Archive for May, 2007

Remembering Mystic

May 14, 2007

Mystic was an especially beautiful scarlet macaw who came into our lives because her owners no longer wanted her. She had been diagnosed with avian diabetes and I was told they ‘just wanted to get rid of her’. Already living with two macaws, a cockatoo, 3 dogs and 7 humans, I agreed to take her in, with the hope that we could help her become a healthy bird and integrate her into our flock. At the time, I wrote into a message board regarding her upcoming adoption.

Adopting a Diabetic Macaw

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Randi Marie
8/29/06 at 11:02 AM

Friends, I am about to adopt another macaw. Her name is Mystic. She is 12 years old, well loved, but the owners can no longer take care of her. She has high blood sugar…one vet says she’s diabetic and needs insulin shots, the other says her diet should be changed. How do we go about this? I will make an appointment with my vet, but because she’s lived with the same couple for 12 years, should we do a gradual move, or all at once? Her current guardian would like to visit once in a while, is that all right? Because she doesn’t know me, we’re wondering if she and I would both take Mystic to the vet first time. I want her to move in, in such a way that is least traumatic to her. She already has health issues, she’s leaving the only family she’s ever known, and she’s a ‘big cuddler’.

Thus began our family’s journey with Mystic. Through Mystic, I discovered the world of avian diabetes. What I learned is how truly little is known about diabetes in birds. For two months, I documented our travails with Mystic through this long thread. I was impressed with the kindness and generosity of spirit with which I was given advice, and because there is much good information contained therein, I’ve deleted very little.

A parrot who becomes lethargic, whose droppings are increasingly frequent and wet, who squirts when eliminating and who loses weight, may have diabetes. High blood sugar will be confirmed by a blood test administered by your vet. My advice to those whose parrot is diagnosed with diabetes: Do not automatically sign on for a program of injecting insulin into your bird, whether it’s Lantus or any other. It’s all experimental now, and as was revealed to me by an excellent and plain talking vet, avian diabetes is caused by too much glucagon being produced rather than too little insulin, which is the case with mammals. So insulin shots are essentially useless and can cause a great deal of harm.

Adopting a Diabetic Macaw (continued)

AG
8/30/06 at 09:15 AM

Before administering any type of injections I would always try diet first, much can be done with that…stay away from carbohydrates and obviously things with high sugar but definitely consult an Avian Specialist, a regular vet is insufficient. I would suggest you visiting this bird a few times in its home and then move the bird at once, make it clear but this way the bird would have seen you 2 or 3 times and you wouldn’t be a stranger….I don’t recommend the owner interacting with the bird until its fully acclimated to you otherwise it might be confused and also miss its owner when it sees her instead of moving on, similar to seeing an ex-boyfriend even though the relationship is over, its much better once wounds have healed. I would even wait a few weeks to take the bird to the vet until it is bonded to you as to not traumatize the bird even more…speak to the vet and suggest him or her recommending a diet that might work first…hopefully your vet wont give you a hard time and tell you they need to see the bird first, which means they want to charge you…I would even call the U of Penn in PA and see who you can get on the phone over there to ask about a diet for a diabetic bird. What you are doing is wonderful and Good Luck!

Randi Marie
9/05/06 at 12:47 PM

Thank you very much, Alexis. I will be taking Mystic to my vet on Thursday, together with her current owner. Then we have to work out some process of transferring Mystic to my household. I understand she loves grapes…I suppose I should not be feeding her any fruit. My vet will tell me that Harrion’s pellets will suffice. University of Pennsylvania? What department do I ask for? I do need to research this topic now thoroughly, and any suggestions on what to read and where to look are much appreciated.

Beatriz Cazeneuve
9/05/06 at 01:12 PM

Yes, take her to your vet with the previous owner but once she moves into your house, I would not have him (or her) visiting. She needs to bond with you and you know it’ll take time, why confuse and/or upset her?

The University of Pennsylvania has one of the best veterinary schools in the country and they do a lot of research (also have the best labs for avian testing). If you look them up in the net, you will be able to find where to call.

I would also, most definitely, try diet first and if that doesn’t work, try the insulin… but couldn’t they try to give it to her orally first? They do it to people.

Randi Marie
9/06/06 at 06:54 AM
Thank you, Beatriz. I read that ‘glipizide’ has proved to be a more effective treatment for diabetes in birds than injectable insulin, in many cases. This medication is given orally, which is easier for some owners who might be afraid of needles. The dosage is either given once a day or twice a day…”. I will ask my vet about this. Any other questions that I should ask her?

AG
9/06/06 at 08:22 AM
Hello again,

I would never recommend pellets for a bird, I would only give them as part of a daily diet…remember there are no pellets in the wild and how boring as well….I daily change things up for my macaw with different fruits, vegetable, meats, fish, pasta…you will find what the bird likes and also what he can eat based on the diabetic situation. The U of Penn should have an Avian sector, I would ask for that and go from there. Another avenue is to call the Bronx Zoo, again ask for whoever takes care of the birds….you might try emailing them…Good Luck!

Lynne
9/06/06 at 09:21 PM

Hello all:

I applaud you for being willing to take on such a responsibility… a diabetic bird… wow.

First, I don’t know if Beatriz was referring to “oral diabetic medicine”, which is available for people, but insulin is a hormone made of proteins and cannot be given orally. The mouth and stomach enzymes destroy it. Insulin must be given usually by injections. They are currently experimenting with giving it by “inhalation”, but I am not sure that this would be possible for birds. You can also have dilute preparations prepared for children and small animals.

Bottom line is that, as with people, if the bird can’t be maintained at a healthy weight and blood sugar (I’m not sure what a normal blood sugar is for birds, but I believe it’s probably higher than it is for people) insulin is probably a must. If the bird needs insulin and doesn’t get it, they will basically starve to death. I’d see if you could possibly find someone who knows about diabetes in big birds and consult with them.

I suppose that I should explain that I am pretty knowledgeable about diabetes, as I’ve had diabetes for years, and have used insulin for years. Now I’m using a microinfusion pump, and it’s made a huge difference in my life. When you have blood sugars under control, you feel like a new person again… the transformation is indescribable. Also, people freak about injections, but insulin injections are given by a very very small thin needle, and many children get their shots at night, while ASLEEP. I can honestly say that most insulin injections are painless; as long as you take the time to make sure that you’re not injecting the medicine straight from the fridge. Cold insulin can sting. I wish you luck.

Randi Marie
9/07/06 at 02:56 PM

Regarding Mystic, her blood sugar is high (1,240.00) and is losing weight. As it turns out, my vet saw her last July, and was relieved to see us today in her office. She said she had been thinking and worrying about Mystic, and is very keen to place her on insulin therapy. Today she completed the tests she started in July, and next week I’m to bring her in for a 10 hour observation. Then we are to commence with the insulin therapy. It all seems to be a rush to me, and would prefer to try her on diet first. I asked her about glipizide, which she dismissed as ineffective. I can see from today and the previous two vet invoices, a steady weight drop, what seems a dangerous trend. So I’ve made the appointments and would appreciate any feedback on right course of action. Right after the vet, the previous owner and her friend brought Mystic and me home, and left, so Mystic is now starting a new chapter in her life.

At first, Mystic didn’t want to leave her cage. She seemed very depressed and lethargic for a few days.

Randi Marie
9/08/06 at 07:40 AM Reply
Additionally, when I was given Mystic’s seed mix, I noted that it consisted primarily of sunflower seeds. But the vet says being fed diet of sunflower seeds, grapes and occasional junk food does not contribute to her diabetes. She said, “If every bird became a diabetic due to a sunflower seed diet, my office would be overflowing with diabetic birds”. So far, she has not eaten the pellets or the cooked mash…I just gave her a seed mix this morning, as we want to counteract weight loss, the Abba 1300 mix. The thought of administering two insulin shots a day to a Scarlet Macaw for the rest of her life is rather daunting. I know a lot about “alternative” therapies, but not for parrots. I’m wondering if there’s another approach out there.

AG
9/08/06 at 08:53 AM Reply

I think what you are doing is great, first of all. Second of all, please make sure you are going to an avian vet and not a regular one, big difference. I would keep the appointments ad in the meantime, contact the Bronx Zoo & the U of Penn in Philadelphia and work your way through the phones till you get an avian on the phone or an email address or something and get opinions. I would also try some fish…perhaps shrimp or fish and offer to the bird, low in sugar and carbs ad good for them, see if its accepted…I would also give some nuts perhaps? Maybe go on a website that offers diabetic recipes and see what foods are recommended and give to Mystic, see if there is weight gain. Might want to try that route yourself for a bit, then vets, your call you see what condition the bird is in, if its happy and comfortable, use your gut…the weight loss could be due to being upset about not having her old owners around too, many new things…Good Luck

Randi Marie
9/08/06 at 09:30 AM Reply
Thanks, Alexis. I will pursue the U of Penn today. The weight loss has been charted over the last half year, and she moved into our house yesterday. My vet is a well known avian vet, young and very in line with the medical profession: meaning, she’s excellent but at the same time, doesn’t see the point of feeding a macaw anything but Harrison’s pellets. So I respect her a great deal, but need to explore additional areas.

AG
9/08/06 at 09:59 AM Reply

Try calling this person at U of Penn

Department of Pathobiology
Laboratories of Avian Medicine & Pathology
Contact Information:

382 West Street Road
School of Veterinary Medicine
University of Pennsylvania
Kennett Square, PA 19348

610.444.5800 x2710 (office phone/voice mail)
610.925.8106 (office fax)

As I said earlier, contact people at the U of Penn in Philadelphia ad the Bronx Zoo or San Diego Zoo…these people are very knowledgeable. A seed mixture with many sunflowers seeds is not a healthy diet for a macaw, and pellets are not in the wild, you need to duplicate their vegetation…Start by buying nuts, pecans, cashews and almonds…these are healthy for them…I would also try a piece of shrimp or cooked fish…be creative…Also eggs are good, scramble some eggs and serve warm, not hot…try these things and call the above institutions until you get on the phone with someone who can help you.

Cindy
9/09/06 at 07:03 AM

With a diabetic I would not be adding all kinds of creative things until finding out from an avian vet, your own or preferably one from U of P, EXACTLY how diabetes manifests in birds. Nutritionally speaking. Yes fruits are great for birds but fruits metabolize as sugar in humans. So why offer all kinds of stuff you don’t know the side effects of? Especially the canned juices which MOST have very high sodium.

I’d go with the Harrison’s and a high quality seed and nuts and “some” whole grains, cooked and definitely NOT animal proteins like meats especially RAW until you have a full understanding just like you are trying to do. Whole Foods and barryfarm.com that Beatriz recommends has all kinds of grains you can get. For proteins I’d use vegetable protein not animal. And if she is eating pellets you need to get a “meal plan” made up by the avian vet or an avian nutritionist who can tell you how to best combine the carbs, fats and proteins in a diabetic. I agree with your vet, btw about having a ton of diabetics in the office if it were strictly food, same with humans. Unless this bird is OLD OLD OLD and just like in humans perhaps diabetes onsets from diet, type 2 instead of type 1.

And maybe she will prefer the large size or the small or the mash.

I’d try mixing mash in with strawberries she may like the seeds of the strawberries, perhaps not the best for sugar but to get her accepting of the mash flavor then introduce to pellets….I’d coat every fruit in the mash, as a matter of fact. Peeled fruit like the inside of an apricot or apple or grape or whatever so she HAS to taste it.

Cindy
9/09/06 at 07:06 AM

oh, and of COURSE tons of veggies but not starch veggies , mostly the leafy dark greens or like, string beans which is neutral…you can get a list if you’re not familiar by goggling the Atkins Carb Counter, you can download it to your hard drive…it lists the high carb veggies to avoid like carrots and corn …then go light on that list….but it really needs to be done with the vet.

Cindy
9/09/06 at 07:10 AM

Hmmmm….sorry to triple post but as I was typing corn …the Harrison’s ingredients flashed in my brain….CORN….perhaps it’s ok in diabetic birds I don’t know.

‘I don’t know’ became a refrain I heard many times regarding avian diabetes.

I’d go on a quest about how many diabetic birds eat Harrisons. I agree it’s the best pellet if you are going to feed a processed diet but it’s CORN! LOL

The weight loss may be your typical avian malnutrition compounded by the diabetes.

Randi Marie
9/09/06 at 09:19 AM

I’m also puzzled about the corn and pellets issue, as yes, Harrion’s contains corn, and it’s the first ingredient in nutriberries. However, I am happy if she eats, as she’s not eating much. Poor thing, she’s lost her home and she’s quite sick. My heart goes out to her.

Alexis, thank you for the number. I called, and after getting shuffled around I spoke to a very nice doctor, who said, “Specializing in avian medicine, the only thing I can tell you is we know so little!”. That was refreshing. But they do know very little about diabetes in birds. What I did learn is that unlike people, in can be a transient condition, meaning it can disappear or not. My main concern is once the insulin therapy begins, does it hook the parrot into a life-long need, or can there be a recovery when twice daily injections are no longer necessary. With people, insulin injections will rob the body of the ability to produce it’s own. She knows my vet (who seems quite well respected), and says that it seems to be a conservative approach, one designed to give the parrot some relief. She did suggest an xray to look at the pancreas. I have not been able to reach anyone at the Bronx zoo.

AG
9/09/06 at 05:43 PM

I was doing some research on line and I found out that diabetes is only diagnosed with a blood test, common factor is extreme thirst and some birds can be helped with human oral glucose suppressing medications alternatively to injections so that might be an option…

Lynne
9/09/06 at 10:44 PM

Hello Randi Marie:

I hope that you’ve been able to reach someone who is familiar with treating diabetes in big birds.

Glipizide might be worth a try, but I don’t think diabetes is too different in any animal (including humans). If a human had a blood sugar of over 1000 mg/dl, they would be in very very big trouble (probably would be dead). Since they’ve documented weight loss, and such high blood glucose, it sounds like Mystic is really very ill with Diabetes.

If the vet wants to consider using glipizide try it, but the main thing is to get the blood sugar UNDER CONTROL as soon as is possible so that Mystic can use the food he/she eats and stop using weight. Trying to get Mystic to eat more isn’t going to help if there isn’t enough insulin in his/her body to use the food… it will just make her blood sugars to go higher. If the vet is agreeable, you could try increasing Mystic’s exercise… which WILL lower Mystic’s blood glucose and could be helpful. I know that on days when I swim.. I use about 35% less insulin. Maybe some flapping exercises would be good?

In any event if Mystic does need insulin, I think that probably after an initial period of adjustment, it will end up being no big deal… honestly. Like I said in my earlier post, insulin injections are really quite painless… especially if you make sure that the insulin isn’t straight from the fridge.

Increasing the fats and protein in Mystic’s diet may be a good Idea, however, even proteins require insulin for proper use.

I wish you the best of luck. Have you contacted the Animal Medical Center? One question I would have would be “how do I handle it if during treatment, Mystic’s blood sugar goes too low?” I don’t think that a parrot, no matter how intelligent would be able to understand drinking juice to correct a low….

I’m keeping you both in my thoughts!

Winston
9/09/06 at 11:09 PM

Perhaps you can contact Dr. Harvey Cohen in NJ. I think his company is Healthy Formulations. He is brilliant, a wiz with herbs and such. There is also Dr. Wen in Riverhead on LI, that practice does alot with natural remedies. Dr Harvey is actually a nutritionist and not a vet.

Randi Marie
9/10/06 at 07:58 AM
Thank you. This morning, I am concerned because she just sits and sleeps. I presented her with soak seed, she took one that I handfed to her. I read, Beatriz, where you used Aloe Detox by Naturade, and your bird improved. As Mystic does drink a lot, I’m wondering if it’s all right to put some of that into her drinking water. She is too lethargic. If it won’t hurt her, I will do that.

Greg
9/10/06 at 10:35 AM

Being lethargic and a little sleepy can be one of the symptoms of diabetes. Don’t know if you know it, but fruit is high in sugar, so limit that. Does she/he exercise. Am going by things told my grandma who is a diabetic, the doctor is advising her to swim or do other kinds of exercise four times a week.. Watch the sugars in the foods you feed her. And she must eat small meals several times a day. I applaud you for adopting a sick bird.

Cindy
9/10/06 at 02:18 PM

I wouldn’t mess around with lethargy. Diabetic people go into a diabetic coma from too low blood sugar. My mother did this frequently from not eating. Combine this with stress lack of eating from changing homes….

I would immediately offer her hand feeding formula made up in a syringe. It doesn’t have to be exactly 104 degrees or whatever she may have preferred when she was a chick. And you don’t have to hand feed it the same way…just offer it to her beak (glop some on the outside of the syringe so she can taste it). I’d also soak some whole grain bread and or anything she will eat. Probably Harrisons mash on it, too. Or soaked bread for the carb with like, Protein 25 or eggs on it for the protein balance. Banana too for potassium. Even baby food.

Lynne
9/11/06 at 02:55 PM Reply

Hello there.

If your baby is lethargic, she needs to go to the vet as soon as possible… preferably yesterday.

The bird may be going into “ketoacidosis” which can be fatal VERY quickly.

Please don’t delay… get the bird to the vet. I’ve had to be hospitalized for Diabetic Ketoacidosis.. and believe me you are very very sick. Please please get the bird to the animal hospital right away.

Randi Marie
9/11/06 at 03:28 PM Reply

Thank you, Lynne. I was also very concerned, and tracked down the vet today. All blood tests are normal except for the blood sugar. I also spoke with the previous guardian, who said she’s been lethargic since last December. Yesterday I ran out and bought some liquid aloe, could not find the Naturade Detox Aloe, but found the Gary Nulls aloe. She has been drinking it (diluted) from her water dish. I don’t know if it’s coincidence or not, but today she has climbed down her cage several times, up other cages, climbed up my bed and into my lap, and is much more active. It’s a huge relief. She’s not eating much, but she is eating. She goes to the vet clinic the entire day on Thursday, and I’ve agreed to proceed with the insulin shots, as there don’t seem to be many other options at this time.

The vet had urged me in no uncertain terms to begin with the insulin treatments. In retrospect, I regret this, but I didn’t know better at the time. She was very authoritative and bossy, even pushy about it.

Mystic was just a darling. She craved company, and each morning, after she emerged from her cage, she’d climb down and climb up Rosabella’s cage, which belongs to our rosebreasted cockatoo. Rosabella would panic and fly about for a moment, as Mystic determinedly made her way to the branches atop Rosa’s cage. This way she was closest to our bedroom. There she would stay until I would go to her. I moved a perch into our room, and started bringing Mystic in to our bedroom every morning rather than have her continue to freak out Rosabella.

mystic.jpg

Barbara U.
9/11/06 at 06:20 PM

Well being diabetic myself maybe I can help. First of all get rid of the seed. A definite NO NO to a bird with an already compromised immune system. I would say lots of fresh veges. Stay away from alot of pasta, rice, bread, and potatoes. However a small amount is ok. For protein try organic peanut butter. Macaws have a higher protein need than other birds. Wheat bread and pasta are better than white. Try broccoli, cauliflower, and carrots. That is the mix my guys like best. Or mixed veges with some added greens, like turnip greens or kale. I stay away from spinach because of the iron content. Also be careful with fruit. Fruits are natural sugar!! Bananas make my sugar go crazy as well as citrus fruits. I have a small amount a day. I hope this helps.

Beatriz Cazeneuve
9/12/06 at 12:08 PM

The Naturade Detox will not hurt her even if you give it to her pure (I diluted it for Pretty Bird 1 part water 1 part detox but I gave it to her in her beak twice a day, once in the morning and again in the evening).

I would stay away from anything that has fat or sugars -up to a point, of course, macaws have a naturally high fat diet compared to other parrots- and most definitely any kind of animal protein. I wonder if you can give parrots sugar substitutes like Spectra… I know dogs and cats can take it but I don’t know about parrots although I would assume that it’s pretty safe as it’s derived from natural sugar.

I’ve also been doing some research on herbs and came up with the following (they are in order of how effective they should be):
* * *
meshasringl (this is the Indian name for the herb, I don’t know the name in English, but the scientific name is gimnema silvestre and it has been used in Spanish countries for a long time with success in controlling sugar levels in diabetics)

goldenseal

cedar berry

nettle

cascara sagrada

comfrey

siberian ginseng

licorice

gentian

Linda
9/14/06 at 02:05 PM

This is a tough one, Randi. What are Mystic’s symptoms, other than the lethargy? Are you seeing severe polyuria/polydipsia–excessive intake of water and excessive excretion? Very few birds are actually, truly diabetic, from what I’ve read; rather, they test positive for hyperglycemia as a result of another problem, often a disease, or a pancreatic issue.

Symptoms of true diabetes would be PU/PD, excessive appetite with continued weight loss. Ask the previous caregivers if the bird was ever obese, as obesity and poor nutrition can cause symptoms very similar to diabetes. The diet Mystic was on sounds like one lacking in good nutrition.

Hyperglycemic birds respond well to low-fat diets, but a truly diabetic bird will need both the diet, and medicine, and even then, may well develop serious secondary kidney and pancreatic issues as a result of the disease. There are several oral medications other than glipizide that work in different ways. Glipizide increases the output of insulin (and there’s been good success with the use of this drug when properly dosed). Other drugs work to enhance insulin sensitivity in the system, and another works to slow down glucose absorption to keep glucose in the system less dramatic.

Is the day-long test the vet is doing the water deprivation test?

Regarding a change of caregivers: in my experience, birds do better if the change simply occurs and is final. Before taking the bird, visits by the new caregiver are a very positive tool, as then the bird doesn’t suddenly find itself in a new place with a total stranger. But once the bird changes residences, it is usually best if the previous caregiver stays away. Visits can be heartbreaking for the bird, and most of the time, visits prevent the bird from going forward in a positive manner with the new caregiver, as it remains torn between the past and present. Often, birds react aggressively toward the new caregiver after a visit from the past caregiver; sometimes, a bird will act aggressively toward both in its confusion.

The transition goes much better if the bird goes from one caretaker to a new caretaker who has been well informed on what the bird likes and dislikes, how it communicates, its favorite words, its established routines. If the new caretaker is familiar with these things, and acts supportive and loving without overwhelming the new family member, things often go amazingly smoothly.

My advice, Randi, is to not allow any contact from the previous caregiver. If you can, get all medical records sent to you by the vets they saw, and find out all you can about the reason (symptoms) that led to the diabetic diagnosis.

Wish I could be more helpful regarding the diet, but this is a subject best dealt with by avian vets who have worked specifically with true diabetic cases. Perhaps your avian vet can consult with other avian vets on the subject–obviously, diet will play a large role in maintaining Mystic in the best possible condition. I’d be very careful in this area, and only follow the advice of vets experienced with this quite unusual condition.

Hope this helps.

Randi Marie
9/14/06 at 09:30 PM
This morning, Mystic was injected with one unit of Lantus, a new (for human) insulin that has been used successfully in 2 previous birds. Mystic spent from 8:30 a.m. – 7:45 p.m. at the vets today, with blood glucose tests monitoring her blood sugar. Her levels did go down, a little too much perhaps, and tomorrow will be the same thing all day observation with a smaller dose. Beginning Monday, she will start receiving two insulin shots a day. This bird is very lucky because she’s as sweet and beautiful as can be. Everyone at the clinic loves her, and her cooperative attitude will make my life much easier.

Her blood sugar this morning was @1400, and I was told that @ 300 is more the norm. Her symptoms, besides lethargy, include watery stools, excessive thirst and weight loss.

I will continue to try to improve her health with diet and herbs, but my understanding is that this is a life threatening situation for Mystic. With the insulin treatment, she has a much better chance to live. Tonight, the vet told me how relieved she is about Mystic. She had seen her in July, and was really distressed about Mystic not getting treated. She then contacted the Gabriel Foundation and persuaded them to take her, because she’s such a wonderful bird. Then we showed up in her office!

There’s very little known about diabetes in parrots, so Mystic is really part of an experiment right now. So far, it’s very promising.

Randi Marie
9/16/06 at 08:50 AM Reply

After two exhausting 11 hour days at two different clinics, Mystic is home today, and we gave her the first insulin shot of many to come. I had great fear and trepidation, but it was very easy! I will continue to post on Mystic’s progress, because last night, the vet told me this is all very new. Mystic is part of a study that will eventually be published, an experiment testing this new type of insulin in parrots. The first two were smaller, one was a conure, so Mystic is the first macaw to be treated with Lantus. Her blood sugar was brought down to @ 280 yesterday, so the doctor is very, very pleased. We started her this weekend with one shot in the a.m., and then starting Monday, two shots, one in the a.m., and one @ 10 hours later. It’s very important that she eat…the vet started by saying, “no corn, no rice, etc”, but after a couple of days, she said, “anything, as long as she eats”. I told her yesterday as I was leaving that it’s obvious she likes pizza (she begged from my son and climbed up on him while he was eating it), and yesterday, the vet ran out and bought her pizza and fed her grapes! Not the best food, but it’s food. We will work on the diet, but that will be an evolution, as she’s 12 and will not look at a pellet, for example. So, we are on our way!

Beatriz Cazeneuve
9/16/06 at 09:59 AM

It’s great that she eats pizza because you can make the dough out of whole grain flours and pureed veggies instead of water and oil, and you can make the sauce with fresh tomatoes, carrots, peppers, etc put through the blender. There is also vegetarian pepperoni and cheese, and you can put black olives on it, some parsley, basil, oregano and black pepper and you got yourself a real healthy ‘pizza’ for her to eat.

Randi Marie
9/16/06 at 07:41 PM

Today at 4:00, I checked on Mystic, and she could not step up. Her feet were clenched, and her wings stiff. She would not, could not eat. I rubbed some maple syrup on her tongue, and then started spooning the aloe mixture (which has fructose) down her throat. I placed her on a pillow and held her. Finally, I just took her to the emergency hospital. I told one of my sons to go out and buy baby bird formula and cream of wheat. They spoke with our vet, gave her glucose orally and IV, then sent me home with her. Tonight, I fed her a few grapes, sunflower seeds and almonds. Then I syringe fed her almost 2 ounces of baby food, which she very willingly gurgled down. She’s safe, for now. Very frightening experience. I’m feeling very mixed up and confused about this whole insulin thing. The vet thinks it’s the only way to go, but she could have died today if I hadn’t been checking on her. I’m just not sure, I wish I knew.

This was a ghastly experience. We almost lost Mystic. We spent a fortune on emergency care, and it took a toll on her. The entire family became involved in keeping her going.

Randi Marie

9/17/06 at 09:06 AM Reply
That last post was a little incoherent. Yesterday afternoon, Mystic’s blood sugar had dropped dangerously low, and she was in a very bad shape. I was afraid she would die in my hands. This morning, we are discussing the wisdom of this insulin treatment. I am uncertain how to proceed. We will give her the shot and watch her all day, but it’s very hard to force a parrot to eat. I would so much rather try and work with her diabetes as an herbalist and energy healer. But with her weight loss and extreme high sugar level, I’m uncertain, and so administering the insulin as instructed.

Beatriz Cazeneuve
9/17/06 at 12:34 PM Reply

Oh, geez, I was so happy when I read that her blood sugar had gone down with the shot… maybe reducing the dosage will work. I am no doctor and I am talking out of my behind here but it seems to me that the dosage might be too strong for her… maybe a lower dosage combined with a holistic approach will be better for her.

This must be so very frightening for you, your family and Mystic, also. I wish I had a solution for you but I don’t.

Randi Marie
9/17/06 at 03:41 PM Reply

The same thing happened today, we even gave her slightly under the dose, starting just a few hours later, she stiffened up and I thought at one point, I’d lost her. We’ve been pouring syrup down her throat. The doctor has been in touch, but I’m really, really unnerved. We fed her all day, grapes, nuts, etc., and still she went into this horrible low blood sugar state of almost convulsive and catatonic behavior. She’s starting to come out of it now.

Randi Marie
9/17/06 at 03:43 PM

Yes Beatriz, the doctor says now, maybe half the dose, but I am wondering about the wisdom of the entire endeavor.

Beatriz Cazeneuve
9/18/06 at 09:27 AM

Well, cutting it in half is a big difference. Personally, I would give it one more try, and see what happens. For conditions like this, the precise dosage is everything but it’s real hard with animals because they can’t tell you how they feel so doctors sometimes have to experiment. And, in a case like this, where everything is an experiment, it must be even harder.

For us, guardians, is extra hard. We need to not only watch them like a hawk (and suffer and worry and fret constantly), we also need to learn their body language as if we were communicating only on this level, which is easy for animals but real hard for people. But I know that you will be real good at it, Randi. Hang in there, we are all rooting for you and Mystic.

Randi Marie
9/18/06 at 12:48 PM

Thank you Beatriz, I will continue to work with the doctor, but would feel much better if I could get Mystic’s eating habits under control first, as that’s a big part of the problem. So far she will not try gloop, fake pizza, nutriberries, pellets, scrambled eggs, chicken, shrimp, breads, most fruits, veggies, yoghurt w/ or w/out fruit, in other words, the only foods I can get into her mouth are sunflower seeds, grapes, real pizza, watermelon, fruit juice, nuts and bird baby food from a syringe. I’m thinking of pureeing veggies to put into the baby food. I eat food and smack my lips in front of her before offering it, does not move her, at least not yet. Any other ideas appreciated. Because of the insulin situation, time is not a luxury, as that’s part of the reason her sugar plummets, because she is such a picky eater. I’ve ordered the mash from Harrison’s to sprinkle in with her seeds, and I’m soaking seed too.

Cindy
9/18/06 at 05:42 PM

Randi Marie, I would totally just go with the hand feeding formula. At least it’s a baseline and balanced. Now I don’t know about for an adult but you can discuss with your doctor. It’s measurable, you will know EXACTLY what she ate, first of all.

I would make sure it is warm like 103-4 so it doesn’t clog her crop or cause an absorption problem.

Then I’d ask the vet if you should add anything else to it given the nutritional ratio of proteins, fats and carbs in the formula.

You can always make up a “formula” from the Harrisons’ mash too if they want her on that.

I know from having a diabetic mother in comas constantly from not eating, that the easiest and most nutritionally sound thing is to stick with something that is dependable and precise.

Think about it this way…if her food intake is not consistent, then her insulin dose won’t be consistent either. The best way for the docs to get the insulin dose regulated is if it’s given against a predetermined food. This is because the bird can’t check her blood sugar during the day like humans do.

I’m sure there are variances in what I’m saying between birds and humans and other animals, but regardless if she can’t eat she will die. Plain and simple. So why not give the hand feeding formula? And it couldn’t be any easier, either.

You can give a bunch of neutral things for enrichment like string beans, dark greens however they may fill her up if she eats them then, she won’t eat or digest the formula. I would really stick with hand feeding formula or Harrisons Mash made up into a formula consistency and syringe fed. Split up over many meals per day, of course just like all diabetics.

Have you been giving multiple small meals? That is very important for diabetes.

Don’t panic TOO much yet, these diabetic comas are gut wrenching but they can come out of it, and look normal, but the food, like you say is key.

Randi Marie
9/19/06 at 09:22 AM

I didn’t even think of preparing the Harrion’s mash like baby bird formula; which is why I love message boards, I learn things all the time. Cindy, if you also posted about the big plate of food and how it’s arranged that’s a great concept. About Mystic, I fed her this morning her gloop, which she did pick through…Last night, she ate some lasagna. One of my sons is hand feeding her bits of food, like beans and cooked sweet potato that he mashes in his fingers first, and then she’ll eat them. She loves best the baby bird formula with the syringe. I fed her close to 2 ounces this morning. When I get the mash, I’ll switch over to that. No insulin today, she and I are not ready for it yet.

Mystic was quickly adopted by all the boys, but especially by my oldest son, Oliver. Not especially fond of birds, he and Mystic formed a special bond and he devoted himself to comforting her when she was especially sick.

Cindy
9/19/06 at 12:08 PM

Yes, I posted about the food, but I got those ideas actually from Beatriz’s gloop but I don’t make it gloopy I just make up the grains, the veggies, the fruits separately and freeze them. Then I take a hunk of each and defrost in the microwave for 20 seconds and add some fresh non-frozen stuff. Some days I add baby fruits or veggies from the baby food jar to change the flavors- other days nothing. I want to make sure they don’t get too attached to one consistency or flavor. You never know if these guys are going to outlive us and if other people will feed like we do. I even give plain old frozen veggies warmed up like the succotash etc to keep them flexible. But the grains they LOVE and I always add lentils or another protein in the bag with the grains.

I seem to remember feeding 100 ccs Exact each meal to my Military when she was a baby but I may be wrong. It was way back in 1992. If you can spread out the hand feeding formula throughout the day it will keep her sugar more level. As many meals as you can give in your schedule, but 5 would be great.

Again, I don’t know about diabetes in birds but the concept of keeping the levels stable with multiple small meals would have to be the same as in humans, I’d think.

I wouldn’t give any human foods especially cold ones around the time she hand feeds so her crop stays warm with the formula in there. Just as a precaution. But ask your vet.

‘Again, I don’t know about diabetes in birds’. Birds and parrots are so intelligent and sensitive, but on a physiological level they are just very different from mammals, and we’re just beginning to understand their complexity.

Beatriz Cazeneuve
9/19/06 at 12:10 PM

If she eats the baby formula so readily, why don’t you mix it with pureed boiled or baked veggies (organic baby food stage 1 would do, too)? I doubt she can actually taste anything when she is been fed with a syringe so I think her attachment to it is more psychological than anything else and baby formula is very high in protein and carbs which I don’t think would be really good for her diet in the long run…

Keep on insisting on the food, I know you don’t have a whole lot of time to waste but don’t despair that she hasn’t taken to it, yet. It took me almost two months of trying every day for about an hour each time to get one of my grays to try any kind of fresh food. I would eat it in front on her, make smacking noises, say “Que rica papa!” (so often, in fact, that Teddy, my YC Amazon learned to say in exactly the same exaggerated tone of voice that I was using in less than a week!), smear it on her beak, push a little bit of it inside, anything to make her taste it. After 5 weeks of this, she started tonguing it, then she started eating it. Not everything, mind you, but at least she is now eating about 6 or 7 different fresh veggies (which added to all the veggies I put in the gloop is not too bad). Also, try sprinkling her seeds on top of the gloop, it doesn’t really matter if she only picks the seeds and doesn’t even touch the gloop itself but she will get used to seeing it and to the idea that gloop is food.

Cindy
9/19/06 at 04:54 PM

Another thing I meant to post was a trick used for sick dogs with eating /swallowing disorders. Or baby animals like ferrets that can’t chew kitten kibble.

You can soak the Harrison’s adult or Hi Po whichever one you want to feed her in water till it is able to be drawn up in the syringe. Each food has a different soak time and also puffs up pretty big so it’s deceiving on the quantity.

So I’d measure out how much you want her full day serving to be. Then soak it. This way you see the amount. Then warm it up in the microwave and for people who don’t know this is DANGEROUS because microwaves cause hot spots throughout the food so you need to check carefully afterwards (like with hand feeding formula).

Of course this is a lot more trouble than Exact baby formula but if there is a concern about vitamin toxicity or the nutrients being OFF in the baby formula versus the adult, it would address it.

You can also use the food processor to chop up the food first but in my experience it really doesn’t chop so well and you still need to soak because you don’t want granules of hard kibble sitting in her crop with mush that DID pulverize if you know what I mean.

Watch out you don’t whip the heck out of it after it’s soaked and introduce too much air bubbles or air in general this is a problem.

Different foods take shorter or longer soaking depending on the ingredients. The organics are shorter soak time because of the fewer preservatives. Iams kibble for example can take hours to puff up but an organic not so long.

I’d still stick with the baby hand feeding or get the Mash, though for now or do whichever the vets say.

I want to say that with my mom, at 76 she was told by many doctors to take care of her diabetes first and foremost that it would kill her faster than her heart (had a 5 graph bypass) or the malignancy in her breast (said ignore it for now and fix the sugar) or any strokes. Those doctors were right, it was the blood sugar that was the most difficult to address. Even after she got a feeding tube after a stroke the hospitals found it very challenging to regulate the sugar even though she was on tube feeding. Insulin is a very tricky thing in the body and it’s very important if humans are any example against birds, that she get real meals not just pick at things because you want variety. Variety won’t save her life in the short term but I really believe a standard feeding schedule and amounts might.

Also with syringe feeding you are making sure she is getting at least a fixed amount of water, too, which may be an issue in an unwell animal.

Randi Marie
9/20/06 at 08:33 AM
This morning we injected a half unit (or less) of insulin (so small, it’s very hard to measure) into Mystic. Then I fed her at least 40 cc of baby bird food. I hadn’t done this on the weekend, but after those two disastrous days, I’m not taking any chances. Beatriz told she would try the insulin one more time, and so I am, even though I have a lot of trepidation! Hopefully, this much smaller dose, in combination with the feeding, will prevent another frightening episode. I spoke to the vet about the syringe feeding, and while she’s not thrilled, she agrees that anyway to get food into her is preferable to nothing. I did puree some dandelion greens and added to her food yesterday, but the vet says, only a very small amount. Cindy, I also am soaking the Harrison’s pellets, if I can mush into a formula, I will feed her that later today.

Cindy
9/20/06 at 12:26 PM Reply

Randi Marie, I don’t see any reason why syringe feeding should be an issue. Scientifically. Unless the percentage of fats, carbs and proteins are wrong with baby food.

She has to get stabilized and it’s not gonna happen with her picking out a bean or a grain or a seed or fruit randomly. Not to mention she wont put any weight on.

My next thing is wondering about the time between meals. I’d ask the vet what the optimal spacing would be to prevent a sugar drop. Although it’s true with diabetes it may not be so scientific and standard…which is why humans have those pump monitor things inserted.

If you are home during the day, I would measure out a full day’s of food. I don’t know the “right” amount, lets say hypothetically it’s 100 ccs 3 times a day. (it’s probably more, I forget).

So since you want 300 ccs of nutrition in her, I’d divide that up by 5 or 6 meals and that would be about 50 ccs 5 times a day. Then just calc it by the number of hours she’s awake say, 12.

So that means about every 2.5 hours she gets about 50 ccs during the 12 hours she’s awake. For about 5 feedings.

Of course this may be too much or too few hours etc but you get my point. You don’t want to be feeding on a full crop so maybe she needs to eat from 6 am till 8 pm …more than 12 hours of a normal bird’s being awake.

Ask your vet what she thinks. This is what we do with Megaesophagus dogs that cant swallow normally, feed them a specific consistency, raised vertically in a chair, many small meals many times per day. Nothing by mouth and no variables. Again, birds are different but it’s the idea of nutrition given in a fixed routine.

Make sure you heat up anything you add to the formula with the formula so you don’t have cold products cooling in the crop with the warm food, too. I wouldn’t add a thing for now. You’re doing like a “control” with her and variables make it unpredictable and not explainable. If you know what I mean.

Cindy
9/20/06 at 04:38 PM

I thought of one last thing. In my experience it’s important to start dosing low and work slowly up to what the optimal dose of med is supposed to be with some diseases in animals. An example is Myasthenia Gravis, a neurological disorder. You give Mestinon for that. And sometimes Pred or another immune suppressant.

But you have to start low and work up till the symptoms subside. If you start at the “max dose” for the weight of the animal it can be an “overdose” and the symptoms mimic the actual disease. And can make things actually much worse. Not to mention confuse the issue. Because you don’t know if it’s the disease or the medicines.

To me, although I never had a diabetic animal, this works that way. If humans go too far either way with insulin they look like they have either hypo or high sugar. And since we’re going on the theory you aren’t drawing a blood stick for Mystic and only going by visual symptoms, this is hard. Since she can’t talk. At least with humans they can tell you symptoms. Lethargy, confusion, jumpiness, etc.

I’d share this idea with your doctor she will know what I’m talking about with the analogy of Mestinon and MG and may agree.

If Mystic is eating a “fixed” diet at the same time every day, of the same amounts of the same things every day, she will be able to ask you about her symptoms and get an idea about if the insulin is helping or hurting or not. At least that’s how I see it.

Randi Marie
9/20/06 at 05:31 PM

Thanks, Cindy. Today, I fed her via syringe the Kaytee baby formula, but by the 3rd feeding, the Harrisons high potency coarse had melted enough to make a nice formula, and she ate just about 40 cc, which is very good. However, the 2nd feeding just preceded a very low period, when she basically could not perch, but sat on a pillow and emitted weak “eeps” periodically. Her feet were not clenched into little balls and her head was not lolling around on the pillow, but held up most of the time, so it was not a totally frightening situation. This weak period lasted for several hours, until I was able to feed her the Harrison’s formula. Shortly afterwards she climbed off her pillow and perched.

My impression is that the insulin sickens her. Last week she was a much better eater and perkier in general. Monday and Tuesday she seemed to recover a bit from that Sat. and Sun., but again today, she’s sick, she can’t eat, she barely moves. Can this be a good thing? I’m thinking may be best to get her healthy with the high blood sugar, and then try the insulin is it’s still very high.

Cindy
9/20/06 at 07:06 PM Reply

Perhaps feed less but closer together. (Again, I’m not sure that diabetes in birds is totally the food).

If she doesn’t have big gaps between meals and shows symptoms then you can question if food is really a factor or not (in causing symptoms).

Has she had her pancreas checked?

I’d keep a daily log if you haven’t already. Charting hour by hour the food, her mood and symptoms. Also if you can see her urinating or drinking. So it can be reconstructed by her doctor.

It could be stress is making her worse if she wasn’t this bad with the other owners. That happens with diabetes.

Is this considered Type 1 (from birth) with Mystic do you know?

Did they give you urine dip sticks by any chance?

Have they considered admitting her and studying her levels to get it right? That may be worse if stress is a factor. If she is totally lethargic and kinda in a daze then I’d admit her. Let them try and monitor and sort it out.

What did the old owners feed her again? Sorry I don’t remember….and has she been this way for 12 YEARS? If not then something is causing it like pancreas I’d think.

Hyper (high) blood sugar is preferable to hypo (low) so even though this involves all kinds of stuff like pancreas and liver…regarding food I would error on the side of too high a sugar than low. As you saw, low can kill her but high cant. Low gives you seizures, comas etc.

I agree you can’t keep banging her up with insulin if she’s worse on it. It does sound like she’s worse on it.

Perhaps goggling you can find another group of owners treating birds? Perhaps the doctors who may know other diabetic bird caretakers can refer you to the other people to help? Sometimes a caretaker knows alot about catching symptoms etc versus the doctors if the doctors never lived with that particular disease.

Randi Marie
9/20/06 at 07:34 PM
It’s definitely the insulin, and this morning we gave her such a small dose, under half a unit. It brings her blood sugar down (bought the urine sticks) but sickens and weakens her terribly. The days without insulin have been so much better. That’s why I’m re-evaluating our course of action.

Cindy
9/20/06 at 07:48 PM

You weren’t kidding there’s not much on the net. Here’s a decent article mentions the challenges of avian and insulin injections and this other stuff called Glipizide/Glucotrol. By a vet who has lived with a diabetic parrot.

http://exoticpetvet.net/avian/diabetes.html

Glipazide (looks like it’s by mouth):

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a684060.html

Beatriz Cazeneuve
9/21/06 at 12:06 PM Reply

Given the fact that you have tried different approaches (the smaller dosage, feeding more often, etc) and she is still getting sick with the shots, I would definitely consider a holistic approach/diet/exercise regimen next. Like you say, it’s bad enough that her blood sugar is high, if she gets so weak she can’t even perch and much less eat while in one of her episodes, I don’t see how this approach can make her better.

Cindy
9/21/06 at 01:11 PM

Well yes but three doses or a trial of only three days isn’t really enough to rule out some type of medication. Although if it’s making her sick for SURE then I agree.

They said she was part of a trial, I’d ask to be sure it’s not a new drug or some fake or new type of insulin at least.

You can die of ONE episode with low blood sugar so it’s important to not futz around with alternatives that aren’t proven. I’m all for holistic, I don’t vax my animals or get shots etc. And Holistic sounds all nice and mother nature-like but diabetics don’t always have that choice just like some other diseases. Especially Type 1. And I think it’s known there aren’t many choices here.

Randi Marie do you know if it’s LOW sugar or HIGH sugar that caused these dramatic responses? If it’s a catatonic reaction then it should be LOW not HIGH. I don’t know how you’d ever know for sure except if you can get a urine catch during that time. Get your vet to list the symptoms of low versus high that you should be looking for because it makes a difference how they treat it. Low is way different than high.

Make sure you get her pancreas checked. That could be the root cause.

Randi Marie
9/21/06 at 02:33 PM

It’s the plunging blood sugar that causes the catatonic response. Yesterday, even with the minuscule insulin dose, her blood sugar did go down…but the accompanying weakness, inability to perch, and difficulty managing her wings, combined with not eating, I just don’t have a good feeling. Like, the cure will kill her, not the disease. Her blood sugar plunged so low over the weekend with the 1 unit dose, I thought for sure I’d lost her (you know, eyes rolling up, head lolling around on the pillow, body stiff, wings splayed). Yesterday was not as bad, but bad enough that she could not perch and wanted to be wrapped in a towel and held against my chest for several hours. She has had a full battery of tests…when I told my vet that the doctor at UPenn suggested pancreas x-rays, she dismissed that and said she was a resident just 2 years ago. So…I really don’t know what to think. I’ve spent a lot of money on tests, clinic experiments, and have 3 months worth of insulin here, that’s not the issue. The insulin is called Lantus, it’s relatively new, Mystic is the 3rd bird to be tested on it. My vet is supposed to be one of the best avian vets around, and she is diabetic too. But…
I don’t have a good feeling about it. Mystic is so much stronger again today, high blood sugar and all.

Randi Marie
9/21/06 at 02:55 PM Reply

Cindy, you wrote: “You can die of ONE episode with low blood sugar so it’s important to not futz around with alternatives that aren’t proven.” For 2 days, Mystic stayed at the clinic for 10 hours each day; they administered to her 1 unit of the insulin Lantus and did blood glucose tests throughout the day. After the first day, the vet told me that she was part of a larger study, and she and another vet were writing a paper about Lantus, which they think is promising and more effective insulin for parrots. She did not prepare me for Mystic’s reaction to the insulin on Saturday. She told me if she gets a little weak, to rub Karo syrup on her tongue and make sure she eats. She never warned me that she could die from low blood sugar. I was rubbing syrup on her tongue for hours before I panicked and brought her in to the emergency clinic, where they intravenously fed her glucose and brought up her sugar. She was in a bad shape.

Cindy
9/21/06 at 04:36 PM

Yes, ok let me clarify what I meant by die of one episode. I meant untreated low blood sugar puts you into a diabetic coma, resulting in unconsciousness If you happen to be asleep say, and nobody is around to find you (like a bird say, at 8 pm she goes to bed and her sugar plunges….). The next step after unconsciousness is bad…how much can a body take, right?

As opposed to high blood sugar that isn’t good overall but is much better than low. I believe this is a generally accepted position.

Just like what happened to Mystic, the patient needs emergency treatment and iv glucose to be saved. ***Since you can’t get a diabetic coma victim to swallow. ****

And eventually people who are bad like this (like my mother) get numb to the warning signs. My mother would be sitting in the hairdressers and nod out. They’d call my house and my son (a teenager) would say ” I’ll be right over, meanwhile call 911 they’ll juice her up and send her home”. It wasn’t funny but it was, kinda, the first time he said that because it was true… since my mother refused to be compliant. These were pre coma stages but she did go into a true coma one day and had a stroke that same day too. It was all downhill from there.

Anyway, that’s why I was making a big deal about the low versus high. High you may be able to detect by hyperactivity. (I’m guessing, here). But low hits fast and hard. As you experienced.

I’m curious what they thought when discharging her after the two days. Did they think they had her stable? Probably they couldn’t stabilize her either. IF they could, then they need to recreate that.

First, my feelings on taking care of a sick animal are:
the most important thing is to partner with your vet that you trust and whom you know will do her very best even if she isn’t one of these famous specialists. Because when the rubber meets the road it’s just you, the animal and the doctor. You need to trust someone. You need to turn control over if it’s a serious situation, too.

Second to a reptile, reading a bird’s body language is probably the most difficult. Dogs, cats, rodents, even fish, you can figure some things out. But universally a sneaky disease like diabetes, myasthenia gravis or other neurological stuff, gi disorders, pancreatitis…stuff like this is very challenging. But you DO eventually learn the signs. If the animal survives long enough and Mystic has for 12 years.

This is why I’m confused. What changed lately to crash her? Pancreatitis is very likely it says in everything I read online. I would definitely do the testing on THAT because at least you’re at peace with a dx and not blaming yourself for not being a miracle clairvoyant.

Yes, like your vet I normally do NOT see any residents or recent grads. I’ve had terrible luck before I caught on to the deal. Even at U of Penn, which is my local hospital and I have had heroes there but the Chiefs not the residents. My vet calls them “cut crazy” because a resident only knows book knowledge and jumps to conclusions WAY too easily and goes down the wrong path and over treats, too.

However that vet was correct on that point about the pancreas.

I don’t like trial meds or clinical studies. Did you sign something? Is your doctor sure she’s not in a placebo group? (UNLIKELY, just asking)

I wouldn’t have my animal use ANY new medicine like that unless it was a last resort or she was in hospice and I was looking for relief from pain, for example. If it were proven it wouldn’t be in clinical trials. And I would NEVER use my animal as a guinea pig. (NOT saying you are, just saying…)

It may be bad for Mystic. Her body may be out of control. But remember these diabetic things can really make the patient look at death’s door but they should spring back. She doesn’t sound too springy and I say it’s the medicine or an underlying undiagnosed condition like pancreas (sorry, broken record I know).

But I’d stop this new med absolutely. God only knows what ELSE it’s doing as an adverse reaction or messing her up like making her nauseous or food-adverse.

I’d feed her a bit every couple of hours or what you are comfortable with. I’d try to find other bird caretakers living with diabetic birds. Maybe you can post on a bunch of other boards like the Too site, Up at Six, sites like that. But don’t believe the medical advise just see if you can get symptomatic info and hear those people’s stories about their birds.

And I’d rule OUT the pancreas.

If I ever needed to trust my animals to anyone you’d be right on the top of my list. You and Beatriz…you’re both heroes in my book. Even if this is hospice care for Mystic, you’re doing everything she would hope for.

Randi Marie
9/22/06 at 09:03 AM

Thank you, Cindy. Mystic’s blood sugar is once again sky high, but otherwise, she seems fine. I haven’t spoken to the vet since Weds., as yesterday she was in surgery for her wrist. So, I haven’t told her that I’ve discontinued the insulin. But, considering how thin Mystic is, how she eagerly awaits her feedings with the syringe (and that’s a good thing, at least she’s getting Harrison’s which provides some sort of balance), and her adverse reaction to the insulin, I think it’s best to stabilize her and get some meat on those bones. The doctor says her organs are in a good shape. She had an Avian and Exotic Comp. Exam, a Comprehensive Avian Profile, Glucose-Glucometer, Fructosamine Level, Fecal exam, Gram stain, Complete Blood Count, Serum Chemistry profile, Bile Acid test, And Protein Electrophoresis, and everything came up normal except blood sugar. She started getting sick about a year ago, and her owner gave her up because she didn’t want to spend the money that I’m spending now!

Lynne
9/22/06 at 10:32 AM

Hello Randi Marie:

I think that you may want to explore the possibility of diluting the insulin.

I’ve been on Lantus (it’s GREAT!) but for a birdie, I think you might need to dilute it. I would maybe talk with a pharmacist and find out from them if there is an approved diluent for Lantus (there must be as there are diabetic infants out there!) If you can dilute it 1-10, then if you give Mystic 1 unit by syringe, you’re actually giving .1 unit. I think that would help a lot.

Check into diluting the insulin. I think it would help. If the lantus can’t be diluted, maybe some lente or ultralente might work???

The key I think is to get the tiny amount that Mystic needs into her without too much of a problem.

Hang in there… Diabetes is a juggling act for humans as it is for birds.

Can the vet supply you with some injectable dextrose solution to help mystic if there’s a low?? People get glucagon, but I don’t know about birdies…

Good luck and I’m glad Mystic is in your hands!

Randi Marie
9/25/06 at 10:56 AM

I’ve been feeding her the Harrison’s mash, mixed with other foods, via syringe…also, she drinks some mixture I prepare with apple cider vinegar, aloe and agaves nectar; her blood sugar is very high, extremely wet droppings and sluggish behavior. Thank you Lynn for alerting me to the dilution, and that’s what the vet will do. This Thurs, once again, she will be at the clinic being monitored for a significantly lower dose of insulin that’s been diluted.

Lynne
9/25/06 at 01:11 PM

Randi Marie:

You’re most welcome. I can’t imagine trying to measure out U-100 insulin via syringe to treat a parrot! It’s hard enough to do that for a person…OYE. I hope and pray that the diluted insulin will work. (Diluting lantus can be tricky, as it “precipitates and then it’s not usable. I’m sure that the manufacturer has a diluent available… there are little children and infants with Diabetes out there, and they need to be treated too.

I’ve been thinking a lot about poor Mystic. I hope she’s doing better soon!!!

Randi Marie
9/28/06 at 08:48 AM

I brought Mystic this morning to the clinic for yet another long day of blood testing, this time for 1/4 unit diluted insulin. The good news is that she’s up 60 grams, and she bit the medical technician! That may sound weird, but I view it as a sign that she’s getting stronger, and behaving more like a macaw.

Beatriz Cazeneuve
9/28/06 at 08:52 AM

Well, hooray and bully for her! Yes, I agree. Her biting is a great sign. And, 60 grams might not be much but it is a gain, and that, in itself, is fabulous, taking into consideration the awful reactions she had to the insulin. Something is working, Randi, it just needs fine-tuning, that’s all.

Lynne
10/04/06 at 10:49 AM

Hello there Randi Marie:

I’m so glad that mystic is doing better. HOORAY that she has the energy to fight back.

When I had a sick bird the vet tech said she was a very “sweet bird”. I said… she is sweet, but that’s not why she’s calm and not fighting… she’s SICK!!!

I’m glad Mystic is responding. I thought that diluting he insulin would work!

Randi Marie
10/04/06 at 11:25 AM
Well, Mystic was in a good shape that day because she had no insulin for a week. She was being hand fed and had gained weight and strength. She was given it that particular day under controlled circumstances. Starting Friday, we began once again with the insulin shot every a.m. Friday we took her with us for a day long excursion, and she did fine.

On the 29th of September, I went to visit Beatriz and because I was watching Mystic closely, she came with. We took a beautiful photo of her in Beatriz’s bird room.

mystic-in-beatrizs-room.jpg

Mystic was also fine on Sat., Sun., Mon., Tues…but last night, she had tremors and her foot seemed uncoordinated. This morning she seemed to have a tick, as her wings seemed to have “hiccups”. I gave her the insulin shot (turns out I shouldn’t have, the prescribed 4/10 of a unit) and she went into convulsions. You know, I’ve just about had it, and I told it to the doctor on duty at the animal hospital. She immediately started with the, “Oh, we need to get the levels right, you should have called immediately when you saw her wings were acting funny, you shouldn’t have given her the shot (why didn’t someone tell me that ahead of time?), last night must have been a sugar low (the glucose urine stick says sky high) she’ll die if she doesn’t get insulin”. I retorted that she’ll die with the insulin. This morning was once again a nightmare, I was crying and holding a convulsive, shrieking bird, rushing her to the hospital, work be damned. OK, and even on Sat., Sun., Monday, she seemed weak and much worse with the insulin than during the prior week when I head ceased with the insulin shots and concentrated on nutrition, weight gain and just happiness. I’m feeling very cynical; of course they’re going to say insulin’s the way to go…Msytic is worth thousands of dollars to them with insulin, and a big fat $0 without. This is my vet’s little pet experiment. Of course, I’m not convinced of my own cynicism, which is why I keep working with the doctors, but I’m very close stopping. I’m also so angry and shaken… I’m not warned enough about what can go wrong and what I should do. Instead, it’s “bring her in, and we’ll charge you a few hundred dollars again…and again. Meanwhile, this wonderful bird is going through hell! Unless I’m truly convinced otherwise, I’m giving up the insulin. She’s not a person, they don’t really know about birds and diabetes, and she’s almost died a few times now.

Cindy
10/04/06 at 05:03 PM

Randi Marie – I’m typing you a reply from my vet who treats diabetic birds. NO INSULIN. It’s too dangerous. It’ll take me a few minutes to compose.

If you’d like me to call you or email you privately with his name and number I’ll be glad to. Just tell me how to reach you if you have a “throwaway email id”. He is in Philly and has been a vet for about 40 years. I’ve known him for about 20 years. He’s had birds since I’ve known him and people travel from 4 states with exotics and bulldogs to see him. A very kind and logical man, too.

I’ll post in a few minutes what he said. He gave me two things to use in the water that he controls his patients with.

Cindy
10/04/06 at 05:33 PM

OK here’s what he said.

He has NEVER used insulin it’s dangerous. Diet can help a bit but everyone tries to fine tune things too much. Low sugar is deadly high is much preferable if you have to have one over the other.

Primary pellet diet is the way to go or the Exact handfeeding but it’s high carbs. There aren’t alot of choices for birds and you can’t feed them egg forever. (eggs are no carb).

He said Macadamia nuts are critical because of Macaw’s need for nuts and especially this diabetic bird. I would say if Mystic can’t or wont eat them I’d soak them, mash and stick in the formula.

I don’t know if you’re already using these products but just in case you’re not….He said he has always been able to control symptoms with Glypozide (generic name) or Tyrode’s solution mixed into water and he said he’d be happy to get some to you if you need him to.

He said in your case to get Glypozide tablet. 5 ML. Mix into water.

The thing is he said he’s pretty sure it’s a gallon of water but it might be a quart. lol. He wasn’t at work when I spoke to him, He doesn’t use the internet. lol.

He says you’ll be able to tell from the symptoms. I’d start with the gallon and make up another one in the quart.

Here’s a link from the Medline Plus US library that I use. IT SAYS THE PANCREAS MUST BE FUNCTIONING FOR IT TO WORK.

I’ve also posted a second link for overdose. It’s good to have with animals I’ve found. Like usual you’d call the poison control center or the ER but …

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a684060.html

http://www.drugs.com/glucotrol.html

http://www.nlm.nih.gov/medlineplus/ency/article/002588.htm

Hope this helps. If you ever want to visit my doctor I’d be glad to go with you. I’m around the Trenton NJ area outside Philly: 1 – 1.5 hours from NYC. He’s 20 minutes from me.

Randi Marie
10/04/06 at 08:21 PM

Thank you, Cindy.

I had like a 10 minute talk with my vet today. She argues that nothing else has worked on diabetic parrots, (I asked about glipzide first thing) and insulin in the past has proven deadly for many. But this Lantus is very promising and there are two parrots that are being successfully treated…and it was very rocky in the beginning with them. I am still not sure…Mystic’s one foot is not back in good working order, and she has these weird tremors and jerks. Now they’re thinking her liver might not be working at optimal levels (fat in blood, blocks oxygen flow, causing the jerkiness, etc), even though a couple of weeks ago, tests came back normal. More tests today. I asked about the liver, and she says they cannot measure insulin output from a bird’s pancreas. OK. But, everyone at the clinic seems convinced that she will die and might have already died if I hadn’t been administering insulin, whereas I think it’s made her feel sick so far, and has not been promising. Perhaps high sugar in birds is different than in humans. All I know is, she’s in a worse shape than she was in a week ago.

Randi Marie
10/05/06 at 07:19 AM Reply
Mystic is not well this morning. She fell off her perch. Her foot is all curled up. She doesn’t eat or drink. I think she had a stroke yesterday morning. She is jerking a bit too. I just don’t know what to do. I’m holding her. I made her eat a little, and put a little aloe detox down her throat. She’s holding her head up though. Maybe she needs time. Even though the doctors are very persuasive, I keep thinking about that week when we just left her alone and I fed her and she was very normal, high sugar and all. Now I don’t know if it’s the diabetes that did it, or the insulin treatments, that make the sugar levels ping. Her balance is also totally off, not just the foot. Her beak is open slightly too. I have her in my lap.

Randi Marie
10/05/06 at 09:51 AM

I left Mystic today at the clinic again. It seems there’s a new complication, high fat in the blood, perhaps the liver is not functioning properly. Also, she’s a female of breeding age, this fat would go toward forming an egg in a healthy bird, but that didn’t happen. I don’t know if it’s the right thing to do, but I just can’t sit here and watch her have convulsions and do nothing. If she gets over this hump, good, and if not, so be it. She’s such a beautiful spirited bird, I really hope she makes it.

Beatriz Cazeneuve
10/05/06 at 11:59 AM

Darn, rats and shoot! I sure do hope this is just another bump in the road, Randi. Such a beautiful, sweet and well mannered bird… it just breaks your heart. Let us know what happens. You and her are in all our thoughts.

Randi Marie
10/06/06 at 05:29 AM

It’s true, she’s a very special being. She’s in the hospital, probably for the weekend. Her condition is serious, the vet is not sure what’s going on, as all blood tests once again came back normal, and the fat in her blood cannot be explained by liver dysfunction. They will take an xray today to check her organs. Yesterday, the vet said, “She could die at any moment but I’ve had birds look worse than this pull through”, but by last night, she was more cautiously optimistic. Vet at first said diabetes and this more recent development are two separate things, but then connected that pancreas also secretes something that controls fat in the blood. I wonder if all the low sugar attacks set off by the insulin treatments stressed her and she’s now spiraling downward, but of course, no one knows.

Beatriz Cazeneuve
10/06/06 at 12:21 PM

Yes, as you said: ‘nobody knows’ and that’s exactly the only thing we do know for sure about birds… that nobody really knows enough. But, the longer she holds on, the more optimistic the outlook because when they are going, they just go. So, let’s not lose hope and keep on with the good thoughts directed her way.

Randi Marie
10/07/06 at 03:11 PM

Thanks, Beatriz. She’s still alive, hanging in there and has stopped with the seizures. The doctor told me that if her blood sugar goes above 500, she’s put in orders to have insulin administered. I have misgivings about the insulin by now, but I just want to go pick her up on Monday and get her home safe and sound. I’m not sure how to proceed, but do know I will try and find an avian vet for a second opinion.

Randi Marie
10/08/06 at 12:06 PM Reply
Last night I received a phone call from my vet. She says that now that fat from Mystic’s blood has been thinned out, her blood sugar is normal! After much thought, talking to the other doctors, and going to a bird fair, she thinks that Mystic is not diabetic but her problem was the high fat content in her blood. She said that it can drive up the blood sugar and can also account for her lack of appetite. This is great news! I’m so excited. I kept telling them that I felt like I was poisoning her with the insulin, I saw how it affected her. She is doing so much better, and I can pick her up tomorrow. They’re still not sure, but it’s looking good! I almost started to cry after the phone call, I am so relieved. I’ll post again when I know more.

Cindy
10/08/06 at 04:28 PM

Randi Marie that is so excellent I know you wanted to cry. “First do no harm” (the vet’s oath) is what you were saying and it ended up being true.

Now you get to do all the healthy food things that you wanted to do all along. If it were me, I’d be still using the syringe to introduce flavors and textures since she likes it and the opening will accommodate small things like cooked grains, (even Quaker oat bran which is pulverized like baby food), baby grains, pieces of veggies like cooked cauliflower (the new orange one is super high vitamin a) even coddled egg would come out and for sure, baby food. If she gets weird about it you can just mix in some soaked mash or juvie food.

I guess they want her on a lower fat content? I’ve seen a couple studies on it recommend 10% in Greys and Amazons with arteriosclerosis.

I wonder what they were feeding her while the blood thinned was it something special?

It’s a whole new day tomorrow. And even if she is having another internal problem at least she is probably not diabetic and for sure can come off that crap they had her on.

Beatriz Cazeneuve
10/09/06 at 12:05 PM

Ah, yes. I have always said that vets might know a lot about conditions and diseases but nobody knows the animal like the owner. That’s why it’s so very important to have a vet that listens to you and for us, guardians (or owners if you wish), to question everything and insist on getting answers/explanations for whatever bothers us. You had the right feeling all along. You knew the insulin was making her sick and now you’ve been proved right. Thank goodness it did not kill her (which could have).

I’ve learned this the hard way myself. That’s why whenever I have a feeling about one of my animals, I keep on taking them back to the doctor until I am satisfied. Because one knows when something is out of whack even when the doctors tell you differently.

So very, very happy to hear the good news, Randi! Congratulations!

(I would have cried, too!)

Randi Marie
10/10/06 at 08:57 AM
Mystic is home, somewhat worse for wear, but alive. Her right foot seems at least partially paralyzed (she cannot grip with it, she lets it hang down, and she has a very hard time stepping up), and she’s quite tired. She’s sleeping now at 9:30 a.m., while the other birds are all spunky. I am supposed to give her niacin suspension 3 times a day to continue thinning the triglycerides in her blood. It’s coconut flavored and she hates it.

Cindy, I posted my email address earlier, please send me the name of your wonderful vet.

I am grateful to my vet for finally figuring it out. At least she wasn’t ego involved with her initial diagnosis, she’s become genuinely fond of Mystic, and I know that’s the nature of the medical profession… a lot of detective work. However, I do think she should have paid more attention to what I kept telling her, and not been so gung ho about the insulin. I feel bad that I didn’t have the courage of my own conviction, because by giving her insulin, I’m afraid I’ve damaged her. The clues were there, and I was pointing them out, but I was afraid to go against the doctor’s insistence. Mystic was much more agile before, able to climb up and down her cage and go from branch to branch, and now her balance is off and her foot is not really functional…she even has a hard time perching. If Mystic were a person, I would suggest acupuncture, but for now, I’m going to rub her foot and leg a lot and get her exercising. So things are not great with her, but much better than the end of last week. Any suggestions regarding her foot and balance would be much appreciated. We are now beginning a new chapter with Mystic.

Beatriz Cazeneuve
10/10/06 at 01:00 PM

Don’t despair, Randi, animals have incredible recuperative powers, much more than humans do. I think it’s because they don’t dwell on their handicaps or infirmities and continue trying hard to do the ‘normal’ things, and that’s the best therapy there is. I have a feeling that, in time, these problems will disappear.

My vet clinic has an acupuncturist, I’m going there this Sunday with my Amazon for a check up and a canary for leg amputation (so what else is new?), I’ll ask if she does birds. I know she does dogs because she did one of mine for back problems but I’m not sure if she does birds.

Cindy
10/10/06 at 04:01 PM

Randi I’ll email you after the birds settle in for the night. Speaking of acupuncture I also have a good homeopathic/traditional vet right in my neighborhood. Deva Khalsa. She’s a friend of mine. She’s kinda famous in that world, published, quoted and lectures.

My feelings are with homeopathy that sometimes it’s good but usually only in animals and people that are living “that” lifestyle. In my experience with sick mammals they have been bombarded with so many NON-homeopathic remedies including vaccines that the homeo ones don’t always really do much. And if you have a real illness usually they have to eventually resort to traditional IF the family is not completely “holistic” or homeopathic. But she is an interesting person and it wouldn’t hurt to see her if you ever want to. She also does physical therapy but I don’t remember about birds, I’ll call her and ask. Perhaps a referral.

Beatriz Cazeneuve
10/12/06 at 11:25 AM Reply

Most compounding pharmacies have a wide variety of flavors, the problem is identifying which flavor will be most easily accepted by the animal. Also, some medicines have such a terrible taste that even though they add the flavor, it doesn’t do that much good (I know because I try them all myself and the cipro for the birds is one of those that flavoring has only a very marginal improvement over the overall taste, regardless of which one you use -I’ve tried both cherry and orange for the cipro and they are both still quite nasty)

Randi Marie
10/12/06 at 08:23 PM

She will be receiving some tooty fruity flavor in a couple of days.

She has suffered a stroke, or a few little ones. Her entire right side is weak and neurologically impaired. Hopefully, her triglycerides are the problem; if not, it’s a mystery. She saw the vet today, again her blood was taken.

Beatriz Cazeneuve
10/13/06 at 06:22 AM

High triglycerides will cause strokes. I know because that’s how my father died (two milder ones and the final) and the only thing wrong with him was his triglycerides. But, like I said, brain damage in animals is reversible, same as people, and if it’s not, they adapt very well to whatever dysfunction they end up with.

Hang in there. Things will get better. We are all thinking of you and Mystic.

Cindy
10/13/06 at 03:28 PM

Yes Randi Marie I think it can reverse too. Meanwhile Mystic isn’t aware of it as sad as it is to see her that way…

I would ask your vet to report this to the company that makes that medication and (report it in the trial) and see if they want to know. They may want to enter it as an adverse reaction. Neurological/adverse reactions are common in meds especially with animals. Sometimes the reaction is the same as the illness and you can’t tell. The CDC keeps a huge database on them.

Randi Marie
10/14/06 at 07:46 PM

Oh, this whole thing has become so complicated! At her last check up, blood was taken and the results came back. The triglycerides are lower and her blood sugar shot up. The vet is quite vexed, this is one of her most difficult cases, and she can’t figure it out. She spoke to me yesterday, and my head started to hurt. She would like to take a biopsy from the pancreas. I said, “no”. I’m not putting Mystic through that. We will keep giving her medicine to lower her fat levels, and feed her and exercise her. The insulin is a possibility for the future, but if she’s gaining weight, I think that’s all that matters now. Cindy, she started receiving medicine for the high triglycerides after the seizures and stroke, not before, is that what you’re talking about? Thanks!

Linda
10/15/06 at 02:49 PM

Randi–I’ve been wading through this sad, sad story, and my heart goes out to you. It sounds as if, in addition to her other problems, Mystic might well have suffered what’s commonly called a “yolk stroke”. A yolk stroke is an acute situation in which an unshelled egg is produced and absorbed, rather than passing out. This causes a sudden, huge deluge of fat in the bloodstream, and the fat causes either small, multiple strokes, one large stroke, or both. As with all strokes, immediate steroid administration can help lessen the permanent damage, and other precautions can be taken, but in the end, the bird will survive or not survive, as it must be immediately treated to get relief.

As the liver and kidneys work to clean the bloodstream, toxic reactions can occur, and almost always, a bird with yolk stroke will seizure.

I have dealt with three yolk stroke cases over the years, and all but one went on to live good lives. The one that didn’t survive lived for a year, but remained with a level of neurological impairment, and then passed away one night. Her case was clearly documented by an avian vet; the other cases were of birds people contacted me about–they were in a panic and their vets were not helping them. The vets saw the fat in the blood and lectured the people on diet–they weren’t even AWARE of the yolk stroke syndrome. All of the birds were female. All had been exhibiting nesting/sexual behavior.

An ill female bird is susceptible to yolk stroke because of the intense handling and attention that stimulates them to produce the egg, even though they are in an unhealthy condition that normally would turn the hormones off.

The yolk stroke condition is a crisis that passes rather quickly, often leaving the bird impaired. The neurological damage will often disappear in part, or entirely, with time.

From all you’ve written, Mystic sounds to have a pancreatic condition, or perhaps a metabolic condition–the one she came to you with–and now, a condition relating to yolk stroke. I agree with Cindy (and his vet) that glipizide is the way to go, and you might consider telling the vet you want to work exclusively with that product. Any medications that you are giving Mystic for elevated blood fat will, I suspect, be short term, as she does sound to be a classic yolk stoke victim, and the acute problems of that condition will naturally pass, either leaving impairment, or leaving no impairment.

Hyperglycemic birds treated with glipizide twice daily have had good results. There are other drugs, thiazolidinediones, and glucosidase inhibitors, which might help. Insulin would be my absolute last resort, and if it causes more suffering than it relieves, I’d abandon it.

Finally, any bird with the problems that Mystic is exhibiting is going to be a test case, and that’s the truth of it. Sometimes, the well-being of the life involved becomes secondary, as vets push the envelop, hoping for the miracle cure. You’re right in your analysis of that, I’m certain. You could try taking Mystic for a second opinion, if you lose faith with the vet you’re using, but any path a vet goes down is going to be an untrodden one, as diabetes is such a rare avian disease, and in truth, no one knows how to successfully treat it. They don’t even know, really, how to properly diagnose it, or even what causes it.

You’ve been brave and kind and true, Randi. Taking on such an afflicted bird as Mystic is a heartwrenching, exhausting, frustrating, agonizing endeavor–it’s like putting a century of living, and fighting, and trying, and weeping–all into just a few months. These battles drain you, both of you, drain you in heart and soul, body and spirit. In the end, it might be the best you can do for Mystic is to give her a peaceful passing–though I hate even writing such words. Some birds can’t be saved, they can only be spared even more suffering–that’s the hardest lesson I’ve learned, in this life, but there it is.

I wish the best for the both of you–whatever the best might be. No matter what happens, your bond will never be broken. Not ever.

Cindy
10/15/06 at 08:42 PM

Hi Randi Marie. I broke the phone cord for my dsl service or I would have responded sooner. No, I was talking about reporting the Lantus. You’ll never know if it was a factor or if she has an underlying condition but they may want to know. Alot of meds have the same adverse reactions in humans and animals. And seizures are listed as a side effect. And some other stuff.

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a600027.html

Well, you’ve taken on a very hard case. And I agree with everything Linda wrote although I have to go back and re-read a couple of times. But she’s very lucky to have found you. They say some people/animals can find the person they need when they most need them and it seems to be the case.

I personally think she has an underlying condition too, not just diabetes since it came on at her age and what’s been going on but I hope not. Usually when there’s a “crash and burn” downturn in my experience with any animal and illnesses it’s usually not the obvious. But plenty of them fight their way back.

I definitely wouldn’t have done the biopsy either. This bird is neurologically impaired not to mention all her other problems. Just the anesthesia is a risky. I assume just like in other animals she could come out of it with pneumonia or worse, even though I guess they anesthetize them in a “bag” not with a tube, I don’t know. But again, in my experience with sick animals unless the benefit justifies the risk I don’t like too many procedures.

I read this in a pub med “A serum amylase level greater than 1,500 U/L is suggestive of pancreatitis and pancreatic biopsy can be used to confirm a diagnosis”.

There are alot of stories on the net about pancreas in parrots. There was one who passed away from pancreatic cancer not seen on the biopsy 4 weeks earlier. So it either advanced quickly or the biopsy didn’t work. Another reason I wouldn’t bother. Especially NOW, given Linda’s post.

Take care, I hope Mystic is stable and responding.

Cindy
10/15/06 at 08:55 PM

Here’s the package insert with the adverse reactions. Says they can be life threatening. I wouldn’t use it now. You already saw an adverse reaction even if you don’t count the “stroke”.

On my Megaesophagus message board where I’m an advisor I kept warning of adverse reactions (that my dog had and it almost killed him) to a particular medicine (Reglan/Metaclopromide). Everyone there told me I was nuts and it’s very rare and that I was making a big deal over nothing. Even vets who post on the board. But even in Merck Vet manual it says some horses were so bad after this stuff they busted out of their stalls in a panic.
So I did a survey after a couple of posters “thought” they saw an adverse reaction. Guess what 73% of ALL animals whose guardians responded that tried that particular medicine had a serious neurological adverse reaction.

It’s alot more common than we know. (reactions to meds or vacs).

http://products.sanofi-aventis.us/lantus/lantus.html

Randi Marie
10/18/06 at 09:22 PM

Mystic has been eating well the last week, but this morning she woke up very sluggish and wouldn’t eat until 11:00 a.m. Then she half-heartedly ate a little. But she perked up later in the afternoon, and ate a lot then and tonight. I do know her blood sugar is once again very high, and attribute her torpidity to that. The vet now says that I should inject 3 units of Lantrus tomorrow morning; she asserts that we were sidetracked by the “yolk stroke” and that she is very susceptible to future strokes and other complications if we don’t keep her blood sugar down. She wants to see if 3 units is the magic bullet, so to speak. What do you think? Help! I’m vacillating terribly here. The vet makes sense, but I’m very uncertain how to proceed.

Cindy
10/18/06 at 10:57 PM Reply

That’s tough. I personally would not. First I would try the Glipizide. But I’m kind of weird in my views. I would rather my animal’s body be the problem than meds that were given bringing on the problem. If you know what I mean. If I thought that the meds were problematic, I’d rather my animal’s body kill them “naturally” than me kill them with meds. It’s like “her diabetes killed her” versus “I killed her with medication I didn’t think was good but gave it anyway out of desperation”. (sorry to be so graphic).

“First do no harm” means over medicating or medicating and making the animal go through pain or drama or side effects just because the meds cure some other symptom. IMO. But I’m biased from the other forum I’m on with people struggling at any cost to keep their dogs alive. Including living with side effects of medication. I’m not a fan.

Example: you may find a bird with transient diabetes if their organ that functions as does the human pancreas is subjected to a bacterial infection. And, it may not be possible to diagnose that a bacteria is present. However, once the infection is cleared up with medication, the diabetes disappears.

Randi Marie I know you’ll do what you feel is best for Mystic. You’re almost in a lose-lose situation. If you withhold the insulin, you’ll blame yourself if she suffers something serious or terminal. If you give it, you’ll second guess yourself in the reverse. Sorry I couldn’t be more help.

Beatriz Cazeneuve
10/19/06 at 06:23 AM

Oh, gee, that’s a tough one to answer… I think it would depend on the faith you have in your vet. If my vet said it was best, I would do it even if I wasn’t 100% sure about it but that’s because I trust my vet a lot. Also, I think that if I knew for a fact that her blood sugar was real high (I assume you continue doing the little stick thingies), I would try the 3 units once, watching her like a hawk the entire day. If she has been eating well and her weight has gone up a bit more and her stroke paralysis is slowly getting better and the only thing left now to fix is her high blood sugar, I would try it once more.

I am going to see my vet this Sunday and I will ask her about Mystic case. I’ve been talking to her on and off since but mostly through messages on our machines so I haven’t gotten a chance to spend. some time talking about anything but what was going on with my birds. She might know a specialist or a professor she could recommend. I’ll let you know.

Randi Marie
10/19/06 at 07:25 AM

Thank you. I woke up early this morning, before I was to administer the insulin, to think about this and read your responses. I’ve decided to hold off on the Lantus for at least several days. I contacted the office of a recommended vet quite a distance from New York, for a second opinion. My vet sort of dismissed him as an old timer…essentially, he has seen many, many birds, but she is more the cutting edge. She so firmly believes Lantus is the way to go, but I’m not sure. I never observed it having a beneficial effect on Mystic. I’m aware that we may not have found the “therapeutic window”, which is why I haven’t totally discounted it. We (my sons and husband have all become involved with loving, holding and feeding Mystic) are going to continue with the medication for high triglycerides, and feed, exercise and hold her a lot for at least several days. I respect my vet, but I don’t want to be pressured into doing something that could affect Mystic adversely right now. The high blood sugar is also dangerous, I acknowledge; thus my dilemma. But I feel uncomfortable about the insulin, and think to wait for several days before acting might be prudent.

Linda
10/19/06 at 01:43 PM Reply

My strong recommendation is to get at least one other opinion from an avian certified vet on how to proceed with Mystic. They are the most informed people to advise you.

If the “old timer” vet is who I think it is, I would, based on that one thing, lose faith in the vet you are using. If the practice of the “old timer” is the one I think it is, they are bird specialists with specialized hospital rooms, and specialized equipment for treating avian species, and they also have a young avian certified vet on staff, and two other very experienced avian vets on staff. I don’t use vets that disappoint me in their knowledge, handling of birds, protocols, even if I personally like them. I drive several hours to go to the “old timer” vet practice, rather than practices in the city, because I love my birds and want the best for them. It’s all about the knowledge, skill, the facility, the experience with bird diseases, the experience with birds themselves.

Again, you are in uncharted waters with Mystic, and don’t think what you feel is right for her should be excused because you aren’t a vet. You see her every day, and know what seems to be helping her, and what is not. In this situation, that information is invaluable.

I understand from further research that diabetic conditions can manifest as a result of kidney infections, and dysfunctional kidney situations. This was mentioned in previous references, but I’ve come across more detailed information–so Cindy is on target, as kidney problems and diabetic/hyperglycemic conditions actually seem to go hand-in-hand. In my heart, I fully believe the diabetes is secondary to another affliction, simply because it is such a rarity in birds–indeed, I’ve yet to come across a case that was considered actual diabetes, rather than diabetes developing from another untreated condition.

The one, shining light in this is that Mystic is in your wonderful, loving hands. She will never know the toll her condition is taking on others, but I do. You are doing the best you can, Randi, and though, in the end, it may be your only consolation, don’t forget that there are no easy answers here, no pocket solution. Meeting Mystic’s daily needs, both physical and emotional–giving her a good reason to fight on, giving her the sense that she is cared for–is a big part of this equation, draining as that effort has to be for you, and your family.

Have you considered contacting Greg Harrison? I think he’d be interested in a case such as Mystic’s. Has your vet contacted other vets for consultation? If she hasn’t: not good. Mystic’s best chance of surviving will emerge from consultation. One vet just isn’t going to get the job done.

Brenda
10/20/06 at 02:53 PM

My African Gray 18 mo. old is also diabetic. He also has levels through the roof and at the vet all day yesterday to monitor dosage of insulin. I learned how to inject him yesterday and did it on my own today. He had to have blood drawn 8 times yesterday and was still sweet to the vets. I live in NJ and this is the first time in 15 years the avian vet has seen a diabetic bird. He still is squirting, so we shall see.

Cindy
10/20/06 at 04:24 PM

It may sound funny but maybe the two vets could “brainstorm” together. I also wish they’d consider the Glypiside. As a couple of experienced vets/caretakers have.

Brenda
10/21/06 at 01:08 PM

My vet is in NJ and she is in touch with a vet in NY that is doing a paper on diabetes in I think African Grays. This is the first true case she has seen in 15 years of being a vet in birds, so she is excited to deal with Dorian. He has been on the meds since Thurs. and still drinking a ton of water and squirting. She has done research and has written and spoken to vets around the world.

Brenda
10/21/06 at 01:16 PM

we tried the other med with no results. He does okay the first day on it and then back to the squirting. I read and tried green herb tea and the same thing happened. All right initially and then back to squirting.

Randi Marie
10/21/06 at 02:13 PM Reply

Hi Brenda, what do you mean by “squirting?”

I did talk with the other vet, the “old-timer”, and if that term means a caring, extremely knowledgeable individual who takes the time to talk and explain things, then that he is! I will no longer administer insulin to Mystic, but instead will concentrate on her diet and her weight gain. She is eating several times a day a Harrison’s Mash diet, along with baby food, occasional hard boiled egg, pureed veggies and little slices of banana, apple and blueberries. Also lots of cuddles and occasional wing flapping exercises. I can go into more detail what the doctor told me if anyone cares to read it. But basically, diabetes is much different in birds than mammals, and insulin treatment does not address that.

Linda
10/21/06 at 02:28 PM Reply

I think the squirting refers to droppings that are purely liquid, and come out in a projectile like manner. This is very common is hyperglycemic birds, which tend to suffer severe dehydration, and the resulting kidney problems that go with it. Symptoms often include excessive water intake (polydipsia) and excessive excretion of a very dilute urine (polyuria).

Linda
10/21/06 at 02:43 PM

Good for you, Randi. And good for Mystic. But especially, good for you, for trying so hard in such a demanding, anguishing situation, and for going the extra mile, gathering all the data, grinding it out. You must be exhausted.

I’m glad you’ve abandoned the insulin. It wasn’t working; it sounded as if it was, in actuality, having an adverse affect. I don’t believe More would have been Better; I think More would have been Seriously Worse. Good for you for taking a stand. No matter how things go for Mystic, and let’s believe they will get better–no matter how they go, I think you will always choose the better quality of life path, and you know, Randi, I think that’s the very best you can do for this sweet girl. She’d agree, I’m sure of it.

Brenda
10/21/06 at 03:07 PM

Squirting is liquid urine. There is some solid in there but he drinks a lot and likewise goes a lot. Also his weight is all over the map up and down. He eats so that is not the problem and still is sweet but stopped talking. He just makes noises.

Beatriz Cazeneuve
10/23/06 at 12:04 PM

Randi, I talked to my vet about Mystic and the debate of your vet recommending insulin while Cindy ‘s vet is opposed to it. She says that because there are no protocols whatsoever when it comes to avian diabetes and everybody is blindly experimenting to see what, if anything, works, vets tend to use the method that worked for them in the past, even if they have only seen a single bird on it. (She says that every single avian vet hates getting a bird with diabetes because they all feel so impotent about it). I took a list of all the tests that were done on her and she could not think of any other that could be used as a diagnostic tool.

She does not know anybody who is doing any work specifically with this condition but she recommends Dr. James Morrisey of Cornell U. She has consulted with him several times and she loves him. (I also have heard excellent things about him from other sources).

Cindy
10/23/06 at 04:39 PM Reply

As far as third opinions (or 4th actually) go, I agree that Cornell is an excellent (although a teaching hosp) place. Usually I have a 50-50 experience with teaching hospitals because they make you go through a resident and raise Cain to get to the chiefs and that’s never good with a serious illness. Of course it’s better than a lot of local docs because they have the best equipment and good mentors. But it’s all relative.

Regarding the old school vets, which mine is, when my dog got a rare disease Megaesophagus-lack of motility in swallowing- he RUSHED me to a specialist hoping that there was something he didn’t know that was current. Sadly there was not and his first words to me were right on target. (if this doesn’t work nothing will – about a med).

I might mention that all the procedures that the specialist performed made the dog much worse. His demise was certain because of it.

Also this has been my experience at HUP (U Penn). They are a little cut-crazy. Want to USE all the technology they know for a few reasons. First hoping it works, second not wanting to be accused of not trying or offering everything, third because they are curious, fourth if you see a resident they throw everything they read about in the mix without the life experience to back it up.

First do no harm. I live by that now and advise that on the Yahoo group I’m on.

Randi Marie I’d read up on the web if you can on bacterial infections/diabetes see if it’s possible with her. That bird I put the link up on had it and they said it was hard to diagnose. I’d prefer an antibiotic to the insulin if you were going to try something. Of course without a scope for culture and sensitivity you never know if it’s the right antibiotic and a scope is not advised without a real benefit like if she is deathly ill, I’d say.

Randi Marie
10/23/06 at 04:44 PM
I ended up speaking with Linda’s vet up near Hartford. I’m driving up anyway next week so my son can look at colleges in the area. She recommended him highly; he called after looking at 40 pages of notes and spent quite some time speaking with me. He was wonderful. What he told me was that the pancreas produces (amongst other secretions) insulin, which he said were beta cells, and glucagon, which are alpha cells. The problem with administering insulin to birds is that their diabetes is caused by too much glucagon being produced rather than too little insulin, which is the case with mammals. In his experience, most birds react like Mystic; no real change, until there’s a drop in blood sugar, often resulting in extremely low blood sugar and death. Mystic really did have several near death experiences. There really is no medicine available to help the pancreas produce less glucagon. It can be caused by infection, or even the tiniest of tumors, which may or may not be detected by ultrasound, and may or may not be benign. He recommended no insulin.

Because of her stroke, her crippled foot, her extreme reactions to the insulin, I had already decided to stop with it. It wasn’t making her feel well, that I could tell. She hated getting the shot. My vet here in New York is convinced that Lantus, this newer form of insulin, is the way to go, and wanted to pursue refining the dosage, seeking that therapeutic window, but I felt very uneasy about it. I’m not a doctor, so I also didn’t feel comfortable just ignoring her. But the combination of Cindy ‘s doctor and Linda’s doctor convinced me to follow my feelings and try to bring her to greater strength through diet, for now.

I was also wary because my vet is vested in this project, as she’s co-authoring a paper on treating parrots with Lantus. I think she’s highly ethical and I admire her, but it’s in my mind it’s sort of a conflict of interest. The woman I adopted Mystic from told me there was a vet who wanted her for the clinic just because she had diabetes. It’s a challenge to treat, and little is known about the condition. As Linda says, it’s uncharted waters.

Brenda, I can’t advise you except to alert you to any weight loss in your parrot. I am currently feeding Mystic with a baby food syringe, using Harrison’s mash formula as a base, and have brought up her weight.

Brenda
10/23/06 at 11:13 PM Reply

Dorian’s weight is not constant and goes up and down . He drinks a lot of water and has a crop that is filled with water. The vet is doing all this with no cost to us. We supplied the insulin and syringes. This was after my husband complained that we paid $600 for tests and she wanted to do more tests to make sure. We know that we can lose him at any time. Also we are in NJ and planning to move to Arizona next month some time, so I don’t know if we will take him or let her find him a home to continue treating him. He is the sweetest bird that I have had. I hand fed him from 8 weeks old. He was really starting to talk and stopped when he got sick. Only noises now and an occasional word. Sorry to ramble on, but this is heart wrenching.

Linda
10/24/06 at 02:24 PM

Brenda: Please, don’t leave your bird. Please, take him with you. He doesn’t need the loss of his loved ones on top of everything else. As much as you would miss him, multiply that by 50, and that’s how much he would miss you. You’re his anchor in all of this. Without you, he’ll drift out to sea and go under.

Where in AZ are you moving? Near Tucson? I have many contacts there–and there is an excellent avian vet, Dr. Todd Driggers (and others) in the area.

You may well lose your bird to this terrible affliction, but he should remain within your loving circle of care and comfort until the end–though this will be very painful for you. You may have to watch him die–and I’m being completely realistic with you, and this is the truth of it–and it may break your heart, but it will be the world to him, knowing you are near. Put yourself in his place and you must know this, without a doubt.

Again, where in AZ? And I’m so very sorry this has happened to your lovely baby. It’s such a cruel road for all.

Randi Marie
10/24/06 at 03:50 PM

Dear Brenda, I do agree with Linda. I hesitate to say so, but it’s true that your parrot will suffer if you leave her, especially now that she’s sick. You may or may not lose your bird to “diabetes”, and the reason why I put it in quotes is because they do not even have a definitive test to diagnose it as such. It’s high blood sugar, doctors don’t know what causes it, what it is, and while it could eventually kill your parrot, it could also disappear as mysteriously as it appeared. There is so much unknown.

My vet is one of the experts, highly regarded throughout the region, but she doesn’t know either, in reality. There are vets out there who want diabetic birds to treat, because they want to experiment and see what works. Are you sure you want to leave your parrot to this fate?

One thing I’ve learned from parrots, they are so finely energy sensitive. They are also so emotional. They are such sensitive creatures, and yours will feel abandoned if you leave her and move away without her. It will not contribute to her well being, that much I know.

Linda
10/24/06 at 03:59 PM

Brenda: Yes, I didn’t mean to be so negative about the prognosis for your bird. I was presenting worst case scenario–there are many in-between scenarios, with very positive outcomes. Don’t lose hope!

Randi is right, however, in the intense interest in birds with this condition. They are all test cases, and that has to be the way of it–but please don’t leave your bird as one, even if you feel you can trust the vet who is working with you. You bird should go through whatever it has to go through, with you there to comfort it. Your presence and comfort are essential, absolutely essential, to the health and well being of your bird. I truly believe this.

Brenda
10/31/06 at 10:51 AM Reply

I am moving to Sun City West in a new house. Right now he is at the vets having the meds adjusted. He is on 4cc twice a day. I am giving him the injections. Had him since he was 8 weeks old. Anyhow my husband who never handled him decided he wanted to try to get him out of the cage. Dorian went right on his hand and let him inject him. He truly is a love and so sweet wanting his head scratched all the time. Let me know of any avian vets out that way. We are going to travel by car to Arizona with our yellow nape and German Shepherd. The vet we are using is doing this for no cost.

Randi Marie
10/31/06 at 10:55 AM
You have a wonderful vet, Brenda, because mine charged me up the wazoo.

Brenda
11/01/06 at 10:26 AM

Dorian was at the vet yesterday and his dosage was increased to 4 1/2 cc with I feel no change. The vet we deal with was not there, and the other vet said when he first came in (the first visit) they tried 5 cc and he went into shock. So we shall see what happens. I still have time to play around with him.

Randi Marie
11/01/06 at 11:54 AM
Brenda, this is the reason I stopped trying the insulin with Mystic, especially after Cindy ‘s doctor said it wasn’t advisable, and then Linda’s doctor explained to me why it really doesn’t work. Mystic would either be almost dying from shock, or it had no effect on her. I am concentrating on keeping her weight up and that’s about it. I’m taking her to Linda’s vet tomorrow, up near Hartford to see if there’s anything else for me to try. But for now, I’m enjoying her lovely personality and making her as comfortable as possible. Linda knows vets in Arizona, hopefully she can recommend one for you.

Randi Marie
11/03/06 at 09:01 AM

Mystic is really not doing well. I brought her up to the vet yesterday close to Hartford, CT. She wouldn’t eat yesterday morning. On the drive up, she starting splaying her wings and getting all spastic. By the time we arrived, I was a nervous wreck. I knew she’d lost weight (I have a scale, but it’s very hard to get an accurate reading) but I didn’t know how much. She’s down to 633 grams, that’s more than 100 g loss. I couldn’t help it, tears came to my eyes and I’ve been very upset about this. We are holding her a lot and she seems pretty weak. She loves almonds in the shell, and hasn’t managed one the last day. The vet took a gram stain and concluded that she’s not digesting starch, her pancreas is not secreting enzymes either. Most likely she has pancreatitis or pancreatic cancer. He gave me some enzyme powder to sprinkle on her food, but she has to eat the food to get it in her system. We all love her in our house, and are rather demoralized by this turn of events. We fed her by hand and brought her weight up, just to see it plummet. Now that she’s refusing and spitting it out, we won’t force it down her throat. The vet in Hartford did say it would be interesting to see the results of a pancreatic biopsy, but as a doctor, he doesn’t recommend it. He was very caring but had very little to say. I don’t think she’s long for life.

On another note, there resides a B&G macaw at his clinic who is diabetic. They did try various therapies with him, glipizide, insulin, etc., only to come to the conclusion to let him alone and live his life without further intervention, high blood sugar and all. There has never been developed anything specifically for diabetes in birds. It’s so rare, and there’s no money in it. He is skeptical about the possibilities of Lantus because it’s geared toward humans, and we are just very different, on a molecular level, from parrots. He did inform me that raptors are much more like mammals than other birds, and are therefore easier to treat with medicines developed for humans, which I found interesting.

Beatriz Cazeneuve
11/03/06 at 12:41 PM

Oh, jeez, so very, very sorry, Randi. It’s just terrible when you try so very hard but just cannot make the bird better. I know, it happened to me with Baby. You always hope that your love, care and devotion might make the difference but, unfortunately, it does not always work out that way.

If nothing else, at least she has had a lot of love in these last few months and, when she dies, she won’t be alone. That means a lot to them, I think.

oliver-mystic.jpg

Oliver feeding Mystic water from a feeding syringe

Randi Marie
11/05/06 at 01:46 AM

Mystic passed away early this morning, between 12:30 and 1 a.m. She wouldn’t eat all day yesterday, but then in the afternoon, happily ate a couple of almonds. Then she let out a squawk, and went into spasms. I held her and calmed her. She had a couple of episodes afterwards where we feared she was in pain. She was intensely energy sensitive, and responded very quickly to being held. My son took over holding her a few hours, then I held her the rest of the night and all morning. Whenever she would shake, I’d place my hands firmly and gently around her, and she would still. But she had stopped drinking water and seemed immobile except her occasional spasms and tremors. Another son and girlfriend held her all afternoon. Then I held her, and then my son. She was quiet, still and alert all day and night again. She slipped away very peacefully after being held round the clock for a day and a half. We are so sad, because she was such a beautiful little spirit, and still, grateful that we knew her too. We put so much energy and love into her. We will really miss her.

sick-mystic.jpg

Beatriz Cazeneuve
11/05/06 at 09:29 AM

Ooooh, Randi, so very sorry to hear about Mystic. She was such a beautiful, well mannered, sweet bird…. but she did not have it easy and, when it comes to animals, physical well-being is the most essential aspect of their existence. Any kind of debilitating condition or disease takes so much away from their quality of life that, as much as we love them and wish to keep them with us, death is sometimes the better option for them. She had a good life and an easy death surrounded by people who loved her. Nobody could ask for more than that, not even humans.

Cindy
11/05/06 at 11:18 AM Reply

Yes she did. She was sent to the right family for this crossing over. So sad and you and your family are very special people. She really fought to hang on I believe because she was in your wonderful care.

Randi Marie
11/13/06 at 02:29 PM Reply

We were all plunged into mourning after our Mystic passed away. We know it’s for the best, but sometimes, you know something with your head, but your heart is still broken. This thread helped me gather my thoughts and your feedback was priceless. Thank you.

The vet called and left a very kind message. She said that in all her years practicing avian medicine, no parrot touched her heart like Mystic. I had become irritated with her tunnel vision regarding diabetes and the insulin, but of course, we’re all human and she really tried. She’s an excellent vet, as well as the other vet I went to in Hartford.

We loved our beautiful Mystic. Even though we knew her for just a few months, we cared for her as if we’d known her for years. Holding Mystic close to us toward the end, it was clear how much our energy and love stabilized her. Her jerky movements subsided and she became calm and smooth. We could all feel our energy being pulled into her field as she prepared to leave her body.

Today, everyone in our family agrees that we’d like to go like Mystic, being held and cradled lovingly and continuously for a couple of days! We buried her in the garden, and did not have the vet perform a necropsy. She most likely passed away from pancreatic cancer, and for some irrational reason, I wanted her to remain whole after everything she had been through. Today she is covered with the just fallen magnolia blossoms. She will always be there, in our hearts, a part of our family.

closer-mystic-hanging-with-sarge-pepper.jpg
How we like to remember Mystic…hanging with Sergeant Pepper.

by Randi Hoffmann