Sounds like my Jasper a many years ago. First, did the vets give a reason for not giving her a medication for her heart issue? Jasper's arterial chambers and ascending and descending aortas are all occluded and she has been on heart medications for 21 years. First Enalipril then Benazipril now with sildenafil (to help lower blood pressure). all of the medications did a good job for her condition at the time. If she has occlusions in her arterial chambers I can't imagine LOW blood pressure. At her age I would also suspect atherosclerosis whitch contributes to high blood pressure. Were any of the chambers of her heart enlarged? IMO she needs a heart medication now. Think of your little cockatoo,
@Danita .
Her toes look swollen, as well, and she could very well be retaining fluids due to her lack of circulation (different than high blood pressure). She may need flourosamide (lasix) to reduce fluids throughout her body. With lack of circulation the blood does not pump fast enough nor reach all of the appendages nor organs and fluid builds up due to this inefficient circulation. The flouosamide and heart medication should decrease her pain to some extent.
For pain, if she has pain - you said no indication o f arthritis on the xrays - Gabapentin is probably the best and combining. Gabapentin is not an opioid, but there are warnings of respiratory suppression when using it with opioids, so that eliminates Tramadol. Jasper has been on a combination of gabapentin and celebres for several years and it has done a good job of suppressing her arthritis pain.
Jasper has had two toes amputated on her left foot (the worst arthritis and the joints had deteriorated into mush ) and that has helped her immensely. And she gets around as well as before. BUT is there is no arthritis in this bird???? Perhaps the irritation is a result of poor circulation and her muscles are atrophying. Her pain and her foot need a deeper investigation including a blood pressure test on the bad one and the good one.
I hope she can find help for this poor darned bird and Dr. Lafeber should know one.