Beauty and I would like to share our story with the hope that we might save other parrots and their owners from going through the preventable nightmare of zinc toxicity.
Beauty, a male Eclectus parrot, came to me from a previous owner when he was three years old. He appeared healthy except for an overgrown beak. I took him to a vet in my town that came highly recommended by the owner. He trimmed Beauty's beak, nails and wings and gave him a clean bill of health. A red flag should have gone up when he asked me if Beauty was a male or female -- Eclectus parrots are sexually dimorphic and most vets know that a green Eclectus is a male. I should have hightailed it to Dr. Sheree Everett, a vet who had cared for several of my other animals and who was highly recommended by friends. As with all of the other vets in our area, Sherree is not a Board Certified avian veterinarian. However, she treats exotics including approximately 80 percent of the birds in my area and takes continuing education courses to update her knowledge of exotic birds and their illnesses. I found that she was also very "open minded" and not afraid to seek second opinions from Board Certified Avian Vets and others, including Carolyn Swicegood. Carolyn and I became friendly before Beauty became ill. I met her through her web site, the Land of Vos, which is devoted mainly to Eclectus. Sheree and I conferred with Carolyn throughout our ordeal. She proved to be a constant source of excellent information, encouragement and strength for both of us, but most important, she became a very good friend to Beauty and me.
After a couple of months, Beauty had completely stolen my heart and I decided to take him to Sheree for another beak trim. Sheree insisted on a blood work up -- a CBC & panel. I was not concerned because if she found a reason for concern at that time, she did not tell me. I assumed that she was simply being thorough and she had always established a baseline profile of her new patients. I realized that she was concerned about the abnormal growth rate of Beauty's beak. As it turned out, his liver enzymes and uric acid levels were a bit high, but not alarmingly so. She asked about his diet and I explained that he had come to me on an all-seed diet and that he might have been given apple now and then but nothing else. I had weaned him over to a varied diet of sprouts, fresh, organic fruits and veggies, pasta, rice, whole grain breads, a quality seed mix, meats, eggs, nuts and Zupreem Maintenance pellets. Sheree felt this was a good diet but because of the results of the blood work, she had me to add Roudybush pellets, available only by prescription for birds with liver problems. During the next year, things went very well for us. Beauty maintained a good, steady weight; his beak growth slowed; his droppings were normal; and he looked and acted very healthy.
We continued to visit Sheree every three to four months (instead of every two) for beak trims, and the longer interval between trims led us to believe that the improved diet had helped. A year later we re-tested.
The CBC & panel in June of 2000 revealed that his liver enzymes and uric acid levels were still high, although somewhat lower than the first test. We never thought about testing him for metals. In early August, it became obvious that Beauty was sick when he began sleeping a lot and stopped eating. Sheree was out of town so I was forced to go to a different vet. This veterinarian did a gram stain (with negative results), but he prescribed Baytril for Beauty. The very next day Sheree returned and I took him to see her because the new vet did not know Beauty's history. She did another CBC & panel which now showed very high liver & kidney enzymes as well as a very high uric acid level. Sheree also did Polyoma, Chlamydia and PBFD tests. They all came back negative and it was then that she tested him for zinc. Beauty's zinc levels were 3.9 PPM. At last we had a diagnosis -- zinc poisoning was confirmed.
By this time, Beauty whose normal weight of 425-430 grams, weighed only 329 grams. Sheree began taking him home with her every night and on the weekend to gavage feed him three times daily. I had already started him on an Aloe Detoxifying formula. We were adding calcium because his levels were very low and he was exhibiting the characteristic toe tapping and wing flipping symptoms as well as mutilating his feet.
His next CBC and panel had improved, but not enough. Sheree also took x-rays but saw nothing abnormal. He still was not eating on his own and he grew weaker by the day. We had discussed the use of chelating drugs but were hesitant because of his weakened condition. We were hoping that he would resume eating and gain enough strength to undergo chelation therapy, which in itself can be toxic. Near the end of August, we believed that we were losing him. I started keeping him at home with me all day and transported him three times daily to Sheree's to be fed. I felt at this point that I had brought him home to die. I cannot describe the tender moments that I spent just holding him and humming to him gently, just hoping that if he could feel my heartbeat and my great love for him, he would try harder to get better. I was, in effect, willing him to live but I knew that it would take much more than this. So many friends and acquaintances were praying for Beauty and for me during those dark days I would not -- could not --give up.
On August 30 Sheree and I agreed that we had no choice but to try the chelating* agent, DMSA (Dimercaptosuccinic Acid). We now believed that it might be our only hope since it had become painfully obvious that the end was near. Beauty was on DMSA for three weeks. During this time he was still being force fed, had no energy, and we felt that we were barely keeping him alive.
On September 9 Sheree had to go out of town for two days and I could not crop feed Beauty. We had to take the chance that he would resume eating on his own. HE DID and my heart soared -- hope revisiting once more as his weight climbed to 351 grams! We continued supplementing him with calcium because DMSA robs this vital mineral from their system. On September 19 the DMSA treatments were finished and we re-tested Beauty's zinc level.
The zinc results came back on September 22. The test came in at 1.0 PPM, low normal, and his panel & CBC results were looking much better as well. We were elated until on September 28, he weighed in at a whopping 478 grams and was having trouble breathing. I was filled with anger. I could not believe that after all he had been through he apparently was now suffering side effects of the DMSA treatment. I wondered if this delicate creature could possibly survive yet another serious challenge. How could all the signs indicate that he was getting better, indeed almost back to normal, and then THIS? The emotional roller coaster that I had been on for so long plummeted.
Sheree could hear no congestion but decided to take x-rays to compare with the x-rays taken on August 22 showing clear, normal lungs. The new x-rays revealed that three fourths of both of his lungs were congested. Sheree was not comfortable diagnosing from these pictures so she sought an avian radiologist for a second opinion. As a result of this consultation, Beauty was put on Vibramycin for a period of ten days in hopes of clearing his lungs. There was also a question of whether or not the x-rays were showing tumors. The radiologist felt that an upper GI or ultrasound would be necessary to know for sure. Since Beauty was growing weaker by the day, I made the decision not to put him through this procedure.
On October 3, Beauty weighed 560 grams which seemed to be solid with no apparent water retention. His eating had slowed even more and he was constantly tired. He didn't even fight me when it was time for his meds; he just didn't have the strength. Also, he was losing control of his feet and was not perching or grasping well. He was giving up and all I could think was that we were losing him again. He was under a heat lamp and we added a humidifier so that he could breathe easier as well. We had put up a long, hard fight. My concern now was about the quality of the time that Beauty and I had left together. He wanted to be with me constantly now and when not in my lap, I carried him around in a fanny pack tied around my chest and he slept in a basket between our pillows at night. On October 9, his breathing suddenly improved and his weight began dropping rapidly as we had hoped. Almost as fast as he had gained the excessive weight, he was back to 460 grams. We immediately did another x-ray to check his lungs and his foot because he was not using one foot at all. His leg and ankle were swollen with no apparent cause. The x-ray showed improvement in his lungs although they were not yet 100%. By October 16, Beauty's weight had dropped to 390 grams and when he uttered his first "hello" after three months of silence, tears streamed down my face. He became brighter and more alert; yet he still did not use his foot. Upon examination, Sheree found that his leg had swollen more and that there was a very small lump on his ankle. She removed the lump for testing and found what looked like a tiny grain of white sand which turned out to be a uric acid crystal. Beauty had developed a case of gout. We started him on aspirin and Allopurinol -- brand name Zyloprim, a xanthine oxidase inhibitor used to lower blood levels of uric acid -- on October 20th. His weight was back to 384 grams and he was still bright, alert and talking more, although there was no change in his foot.
On October 30, Beauty was re-tested for zinc. The results came back on November 14 and the reading was 2.4 (normal is .8-2.5 PPM). The reading was in the high normal range but not high enough to begin chelation drugs again. As the vet explained, it is not uncommon for levels to rise after chelation therapy because the metals that were stored in bones and other tissue then leach back into the bloodstream for excretion from the body. This is why blood levels of zinc are re-tested approximately every two months. If levels increased above normal, chelation therapy would once again be needed.
Beauty has been doing well and is almost back to normal with the exception that he does not use the affected foot. He has gout and his blood level of uric acids must be watched on a regular basis to prevent crystals from forming on his kidneys and elsewhere, as in the case of his foot. He will need to be kept on a diet of low purine*** foods and limit his fats and refined carbohydrates. We will resume the Allopurinol treatment if the attacks begin again. He has adapted to life using only one foot and gets around very well. He might regain the use of his foot again and for now, he does scratch his head with it! He is bright, alert, talking well and does lots of beak grinding to confirm his contentment. He is very spoiled but I am extremely cautious about what he eats and about his activities in general. I worry that he doesn't understand that only one foot has some limitations so we watch him even more carefully than before.
Throughout this time we had family, friends, my wonderful vet Dr. Sheree Everett, and Carolyn, a fast friend, standing right beside us. Sheree had practiced in my town for over fifteen years but had never seen a metal poisoning case as serious as Beauty's. She is convinced that Beauty had this illness when he first came to me and that no one had recognized it in prior test results nor in changes in his daily regimen. Because testing for metal toxicity is expensive, it is usually performed only as a last resort when it is difficult to make a diagnosis. Since Beauty came to live with me, he has not been in a metal cage nor had any metal toys or food dishes (I use stainless steel). Since August, Sheree has unfortunately become all too familiar with the telltale signs of metal/zinc poisoning as more birds have been brought to her suffering from it.
Extensive tests must be done if there is even the slightest indication of a metal toxicity problem. If your bird's tests show "above normal" liver and kidney enzymes and uric acid levels, ask for a test for metal toxicity, even if just to rule it out. Many veterinarians, even Avian veterinarians, are just now realizing the magnitude of this problem and the ability of the symptoms to masquerade as "other" problems. Imagine what would have happened if I had simply continued to give Beauty the Baytril in the beginning. More importantly, please, think about your birds' habitat now before it's too late. You do not want to find yourself and your bird going through what Beauty and I have been through, like spending months fighting for your bird's life. Remove dangerous metals. Make your own toys which can be strung with leather, stainless steel wire, or natural tight rope. Dishes should be stainless steel or safe crock wear (plastic or ceramic with a safe glaze). Avoid imported pottery products which can contain toxic metals. Perches are available with stainless steel parts; cage saver washers are available in plastic; and stainless steel "quick links" are now sold everywhere. Cages should be made of stainless steel or safe powder coating with no chips, rust or exposed non-stainless steel metal parts.
We need to find vets who are not afraid to test and find an answer, even if they must seek help to do so. We also need to know our birds, their habits and their signs of illness. As with any prey animal, it is the nature of parrots to hide their illness until it's almost too late to help them. We have taken these beautiful birds out of the wild and in doing so, we have taken on the responsibility of making their environment safe.
As for Beauty and me, we live each day to the fullest and are grateful to those who were there for us. Our Christmas gift came a week early in 2000. Beauty started using his foot again and continues to use it more each day. We sincerely hope our experiences, as related here, might save someone else the heartache and pain of this terrible illness. Most of all, we want to say, "NEVER give up"! Love is an important part of the cure.
As an update to this story. Two years have now passed and Beauty is the picture of health. He is wonderful and we feel so blessed to still be sharing our lives together. Earlier this year we bought him a girl friend named Kava. He really isn't interested in having a girl friend, but she has increased his activity level. He is much more active now than he ever has been which confirms that he was sick from the very beginning. He talks more than ever, and you would never know he's the same bird. He really is our Miracle Boy!
Key to Terms
*The term "chelation" (pronounced "key-lay-shion") is from the Greek for "claw" because this process binds a metallic element to another substance. The chelated minerals, often iron and zinc, are generally bonded to amino acids (the building blocks of protein)
** CBC -- complete blood count, a good, sensitive indicator of a birds' general health.
Panel -- other parameters which are included on a blood chemistry panel, Liver Function, Creatine Phosphokinase, Calcium, Phosphorus, Uric Acid, Glucose and Protein.
***Low Purine Diet -No organ meats, shellfish, fatty fish, red meats & poultry, asparagus, mushrooms, spinach and most legumes or dry beans or peas.
Betsy Hayes