Puddings & Toyboys

A blog about my beautiful budgies.

Tag Archives: liver

Poor Patient Compliance (PPC)

Previously, I had posted about Bezukhov’s second x-ray.  At the time, a blood sample was also provided.  We had the results of these a few days after.

Ms Exotic Hospital Vet (EHV) said that Bezukhov’s blood results were “largely promising“.  However, she noticed one of the parameters that tells us about the gall bladder and liver function has “steadily increased over the last few blood tests“.  With this in mind, she prescribed two types of medication: one to support the gall bladder & the other to support the liver.

The medicine to support the gall bladder is Destolit.  Worryingly, it is untested in birds; the tablets are made for dogs & cats.  The tablets need to be cut very small (1/8ths), mixed in 0.5ml of water/juice, of which 0.02ml is to be administered.  (It was originally 0.01ml of ¼ tablet, but that is basically half a drop & I found that impossible to control).

Bezukhov still has Aloe Vera & Milk Thistle in the water & that is to continue indefinitely.  The additional medication for the liver is Lactulose.  He had this previously.  It is a sticky, syrupy medicine which is difficult to remove once it gets onto the feathers.  (Cagney did attempt to clean him up but with little success – it took Ms EHV to use the opportunity when Bezukhov was still groggy from anaesthetic to properly clean his cheek & chin feathers).

As for frequency of administering the medication, Ms EHV described Bezukhov as having “Poor Patient Compliance”, (i.e. he refuses to take his medications).  With that in mind, she was not going to prescribe Clavaseptin (antibiotic to support the liver to be taken twice a day).   This leaves us with the Lactulose & Destolit.

Ideally, they are to be taken once a day.  However, as this may potentially be a long-term solution, we agreed that a more manageable once every other day should still be effective.

After much discussion of the above, the new medication regime for Bezukhov began on the 22nd February.

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Bezukhov’s second x-ray

A few days ago, on Thursday 29th January, Bezukhov had an x-ray & supplied another blood sample.

Ms Exotic Hospital Vet (EHV) had previously suggested he have these tests again so they can be compared with the previous results.  His last x-ray was taken on the 24th September 2014.  From this it was seen he had “Air Sacculitis & likely liver disease“.  He had various medication for this over the following 6-7 weeks.

Bezukhov’s last blood sample was given on the 10th November 2014.  The results were a ‘mixed bag’.  Medication was ceased but we have continued with Aloe Vera & Milk Thistle in his water.

As per usual, I bundled Bezukhov into the travel cage.  Surprisingly, he was not so panicky as he usually is.  Although, when Cagney & Phineas started eating their seed, Bezukhov did get flustered even though he had his own seed right in front of him.  He does not like to miss out on food, particularly if others are eating, but clearly the travel cage is a hunger strike zone.

(click on photos to enlarge)

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A mixed bag

20141111_120423_sh21The last blood sample that Bezukhov provided to the vet was fortunately sufficient enough to run the relevant tests.

Unfortunately, the results turned out to be a ‘mixed bag’.  The good news is that compared to the previous blood results, his liver appears to be in a much improved state.  However, Ms Exotic Hospital Vet (EHV) was concerned about the readings for his gallbladder & bile.  It is possible that having a repeat blood test within 7 days could have affected the results, i.e., his protein levels may be lower than normal, so this has to be considered.

Ms EHV recommended ceasing all medication (Ronaxan, Lactulose & nebulising with F10) but continuing with the Aloe Vera & Milk Thistle supplements in his water.  He is to be watched closely for any signs of illness, odd behaviour or seizures.  We plan to repeat the blood tests in about 6 weeks time.

 

 

 

Forty-one days later…

Forty-one days ago, Bezukhov had a vet visit.  Today was his follow-up consultation.

I don't like it in here.

I don’t like it in here.

Ms Exotic Hospital Vet (EHV) asked lots of questions about his well-being & behaviour.  I was pleased to report he was in good spirits & eating & pooping normally.  Unfortunately I had to also report he had had more seizures.  In the space of 10 days he had at least 3.  This was a disappointment as it suggested the medication, though it may be working for other things (chlamydia, liver etc.) it most probably is not treating the root cause of the seizures.

As expected, a blood sample was needed to compare with the previous one.  Bezukhov had to be anaesthetised for this.  Whilst he was under, the vet also examined him & before he came round, attempted to clean off some of the sticky, syrupy medication on his cheek & chin feathers but he came to quite quickly so she did not have enough time to clean those feathers properly.

She said he would most likely be groggy for most of the day & possibly tomorrow.

I am to continue giving Bezukhov his previously prescribed medication, although the 45 day course of Ronaxan ends in 4 days.  I do not need to nebulise Bezukhov with the F10.  He will be very pleased about that as I would put him in the travel cage for that & he absolutely hated it!

I feel groggy.

I feel groggy.

When we got home, groggy Bezukhov started immediately chirping in response to the others.  I thought I would leave him in the travel cage for a little while to rest & recuperate.  However, Bezukhov had other ideas.  After about 10 minutes of being quiet & still, he gave himself a shake & started climbing all around the travel cage.  He wanted out!

So I let him out.

He flew to the Manor & was reunited with Cagney.  He had a few seeds but after the initial excitement of being home, he has spent most of the day sleeping.  I kept Phineas locked up so Bezukhov did not have any stress having to deal with him.

By the evening, Bezukhov’s appetite has slowly returned.  I hope he will feel much better tomorrow.  In the meantime, we wait to hear about the results of the blood test that will be available in a few days.

Bezukhov on the window perch

Bezukhov on the window perch

 

 

 

Last Wednesday

As previously posted, Bezukhov has been moulting.   Moults can take a lot out of a bird.  I was not too worried when Bezukhov appeared a bit grumpy & lethargic.  It was after all, the moult.  Or was it?  After awhile, I noticed his poop changing & somehow his lethargy seemed too pronounced.  A few times he also looked like he was vomiting.  He did not bring anything up – it looked more like he had an obstruction or irritation.  My concern was enough to take him to the vet.

On Wednesday 24th September, Bezukhov was seen by Ms Exotic Hospital Vet (EHV).  She had previously seen him over his random seizures.  Since his last visit to her on the 20th May, I made a note of any other ‘episodes’.   In total, he had six over four months, of which two were proper ones & the others were minor that lasted a second or two.

Given Bezukhov’s medical history & his current state, Ms EHV wanted to take x-rays & a blood sample.  With a heavy heart, I signed the form for him to have the x-rays.  She arranged for the x-rays to take place about an hour later & suggested I go home & pick him up later.  With an even heavier heart, I returned home, Bezukhov-less.

Cagney poop top left, Bezukhov poop bottom right.

Cagney poop top left, Bezukhov poop bottom right.

In my absence, though being watched over by the budgie-sitter, Cagney had temporarily & voluntarily moved into the Ferplast with Phineas.  Phineas must have been over the moon with those few hours with just his adored Cagney.

A short time later I received a call from the vet saying that Bezukhov had come round from the anesthetic.  Cue a huge sigh of relief from me.  When I picked him up later that day, Ms EHV gave me a run down of what she had found.  It was already written down & covers a whole sheet of A4 paper.  In short, his condition is “Air Sacculitis & likely liver disease“.

Though it is not confirmed he has Chlamydia Psittaci (this was not detected in his poop sample provided in July), it is apparently a known cause of liver & breathing problems.  His treatment plan takes this into consideration.  It is worth noting that liver disease can cause seizures because toxins are not filtered.

Treatment is as follows:

  • Bezukhov's medication

    Bezukhov’s medication

    Nebulise with F10 solution up to 3 times a day (for Air Sacculitis)

  • Milk Thistle & Aloe Vera to be administered, either directly or in water (for liver)
  • Lactulose twice a day (for liver)
  • Ronaxan once a day for 45 days (for Chlamydia)

I was told the Ronaxan is the most important of his treatments.  Check-up in 4 weeks time.  Results of blood test to be available in a few days.

Though it all sounded very daunting, I was just delighted to be bringing Bezukhov home.  As I brought him into the lounge, there was a chorus of chirping.  He clearly was also relieved & happy to be back home.

Note: Chlamydia Psittaci can be caught by humans so I was advised to take care & also to not allow anyone on chemotherapy, the elderly or very young to handle Bezukhov.

 

The last two weeks

We are still reeling from the loss of Thomas.  After my last post on Thomas & his health problems, various things were going on in the background.

In writing this post it has turned into a clinical list of events.  That is partly my intention as I feel the need to log our efforts to help Thomas:

  • Tuesday, 14th January – Thomas began a course of antibiotics in the evening, to deal with a suspected infection.
  • Friday, 17th January – By this time, his poops were like pea soup & Thomas was more lethargic & sleepy.  I spoke to Mr EV that day & he said to come off the Baytril.  I removed it & replaced it with Guardian Angel in his water.
  • Monday, 20th January – Two lots of poop samples were given to Mr EV.  One was to test for bacteria and/or infection & the other to check if he is digesting food properly.  In the meantime, Thomas had a combination of Milk Thistle, L-Carnitine & Guardian Angel in his water.
  • Thursday, 23rd January – One lot of results were in: Thomas did NOT have an infection.  The other results were due later on, but speculating on those, Mr EV seemed to think the problem was all to do with Thomas’s liver not doing what it is supposed to do.  He mentioned another supplement that is used for dogs & cats but not tested on birds (probably due to dosage etc.)
  • Friday, 24th January – All this time, Thomas was getting worse.  At this point, I gave him Aloe Vera juice in his water (5ml in 50ml of water) & also pegged up a piece of Aloe Vera leaf which he appeared to nibble/lick.
  • Saturday, 25th January – Thomas had some slurps of the water with Aloe Vera.  He was eating millet when offered & sometimes seed.
  • Sunday, 26th January – In the morning, he stopped eating seed.  Not even millet.  In desperation I offered him different vegetables. He turned away from broccoli, celery, & spinach.  However, his eyes lit up when he saw the beetroot stalk.  Whatever beetroot had, he wanted it.  He could not get enough of those stalks.  In the afternoon he was even inspired to eat a little seed.  I switched back to Guardian Angel in his water.

Despite the obvious need to medicate to improve Thomas’s condition, his general well-being was Read more of this post

Two steps forward, one step back

Following on from my previous post on Thomas & his health problems, we located the medication, L-Carnitine.  It is a liquid version for humans, of 500mg strength.  Mr EV had already been researching the product & confirmed that the lemon flavour of this particular product will actually be beneficial rather than detrimental.  He suggested a dosage of 2 drops per 50ml of water (similar to the Milk Thistle).  Thomas is to have the L-Carnitine on one day & the next day Milk Thistle, & so on.

This new regime began on Tuesday 17th December.

About one week later, Thomas was definitely livelier.  He was flying more, was more alert & more vocal.  His poops seemed a little drier, not quite so sloppy.  He was also responding to Cagney & began flirting again.  This, once again, caused a little friction with the others, but as yet, no major fights have happened, just near misses.

Over the Christmas holiday, Thomas was mostly better but had the odd down day where he seemed a bit lethargic.

However, in the last week, Thomas seems to have taken a step back.  He has still been coming out but he has not been flying as much & not flirting with Cagney.  His poops have also got wetter again.  Yesterday, I had a telephone consultation with Mr EV.  He suggested a short course of antibiotics in case Thomas has picked up another infection.  This began today, alongside the Milk Thistle/L-Carnitine regime.

We continue to keep a very close eye on Thomas.

(Click on photos to enlarge)

 

Thomas is a brave boy

Bezukhov & Cagney visiting Thomas

Bezukhov & Cagney visiting Thomas

Phineas visiting Thomas

Phineas visiting Thomas

Following on from my previous post on Thomas & his health problems, there was little change, in fact, no change, from taking the six days worth of medication: Ornicure Doxycycline.  He spent several days in the travel cage so I could monitor him & also make sure he was not overly stressed.  On Friday 29th November (day 4 of medication), he vacated the travel cage & after a brief walkabout on top of the Manor, returned to live with Phineas, well, he returned for seed I think…. it was a coincidence that Phineas also lives in that cage….

Mr Exotic Vet did not prescribe more of the same medicine but said to remove it whilst he investigated other options.  On Wednesday 4th December, I had another consultation with Mr EV & he thought it was time for Thomas to have an X-ray.   He was booked in for the Friday morning.

On the Thursday evening, I got Thomas back into the travel cage so we could go out early the next morning.  The X-ray was scheduled early, before the morning consultations.  Friday morning, Thomas was a very brave boy.  Mr EV said he would be anaesthetised for the shortest possible time, just to allow him to be still enough for the X-ray to be done.  Sure enough, it was not long before Thomas was back up on the perch & looking very much the same as before he went in for the procedure.  I took him home & waited for the results. Read more of this post