# Tiel with severe Anemia - Panacur a cause?



## sweltering (Oct 5, 2012)

*Tiel with severe Anemia -Help with cure?*

My male 4 year old, Rosie, was treated for Giardia a month ago with Flagyl, followed by Panacur, followed by Amoxi with Prozyme to help digest his food. It has been a downhill slide since the Panacur. His red blood cell count this week was down to 15 and the Vet's prognosis was not positive. Putting to the side for now what caused this; which I strongly suspect was Panacur. I was hoping to hear from anyone who's bird was this ill and what they did for recovery, if it is even possible. The last test showed that his red blood cells were not regenerating. He is eating well but his health has worsened, today he is very weak and wobbly, not moving much and when he does he loses his balance. Please let me know anything, even if it's bad news I am just wanting information to either help or prepare.


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## tielfan (Aug 31, 2008)

I don't know anything about this subject but apparently Panacur can cause bone marrow problems, see http://www.vetnet.co.uk/forum/autoimmune-hemolytic-anemia-caused-by-panacur-2011112518320831854.htm Red blood cells are produced in the bone marrow.

Did your vet have any recommendations? 

I recently heard about a food product for critical care nutritional support, see http://talkcockatiels.com/showthread.php?t=34035 I know your bird is eating well, but Emeraid contains some special ingredients that are supposed to help with tissue repair. It probably wouldn't help with bone marrow regeneration, since regeneration normally requires a transplant in humans; but maybe it's worth a try as a desperation measure. 

I'm sorry, I wish there was more I could do to help you.


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## sweltering (Oct 5, 2012)

*AHIA Treatment found with steriods*

I found this Avian Vet in California that has a 75 % success rate with this drug treatment program. I've sent the info to my vet although it may be too late for Rosie - http://www.altaranchopet.com/Information_library/Dog_Cat/autoimmune_anemia1.htm

Autoimmune hemolytic anemia (AHIA) is a serious disease in which the body’s immune system destroys the red blood cells.

The first drug we use is Prednisone (a form of cortisone). Given at high doses, this drug will inhibit the immune system’s ability to kill the red cells. Often times, we must add additional drugs such as Cyclophosphamide, Azathiaprine or Cyclosporine, all of which are very potent drugs. All of these drugs have side effects that are fairly common. In general, the positive, life saving effects of the drugs outweigh the negative side effects, however, these patients must be monitored carefully both at home and through laboratory tests. 
For patients that are severely anemic, blood transfusions may be necessary to provide red cells until their body can produce more. Transfusions can be life saving, but they do pose some risk of adverse reaction where the body rejects the new cells. 
Because prednisone can cause stomach ulcers, we typically administer drugs to help protect the stomach during the course of treatment. 
Vitamin and iron supplements are given to provide the building blocks for the new red cells. 
PROGNOSIS: It is important to understand that our treatment may not cure the disease, but instead, may keep it in remission. Most pets require treatment for a minimum of 6 months during which time we try to wean them slowly off the life saving drugs. In some cases, drugs are not enough to control the disease and we may have to surgically remove the spleen because this organ is the site where the majority of the red cell destruction takes place. Overall, 75% of pets with AHIA can go on to live a normal life. Unfortunately, some patients will die from this disease despite even the most aggressive treatment.


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## srtiels (May 1, 2009)

I would avoid using the prednisone. It will retain fluids in the body and this can accumulate in the abdominal cavity (ascites) and around the heart (edema)....not good.

The first thing that might help is to do Sub-Q fluid therapy to get the fluid volume up in the blood. When this is low the bird also has a harder time maintaining body heat. Injectable B-complex and iron dextran will also help.

If Prozyme was given, did the vet have you do a course of Probiotics before and after all the treatments. Many times this alone will aid in good intestinal flora and nutrient absorption and digestion.

WHY was the bird treated with Flagyl and later Panacur to begin with? Were test done to show there was a protozoa (flagyl) or intestinal parasite (panacur) problem to begin with?


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## sweltering (Oct 5, 2012)

Rosie has really no chance at this point for any recovery. Yes, we did actually see the Giardia in his sample. Flagyl was prescribed and Harrisons High Potency Pellets. At 7 days he was still ill so was prescribed Panacur and Avi Booster Concentrated. A week later he had lost 9 grams and xrays revealed his abdomen severely bloated with gas and he was kept overnight. He was then prescribed Amoxi drops, Prozyme and Harrisons Mash. Rosie would not eat the mash but wanted to eat so I continued with cooked rice/grains, mash and Harrisons H.P. pellets. 

The next re-check he had lost another 9 grams, down to 61 grams had a red cell count of 15 down from 50 the week before and was seriously anemic. Blood tests showed that he was not regenerating red blood cells. The Dr. gave him a shot of Iron and B vitamin. He suggested a blood transfusion but there were no guarantees. At this point we had spent $1200 with no idea of what the root cause was so we decided to care for and love him hoping he could beat whatever it was. So, that is how we got to where we are today. He is pretty much immobile and has little strength left. I am just devastated about this. He was incredibly healthy and active a month ago and now he is just a small ball of fluff that can barely chirp. :tiel1: P.S. I'm sorry this is so long winded.


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## enigma731 (Aug 12, 2011)

First of all, autoimmune hemolytic anemia is a very specific type of anemia in which the body attacks its own red cells. This is unlikely to be the case with anemia following a drug reaction, which is what it sounds like Rosie has. Prednisone is an immunosuppressant, so it would only work if there is a misdirected immune response in the first place. 

Unfortunately I'm not sure how one would treat without some type of transfusion. It does sound like vitamins and supportive care are your best options, but if his body doesn't start regenerating red cells at some point, he will not recover. 

I'm very sorry that you're going through this, and that I don't have more advice.


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## sweltering (Oct 5, 2012)

That is interesting information. Of course I don't know the cause, just my intuition which is an artform not a science. The Vet is just willing to do whatever, I don't think he does well with bad news.

Rosie will probably pass tonight he is spending alot of time on the floor of the cage and fell from one of the bird feeders when jostled by my other cockatiel a little bit ago. So for now I am singing him his favorite song "Waltzing Matilda" and l letting him eat whatever he wants, which in his case is millet. My father in law's last meal was cookies and milk. Mine will be chocolate.


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## enigma731 (Aug 12, 2011)

I'm so sorry to hear that. Unfortunately I think this is one of those areas where avian medicine just is not very developed, so there isn't a very good protocol for treatment when something like this happens. I'm glad you are keeping him as comfortable and happy as possible.


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## tielfan (Aug 31, 2008)

This is very sad. You're doing the best you can for Rosie but sometimes our best isn't good enough. Best wishes to all of you.


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## sweltering (Oct 5, 2012)

I guess Rosie is a real fighter. This morning he has been eating from several food dishes for several hours on and off. He is more energetic but still very unsteady, cannot balance on one foot to scratch for example. He seems to want to be in the sun so I moved his cage onto the patio; the temperatures today are very pleasant. His poops have more form and substance; white and pale green; but still with bubbles. Thank you all for your comforting thoughts. We will see if Rosie is able to fight himself back from the brink.


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## birdsoo (Jul 4, 2012)

Aww bless her lil heart. Maybe she had reaction to all that medication and her body is very slowly recovering? Did they vet check her droppings after the meds to see if there is any infection? If her whole balance is off, she might have some infection in her GI tract and that might also be why her droppings are bubbly. 

I remember reading about the herb salad for birds that gives them the necessary nutrients to fight off diseases. Maybe you can order a package and offer some?


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## sweltering (Oct 5, 2012)

He put him on Amoxi which is an antiobiotic and Prozyme to replace his enzymes. The antiobiotic Amoxi has sulfa in it and that can cause an allergic reaction too. The Vet Tech said the bubbles could be from the enzymes but I didn't bring it up with the Vet. I stopped all meds but still give him the Prozyme. If he recovers it will only be because he is strong willed.


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## tielfan (Aug 31, 2008)

I'm so relieved to hear that Rosie made it through the night!

Give him plenty of sunshine, since he enjoys it. Direct sunlight helps birds produce vitamin D3 which is essential to calcium absorption. I don't know of any direct benefits for red blood cell production, but it certainly can't hurt and will be beneficial for some of his other physical functions. Muscles need calcium for normal function, and if he previously had any calcium deficit this will help improve his muscle strength.


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## sweltering (Oct 5, 2012)

It's just downright crazy. He is eating like a horse today and his feet and tongue are pink! This afternoon his drunken wobble continues but he is a very different bird from yesterday. Cautiously optimistic!


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## tielfan (Aug 31, 2008)

That's wonderful news! Maybe he has turned the corner and is on his way back to good health.


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## SunnyandChickie (Jul 9, 2012)

That is great to hear!


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## sweltering (Oct 5, 2012)

Rosie continues to improve. His tongue is actually pink today. He is still eating when he isnt' sleeping and his poops continue to improve. I guess these little guys can battle back from severe anemia after all. I started him on probiotics as was suggested by the group yesterday. Rosie's recovery can be a positive marker for others whose fids fall into the same ill health.:flowers:


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## stevechurch2222 (Sep 25, 2011)

So glad that Rosie is improving that is indeed great news.


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## wings (Feb 12, 2009)

Your story broke my heart, but I am overjoyed to hear that sweet Rosie is showing improvements. Wishing her strength, and a full recovery!


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## sweltering (Oct 5, 2012)

I'm sorry to cause others to be sad. I just had to reach out to other bird owners who would understand my feelings and provide some insight and advice. I believe Avian medicine is an artform not an exact science. By using their medical knowledge, bird owners experience and my intuition I really believed that Rosie would have the best chance.

Thanks again for everyone's' advice and support.


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