# Sick Girl Not Getting Better



## Nicole (Dec 13, 2011)

My little Salmon is not getting better She's been lethargic for the last month or more... She was egg bound about a month ago and went into hospital at an avian specialist veterinary clinic. They crushed the egg and sent her home to pass it. After a few days her condition seemed to decline so we took her back in and the vet pulled out the egg. (She was also being given Calcivet, Enrotril and Meloxycan as well as an antibiotic I can't remember the name of, but it was viscous and white.) After a week she was still not improving; if anything, she was more lethargic. We took her back in and the vet checked her droppings. Her giardia had resurfaced so she went back on an in water treatment for that (antibiotics had finished, but still on the calcium drops). The following week she laid another egg which in my very limited knowledge, seemed adequately formed; perhaps more translucent than a chicken egg, but not soft. We left it in there as advised though she had no interest in it but still was behaving hormonally. After another week, she did not lay another leg, but her energy levels seemed to be marginally decreasing on a daily basis. I had been quite busy that past fortnight, but noticed a vast difference on my first day off, my partner also noticed her consistent lethargy. We took her back in and this time the vet noted that she could no longer keep up her charade of alertness and was obviously tired. She tested her droppings again and the giardia levels were back down. She did a crop wash and found bacteria from her upper intestine? so gave her an injection of Doxycycline. She told us that she must have had an underlying problem initially and most likely wasn't calcium deficient as she wouldn't have laid an egg so successfully with only a short period of supplementation. She then took a blood to test for organ function. Her pancreas, liver and kidney results were all normal, her cholesterol was slightly elevated but the vet had been expecting this since she's hormonal at the moment. We have just finished another 5 day course of Enrotril, a week has passed, and she is still sleeping about 1/2hr to 3/4hr out of every hour. (She has also been cleared for chlamydia.) Anyone got an idea what could be wrong with her? Don't know what else to do...


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## Kenziekenz (Dec 5, 2011)

Oh how terrible! My heart goes out for Salmon. I have no idea what could possibly be wrong, but I really hope they can get it figured out. The poor girl.


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## enigma731 (Aug 12, 2011)

Wow, that's quite the medical history. It sounds like you've been taking really good care of her. 

When the vet took blood, did she do a complete blood count? It almost sounds like this is an infection gone systemic, or else like you may have been treating with the wrong antibiotic. Did the vet identify the bacteria? If not, it might be an organism that is not sensitive to the antibiotics that have been prescribed.

She also might have her intestinal flora out of whack as a result of all the meds. You could try giving a probiotic for a while. Benebac is a good brand. I doubt this is the full answer to her problems, but it would certainly help after everything she's been on. You might also talk to your vet about the possibility of her having a yeast or fungal infection, since antibiotics wouldn't do a thing for that. 

How old is she, and what is her diet like?


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## Nicole (Dec 13, 2011)

Thanks, Kenziekenz. Me too 

Thanks for your suggestions, Enigma731, you seem to have a lot of knowledge!

She did gram stains and crop/faecal wash so I'm pretty sure she identified the bacteria, though of that I can't be sure. She also checked for yeast and fungal infections. As far as the complete blood count, I don't know - it was something I was actually thinking myself. Can cockatiels have blood cancers and such?

She's 3 years old and eats seeds (no sunflowers) and greens. Offer her egg, corn/other vege etc. but she's not interested.


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## enigma731 (Aug 12, 2011)

Disclaimer: I'm not a vet and I have no special training in avian medicine. I'm just a graduate student in a medical field who has had birds for a long time and reads a lot of case studies in my spare time. But if I can help with ideas, that's great. I just don't want to misrepresent myself. 

How has her weight been? Is she maintaining okay, or has she been losing during her illness? Do you have a gram scale you can use to weigh her?

I would ask about the bacteria. If she just did a slide mount of the samples during your appointment, that's not the most sensitive test. Usually with a gram stain, you just get a count of gram positive versus gram negative bacteria, and possibly some very rough characteristics of the bacteria (shape, size, etc.). A better test for the appropriate antibiotic would be cultures and sensitivity testing. This takes a few days and is sort of expensive (around $100 at my vet), but it could be very worthwhile if the problem is in fact having the wrong antibiotic. A CBC could tell you if you're still looking at an infection. Elevated white cell count would indicate that her body is still fighting something, most likely bacterial. 

Likewise, the tests for yeast and fungal infections are sort of unreliable, and tend to produce a lot of false negatives. If you don't uncover anything else, you might consider treating prophylactically for yeast/fungal, just to see if it might help. It's generally not a good idea to treat blind, but in a case where you've got all negative tests and a bird that's still sick, I'd see if your vet would be willing to do a trial of the meds.

I would assume they can get blood cancers, although I don't have any firsthand knowledge of that. She's also young for cancer. You might consider an xray to see if there's still anything reproductive/internal going on. This would also be pretty expensive, but you seem very invested in helping her. 

Does she have any other symptoms besides lethargy? What is her breathing like? Are her droppings normal? How about neurological signs -- Can she perch okay, balance okay, move normally when she's not asleep? When she sleeps, does she sleep on one foot, with her head turned back?

I would start by calling and discussing all these things with your vet, then try to come up with a plan where you prioritize what tests/treatments you're going to try based on what the vet thinks is most likely. I really hope you get your answers.


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## morla (Aug 15, 2011)

Aw! Poor Salmon!


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## Nicole (Dec 13, 2011)

Thanks, morla... not nice for her - wonders why she keeps getting pricks and prods and horrible drops forced down her throat when she's not feeling well, I think. (Get the distinct impression she feels betrayed.)

Thanks so much, enigma731! Disclaimer aside, perhaps you should go into veterinary medicine?... 

Last time we went to the vet I think she did say something about a systemic infection but then ruled it out. I cannot remember whether this was as a result of blood work or some other testing. I do remember her saying on a previous occasion though, that they can safely take 4 drops from a cockatiel so have to decide what the most appropriate tests are as there's a limited amount of info they can get from this quantity. Wish I had at least a rudimentary background in bio chemistry so I could be more equipped when it came to asking the right questions. Didn't even know birds could have chlamydia before I had one living with me... 

As far as I can tell, she doesn't have any other symptoms. She sneezed a few times yesterday but it could have just been dust or dander; don't know. Shivering a little? Her weight when she is healthy is 98g, though this has been fluctuating due to the egg laying. (These were her first eggs, her previous owner said she was male.) She's gone from 98 up to 106 down to 95 back up to 101 and last week was 94. Vet said the ordeal had taken it out of her but she wouldn't call her underweight. Don't know what she is this week - need to get some scales.

What I did notice however, was that after the initial slump from the Doxycycline injection and the blood test on Tues, she seemed to improve for two days. Although we were also giving her 2 x 2 drops of Enrotril daily, she plateaued on the Thurs and then started going downhill again. Do you know whether Doxycycline needs to be given in an injection? 

The vet I guess also wants to give her time and see if she improves on her own, but I don't feel comfortable when she looks miserable most days, and I have lost a very special little birdy friend very suddenly in the past, so I'm aware how quickly it can happen. (She is currently sitting on my guitar with her foot up, shivering slightly, and bleary eyed.)

I will mention the fungal/yeast possibility as well...


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## enigma731 (Aug 12, 2011)

I think Doxy is most effective given by injection. There is a form that can be put in the bird's water, but this generally isn't recommended because they don't maintain the proper strength of dosage and that can cause the organism to become resistant to the antibiotic in the future. I think I have most frequently heard of more than one Doxy injection being given, though. For instance, I know if you treat for chlamydiosis, the treatment is 30-45 days long. It's a good observation about her perking up after the injection. You might bring that up with the vet. I think if you did blood again, I would push for the CBC. That would probably give you a better idea of whether you're dealing with an infection or some kind of reproductive issue. 

Generally weight loss is considered major if it's 10% or more of body weight. It sounds like she's more or less been fluctuating within those margins, so that's a good sign. 

I wish I had a more definitive answer for you. I would not be comfortable waiting either. They can go downhill so fast. Your girl sounds like a fighter, though. I'll be sending you both good thoughts.


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## Nicole (Dec 13, 2011)

Thank you! Have phoned the vet and they suggested she be hospitalised for a day so they can monitor her behaviour... think they should have a loyalty card, 10th visit free


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## enigma731 (Aug 12, 2011)

I SO empathize there. >.<

I hope she gets the help she needs.


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## Nicole (Dec 13, 2011)

So, we took this new bird called Salmon home from the vet... seriously; totally different creature! She now paces up and down her perch squeaking in a this cute voice we haven't heard much of. She's almost as much of an exhibitionist as our little boy, Turdie! (And she's got loads of energy during the day.)

She has an abnormality in one of her nares - missing or malformed right operculum? which makes her much more susceptible to infection, so it seems she may have had a chronic sinus infection for over 6 months. I can't believe how different she is now. The vet gave her antibiotics (a different one) and she has drops into her nostrils twcie a day for 5 days.

We are very happy to have finally identified her problem, and I suspect the veterinary clinic is too. The receptionists seemed quite pained by my persistence, think they thought I had Munchausen by Proxy... 'Here we go, the Salmon obsesser again..." lol. 

Thanks for your guidance, enigma - I probably would have backed out of calling the clinic again if it wasn't for the above correspondence.:flowers:


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## carrielee76 (Nov 19, 2011)

I am glad your baby is doing better. If the receptionists felt that way then I think they need new jobs..lol. To most of us, our birds are our children, just with feathers  and will do whats needed to keep them healthy and happy!


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## enigma731 (Aug 12, 2011)

I'm so happy to hear this! Believe me, I know how you feel about people thinking you're paranoid. My rescue baby had weight loss issues for the first two MONTHS that I had her. The vet kept telling me it was just stress from the adjustment, but it finally took a triple course of antibiotics to get her better. It's worth it to push, even if that sometimes means making yourself look bad. 

I think we need pics of Salmon now. In celebration of her amazing recovery.  

Just one additional thought for you -- Do you give her showers? It sounds like a shower (in the real shower), or just spending some time in a hot steamy bathroom a few times a week might really help prevent future infections by keeping her nasal passages cleaned out. Just make sure she stays warm while she's drying off, and I wouldn't get her wet until this current infection is completely gone.


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## stevechurch2222 (Sep 25, 2011)

Glad to hear that Salmon is getting better,looking forward to seeing pictures of her.


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## Nicole (Dec 13, 2011)

Thanks everyone!  They are definitely my feathered babies. :yes:

Will be sure to post her picture - and Turdie's, because he doesn't like being left out of ANYTHING - when I get home from work. (He's another story... if anyone has any ideas about how to placate a little mister with an ego the size of Tom Cruise, I'm all ears. He can be the cutest, oddest/quirkiest, most endearing little thing, but when he's in a mood, doesn't matter what type of entertainment you offer him, his demand for that elusive, unknown requirement that we can never fulfill is insatiable - he is the little girl with the little curl. Except he's a boy.)

Enigma, so glad your rescue baby recovered . You know when something's not right. Think if you spend enough time with an animal, or person for that matter, you can usually gauge when something is off. Even if there is a possible explanation (or an improbable one by the sounds of your case), it's the subtle changes, or the gradual decline, or simply the lack of improvement which indicates things aren't as they should be.

Great suggestion about the steaming! We have mould which only exacerbates the problem, so she would benefit from the assistance.

And as far as the veterinary clinic is concerned, they are actually pretty great. Reception is staffed by nurses, I think, so they're all very knowledgeable. They all also love birds and talk fondly of the characters squawking out the back; they have been really helpful. I guess I was also aware of how I was coming across, especially since Salmon likes to pretend she's better than she is when she visits that funny place where things 'happen'. (And I'm sure they've experienced cases where people actually are hypochondriacs on behalf of their pets and are therefore never content, and I was praying I wasn't  - but knew I wasn't - one of them, lol.)


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## enigma731 (Aug 12, 2011)

Since you have mold, you might also consider an air purifier. I live in a former smoker's apartment, and mine has made a HUGE difference. You can't even tell now that there was a smoke residue. It also might help YOUR health, since breathing mold isn't good for anyone.


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## MissCV (Sep 18, 2010)

What a great result! Its fantastic to hear that she is all better now.


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## Nicole (Dec 13, 2011)

Thanks MissCV.

Good idea, enigma - have some salt like products to absorb the damp, but am currently googling air purifiers. 

Have a happy Xmas!


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## enigma731 (Aug 12, 2011)

You too!

Also, do make sure you give her a course of probiotics once she's off all the meds. That will help insure that her system gets back on track properly.  You can use a bit of plain yogurt, or a probiotic made specially for animals. I have had good success with Benebac.


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