Trich, Abscess, Pox and/or Something Else ??

[TAWhatley]

Hi All,

My friend, Anita, brought me an Egyptian Goose last night that she
had been keeping an eye on at Tri-City Park after she noticed some
kind of abnormality in the mouth. When I saw (and smelled) the bird,
my first thought was trich but then got a look at the underside of the
lower beak .. now I'm not sure what this is. Any suggestions/advice
will be most welcome.

http://www.rims.net/2006Feb06

The first picture is of the underside of the lower bill and the others are
the trich looking growths/swelling.

Terry

[Reti]

Terry, could it be trich + something else?
E.coli also tends to smell.
I would give Metronidazol anyway maybe with Baytril. Or, give Metro and see how it goes for a couple of days.

Reti

[TAWhatley]

Thanks, Reti. Anita is looking after this bird, and we did start her on Spartrix last night ..

Someone on another list mentioned that perhaps a burn caused this.

Terry

[feralpigeon]

Terry, this is a bit like a classroom learning experience, poor bird. I don't know if it looks this way close up, but inside on the tongue it looks a bit fuzzy or hairy some of the growth. I'm wondering if there is a combo of things going on as well. The fuzzy/hairy stuff makes me think of thrush, and so also worms/parasites. And of course Trich comes to mind. What ever it is, there are probably layers to what's going on.

fp

[Pidgey]

If it stays mostly dry on the underneath side then I don't imagine that trichomonads would survive in it. Remember that the real problem with trichomoniasis isn't the trichomonads, but the immune system's over-response to them.

This looks like there's enough tissue destruction that the lower mandible is in pretty bad shape. If it were me, I'd do a bunch of labwork to try and identify the causative agents but you might even need a pathologist for this one as it may have turned cancerous. There could be everything from a burn (thermal or chemical) to Knemidokoptes (or some other burrowing parasite) to viral to bacterial to...

Tests, need tests, lots of tests. You should probably paint it with Betadine and other topicals in the interim, though, as there's no doubt some kind of infection that's not doing any good.

Pidgey

[TAWhatley]

Originally Posted by feralpigeon

inside on the tongue it looks a bit fuzzy or hairy some of the growth. I'm wondering if there is a combo of things going on as well. The fuzzy/hairy stuff makes me think of thrush, and so also worms/parasites. And of course Trich comes to mind. What ever it is, there are probably layers to what's going on.

fp

Hi fp,

My rehabber friend thought candidiasis was a possibility also. I think what you are seeing as the fuzzy/hairy things are actually the serrations of the beak. On that one side the serrations are hugely puffed up, bleed easily, and look like there are trich growths on top.

Terry

[TAWhatley]

Originally Posted by Pidgey

Tests, need tests, lots of tests. You should probably paint it with Betadine and other topicals in the interim, though, as there's no doubt some kind of infection that's not doing any good.

Pidgey

Thanks Pidgey. Sounds like this bird needs to get to Dr. Levine (avian specialist) ASAP. I will advise Anita to paint the underside of the beak with Betadine also.

Terry

[Pidgey]

My first thought was: you need a pathologist... NOW!!!

Somehow, my fingers just didn't type that. I'd try to run a few cultures as well as just snapshot-ing a simple smear for a Gram stain. I don't personally have Diff-Quik...

(you'd see the budding hyphae of candidiasis with that one as shown here:

http://helios.bto.ed.ac.uk/bto/microbes/yeast.htm )

...but I'd want to do that, too. I suppose I'd do all that to try and confirm a bacterial infection so that I could start dosing the bird from the inside with an appropriate antibiotic if necessary.

Other considerations would be to debride the outside and get a hydroactive dressing on it as the debris may harbor enough infection as to not be effectively treatable from either the inside (with antibiotics) or the outside (with topicals).

It does look like it's been there for awhile and it's certainly not healing worth a flip. Oh, and the other thing to do would be to examine some scrapings under low power (40X) to see if there are any parasites.

Pidgey

[TAWhatley]

Thanks again, Pidgey. Am getting the ball rolling on this end .. complicated a bit by the fact that Anita has the bird and I don't. Am getting some interesting responses from other lists/boards that I will post about in a bit.

Terry

[TAWhatley]

The Egyptian was seen by Dr. Levine this afternoon. He took a biopsy sample and started the bird on Itraconazole in case of a fungal infection. He felt the problem was either a tumor, pox, or a fungal infection and advised that in the case of a tumor or pox that the prognosis was poor and if it was fungal the prognosis was guarded.

So, we will hope for good news from the lab and do our best for the bird.

Terry

[Pidgey]

I kinda' thought it would be that bad although I don't see why the prognosis would be poor if it's pox although that'd be just about the worst looking single spot of pox imaginable. If memory serves, though, there is a pox strain that's carcinogenic. We're really worried that it's eating into the structural part of the mandible whatever it is, aren't we?

Pidgey

[TAWhatley]

Originally Posted by Pidgey

We're really worried that it's eating into the structural part of the mandible whatever it is, aren't we?

Pidgey

Yep .. that's about the bottom line without more information at this point.

This is an especially difficult case for me because my dear friend, Anita, has been wanting to learn about rehab .. she's already an accomplished rescuer. She begged to be allowed to care for this bird, and I'm very sorry that I said yes to her .. not because she's not capable, but just because this is a very, very difficult case to start out with. Still .. Anita is a trooper, and she will see that all protocols are followed, and she will watch this bird like a little human hawk (Anita is about 5' tall and weighs about 85-90 pounds .. tiny little human piece of 100% love for birds and animals).

Terry

[Pidgey]

Better not let her get too close to Butchie Boy then--he could down her in one gulp!

Did you ask the doc about debriding it and then covering with a hydroactive dressing? Sometimes it's best to shoot first and ask questions later. That's the real trouble here, there's a finite amount of time until it gets the mandible and you feel like you need to head it off at the pass. I'd have done the microscope part of the lab with the bird sitting on my lap.

Pidgey

[feralpigeon]

Originally Posted by TAWhatley

The Egyptian was seen by Dr. Levine this afternoon. He took a biopsy sample and started the bird on Itraconazole in case of a fungal infection. He felt the problem was either a tumor, pox, or a fungal infection and advised that in the case of a tumor or pox that the prognosis was poor and if it was fungal the prognosis was guarded.

So, we will hope for good news from the lab and do our best for the bird.

Terry

Well, whichever, it's got a way head start on everyone. Did the doctor recommend anything topically at all?

fp

[TAWhatley]

Originally Posted by Pidgey

Did you ask the doc about debriding it and then covering with a hydroactive dressing? Sometimes it's best to shoot first and ask questions later. That's the real trouble here, there's a finite amount of time until it gets the mandible and you feel like you need to head it off at the pass. I'd have done the microscope part of the lab with the bird sitting on my lap.

Pidgey

Yes, we asked about debriding and were told not to at this point. Even the gentlest touching of the right side or under side of the lower beak causes lots of bleeding.

The vet did do a quick microscope check himself and found nothing that he recognized as a causitive agent.

Terry