Sir Jolly's having a bad reaction

[Anansi]

Hi, Stephen.
What you described is exactly what happens to Oscar. Curiously, it's always his left leg too. Earlier this year he had a major episode, followed by another one several months later. You may recall me posting about it at the time.
Since then, I've taken him to his vet in Ballarat, and it remains largely a mystery. The vet said that there has been no conclusive scientific research done into toe tapping, and they're still trying to understand it. He seems convinced, though, that it's diet related.
I do know one of the causes for Oscar is bird seed. I've tried giving him bird seed three times, and in each case, after being on it for a week, he's had an episode.
Since his last episode, he has not even toe tapped, but it's winter here in Australia now, and he never toe taps during winter. For some reason, he only ever toe taps during the warmer months.
When Oscar has one of these major seizures, they usually last four nights. After that they settle down to a toe tap for about a week, before he's fine.
It's a very distressing thing to see him go through. He certainly isn't happy, and I doubt he sleeps while it's happening.
Anyway, I hope that Jolly is getting better now.

Thank you very much for putting this reminder of your experience, Keatz. Much appreciated. While I do remember you posting about toe-tapping, I don't recall having read about those kicking spasms. Could you post the link to your thread so that I can re-familiarize myself with Oscar's case?

I really doubt that bird seed is the culprit in this case, as Jolly and Maya are actually eating even less seeds than they were up to a few months ago. (Though there has never been a significant amount of seed in their diet.) But again, I'm definitely not ruling anything out at this stage.

Yes, I spoke in depth with Jolly's CAV about this as well. And like Oscar's, he mentioned that there is much debate right now regarding toe-tapping... and that no one actually knows the answer. He pointed out to me again that many ekkies who had particularly stubborn incidences of TT/WF turned out to be afflicted with the neurological variant of ABV/PDD (which he suspected to be the case with Maya 2+ years back, though she's only had the one bout.) He mentioned other suspected causes as well, like calcium deficiency or some pellets. But in the end there's nothing yet that can be definitively and conclusively named as the cause. Unlike Oscar's vet, however, he leans toward the neurological PDD variant. Especially given the neurological nature of toe-tapping and wing-flipping.

My personal opinion, not that it has much clout when measured against good CAV's, is more in the middle. I believe that ekkies are just more prone to neurological reactions than other species of parrot. So something goes wrong with their diets? They tap/flip. They develop the neurological variant of PDD? They tap/flip. Not much different than a cockatoo's, grey's or ekkie's greater likelihood to pluck than say a macaw or a conure. Some birds, IMHO, just have more of a sensitivity to certain issues. Or perhaps put more accurately, some birds are more likely to physically manifest symptoms of their issues in a particular way than others. Know what I mean?

So in the end, I really don't know if either Jolly or Maya has that PDD variant (I know I keep emphasizing the "variant" part. It's not a love of redundancy on my part, but rather because I want to differentiate that form from the far scarier gastrointestinal version that took my Bixby away from me back in 2015). So all I can do is search out all the likely triggers and try to account for them.

Jolly is down to a very mild and occasional toe-tap as of this morning. And hopefully the toe-tapping is gone by the time I get home. He's stopped gnawing at his feet, so the Gabapentin is definitely doing its job of subduing the nerve discomfort there. And the cut is not showing any signs of infection. I didn't think it would, but the pre-emptive antibiotic treatment certainly didn't hurt. He's gained some weight from all the oatmeal and peanut butter, but he'll burn that off in no time.

 

[Keatz]

Hi, Stephen. Here's a link to my post.

http://www.parrotforums.com/eclectus/74255-leg-spasms.html

I described Oscar's symptoms as leg spasms, but they're exactly the same as how you described Jolly's symptoms.
After Oscar's first incident, I contacted the Eclectus Research Centre. They seemed to think that it was a build up of too many vitamins in his liver, resulting in muscle spasms. Prior to that incident, he'd chowed into a lot of pellets, which they suggested could have been the cause. Prior to his second incident, I'd started giving him birdseed again in the evenings. I thought I'd try a new brand. Even though I think I have an idea of what food contributes to it, sometimes I think I have it under control and it inexplicably returns.
My vet thinks that another possible cause is that Oscar may have trouble processing food. The reason he thinks this is because he believes that Oscar was not weaned correctly, which has resulted in some feather issues. He has bald spots under his wings and a damaged feather follicle causing a primary wing feather to grow out crooked. (The vet said it's too risky to fix or remove the follicle, and suggested I just snip the feather off each time it fully grows out, which I do.) Anyway, he seems to think that some of his feather problems may be a result of him not being able to process his food properly and by extension, this may be why he has leg spasms. He said it's just a theory, but he thinks that Oscar is more sensitive than most eclectus. (Tangentially, he said that of all the parrots he treats, eclectus present him with the most challenges.)
I think your theory about it being a neurological variant of PDD may be accurate. My eclectus book says that when other symptoms, such as wing flipping and seizures, occur with toe tapping, other conditions should be considered. When Oscar has an episode, it is so severe that I find it hard to believe that it's just a food allergy.
I will keenly follow Jolly's case. Hopefully, it will give me some ideas to throw at my own vet. I hope that Jolly's feeling a lot better now.

 

[Anansi]

Thank you for posting that link. Now I fully remember your case! But we were waiting on your video. Could you post it so we can see just how closely it mirrors what's happening with Jolly now? And also, how were Oscar's levels after the blood tests? Did anything seem amiss on that front?

There's still a very mild tapping, and he's holding the left foot up in rest position more often than the right. If it does turn out to be the PDD variant, there is some hope in that the current treatment has kept Maya episode free for over 2 years now. God-willing I hope to never see either of my birds going through something like that again. Maya's was rough, but Jolly's was heartbreaking! I can see now what you were going through, Keatz. What a violent motion that spasm is!

 

[Keatz]

I didn't get that video up because I couldn't work out how to do it. I think someone mentioned doing it through YouTube, but I don't have an account there and it seemed convoluted. Is there another, easier way of getting the video to you? (The video was taken during the day, when the episode was at its mildest, but he's still kicking his left leg out.)
Oscar's tests all came back normal. In fact, the vet was very pleased because he said that Oscar is in perfect health -- other than the toe taps.
It really is a distressing thing to have to go through, partly because I can see how much distress and discomfort it causes Oscar. He even makes sooky noises and tries to chew his foot.
It's also a frustrating thing to deal with because it is so hard to get treated. I have the uneasy feeling that, in Oscar's case, it is probably going to be a recurring problem.

 

[Anansi]

The YouTube process is like 5 minutes, I promise! But if you'd like, we could PM each other our email addresses and just send the video that way.

Tell me, have Oscar's vets ever tried the combination of Celebrex and Gabapentin? The fact that Oscar's situation has repeated while his labs have been perfect lends credence to Jolly and Maya's vet's PDD variant theory. And his thought was that it's a condition that would have occasional flare ups that would be manageable enough if treated quickly. The Celebrex cuts down on the inflammation while the Gabapentin gives relief to the nerve pain/discomfort that causes them to gnaw at their feet. It was VERY effective for Maya, and is proving effective again for Jolly.

And here's the best part. I'm not even sure if it is the PDD variant. But insofar as this treatment goes, it hardly even matters. Whether or not that's the cause, these meds provide relief. (Of course, in the long run we'd prefer to get to the root cause, but in the short run? We want to get it under control before gnawing leads to mutilation.)

You know, I've also often wondered if some of the cases of plucking might not also be attributable to a neurological cause - at least initially - and thus be treatable in a similar way.

 

[wrench13]

Well doesn't Jolly look great in that pic! Glad he is out of the woods.

 

[ChristaNL]

Ehm....not sure how to put this without sounding extremely condescending or accusing (to) anyone.


Blame it on the different ways of information-availability maybe?
but...


I've always been told that if you have a parrot that is diagnosed with positive borna / (or worse) fullblown PDD you can not take in another bird and expect that bird *not* to get infected.
(Direct contact will do it, but also indirect - f.e. the manure, dust particles, peoples hands etc. )
Did we miss something here?



(there are special care-units/ forsterplaces here for parrots with KDD so they will have a good life but not infect other birds)


one of the sources I had: http://www.noivbd.nl/ABV-PDD InfoEng.htm
(was reading the dutch version, so not sure if they are exactly the same)

 

[Kentuckienne]

There are some interesting recent papers about this.

The Helene Pendl article “Immunology” at this link: https://www.sciencedirect.com/topics/veterinary-science-and-veterinary-medicine/avian-bornavirus

Ok it’s technical...they speculate that the presence of a particular type of T-cell triggers an autoimmune response - which damages the nervous system and causes spasms among other things. Basically the body is attacking its own nervous system. An African grey with PDD went into remission after treatment with Cyclosporine A, a specific T cell immunosuppressant. Additionally, gangliocides are implicated in triggering the autoimmune response ... which makes avian PDD resemble human autoimmune diseases such as GBS. There don’t seem to be good repeatable trials, but it seems worth trying an immune suppressing drug ...

 

[ChristaNL]

Thank you... I love to find the more up-to-date articles. :07:



One of the disadvantages everywhere is the "we've always done it this way, so we must be right" attitude - and the internet is a great source of information as wel as old wives tales ...


More important of course (and sorry I hijacked your thread) -> Sir Jolly is still doing good?

 

[Anansi]

Ehm....not sure how to put this without sounding extremely condescending or accusing (to) anyone.

Blame it on the different ways of information-availability maybe?
but...

I've always been told that if you have a parrot that is diagnosed with positive borna / (or worse) fullblown PDD you can not take in another bird and expect that bird *not* to get infected.
(Direct contact will do it, but also indirect - f.e. the manure, dust particles, peoples hands etc. )
Did we miss something here?

(there are special care-units/ forsterplaces here for parrots with KDD so they will have a good life but not infect other birds)

one of the sources I had: NOIVBD Links
(was reading the dutch version, so not sure if they are exactly the same)

Actually, most researchers assert that ABV is passed vertically, which is to say mother to child. The usual caveat is that one would be wise not to allow one bird to eat or come into contact with the fecal matter of another. Which, well... I'm sure most of us would be guarding against anyway. One of my sources was a pioneer in ABV/PDD research. Another is a certified avian vet with around 25 years of experience with ekkies. And yet another is a former breeder who has worked with ekkies for over 20 years, and has had enough PDD positive birds to know that the disease is primarily spread mother to child.

That said, perhaps you need a bit of background on this situation, as you seem to be wondering if I knowingly put my birds into danger.. My first ekkie, Bixby, was apparently born with ABV. I did not learn of this until after he died... and after I'd gotten Maya as a rehome. His PDD was the gastrointestinal version that you read about in the article that you linked for me. A terrible, debilitating disease that caused him to waste away slowly and left him susceptible to a variety of secondary infections.

Months later, I was offered Jolly. Of course, my fear was that she might have contracted the disease and was now contagious herself. It was then that I was first told of the vertical nature of disease transmission when it comes to ABV (as opposed to PBFD or Pachecos, which are both horizontally transmitted, ie bird to bird). But I still worried and decided to have Maya tested for ABV. She tested negative. But to be sure, I also had her x-rayed. (Signs of PDD are often seen in x-rays, be it an enlarged proventriculus or liver, among other things.) Again, negative. And yet another vet explained to me the vertical nature of ABV transmission.

So, once I felt reasonably confident that Maya was not infected, I took in Jolly. And while Jolly was in QT, I had him tested for ABV and PBFD. Both also came back negative. So no, neither of my living birds has ever been diagnosed with full-blown PDD or with ABV.

All that said, there is still a lot that vets and researchers don't know about ABV and PDD, including what might be the exact catalyst that triggers the relatively harmless ABV into the far more malevolent PDD. Nor do they understand why some birds seem to catch the gastrointestinal version that renders birds unable to digest the food that they've eaten (like Bixby), and others seem to catch the neurological variant. (And some present with both.)

At present, anything that I'm saying in regards to ABV and PDD in regards to my birds or, by extension, Keatz's Oscar, is purely theoretical. But the fact of the matter is that one of the prevailing theories right now regarding toe-tapping is that a far greater number of ekkies out there suffer from a less devastating neurological variant of PDD that manifests from time to time with those telltale spasms and such... symptoms that can be treated as they occur by anti-inflammatories and nerve meds.

End of the day, both of my birds have tested negative for ABV. But with there being so much people just don't know about the disease, or about toe-tapping and wing-flipping, I'd be foolish not to consider the possibility. And further, even if they don't have ABV, the meds prescribed still treat the symptoms of toe-tapping. So why not?

Oh, one other thing. Being diagnosed as positive for ABV does not necessarily mean that a bird can get PDD. Why? Because there are actually 9 strains of ABV, and only 2 of them have the potential to become PDD. The sad part is that while there is a test, intermittently reliable as it is, for ABV, at this point in time it remains incapable of distinguishing between the strains of ABV. So a positive result still means little or nothing (which is why I also had x-rays done). And on top of all that, a rather significantly large percentage of the avian population is infected with ABV. But obviously, most are only infected with the other 7 strains.

 

[Anansi]

There are some interesting recent papers about this.

The Helene Pendl article “Immunology” at this link: https://www.sciencedirect.com/topics/veterinary-science-and-veterinary-medicine/avian-bornavirus

Ok it’s technical...they speculate that the presence of a particular type of T-cell triggers an autoimmune response - which damages the nervous system and causes spasms among other things. Basically the body is attacking its own nervous system. An African grey with PDD went into remission after treatment with Cyclosporine A, a specific T cell immunosuppressant. Additionally, gangliocides are implicated in triggering the autoimmune response ... which makes avian PDD resemble human autoimmune diseases such as GBS. There don’t seem to be good repeatable trials, but it seems worth trying an immune suppressing drug ...

Yeah, I've heard that there is such a treatment available, but that we just can't get it here in the states just yet. There are years of trials and such before they will allow it. But thank you so much for that link. I'm looking forward to reading it, my friend.

 

[Anansi]

Thank you... I love to find the more up-to-date articles. :07:



One of the disadvantages everywhere is the "we've always done it this way, so we must be right" attitude - and the internet is a great source of information as wel as old wives tales ...


More important of course (and sorry I hijacked your thread) -> Sir Jolly is still doing good?

No worries. It wasn't a hijacking, as we're very much still on topic. And Jolly's toe-tapping seems to have gone away. I'm still watching, but we may be past the most of it.

 

[ChristaNL]

Wow - thank you for that one! :07:


(sorry I should have included your previous one)





I was really confused (and definitely not accusing you) because you must have good reasons to do what you do and how, it just did not add up to everything I've read about or have been told.
Like I said before- it's is sometimes hard to find the solid evidence based "facts" (and even those change / sometimes dramatically).




I am *so* sorry you had to find out "the hard way" how this particulair disease works and am gratefull you took the time to share your knowledge here.

 

[Anansi]

Thanks, and you're welcome. In looking back over my posts from yesterday, I do feel I should clarify one thing for anyone who has a bird diagnosed with the gastrointestinal version of PDD (like the one that took away my Bixby). I don't want it to seem all doom and gloom, like all hope is lost. If caught early enough, the disease can be managed quite successfully. The longest ongoing treatment of full blown gastrointestinal PDD that I've heard of is at around the 14 year mark, with the bird (a macaw) living a happy and healthy life with only the occasional flare-up. But Bixby's case was misdiagnosed when it could've been managed. So by the time it got serious, it was too late.

 

[Anansi]

Got the call regarding Jolly's labs. Everything is perfect! Liver values are great! WBC count is normal. Cholesterol is right where it should be. Calcium is optimal. Kidney, blood sugar, blood protein, electrolyte levels all on point! Negative on yeast, fungal or parasites with the gram stain test as well.

On one hand, I'm happy to know that he's in great health and that his diet is exactly where it should be. But on the other, it would've been nice to be able to point my finger at something.

Sigh...

Anyhow, he continues to improve. The toe-tapping is virtually gone, though there is still a bit of weakness in his right foot. But even that is showing improvement. Keeping a close eye on him.

 

[GaleriaGila]

Wonderful news all around!

 

[Terry57]

I'm so glad his labs came back and are perfect. It can be frustrating to not have an answer, though. I hope Jolly is completely back to his wonderful self soon.

 

[Scott]

Fantastic results! I hope the tapping becomes a thing of the past and never reappears! Really odd to have such transient experiences without solid medical clues.

 

[Kentuckienne]

I keep thinking about this...what could be in blueberries and blackberries that could cause a neurological problem? They are both low in pH (acidic) but found nothing of interest there. Then I thought, those are two of the highest sources of anthicyanins (source of blue color) but all the research I found on anthocyanins painted them as neurologically protective. The strongest connection I can think of between blueberries and blackberries or raspberries is pesticide use. These plants have enemies. They are typically sprayed many, many times before harvest. There are even exceptions where plants can be rooted/started in treated soil and still be labeled organic.

Here’s someone exhorting us to spray, spray, there is no other way:

https://pesticideguy.org/tag/blueberries/

And here’s an article from a Michigan university recommending spraying every 5 to 7 days for fruit flies, using equipment that can drench the whole plant and fruit. According to that same paper, the minimum PHI (pre-harvest interval, the number of days that must elapse between treatment and harvest) is 1 (ONE DAY) for malathion, which is a potent organophosphate, and organophosphates are neurally disruptive as a class - that’s what makes them such good pesticides.

It would be interesting to know if there are other anecdotal accounts of sensitive birds developing neurological symptoms after eating “dirty dozen” foods like berries, spinach, cucumber ...

http://www.ipm.msu.edu/uploads/files/SWD/ManagementRecommendations-RaspberryBlackberrySep2012.pdf

 

[Keatz]

Hi, Stephen,

Sorry about the delayed response. I went away for a couple of days.
When I got back, I was keen to read about Jolly's progress. I'm glad that he's better now. Like you, though, I'm frastrated that the vet hasn't found a cause for Oscar's leg episodes. It would be nice to know the cause, if only so that it can be treated.
I'm going to suggest the medications you mentioned to the vet next time I see him. I'm not sure they're available in Australia, but I'll ask for them anyway. I will also raise the PDD variant issue with him again.
My experience with vets in Australia, even those who specialise in birds, is that it's really difficult to get them to do tests, let alone get medications off them. I really have to harry them. It's ironic, in a way, that we have so many bird species in Australia, but not nearly as many bird vets as you seem to have in the States. I've taken Oscar to three different vets before I finally arrived at the one I have now. Part of the frustration that came with Oscar's condition was actually finding a vet. The first couple just looked at him, said he's fine and told me to watch what he eats.
Anyway, I'll check out YouTube and see whether I can get the video up and let you know how it goes.