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How much hope is there for birds with heart disease?

AGS

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Well he seems to be feeling a bit better at least. He was whistling for a while.
 

AGS

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Well we ended up waiting for his appointment and just got back. @Hankmacaw @enigma731 just wanted to update you guys.

His exam looked good except that she said he has a feather cyst near his tail that seems to be resolving itself. We also did bloodwork and x-rays. The bloodwork we have to wait a few days for. The x-rays showed some weird things. No visible problems with his heart (no enlargement, fluid build up, etc.). She said it’s possibly still atherosclerosis because it doesn’t always show up on x-rays. He has an enlarged spleen though. She said it’s possible it’s cancer but usually it’s even bigger when it’s cancer, so she thinks it’s most likely an infection. He has a bit of gram negative bacteria but probably not enough to cause that. But his lungs have a weird spot in them. I asked them to send me the x-rays so I’ll post them when they send them so you guys can see. She said it could be any lung problem (infection, asthma, etc.). But also that’s where a big vein (?) runs so it could be that too. It only shows up on the side view, front x-rays don’t show that spot. So I’m not sure what to think there.

She prescribed two medications. Meloxicam and Baytril. I wanted to ask about those. I know baytril can be problematic so if you guys have any suggestions I can always ask them for something else. It would be for the lung issue as well as the bacteria in his intestines.
 

enigma731

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Baytril is fine, I've used it lots and lots of times. It sounds like your vet is doing the right things and the bloodwork results should help. How is he acting?
 

AGS

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Here are the x-rays. On one I put an arrow pointing to the enlarged spleen and circled the weird spot on his lung/aorta. The vet thinks it might be his lung but here: Atherosclerosis | Arizona Exotics | Birds Resources you can see that’s also where the aorta is and apparently that’s one of the most common places for atherosclerosis to show up on x-rays. She wasn’t sure which it was, maybe one of you can see better.
F8CA7FA7-19DB-4267-8A1C-0D3281B70636.jpeg 8F63A1E5-7952-413F-91DD-ADA658C5729A.jpeg 060E07C2-B131-4FF8-B286-D119BD9698F3.jpeg
 

Hankmacaw

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Atherosclerosis is quite common in birds and the atherosclerosis combined with an infection or two could really make your poor baby feel bad. The only problem with Baytril is that it has a tendency to make some birds nauseous. You can minimize that by giving him some food before giving the medication. The Meloxicam is a NSAID, it is for pain and also is a very good inflammation reducer.
 

AGS

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Would you say it’s more likely that than a lung issue? I just don’t think it’s a coincidence that it’s in that exact spot. Is that an earlier sign or do you think it’s progressed a lot? At least it doesn’t seem like he has heart failure. I will talk to the vet again when she calls for the bloodwork.
 

AGS

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Also what does treatment look like for that? I know you’ve mentioned medications for Jasper but I don’t know which ones are for the heart failure and what’s just for the atherosclerosis. Sorry to ask so many questions. I’ll ask the vet too when she calls but if I call right now they will only let me talk to the receptionists.
 

Hankmacaw

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Atherosclerosis is associated with the heart in most cases. When the heart doesn't pump strongly enough the blood has a tendency to deposit plaque on the walls of the arteries. Excessive fats in the blood can also do this.

The spot in the lung could be an infection, a granuloma left over from a prior infection or a malignancy. I have no way of knowing.

The same medications used for the heart are used for atherosclerosis, Most of those medications relax the muscles in the walls of the arteries and allow blood to flow easier. Diet is a big issue with treating Athroscleriss and heart disease.
 

AGS

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Question about the medicine since you said eating beforehand is best for the baytril. The prescription says every 12 hours, but I don’t think that would be possible with food first. He goes to bed around 7pm and doesn’t want to stay up later than that. If I give it to him then I have to do it again at 7am, but he will not eat that early. Earliest he will eat usually is around 10am or so. But if I give it to him that time in the morning, 12 hours later he will already be in bed and also won’t want to eat more if I wake him up. So would giving it to him at 10am then at 7pm be okay? Or does it have to be 12 hours?
 

AGS

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His bloodwork came back today, pretty much 100% normal with the exception of some that are off due to the parasite he has. No high cholesterol or anything wrong with the blood count numbers. I kind of wonder if the enlarged spleen is just due to having giardia for so long.

I’m pretty much 100% sure that it’s not something in his lung on the x-ray but rather the atherosclerosis. It’s the exact same shape and spot as the aorta that runs along there. The vet wants to see if the antibiotics clear it up and in 2 weeks do more x-rays to see if it goes away, but if not it’s probably atherosclerosis. But I just see him doing so poorly and wonder if he will even last that long. So I will call tomorrow morning and see if she will get him on some medications now.

I also set up a telemedicine appointment with Dr. Driggers to get his opinion and make sure we’re doing the best treatment. But the earliest they have for that is the 27th.

If anyone has advice in the meantime I’d appreciate it. For treatment, management, diet, etc. I’ve done a lot of reading but I can’t find much in terms of treatment, just preventative stuff and diet.
 

enigma731

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Did the vet say it's probably atherosclerosis? It's very typical to see a motion artifact from the aorta on xrays. I know I probably seem like the bad guy here because I keep doubting the heart disease idea, but I really think you need to follow the diagnostic evidence. The evidence says he has an infection.
 

AGS

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She said she can’t tell. But she did say it’s something there, so it’s not just the x-ray. I’m giving him the medicine still but he’s just getting worse. He is doing really badly right now. She wants to wait 2 weeks to see if it’s atherosclerosis and I just know he can’t wait that long. He even flew a bit this morning (like 2 feet) because he didn’t want to be toweled and immediately started panting. And it seems that the tips of his toes are swelling a bit which I know happens in people with cyanosis.
 

AGS

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Sorry I misunderstood. At the appointment she said she couldn’t tell. Today when she called for the bloodwork she said if the antibiotics don’t work then it’s probably that. The reason I didn’t ask for medications today is because she called really early and my mom didn’t wake me up.
 

AGS

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So I finally was able to speak with the vet today and she said just based on eliminating other possibilities she does think it’s atherosclerosis. She said there would be at least some improvement by now if it was an infection, and based on his white blood cell count she thinks it’s more likely his spleen is enlarged due to the chronic giardia infection. She wants him to see a cardiologist but for now since he’s doing so badly she wants to put him on medication. We will pick it up today, it’s called isoxsuprine. I assume we‘ll just see how he does on this for now then possibly add more medications down the line. He doesn’t seem to need Lasix for now since he has no fluid build up, but I’ll definitely keep monitoring his weight.
 

Hankmacaw

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Isoxsuprine is the one I can't ever remember. Macawnutz has a Hy that has done well on it for quite some time.

Her is a good article about Atherosclerosis in birds and it mentions isoxsuprine and how it works.

 
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