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Parrot Heart Disease (long)

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noblemacaw

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I have had several inquiries about sharing what I know about this subject. I will start from the beginning and share my travels thus far of my experience of heart disease in parrots.

June 8th 2011 my 9 year old Illiger's macaw Diego collapsed in his cage several minutes. He presented with stroke like symptoms so I called the vet and rushed him to the hospital as fast as rush hour would let me. Even with heroic measure his doctor performed Diego died while she was treating him. After much discussion she diagnosed that he had a fatal stroke.

The next month our local bird club had a seminar with a well known Floridan vet about well bird care. I attended the seminar because I wanted to update my knowledge of parrot care. Parrot heart disease was discussed and a breeder of African greys was asking the vet questions about loosing a forth of her flock to heart disease. During a break I discussed what happened to Diego with the visiting vet and she agreed with my doctors diagnoses.

Freaked by what happened and what I learned at the bird seminar I made a appointment to have my 16 year old Noble macaw Mihijo blood work up and well bird check up.

The first blood panel report from Dr. Blair

Date: October 6, 2011
Re: Mihijo Vasquez
Mihijo had several significant lab abnormalities on his recent results:

  1. WBC 26,000 (8-22,000) – his white cell count is elevated, but it appears to be a stress response. I did not see any cells that indicated infection.
PCV 40% (48-56%) – he is anemic. This will occur secondary to any chronic disease process (i.e. hyperlipidemia).

  1. UA 32 (1.8-11.79)
Ca 12.0 (8.4-11.86)
Phos 16 (4-8)
Chol 1,243 (96-264)
TP 9.9 (2.4-4.39)
Bile acids 154 (7-100)

These values are all likely elevated due to the high cholesterol level. However, the uric acid is a measurement of kidney function and the bile acids is a measurement of liver function. Until we control the hyperlipidemia, we cannot be sure that those organs are functioning appropriately.

Many of these lab abnormalities can be explained by very severe hyperlipidemia – in other words, he has a significant amount of cholesterol and other lipids in his blood stream. Over time, elevated lipids in the blood stream lead to vascular disease (i.e. atherosclerosis), strokes, heart disease, and liver disease. Causes of hyperlipidemia vary in birds and include genetics, diet, lack of exercise, and chronic hormonal stimulation.

It is essential that we begin to control this issue or there is a high likelihood that Mihijo will have complications associated with this hyperlipidemic state. As with humans, this condition is not reversible immediately – it will take time and is a condition that needs to be managed life long. The following are my recommendations.


  1. Diet: There is some controversy regarding the best diet for these birds. Most practitioners recommend a formulated pellet such as Roudybush Low Fat or Harrison's Adult Lifetime plus vegetables/fruits. Let’s try the Roudybush Low Fat pellets – you can purchase these online.

In addition, make sure to eliminate all simple sugars from the diet and substitute with whole grains (spelt, wheatberry, oat groats, flax seed, buckwheat, barley), whole uncooked veggies (broccoli crowns, summer and winter squashes, peppers) and a small amount of fruits (primarily berries).

Regardless, seeds, millet, nuts, and high fat table foods should be avoided.


  1. Foraging and exercise – it is important that we encourage weight management and an active lifestyle. Hide food around the cage, wrap food items in spinach, or purchase commercial foraging toys for his food items. In addition, he should have 5-10 minutes of aerobic exercise (walking, climbing stairs, flapping) at least twice per day.


  1. Add omega-3 fatty acids as a supplement. Omega 3's substitute for cholesterol on the RBC membranes and can reduce cholesterol.

Usana OptOmega or Barlean’s flax seed oil: Give 0.02 ml (2 drops) on food once daily.


  1. Manage reproductive hormones

We need to focus on controlling Mihijo's hormones long term. By far, the most common diseases we see in this practice involve reproductive abnormalities in our pet birds. Even a bird that is not actively laying eggs can have chronic reproductive issues. Unfortunately, when a bird is chronically hormonally active, it can lead to a variety of issues, including liver disease, high cholesterol/triglycerides, blood clots, strokes, heart attacks, egg binding, and egg yolk peritonitis (females).

The main treatment strategy involves attempting to decrease the reproductive hormones, such as estrogen and testosterone. We can do this with a combination of things:


  1. Lupron: This is a hormone injection that down-regulates the reproductive cascade. It generally lasts 12-16 weeks. This is our quickest way to stop this process, but it must be coupled with some of the other management strategies below. I think it is premature to try this with Mihijo, but if we are not making progress, this may be a tool we will use.


  1. Eliminate perceived mates: Birds in the wild only sit with or cuddle with those individuals who are mates. If allowed to cuddle, sit on our shoulders, or be petted/stroked, our pet birds begin to think of the humans in the household as 'mates'. Other birds, mirrored reflections, and even toys can also serve as mates. The presence of a 'mate' causes them to have an increase in reproductive hormones. As difficult as it is, it is important to restructure how we handle our birds. Talking, teaching tricks, and playing flying or laddering games are much more healthy ways for us to interact with our birds than cuddling as we would do with other mammals. In addition, it is important to remove access to toys or mirrors that may be stimulating to your bird. This step will be very difficult for you, but it is absolutely essential!


  1. Perceived nest boxes: If a bird perceives a nesting area or nesting cavity, this will cause the reproductive hormones to increase. This may include crawling under a towel, under your hands, into a corner of the cage, or even under a newspaper. Remove any huts or tents from your bird's cage and make sure Mihijo is supervised when out of the cage.


  1. Nesting material: Anything that he can chew obsessively will mimic nest-building. It is important to eliminate paper, chew toys, or anything else that your bird may obsessively chew on from the cage. For some birds, this is seasonal - certain toys need to be removed during the 'breedy' season, but are not a problem during other times of the year.


  1. Meal feeding may really help some birds. In the wild, birds only breed during the breeding season when food is abundant. In our houses, we are always feeding our birds abundant food, so we think this could be a trigger. We've started having some owners meal feed the food for 15-30 minutes twice/day, then remove the fresh food from the cage (you can leave pellets in the cage). Avoid any soft moist foods such as oatmeal, wet cereal, mashed potatoes, or baby food - these can be a reproductive trigger for many birds.


  1. Light: Light plays an important role in regulating hormones. Unfortunately, it is difficult to sufficiently control light in our home environment. It may be beneficial to provide 12 hours of light and 12 hours of dark to your bird. If you do not already have this arrangement, consider setting up a sleeping room for your bird. It should be located in a quiet part of the house, and the room should have a door and shades on the window so that it can be adequately darkened.

While this seems like a lot to focus on, it is essential for Mihijo's health. Please call in 1-2 weeks with an update or earlier if you have any questions or concerns. I would like to recheck a profile ($95) in 6-8 weeks to assess our progress. If you note any changes in his clinical status or signs of illness, please call immediately.

Thank you,

Jennifer Blair, DVM

I immediatly took action to change Mihijo's diet to the one above. The only thing I did not change in his diet is the fresh food mix I make and freeze. Dr. Blair was okay with the ingredients in it. After 6 weeks I took him in for another blood check. The results of that pricking. I also was concerned with my inability to lower his hormones naturally. I have always had problems with him this way which is why he is plucked. We scheduled another appointment for him to get his lupron shot.

Rebecca,

I have attached Mihijo's complete lab results for your records. In general, here is a
summary of the abnormal results:

UA 20 (2.18-10.46) - was 32
Glucose 512 (231-300)
Phos 12 (4-8) - was 16
Chol 1,084 (96-264) - was 1,243
TP 9.4 (2.4-4.39) - was 9.9
Globulin 7.4 (2.1-3.8)
Amylase 690 (239-564) - was 814
Bile acids 90 (7-100) - was 154

As we discussed, this is an improvement from the previous values, but the cholesterol
is still very elevated.

We will continue the current management protocol with regards to diet, exercise,
foraging, flax seed oil, and managing reproductive hormones. In addition, we have you
scheduled for Friday, November 18th at 2:45 pm for a recheck and Lupron injection
(small, 0.5 ml). We will plan to recheck his profile 6-8 weeks later.

Please call if you have additional questions or concerns.

Sincerely,
Jennifer Blair, DVM

I did not like the way Mihijo was breathing which is why he was scheduled to be seen again on the 18th of Nov along with getting the shot. His breathing appeared very labored so I took pains not to tax him physically. I called this in two days before the appointment but Dr. Blair had a full surgery schedule so I decided to keep close eye on him and wait until Friday. I brought him in and she also did not like his breathing. I reported that he was still very hormonal with his daily vocalizations of his opera and masturbating on his perch (I took out the toys he was using). At this appointment Dr. Blair gave him his lupron shot and requested permission to x-ray him. The x-ray gave her major concerns because she showed me his x-rays from 2000, 2004 and current. You can see his heart and liver growing larger with each later x-ray. His testicles were also enlarged. This is what is causing his breathing problem. His lung sacks are pressed up against the rib cage because of his enlarged organs. It was the doctors hope that the hormone reducing shot and diet would help shrink his organs enough so that he can breath easier.

Needless to say Mihijo's health is not good but I am learning all I can about how to treat him and help reverse most of his issues. Mihijo will be 17 years old on Feb 27th and it is my desire that he see his 17th birthday.

Update would include that the shot did help with the hormones. I see a noticeable difference with his personality because he did stop singing and masturbating. The Lupron is suppose to last 4 months but he might need another shot when he goes back in later this month for a blood workup and another x-ray. Please don't hesitate to ask me any questions. This is a lot of information but I hope it helps other bird parents with parrot heart disease.

Noblemacaw
 

suncoast

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I don't know how I feel about this information. I am totally on board about the diet part, but I think us trying to control what comes naturally as far as hormones go is a losing battle. What the problem is is captivity. They can't do what they would do in the wild which is select a spouse and reproduce. And we can't neuter them. I think the better thing would be to let them chose a mate and have a life. We tried restricting our Lovie hen's shredding habit, but she became miserable and mean. So now we let her shred but remove it everyday. She's a much happier bird. I am also guilty of cuddling my Too's but only in the morning when they get up and in the evening before bed. And it's really not cuddling per say, Truely likes to sit on my knee and grind her beak. In the morning she does cuddle up under my chin for about 5 minutes. Folly isn't much of a cuddler either.

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Anne & Gang

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very informative...I also don't know how I feel about the removing of shreddables that can be viewed as nesting materials...
 

noblemacaw

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In Mihijo's case I need his hormones to lower so his testicles can shrink so that he can breath better. This is very serious for him and I need for those levels to be lower. Dr. Blair is advising hormone lowering for my bird in particular not to all parrots. I am not saying to control the hormones of all parrots but for my birds health I need to do something about them.

Noblemacaw
 

suncoast

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I will be saying prayers that you can get this under control. You obviously love him to pieces and want him around a long time.

Ginger
 

Tangle Elf

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Your vet sounds amazing and very caring. Thank you so much for sharing this information. We'll go in next week to find out more about Korbin Dallas's heart murmur. I feel a lot more prepared now. I like that you pointed out that this is for your bird specifically. Different veterinarians have different views, different birds have different needs and all we can do is just take all the information and do the best we can. I'll be keeping Mihijo in my prayers.
 

Renae

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Thanks for sharing that information, I hope that yourself and your vet find something to control the hormones so his breathing gets better. :hug8:
 

magni

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I am a little confused. I thought some nuts are important to some parrots:confused:
 

Bokkapooh

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In Mihijo's case I need his hormones to lower so his testicles can shrink so that he can breath better. This is very serious for him and I need for those levels to be lower. Dr. Blair is advising hormone lowering for my bird in particular not to all parrots. I am not saying to control the hormones of all parrots but for my birds health I need to do something about them.Noblemacaw
Does he masturbate? Masturbation is the quickest way to help his testes shrink. I encourage all my male birds to masturbate, and they do. Too many people try to stop their birds sexual drive. But its a perfectly normal healthy act.:) Good luck with your baby!:hug8:
 

noblemacaw

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I never restricted Mihijo's masturbation it was only while trying to eat my dinner is when I objected. LOL. The problem is/was the testicles were enlarged even with freedom to do his thing. He needed the Lupron shot to get those levels down quickly so that they could shrink. I am also working hard to get his blood fats in order with the hope that the heart and liver will shrink also. Mihijo's breathing is labored along with blood fat levels so high that I am concerned that he will drop over dead.

Every day I tell him I love him but every morning when I go downstairs to uncover and feed him I fear I will find him dead in the cage. It is when I hear him say in his soft voice "hi" or "hello" is when I sigh in relief. Sometimes I stare at him praying and hoping he will continue to fight to live. "Don't die please." I whisper to myself.

Noblemacaw
 

Karen

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Masturbation is the quickest way to help his testes shrink. I encourage all my male birds to masturbate, and they do.
I didn't know this. Do you have artical/research links so I can educate myself about this?
 

Bokkapooh

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When they masturbate, make sure he "finishes". Like human men, if they do not "release" they don't release all the tension, and for birds, they can get enlarged testes. This is why Im worried about Moby, and he needs an Xray done. He doesn't "finish" and enlarged testes needs to be taken seriously. Sorry, this is probably an offensive/gross topic to the sensitive.
 

Tangle Elf

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When they masturbate, make sure he "finishes". Like human men, if they do not "release" they don't release all the tension, and for birds, they can get enlarged testes. This is why Im worried about Moby, and he needs an Xray done. He doesn't "finish" and enlarged testes needs to be taken seriously. Sorry, this is probably an offensive/gross topic to the sensitive.
Not to make it any worse, but how do you know if a bird "finishes?" Do you just mean don't interrupt them or are there visible signs?
 

Leza

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so does your vet know why the high cholesterol/heart disease is occurring?
 

Bokkapooh

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Not to make it any worse, but how do you know if a bird "finishes?" Do you just mean don't interrupt them or are there visible signs?
From what I can tell they do a wing display.
 

noblemacaw

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My vet contributes Mihijo's high cholesterol to both diet and hormone levels. I have always had problems with getting Mihijo's hormones levels to drop seasonally. Before he began to pluck he did not moult for a year and I know that my Noble macaw moults two hard moults a year and several soft ones. He began to pluck his down but moved with pulling out all feathers. By the time I was able to get his hormone levels to drop his plucking became habit that I could not stop. This was back in 2000/2001.

Not to get into why I could not maintain the cost of Mihijo's vet care I tried my best to keep him healthy on my own. While I was in school getting my BS I could not afford to run the tests needed to keep a eye on things. When Diego died of a stroke I really had to re-evaluate my level of care and made some hard decisions concerning my only remaining parrot. I also took the steps to relearn parrot nutrition because I really believed I fed my birds a very healthy diet.

I did and will do what it will take to continue to get Mihijo the tests and x-rays he needs to keep eye on his disease. I will continue to do what is necessary to lower his cholesterol levels and to get him as healthy as he can be. 16 years old is not old for a parrot and I would like for him to live for many more years yet.

I use to let Mihijo eat table foods (Both birds loved their cheese and steak) and use to feed him Goldenfeast South American II. In the winter because he is plucked I upped his nut intake I also did this with Diego but because you can't run a blood panel on a dead bird I do not know what his level was. I suspect it was these factors that elevated Mihijo's cholesterol along with my inability to get those hormones to lower seasonally (twice a year the hormones should lower enough so the bird can moult) For my Mini macaw Noble macaw his diet cannot have much fats at all.

Noblemacaw

How my vet knew is because of the blood test she ran on him for his well bird check up last fall.
 

Leza

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Thank you for sharing, maybe your Diego didn't die in vein and your information will help save someone else's birdie. :hug8:
 
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