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I have a timneh, 1 1/2 years old. He has been treated with

Customer Question
an antibiotic and anti-inflammatory for...
I have a timneh, 1 1/2 years old. He has been treated with an antibiotic and anti-inflammatory for tiny red spots on the white skin around his eyes. Almost looks like tiny bruises. It cleared up, comes and goes now, worse with stress. That was 2 months ago. Two days ago he became very lethargic, regurgitated water he had just drank (only once), and has had large, mucus like stools. He is very unstable on his feet, and very hunched over. Very quiet, doesn't not really move much. Took him to vet, they have him oxygen and fluids, and complete exam. X-ray did not show metal - she thought heavy metal poisoning. His intestines looked dialated in X-ray. Vet thinks it might be pdd. His "knees" seem inflamed. Checked for access to metal, he does sit sometimes on a cheap curtain rod. No signs of chewing or scraping but he does use his beak to pull himself up. Have you ever seen such a combination of symptoms? I believe the red spots are key. Kristi
Submitted: 2 years ago.Category: Bird Veterinary
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Answered in 1 day by:
11/25/2015
Bird Veterinarian: Dr. Pat, Bird Veterinarian replied 2 years ago
Dr. Pat
Dr. Pat, Bird Veterinarian
Category: Bird Veterinary
Satisfied Customers: 3,596
Experience: 25+ years working primarily or exclusively with birds
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Greetings, I am Dr. Pat. I have worked with birds exclusively for many years.​ I have a couple of grays myself and have had many African Gray patients.

Can you share any blood work results? What antibiotic, antifungal and what antiinflamatories? Is he on anything for metal toxicity?

There are tests for Borna virus (the presumed cause of PDD) and I would certainly run that test. Also metal toxicity can be evaluated with a blood sample.

I have seen PDD be associated with severe neurological damage including lameness, but generally not with swelling in the legs. And the petechiae-like dots on the face are not seen.

How long has this been going on?

How long have you had him?

Where is he from? Breeder, pet store, private?

Any accidents or trauma?

Interactions with other birds/pets/children/guests?

What is the usual diet? has it changed recently?

Has the bird gotten into anything? Chewed electrical wires?

What is your geographic location and local weather?

IMPORTANT Check the website for the feed you give, there have been many recalls; or check this link:
https://www.avma.org/News/Issues/recalls-alerts/Pages/pet-food-safety-recalls-alerts.aspx?fvalue=Other

or
http://www.petfoodrecall.org/

or
http://www.fda.gov/Safety/Recalls/default.htm

If this were my patient, and money no object, I would start with complete fecal analysis and direct smear, stained with Sedi-stain and unstained for multiple parasites, fungi, spirals; direct smear stained with Sedi-stain and unstained of the oral cavity; anerobic and aerobic bacterial culture and sensitivity of the feces and choana. Depending on the case I might do a fungal culture. Routine blood work is necessary to rule out other issues including metal levels. There are MANY DNA/RNA tests for bird diseases. Ultrasound is often more informative than radiographs and does not require anesthesia (ask your vet about this option). Generally I start them out on medications as indicated by the tests.

One thing I would mention is that labs often only grow "abnormal" bacteria. I request that they grow ALL bacteria, and have found that many pathogens are overlooked. These include things like C. dificile and MRSA. In a mystery case it is important not to overlook anything. If you are involved with health care, elder care or children care, these are fairly common pathogens in pet of health care workers.

With the GI signs you described I would certainly add anaerobic bacterial culture of crop and feces.

Also I use a lab that only does birds and exotics and they are geared more toward rapid and correct diagnoses.

AAV recommended lab work

Please get back with me and I will try to help.

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Customer reply replied 2 years ago
I got him from a well reputed pet store that does specialize in birds, Preuss pets in East Lansing, Michigan. He had been screened by a vet prior to purchase in late August 2014. He was ill last January, and diagnosed with a yeast infection and gram negative rods (only a few). He was given baytri, Bebe-bac, terbinafine and meloxicam. He recovered within a few days. He started having the red "spots" by his eyes in September. His labs showed 70% gram positive cocc, 1%gram positive rods and "heavy" bacteria. The complete cell analysis showed slightly degranulated heterophilis, from stress or a low level bacterial infection. He was given Septra and pediapred. He again recovered in a few days. Both times the full cycle of medication was given. Since September he has periodically gotten the red spots, and the vet thought it might be an allergy or just an irritation. It does clear up with a few doses of pediapred. He seemed fine until this past weekend. We are in Michigan, it is getting colder. I have 2 Indian ring necks, a green cheek conure and a Parrotlet that I have had for 6-13 years. In July I adopted a 5 year old rose breasted cockatoo. She sometimes shares a play stand with him. None of the other birds seem ill or have any symptoms. None have ever had need to go for veterinary care.He has not been in contact with any strange people, birds or animals.He typically eats well, for dry food a mix approximately 10-15% seeds (not sunflower), dried fruit and nuts, with a mixture of pellets including avian entree, Harrison's, zupreem, and caitec baked pellets. For fresh food he eats a mix of cooked brown rice, wheat pasta, quinoa, boiled beans and assorted chopped vegetables and fruits. He was eating edamame but I recently cut that out worrying that the estrogen in the soy may be affecting his behavior. He has been very clingy with me, and makes a call like the blue jays outside rather than speaking much or making other household noises like he used to. This has been going on for several months. Now in retrospect I wonder if the behavior change could be the result of an underlying illness, not a spoiled hand fed bird. (I did finish his hand feeding when I purchased him).I can't find any sign of chewed wires, possible sources of poisoning or anything out of place. He does have his wings clipped, and does sometimes fly off the top of he cage, hitting his chest to the ground.As I mentioned before, the only source of anything I can come up with is he sits on the top of a curtain rod I bought a target with a resin finish that is imported. It just says it is metal. don't see any sign of chewing, but he does need to use his beak to pull up. The red spots started after he started spending more time at work in my office instead of at home. (Due to his loud squawking call whenever he hears me). He does have an avian full spectrum light in there which I moved farther back to see if that could be causing it. (We own a furniture store - I am there 6-7 days a week, so several of my birds live there. If I don't work Sunday I bring him home).I have attached photos of the labs we have back so far, as well as the breakdown of everything ran when we were there Sunday. I'm hoping to have the heavy metal, zinc and Borno virus results tomorrow, those were not back yet yesterday. They suggested switching him to baytril tomorrow if he is not better.He is a little stronger, and is starting to eat on his own. I did not hand feed him today to see if he could eat, now that he is standing up ok without having to use his beak for balance. He is still a little unsteady but much better. He is moving in the cage, and calling out and making other noises. His stool has less mucus, but he still is going a lot at once less often than usual. I tried to clean up his vent area, it was pretty caked up. It does seem somewhat swollen, and he has two little bones just above it that seem really sharp. That might be perfectly normal - I don't normally have any need to touch that area! Also, he was wet so the feathers were not covering things as they normally would.Sorry this was a ton of information, but I'm hoping you might have some suggestions as to what might be wrong. It seems odd he has had so many problems in such a short time. I just don't want to miss an underlying condition. Please let me know if there are specific tests that I should have done.Thank you,
Kristi Karimpour(###) ###-####
Customer reply replied 2 years ago
Just got the latest labs, he did test positive for the avian bornavirus dna. Do you see much of this? Or can you recommend a specialist?
Customer reply replied 2 years ago
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Bird Veterinarian: Dr. Pat, Bird Veterinarian replied 2 years ago

Thank you for sharing the information. That is the lab that I use as well, so I trust the results and analysis. It is amazing and wonderful that you care so much and have done all the testing to help diagnose the problem.

Borna Virus is a puzzling and frustrating disease complex. I have seen a fair number of cases. In most Grays it seems to have GI effects (the virus attacks the nerve system of the GI, so not much treatment) and most cases I have seen also involve severe nerve damage to the legs. So an abnornaml gait may be causing the swellings, but truly I have not seen much external signs in the cases of Borna I have seen. But it can be variable depending on geographic location. I am quite concerned about the red spots, as well.

The classical disease basically paralyzes the gizzard and proventriculus, which are equivalent to the stomach in humans. Digestion is slowed, food sits in there and does not move forward. So what you see is a bird who is thin and malnourished; ulcers and secondary infections can happen in the GI; vomiting or diarrhea; the GI can develop toxins and also not remove toxins as well. Much less is known about what happens in the rest of the body. Certainly the leg function is damaged in many birds, and there can be brain damage as well.

There is evidence that Celebrex can help, but honestly in the cases I have seen that are in an advanced state, it does not do much. The best thing I have found is to make their habitat comfortable and safe (handicap cage), feed high fiber diet, and to prevent any other infections.

His lab work is not too exciting, a mild inflammatory response. That is typical in Borna-positive cases where they are showing Borna-associated signs.

There is very little known about the disease itself, although information is starting to come in from researchers. What that means is that veterinarians do not have many options for treatment. And the virus may be associated with other pathogens, which explains the various presentations in individual birds.

Highly recommend:

Susan Orosz PhD DVM Dipl

Bird & Exotic Pet Wellness Center*****br />Suite 306
Toledo
Ohio
43623 United States

You might contact the closest veterinary teaching hospitals:

https://vetmed.tennessee.edu/vmc/AEZAnimalHospital/InternalMedicine/Pages/default.aspx

is the closest

One of the most advanced research labs for Borna Virus is the veterinary lab at Texas A&M. You might make contact with them to see if they have suggestions for a clinician in your area that they like.

Be prepared. The younger birds are often the most severely affected. There are advances being made in the care and treatment of this disease, but do not expect miracles. I just want to be honest about this. Having a Timneh myself, I am very fond of these birds and only want the best outcome.

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Customer reply replied 2 years ago
Thanks for your prompt response. In reading online, I did come across the articles by Dr. Orosz, and was please to see she is only about an hour away from me. I spoke to her office this afternoon, and will take him there as opposed to the closer avian vets if he needs care. I'm very concerned about my rose breasted cockatoo, and will have her tested Monday. She is 5, dr. Orosz's staff seemed to feel that it is not likely she would contact it from him, that if she is positive it is likely a separate infection. I adopted her in August, the first he was ill was last January. Do you typically see multiple birds in the home infected? Can you call me? I don't mind paying an additional fee, trying to get whatever information I can.(###) ###-####Thank you,
Kristi
Bird Veterinarian: Dr. Pat, Bird Veterinarian replied 2 years ago

sorry, I am not in a good phone area.

Borna is still a great mystery. Because the tests have only recently become available, I honestly do not know if I had multiple birds in a household. The current thoughts are that transmission is from parent to chick, or other oral contact. I usually saw positive birds from the same breeder or source, often skipping generations and fairly unpredictable. I followed a number of multiple bird households, and never saw negative birds be positive after introduction of a new, positive bird. But the honest answer is that no one really knows yet. I think the chances are slim. If you have not tested all the rest, prior to the new one, you wouldn't be able to know it anyway.

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