met (medical and social). There will be time for you to regain her affection when she's fully recovered.

The vet said that she would follow-up with us, by phone, in two weeks. I am thinking it might be to long of a wait and maybe should go again this weekend?

It sounds like your current vet has accurately diagnosed the problem, and has provided a viable treatment for recovery. It might give you additional piece of mind to visit the vet again, but that should be balanced against the additional stress it might cause Kiwi. Consider that it may be best to stay on the treatment path you're on, and limit Kiwi's stress as much as possible to support her recovery.

 

[Hankmacaw]

@HRM Can you provide a reference for the use of oysters shells as a treatment for Heavy Metal Toxicity. I cannot seem to find any authoritative reference.

 

[HRM]

It was her vet that recommended oyster shells. She said its given to birds who are having trouble laying eggs and it might help with the metal as well.
We are giving her the Hari oyster shells for birds, which we purchased from the animal hospital.
We are also checking her stable and it has increased since two months ago .
Taking her to the vet does stress her out a lot so you might have a point in waiting.
Thank you

 

[jmfleish]

Here's the problem with what is going on with your baby, she has a chunk of metal stuck in her. All the chelation in the world will not help her get rid of this. Chelation is a way to remove heavy metal from the blood stream and the bones. It will do absolutely nothing to remove an actual piece of metal. You are not dealing with lead. If it was lead, your bird would be dead within 24 to 48 hours. If your bird tested positive for zinc, the chance that the metal is the problem. You need to keep up with anything sticky to try and get it to move through her body, that is why you are feeding the nut butters. Please do not feed anything that is sugar free, you run the chance of poisoning her. I would try to get anything sticky in her that is all natural. At this point, you don't care what the fat content is, you do care what the sugar content is and you care if it's pasteurized. Give her whatever she will eat. If it's peanut butter, go with the peanut butter. If it's almond butter, go with almond butter, just try to go with something that has a minimal ingredient list. It's the sticky that you want because you want it to adhere to the metal piece and move it through the digestive tract. The chelation itself is just going to remove the metal in her bloodstream and bones that has leached from the piece of metal and that medication itself will make her sick. It's hard on her body. Keep getting x-rays to see if the metal piece is moving at all. If it isn't, surgery may be your only option.

 

[HRM]

I thought DMSA would slowly break down the metal, which is what the vet told us. Kiwi has more energy today, which is good. She gets very happy when we take her out on our balcony and starts tweeting and bathing ... hopefully properly administering the medication is helping
Thank you Everyone!!

 

[jmfleish]

I thought DMSA would slowly break down the metal, which is what the vet told us. Kiwi has more energy today, which is good. She gets very happy when we take her out on our balcony and starts tweeting and bathing ... hopefully properly administering the medication is helping
Thank you Everyone!!

No, it will not break down the zinc metal piece...it will bind to the zinc that has leached into the blood and bones and slowly remove it. The metal piece needs to pass or be removed surgically.

 

[Hankmacaw]

It appears that DMSA removes only the serum or blood carried zinc molecules. I thought this was interestinf and might give you some information.

"Source removal: To prevent further toxicosis, the source of the heavy metal needs to be removed and/or the patient needs to be prevented from chewing the source.6 If metal objects need to be removed, surgical procedures are indicated, but typically the need is not urgent if the bird improves after chelation therapy.1,3,4 Objects can be removed endoscopically (FIGURE 5), surgically, or with gastric lavage.

For gastrointestinal evacuation you can use bulk diets, lubricants, and/or cathartics (e.g., lactulose, mineral oil, barium sulfate, magnesium sulfate, or psyllium). Psyllium or other oral cellulose products (e.g., sodium sulfate) can be used at 125 to 250 mg/kg.4 Lubricants do not work well in waterfowl. For zinc-coated objects, a neodymium-ferro-boron alloy magnet attached to enteral tube can be used for removal.4"

Lead and Zinc Toxicity in Birds

Lead and zinc are the most commonly reported of avian toxicoses in both captive and free-ranging birds.

todaysveterinarypractice.com

 

[jmfleish]

It appears that DMSA removes only the serum or blood carried zinc molecules. I thought this was interestinf and might give you some information.

"Source removal: To prevent further toxicosis, the source of the heavy metal needs to be removed and/or the patient needs to be prevented from chewing the source.6 If metal objects need to be removed, surgical procedures are indicated, but typically the need is not urgent if the bird improves after chelation therapy.1,3,4 Objects can be removed endoscopically (FIGURE 5), surgically, or with gastric lavage.

For gastrointestinal evacuation you can use bulk diets, lubricants, and/or cathartics (e.g., lactulose, mineral oil, barium sulfate, magnesium sulfate, or psyllium). Psyllium or other oral cellulose products (e.g., sodium sulfate) can be used at 125 to 250 mg/kg.4 Lubricants do not work well in waterfowl. For zinc-coated objects, a neodymium-ferro-boron alloy magnet attached to enteral tube can be used for removal.4"

Lead and Zinc Toxicity in Birds

Lead and zinc are the most commonly reported of avian toxicoses in both captive and free-ranging birds.

todaysveterinarypractice.com

Yes, the heavy metal tends to accumulate in the tissue, bones, and organs and chelation is what slowly removes it. It won't break down any actual metal pieces in the body which would need to be removed or passed to stop the leaching of the heavy metal in the body. There's no way to tell for sure that the metal seen on the radiograph is truly the source of the zinc but it's probably a pretty good indication. I didn't even think of trying to remove it endoscopically. That's definitely a choice if it can't be flushed out naturally, depending on where it's located. If it were my bird, I would definitely want to get it out one way or another. Chelation is a pain as well because after a course of treatment, you will see the numbers go down but after about a month, you will see them go up again and you will have to chelate again. It's a slow process and can take several courses.

 

[HRM]

Hi Everyone,
I hope you're all doing great!
I wanted your input on giving EDTA calcique injections twice daily. The metal in Kiwi's stomach is now slightly smaller and the vet suggested we switch to injections since she believes her body isn't responding to the oral DMSA. She developed an infection and was vomiting a lot a few nights ago. Her stool was also black and the vet thought it could be blood. I think we treated the blood since her stool is back to looking normal and we are currently treating the infection. We also learned, with the help of the vet technicians, how to do the injections ourselves. We have been doing the injections for five days and the process is emotionally difficult. The vet suggested to keep going for a month. We are having doubts as to whether Kiwi's tiny body can handle being poked twice a day for a month. I wanted to see if anyone had any experience or input.
Thank you all

 

[MR. Mango]

I don’t have any experience with heavy metal poisoning but I know that this has had success in removing other toxins in the stomach, have you tried offering soaked chia seeds? Btw sorry if this is something that doesn’t have any effect in this situation

 

[HRM]

I haven't tried chia seeds but I think I should!! I tried metamucil and I think it helps a little. I'll definitely try giving her some chia seeds tomorrow
Thank you

 

[BirdG1rl]

Hope your baby will be okay! Sending love to you and your fid!