Heart Murmurs in older parrots

[ravvlet]

Hey all, Kirby got his fancy new radiographs read as well as his CBC.

Good news first - no issues with infection (which means I don’t have to wrestle with him over the new banana flavor they did his precautionary meds in) and his liver bile levels are only mildly elevated now, which means hopefully they’ve improved since his draw in October - this is of course a health issue we’ve been monitoring and treating over the last three years.

The bad news is that in addition to atherosclerosis, which he was already diagnosed with, the vet did hear a mild (Grade 1) heart murmur. She said this could be new or it could be an extant issue as it was really hard to hear and easily missed. He had had mildly elevated triglycerides on his chemistry, which they said could also be the cause of that issue. I’m not sure if the triglycerides is a new problem or not; I know he gets the lower fat Harrison’s/TOPS pellets and no seed whatsoever so I feel like his fat intake is generally really low.

We are waiting for them to send the results in to our regular vet so that she can advise us on how this differs from his partial (liver only) draw in Oct and his full panel last December, but his follow up isn’t until next Friday and waiting that long is going to drive me nuts.

The vet he normally sees is slammed busy - like, I cannot get them on the phone busy - so I thought I’d reach out to connect with other parronts whose fids have had or have heart murmurs. Is this something we can resolve with continued good diet and exercise? Is it safe to do the flap-flap game with him? I’m trying to again be consistent about it. Actually more worried he’s going to hurt himself - when we play he tries to fly away and if he gets off my hand or his perch he falls like a rock! His clipped cutting feathers haven’t molted yet (most of the rest have) so that might be why.

We were also told by the ER vet to get a cardiology consult; is that a specialty vet? I know they have them for mammals but I don’t know if I’ve ever heard of an avian one, although I guess they must exist?

 

[ravvlet]

Oh, I should add he’s on what our vet calls their “cardiac formula” (the label doesn’t say what’s in it & I used to have it written down but lost the note; I intend to ask tomorrow) and has been for about 3 years as well as lactulose/silymarin for his liver.

I never got a call back from his regular vet, but I did get a text from the vet he saw at the ER- she said he could continue exercise for now but to watch for open mouth breathing or extreme lethargy; which sounds about typical for what we’ve been told in the past.

I don’t know that I’ve ever seen him really panting or winded but he’s a bit of a perch potato and I try to go real easy on him out of concern. He really, really hates being “manhandled” so I am not yet able to listen to his heart rate by putting my ear to his chest.

Is it bad to kind of want to switch vets? The ER practice is also a full animal hospital for regular appointments and I wish I’d known they were so thorough and awesome before! I’ve taken Kirby to the other two AVs in town but this is his first time seeing them as it’s the farthest out by far, but I love that they have a text line and they’ve been really prompt and informative. However, our current vet’s personal “specialty” is amazons, she owns six herself, and she’s obviously been seeing Kirby every 3-4 months for three years now (wow! I didn’t realize that until now) so she’s got the most hands on knowledge about his particulars.

Sorry for the ramble, just another late night musing about this because I’m feeling pretty anxious about this diagnosis. I am really hoping we get good news from his regular vet about the comparative levels of his last CBC versus this one & his radiographs.

 

[SailBoat]

A couple of general comments.
- Mid to older Companion Parrots with Heart issues has become ever more common. Young Companion Parrots with Heart issues is a rapidly developing group. The growth in Heart problems is tied to two very common issues. The first is diet and the second is a lack of use of their wings (flight). Your Parrot having a faint Heart murmur would not be surprising, as more Avian Vets are paying closer attention to Heart issues. We have had three Amazon with very serious Heart issues and lost all three to Heart failure. That is just part of working with much older Amazons.
- I understand that this goes against the current grain, but a 100% Pellet diet has issues. We are founded in a well balanced diet with a foundation in Fresh Foods, including dark to light green Veggies. There are a vast number of Seed Types that are very healthy for ones Parrot. When discussions circle around eliminating seed from their diet, it is commonly the eliminating Sunflower Seed, especially the cheap type purchased in volume (Wild Bird Bulk Bags).
- You are in that confusing zone where the specific health problems can have you looking at apposing diet requirements. We have found that it comes down to changing from eliminating to adjusting percentages of specific food types. The thing that is commonly lost is that an Amazon's diet is a bit different that a Mac's diet and the difference is the percentages.
- Vet Care and more importantly Vet choice is who you are comfortable with. All things being equal, choose the Vet that you can communicate with.
I can drill into specific questions if you would like.
Cheers

 

[ravvlet]

Thanks Sailboat! Regarding his diet, he does get greens - I use the “I love amazons” guide - 2-3 times a day. I was just mentioning the pellets because his chop doesn’t have any fat content as it’s all veg (I didn’t put fruit in this time around because we accidentally forgot).

His current chop is bell pepper, rainbow chard, cabbage, broccoli, carrot, beets, and red quinoa.

 

[AmyMyBlueFront]

Thanks Sailboat! Regarding his diet, he does get greens - I use the “I love amazons” guide - 2-3 times a day. I was just mentioning the pellets because his chop doesn’t have any fat content as it’s all veg (I didn’t put fruit in this time around because we accidentally forgot).

His current chop is bell pepper, rainbow chard, cabbage, broccoli, carrot, beets, and red quinoa.

What 'Boats said! Amy has heart issues also,not a murmur but a blockage in an artery. This was discovered a few years back at a wellness/grooming visit. He gets a bit stressed when toweled and manhandled and when he was put back in his carrier he collapsed and was panting frantically. His Doctor immediately put him in a healing box with a little heat and oxygen and when he calmed down did an x-ray and found the blockage,he is now on 0.11 ml of Isoxsuprine once daily.
He doesn't fly,never has and refuses to learn. He did use to get some seeds years ago with fruit/vegs and now for a long time he is on pellets and all natural/organic stuff ( Bird Street Bistro ) and fresh fruit/veggies, but the damage has been done


Jim

 

[ravvlet]

What 'Boats said! Amy has heart issues also,not a murmur but a blockage in an artery. This was discovered a few years back at a wellness/grooming visit. He gets a bit stressed when toweled and manhandled and when he was put back in his carrier he collapsed and was panting frantically. His Doctor immediately put him in a healing box with a little heat and oxygen and when he calmed down did an x-ray and found the blockage,he is now on 0.11 ml of Isoxsuprine once daily.
He doesn't fly,never has and refuses to learn. He did use to get some seeds years ago with fruit/vegs and now for a long time he is on pellets and all natural/organic stuff ( Bird Street Bistro ) and fresh fruit/veggies, but the damage has been done


Jim

Thanks Jim.

I got him about 3 yrs ago from someone who’d acquired him from his original owner who died, and at that time he was eating white bread, ritz crackers, peanuts, sunflower seeds… you get the idea. We were able to switch his diet immediately but I suppose this is just the aftermath of a very long (he’s over 30) very poor diet. I’m just nervous because we lost our much younger baby bird and finding out our time with Kirby might be more even limited that we thought is not great.

I have been going over his bloodwork notes from the ER/exotics hospital doc again because our regular vet never called us back to discuss them with us (I made an appointment to see the Exotic Hospital doc as a recheck for tomorrow as I really would like some answers) and I somehow missed some other important issues, I guess I was so freaked out about the heart murmur.

“The radiologist agreed with Dr. Music's presumptive diagnosis of atherosclerosis. This fits with the fact that he had mildly elevated triglycerides on his chemistry and may be the cause of his soft heart murmur. He also had borderline high uric acid levels (likely a sign of dehydration), moderately high amylase (a pancreatic enzyme) and mildly elevated bile acids. I am positive that his regular vet will compare these results to his previous bloodwork and make further recommendations for treatment. Thankfully, Kirby's CBC showed no evidence of systemic infection, other than an elevation in his basophil count (this blood value can sometimes increase with non-specific inflammation).

We recommend following up with a cardiology consult to assess the heart murmur and having your regular vet start management for his atherosclerosis.”

He was dehydrated at the time of his appointment, which was VERY odd, as he had fresh water in his bowl and he was eating his (very wet) chop. I’ve been keeping an eye on him since and haven’t seen any signs of dehydration.

I had written off the uric acid issue as caused by the mysterious dehydration, but I somehow missed the pancreatic enzyme. I googled it last night and everything I am reading is really bad! Is it possible this is just another thing he’s dealing with because most of his life he was getting a bad diet, or have I screwed up something here? I am really hoping we get some answers tomorrow morning; the new vet indicated they had received his old boodwork from his previous vet so they can compare both his Oct liver draw and his yearly full panel from last December.

It is interesting to me that there are meds he could be taking for his arterial thickening, because we’ve never been offered them by his regular vet? Instead, she’s had him on what she calls her “cardiac formula”, which is more of a supplement:

-20ml flaxseed oil
-1000 ml taurine
-400 mg co-enzyme 210
-800 iu vitamin E
-1,000 mg l-carnitine
Dose instructions: 0.05 ml orally, every 24 hours (we give this in the evening on a pellet)

I had hoped the fact that he was getting this and not actual meds meant his condition was not serious, but now I’m not sure about that either.

I would of course be more than happy to make whatever changes necessary to ensure he’s doing ok. I am already overwhelmed because I really thought we had their diet etc down to a science.

I have been weighing Kirby every morning and he’s been 435-450g this week; I increased his pellet by a little bit as the vet noted some mild muscular atrophy in his breast muscle and I increased the size of his play gym/started doing flap flaps again and didn’t want to not compensate with calories. 450g was a pretty good weight for him as I recall, so I think he’s ok with the extra scoop of pellet and he’s still eating his chop.

Well, sorry again for rambling. Here are some bonus photos of his set up with his new playgym, which he demanded to have breakfast on this morning:

 

[AmyMyBlueFront]

Thanks Jim.

I got him about 3 yrs ago from someone who’d acquired him from his original owner who died, and at that time he was eating white bread, ritz crackers, peanuts, sunflower seeds… you get the idea. We were able to switch his diet immediately but I suppose this is just the aftermath of a very long (he’s over 30) very poor diet. I’m just nervous because we lost our much younger baby bird and finding out our time with Kirby might be more even limited that we thought is not great.

I have been going over his bloodwork notes from the ER/exotics hospital doc again because our regular vet never called us back to discuss them with us (I made an appointment to see the Exotic Hospital doc as a recheck for tomorrow as I really would like some answers) and I somehow missed some other important issues, I guess I was so freaked out about the heart murmur.

“The radiologist agreed with Dr. Music's presumptive diagnosis of atherosclerosis. This fits with the fact that he had mildly elevated triglycerides on his chemistry and may be the cause of his soft heart murmur. He also had borderline high uric acid levels (likely a sign of dehydration), moderately high amylase (a pancreatic enzyme) and mildly elevated bile acids. I am positive that his regular vet will compare these results to his previous bloodwork and make further recommendations for treatment. Thankfully, Kirby's CBC showed no evidence of systemic infection, other than an elevation in his basophil count (this blood value can sometimes increase with non-specific inflammation).

We recommend following up with a cardiology consult to assess the heart murmur and having your regular vet start management for his atherosclerosis.”

He was dehydrated at the time of his appointment, which was VERY odd, as he had fresh water in his bowl and he was eating his (very wet) chop. I’ve been keeping an eye on him since and haven’t seen any signs of dehydration.

I had written off the uric acid issue as caused by the mysterious dehydration, but I somehow missed the pancreatic enzyme. I googled it last night and everything I am reading is really bad! Is it possible this is just another thing he’s dealing with because most of his life he was getting a bad diet, or have I screwed up something here? I am really hoping we get some answers tomorrow morning; the new vet indicated they had received his old boodwork from his previous vet so they can compare both his Oct liver draw and his yearly full panel from last December.

It is interesting to me that there are meds he could be taking for his arterial thickening, because we’ve never been offered them by his regular vet? Instead, she’s had him on what she calls her “cardiac formula”, which is more of a supplement:

-20ml flaxseed oil
-1000 ml taurine
-400 mg co-enzyme 210
-800 iu vitamin E
-1,000 mg l-carnitine
Dose instructions: 0.05 ml orally, every 24 hours (we give this in the evening on a pellet)

I had hoped the fact that he was getting this and not actual meds meant his condition was not serious, but now I’m not sure about that either.

I would of course be more than happy to make whatever changes necessary to ensure he’s doing ok. I am already overwhelmed because I really thought we had their diet etc down to a science.

I have been weighing Kirby every morning and he’s been 435-450g this week; I increased his pellet by a little bit as the vet noted some mild muscular atrophy in his breast muscle and I increased the size of his play gym/started doing flap flaps again and didn’t want to not compensate with calories. 450g was a pretty good weight for him as I recall, so I think he’s ok with the extra scoop of pellet and he’s still eating his chop.

Well, sorry again for rambling. Here are some bonus photos of his set up with his new playgym, which he demanded to have breakfast on this morning:

Kirby and Amy have the exact same house! He'd be in 7th heaven if he could play with Kirby on his gym lol.


Jim

 

[ravvlet]

That’s cool! I love Kirby’s house, it’s enough room for him to hang from his toys and flap like crazy lol. He was in a much smaller cage with his previous owner - which is a long and crazy story - but when they rehomed their BFA the person took Kirby’s smaller cage and left him the BFA’s bigger one, which is how we ended up with it.

I think my first post here was actually to confirm that Kirby was an OWA and not another BFA like they’d thought!

We are still waiting to hear from his normal vet; the emergency vet clarified the pancreatic enzyme and uric acid levels were considered borderline levels and it would be up to her to decide if it’s indicative of a problem based on his previous work ups. Hoping it’s not a new issue, and ofc waiting to see what kind of cardiology consult we are looking at.

 

[AmyMyBlueFront]

Best wishes for a good outcome with Kirby's work-up.
Amy is due for a complete physical/bloodwork also...his doctor is an awesome lady,I've been taking the fid's there for almost 35 years. He gets lightly sedated during his procedure as not to stress him out. I stress more than he does,Doc Kristin should sedate me too

JIm

 

[ravvlet]

Kirby just got done seeing the vet (we ended up switching vets, but it’s one he’s seen before).

He is, for reasons wholly unknown to me, molting - he lost a couple flight feathers (one clipped one, woo hoo!) during his appointment, and he’s been exploding those little downy feathers last night and today. I could have sworn he molted back in the fall, and I have the feathers in a vase on my desk to prove it - but the vet said his feathers look healthy and it doesn’t appear to be overpreening, so who knows what’s going on. It was sunny for almost a whole week here and I moved his cage so he’s got a better view of the window - maybe he thinks it’s a different time of year!

We are redoing his blood panel as well as getting a culture on his sinuses - he had a lot of nasal blockages so we will be shopping for a good humidifier to have in my office during the winter months. For now, his liver levels look almost good enough that she might take him off the lactulose/silymarin entirely and see how he does.

Heart murmur was definitely still detectable, and additionally she noted his heart rate was abnormally high. She hadn’t gotten the radiographs from the ER vet/our previous vet yet but put in a request for them, and once she’s reviewed them she said we may actually start him on a cardiac med as well as the supplement he’s already taking. I wonder if the murmur is new, or if he’s already had it, but I guess there isn’t any way to determine that.

We are increasing his pellet a bit (something I’d already started at home, but she approved) as he is a little (~15g) lighter than what she feels would be a healthy weight for him (he still has a lipoma near his vent that’s shrunk, but it contributes to his weight, so I guess his “healthy” is a bit higher than what might otherwise be normal for his species). I am happy to report so far in spite of increasing his pellet he’s still going over and eating his chop, sometimes even going to eat it before he finishes his pellets, which is great.

I think that’s everything - she said we could continue with light exercise but not to overdo it until we have a good grip on his heart issues again, and hopefully can get his heart rate under control. He’s been active and happily climbing around his playgym since we got home. We are also going to start doing nasal cleaning with the vet periodically, as it’s been an ongoing issue and while I have been given a demonstration by his previous vet on how to do it at home, she and I both were concerned about me accidentally jamming something further in there and making it worse, heh.

She said she could call and give me her thoughts once she has the radiographs re: cardiac meds, and as a bonus, their pharmacy does mail in orders, which is great because it’s an hour drive one way to this vet.

 

[SailBoat]

Very good information and visit!

NOTE: If you can work to a developing a comfort in both you and your Parrot to placing your ear to the chest, you will find it helps. This will allow you to listen to your Parrots heart rate. This will allow you to hear the Heart beat

Warning: Parrot Heart Rate is very high to begin with! As a result, it can be shocking to first hear it. The goal is to get a feeling for your Parrots rate at rest and that will help you monitor. Especially, when your Parrot has been active.

Again, Great News!

 

[ravvlet]

Oof, Kirby is not having a great Saturday. I noticed he’s been sneezing a bit, and the nare they had to really deep clean is a bit pink today. I guess I’ll be calling his vet Mon AM.

Also had to run some errands a few hours today, and when I came home, he’s gone bananas. Sitting on his perch leaning forward with his wings out and chattering nonstop at me - but when I offer a step up or a pet he walks away! We spent a good half hour whistling and barking at each other.

 

[SailBoat]

Possible Hormonal Response??

 

[ravvlet]

Probably! I think he just got really excited that I was home. He did want to step up eventually, and he’s never been a super cuddly guy. He seemed like he was having a good time either way, in spite of having the sniffles/sneezes. I hope the culture comes back soon, I am real suspicious he’s got some kinda sinus funk again .

 

[ravvlet]

Kirby’s culture came back positive for 3 different types of bacteria! Yikes. They mailed us a med that arrived today for him, but he hates the flavor so we had to do the dreaded “towel” song and dance.

Additionally, this morning he didn’t want to eat his pellets, and opted to eat his chop. I know sometimes he doesn’t get to them until later if he’s really into his chop but it’s 1pm now. It might also be because I wasn’t in the room with him at the time as we’ve had a busy day, but I even tried hand feeding them to him and he just breaks them in half and drops them.

I called the vet and the front office person told me to call a different local vet as the avian vet was leaving for the day, and were not clear if it was an emergency? We’ve just given him his first dose of his new antibiotic, so I guess the thing to do for now is wait and see if that kicks in and he perks up enough to chow down. I emailed the vet to let her know what was going on because I have NEVER seen this bird completely ignore his pellets, and I guess we are going to wait and see if he gets into them this afternoon and decide if he needs to be seen by the emergency vet.

His bloodwork was normal and everything, so maybe I’m overreacting? Ugh. I am so worried. We are supposed to go test drive a car and need to leave basically right now but I hate the idea of leaving him unattended when he’s doing this. He is acting totally normal otherwise - he’s grinding his beak as I speak and was yelling and dancing while I was on the phone with the vet. I guess I’m just on edge after losing our other parrot to (apparently) not eating.

Update: We went to test drive the car; of course ended up being late because of traffic so it was more of a “sit in the car and contemplate how much buying a car sucks”, haha. Kirby ate all his pellets; he was just being dramatic I guess because I was too busy this AM to sit and watch him eat his breakfast! Birds. He seems ok now.

 

[HeatherG]

Wow! You had excellent workups (imo) and I will be copying down your “cardiac formula” and may check it out for QP use.

I’m sorry to hear of his sinus issues on top of being old and a typical aging American. That could cause rapid heart rate and lots of other signs. Wow, sinus issues suck for everyone. I have been avoiding sinus rinses but perhaps you are more dedicated…

I will be thinking of Kirby and you. You clearly love him very much and take great care of him. It occurs to me that if Kirby had lots of stress poops while traveling to the vet that could contribute to dehydration. Winter is also very drying.

 

[HeatherG]

Very good information and visit!

NOTE: If you can work to a developing a comfort in both you and your Parrot to placing your ear to the chest, you will find it helps. This will allow you to listen to your Parrots heart rate. This will allow you to hear the Heart beat

Warning: Parrot Heart Rate is very high to begin with! As a result, it can be shocking to first hear it. The goal is to get a feeling for your Parrots rate at rest and that will help you monitor. Especially, when your Parrot has been active.

Again, Great News!

A baby stethoscope helps but it’s hard to count that fast.
Lipomas are definitely more common in chubby birds and people.