# Desperately Need Second Opinions - Strongly Disagreeing With my Vet



## JennMichelle (May 14, 2012)

I've posted about Gandie before for weight problems and protein (albumin) deficiency. His weight has since been normalized and after a high protein diet I was waiting for his blood test to come in and feeling pretty confident that his numbers would have improved. I was wrong, but before I go into that I have to mention something that happened the first time we attempted to go to the vet.

We recently purchased a nice tiny traveling cage that I thought would make him and my other birds a bit more comfy when going to the vet. It has a carrying case meant for cold weather and restricting light but it was a bright sunny day and I didn't think it was necessary. Gandie did not like the cage so much and we let him hang out in it to try to acclimate. Eventually it became time to actually get in the car so we brought him outside. He started to get visibly upset. When we were in the car he started breathing heavily and rapidly, his eyes opening and closing strangely. Then he started to screech in a way that cockatiels normally do to express pain or severe discomfort. Then he became really still, puffed up and quiet. It scared me so much I took him back home and immediately put him in his cage to rest. In about 10 or 15 minutes he was completely back to normal like it had never happened but the vet and I agreed that we needed to wait to take him in again and scheduled another appointment.

On that appointment I only put him in the cover and he did much better along the way. The vet wanted to put him in an incubator as soon as we arrived to try and calm him down and I thought that was a good idea, considering the last time we tried to take him in. However, Gandie is extremely attached to me and I hadn't realized that when he was going to put him in the incubator he wasn't going to allow me to be in the room with him. Long story short he had another fit while he was in the incubator (he doesn't like being alone), calmed down in about 10-15 minutes like before, and then the vet did the blood test.

The vet said that these were seizures and I'll agree that they definitely look like seizures. He said he was going to look into why they might be happening and I carefully tried to explain to him that these fits only happen to Gandie under extreme duress and that wasn't why we brought him in.

Fast-forward to now, the blood results are back and they are worse than before. His uric acid levels are higher than normal along with other things (I wish I could be more specific here but no one is letting me see the blood test) that would indicate damage in the kidneys and liver. He gives me Vitamin B Complex and Lactulose and instructs me to give him .01 ccs by mouth of that mixture. Then he says that he's ordering a third medication, DMG, for his seizures. 

This is where I'm having issues. He's only had two seizures and has otherwise NEVER had any issues like this. I don't think it's right to start him on a seizure medication, which would be a lifetime thing, if he doesn't need it... and since these seizures pretty much never happen I don't really feel that he needs it. On top of all of that, how accurate would a blood test be following a seizure? He mentioned that his blood sugar and some other numbers were higher than normal and attributed that to possibly being related to the seizure but I'm wondering if the other numbers could have been affected too. 

My vet is technically retired and only comes in to his practice a couple of days a month to see birds specifically. The woman who essentially took over his practice isn't totally comfortable with birds (she says she took classes on them in school but lacks experience) but she agrees with me that the DMG probably isn't a good idea unless his seizures happen more frequently and under "normal" situations. We also have no idea how much medication to give Gandie of the other stuff. My vet said .01 ccs and to mix the medicine but he didn't say if I should give him .01 ccs of the mixture or .01 ccs of the Vitamin B complex and THEN to mix it and since he's not there all the time, no one can really answer my questions.

So what I'm wondering is:

1. Do you guys think the DMG is a good idea, given his history?
2. Does anyone have any idea how much Vitamin B Complex or Lactulose I should give him?
3. Is it time to find a new vet?


I know that's quite a lot but I feel totally lost and overwhlemed here.  On top of all of this, in the past day my 9 year old budgie has suddenly become lethargic and developed an orange stain above his cere, so now I've got two major problems and no reliable bird vet.


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## tizercat (Sep 5, 2012)

I work at a vet clinic (as a lab tech) and my opinion is that the seizure Gandie had before the blood draw would not likely affect uric acid/kidney values but would definitely affect glucose (potentially a lot) and possibly affect some liver values (mildly-moderately). You have the right to see the test results and take them to another vet for a second opinion, so phone the clinic and request that they send you a copy.

As for the medication, I would hold off on the DMG personally as I've never heard of it (though a quick Google of it right now indicates that it's a supplement more than a drug and is unlikely to harm Gandie at all). You can't overdose Gandie on the vitamin B/lactulose but I'd personally go for the 0.01 ccs of the mixture to be safe while waiting for clarification. I'd also look around for another vet; you're not comfortable with the current one and that is reason enough to seek an alternative, irregardless of how anyone else might feel about him. Good luck, finding an avian vet is rarely easy. The practice I work at has 9 associate vets and only 2 are comfortable with treating birds at all, and only 1 of those does so by choice routinely. Avian medicine is not taught routinely in vet school and the vets have to specialize in it to get any knowledge.

p.s. I'm not a vet and this response is just my personal opinion and what I'd do if Gandie was my bird.


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## JennMichelle (May 14, 2012)

tizercat said:


> You can't overdose Gandie on the vitamin B/lactulose but I'd personally go for the 0.01 ccs of the mixture to be safe while waiting for clarification.


Thanks for your response. I had no idea what the DMG was (I hadn't heard of it before either) but I can understand why the vet may have been insistent on it if it's merely an herbal supplement. I'd be OK with an herbal supplement to be cautious. 

The reason I'm worried about that is that I was under the impression that the lactulose is, in part, a laxative so I figure there's probably a way to overdose on that. 

What you said about the liver values is really interesting because from my understanding (of having listened to the vet and not seen the blood tests) both his kidney and liver values were only slightly high and drastically high, so maybe there is a chance that his liver is not in as bad of shape as we thought? That would definitely make me feel better about all of this.

Also I wanted to mention that Gandie is already on milk thistle supplements and has been for about 3 months. Sorry that I forgot to mention that.


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## roxy culver (May 27, 2010)

I wouldn't give the DMG if there is no need. These seem like two isolated incidents caused by stress, not a common occurrence.

I would also find a new vet and request the lab results. You need a vet you can get ahold of all the time, not one that's only there every once and a while.

I don't know about the dosage of the medication, that would be the first question to ask the new vet.


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## JennMichelle (May 14, 2012)

Just got a hold of the blood results (finally, it's been two weeks) and I'm really (pleasantly) surprised. The only number that is super abnormally high is his glucose level which the vet wrote off as being a result of the seizure. All of the other high values are not extremely high given the range of what is normal. I'll transcribe those results in a bit.

I do agree that a new vet is in order, I just hope there is one available. 

Also, I have Gandie presently on an egg supplement to raise his albumin levels from the previous blood test. This new blood test shows that the albumin levels are now well within the normal range (although still on the lower end) but now his cholesterol is pretty high. Should I take him off the egg supplement?


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## bjknight93 (Nov 13, 2011)

The only thing I know of here is the lactulose. My vet recommended 1 drop twice a day for Allie. For liver issues I prefer to use herbal extracts as a treatment. They are gentle on the system and they are effective. Krissi's uric acid levels were high and we treated her with Milk Thistle and Dandelion extracts by putting it in her water. A second blood test revealed her uric acid was within normal range.

If you choose to use herbal extracts here are the ratios: 1 drop each per 3 oz of water. So if you have a 6 oz dish then you put 2 drops of Milk Thistle extract and 2 drops of Dandelion extract. A third thing I use every week or so is Corn Silk Extract. I put 3-4 drops in the water once every week or so.

When using herbal extracts it is recommended to change the water twice a day.


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## enigma731 (Aug 12, 2011)

Just wanted to add that if you are buying your own herbal extracts, it's important to make sure they are alcohol-free.


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## MeanneyFids (Aug 24, 2010)

some birds can get stress induced seizures, if under stressful conditions they can seize... im wondering if he is one of those birds


http://www.avianweb.com/seizures.html


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## roxy culver (May 27, 2010)

> Also, I have Gandie presently on an egg supplement to raise his albumin levels from the previous blood test. This new blood test shows that the albumin levels are now well within the normal range (although still on the lower end) but now his cholesterol is pretty high. Should I take him off the egg supplement?


Yes I would take him off the egg supplement, since his levels are within normal range. See if you can't get him to start eating pellets, maybe it will help?


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## sunnysmom (Sep 23, 2011)

I think I would find another vet and also hold off on the DMG. My fiance thinks my tiel had a seizure once when I wasn't home. I didn't see it but from my fiance's description it is possible. We had a hawk around our house for a couple days and we think Sunny saw or heard it and freaked out while in his cage. We took Sunny to the vet for his regular check up shortly thereafter and the vet didn't seem concerned since it was an isolated incident. Also, I think it's so important for you to find a vet you're comfortable with. The first vet we ever to took Sunny to did what your vet did- he took Sunny to a different room without me and Sunny was so traumatized it seriously took him almost 4 days to return to normal. Our new vet- who we love- wants me to stay with Sunny during the exams, etc. I think that vets that don't deal with a lot of birds don't understand the attachement, etc.


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## JennMichelle (May 14, 2012)

roxy culver said:


> Yes I would take him off the egg supplement, since his levels are within normal range. See if you can't get him to start eating pellets, maybe it will help?


He is eating pellets - Harrissons High Potency. The egg supplement was there because the pellets didn't seem to be doing it on their own but now that his levels are normal again it's probably a good idea to get him off of those.



sunnysmom said:


> My fiance thinks my tiel had a seizure once when I wasn't home. I didn't see it but from my fiance's description it is possible. We had a hawk around our house for a couple days and we think Sunny saw or heard it and freaked out while in his cage. We took Sunny to the vet for his regular check up shortly thereafter and the vet didn't seem concerned since it was an isolated incident. ... I think that vets that don't deal with a lot of birds don't understand the attachement, etc.


Thanks for sharing that - I'd heard that cockatiels are prone to stress-induced seizures before but only through reading about it in a book. It's a little comforting to hear that there are others who might have observed this.



bjknight93 said:


> The only thing I know of here is the lactulose. My vet recommended 1 drop twice a day for Allie. For liver issues I prefer to use herbal extracts as a treatment. They are gentle on the system and they are effective. Krissi's uric acid levels were high and we treated her with Milk Thistle and Dandelion extracts by putting it in her water. A second blood test revealed her uric acid was within normal range.


I would really like to try this. I'm already using the Milk Thistle but not the Dandelion or Corn Silk extracts. Uric Acid was one of the high values on his last blood test so I think this could really benefit him. The Vitamin B Complex is supposed to help his kidneys which is what I'm most concerned about considering that those numbers wouldn't have been affected by the seziure. The liver related levels are elevated but not extremely, so its possible that some of them might be due to the seizure.


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## tielfan (Aug 31, 2008)

Other people have already said everything that I would have said about the medical aspects of the situation (and some of them said a lot more than I knew!).



> The first vet we ever to took Sunny to did what your vet did- he took Sunny to a different room without me and Sunny was so traumatized it seriously took him almost 4 days to return to normal. Our new vet- who we love- wants me to stay with Sunny during the exams, etc. I think that vets that don't deal with a lot of birds don't understand the attachment, etc.


I suspect that the birds who freak out when separated from their owners like this are having an instinctive reaction. Pet birds have a flock bond with the people in their household, and in the wild the flock is very important to a bird's sense of safety. When a stranger walks off into another room with the bird, the bird might think it's being dragged away from the flock by a predator. Not all birds are this sensitive, but for the ones who are it's a good reason to panic.


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## JennMichelle (May 14, 2012)

As an update, I went through his numbers with my father and found through a little research that a LOT of them are affected by seizures. 

A second thing we found was a report about a cockatiel like Gandie who had low albumin levels and a member of the AAV advising the owner not to add any protein supplements or diet changes until multiple blood tests showing a trend had been performed. In fact, he even went as far as to say that a higher protein diet could cause kidney damage and possibly lead to all out kidney failure. :/ This was not what we were told at all, Gandie had only one test before we were told to supplement his diet with more protein and now it looks like he has kidney problems. Needless to say, I'm really upset and we're changing vets. We found a promising one about 20 minutes away with three AAV vets.

In the meantime, I'm taking out his protein supplements entirely. I'm keeping him on the milk thistle to be on the safe side with his liver but is there anything else I can do to help with his kidneys? 

Considering the stress involved on Gandie's part in going to the vet we don't want to take him in to see the new one right away unless we see something that would indicate that we need to. Even following the seizure, none of his numbers were so drastically high (except his glucose which was through the roof at 700) that we feel like he is in immediate danger. Even my old vet didn't think it was necessary to see him again for another 2 months.

So what I'm looking for now would be any recommendations on how to help his kidneys recover a bit aside from removing what might have harmed him. He drinks a lot of water (he always has, I think he likes to play with it a bit) and I know that in itself can be indicative of kidney damage.

Also thanks again to everyone who posted the links to stress seizure information. Not only was that extremely useful but it also helped us to reassure ourselves that it wasn't some sort of end-stage liver failure induced seizure (even though his numbers didn't reflect that either, it's still nice to have multiple sources with that information).

His diet right now consists of about an inch of Harrissons High Potency with a teaspoon of seed mix (low on sunflower seeds, he doesn't like them anyway). He also gets a spray of millet that he eats periodically. It takes him somewhere between 3-4 days to eat one spray so I don't think he eats much of it daily. He gets the occasional cheerio, whole wheat bread and walnut treat. Also whatever vegetable we have with dinner (haha). I've been trying to get him to eat a vegetable mix that has more greens in it but he won't touch it. :/ His favorite vegetable is corn so he'll just eat all of that out of the mix and ignore the rest.


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## MeanneyFids (Aug 24, 2010)

i dont know 100% with birds, but if his glucose is through the roof, it could be diabetes, especially with drinking a lot (which could also be caused by kidney disease)

cats with diabetes can be tested checking glucose and if it is high in their urine it can indicate diabetes and in cats, drinking a lot is a symptom. 

it would not hurt to ask your new vet about it, as its not unheard of for birds to be diabetic.


http://www.exoticpetvet.net/avian/d...fections
anxiety which could lead to seizures


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## JennMichelle (May 14, 2012)

DallyTsuka said:


> i dont know 100% with birds, but if his glucose is through the roof, it could be diabetes, especially with drinking a lot (which could also be caused by kidney disease)
> 
> cats with diabetes can be tested checking glucose and if it is high in their urine it can indicate diabetes and in cats, drinking a lot is a symptom.
> 
> ...


I will definitely ask the new vet about that when we go to see them. Apparently following a seizure, glucose levels are known to go through the roof though, so that particular number is probably not a reliable representative of what his numbers are normally like. For comparison, his blood test only two months before this one had his glucose at 324 which is within the normal range.

While I'm at it, here are his blood test results post seizure and the blood test taken two months ago for comparison.

Albumin: Post Seizure: 1.5 Two Months Ago: .9
Globulin: Post Seizure: 3.0 Two Months Ago: 3.1
AST: Post Seizure: 405 Two Months Ago: 381
Phosphorus: Post Seizure: 5.0 Two Months Ago: 3.6
Glucose: Post Seizure: 700 Two Months Ago: 324
Calcium: Post Seizure: 15.5 Two Months Ago: 8.5
Sodium: Post Seizure: 168 Two Months Ago: 147
Potassium: Post Seizure: 3.9 Two Months Ago: 3.8
Chloride: Post Seizure: 135 Two Months Ago: 108
Cholesterol: Post Seizure: 480 Two Months Ago: 264
CPK: Post Seizure: 465 Two Months Ago: 333
Uric Acid: Post Seizure: 15.5 Two Months Ago: 2.1

Obviously a lot can happen in two months but many of these, particularly AST, Glucose, and CPK, are known to rise sharply following a seizure. The blood test was only done about 10-15 minutes following the seizure so I think it would certainly reflect those spikes. This is just from my understanding of what each of these things do in the body which is admittedly mostly based in the knowledge of human biology not avian.


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## MeanneyFids (Aug 24, 2010)

i hope he is ok  it sucks when they are sick


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## JennMichelle (May 14, 2012)

DallyTsuka said:


> i hope he is ok  it sucks when they are sick


Me too. I have high hopes for him because he's been through a worse health crisis before and completely recovered from it with flying colors but it's actually hard for me to look at the numbers regardless of how I feel about them - especially having seen the seizure first hand (and hearing it in the other room the second time). It was easily the most terrifying thing I've ever encountered with a pet before.

Oddly enough, I've had a diabetic pet before but it was a cat. We first noticed that he had diabetes when he got a infection (his blood sugar was 350 something when we brought him into the vet, when cats are supposed to be around 100). He had also been excessively drinking but he had the other symptoms of type 2 diabetes like being overweight, cataracts, etc.

On a side note, I have to say that I love your birds. I saw a video of your Tsuka talking and it reminded me a lot of how Gandie talks. Also Mango's coloring is beautiful.


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## tielfan (Aug 31, 2008)

Since you want to scale back on the protein, you might want to switch to the Lifetime (regular) Harrisons instead of the high potency. There's a list of the ingredients for the various Harrisons foods at http://www.harrisonsbirdfoods.com/ingredients.html If you're using the fine, there's 20% protein and 12% fat in the high potency formula versus 14% protein and 6% in the lifetime formula. The chart at the bottom of the page shows that there are also some differences in the vitamins etc, so there's a tradeoff.


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## JennMichelle (May 14, 2012)

tielfan said:


> Since you want to scale back on the protein, you might want to switch to the Lifetime (regular) Harrisons instead of the high potency. There's a list of the ingredients for the various Harrisons foods at http://www.harrisonsbirdfoods.com/ingredients.html If you're using the fine, there's 20% protein and 12% fat in the high potency formula versus 14% protein and 6% in the lifetime formula. The chart at the bottom of the page shows that there are also some differences in the vitamins etc, so there's a tradeoff.


Yeah I was wondering about that myself. I think in order to scale him back slowly I'm just going to eliminate the egg for now. I have a hard time getting this guy to eat vegetables that aren't corn so I hesitate to scale back on those vitamins until I can fix that. For example, I've been trying to get him to eat broccoli all night. He's shifting between playing with it and avoiding it entirely (and I mean that, he'll completely avoid the entire perch I put the broccoli above). I'm hoping I'll be able to acclimate him to it but he's being incredibly stubborn. I have two other birds and they were curious enough to try it. 

From what I understand... Vitamin B will help him with his kidney problems. That seems to be present in both formulas but I'm having trouble figuring out if there is MORE of it in the High Potency than the normal maintenance.


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## tielfan (Aug 31, 2008)

The chart at the bottom of http://www.harrisonsbirdfoods.com/ingredients.html lists several of the B vitamins and shows that the high potency does have more (the chart headings of ALF and HPF indicate Adult Lifetime Fine and High Potency Fine).

There are other ways to add B vitamins to the diet though. Brewers yeast will do it.

For the veggies, try hanging up some small leafy greens like baby organic salad greens to see if he likes them. If you have access to chemical-free lawn grass, pick some of that and wash it and clip it to the cage. Unripe seed heads are a bonus. Grass is part of the native diet of wild cockatiels so you might get some help from his natural instincts.


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## JennMichelle (May 14, 2012)

I'll definitely try the leafy greens. I got him to eat a veggie mix yesterday so that's a start. His protein supplement had brewers yeast in it so I'll have to find another source somewhere. Before I got that stuff I had scoured health stores and super markets but a new one just opened up so maybe I'll have more luck there.

I live in a condo and the management sprays the grass with so much pesticide that I'M afraid to walk in it (I used to have an outdoor cat that would come home with his paws stained yellow it was so bad) so I can't feed him that but I'm sure I can find alternatives. Thanks for your help on upping his vitamin B intake. :3


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## tielfan (Aug 31, 2008)

Brewers yeast is one of the most basic "health food" items, so any half-decent health store ought to have it. If they don't, it should be easy to get it online.


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