Pi_1 Posted November 7, 2011 Author Share Posted November 7, 2011 After doing extensive research, I'm going to bring Betsy to the vet tomorrow and request she be put on the following to treat what I think has to be Aspergillosis at this point: Voriconazole 10 mg/kg BW q12h - Days 1-7 Lamasil 10 mg/kg q12h - Starting day 1 and continuing past cessation of Voriconazole She has been progressively worse all weekend, and I'm starting to hear her cough a little - with a wet clicking sound occasionally. She has now received two courses of antibiotics with no effect. Also, the oral bronchodilator has little to no effect on her breathing. I've started giving her Albuterol from an old inhaler I had lying around - it is the only thing that seems to help - and does quite substantially. Since she is terrified of the inhaler itself, I do 3-4 puffs into my mouth, then go over to her and breathe it into her beak to give her the dose. It works within 15 minutes or so and lasts for a couple-few hours. I miss our old Betsy. She is so lethargic these days. I stay up with her until 3-4 AM every night and then get up every 2 hours to make sure she's still breathing ok. Last night when I gave her a dose off the inhaler she started playing a bit - it was so cute it made me smile. She was grabbing at my fingers, saying "gonna get you Daddy", LoL. Then she started playing with a toy in her cage and saying "OOOHHH.......get it! Get it!" as she played with it. It was nice to see since all she does most of the day is sit around....and when I bring her out she just sits on my lap with her head down asking for pets. I guess it's good she isn't getting worked up. At least she is still eating and drinking pretty well. I've been giving her lots of her favorites so she'll be enticed to eat and filling her dish up multiple times a day. I figure any food is good at this point - want to keep weight on her since she had lost a little at the last vet visit - but that may be from feeding her only pellets and sunflower seeds for a week. Any thoughts or suggestions much appreciated - I'll keep you all updated tomorrow night after the vet visit. Wish me luck...... Link to comment Share on other sites More sharing options...
Pi_1 Posted November 7, 2011 Author Share Posted November 7, 2011 Oh, and I'm still looking for a recommendation on a steroid to use if anyone has any ideas...... Link to comment Share on other sites More sharing options...
danmcq Posted November 7, 2011 Share Posted November 7, 2011 I really think you should get Betsy to a certified avian vet to take over her care. Long distance advice and the closest care you presently have is just not helping Betsy's condition, nor come up with any cause. Only a certified avian vet can truly advise and treat correctly to help her. I must say, your efforts in keeping her in at least a somewhat stable mode through this is commendable and s probably the only thing that has kept her alive thus far. Link to comment Share on other sites More sharing options...
Dave007 Posted November 7, 2011 Share Posted November 7, 2011 (edited) Oh, and I'm still looking for a recommendation on a steroid to use if anyone has any ideas...... You originally wanted areas that speak about your problem so go to your browser and type this in. Immunosuppressive Steroids For Use on Respiratory Distress in Afican Greys. No official link has to be used. There's loads of articles from various Vets that talk about treatment plus different drugs but all the drugs are prescription drugs. You can get info there. Naming off druigs that were used by others here isn't a good idea because what's good for one bird may not be good for another bird with the exact same problem. Compare it to people. Penicilian may do the trick for some people and may be dangerous to other people who have the same problem. It's not a good idea to be blowing Albuteral into the bird's beak/mouth even if you think he's getting some relief. That's temporary and can be dangerous.. The Albuteral that's in those puffers has doses that provide instant relief for people. The albuteral in those puffers contains between 90 to 108 mcgs which is extremely strong. Human mouth to bird mouth can cause infections. Tell your vet that you're doing that and see what he/she says. Edited November 7, 2011 by Dave007 Link to comment Share on other sites More sharing options...
Pi_1 Posted November 7, 2011 Author Share Posted November 7, 2011 I really think you should get Betsy to a certified avian vet to take over her care. Long distance advice and the closest care you presently have is just not helping Betsy's condition, nor come up with any cause. Only a certified avian vet can truly advise and treat correctly to help her. I must say, your efforts in keeping her in at least a somewhat stable mode through this is commendable and s probably the only thing that has kept her alive thus far. Thanks for the concern and thoughts. Unfortunately, the current vet I'm going to IS an avian vet........that is the reason I started driving over two hours each way to bring her there. Link to comment Share on other sites More sharing options...
Pi_1 Posted November 7, 2011 Author Share Posted November 7, 2011 (edited) You originally wanted areas that speak about your problem so go to your browser and type this in. Immunosuppressive Steroids For Use on Respiratory Distress in Afican Greys. No official link has to be used. There's loads of articles from various Vets that talk about treatment plus different drugs but all the drugs are prescription drugs. You can get info there. Naming off druigs that were used by others here isn't a good idea because what's good for one bird may not be good for another bird with the exact same problem. Compare it to people. Penicilian may do the trick for some people and may be dangerous to other people who have the same problem. It's not a good idea to be blowing Albuteral into the bird's beak/mouth even if you think he's getting some relief. That's temporary and can be dangerous.. The Albuteral that's in those puffers has doses that provide instant relief for people. The albuteral in those puffers contains between 90 to 108 mcgs which is extremely strong. Human mouth to bird mouth can cause infections. Tell your vet that you're doing that and see what he/she says. Regarding the Albuterol, all of these treatments are temporary, which is why I'm so upset with the situation. But I'm concerned with keeping her comfortable and breathing until we can start treating the real issue. As far as dose, I spoke with the vet, a pharmacist, and the manufacturers of a special mask that allows use of inhalers with birds. The vet had also prescribed a steroid inhaler (Flovent), and since the masks take several weeks on special order, we had to figure out how to dose her. The first suggestion given to me was to place her in her carrier, make it air tight, and use 5-10 puffs into the carrier. This dosing seemed wildly inaccurate to me, so I asked for other options. The second was to take a large foam cup and secure that to her head, then puff the inhaler into that and allow her to breathe it for several minutes. I nixed that idea since there is no way she would keep a cup on her head without becoming frantic. In the absence of other ideas, I decided my own mouth to beak idea was the best option, so have been using it. I also spoke to an avian specialist this weekend, and asked him about the dosing, since the vet and pharmacist didn't seem too concerned. All parties asked stated that it would take massive doses of either inhaler to be dangerous, and that any method I used was unlikely to get even a fraction of the full dose into her. They all said not to worry, but that if she showed signs of being jittery or nauseous I would want to decrease the dosing. She has not thus far. Regarding the mouth to beak method......I'm aware infection from humans is possible, which is why I always wash my hands when I come home before handling her and never kiss her on the beak or things like that. In this case, however, I felt the risk was worth the reward, and since there was no other reliable way to administer the meds, went ahead with it. And it works. I DO wash my mouth out with an alcohol-based mouthwash prior to doing it, and I don't breathe air from my lungs into her beak. I hold the discharge from the inhaler in my mouth and slowly push it out into her beak without breathing. It's the best way I could think of to do it, and I'm not sure if she'd still be with us if I hadn't. I told both the vet and the avian specialist how I was administering the inhaler and neither was all that concerned given the circumstances. The specialist just made sure I knew there was a small possibility of infection......but also said it was well worth the risk if she was breathing easier. Regarding the steroid choices, I'm also aware there are many different cortico-steroids available. I asked here because I thought some of you may be experienced with some of them or be able to point me to an avian study that shows the LEAST immunosuppressive steroids for African Greys. I am well aware of how to conduct a Google search, and have been researching all weekend. I just thought some of you might be experienced in the area and be able to give me some recommendations to speak with the vet about. The worry with steroids is that they will suppress the immune system too much, letting the infection further take hold. Her breathing is so poor, however, I think we'll need a low dose steroid just to keep her breathing while the medication works. Thus my question about LESS immunosuppressive steroids. It isn't as easy as you might think to find studies nor info on the subject in relation to birds, and especially the specific category of African Greys, who are more reactive and sensitive to many drugs that other common test birds like pigeons. I've been researching all weekend... And I think naming off drug regimens that were successfully used by others is VERY helpful, if only for reference. Edited November 7, 2011 by Pi_1 Link to comment Share on other sites More sharing options...
Pi_1 Posted November 7, 2011 Author Share Posted November 7, 2011 Just FYI, the vet called in sick today and had to push my appointment to tomorrow. I could have still gone in, but she is the only certified avian vet in the building so I figured, even though I didn't want to, that I should wait....... I'm hoping now that I'm more informed on the subject I can better tell her how I want to proceed and perhaps put her in touch with the avian specialist I spoke with so they might collaborate a bit, as he treats birds exclusively and does research on respiratory disease........ Link to comment Share on other sites More sharing options...
danmcq Posted November 8, 2011 Share Posted November 8, 2011 I'm hoping now that I'm more informed on the subject I can better tell her how I want to proceed and perhaps put her in touch with the avian specialist I spoke with so they might collaborate a bit, as he treats birds exclusively and does research on respiratory disease........ I hope this works out. This missing piece that will at least give guidance in how to properly treat your grey, is first and foremost finding the root cause. Until that is found, all this is just "Best Guess" treatment in terms of the medicines being used. Link to comment Share on other sites More sharing options...
Pi_1 Posted November 8, 2011 Author Share Posted November 8, 2011 I hope this works out. This missing piece that will at least give guidance in how to properly treat your grey, is first and foremost finding the root cause. Until that is found, all this is just "Best Guess" treatment in terms of the medicines being used. Yes, that's the problem with Aspergillosis. According to the specialist, a scope and biopsy is the only reliable way to diagnose with certainty, and for a bird with respiratory distress that can be a death sentence. Since there is no sign of infection and antibiotics have been ineffective in treating the issue (she has had two full 14 day courses of antibiotics now - Enrofloxacin and Doxycycline), however, we can make a pretty good guess at the cause. And since time is of the essence, I'd rather her not make it due to aggressive treatment than have her pass away while waiting for a diagnosis and sitting on our hands. I just wish the vet had brought this to my attention sooner instead of insisting this was just allergies for weeks......she would have a much better chance if we'd started testing and treatment weeks ago before things progressed this far...... Link to comment Share on other sites More sharing options...
Pi_1 Posted November 8, 2011 Author Share Posted November 8, 2011 I'll let you know how the vet visit goes today...... Link to comment Share on other sites More sharing options...
danmcq Posted November 8, 2011 Share Posted November 8, 2011 Fingers crossed and hoping for the best. Link to comment Share on other sites More sharing options...
Malikah Posted November 8, 2011 Share Posted November 8, 2011 Fingers crossed and hoping for the best. Here too!! Link to comment Share on other sites More sharing options...
Pi_1 Posted November 11, 2011 Author Share Posted November 11, 2011 Wanted to stop back to let you all know what happened and thank you for your help. I took Betsy to her vet appointment and didn't have any luck. The vet wouldn't speak with the specialist I asked her to, wouldn't prescribe any medication other than a refill on one of the two inhalers, and insisted Betsy did not have Aspergillosis - reasoning that if she did have it, the steroid would not have helped. She wouldn't listen to reason, and told me to come back the following week if Betsy had not improved from her "allergy". At that point I called the vet in Detroit and they agreed to see her right away. I began the long drive down to the other vet, but Betsy collapsed on the way. She died in my hands - she stopped breathing. The autopsy came back today and showed she had Aspergillosis. If only the vet had listened to me and treated her earlier. Apparently the autopsy showed it hadn't progressed very far, but I just think it was the stress of such a long car ride coupled with the trouble breathing - this was the reason I was hesitant to take her so far for a second opinion in the first place. We had her cremated this afternoon. She died far too young - she wasn't even 3 years old. Just an FYI for anyone else experiencing breathing troubles - the specialist (and my research) told me that Aspergillosis is impossible to diagnose reliably without putting the bird under anesthesia, scoping their airway, and taking a biopsy. Blood tests are unreliable. So if signs point to your bird having this illness, treatment should begin right away even before or without a positive diagnosis as time is of the essence. For reference, the specialist said he had the most luck treating Aspergillosis with the following regimen of drugs (antibiotic included for secondary infections or in case Aspergillosis diagnosis is wrong): Voriconazole 10 mg/kg BW q12h - Days 1-7 Lamasil 10 mg/kg BW q12h - Starting day 1 and continuing past cessation of Voriconazole Doxycycline 25 mg/kg BW q24h He said not to allow your vet to give your bird Itraconazole or Amphoteracin B. Studies and his experience show better results and less side effects with the drugs listed above. He also said pet birds should NEVER be given nuts in the shell as the shells often carry spores and are one of the leading causes of infection. Anyhow, thank you all for your help and advice - I wanted to at least stop back to update you and leave the advice of the avian respiratory specialist we spoke to for anyone that may find this thread with similar questions. We'll miss you Betsy - she was an amazing and precious creature....... Link to comment Share on other sites More sharing options...
Pi_1 Posted November 11, 2011 Author Share Posted November 11, 2011 Oh, and I'll never take another creature to this vet as long as a live.........I'd probably have a better chance treating it myself...... Link to comment Share on other sites More sharing options...
Malikah Posted November 11, 2011 Share Posted November 11, 2011 I'm sorry for your loss. Link to comment Share on other sites More sharing options...
Life is Greyt Posted November 12, 2011 Share Posted November 12, 2011 very sorry for your loss Link to comment Share on other sites More sharing options...
pikachu Posted November 12, 2011 Share Posted November 12, 2011 I'm so very sorry. Link to comment Share on other sites More sharing options...
Pi_1 Posted November 12, 2011 Author Share Posted November 12, 2011 Thanks all - I just hope this thread might help some Greys in the future suffering from the same issues...... Link to comment Share on other sites More sharing options...
danmcq Posted November 12, 2011 Share Posted November 12, 2011 (edited) Oh no, such sad news. You tried your best and I have no doubt Besty knew you were giving her your all. Edited November 13, 2011 by danmcq Link to comment Share on other sites More sharing options...
Barbara2 Posted November 12, 2011 Share Posted November 12, 2011 I am so, so sorry that you had to go through this. Betsy was blessed to have you in her short life. I have no words and know how much it hurts. Thanks for taking the time to post all of the info to hopefully help some other grey down the line. Link to comment Share on other sites More sharing options...
roseepting Posted November 13, 2011 Share Posted November 13, 2011 I am so sorry to hear about Betsy. I had been out of town and came home to find our Tumba had passed away due to his cancer. Anyway, I am just catching up on the story of Betsy. Again, I am so sorry you and she had to suffer so long without proper treatment. Link to comment Share on other sites More sharing options...
Pi_1 Posted November 14, 2011 Author Share Posted November 14, 2011 Thanks all, your condolences mean a lot. Thank you also for all your help throughout the last couple of months. Just an FYI - I was tested for Aspergillosis last week via a tracheal "scraping" and it came back positive. I thought I was having allergy issues, but it had been going on for months and after Betsy I became concerned. I'm pretty certain the cause of infection for both of us was construction on the street outside. We live in a historic district and a lot of the side streets, including one that runs next to our house, are made of red bricks. They probably haven't been moved in a hundred years or more, but this year the city tore them up to work on the water in our area and to allow AT&T to run cable. It was a long process and was right next to the house. Although not much dust was kicked up, I'm pretty sure at this point the fungus and spores that resided in those bricks was kicked up and entered our house. Otherwise, there is no way a healthy human could be infected - it would take massive amounts of spores (the doctor said massive and prolonged exposure would be needed). So I think I've found the source and am pretty upset. You'd think the city would test for things like this before contaminating our whole block! I wonder how many workers and/or neighbors were also infected? Ridiculous....... Anyhow, I'll be getting some sort of treatment next week. My boss has a pair of Greys who recently had eggs. Apparently they are viable, and he has offered one of the babies to us if we want one since he feels awful for us and knows how much we loved our Betsy. I haven't decided whether to take one yet as it's a bit soon, but am excited to at least go see them when they are hatched. They're "due" around Thanksgiving. The hardest part of the whole thing is that the memory of Betsy passing away in my hands is seared into my brain forever. I'll never forget looking into her eyes and telling her I was there for her and loved her as she took her last breath. I can't sleep....I just play it back as if it were a movie over and over thinking that if hadn't decided to take her on the long drive to the other vet she might still be with us. I remember every second, every detail - from the moment I saw her collapse to the moment I stopped CPR and let her go. I can still hear her little voice saying "Daddy" as she gasped for air. I feel terrible also, since she was upset with me for dragging her to the vet again. I can't help but think she died thinking I was being mean to her. Link to comment Share on other sites More sharing options...
Pi_1 Posted November 14, 2011 Author Share Posted November 14, 2011 And I can still hear her singing - every time I think of it it just kills me. My fiance recently taught her to sing the "Gremlins" song that Gizmo sings in the movie. She was singing it the whole way to the vet.......I wish she'd never taught her that darned song........ Link to comment Share on other sites More sharing options...
Pi_1 Posted November 14, 2011 Author Share Posted November 14, 2011 I am so sorry to hear about Betsy. I had been out of town and came home to find our Tumba had passed away due to his cancer. Anyway, I am just catching up on the story of Betsy. Again, I am so sorry you and she had to suffer so long without proper treatment. I'm so sorry to hear about Tumba. I'm aware of your issues as I had read your thread on it previously. At least you know that it was inevitable and you did everything you possibly could for Tumba - I would take some small comfort in that. But what a way to return from vacation. I'm so so very sorry for your loss and feel your pain....... Link to comment Share on other sites More sharing options...
judygram Posted November 14, 2011 Share Posted November 14, 2011 I am so sorry to hear of your loss of Betsy, I am just now reading about it as I have been absent from the forum but she was loved dearly and I know she knew that, its so sad her life was cut so short but you did everything you could to save her, please accept my condolenses on your loss. Link to comment Share on other sites More sharing options...
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