RE: Lame(?) African grey parrot

Mair Tyler — Sat, 16 Jul 2016 17:53:18 GMT

Thank you Marie, that is really helpful advice.

RE: Lame(?) African grey parrot

Marie Kubiak — Sat, 16 Jul 2016 17:46:30 GMT

Difficult to work out significance of hip asymmetry with the positioning-if you do repeat them then try and extend the legs caudally. I find taping the feet to a sandbag helps greatly!

There is no other orthopaedic change evident that I can see (though the 3rd view with right leg abducted did confuse me for a while!). A laterolateral would be very useful though in evaluating the spine and other organs (more on that later..).

Mineralisation is suboptimal but not awful and iCa is ok. No pathological fractures, bowed long bones or other changes and 'hypocalcaemic' type disorders tend to be general rather than focal.

I would be tempted to repeat the pelvic vd view with legs extended and assess that first. If spinal/hip lesion identified then you have a target. As many arthritides in birds are infectious then a wbc count would be prudent for helping investigate any bony lesion.

If all is ok from an orthopaedic view then that supports neurological (indeed the presentation of weak, unresponsive foot suggests neurological compromise). Simple leg pull trauma is often seen when legs get trapped between cage bars (ringed leg more commonly affected) and occasionally through other injuries (perching on object that rapidly moves, typically a slamming door). Cage rest and NSAIDs is often enough in most cases but this hasn't helped here.

Neurological infectious conditions include Chlamydia psittaci and Avian Borna virus and both are very common so I would recommend testing for these if owners are willing. A nice lateral rad will help support testing if splenomegaly or proventricular enlargement (respectively) are seen but absence of radiographic changes doesn't exclude infection. Heavy metal intoxication is also a consideration but no clear evidence on rads and unilateral symptoms wouldn't be expected.

Another potential cause is compression of the sciatic nerve on the right side. Usually due to a renal mass/swelling but gonadal pathology can do the same. There is an odd density area in the cranial renal segment that could do with endoscopic assessment if symptoms are not explained by non-invasive tests. The liver is definitely enlarged which could fit with Chlamydia but is non-specific and if on a crappy seed diet then is to be expected with chronic fat overload.

So in summary no quick fix, a couple more rads needed to rule out orthopaedic cause, then full bloods (including borna and Chlamydia serology) and scoping to try and find cause potentially with biopsy harvesting from liver and kidney/gonad.

If declined then you could trial gabapentin (11mg/kg bid) or tramadol (10mg/kg bid) to manage any pain and a prolonged course of doxycycline (50mg/kg sid) to cover bacterial arthritis and chlamydia but it is very much hit and miss and not a great approach given the presentation. If progresses to bilateral weakness then metal intoxication a consideration and sodium calcium edetate (35mg/kg/d) could be thrown in but be cautious without renal parameters and fluid therapy.

Marie

RE: Lame(?) African grey parrot

Mair Tyler — Sat, 16 Jul 2016 15:25:10 GMT

Yes I wondered about that joint too, not sure if again it's a positioning thing or if there's actual pathology there...

RE: Lame(?) African grey parrot

Utlendigur — Sat, 16 Jul 2016 15:21:26 GMT

Could the bone thinning on the R side just be down to disuse? Would have expected it to be generalised if hypocalcaemia.

Also is there something going on with the R femorotibial joint? On the lateral views it just looks like there's more soft tissue density around it, and less distinct joint margins than the left. But viewing images on smallish screen so may just be imagining it

RE: Lame(?) African grey parrot

Mair Tyler — Sat, 16 Jul 2016 15:12:41 GMT