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If you can get the powdered nystatin and mix that with water and put that down for him to drink. For pigeons there is also a product called Medistatin. It's the same as Nystatin, but also in powdered form that gets mixed with water. Works best on an empty crop, so let him drink and wait half an hour before letting him eat. Do the same in the afternoon.
 

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Can you take an earbud and try and see if you can remove the yellow secretion? Is it covering the breathing hole? Don't force it. I'm surprised the vet didn't try and remove it.
 

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Discussion Starter #63 (Edited)
It wasn't covering the breathing hole. It was a very thin line on the side of the beak, like 1 mm wide, even less, film thickness, like a bit of saliva, but with a yellow tint and a bit of dried stuff in the corner of the beak. It would have been a case of wiping it. This vet isn't shy with taking out stuff, he's cleaned my Pepper's beak, which was half necrotic with canker to the point I couldn't watch him doing it anymore. The previous rescue I went with to him had puss in her eye and he just squeezed it out, leaving her eye perfectly clean. I can try it tomorrow, and the nystatin...if he's still alive. He looked so bad when I let him sleep, I'm not sure he will still be with us. God knows I've been waking up to check if he's still alive for 7 weeks now, but this time I'm really not having much to hope on...
Edit: What would be the dosage for Nystatin? You mentioned it but for the liquid. I don't know the concentration of that.
 

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30 000 units per 100 gr birdweight. The powder form must have instructions, ex so many gr equals so many units of Nystatin. You can measure the whole bottle in ml, then you will now the contents in ml. Post a photo when you get it. You can't really overdose on Nystatin, but we can try and work out exactly how to mix.

Just keep him warm for tonight, that's the best to do for now. xx
 

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Discussion Starter #65
Thank you, Marina, I'm relatively decent with math. If the medicine has UI/g in the prospect I'll figure it out. No matter what happens, know that yours and Columbine's support helped me get through these times. I love all my pigeons to bits, but this one won my heart when he picked the peas from my fingers. No other pigeon ever did that.
 

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Here is another link about visible indicators of health in throat and head, it contains more details and pics than the one I posted days ago. Read it carefully and try to compare the mouth/throat of your bird (you checked it yesterday) with the information given in the link.
It could maybe help you, please give it a look.


Have you read the links about yeasts infection that I posted days ago? The vet gave you clortrimazole because he "thinks" that yeasts could be only in the respiratory tract?
Or even in the mouth/throat? From what I know nystatin kills yeasts by killing cell walls of fungi.

I'm praying for your bird and for you.
 

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Discussion Starter #67
I've read that topic but I didn't see the beak so well in depth of throat. I was still holding him so could mostly look from a side.
My vet didn't think from the start it could be a fungal issue, but since everything else failed, I suppose he thought giving it a try won't do more harm. Not like he had another idea about what to do. If anything, I wish he accepted earlier to prescribe an antifungal. At least I'd have known I tried everything.
He's also excluded a viral issue but I'm not so convinced about that either. He says a virus would have cleared by now, but that is not necessarily true, is it? Blue had the pox for almost 2 months.
I'll work up the courage to look in this beak tomorrow, if I still have what to look at. I can't hear him breathing tonight. Usually I could count his breaths just listening to the door.
 

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Discussion Starter #69 (Edited)
This is a video from now: New video by Oana Rusu. He had a coughing fit during the night, but was breathing quite ok this morning- like regular speed and beak almost closed, then at some point after the clortrimazole nebulisation he got like this, and has been so for the past 3 hours. I just decided to try nebulise him with acetylcisteine, to at least try and get him some relief, it's painful to watch. It seems to calm him somewhat. I researched clortrimazole nebulisation on birds, there don't seem to be negative things about it, and it is one of the treatments for aspergillosis.
I wrapped him in a towel and my husband held him while I opened his beak: gotta say I managed a much better job than what I saw on monday. He also didn't struggle for quite a long time while I peered in his mouth. What I saw: there are no secretions visible. It looks clean, except a very small bump on the side of the beak, upper part, that seemed to be slightly discoloured compared to the rest. The bump looked from the same material as the rest of the mouth, not some excrescence, just like a bit of swelling, maybe 1-2 mm in diameter, not symmetrical with the other side. I could not tell much about thew tonsils, as I don't know exactly how they should look like when normal, but they did not seem swollen particularly. Definitely didn't have the puffy rounded yellow look the pictures in the article showed, though they did look fairly prominent - like not flat. What did look "wrong" was the trachea opening, which is round, like widely open. Looked like a dark hole. Fits with him breathing like a locomotive. Colour inside the mouth looked fairly light, I can't tell if discolored or rosy - again, no comparison, definitely not blue. No mucus.

I wasn't comfortable with taking him to those tests, but I gathered the poop from last night in the morning and took it to the lab. They had several kinds of tests, but they said there isn't a lot of point for the indepth one, and not even for the middle kind, recommended me a basic test. They just called me to tell me there was nothing particular in the poop, same as they did on monday. His poops were kinda watery with bits this morning, turned proper towards afternoon. He's active if stimulated, otherwise he just sits and breathes. This morning he preened thoroughly, then went straight to food, and he's eaten after that too.

I don't know if a bronchodilator like acetylcisteine is doing anything to soothe him, or what else I could use instead for pure relief. He does look like less struggling to breath after it. If there is something else, would be great to have an alternative that doesn't appear in studies and not particularly recommended.
Considering all these, should I go along with the nystatine?

Edit: the nebulisation seems to have had minimal effect. It really feels like his lungs can't get enough air in them. I have been recommended nebulisation with F10, and I bought the stuff. Anybody knows about it? There are some articles that say it's one of the treatments for aspergillosis, though effects are not documented, but at least it has not been found to be harmfull.
 

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It won't hurt to give him some Nystatin. I have no experience with nebulisation, so can't give any advice unfortunately.
 

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According to the article, a round trachea opening is a sign of troubling in breathing...

"A bird that is breathing with ease can relax the muscles of the windpipe, making the opening appear narrow and elongated. If the bird is having trouble getting its breath, several mechanisms are available to it to provide more oxygen. One option is to contract the muscles of the windpipe, which will dilate it and give the opening a rounded shape. The healthy pigeon has a glottis (windpipe opening) that is narrow, elongated with sharp edges and with small spicules along the side. The more rounded the glottis, the more distressed the bird. To provide itself with more oxygen the bird can also breathe faster and deeper. This will cause the glottis to move, in the process elevating the tongue tip."


A fairly light color in the mouth (maybe you could give a look at the mouth of one of your other pigeons) could suggest a light anaemia or, as the article mentions, low blood pressure.
If you can find the Omni-vit it contains iron and even vit K. If you wants to try to make dried legumes, lentils are a good source of iron.
I read here


that "Chronic inflammatory or infections disease may also lead to this type of anemia" but they don't mention which infections...

Honestly I don't know anything about nebulisation, I read too that aerosolized antifungal medication is one of the treatment for aspergillosis.
Yesterday I asked if your vet "thinks" that the fungal infection could be only in the respiratory tract or even in the mouth/throat because I think that nystatin could not kill fungi in the respiratory tract.

About the very small bump - is it maybe possible that it appeared because of the vet test in the mouth?
 

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Discussion Starter #72 (Edited)
As sudden as his heavy breathing started this morning, it calmed a little while ago. He's still opening his beak a little, but compared to earlier, it looks almost normal. His behaviour got normal too. I brought him in for the night and he flew up for sleep and started preening. I don't know if the acetylcisteine has a delayed effect or he just calmed on his own. Regardless of what it is, I'm happy he got some kind of respite.

The difficulties breathing are sorely obvious in how he gasps for breath at 60 breaths/minute, and yes, his tongue moves upwards . Today I even thought about an oxygen tank, but not sure where I would get something like that and how would I use it.

I did inquire the vet about nystatin on monday, and his response was that he prefers something that goes straight into the respiratory system instead of passing through the entire system, which is heavy on the liver. I wonder if that gasping could be caused by some effect clortrimazole has on the liver? the articles said the birds treated like this didn't show symptoms of liver or kidney damage. I'm afraid to even hope, but it's at least somewhat good to not read articles with negative effects from a treatment. Here are the two I found:
There is also a paragraph on F10 nebulisation.

PS:I found Super-vit from Versele Laga, not Omni Vit. It has iron but no vit.K.
 

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I know, what the article says about the round shape of the trachea (troubling in breathing) doesn't add anything new 😔...that shape is only another sign of respiratory issues...

I'm going to copy an extract from an article about nystatin:


"How does Nystatin oral suspension work?

Nystatin kills fungi and yeasts by interfering with their cell membranes. It works by binding to a substance called ergosterol, which is an essential component of fungal cell membranes. This disrupts the cell membrane, causing holes to appear in it.
The cell membranes of fungi are vital for their survival. They keep unwanted substances from entering the cells and stop the contents of the cells from leaking out. As nystatin causes holes to appear in the cell membranes, essential constituents of the fungal cells can leak out. This kills the fungi and treats the infection.

Nystatin is not absorbed into the bloodstream, which allows it to act directly in the area of infection.

(...)

▪ For the treatment of mouth and throat infections the suspension should be held in the mouth for as long as possible before swallowing, as this will keep it in contact with the fungi for longer.

▪ Nystatin oral suspension is not absorbed into the bloodstream and so will not be effective for treating fungal infections or disease involving other areas of the body.

Another article :

.


"While nystatin is usually is not normally absorbed, low concentrations may enter the circulation in patients with inflammation and damage to the gastrointestinal tract. Nevertheless, nystatin is considered very safe and is unlikely to cause hepatic injury".

From what I can understand:
  • nystatin would not be useful in case of fungi in respiratory tract;
  • it does not cause liver damage.

I read the first article you posted (will read the other one later). I don't know if it's relevant but I noticed that it says:
"Chronic inflammation may reveal nonregenerative anemia."

Have you tried to check the mouth of one of your other birds?
 

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Discussion Starter #74
I didn't, but they are usually a pain in the behind to give vitamins to, they hold their beaks very resolutely shut. Their natural colour might also influence things, my pigeons are all black or grey. My newest rescue (aside from baby) is a mix of black and white but her beak is actually black. I can try it, but I reckon all it would tell me would be a possible anemia with possible multiple causes, including infections. Would that be useful?
From what you are telling me, nystatin wouldn't really help our respiratory issue and I don't have evidence of a fungal problem in the digestive tract.
He is currently still breathing relatively ok, but with small coughs every now and then. The night is so long now, with dark from 5 PM to 7 AM that I thought I'd give my birds a bit of light around 8 PM to eat. My finches whine about it, and they went to eat immediately, but my pigeons only proceeded in making noise. The baby got off the wardrobe and considered for a bit sleeping on the bedside table but then changed his mind and went back up - and I assumed he's not interested in eating and turned off his light.
I tried to look for how long is the immunosupressive effect of dexamethasone, but no luck. Still looking for alternatives for support treatment of his breathing instead of the acetylcisteine, that I don't even know if it's working.
 

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Surely anemia (if he really is anemic) would not be the key to identify the source of his breathing issues... As you said, anemia could have multiples causes.

What a complicated situation...
 

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Surely anemia (if he really is anemic) would not be the key to identify the source of his breathing issues... As you said, anemia could have multiples causes.

What a complicated situation...
Hi, you are giving your baby a lot of antibiotcs ,dont forget to give probiotics and electrolytes and apple cider vinegar and vitiamins, antibiotcs kill all of the good flora in in the birds gut you need to restore that good flora
 

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Hi,

Dexamethasone is a very powerful corticosteroid and remains in the body longer than most other forms. Tapering the doses should be advisable versus stopping completely. It can cause anemia and weight loss among other side effects. In humans, immunosuppressive effects occur after about two weeks with oral prednisone, but this may happen sooner with dexamethasone.

There may be insufficient studies done on birds regarding dexamethasone, especially with pigeons. And from a cursory search, limited information exists in the literature for humans, but I will have to look harder. Also, dexamethasone remains in the human body for several hours and has a longer biological half-life than methylprednisolone (the active metabolite of prednisone). I suspect it is longer with birds as are most drugs. A tapered dose schedule should be calculated with the biological halflife in mind as well as renal clearance.

Doxycycline can also accumulate in pigeon blood plasma, and dosage should be carefully lowered in long-term treatment regimements. 6-10mg/kg/day is a safe dosage range. 10mg/kg/day for 3-7 days, and 6mg/kg/day for courses longer than that. The only thing is to avoid calcium supplements as doxycycline will chelate and bind around calcium ions. Calcium may be needed afterwards.

Nystatin would be advisable as a nebulised suspension as it can not be systemically absorbed. It has been known to sucessfully treat fungal lung infections such as pulmonary aspergilosis in humans when used in a inhaled suspension with a CPAP device. Nystatin has to be in direct contact to the yeast or fungus, which makes administration difficult in some cases.


I just saw this thread, and have yet to review it in closer detail. Sounds like a very difficult and challenging case. I will try to research dexamethasone a bit further for you.
 

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Have you been able to give liquid vitamin A? As long as the suppliement is formulated for birds and contains vitamin A, vit. E, and vit. D3 it should not cause an imbalance.

N-acetylcysteine (NAC) as a mucolytic and antioxidant agent. It may loosen mucus and increase fluids in the air sacs and typically is used to relieve mucus buildup (asthma) symptoms. Clear fluids in the air sacs may be impossible to see on X-rays unless they are opaque due to an infection or thick with mucus. The popping or clicking sounds while breathing are sure indicators of excess liquid in the air chambers or a nasal mucus/fluid blockage. This being said, a stethoscope will be handy for auscultation to determine if the sounds are indeed being produced in the lower airways versus in the nares.

Silymarin (standardized milk thistle extract) may be given in the water to prevent liver scarring or fibrosis from excess medication. It is safe for pigeons and has a large safety margin for dosing.

Is the enviroment very humid or dry? I ask, as this can affect certain individual birds and exacerbate breathing issues.

And I agree with others, perhaps a second vet's opinion or diagnosis may shed some much needed light here.

I hope he is improving and only gets better soon.
 

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Discussion Starter #79 (Edited)
Thank you very much for the insights Jonrf.
I have been prescribed dexamethasone for another rescue before this one, in conjunction with gentamycin and acetylcisteine, after a 2 weeks round of doxycicline didn't wield any results. Fortunately, that rescue responded very quickly, with symptoms disappearing after the 2nd round (the combo was prescribed nebulised, once every 2 days). We took the treatment to 5 rounds (10 days) as minimal with antibiotics. Unfortunately, after a few weeks (probably 3-4), some symptoms returned in that bird. They do not appear harsh - she breaths normally, beak closed, normal rhythm, but she snores at night and has a slight wheeze occasionally. I'm monitoring her, and considering going back to the doctor, but a combination of lack of time due to caring for the current rescue, which has been harrying, and some doubts about treatments prescribed by my vet have prevented me from taking a decision yet. Meanwhile I'm giving her vitamins.

I researched dexamethasone only after the current rescue started getting worse. He was put on a larger dose - nebulisation daily instead of every 2 days, and was on it for a week. After that, I read about it and got rather scared of the immunosuppressive effects. The vet keeps prescribing it although I shared my concerns with him, but admits it should be given as rare as possible. I did not know about tapering, I've tried to cut it off, but his nasty crises forced me to use it every now and then - i think about 1-2 times per week, though I've had a week or two without any. Last time I used it was 3 days ago, and it didn't look like it had any effect, although I don't know how soon an effect is visible. Same with acetylcisteine, used it last time 2 days ago, minimal difference after it, though he calmed greatly after a couple of hours. It's very hard for me to tell what does something and what not.

3 days ago he was relatively ok in the morning, but a little while later I found him sitting on one wing and breathing deeper and faster. I rushed him in the nebuliser with clortrimazole (was the 1st treatment with it), but after it he got really bad - gasping with beak wide open, standing hunched - I thought that was it. Several hours later he was same - and that's when I decided in a fit of desperation to give him dexa and acetylcisteine. There was some effect but not a lot. Next day, same thing, but only gave him acetylcisteine - same thing. Thing is, when he is gasping it doesn't feel like a wet gasp, more like tachycardia. He did have a wheezing and cough a couple of weeks ago that suggested a blocked nose, but not the current crises - which is why I'm questioning the use of acetylcisteine.

Yesterday I decided to change the tactic. As soon as I saw him starting to breathe harder in the morning, I took him in the balcony quarantine (it's a small enclosed space where he can see my other pigeons, but he can't fly around, as it is basically a shelf) and tilted the window down. I thought maybe the oxygen level gets low in the bedroom with people sleeping in too. Only after his breathing got fairly stable I got him in the nebuliser for the treatment. I missed a few hours yesterday from home, but when I left and when I got back he was breathing relatively ok - as in not normal, but not fast and beak only a little open. Last night, when he went into the usual 4 am crisis, we opened the window and he calmed down. Today he seems fairly stable, I took him in the balcony and will get him the 4th round of Clortrimazole a little later. He should have 3 days of break after today. I don't know if I can say he is better, he's better than he was this week, more like he was a couple of weeks ago. Just checked him and he's got his beak closed now. I'm thinking if it wouldn't be a good idea to let him sleep in the balcony - I'm just concerned of not being able to hear him at night when he goes into a fit, and also thinking if moving him from his familiar spot would stress him. We have a heater in the balcony during the night, 3 of my pigeons sleep there.

About your question about vitamin A, yes, I have been giving him vitamin A+D3 in the water since saturday. Gave him 3 days (3-5 days recommended on the bottle), then a day with ACV, one with vitamins for the rest of the week. I also gave him a multivitamin pill every 3 days - I have something with vitamins, trace minerals, prebiotics and electrolytes. Yesterday I mixed some fresh spinach and carrot shredded in a bowl with seed to make them more appealing but not sure how much interest he took in them. I saw him roaming in it, but don't know if he only picked on the seed. I wonder if mixing the seed with some spinach and carrot juice would help?

Edit: the environment now is fairly humid - it's been foggy recently outside, but not excessively I'd say. We keep @ 22-23 degrees Celsius in the apartment. As for a second vet, my bets bet was the university people, but I didn't get the feeling they are particularly experienced with birds. Other vets I tried in the past flat out refused to see pigeons or admitted they only learn some stuff bout poultry in school and they don't know much above giving broad spectrum antibiotics. I met my current vet years ago at the university, he was there for his Phd, and I got sent to him by somebody from the Romanian Birds Association when I found an injured stork on the side of the road.

Thank you for the sylimarin info - I have bought some and I'll put some in his water if you say it's safe.
As for doxycicline, I had a lot of mixed info about the dosage, started him on 4 mg/day (he is 250 grams), then was told the dose is too low and I raised to 6 mg for the 2nd week. I'm fairly sure I caused aspiration one day when he jerked and the syringe slipped outwards as I was pushing the liquid out. Some people told me to give even higher doses but after consulting with my vet, I stayed at 6 mg. Unfortunately, because the vitamins I have say they contain minerals, I stopped giving them to him during the 2nd week of doxycicline. I resumed after.
 

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You're welcome. It is very late here, so I appologize that my reply must be quick. I will reply in greater detail tomorrow after doing some research. It could very well be that your pigeon may need extra or supplemental oxygen. Also, it may need a slightly drier environment. Perhaps try to limit acetylcystine and replace with albuterol or salmeterol nebulization per a vet's consultation, as I fear the acetylcystine may increase fluid buildup in the air sacs, especially with high air humidity. The air sacs may take time to heal.

There could be scarring or fibrosis in the tissue. Sounds very similar to COPD and pneumonia patients. In COPD and asthmatic patients, there is an imbalance in their mucus consistency and production and oftentimes is accompanied with an inflammation or proinflammitory process involving an overactive immune system response. In such cases, immunosuppressing drugs are actually beneficial to alleviate the inflammation by decreasing proinflammatory cytokines, thus limiting neutrophil or macrophage activation (and attack) and mitigating further tissue damage. That is, if there is no active infection or other causes like allergic reactions.
 
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