Help with Medicines

Mohitgaur088 · Nov 15, 2018

Dr. Rina Dev's clinic sent this prescription and I looked for these medicines on medical stores! I've found these, so please do help me make sure that they are same formulations. Just help me with this and I'll tell you later why these medicines and all. I'm from India so you may not be sure of all this, but anyway if you can help a little..that will be great.

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ChristaNL · Nov 15, 2018

Wow, you certainly are trying hard for your bird

I will wait till EllenD gets here- she is a bit more up-to-date with everything and will have things to say about how to give them.
I just wanted to say: Good for you! You keep fighting.

Mohitgaur088 · Nov 15, 2018

ChristaNL said:
Wow, you certainly are trying hard for your bird
I will wait till EllenD gets here- she is a bit more up-to-date with everything and will have things to say about how to give them.
I just wanted to say: Good for you! You keep fighting.

I'm also attaching her test reports for EllenD

These three medicines I found do have same formulations....So i guess I shouldn't worry about getting something wrong!

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ChristaNL · Nov 15, 2018

so...they are still not sure about possible psittacosis ... (possible chlamydial infection)
No worries, a week or 6-8 with continuous antibiotics will most likely clear it up anyway

Mohitgaur088 · Nov 15, 2018

Yeah...I hope the same

ChristaNL said:
so...they are still not sure about possible psittacosis ... (possible chlamydial infection)
No worries, a week or 6-8 with continuous antobiotics will most likely clear it up anyway

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Laurasea · Nov 15, 2018

Parrot fever is an infection caused by Chlamydia psittaci, a specific type of bacteria. The infection is also known as parrot disease and psittacosis. And secondary bacterial and yeast infection due to lower imnunity from fighting the primary Infection. Follow all directions carefully, this infection can be difficult to clear and relapse is common. Also clean the cage daily and carefully to help prevent this, every bar, every perch, food and water bowls. Most likely your bird gas low vitamin A levels as well and probablyow vitamin D levels both are important in helping the immune system. You need to get her eating foods high in vitamin A like red chilli peppers, red and orange bell peppers, pumkin, and squash. I would feed a half teaspoon of live culture yogurt every couple if days to to help with the yeast overgrowth, and because she is on antibiotics. If you live where it is warm 15 miniuts daily outside in part shade will help her too. But wait a few days till the eye drops have started to help her eyes as they are most likely sensitive to the sun right now. J
Keeping her warm will also help her get better. This is a treatable infection, but her immune system is down from fighting it, so she needs your good care. I'm so glad you got help, and getting the veggies in and some leafy greens to nibble on will really help her body fight this. Good luck!!!

Mohitgaur088 · Nov 15, 2018

She's already on probiotics

And we're giving her sunlight for some 10 minutes and vegetables. We try to keep her place as clean as possible but from now onwards more care will be taken. She's on a pellet diet but added Vitamin A will be good of course, Please do tell me more sources of vitamin A.

Laurasea said:
Parrot fever is an infection caused by Chlamydia psittaci, a specific type of bacteria. The infection is also known as parrot disease and psittacosis. And secondary bacterial and yeast infection due to lower imnunity from fighting the primary Infection. Follow all directions carefully, this infection can be difficult to clear and relapse is common. Also clean the cage daily and carefully to help prevent this, every bar, every perch, food and water bowls. Most likely your bird gas low vitamin A levels as well and probablyow vitamin D levels both are important in helping the immune system. You need to get her eating foods high in vitamin A like red chilli peppers, red and orange bell peppers, pumkin, and squash. I would feed a half teaspoon of live culture yogurt every couple if days to to help with the yeast overgrowth, and because she is on antibiotics. If you live where it is warm 15 miniuts daily outside in part shade will help her too. But wait a few days till the eye drops have started to help her eyes as they are most likely sensitive to the sun right now. J
Keeping her warm will also help her get better. This is a treatable infection, but her immune system is down from fighting it, so she needs your good care. I'm so glad you got help, and getting the veggies in and some leafy greens to nibble on will really help her body fight this. Good luck!!!

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Laurasea · Nov 15, 2018

Well that sounds fantastic,! A pellet diet will have the right mix of nutrition! I'm sure you keep things clean

it's just she is shedding that bacteria and you don't want her to reinfect herself. My friends cockatiel likes shredded carrots, you can try yams and sweet potato my birds like these cooked better than raw. People make bird bread there are some recipes on the forum. You definitely are taking good care of her, and if she is on pellets than she probably doesn't have low vitamin levels so that's great. Keep us posted! I'm sure EllenD will have some great advice to add!

EllenD · Nov 15, 2018

Basically it's Psittacosis Chlamydia, just as thought, with a Yeast Infection secondary to all of the antibiotics already given....Nailed that one! Lol...I'm pretty confident looking at the Culture/Sensitivity results that this confirms that the main, original issue was and still is Psittacosis Chlamydia. Finally some confirmation!

You've got two different eye-drops. the Gatifloxacin, which is an antibiotic eye-drop from the Quinolone family (Cipro/Macrobid family), so this will treat the Bacterial Conjunctivitis in the eyes, and is the correct spectrum antibiotic according to the culture results. So this is good....The second eye-drop, the Lotepred, is a steroid that will help to stop the swelling and itching in her eyes. So this one is also good. Use as directed.

The Terbicip tablet is an oral Anti-Fungal medication to treat the secondary-Yeast infection caused by all the antibiotics...YAY! This is very good. The Probiotics will also help to calm her stomach and GI Tract, and will slowly replace all of the healthy/normal bacteria back into her GI Tract, but Probiotics will not "treat" the secondary-Yeast infection throughout her GI Tract, so she definitely NEEDS this medication...Looks like they gave you the compounding information and it's pretty straight-forward, just be sure that since you're only giving her literally "1 drop" by-mouth twice a day that she actually ingests that "1 drop", and do not at all hesitate to give her a second drop orally if you think that she didn't get the first drop, for example if she shakes her head because it tastes terrible, etc. And it's best that you just give her this directly right into her beak/mouth and that you don't mix it with any food because she really NEEDS to get this Anti-Fungal medication into her system, all of it. And if you mix only a single drop into food or juice, unless she eats or drinks every last bit of it she won't get all of it. So use an eye-dropper or oral syringe and just go in to her beak on the left-side...(HER left, so if you're facing her you go-in with the syringe on YOUR right, and then aim the syringe over her tongue and across to the other side, or HER right side, your left if you're facing her, as the entrance to her Crop is on HER right side, at the back of her throat, and that's where you want it to go. So if you're facing her you put the syringe into HER left side of the beak (your right), go OVER the tongue, and aim towards the back of her throat on HER right side (your left) and then push it in. This will also keep you from aspirating any liquid into her lungs...

The Cefpodoxime is the main antibiotic they are putting her on to treat the Bacterial Infection causing this whole mess. Good choice since the Doxy did nothing and that pretty much eliminates using any of the Penicillin drugs or the Tetracycline drugs. The Cephlosporins are very strong and should knock it out, though same directions as giving her the Anti-Fungal drops you're going to be compounding from a tablet. Make sure that you get it directly into her beak/mouth, using the same technique, and that she gets the entire dose and keeps it in her mouth without spitting it out or shaking it out.

****I would caution you that since you're only supposed to give her the Anti-Fungal med and the Antibiotic med twice daily for 14 days, that after that 14 days is up, if her respiratory symptoms are not markedly improved, it's most-likely because it was too-short a course of the Cefpodoxime, and you'll most-likely have to continue both it and the Anti-Fungal for at least another week, as 21-days is the recommended minimal treatment length, and this is a difficult bacteria to knock-out and to keep relapse from occurring, as you already know. But I think the choice of a Cephlosporin is a good one based on how the Doxy did nothing at all to help her.

The Milk Thistle is not a medication but rather a plant-based supplement that is great for liver-support...I don't see any blood-work results or anything written that indicates that her liver enzyme levels were off, so in that instance they are giving her the Milk Thistle to protect her liver from all of these continual medications, which is a good idea. Milk Thistle is safe to actually give your bird everyday as a liver supplement anyway, so this is a very good idea.

Finally, Nutrolin B is also not a medication so much as a supplement, but it's used to treat a whole lot of symptoms in a more "natural" way, which is a good idea with a bird who has been taking so many prescription medications...It treats GI Tract disturbances and irritations, as well as replaces the normal, healthy flora in the GI Tract, as it's main-function is as a Probiotic...It's also a Vitamin B supplement, I believe Vitamin B1 (Thiamine), Vitamin B2 (Riboflavin), and Vitamin B6 (Pyrodoxine), which are all meant keep her from becoming anemic, keep her Neurological System functioning properly, and also eye support...But basically this is mainly a very strong Probiotic, which you need to give her daily throughout the rest of the Antibioitic treatments, and for at least a couple of weeks after she finishes the antibiotics, both the oral and the eye drops.

I think this sounds like a good plan, but you need to keep a close watch on her as far as how well her symptoms are clearing, specifically the Respiratory symptoms. Her GI symptoms will no doubt improve and should be cured with the Anti-Fungal med and the Probiotics, as should the eye infection. What you're looking closely for is to see if the antibiotic (the Cefpodoxime) is FINALLY the correct antibiotic for treating the Psittacosis strain that she has, which is causing both the Respiratory symptoms and the underlying cause of the eye Conjunctivitis...

Keep us posted on how she's doing, and if you have any specific questions about the meds or dosing them just ask...

Mohitgaur088 · Nov 16, 2018

Thanks for your help ... You're just amazing

I' have some questions..
1. I've got Gatifloxacin, neutrolin B and Terbacip. Other two medicines and milk thistle has been couriered to me and will be arriving soon. Should I start with all three which I have now? Or with Gatifloxacin atleast? Or should I wait for other medicines to arrive! I believe I should start with Gatifloxacin anyway as her eyes are going downhill again....
2. She's already on pro-biotic! Do I need to stop giving her pro-biotic as neutrolin B is the same thing? Or should I give her both of them?

EllenD said:
Basically it's Psittacosis Chlamydia, just as thought, with a Yeast Infection secondary to all of the antibiotics already given....Nailed that one! Lol...I'm pretty confident looking at the Culture/Sensitivity results that this confirms that the main, original issue was and still is Psittacosis Chlamydia. Finally some confirmation!

You've got two different eye-drops. the Gatifloxacin, which is an antibiotic eye-drop from the Quinolone family (Cipro/Macrobid family), so this will treat the Bacterial Conjunctivitis in the eyes, and is the correct spectrum antibiotic according to the culture results. So this is good....The second eye-drop, the Lotepred, is a steroid that will help to stop the swelling and itching in her eyes. So this one is also good. Use as directed.

The Terbicip tablet is an oral Anti-Fungal medication to treat the secondary-Yeast infection caused by all the antibiotics...YAY! This is very good. The Probiotics will also help to calm her stomach and GI Tract, and will slowly replace all of the healthy/normal bacteria back into her GI Tract, but Probiotics will not "treat" the secondary-Yeast infection throughout her GI Tract, so she definitely NEEDS this medication...Looks like they gave you the compounding information and it's pretty straight-forward, just be sure that since you're only giving her literally "1 drop" by-mouth twice a day that she actually ingests that "1 drop", and do not at all hesitate to give her a second drop orally if you think that she didn't get the first drop, for example if she shakes her head because it tastes terrible, etc. And it's best that you just give her this directly right into her beak/mouth and that you don't mix it with any food because she really NEEDS to get this Anti-Fungal medication into her system, all of it. And if you mix only a single drop into food or juice, unless she eats or drinks every last bit of it she won't get all of it. So use an eye-dropper or oral syringe and just go in to her beak on the left-side...(HER left, so if you're facing her you go-in with the syringe on YOUR right, and then aim the syringe over her tongue and across to the other side, or HER right side, your left if you're facing her, as the entrance to her Crop is on HER right side, at the back of her throat, and that's where you want it to go. So if you're facing her you put the syringe into HER left side of the beak (your right), go OVER the tongue, and aim towards the back of her throat on HER right side (your left) and then push it in. This will also keep you from aspirating any liquid into her lungs...

The Cefpodoxime is the main antibiotic they are putting her on to treat the Bacterial Infection causing this whole mess. Good choice since the Doxy did nothing and that pretty much eliminates using any of the Penicillin drugs or the Tetracycline drugs. The Cephlosporins are very strong and should knock it out, though same directions as giving her the Anti-Fungal drops you're going to be compounding from a tablet. Make sure that you get it directly into her beak/mouth, using the same technique, and that she gets the entire dose and keeps it in her mouth without spitting it out or shaking it out.

****I would caution you that since you're only supposed to give her the Anti-Fungal med and the Antibiotic med twice daily for 14 days, that after that 14 days is up, if her respiratory symptoms are not markedly improved, it's most-likely because it was too-short a course of the Cefpodoxime, and you'll most-likely have to continue both it and the Anti-Fungal for at least another week, as 21-days is the recommended minimal treatment length, and this is a difficult bacteria to knock-out and to keep relapse from occurring, as you already know. But I think the choice of a Cephlosporin is a good one based on how the Doxy did nothing at all to help her.

The Milk Thistle is not a medication but rather a plant-based supplement that is great for liver-support...I don't see any blood-work results or anything written that indicates that her liver enzyme levels were off, so in that instance they are giving her the Milk Thistle to protect her liver from all of these continual medications, which is a good idea. Milk Thistle is safe to actually give your bird everyday as a liver supplement anyway, so this is a very good idea.

Finally, Nutrolin B is also not a medication so much as a supplement, but it's used to treat a whole lot of symptoms in a more "natural" way, which is a good idea with a bird who has been taking so many prescription medications...It treats GI Tract disturbances and irritations, as well as replaces the normal, healthy flora in the GI Tract, as it's main-function is as a Probiotic...It's also a Vitamin B supplement, I believe Vitamin B1 (Thiamine), Vitamin B2 (Riboflavin), and Vitamin B6 (Pyrodoxine), which are all meant keep her from becoming anemic, keep her Neurological System functioning properly, and also eye support...But basically this is mainly a very strong Probiotic, which you need to give her daily throughout the rest of the Antibioitic treatments, and for at least a couple of weeks after she finishes the antibiotics, both the oral and the eye drops.

I think this sounds like a good plan, but you need to keep a close watch on her as far as how well her symptoms are clearing, specifically the Respiratory symptoms. Her GI symptoms will no doubt improve and should be cured with the Anti-Fungal med and the Probiotics, as should the eye infection. What you're looking closely for is to see if the antibiotic (the Cefpodoxime) is FINALLY the correct antibiotic for treating the Psittacosis strain that she has, which is causing both the Respiratory symptoms and the underlying cause of the eye Conjunctivitis...

Keep us posted on how she's doing, and if you have any specific questions about the meds or dosing them just ask...

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Scott · Nov 16, 2018

So happy to see diagnostic and med progress for Shine!

You are an amazingly dedicated parront!

Mohitgaur088 · Nov 16, 2018

Scott said:
So happy to see diagnostic and med progress for Shine!

You are an amazingly dedicated parront!

I'm not ready for a breathing issue emergency. Please tell me what to do urgently. Shine may have one anytime and I'm worried.

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EllenD · Nov 16, 2018

I would start ALL of the meds you have now, and then just start the others as you get them, as they are all independent of each other, and you have both the Antibiotic and the Antifungal, both of which she needs to start immediately...The Milk Thistle is a supportive-supplement, so that has no bearing on anything else, and the eye-drops are only treating the eye-infection LOCALLY, while the Antibiotic is treating the underlying-disease/bacterium that is actually causing the eye-infection. So while the antibiotic eye-drop will clear-up the eye-infection locally, it would simply come right back if she was not taking the Antibiotic to treat the underlying systemic-infection causing it...And the other eye-drop is just a steroid to help the swelling and itching and to make her feel better, not actually treat the infection...So start her immediately on the meds you have, and then start her on the other ones immediately when you get each of them...Just keep track of the date you start each of them so you know when each round started and should end...

As far as the Probiotic goes, I don't remember what one you've been giving her all this time, but I do know that the Neutrolin-B contains a strong dose of a good Probiotic mix, along with other supportive-supplements that will help her...So since the Probiotic in the Neutrolin-B is just as good as whatever you've been giving her as far as the Probiotic goes, I would discontinue the other Probiotic and just give her the Neutrolin-B as-directed from this point forward. That way she gets both a good Probiotic and the other beneficial supplements in the Neutrolin-B...All B-vitamins are water-soluble, so they are much safer to give than say a fat-soluble vitamin that will be stored by the body and can cause toxicity. So with the Neutrolin-B, her body will absorb the amount of the added B-vitamins that it needs and then simply excrete the excess in her urates. So I'd go with the Neutrolin-B and stop the other Probiotic.

Scott · Nov 17, 2018

Mohitgaur088 said:
Scott said:

So happy to see diagnostic and med progress for Shine!

You are an amazingly dedicated parront!

Click to expand...

I'm not ready for a breathing issue emergency. Please tell me what to do urgently. Shine may have one anytime and I'm worried.

Sent from my YU5010A using Tapatalk

I'm sorry but don't have that sort of expertise. Has Shine had breathing issues, and do you see symptoms suggestive of a problem?

Mohitgaur088 · Nov 17, 2018

Scott said:
Mohitgaur088 said:

Scott said:

So happy to see diagnostic and med progress for Shine!

You are an amazingly dedicated parront!

Click to expand...

I'm not ready for a breathing issue emergency. Please tell me what to do urgently. Shine may have one anytime and I'm worried.

Sent from my YU5010A using Tapatalk

Click to expand...

I'm sorry but don't have that sort of expertise. Has Shine had breathing issues, and do you see symptoms suggestive of a problem?

No, she never had any sort of breathing issues. But I always worry about a breathing emergency, I don't know how to do that Bird CPR thing accurately. Chlamaydia may result in one but fortunately nothing so far! I just wanted to know in case I ever go through such situation in life :-(

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Scott · Nov 17, 2018

Mohitgaur088 said:
Scott said:

Mohitgaur088 said:

I'm not ready for a breathing issue emergency. Please tell me what to do urgently. Shine may have one anytime and I'm worried.

Sent from my YU5010A using Tapatalk

Click to expand...

I'm sorry but don't have that sort of expertise. Has Shine had breathing issues, and do you see symptoms suggestive of a problem?

Click to expand...

No, she never had any sort of breathing issues. But I always worry about a breathing emergency, I don't know how to do that Bird CPR thing accurately. Chlamaydia may result in one but fortunately nothing so far! I just wanted to know in case I ever go through such situation in life :-(

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Found a few links, cannot vouch for the authenticity or safety of such advice:
https://www.exoticpetvet.net/avian/cpr.html
https://www.audubon.org/news/can-you-do-cpr-bird

EllenD · Nov 17, 2018

I doubt you're going to have to worry about doing CPR, but those links describe the process pretty accurately. I've only ever done CPR on a bird one time, though I've seen it done a number of times. To be totally honest with you though, if your bird stops breathing/heart stops beating, CPR won't bring her back, it will only keep oxygenated blood circulating through her body/to her brain for a very short time...In order to get their heart started again you have to have the correct Cardiac-Drugs to stimulate the heart to start beating again. And the chances of bringing a bird back even in an Emergency Animal Hospital with all of the correct Cardiac Drugs, Oxygen, etc. are basically 1%. That's why birds so often die while in surgery, once they stop breathing it's incredibly difficult to get them back...Same goes for any small animals, such as rabbits, ferrets, reptiles, etc.

Again though, I don't think you're going to have to worry about this happening, it sounds like she's doing much better, and she's finally on the correct medications for exactly the microbe causing this...

Mohitgaur088 · Nov 18, 2018

Thanks for clarifying

Should I use different droppers for every medicine? Also, Terbacip 250 mg needs to be dissolved in 25 ml water and just one drop out of it will be given to her! I'm preparing fresh solution every time, should I rather keep the same solution to be used again?

EllenD said:
I doubt you're going to have to worry about doing CPR, but those links describe the process pretty accurately. I've only ever done CPR on a bird one time, though I've seen it done a number of times. To be totally honest with you though, if your bird stops breathing/heart stops beating, CPR won't bring her back, it will only keep oxygenated blood circulating through her body/to her brain for a very short time...In order to get their heart started again you have to have the correct Cardiac-Drugs to stimulate the heart to start beating again. And the chances of bringing a bird back even in an Emergency Animal Hospital with all of the correct Cardiac Drugs, Oxygen, etc. are basically 1%. That's why birds so often die while in surgery, once they stop breathing it's incredibly difficult to get them back...Same goes for any small animals, such as rabbits, ferrets, reptiles, etc.

Again though, I don't think you're going to have to worry about this happening, it sounds like she's doing much better, and she's finally on the correct medications for exactly the microbe causing this...

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EllenD · Nov 18, 2018

You can use the same dropper every time, but you want to rinse it very well in-between medications so that you don't contaminate the different meds, or accidentally not give her the correct amount of one medication because there is residual of the last medication you gave her remaining in the dropper. Just use water and rinse it out well between meds.

As far as the one you have to compound into liquid, you don't have to use a different batch every time, especially if you're just going to be running through tablets every time, if you don't want to. Obviously that would be the best thing to do, but the fact that it's a tablet you're mixing makes it okay because it's not going to lose it's efficacy. I would keep the already compounded solution in the fridge though, just to keep it from growing bacteria or fungi, which is really the big worry when re-using a compounded med like this, the fact that it will start growing microbes as soon as you mix it up...So that choice is up to you, but if it were me and I had enough tablets to compound a new batch every single day, then I would mix up a new dose every day...If you're giving her that medication twice daily (which I think you are if I remember correctly), then I wouldn't mix a new batch twice a day, I would mix it up fresh each morning, give her the first dose for the day, and then put it in the fridge, and then get it out and give her the second dose from that same batch each day, and then throw it out after giving her the second dose of the day. Then I'd mix up a fresh batch the next morning. It won't grow any significant microbes over one day's time if it's kept in the fridge. Just don't keep it longer than 24-hours.

Mohitgaur088 · Nov 18, 2018

EllenD said:
You can use the same dropper every time, but you want to rinse it very well in-between medications so that you don't contaminate the different meds, or accidentally not give her the correct amount of one medication because there is residual of the last medication you gave her remaining in the dropper. Just use water and rinse it out well between meds.

As far as the one you have to compound into liquid, you don't have to use a different batch every time, especially if you're just going to be running through tablets every time, if you don't want to. Obviously that would be the best thing to do, but the fact that it's a tablet you're mixing makes it okay because it's not going to lose it's efficacy. I would keep the already compounded solution in the fridge though, just to keep it from growing bacteria or fungi, which is really the big worry when re-using a compounded med like this, the fact that it will start growing microbes as soon as you mix it up...So that choice is up to you, but if it were me and I had enough tablets to compound a new batch every single day, then I would mix up a new dose every day...If you're giving her that medication twice daily (which I think you are if I remember correctly), then I wouldn't mix a new batch twice a day, I would mix it up fresh each morning, give her the first dose for the day, and then put it in the fridge, and then get it out and give her the second dose from that same batch each day, and then throw it out after giving her the second dose of the day. Then I'd mix up a fresh batch the next morning. It won't grow any significant microbes over one day's time if it's kept in the fridge. Just don't keep it longer than 24-hours.

One last thing, all doses are gonna be just "one or two" drops and you said if she ever disturbs one drop, like by shaking head (which hasn't occurred so far) then I shouldn't hesitate to go for another drop! Won't it be overdose if i give her another drop? I just wanna ask because I'm curious ....

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