IS IT REALLY WASTING??
August 9th, 1991 was a day I will never forget. We have several parrots, but our Moluccan Cockatoo, 'Gabby', is a beloved favorite. His boundless enthusiasm, sweetness, and intelligence have always been a constant source of joy for us and he was just two years old when we nearly lost him forever. On that summer morning as I turned the corner into the bird room, I noticed that Gabby seemed strangely quiet.
On that summer morning as I turned the corner into the bird room, I noticed that Gabby seemed strangely quiet. This was very unusual since he always began talking, hollering, and showing off with magnificant displays as soon as he saw me approaching. Now he just sat there all fluffed up with his eyes half closed looking abjectly miserable. When I went over and offered a smile and a cheerful good morning, he just looked up at me and gave me a barely audible squeak as if pleading for me to help him. He made no attempt to move or solicit my attention and I could feel the panic starting to rise in my throat. I sat down by his cage and spoke softly to him as I watched intently. Without warning, he swung his head from side to side and vomited, then he vomited again. I rushed to the phone, and when our avian veterinarian, Dr. Tammy Jenkins of the St. Francis Animal and Bird Hospital answered, I was barely able to keep my voice steady as I told her Gabby's symptoms. She said the situation sounded very serious and that we needed to bring him in for tests immediately. This trip to the clinic marked the beginning of a four month saga during which Gabby became the subject of a national research effort.
When we arrived at the clinic, Dr. Jenkins ran a CBC (complete blood count) and culture and sensitivity tests. The results of these tests were all over the charts and indicated there was a myriad of problems to sift through. An extrememly elevated CK and liver enzyme count... what could cause this? A secondary bacterial infection... secondary to what? A fungal infection... what were the possible sources? The quality of our avian husbandry was well known to be pristine regarding cleanliness, the finest in fresh and manufactured diets, purified water, air filtration, and on and on. Aware of these things and especially suspicious of the high CK count, Dr. Jenkins was looking at a far more frightening possibility: Psitticine Wasting Disease, otherwise known as Proventricular Dilation Syndrome. For me, just the words brought tears, denial, grief. It is a fatal, contagious, horrible killer of parrots. It is a death sentence.
Gabby remained hospitalized for the next three days and received Amikacin and Piperacillin antibotics by injection. We were amazed at his marked improvement and breathed a momentary sigh of relief. We had no real answers, but it seemed that everything might be all right and Dr. Jenkins felt we could bring him home and continue oral antibiotics as we monitored his condition. At this time his diet was modified only slightly to rule out foods that could contribute to gastrointestinal upset. So, with his naturally sunny disposition and rambunctious character, Gabby came home and tried his best to be his irresistible, happy-go-lucky self again. He never quit trying.
Within 48 hours the vomiting reoccurred. A breeder friend rushed over and administered more of the injectible antibiotics. She also suggested I remove the solid food since he appeared hungry and it was a source of stress and frustration for him not to be able to eat without obvious discomfort. I called Dr. Jenkins immediately and she made arrangements for us to bring him to a nearby animal emergency hospital for a barium test later that afternoon. Once we arrived, the staff veterinarian, Dr. Nelson, prepared 15 cc's of a 25% barium solution mixed with avian handfeeding formula which she fed to Gabby by syringe. Two hours later, the majority of the mixture was still retained in his crop with only a small amount passing into his intestines. She then gave him .3 mg of Reglan to stimulate his GI tract, but this yielded only a minimal response. The barium x-rays did not conclusively reveal a tissue or foreign object blockage. All we had were shadows, questions, and lots of maybes as to why Gabby's entire digestive system had simply shut down. Aware that the situation was life-threatening, Dr. Nelson promptly reviewed the test results with Dr. Jenkins and they concurred that Gabby either needed to have a fluoroscopy or undergo exploratory surgery at the University of Minnesota. We needed some answers and we needed them now.
We brought Gabby back to Dr. Jenkins that night where he remained hospitalized in intensive care for the next three weeks. He had lost of a lot of weight and was very weak. During this time, his diet consisted of Roudybush handfeeding formula and bland Gerber strained fruits mixed with baby rice cereal. His environment was virtually sterile and "unchewable", right down to a stainless steel perch. All of these "controls" helped to eliminate variables that could factor in to an already complex equation. Like a living pin cushion, Gabby received up to five injections per day which included Amikacin, Baytril-60, Ketoconazole, Piperacillin, and Metoclopramide. Dr. Jenkins said he was so sore from all the injections that he would roll over on his back and kick at her when he saw her approaching with medications. She performed another avian chemscreen and CBC which revealed that the bacterial and fungal infections had cleared up, but the CK and liver enzyme counts were still alarmingly high.
In his condition, exploratory surgery was out of the question so a fluoroscopy was scheduled with Dr. Duke at the University of Minnesota. Like watching a motion picture x-ray, this sophisticated test revealed crop stasis and a very enlarged and flaccid proventriculus and ventriculus that were not strong enough to move solid food through his digestive system. These are classic symptoms of Psitticine Wasting Disease and this is the bleak and tragic point where so many parrots are euthanized each year. Dr. Jenkins said there was always hope as long as Gabby was alive, but we were on uncharted ground and it would be a very long road if we decided to go forward. To us, there was simply no other option. We had to do everything possible to save the life of our wonderful friend.
Dr. Jenkins consulted with seven top avian veterinarians and research specialists across the country. This cooperative effort ensured that as much information as possible was accumulated, shared, and analyzed. Gabby's symptoms and supportive care were literally being monitored nationwide. After three weeks of intense hospitalization, Dr. Jenkins said Gabby had great courage and a very strong will to live even though Psitticine Wasting Disease remained the leading candidate of possible villians, followed by foreign body ingestion and acute pancreatitis. She also told us that we had to wait nine weeks to rerun the tests so enough time could elapse to ensure meaningful results. Since there was such a substantial "waiting period" involved, she said we would be allowed to bring Gabby home and continue his care under her strict supervision if we could develop a "safe" environment for him. She told us to do our homework and "invent something wonderful..." that did not bring ingestible variables such as wood, leather, rubber, plastic, or paint into his living quarters. She knew we were always looking for ways to improve avian environments and had done research in this area in the past.
We began this all-important project by designing a large stainless steel cage. That was the easy part, there's no controversy over the safety and quality of stainless steel. The next phase was more complicated. How to configure the interior "furnishings" of this very special castle. We consulted the Toxicology Department at the University of Minnesota, the F.D.A., and a multitude of industry laboratories for safety data sheets on a variety of materials. Wading through what seemed like an endless sea of technical information, percentages, and analytical reports, we finally found the needle in the haystack we were looking for! A material that met all of the veterinary requirements for safety, hygiene, durability, and quality. From this we designed different diameters of orthopedic style perches and several models of high-action motion toys. This was the beginning of the Perma-Play Product line, born of necessity and backed by a one year guarantee and a lot of love. After all, Gabby was coming home, and nothing but the best would do.
Dr. Jenkins was delighted with the environmental concept and gave it her wholehearted endorsement by saying that we could now come and pick up our beloved Gabby. Finally arriving home, I gently lifted him out of his carrier so he could explore his new environment. He looked around for a few minutes with his beautiful dark eyes and "tested" everything in his new haven carefully as if he couldn't quite believe he was really home. Then he looked at me with an expression I still can't completely fathom - joy, relief, love... and all of these emotions and more were clearly written across his gentle, intelligent face. Then he began to beat his wings and holler his approval at the top of his lungs. It was deafening... it was the most wonderful sound I have ever heard!
The nine weeks until Monday, November 4th seemed to last forever. Gabby needed a miracle and we needed to stay sane. During this time, he migrated through seven special diets developed by Dr. Jenkins to balance all of his nutritional needs with easily digestible foods that would support his medical condition. He seemed to do very well on this avian version of "home cooked recipes" combined with select avian and human baby foods. His weight was up and his attitude was undaunted. He had no idea that our hearts ached every time we looked at him. Neither of us could imagine life without this extraordinary bird and we knew we had to keep those thoughts from being reflected in our actions. Gabby needed an upbeat, happy setting so he wouldn't undergo stress worrying about gloomy human partners. So we played and laughed and cuddled and kept our fears to ourselves... with his help. I don't think it would be possible for anyone to stay depressed around such a cheerful ray of sunshine.
Finally, the day arrived for us to go back to the University. Needless to say, Gabby wasn't pleased at the reunion with his medical support team and he expressed his disapproval of the avian assistant with an impressive blood draw of his own. In my arms he was a sweetheart, but he hissed vehemently at anyone else who approached him. It was obvious that he was feeling much stronger than he was during his last visit and, thankfully, the assistant was a good sport (even during her bandaging). Once the fluoroscopy and blood tests were finished, we were on our way home again to wait another two days for the results.
On Tuesday, November 5th, Dr. Jenkins called to say that the fluoroscopy had revealed a perfectly functioning GI tract with a normal ventriculus and proventriculus. What joy! We were halfway there! Then she told me that the avian chemscreen was the test that would determine Gabby's CK and liver enzyme counts and that those would be the critical factors in establishing a firmer diagnosis. She said it would be another 24 hours before the results were in.
At nine P.M. on Wednesday, November 6th, the phone rang again and I could barely bring myself to answer it. When I picked it up on the third ring, I heard Dr. Jenkins voice telling me that Gabby's entire blood panel was normal and that Dr. Duke could hardly believe this was the same bird he had seen in August. That night our tears were for a very different reason and they didn't stop for a long time. We still didn't know for sure what Gabby had suffered from, but at least Psitticine Wasting Disease was no longer the top contender. Foreign body ingestion and acute pancreatitis were now the primary suspects. We also learned that a series of final tests would need to be performed in six months to a year before we would have enough answers to issue a clean bill of health.
That year has passed and Gabby has come through his tests with flying colors. He is an incredible creature who received a miracle at the hands of a very gifted avian veterinarian and all those who participated in his care. Is it really Wasting? Not this time, not for Gabby. He is alive and well and wonderful. There are no ingestible materials in his environment and his diet consists of hulled seeds and nuts, pellets, fresh fruits and vegetables, and our avian veterinarian's recipe which takes about 20 minutes to prepare every other day.
This article was written from the heart to encourage anyone whose bird may be in a situation similar to Gabby's. It is questionable how many Cockatoos, Macaws, and other parrot species have been and will be euthanized based on a diagnosis of Wasting or PDS when in reality the cause may be foreign body ingestion or another "curable" problem. The long road was the good road for us and it is our hope that it will be for others too. The avian diet and environmental considerations that are currently part of Gabby's lifestyle are documented and available on request by writing to:
Additional Avian Support Information c/o Perma-Play Products LLC, 5212 Larada Lane, Edina, MN 55436, (952) 931-0515 Office, (952) 931-0527 Fax.