Regurgitation in a (?)middle-aged female Budgerigar

RE: Regurgitation in a (?)middle-aged female Budgerigar

Dermod Malley — Sat, 16 Jul 2022 14:11:11 GMT

Likewise

RE: Regurgitation in a (?)middle-aged female Budgerigar

Dermod Malley — Sat, 16 Jul 2022 14:10:52 GMT

Sorry to hear the outcome, but these interesting cases have a habit of leading to necropsy, in my experience.............

I have been there so many times.................. I can really empathise.

Did you see any gonad(s)? Well enough to identify them and comment on its/their appearance?

Best wishes

Dermod - catching up on emails after an enforced rest!

RE: Regurgitation in a (?)middle-aged female Budgerigar

Dermod Malley — Sat, 16 Jul 2022 14:05:16 GMT

Thanks for the follow-up.

I'm afraid I can see very little on the attached pictures (which, incidentally, are left and right and not op and bottom). Any advice on how I can enhance them? Don't be too technical, I'm a dinosaur - and a temporarily incapacitated one, hence the delay in response.

RE: Regurgitation in a (?)middle-aged female Budgerigar

Beats — Wed, 13 Jul 2022 19:29:24 GMT

Thank you benjamin for posting such a thought-provoking case and providing such detailed follow-up.

RE: Regurgitation in a (?)middle-aged female Budgerigar

Benjamin Alyoshkin — Wed, 13 Jul 2022 09:24:42 GMT

I hope this finds you well. Dramatic and sad end to the Budgerigar happened yesterday during the re-check and repeat X-ray study. The bird did not survive the general anaesthetic and resuscitation wasn't successful. I've attached the two images I managed to get, I think the swelling is the distended clavicular air sac. I WONDER WHAT THE MECHANISM MIGHT BE?

P.M. 1. The crop was full but I don’t think I saw the picture of aspiration as there were no seeds in the trachea (sadly I didn't think to open the syrinx). Although he was pre-starved for 1-1.5h, there were seeds on the paper litter at the bottom of the tray, and he was seen pecking them after I administered Midazolam I/nasally.

2. Thinking about it, and looking at the sequence of the two x-rays, VD taken first, one possible mechanism of the acute death could be a respiratory and cardiac arrest. The crop was not empty at the time of GA. During positioning on his back, this initially could have caused excessive pressure, and later occlusion/ torsion, entrapment and severe distention of the clavicular air sac, causing further pressure on the trachea and the vagus among other things and potentially (?)suffocating him / causing acute heart failure. I’ll have a fresh good look at the photos I took during the p.m.

3. The ventriculus looked bilobed and so turgid I thought initially it was a hen-bird with two eggs in shell. Proventriculus looked well outlined, inside it, there was yolk-coloured purée digesta. The liver appearance didn’t strike me being excessively enlarged(?!), but that's likely because I don’t do bird pm’s often. It was slightly mottled, the R and L ventrolateral aspects had some yellowish tint (lipidosis/pm autodigestion).

4. His pectoral muscles were really good, but he didn’t seem to have much fat reserve.

I'd be most grateful for any corrections and thoughts! THANK YOU

RE: Regurgitation in a (?)middle-aged female Budgerigar

Benjamin Alyoshkin — Fri, 08 Jul 2022 12:33:03 GMT

Hello Everyone, hope this finds you well.

No new reports of regurgitation for a week now. Did not manage to do a hands-on check or weigh the budgerigar. Consensus opinion that this is a male. Gram stain on pooled faeces pending, I attached two images of in-house DiffQuick, x10x100 oil, I did on Wednesday (resolved to using surgical spirit instead of fixative Stain A). You will notice that the hyphae-looking background, especially between 10 and 3 o’clock on the dial, is an artefact (similar picture on two unrelated view fields).

LHS or Top image, I think I can recognise yeast-looking budding cells (?), if this is so, how would you interpret the numbers, mild or moderate, and is this significant?

RHS or Bottom image, the spherical shapes appear to have inclusions at one pole. Is this something you would recognise as a true finding? I feel I can distantly think of a protozoan, or may it be just an artefact?

Apologies, the snapshots are crude and will not be ‘crisp’ enough when zoomed up.

THANK YOU FOR ANY THOUGHTS!

Best wishes

Ben

RE: Regurgitation in a (?)middle-aged female Budgerigar

Benjamin Alyoshkin — Sun, 03 Jul 2022 18:18:07 GMT

Hello! Thank you so much for all the comments above and the brilliant advice! The bird had a tentative short-term improvement when I saw it last time. The staff have initiated crop feeding with critical care food, which the bird had been keeping down. Funny that Dermod discussed the gender differences. A bird-experienced member of the team started doubting if this were a female. Could this be a cock-bird with the cuticle erosion/ cere hyperkeratosis and colour changing? Thank you, Mark for the XR interpretation! Thought the bird was too unwell to be exhibiting sexual frustration but did not even think of this as a possibility, so thank you to Stephen.

Amphotericin B was discontinued after 3 days. One other colleague suggested using Tylosin in drinking water, and the budgie stopped regurgitating within the two days of discontinued Amphotericin B (benefitted from the short tx/ benefitted from discontinued Amphotericin although regurgitation had started prior to tx/ benefitted from Tylosin/ other). Metoclopramide was also suggested by another colleague, but we ended up not starting on it just yet as the regurgitation stopped/ not all team is experienced with s/c injecting.

Has anyone used injectable Emeprid by mouth/ via garage?

MORE FOLLOWS, THANK YOU!

RE: Regurgitation in a (?)middle-aged female Budgerigar

Mark Rowland — Sun, 03 Jul 2022 10:13:09 GMT

Hello

You have dorsal displacement of the proventriculus on the lateral and distortion of the cardiohepatic silhouette on the vd. Both indicate hepatic enlargement. There is gas in the crop so there is likely a degree of ingluvitis also.

I would be treating with metoclopramide and metronidazole as well as the enrofloxacin. I wouldn't be using Amphotericin B in this patient as yet. Supportive feeding with harrissons recovery while you await diagnostics.

Goodluck

RE: Regurgitation in a (?)middle-aged female Budgerigar

Dermod Malley — Sat, 02 Jul 2022 21:40:02 GMT

it's a long time since I saw a regurgitating budgie in anger and I wonder if I'll get struck off for replying (a "veterinary activity") when I'm retired (how do they strike off retirees anyway?) but my approach to regurgitating budgies was always to perform a crop wash - normal saline - collect the aspirate and examine microscopically. Several films: Gram stain; DiffQuik/Rapidiff/Gram/Modified ZiehlNeelsen using Malachite Green as the counterstain.

These stains would usually show one of:

Abnormal (keratinised) epithelial cells (hypovitaminosis A);

Candidiasis (usually responded to nystatin);

Gram positive organisms (normal unless CLUMPS of cocci which required ORAL clavanulate-potentiated amoxycillin;

Gram negative bacilli (always abnormal and best to submit a swab for bacteriological ID and sensitivities)

Macrorhabdus ornithogaster.(never seemed to respond to any antimicrobial agent but bulky food ("egg food") seemed to help);

Acid-fast bacilli - usually responded to oral doxycycline. I never had much joy with fluoroquinolones

Trichomoniasis - good old metronidazole - usually the paediatric formulation.

Rarely: no abnormality but, if so, call it "Randy Budgie Syndrome" - usually in cock birds only - a brown cere is supposed to indicate female gender but a blue cere can take on a neutral brown-looking colour in a cock bird with liver disease..

I must admit I have never done the amount of work-up that you have undergone in this bird. My protocol above never seemed to let me down and I can't ever remember resorting to systemic treatment..Age advantage!: I practised in the days before the Cascade Police cared about "exotics"..

Best wishes

Dermod Malley FRCVS (by examination in Psittacine Medicine).

RE: Regurgitation in a (?)middle-aged female Budgerigar

Stephen Courtney — Wed, 29 Jun 2022 19:44:41 GMT

Hi Ben hope you are doing well, let us know if you ever want to come back to the South Coast!

If I remember right regurgitation in female budgies can relate to unrequited maternal instincts - you can get porcelain eggs for them to sit on and satisfy their desires in this respect. I might be wrong but if the bird is otherwise well, is worth considering

It has been some time since I had a case like this but I think this is possible