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Recurring plaque in back of oral and nasal cavity. Anyone experiencing anything similar?

clisa

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Hi, my avian vet can not figure out why this whitish plaque keeps growing in the back of my sun conure's oral cavity bordering on the nasal cavity. As it builds up, her breathing becomes labored and I can hear it. The vet has sedated her now 4 or 5 times to clean it out and it keeps coming back within 1-3 weeks. She cultured the plaque twice, each time it comes back with different bacteria, not a common one. We've tried rounds of several different antibiotics (baytril, azithromycin, sulfatrim, doxy) and antifungal and nothing works. The vet said that the surface underneath the plaque is somewhat irregular and worries it could be cancer but she can't culture that part without risking excessive bleeding and death. We've omitted all sticky food from her diet and just do pellets and seed. Both my avian vet and I are stumped, so I thought it wouldn't hurt to reach out on this forum to see if anyone else has experienced something similar in their bird and if there was any effective treatment.

My avian vet is very very experienced and she said this is only the second bird she's ever seen this in. I appreciate any ideas as I don't want to lose my sweet Susie to this condition.

Thank you,
Lisa
 

Zara

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Welcome to the Avenue Lisa :)

:bump8:
 

taxidermynerd

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Unfortunately the only way to know for sure is to biopsy, but as you mentioned, it's too risky.

I had a similar problem with my budgie, he had a mass growing inside his beak that ended up growing through his face and possibly further into his head. We suspect it was perhaps cancer.

We came to the same conclusion, that testing was too risky. We put him on palliative care, to keep him comfortable. We had 4 months together from when he was diagnosed as terminal to when we had to say goodbye.

I'm afraid I don't have much more to offer other than suggesting supportive care. I hope your story has a happier outcome than ours.
 

camelotshadow

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Odd that it grows back with different bacteria. Don't really think of cancer growing bacteria unless its making the area more susceptible to infection.
I hope its not cancer.
Could it be a immune deficiency disease? Still not sure why it would just be in that one area.

What about protozoa? Symptoms of canker which can lead to bacterial infection,

 

clisa

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Unfortunately the only way to know for sure is to biopsy, but as you mentioned, it's too risky.

I had a similar problem with my budgie, he had a mass growing inside his beak that ended up growing through his face and possibly further into his head. We suspect it was perhaps cancer.

We came to the same conclusion, that testing was too risky. We put him on palliative care, to keep him comfortable. We had 4 months together from when he was diagnosed as terminal to when we had to say goodbye.

I'm afraid I don't have much more to offer other than suggesting supportive care. I hope your story has a happier outcome than ours.
I'm so sorry about your budgie. This has been going on since Feb 2020, but the time between clean outs is getting shorter and shorter. I hope it's not cancer but something more treatable though the possibilities seem to be dwindling. Thank you for sharing your experience with your budgie.
 

Shezbug

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@MiniMacaw ? I am guessing it is a totally different reason for the plaque but Seamus came to mind as soon as I read this.
 

clisa

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Odd that it grows back with different bacteria. Don't really think of cancer growing bacteria unless its making the area more susceptible to infection.
I hope its not cancer.
Could it be a immune deficiency disease? Still not sure why it would just be in that one area.

What about protozoa? Symptoms of canker which can lead to bacterial infection,

Interesting, I've never heard of canker but I will ask my vet about it and see if she can test for that at the next clean out, though from the link you sent it seems like it's tough to test for in a living bird. As for the bacteria, she thinks the bacteria are not the main problem but are just opportunistic residents of the irregular membrane underneath. She had given Susie a vitamin D injection a few times ago which actually seemed to extend the time between as she said sometimes a vitamin D deficiency can cause such irregularities but then it came back after a month (which was pretty good) and after a second vitamin D shot, it returned after a week, so there goes that theory. Thank you for your reply and suggestions.
 

clisa

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@MiniMacaw ? I am guessing it is a totally different reason for the plaque but Seamus came to mind as soon as I read this.
I did a search for Seamus and I saw that Seamus is a macaw that had similar symptoms, but different backstory. I guess I should add that Susie, my sun, was born with a scissor beak and we had adopted her from the breeder who said she wasn't sellable. She has been the most amazing bird, and my daughters favorite of our now 4 birds and is the glue that holds the flock together. I thought her plaque buildup was perhaps a result of her congenital deformity but she's 16 now and I feel like we would've seen it sooner. Our vet said the only other time she's seen this plaque buildup was in a cockatiel with a perfectly normal beak.
 

budgieluv3

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I have no experience with this. I am sorry you are going through this.:hug8:
 

MiniMacaw

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Sorry I’m just seeing this...

Seamus has a build up of excess keratin in his mouth. The vet he sees also said he’s only seen this one other time in his over 20 years of experience. We have done so many biopsies and histopath samples. Initially they were coming back as bacterial infections. His too changed from one to another in a period of about 3 months. During that time we switched him to 5 or 6 different antibiotics and other meds, always testing for sensitivity to the new meds (which he unfortunately builds up rather quickly).

Finally we have a system that seems to be working for us, for now. We do go in every six weeks right now for a beak correction (he has scissor beak as well) and a deep cleaning under anesthesia. We use a diluted listerene mix and a small spray bottle and spray both inside his mouth and all over his feathers. This is so when he grooms himself he’s not getting as many bacteria near his mouth as perhaps he otherwise would be. It sounds like it would be difficult to do, but Seamus likes the listerine mix and patiently sits while we spritz him. (It’s 10 parts water to 1 part listerine and may be an idea to bring up to your vet).
We also use an antibiotic called tazicef which is generally an IV med, but we dilute with sterile saline and also squirt into his mouth, trying to hit the areas with the most growth. This one is slightly more difficult due to the meds smelling (to me anyway) like cat urine and Seamus does not enjoy this one. However, we have noted a huge improvement in his mouth health since beginning these two protocols. They’re both “outside the box” thinking for treating excess sludge in a birds mouth, but at the time we had nothing to lose in trying.

Its still an ongoing issue, one that we may not win, but we have beat all the bacterial infections away. (Something oral antibiotics wasn’t doing alone). I know the frustration of dealing with a condition like this in a bird we love, it’s emotionally exhausting. But little improvements are possible. :heart:
 
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clisa

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Thank you so much for sharing more about the treatment protocol you use. I am definitely going to ask my vet about the listerine and the tazicef. Right now, she's on her second dose of injectable doxy since we thought the goopiness and stickiness of the oral antibiotics were actually causing food stuff to stick there. But, I'm hearing the wheezing so I don't think the doxy is solving the problem. Have you tried vitamin D and calcium treatment to test the possibility of deficiency? I found this:


We tried vitamin D and it didn't work for Susie but each case is different and might be worth a try unless Seamus has a high level of vitamin D in his diet anyway and apparently one can overdose on this lipid-soluble vitamin. The article also mentioned calcium deficiency though which was interesting to me because this past year Susie laid a number of eggs, so I wonder if there's a connection there. The search continues.
 

clisa

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Actually correction, Susie received Vitamin A shots. We really thought that was it.
Hypovitaminosis A can lead to:
  • Oral candidiasis (fungal disease) with raised, crusty lesions at the commissures (soft sides of mouth where the upper and lower beaks meet) that bleed if disturbed.
  • Mycotic (fungal) infection leading to necrotic lesions on the beak.
  • Dermatomycosis (fungal skin infection). The fungi damage keratinized layers of the epidermis and produce inflammation, leading to massive destruction of the feather follicles; this is rare, and it is caused by poor hygiene and husbandry.
  • Aspergillus, a mycotic pathogen isolated from the plumage. It results in severe pruritus (inflamed, itching skin).
  • Squamous metaplasia (scaly-looking, abnormal tissue) or hyperkaratinization (excessive keratin) of mucous epithelial cells which line the cloaca, ureters and collecting ducts, Bursa of Fabricus and conjunctiva of the eye. The respiratory, reproductive and digestive tracts undergo structural changes which render them unable to secrete the mucous which prevents invasion from pathogens. These pathogens then penetrate the mucous membrane barrier and invade the tissues.
  • Hyperkeratosis and hypertrophy (enlargement) of epithelial cells, leading to obstruction of the respiratory airways.
  • Diseases of the oropharynx (the mouth and back of the throat).
  • Gross lesions are initially found in the esophagus and pharynx. The mucus glands and ducts appear as small, yellowish nodules which often coalesce with one another.
  • Keratinization of epithelial cells occurs, causing squamous metaplasia (benign change in the surface of cells that line the organs) of the mucous membranes and the glands of the oropharynx, leading to hyperkeratosis (production of too much keratin). The metaplasia blocks the ducts of the salivary and mucus glands, causing submandibular swelling involving abscesses filled with a yellowish, caseous exudate and blunting of the choanal papillae (small protuberances on the roof of the mouth). Ptyalism (excessive salivation) occurs and sinusitis is common.
 

clisa

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By the way, thank you all for such a warm welcome and embrace. I really needed other bird peeps to brainstorm with. Thank you thank you.
 

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Pat H

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WELCOME to the Avenue!!!
Another thread was about using Apple Cider Vinegar in the drinking water... wonder if something as simple as this could help?
 

Hankmacaw

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@clisa @MiniMacaw and I go to the same vet, so what we have learned from him has pretty well been passed on. The only thing I might add is that with the wheezing you may want to try a test for aspergillosis that is more definitive for the disease. I can't remember the name of the test, but Dr. had it done on my Jasper to confirm the presence of asper when the other tests came back not confirming it. Sure enough she had asper and a staph infection both in her airsacs. He had also done a CT scan (he charges only $500) for one and saw the masses in her airsacs and wasn't happy until he exhausted that possibility, since she had a history of asper.

Keep thinking out of the box - sometimes that is where the answer lies.
 

clisa

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@clisa @MiniMacaw and I go to the same vet, so what we have learned from him has pretty well been passed on. The only thing I might add is that with the wheezing you may want to try a test for aspergillosis that is more definitive for the disease. I can't remember the name of the test, but Dr. had it done on my Jasper to confirm the presence of asper when the other tests came back not confirming it. Sure enough she had asper and a staph infection both in her airsacs. He had also done a CT scan (he charges only $500) for one and saw the masses in her airsacs and wasn't happy until he exhausted that possibility, since she had a history of asper.

Keep thinking out of the box - sometimes that is where the answer lies.
Thank you, yes, I will check with my vet if she had tested for that already. I vaguely remember her saying that she ran tests to rule things out and I can't remember if that was one of them.
 

clisa

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WELCOME to the Avenue!!!
Another thread was about using Apple Cider Vinegar in the drinking water... wonder if something as simple as this could help?
That would be a godsend if something that simple could help. I guess it doesn't hurt to try. Thank you.
 

Hankmacaw

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PS - My veterinarian's name is Dr Drigger, Gilbert, AZ, 480-706-8478 if your vet may like to consult with him.

I think the extra test he ran for asper was a PCR test, but not sure.
 

clisa

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Thank you for the reference. I'm in NY so wouldn't be able to bring her there but I might pass his contact to my vet if she needs info on it. She's always open to consulting with other colleagues.
 
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