Two weeks after an accidental fire in the home, Gus a 13 year old Grey Parrot presented to Avian Veterinary Services with his owner describing him as off colour and having a change in his voice. This normally extremely vocal grey had become less chatty and when he did vocalize he was sounding hoarse.
We always take a voice change seriously as this implies something is putting pressure on the bird’s voice box or syrinx. Considering it is responsible for the incredible range and volume of a parrots voice the 'syrinx' is actually a delicate, tubular structure barely a few millimetres wide and situated where the windpipe splits into two as it enters the 'chest'.
Possible causes of voice change in birds include trauma to the windpipe from a collision, inhaled foreign material e.g. seeds or fluid, infectious agents e.g. bacteria or fungi, inhaled irritants or toxins e.g. smoke or chemical fumes or even a worm called syngamus that actually lives down the windpipe.
The rigid endoscope (which is essentially a 2.7mm diameter fibre optic camera that was designed to look into human joints) is an extremely valuable tool for investigating disease in birds as their unique anatomy offers two clear advantages compared to the mammalian patient -
1. Without a diaphragm separating chest and abdomen, we are able to visualize virtually all the internal organs from heart and lungs (Fig 1.) down to kidneys, reproductive tract and intestines (Fig 2) via a single tiny hole made between the last 2 ribs. The incision does not usually require stitching and is generally completely healed over within 48hours.
Figure 1: Normal Lung Figure 2: Adrenal, Kidney and Teste.
The presence of an 'air sac system' which is basically a series of bags of inspired air creating an 'air jacket' between the internal organs and the body wall. Birds lungs don't expand and contract like ours, they are like pink sponges fixed into the rib cage and the 'air sacs' do the ventilation acting as a set of bellows, blowing air through the lung where oxygen is extracted.
This is an incredibly efficient system and the faster a bird flaps its wings during flight, the harder the bellows are made to work and the more oxygen the lung extracts to supply the active muscles. (The down side is that although birds are incredibly efficient at concentrating inspired oxygen they are also efficient at concentrating other stuff which is why they appear so sensitive to inhaled toxins like air fresheners and over-heated non-stick pans!).
If an endoscope is used to look inside us, we need to be 'pre inflated' using carbon dioxide so the body wall is lifted away, exposing the organs that the clinician is interested in. With birds already pre-inflated with its own air sac system this insufflation is not required making the process far more straightforward.
Birds were basically designed to be scoped!!
Going back to Gus........ he was immediately admitted for X-rays and endoscopy (we always do both to make sure we have a clear air space to safely insert the scope) and what we found were fungal growths or aspergillosis in both the syrinx and air sac system. (see figs.3-5).
Figure 3: Aspergilloma
Whether this was associated with damage from the fire or not the good news was this voice change had actually alerted us to the infection at a point early enough in the proceedings that it was fully amenable to treatment involving a lengthy course of a modern antifungal voriconazole.
Within a month Gus was back to his normal 'talkative' self much to the delight of his devoted owner Ken.
Birds can be tricky patients with their in-built ability to disguise illness as a defence mechanism againstpredators they are however, contrary to popular opinion, excellent 'healers' if given the chance.
Figure 4: Asper at Syrinx
It is generally considered that aspergillosis is an opportunistic disease in birds with some form of immunosuppression occurring at the time of infection e.g. stress, concurrent disease, damage to respiratory tract or malnutrition e.g. hypovitaminosis A associated with sunflower seed or peanut addiction.
A primary infection may, however, occur if the bird is exposed to overwhelming numbers of spores in the environment such as mouldy peanut shells or organic bedding.
For further information on Aspergillosis prevention and its treatment in Parrots please contact your local avian vet. Find your nearest vet here.
What follows is an email sent to Northern Parrots from Gus's owner Ken:
I need to thank you for giving me the peace of mind in finding Avian Veterinary Services (AVS) on your web site for recommended avian vets when I needed emergency treatment for my African Grey last April 2013.
Gus my Grey who is 13 had been having severe breathing problems after a fire at our home in March of last year, he was unable to talk and was very distressed and as a result I immediately went on your web page to seek a vet urgently.
I contacted Carli at AVS and she advised me to get Gus there as soon as possible, it is a two and a half hour journey from my home in North Wales but Richard and Carli had waited for me and they began to assess Gus who was by now critically ill.
Over the next five days using his skill and judgement Richard had diagnosed Aspergillosis and began Gus's intensive care plan.
This month Richard signed Gus off and asked if he could see him in 12 months time, he was so pleased with him and Gus by now knew both Richard and Carli and she spoilt him with one of his favourite treats which was a piece of banana, friends for life!
AVS are not only so very good at what they do but they care which is priceless when your Parrot is very ill, also during my latest visit Richard and Carli gave me a tour of the new practice and the holding cages for birds to reside when their owners are on holiday is amazing.
Such care and devotion was a joy see.
I do hope that these few words go some way to allow me to thank everyone and also may help other bird owners.