Ask An Expert: Dr. Brian Speer, DVM

Answered by Dr. Brian Speer, DVM:

It sounds like you have done some good things for this bird's life.

The clinical signs you describe: Polyuria and polydypsia (increased urinary output and increased water consumption) can be potentially meaningful. When you had your veterinarian examine this bird and run some baseline laboratory values, what was seen? Some hepatic functional and/or renal functional disorders can be seen with these clinical signs, and they also can be seen sometimes for merely behavioral reasons. If diagnosed and treated appropriately in a reasonable timeframe, most conditions associated with causation of polyuria and polydypsea can be managed if not resolved, medically.

Your diet should be improved, however. With the still persistent diet containing primarily fruits (lots of simple sugars) and nuts, this bird is being bombarded with excessive energy in its diet, which can and will lead to a myriad of longer term medical problems, including but not limted to obesity, liver problems, cardiovascular disease, some kidney problems, etc. I would suggest that the diet be shifted to a predominately formulated base, with vegetable materials and limited fruits or seed as a general outline. Seed / nuts - if made available, should be used as environmental enrichments and positive reinforcers for additional behaivors, not simply dropped into the bird's food bowl.

Answered by Dr. Brian Speer, DVM:

Theoretically, the dust could be contributing to the problem, although I would be doubtful if the dust you describe is the primary causation here. Air filtration may help remove dust, and if dust is a contributor, may help reduce the frequency of flare-ups of the symptoms you describe. Other than the costs involved in purchase and setup of a filtration machnine plus the delay in time for diagnosis should there be other medical issues involved, there should be no direct harm posed by your proposed approach.

Answered by Dr. Brian Speer, DVM:

In experienced hands, a nasal flush should pose no significant risk to a cockatiel as compared to a larger bird. The purpose and therapeutic merit of such a procedure, of course, needs to be balanced with a good understanding of the systemic health status of the bird, its nutritional health, and the potential purpose / merits of the procedure.

Answered by Dr. Brian Speer, DVM:

Without physically evaluating your bird, it would be impossible to factually comment on what the causes of your observations are. There may be stressor(s) in the aviary environment generating anxiety, there could be environmental irritants that have a role in the augmentation of clinical signs, or there could be subclinical disease that is initially manifesting in this manner. Best recommendation: A good physical examination by an experienced and qualified avian veterinarian to rule out the latter categories, and narrow down the potential considerations of causation that remain.

Answered by Dr. Brian Speer, DVM:

Yes, there are many things to worry about. From your description, and considering the age of your bird, a good physical examination by an experienced avian veterinarian is a very good idea.

Answered by Dr. Brian Speer, DVM:

Your questions are fair, and intentions are good with this question. Unfortunately, without any more detailed specific information, it would be impossible if not quite misleading for me to provide you with specific answers about the patient in question. Here are some important thoughts to consider though as you help your friend muddle through these issues:

There are a number of different types of cancers that can be found in this area. Epithelial neoplasia is not an accurate enough description, unfortunately. Squamous cell carcinoma, metastatic air sac carcinoma, Osteosarcoma, Fibrosarcoma, etc all would be potentially more accurate descriptions with which to work with. Each of these tumor types has certan behavioral tendencies. Metastasis, overall, with most of these tumors in birds is rare. Treatment options are limited by the size and type of tumor, the location and degree of involvement / invasiveness, the specific type of surgical removal or debulking procedure being considered, the potential benefit for surgical removal, the risk of surgical removal, the potential for non-surgical treatments such as radiation, chemotherapy, or combinations of these options. The overall health and stability of the patient also influences the treatment options being considered. In addition, the behavior of the bird and its interaction in the home environments influence treatments - as a wild and comparatively unhandleable bird may suffer from a much lower quality of life with a wing removed when compared to a pet bird that can be trained and helped to adapt to its new condition(s).

Best suggestions: Sit down and have a talk with the diagnosing clinicians. What is the EXACT diagnosis? What are ALL of the treatment options and relative prognosis / risk with each? What are the relative potential costs with each of these? What do you feel is the best, knowing my bird and myself? (IE: What would YOU do). This last question is one gathering the professional / personal opinions, not necessarily having to be a solid guideline, but does provide helpful information to hear.

If surgery is to be considered - What is the procedure, exactly? How many of these procedures has the surgeon done? Are there other opinions or surgeons that may offer me a better potential success rate?

Answered by Dr. Brian Speer, DVM:

Lots to talk about here, but challenges in detail are a real issue without actually physically evaluating the patient in question.

Ear infections, overall, are comparatively uncommon in parrots. It is possible that the traumatic injury could have predisposed to this problem. In reality, there is no cytologic evaluation, culture information or factual solid confirmation of the presumption of infection here. Crusty material can accumulate in the ear canals when there is inadequate vitamin A in the diet, when foreign material gets into the ear, when secondary infection gets rolling, and secondary to trauma and even clots of blood accumulating in the area.

Enrofloxacin is a very broad spectrum antibiotic. There is no long term adverse effects with this drug's use on the liver of parrots that is known. Water-based medication with this antibiotic in macaw species has only been published in the red-shouldered macaw (ara nobilis). (J Avian Med Surg, December 200; 286-290, 19 refs). In this study, it was shown that 200 mg/liter of water was effective at maintaining plasma concentrations, which would/should only be helpful for known and susceptible bacterial infections. I do not know what concentration is being achieved at 4 drops per 100 ml of water for your bird.

What I would suggest is that your original veterinarian be asked to have a look at the bird and its ears carefully, possibly even with magnification. Retained material in the ears should be carefully removed, and possible bacterial culture samples taken from this area. At the same time, a careful oral examination is appropriate, as it is possible that the ear abnormalities are the result of more significant soft tissue trauma and skull boney damage.

Answered by Dr. Brian Speer, DVM:

This is not an easy set of questions to answer, unfortunately. What you really need to get established as soon as possible for your ill lovebird is a succinct diagnosis and clear treatment intervention plan. For the most part, what you seem to have here is at best some presumptive diagnoses, and quit a bit of symptomatic treatments being delivered.

You may ask your veterinarian for a referral to an established specialist in avian medicine and surgery, to try to help you best get to the root of things as soon as possible. One option to consider for you would be at least a phone call to a colleague of mine in Swindon-Wilts, UK. His name is Dr Neil Forbes, and the telephone number there is 44-1793-603800. As an established diplomate in the European College of Avian Medicine and Surgery (ECAMS), Neil should be able to help guide you and/or your local veterinarian towards some diagnostic answers.

Best of luck for you and your bird!