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Should I treat AGY (Avian Gastric Yeast) if there are no symptoms??

soundsfun

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At their annual vet check this spring, Tofu and Kimchee were diagnosed with AGY (rod-like organisms were found in their gram stains). Neither had any symptoms of AGY and seemed completely healthy to me (active, eating well from their pellet/chop/seed diet, happy, and maintaining good weight). The only sign anything was "off" was that some of Tofu's droppings were runny, and sometimes only consisted of urates.

Our vet recommended treating them both with Amphotericin-B, which we did for 2 months. We also treated them with an antibiotic during the final couple weeks of treatment, as the vet detected bacteria-like organisms.

The course of treatment was pretty rough on both of my boys (Tofu especially). They were steadily losing weight and became increasingly lethargic. The twice daily medication routine was also taking a toll on all of us.

I did some research on AGY, and learned that many budgies can carry/host AGY yet never show symptoms or get sick from it. Seeing my little guys suffering while on Ampho-B, and considering that they never had any AGY symptoms to begin with, convinced me to discontinue the treatment when we hit 2 months. My vet would have preferred that we continue, but understood my decision.

The final checkup still showed some lingering AGY organisms in the gram stains, but since stopping the treatment, both boys have rebounded and mostly gotten back to the level of health they were pre-treatment (Tofu's just 2-3 g lighter than he was).


What do you all think - should I start up treatment again, knowing the AGY's still lingering in their systems? Or only treat when there's symptoms?
 

soundsfun

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Thanks for taking time to reply @Macawnutz. You're right... those awful two months will be for nothing if I don't finish the course of treatment. I've made an appointment to bring them back to the vet, and will continue treatment for as long as it takes.


Now, for the sake of informing my future decisions, if or when AGY reoccurs in my budgies, I'd really appreciate more input/discussion about my original question: Should AGY be treated in birds that are asymptomatic?

Here are a couple of quotes from one of the sources I referred to (https://nilesanimalhospital.com/files/2012/05/Megabacteriosis-Avian-Gastric-Yeast.pdf) that notes how AGY can be present, but not cause any signs of disease:

"Megabacteria have been detected in birds, particularly budgerigars, which fail to demonstrate any clinical signs of disease. The vast majority of birds in the collection at Texas A&M University that were diagnosed with megabacteriosis failed to display any clinical signs of ill health, nor any gross lesions on necropsy."

"All clinically ill birds should be treated; however, there is a debate whether non-clinical birds displaying megabacteria in their droppings should be treated."


My vet has discussed with me how tricky it is to deal with AGY, and we discussed the practicality and reality of constantly re-treating birds for AGY, acknowledging that Ampho-B is not something that we want to give to our birds on a regular basis. Personally, I'm leaning towards only treating Tofu and Kimchee when they show clinical signs of disease.

Thoughts? What would you do? Those of you who've got birds with AGY, what's your approach to treating it?
 

Macawnutz

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I'm quite sure since you are researching here that you know what I went through with AGY. My macaw almost died from it. It was a secondary infection but it was the one that nearly killed him.

You are also quoting the only vet that found the AGY. Every vet prior to me finding Dr. Sakas wanted me to put my bird down claiming he had PDD. While I was so relieved to have found the cure... the cure was as bad as the disease. Amp B is nasty stuff. It's been so long since we battled this, Korbel is 11 now so 11 years ago. I was so afraid the Amp B would kill him faster than the AGY.

I don't know if my vet gave his opinion in that article but.... I did know my vet well before he passed. He would have told you to treat your babies at least once. If it recurred down the road I do not know how he would have handled it but he would have tried to eliminate it to start with.

My opinion? I'm a fighter. I don't think I could look at my birds knowing it was there and not "see symptoms". I would question everything and I know that is an awful way to live but.. that's my opinion.
 

soundsfun

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Thank you again, @Macawnutz, for sharing your perspective and approach to dealing with AGY. I read the thread detailing your ordeal with Korbel and AGY a while back, so I couldn't quite remember if it was you or another member with a macaw. I appreciate that you've taken the time to share your thoughts with me. The fact that Korbel has gone 11 years since being treated for AGY gives me hope. Has it recurred since?

Yes, questioning everything does involve lots of worrying for us parronts, but that's the kind of parront we should all be! :heart: That's actually what prompted me to post this thread - I don't take this decision lightly, and want to explore all the options so I can make a fully informed decision. Knowing that there's debate among top-notch vets like Dr. Sakas whether to treat non-clinical birds or not is what gives me pause.

Amphotericin is nasty stuff. Tofu lost so much weight, and was so lethargic at one point that I truly believed he would be gone within a day or two. Keeping him isolated in a warm cage helped him to stabilize, thankfully. Seeing him go downhill so seriously during the treatment, though, is what made me question if I want to put them through that again if they aren't symptomatic.

From what I've learned about AGY in budgies, it's very likely to recur repeatedly, and something they'll have to live with for the rest of their lives. So I'm looking for a long-term plan for living with AGY.

@Britnicorn, I know your two little guys have gone through AGY. If you're around and have a chance to chime in, I'd love to hear how you're dealing with AGY in the long-term. Would also love to hear from any other parronts, especially budgie parronts, who have or are living with AGY too.
 

Xoetix

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I don't know much about AGY, but is this particular medication the only medication available? Is there anything else that can be used for treatment that doesn't take quite such a toll on the bird?
 

soundsfun

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Hi @Xoetix I'm still learning about AGY myself but I've read that, while there are other antifungals out there, Amphotericin-B has the best track record for treating AGY. AGY is still a poorly understood condition, so there could very well be another effective treatment out there that isn't so tough on the bird. I'd be thrilled if that could be discovered at some point in Tofu and Kimchee's lifetime!
 

Xoetix

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Hi @Xoetix I'm still learning about AGY myself but I've read that, while there are other antifungals out there, Amphotericin-B has the best track record for treating AGY. AGY is still a poorly understood condition, so there could very well be another effective treatment out there that isn't so tough on the bird. I'd be thrilled if that could be discovered at some point in Tofu and Kimchee's lifetime!
I hope so too! Sometimes the treatment is nearly worse than the issue itself.

As an aside, I LOVE your birds' names! :D
 

Macawnutz

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Thank you again, @Macawnutz, for sharing your perspective and approach to dealing with AGY. I read the thread detailing your ordeal with Korbel and AGY a while back, so I couldn't quite remember if it was you or another member with a macaw. I appreciate that you've taken the time to share your thoughts with me. The fact that Korbel has gone 11 years since being treated for AGY gives me hope. Has it recurred since?

Yes, questioning everything does involve lots of worrying for us parronts, but that's the kind of parront we should all be! :heart: That's actually what prompted me to post this thread - I don't take this decision lightly, and want to explore all the options so I can make a fully informed decision. Knowing that there's debate among top-notch vets like Dr. Sakas whether to treat non-clinical birds or not is what gives me pause.

Amphotericin is nasty stuff. Tofu lost so much weight, and was so lethargic at one point that I truly believed he would be gone within a day or two. Keeping him isolated in a warm cage helped him to stabilize, thankfully. Seeing him go downhill so seriously during the treatment, though, is what made me question if I want to put them through that again if they aren't symptomatic.

From what I've learned about AGY in budgies, it's very likely to recur repeatedly, and something they'll have to live with for the rest of their lives. So I'm looking for a long-term plan for living with AGY.

@Britnicorn, I know your two little guys have gone through AGY. If you're around and have a chance to chime in, I'd love to hear how you're dealing with AGY in the long-term. Would also love to hear from any other parronts, especially budgie parronts, who have or are living with AGY too.
No, Korbel's AGY has never reoccurred. Honestly if you eliminate it from your bird and your surroundings it should not "reoccur" unless reinfection from a new source. My thought would be that the reoccurrence in budgies most are describing is a non thorough after check.

AGY used to be difficult to diagnose. Often it would take a specialized test and that test was costly. That test also had false results. We know it does not shed every day. Vets will tell you to collect fecal matter over a few days or they will recommend more than one test to be sure it is gone. We tested Korbel every few weeks for months and than once a year. Of course now most vets can see the rods in a simple fecal gram stain so checking is easier. AMP B is still the recommended course of treatment.
 

Britnicorn

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In my opinion, and it’s honestly just an opinion because I am no vet, but if you wait until your babies are showing clinical symptoms to treat it you’re basically treating it when it’s almost too late. Birds hide their symptoms/pain so well, so the fact that you’re noticing changes in their poop is enough of a reason to treat for me

My budgies had been suffering from AGY on and off. Every few months they got a flareup. I think I caught it early every time because I watch their poop so much and notice every tiny change in their personality/routine. It’s been almost a year since their last flareup, I am praying it’s truly over for us. I am lucky in that the medication barely affects my two boys, just dries their skin out a bit and makes their poo watery but otherwise they stay happy and healthy. I also think I gave them a much more diluted dose than normal, as prescribed by my vet. I always treated when AGY showed up, sometimes even when it didn’t show up in the gram stains but they’re having the same symptoms as before I treated for it anyway.

I would be scared to treat if the medicine affected my boys the way it affects yours, too. Maybe you could discuss with your vets treating on a much more diluted level the way mine got treated? I think it would still help since they aren’t terribly ill yet. I’ve also seen some treatments include putting a drop or two of the antifungal into the water instead of treating it directly orally when no one is clinically ill.
 

soundsfun

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@Xoetix Ha ha, thanks for the comment re: their names. I've always found food names so funny and cute!

@Macawnutz I really hope it never comes back in my budgies after I complete this first course of treatment. That will motivate me to keep going, even if it takes months to complete it. I'll ask my vet about doing regular checks at the same kind of intervals you did with Korbel - great idea.

@Britnicorn Thanks for popping in to reply! You make an excellent point - they do hide their symptoms really well, so I agree there is a risk to treating only when symptomatic. I also never thought to ask my vet about a diluted dose or about adding it to water but those could help to lessen the toll it takes on them.

Thank you all for the thoughtful feedback. It's helped me to figure out a plan. I'll ask my vet to fine tune the dose of Ampho so it doesn't take such a toll on my budgies, and also inquire about medicating them via their water or food, so it isn't such an ordeal to treat them long-term.
 
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