# Concussion



## foobie (Sep 6, 2011)

Hi everyone,
My Junior flew into a wall two days ago and has a concussion. I took him to the fed who gave him a steroid shot and traumeel drops (every six hours). He will eat a little millet and drink water. He has also been talking. He still seems weak and is puffed up all the time. We also have a warming lamp on his cage and have made it fall-proof. He still can't use his right leg. Has anyone gone through this with their bird? Is there anything else I can do? I love him and I am devastated. Any help or encouragement would be greatly appreciated!


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## tielfan (Aug 31, 2008)

Do you know what kind of steroid was given, and what's in the trauma drops? Probably the best person to give you advice on this is enigma731. She isn't on the forum at the moment but will probably be here later today, and she'll be able to help you more if she knows exactly what treatment has already been administered.


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## foobie (Sep 6, 2011)

*Junior*

Hi tielfan,
I think it was dexamethasone. The traumeel is some kind of holistic medicine to relieve inflammation. I haven't given him any today yet. They didn't give me a time frame. Thanks for your quick reply. I will check with enigma731 this afternoon. Thanks again!


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## tielfan (Aug 31, 2008)

Thanks, that helps. I didn't realize at first that Traumeel was a brand name and thought it was a misspelling of trauma. 

I expect that she will consider the steroid to be the main effective medication. Traumeel is a combination homeopathy/herbal preparation, more homeopathic than herbal. The medical community considers homeopathy to be a placebo, but some of the herbs are present in enough quantity that they might have a minor beneficial effect. The main ingredient, arnica, is diluted at the homeopathic level.

The company website http://traumeel.us/

An independent evaluation http://saveyourself.ca/articles/reality-checks/traumeel.php


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## JennMichelle (May 14, 2012)

Sorry to hear about your Junior.  My Gandie flew into a window a while ago and while he didn't get a concussion I feel your concern. It's very heart-wrenching to watch a sick cockatiel.

When cockatiels are sick, heat is really important so a heating lamp is a great thing to have. You can further insulate him by covering the cage with saran wrap in all of the places that the light doesn't directly shine on - but if you do that watch him closely to make sure he isn't panting or slicked down with his wings up (like he is overheated). I did this when my cockatiel was getting supplemental heat for a liver problem and he really seemed to benefit from it. I used a heating pad under the cage as the main heat source, so I'm not completely sure if adding the saran wrap would be too much heat with a heat lamp (if some one wants to elaborate on this, feel free) but he should be fine if you watch to make sure that he does not become overheated or dehydrated. Normal cockatiel body temperature is about 104. I got my "incubator" to about 95 degrees but from what I understand, good supplemental heat is usually around what the cockatiel should be at body temperature so higher than that is ok.

It's also good that he's eating millet. An active interest in eating is usually a good sign in cockatiels.


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## foobie (Sep 6, 2011)

*Junior*

Thanks JennMichelle and tielfan,
It's such a comfort to have your advice and support. Right now the room temp is about 80 and the lamp has a 25 watt bulb. He is puffed up, but I think he's comfortable. We put a false bottom on the cage, so there isn't a place for a heating pad. I mixed some baby bird food for him, but he doesn't want to eat it. I moved his cage into another room, because he was sounding his usual alert when someone came to the door, and I thought he still needed a quiet place. Is it ok to take him out of the cage and pet him? He really likes that. Junior was abandoned by our neighbor. We've had him 2 years and really love him. I feel so responsible for this.


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## bjknight93 (Nov 13, 2011)

You can take him out and cuddle him.  it might make him feel better. Just don't let him fly away from you.


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## tielfan (Aug 31, 2008)

Don't feel guilty; a wall is a solid, visible object and unlike a window there's really nothing you can do to prevent a bird from flying into it (I've had a cockatiel knock himself silly flying into a wall). 

It's best to NOT provide supplemental heat with a head injury. Heat is beneficial in a lot of ways, but it does promote swelling and there's no where for the swelling to go inside the skull. 

I found a good article on avian head trauma at http://www.newyorkbirds.net/headtrauma.html It says that a steroid injection is the best treatment and dexamethasone is one of the steroids commonly used for this purpose.

It also says to avoid handling the bird for 48 hours. The accident was two days ago, so if he likes being petted it may be safe to do it now. But do it carefully, and try to arrange the situation so he won't be tempted to fly and won't be able to get into very much trouble if he does take off. He definitely doesn't need another crash.


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## tielfan (Aug 31, 2008)

Here's another good article on head injury: http://www.birds-online.de/gesundheit/gessonstiges/gehirnerschuetterung_en.htm It talks about loss of appetite after a head injury and recommends feeding foods that are easy to digest. Soaked seed is a good option if Junior likes it, and the wetness makes it stick to your finger easily so you can offer it to him on your finger tip.


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## foobie (Sep 6, 2011)

*Junior*

Great information tielfan. I'll check out the article!


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## foobie (Sep 6, 2011)

*Junior*

So far, he's devouring the millet. I will try the soaked seeds. Thanks!


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## enigma731 (Aug 12, 2011)

From everything I've read, dexamethasone is the treatment of choice for an injury like this. So your vet did the right thing there. I'm not sure about the Traumeel drops -- If it were my bird, I'd want an anti-inflammatory/painkiller to take home, like Metacam. (I believe it can be used in combination with dex, but you'll want to double check that with your vet if you request it.) 

Head injuries take time to heal. In humans, concussions can take weeks to months to heal fully. How does he seem now in comparison to the last two days? If he's not getting worse, then I would just try to give him lots of support, rest, and time. However, if you notice him going downhill, then it's time to consult the vet again to consider the possibility of greater measures like possibly putting him on oxygen.

The one-sided lameness could be caused by inflammation/muscle damage from the crash, or it could mean that there was a small bleed in his brain due to the crash. It's way too early to tell at this point, but I think you've taken every action you could in this situation and have every reason to hope for a good outcome. 

Please keep us updated! I will be thinking of you and him.


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## foobie (Sep 6, 2011)

*Junior*

Thanks for your reply. Junior seemed to be making progress tonight. He ate some regular food and was drinking his water. He might have a little more strength on his right side too. I will call the vet tomorrow and find out if there's anything else I can do. I so appreciate your help. I will keep you posted.


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## enigma731 (Aug 12, 2011)

It's very promising that he's eating better. You're doing great with him.


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## foobie (Sep 6, 2011)

*Junior update*

I called the vet this morning and told them he was "a tad" better. They said he should be either much better or back to normal, and wanted me to bring him in for another steroid injection. My partner said he seemed much better because he was eating and drinking more and had better balance. I didn't want to traumatize him further by dragging him to the vet again. They told us to just watch him, and if he gets worse to bring him in for a shot. He's still in a dark quiet room and is taking the traumeel. (as per the vet's instructions). Hopefully we're still doing the best thing for him. Thanks again for all the support.


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## JennMichelle (May 14, 2012)

Glad to hear that Junior is doing better. I agree with your partner in that if he is eating and drinking more with better balance that he is doing much better but if what you are doing is helping him it can't hurt to continue the treatment.

I sympathize with not wanting to drag him to the vet. My male cockatiel hates the vet and travel with a passion and it is usually very stressful for all involved. The steroid shot is to reduce swelling that happens with a concussion so if you see him decline you probably need to go in for another round. I'm not huge on homeopathic medicine myself, but if you think it's helping go for it - I've heard of people finding some success with it.

Is he still very fluffed up all the time? If he isn't, that would also be a very good sign.


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## foobie (Sep 6, 2011)

Hi JennMichelle,
I don't think he's as fluffed up, if that makes sense. He still seems lethargic, but maybe that's the traumeel. When he was first home from the vet he seemed to be rocking while he was sleeping, and he's not doing that anymore. The main improvement is the eating and drinking. It's so difficult to know what's right for him! From what I've heard, the first forty-eight hours are the most crucial as far as brain swelling. I just don't want him to have something he doesn't need.


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## JennMichelle (May 14, 2012)

Considering what is in Traumeel, I don't think that would be making him lethargic. However, discomfort would so it still makes sense to me that he wouldn't be as active as he has been. Rocking back and forth might have meant that he was off-balance so I don't think that it's a bad thing that he's stopped.

I'm not a vet but I don't understand why your vet thinks he should be completely better. As some one said, concussions in humans can take quite a while to heal and although birds do seem to heal quickly (I watched a scab from hitting the window go away in about two days on my bird) I don't think that a concussion would get better that quickly.

It seems to me like you're doing all of the right things and that as long as he is improving and not declining you're on the right track.


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## foobie (Sep 6, 2011)

Thanks for the encouragement. It's hard to know what's best. This morning, he walked across his cage, which was really a good sign. He seems to want more attention too, but we're still keeping him in a quiet room. I agree with you about the time frame for a concussion. I'd rather let him heal slowly then put him through another vet visit.


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## foobie (Sep 6, 2011)

*More about Junior*

I have to admit, I'm overly obsessive about my animals. Also, I don't have blind trust in most doctors (medical or otherwise). So, I hope no one minds me double-checking some things I feel would be good for Junior. It's been four days since his concussion. The vet wants me to keep him in a quiet room until he is normal, but he seems to want to socialize. Is he still in danger of brain swelling? Everything I've read says it happens in the first 48 hours. He can walk a little now, and he's eating and drinking. He's sleeping a lot, but it could just be from being alone. As always, I appreciate any suggestions.


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## tielfan (Aug 31, 2008)

enigma will be your best source of advice on this, since she works in the field of human brain issues. But my nonexpert opinion is that if he wants to socialize you should socialize with him, but avoid getting him overexcited or overtired.


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## enigma731 (Aug 12, 2011)

Acute brain swelling as a result of the concussion does happen mostly in the hours following the accident. However, there are many inflammatory processes which will continue for weeks or even months as a result of the injury. Therefore, you will want to avoid having him get over-excited or over-tired, since it could worsen the inflammation. But I also think there's something to be said for the support of handling him. If he likes to be handled, then I think you can give him some time with you. Just be gentle and make sure he can't get startled and take off again.


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## foobie (Sep 6, 2011)

Thanks tielfan! That's what we started doing. I will also check with enigma about the brain stuff.


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## enigma731 (Aug 12, 2011)

I just answered you.


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## foobie (Sep 6, 2011)

*Junior*

Thanks enigma. We are keeping the handling to a minimum. Also, he stills sleeps a good portion of the day. He will eat, drink, and has shown improvement with his walking. Should I be concerned about the sleeping, or is it just part of the process. I'm still second-guessing myself regarding the second steroid shot. Sorry to keep pestering you.


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## enigma731 (Aug 12, 2011)

I'm probably the most neurotic bird owner you will ever meet, so please don't ever worry about asking too many questions.  

As far as the second steroid shot, that's a tough call and I unfortunately don't think there's a clear answer. The thing with brain swelling is that the longer the inflammation persists, the more brain cells can die as a result of a toxic biochemical environment. That's where permanent damage comes from in concussion or stroke. 

Unfortunately, though, I'm really not familiar with the timeline for healing in a bird. I think your vet's estimate of being "back to normal" in two days is probably unrealistic, but I'm also not sure what length of time the dexamethasone stays active. There's also the complicating factor of your bird's stress level when he goes to the vet -- that means that potentially, taking him in could also worsen the inflammation that's already present. So it really isn't a clear decision. 

I think probably if he were my bird, I would be insisting on an oral anti inflammatory that can be given at home. I know you have the Traumeel -- But, without any disrespect to holistic medicine, those active ingredients have never been shown to be beneficial in studies of concussion. I would want something proven, like Metacam. I think, if giving an oral med like Metacam did not further improve symptoms, then I probably would be reconsidering the second steroid shot. But keep in mind that I am not a vet, and this is just my opinion.


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## foobie (Sep 6, 2011)

I think this vet is really into homeopathic stuff (which doestn't seem to work that well with humans either). I will ask about the metacam though. Tielfan said you work in the field of human brain issues. I wish you could help with mine! Thanks again.


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## enigma731 (Aug 12, 2011)

I mostly work in stroke rehabilitation, but concussion/traumatic brain injury is pretty similar in terms of the biology at work. What I don't know is how a bird's metabolism differs from a human's in terms of medication absorption.


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## foobie (Sep 6, 2011)

Junior was more active this morning. He walked back and forth in his cage, and ate lots of broccoli. He was also singing. Music to my ears.


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