June 19, 2010

A Case of Visceral Gout in a Grey-cheeked Parakeet

Our greycheek, Kelly, died about a year ago from visceral gout. Three years back she was having balancing problems, and we thought she was just being clutsy from getting overexcited. As time grew on, we heard her emit an almost regular short squeak, and with each one there was a slight jerk to her head and body, but she otherwise was alert, and you could see recognition in her eyes. So that night, we went to bed and tried to get some sleep and planned on having her checked out the following morning at the vet. Well a short time later, probably as soon as we managed to knock out, we heard the same squeaking, but this time more rapidly and somewhat urgent sounding. When we went to check on her, she was on the floor of her cage having seizures to one side. We grabbed her carrier box and made a mad pace to an emergency clinic that normally only saw cats and dogs, but had reports of basic emergency bird care. By the time we got her there, the fool bird acted fine.

So... back home we went. We put her back in her cage to sleep and tried to get some of our own. Not long thereafter, we started hearing the same squeaking, but this time she's seizing on both sides of her body, and her eyes were narrowed shut. We did another pace down the highway back to the emergency vet. He saw her and said he couldn't do anything but called (after midnight mind you) one of the avian vets at the UW Animal Hospital.

The vet at UW stated that Kelly had grossly elevated urate levels and seemed to possibly have a bacterial infection. She was dosed for a few days under constant watch with allopurinol and an antibiotic. After a few days, she came back home with us, and the doc said she'd also lost enough weight that I should feed her virtually anything she wanted, including her most favorite treat, Nutriberries, and let her eat her fill. She recovered completely, and we were told this was lucky, as visceral gout is usually fatal.

Well two years later, she started showing the same symptoms. This time we hauled her straight to the UW avian vet. Visceral gout had come back, probably worse though no seizures this time, just the squeak/twitch. She was refusing food and was losing several grams of weight a day. No urate coming out in her poop at all this time.

She had a brief period of being alert at the hospital, but they said with visceral gout all they could do was give her allopurinol again, minus the antibiotic this time as no infection was noticed. Knowing this disease was usually fatal, I begged them to give the antibiotic anyhow, especially given her chances, along the lines of "if it worked before." They sent her back home with us, and again, we feed her anything she could eat. This time though she was much weaker and was not eating or drinking on her own. I got some banana and rice Gerber flakes, mixed it up slightly thicker than the norm but not real lumpy, and tried to syringe feed her. She would barely eat, but she did eat some. The second day she was worse and was noticeably thinner, so I had to take the risky measure of pushing a crop-feed. Thankfully she didn't choke, and I knew I had been lucky and hit the mark. Her cage area underwent some modifications as well, and with the help of a heat lamp and a sliding light control switch, her cage was kept at a constant 90 degrees, and we kept water near her for humidity.

She was still getting thinner even with the crude attempt at crop feeding and was also now vomiting. She started looking sub-skeletal, early starvation. I told my roommate that we "had to consider the realistic options." Gads did he ever start acting weird! I had to be the clear-headed one for a change. In a day or so, and after my reminding him of her daily weight drop, I told him that basically she'd die of starvation within just a few more days, 2-3 at the rate she was going. She was almost never alert now, and no food or water was being consumed. So we took her to the vet... a more humane solution than letting her slowly starve to death, and there were obvious signs that she was in discomfort and pain.

Anyhow, this is probably a combination of release as well as to mention visceral gout is something to watch for. Also, as an early suggestion in view of the fact so little seems to be known about why it comes about in birds, to consider the antibiotic regimen along with the allopurinol anyhow. The vet admitted that he couldn't explain why Kelly pulled through the first time but not the second.

Article by T. Johnson

Additional reading for this topic:

  • Bacon, Constance. "Eclectus Diet," Winged Wisdom, Sept./Oct. 1997.
  • Banday, M.T., Bhakt, Mukesh and Hamid, Sheikh Adil. Avian Gout: Causes and Treatment, May 26, 2009.
  • BirdChannel.com. "Medical Conditions: Gout."
  • Ensley, P. Caged bird medicine and husbandry. Veterinary Clinics of North American Small Animal Practice. Aug. 1979, 9(3):499-525. (avail. on PubMed).
  • Foster, Drs. and Smith Educational Staff. Gout in Birds: How to Recognize the Signs in Your Bird.
  • Guo X, Huang K, Tang J. Clinicopathology of gout in growing layers induced by high calcium and high protein diets. British Poultry Science, Oct. 2005, 46(5):641-6 (avail. online in PubMed).
  • Hines, Ron DVM. Gout In Pet Birds, Avian Kidney Disease.
  • McAfee, L.T. and Gergis, A.L. Gout in a parakeet. Modern Veterinary Practice. May 1981, 62(5):388-90 (avail online in PubMed).
  • "Nutrition-Associated and Metabolic Disorders," California Avian Laboratory.
  • Pegram, R.A. and Wyatt, R.D. "Avian gout caused by oosporein, a mycotoxin produced by Caetomium trilaterale," Poultry Science, Nov. 1981, 60(11):2429-40 (avail. online in PubMed).
  • Roth, Erica. How to Treat Avian Gout, eHow.com.
  • Shivaprasad, H.L. Avian Gout excerpt from "An overview of anatomy, physiology and pathology of urinary system in birds," AAV Proceedings (1998) 201-205.
  • Swicegood, Carolyn. "The Kitchen Physician: Nature's Pharmacy."
  • Visceral and Articular Gout. Avianweb.com.
  • Warden, Margrethe. Visceral Gout in Birds. Lorikeets.com.
  • Wissman, Margaret A. "Causes and Cures: Demystifying Gout," Bird Talk, 23 (Sept. 2005): 52-53,86.

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