Wednesday, February 23, 2011

PDD or Fatty Liver Syndrome?

Hi Sandee,

I have a 6 yr old female green rump. She has been healthy most of her life up until the past 6 months. I'll try to keep this breif... But she has gone through many tests and doctors now. The only test that came back abnormal was her bile acids. She has something wrong with her liver apparently. Also, she got some xrays done and it shows a massive growth inside of her that is pushing on other organs causing a respiratory click, and straining when trying to defacate. The vets could not determine exactly what this mass was inside of her and she is too small and sensitive to go through a barrium series/endoscopy. I have done so much internet research and am just exhausted with this whole situation... $1600 later.... She is behaving pretty normally. But she still has the breathing and defacation problems, also her belly is extended.

She has been exposed to a couple other birds in her life but hasn't come in contact with them. Also she has eaten a lot of nuts in the past (high fat I know) but she is now on seed only - and I am trying to get her to eat lowfat pellets (not working well.) She'll eat fruits and veggies sometimes though. I also give her an herbal detox supplement that she drinks easily.

So, can you possibly make any assumptions about this? Thank you in advance for your help.

Betsy the worried mama.

Dear Betsy:

Thank you for your email. I am terribly sorry to hear about this situation with your parrotlet. I must say although I have almost 30 years experience with parrotlets, I am not a vet nor am I qualified to diagnose your bird. Since you are working with your veterinarian I can render my opinion which you should discuss with your veterinarian.

PDD is rarely found in parrotlets. That doesn’t mean it can’t be, I just know of only 1 bird that ever had that diagnosis and that was a bird that was in a pet shop that had an outbreak. PDD is characterized by the passing of whole foods, especially seeds, which the bird cannot process due to the inability of the proventriculus to function. It does not manifest as tumors or growths and tremendous progress has been made in both the diagnosis and treatment (there is now a test available) in the last few years. Avian bornovirus is the agent responsible for this disease and many birds have been treated with Celabrex to extend their lives. However, I do not believe this is the problem with your bird.

There is an old saying that I love to use “Don’t look for zebras, look for horses.” In other words, the most common or most likely scenario is the one to look at. In this instance, it would be liver failure or fatty liver syndrome. Although I would also suspect it could be a tumor or even an malformed egg that is stuck in the uterus, but I am assuming your vet has ruled out the latter possibility although in a female bird of that age, that would be my first suspicion. Parrotlets are very tiny and have very quick metabolisms and a high fat diet can result in FLS in a relatively short period of time. My guess would be that is the problem with this bird and I would focus on seeing if that issue can be resolved.

Changing her diet this late in life, particularly to pellets, is going to be very difficult but it is something worth trying although I have to admit I am not a big proponent of pellets or other processed foods. I don’t eat them myself and I don’t believe they are healthy for birds but that is something for you and your vet to discuss. After, all pellets are just processed seeds (usually corn which is low in fat but very high in sugar and something I don’t eat myself) plus artificial vitamins. I would recommend a diet rich in whole, real foods – lots of fresh vegetables, greens, fruit if you can (parrotlets are not big fruit eaters), grains, legumes, sprouted seed, etc. You might also check into holistic treatments such as aloe detox or milk thistle but only under a vet’s direction. Dr. Dave McCluggage is a certified holistic vet and has been one for more than a decade. You might want to see if you can contact him or ask your vet to contact him. I would also check with the Association of Avian Veterinarians to see if they have any recommendations for holistic vets.

I wish you the best of luck with this bird. She is very lucky to have such a caring owner.

Sincerely yours,

Sandee L. Molenda, C.A.S.
The Parrotlet Ranch, Owner,
Join the International Parrotlet Society, – the World’s Largest and Oldest Parrotlet Organization
A Chattering Bird Builds No Nest.
Camaroonian Phrase

Hi Sandee,

Thank you SO much for your response! I have felt so alone and frustrated during this whole ordeal and you are the only person who has given me hope and confirmation about my bird's condition. I have a couple more questions for you, please?

The reason why I suspected PDD was because she has had two occurences of undigested seeds in her droppings. When I first took her to the vet, they sent me home with oral baytril. After the first dose, she vomited and became deathly sick. (Later down the line I realized she probably got sick because her liver couldn't process it - you think?) She spent the night at the vet, was tube fed, and given injections of baytril. Then once I got her home and she began eating seeds again, I noticed she had undigested seeds in her droppings. She tested negative for giardia - and it went away after a couple days. A few weeks later I took her to get a FOURTH opinion where they finally did x-rays (definitely not an egg - but they said possibly a tumor or liver enlargement but couldnt tell for sure without further invasive tests), a bile acid test (finally now we see an abnormal test result), and attempted to draw fluid from her abdomen. Needless to say it totally stressed her out - and once again she had undigested seeds in droppings that lasted a couple days. I spoke with a couple people to see if this was a symptom of stress, but no one confirmed that. So my suspicion of PDD rose higher. What is your opinion on the undigested seeds occuring after high stress situations?

I suppose all other symptoms point to FLS. Her feathers are dull, and her bile acid level came back as 288 (vet said normal is 50 but she was not fasted.) The vet told me she would die within a few weeks and that was on January 6th. I have let her feathers grow in so she can start to fly a little more and get more exercise that way but she is so heavy she falls straight down. My next question - if she has FLS, will the liver gradually shrink back to normal size? And also, why do you think the vet didn't diagnose her with this? They sent me home with a supplement called "Booster" by "Heal-X" (have you heard of this?) and they recommended putting her on a series of weekly high doses of antiobiotics!! I declined the antiobiotics. They also recently called to suggest another bile acid test and I declined that as well.

I will get in contact with Dr. McCluggage and try to get his opinion as I think holistic treatment is the only way to go. In the meantime, please let me know your additional thoughts on the above....

Thank you so much for your time!


Dear Betsy:

Undigested seeds is a very serious thing as it means the body is unable to process food. That doesn’t happen because of stress. It can be a symptom of several things including PDD, liver failure or avian gastric yeast. I have to admit I am very surprised that your vet would prescribe injections of Baytril because a) there is no sign of bacterial infection and b) Baytril is very hard on the liver. Everything in this situation points to fatty liver including the scientific tests. Nothing has shown this to be PDD (and again, there IS a test) and stress would not cause that kind of shutdown.

As for recovery, I can’t answer that. We know humans do not always recover from liver failure and we know a lot more about human medicine than we do avian. We also cannot do things like transplants in parrotlets.

My belief is that the dog-cat-human (i.e., mammal treatments) do not work on birds very effectively. We have much more knowledge and experience with them and their reactions to medications. Birds, especially parrotlets whose livers are so tiny, just don’t handle those kind of modalities very well. I would recommend contacting Dr. McCluggage and working on holistic cures for fatty liver. It will not cause harm like medications can so if it doesn’t work, you are not contributing to the problem.

I hope this helps and please let know how things go.

Sincerely yours,

Sandee L. Molenda, C.A.S.

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