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Oscar's respiratory diagnostic adventure

flyzipper

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Oscar is a male Military Macaw who is approximately 10 years old.

This thread is to share what I'm learning along the way as we attempt to determine what's causing Oscar's respiration to be... "not normal".

October 2020 - Oscar came home to live with Marvin, Jericho and I.

January 2021 - Initial consultation with my regular avian vet about Oscar's breathing being "not normal". At this time, he had an occasional clear discharge, primarily from his left nare, and (it may be my imagination, but) his voice changed. My primary vet did a nasal culture and flush, and listened to Oscar's breathing -- neither were worrisome.

June 2021 - back again to my primary vet for a repeat of the above (same symptoms, same diagnostic, same non-conclusive non-worrisome response). When we discussed Oscar's heavy and slightly audible breathing after flight, my vet suggested it might simply be exercise intolerance.
At the time, I created this other thread asking about exercise tolerance...https://forums.avianavenue.com/index.php?threads/macaw-activity-levels-and-exercise-tolerance.264590/

July 2021 - for the first time, Oscar had a thicker, slightly yellow-green-ish discharge from his nares. I contacted my primary vet to obtain a referral with the Ontario Veterinary College Avian & Exotic Medicine Service (an excellent practice associated with an excellent veterinary school, hereafter referred to as the, "the OVC").
Even though Oscar has a healthy appetite and activity level, he's definitely, "not normal", in the breathing department, and that's the nagging feeling that pushes me to figure this out for him. Even though my primary vet didn't seem overly worried -- I am.

That appointment was today.
PXL_20210813_182408286 (Medium) - Copy.jpg
  • 9:00am - caffeination for me, and travel-caging for Oscar
  • 9:30am - hit the road (the OVC is 174km, or just shy of 2 hours from our home).
  • 11:30am - arrive and complete a new patient intake questionnaire (lifestyle, nutrition, environment, other pets, etc).
  • 12:15pm - they take Oscar inside for the initial exam.
  • 1:00pm - discuss diagnostic options - complete blood work, nasal culture, and CT scan - agreed to it all. Discussed sedation risks, and the risk from the "contrast injection" for the CT scan (they perform 2 -- one clear, and one with a contrast injection). They told me they don't do contrast injections for birds smaller than 100g because they deem it a high risk for that size bird, but described the risks to a 1000g bird that's "normally healthy", like Oscar, as only a slight risk. The CT scan takes about 15 minutes, but needs access to equipment.

    This is a pretty good overview that describes the value of a CT scan, and compares it to other options (link).

    They said he was a joy and talked to them quite a bit during the exam (he does like women).

    CT scan scheduled for 2:30pm, so I wandered around campus trying to find a Starbucks. Suggestion for Google Maps -- if a Starbucks is in a building which requires a student card to enter, please note it in some fashion. Ended up walking 4km to find a publicly accessible Starbucks.

  • 4:00pm - received a call that Oscar was out of sedation and light anesthesia, and was doing well. Groggy, but otherwise fine.

    Nasal culture and blood work were fine.

    CT scan revealed a, "thickening in one of Oscar's right air sacs, which will require a closer look and biopsy via scope at a follow-up appointment". The benefit of the CT scan is they know where to perform the scope, and based on the location it will be a slight incision that's just large enough for the scope. The scope procedure was described to me as low risk, and the best course of action to determine the cause of the thickening. I agreed with the recommendation, and the appointment will probably be within a month.

    The usual suspects will be investigated during the scope procedure -- bacterial infection, aspergillosis, or scar tissue from a past issue.

    The OVC was very professional and confidence-inspiring.

  • 4:30pm - drove home through periods of torrential rain - Oscar was very quiet.
  • 6:30pm - arrived home and let Marvin and Jericho out of their cages (it was a long day for them too).

    Oscar is enjoying some extra nuts on his jungle gym, Jericho is on my shoulder grinding his beak, and Marvin's chewing a toy while I type this thread.
All is, once again, right with my world.

Today's cost breakdown (Canadian dollars)...
1628897883195.png

(the eagle-eyed among you will notice I also had Oscar microchipped while he was sedated)
 

Greylady1966

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I wish I could read the statement but it gets fuzzy when I enlarge it. I was curious about the difference in cost from US to Canada. I'm glad you got him in and found a hospital that has all the testing there. Please keep us updated.
 

flyzipper

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I wish I could read the statement but it gets fuzzy when I enlarge it.
Is this any better?
Capture.PNG
(left-click on the thumbnail and it should expand to a readable size)
 

Greylady1966

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Yes it is. The CT is less than Nikki's was but I'm not sure how your money compares to mine. Poor guy had a big day!! Hopefully you'll get to the bottom of it.
 

Greylady1966

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Was Oscar an only bird when you got him? Did the doctor think a hard fall or flying into cause something like Oscar has?
 

flyzipper

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I'm not sure how your money compares to mine.
$395 CAD = $315 USD = $267 EUR = $428 AUD

Was Oscar an only bird when you got him? Did the doctor think a hard fall or flying into cause something like Oscar has?
Oscar joined my 2, and came from a flock of 8 other macaws. Based on his feather condition (plucked on the top of his head where he can't reach), and his tendency to duck when my other guys fly anywhere close to him, I'm guessing he may have been picked on and his previous situation was more rough and tumble than now.

Physical trauma wasn't mentioned as a cause for the observed air sac thickening.
 

Hankmacaw

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One other potential comes to mind, (actually two). I have a bird with pulmonary hypertensive syndrome. This disease most often results from South American (and a few other birds) living in proximity with powder down birds (mainly cockatoos, African greys and cockateils). After continuous and sometimes not a very long time of exposure to the powder down birds a macaw will develop this disease. This is a good overview of the disease.


A long time member here lost her Zoe when Zoe was only 3 years old and had been exposed to only one Grey and there were air filter present. This is the very sad story. Start reading at post #44. and then post #61

This was one of the saddest times on AA.

This is the other potential situation for Oscar. Since we never really know a bird's background, Oscar could have had his runny nose and breathing problems for quite some time. Seamus is an extreme example of what can happen when chronic conditions are not attended to - but it is a possibility with Oscar.

With the thickened air sac wall my two GUESSES would be chronic air saculitis or Pumonary Hypertnsive Syndrone.

My Kitty has Pulmonary Hypertensive Syndrome from living with cockatoos (nine of them) for twenty years. There were 6 air purifiers or she would have died by now. It's not fun watching her when it acts up and she has to go into the nebulizer and oxygen box.
 

FiatLux

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I am so glad you and Oscar had access to such specialized care. And that Oscar has such a devoted caretaker. I hope the next visit brings resolution and that any procedure taken does as much to ensure Oscar lives a long and healthy life as possible.
 

Kassiani

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That was quite a day for you and Oscar. I hope you both had a good night's sleep last night and that they get to the bottom of whatever is going on with your boy.
 

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Didnt realise Oscar had issues with his breathing hoping things improve with.him.
 

flyzipper

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Since we never really know a bird's background, Oscar could have had his runny nose and breathing problems for quite some time.
Agreed. As far as I know, his previous owner only had macaws, but I have a few questions out to him, so we'll see what additional insights can be uncovered.

chronic air saculitis
Having not encountered that term before, I Googled and it appears chronic air sacculitis is a symptom that broadly describes inflammation of the air sacs, and isn't a disease unto itself. The underlying cause appears to be the items we're exploring as, "the usual suspects", bacterial, fungal, chlamydia, etc. So it appears the path we're on will effectively explore the cause. Am I missing/neglecting something by thinking in this way?

Appreciate your insights.
 

flyzipper

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Found this resource useful, so posting here as a sort of bookmark (source).
 

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flyzipper

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Oscar was groggy last night, staying on the perch he usually moves to when he wants to be picked up, but he didn't want to be picked up.
He's still pretty low-key today, but we're enjoying our typical daily routine, although he hasn't flown.
 

Wardy

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Oscar was groggy last night, staying on the perch he usually moves to when he wants to be picked up, but he didn't want to be picked up.
He's still pretty low-key today, but we're enjoying our typical daily routine, although he hasn't flown.
Poor Oscar
 

flyzipper

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Having not encountered that term before, I Googled and it appears chronic air sacculitis is a symptom that broadly describes inflammation of the air sacs, and isn't a disease unto itself. The underlying cause appears to be the items we're exploring as, "the usual suspects", bacterial, fungal, chlamydia, etc. So it appears the path we're on will effectively explore the cause. Am I missing/neglecting something by thinking in this way?
Apparently I overuse the word, "appears", when I'm uncertain.
 

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@flyzipper You are correct that air sacculitis is the name of the condition and not the name of the disease. The actual disease can be gone and cured, but damage to the air sac remains - so keep that in mind. The damage could be from pulmonary hypertensive syndrome and the offending material may still be in the air sac (i.e. powder down, dust, shavings......) not getting worse because the source is gone, but not curable. Damage by volatile organic compounds (paint fumes, smoke...) may have occurred at some point. And of course the bacteria and fungal microbes you mentioned before.

Kitty, my GW female has chronic air sacculitis due to the pulmonary hypertensive syndrome she acquired living with cockatoos.

PS - your vets appear to be on the correct pathway - hopefully they can pin it down. Don't be afraid to offer ideas - no vet knows everything and something you say may ring a bell with him.
 
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