Lead and Zinc Intoxication in Companion Birds (Parrot Metal Poisoning Treatments)

Here is a personal story:

Both Beauty and I would like to tell our story in the hope that it would prevent future parrots and the people who care for them from having to suffer through the traumatic experience of zinc toxicity, which can be avoided.

When he was three years old, Beauty, a male Eclectus parrot, came to me from a prior owner who had owned him before. He seemed to be in good health, other than his oversized beak. I took him to a local veterinarian who came highly recommended by the proprietor of the business. He gave Beauty a clean bill of health after performing routine maintenance on his beak, nails, and wings. When he asked me if Beauty was a male or female, I should have known something was wrong because Eclectus parrots exhibit sexual dimorphism, and most veterinarians are aware that a green Eclectus is a male. However, I failed to recognize the warning signs. I should have made a beeline for Dr. Sheree Everett, a veterinarian who had treated a number of my other pets and who came extremely highly recommended by a number of my close friends. Sherree is not a Board Certified avian veterinarian, just like all of the other veterinarians in our area, who treat birds of prey. Nevertheless, she treats exotics, which account for around eighty percent of the birds in my region, and she participates in ongoing education classes to expand her understanding of exotic birds and the ailments that affect them. I found that she had an extremely “open mind” and was not hesitant to seek the advice of other people, including Board Certified Avian Vets and others, such as Carolyn Swicegood. Before Beauty got sick, I got to know Carolyn, and we became friends. I was introduced to her through the website she runs called the Land of Vos, which is primarily focused on Eclectus. Throughout the struggle, Sheree and I consulted with Carolyn on a regular basis. She not only became a very dear friend to Beauty and me, but she also proved to be a continual source of fantastic information, encouragement, and strength for both of us.

After some time had passed and Beauty had thoroughly won my heart over, I made the decision to take him back to Sheree so that she could give him another beak trim. Sheree insisted on having a complete blood count and a panel of blood tests done. Because she did not inform me of any cause for concern that she may have discovered at the time, I did not feel concerned about the situation. My assumption was that she was merely being thorough and that she always began her relationship with a new patient by establishing a baseline profile. It dawned on me that she was concerned about the extraordinary growth rate of Beauty’s beak, which she saw had been occurring for some time. His liver enzymes and uric acid levels turned out to be somewhat elevated, although they were not at an alarmingly high level. She inquired about his nutrition, and I informed her that when he arrived at my office, he was eating just seeds, with the exception of the occasional apple. Aside from that, his diet consisted entirely of seeds. I weaned him off of his previous diet and transitioned him to one that included sprouts, fresh, organic fruits and vegetables, pasta, rice, whole grain bread, a premium seed mix, meats, eggs, nuts, and Zupreem Maintenance pellets as part of his daily intake. Sheree believed that this was a healthy diet for the bird; but, in light of the results of the blood test, she instructed me to supplement the diet with Roudybush pellets, which are not sold over the counter and are reserved only for birds suffering from liver conditions. During the course of the following year, we experienced a great deal of success. In addition to keeping a healthy and stable weight, Beauty’s beak growth slowed down, his droppings were normal, and he seemed and behaved in a very healthy manner.

We continued to see Sheree for beak trimmings every three to four months (instead of every two), and the extended intervals between visits led us to conclude that the improved diet had been helpful. We repeated the test once more a year later.

His complete blood count and panel in June of 2000 showed that the levels of liver enzymes and uric acid have remained elevated, but to a lesser extent than they were in the initial test. We did not consider putting him through a metals screening. The fact that Beauty started sleeping a lot and stopped eating at the beginning of August made it abundantly clear that he was ill. Because Sheree was out of town, I had no choice but to visit another veterinarian. However, despite the negative results of the gram stain that this veterinarian performed, he recommended Baytril for Beauty. Because the new veterinarian was unfamiliar with Beauty’s past, I took him to see Sheree the very next day after she got back from her trip. She underwent a second CBC and panel, which revealed extremely elevated levels of liver and renal enzymes, in addition to an extremely elevated uric acid level. In addition, Sheree was tested for chlamydia, polyoma, and PBFD. After the results of all of those tests came back negative, she decided to test him for zinc. Beauty’s zinc levels were 3.9 PPM. At long last, we got a diagnosis; tests revealed that the patient had zinc poisoning.

At this point, Beauty weighed only 329 grams, which is significantly less than her regular weight of 425-430 grams. Sheree started giving him gavage feeding three times a day, which required her to bring him home with her every night and on the weekends. I had already begun giving him a detoxifying solution made from aloe vera. We were giving him additional calcium because his calcium levels were so low, that he was exhibiting the classic symptoms of mutilating his feet and tapping his toes, as well as flipping his wings and tapping his toenails.

His subsequent CBC and panel had shown some signs of improvement, but not quite enough. Sheree had x-rays done as well, but she did not find anything wrong. He was unable to eat on his own and continued to lose strength with each passing day. We had considered the possibility of using chelating medicines, but because of his fragile condition, we were hesitant to do so. We had high hopes that he would start eating again and recover enough strength to be able to endure chelation therapy, which can be hazardous to one’s health on its own. We began to fear that we would never see him again towards the end of August. I started taking him to Sheree’s three times a day to have her feed him, even though I was keeping him at home with me during the day. At this time, I had the feeling that I had just brought him home to pass away. I am unable to adequately convey the sweet moments that I spent simply holding him and singing softly to him, just hoping that if he could feel my heartbeat and the tremendous amount of love that I have for him, he might make more of an effort to get better. In a sense, I was hoping against hope that he would pull through, but I also realized that there was a lot more work to be done. During those difficult times, so many of my close friends and acquaintances were praying for Beauty and for me. Nevertheless, I would not and could not give up.

On the 30th of August, Sheree and I came to the conclusion that the only option we had was to test out the chelating agent DMSA (Dimercaptosuccinic Acid). After it had become brutally evident that the end was drawing near, we began to believe that this was our last, best chance of survival. DMSA was given to Beauty for a total of three weeks. During this time, he was still being force-fed, had little energy, and we felt that we were barely keeping him alive. During this time, he also had no appetite.

Because Sheree had commitments out of town beginning on September 9, I was unable to crop feed Beauty at that time. It was necessary for us to take the risk that he would start eating on his own again. HE DID, and it sent my heart soaring — optimism resurfacing for a second time as his weight climbed to 351 grams. We continued to give him calcium supplements when we discovered that DMSA depletes a person’s system of this essential mineral. On September 19, when Beauty’s DMSA treatments were completed, she underwent a second round of testing to determine her current zinc levels.

The findings regarding zinc were finalized on September 22. The outcome of the test was 1.0 PPM, which is considered to be low normal, and his panel and CBC results were also looking much better. We were overjoyed until the 28th of September when he hit an astounding 478 grams and started having problems breathing as a result of his size. I felt rage rising up inside of me. After everything that he had been through, I found it impossible to believe that he was obviously now suffering from the side effects of the DMSA treatment. I couldn’t help but wonder if something as fragile as this could possibly prevail over yet another formidable obstacle. How is it possible that all of the indicators pointed to his getting better, and that he was almost back to normal, and then THIS happened? My long-lasting ride on an emotional roller coaster came to an abrupt and precipitous end.

Sheree was unable to detect any congestion in her lungs, but she still opted to have x-rays to compare with the ones she had gotten on August 22 that showed clear normal lungs. The most recent x-rays that he had taken showed that he had congestion in three-fourths of both of his lungs. Because Sheree did not feel confident making a diagnosis based on these images, she decided to consult an avian radiologist for a second opinion. As a direct consequence of this appointment, Beauty was prescribed Vibramycin to take orally for a period of ten days in the expectation that it would cleanse his lungs. There was also the matter of whether or not the x-rays were indicating the presence of malignancies. The radiologist was of the opinion that an upper GI or ultrasound would be required to obtain definitive answers. I came to the conclusion that it would be best not to subject Beauty to this treatment given that he was declining in health with each passing day.

On October 3rd, Beauty weighed 560 grams and appeared to have minimal water retention based on her weight. Even less food was going into his mouth each time, and he was exhausted all the time. Because he lacked the strength to do so, he refrained from fighting me when it was time for him to take his medication. In addition to this, he seemed to be losing control of his feet and was having trouble perching or grabbing. He was giving up, and the only thing that came to mind was that we were going to lose him once more. He was sitting in front of a heat lamp, and we also put a humidifier in the room so that he would have an easier time breathing. We had put up a protracted and arduous struggle. My primary preoccupation at this juncture was with the nature of the time that Beauty and I still had together. Now that he was used to me, he wanted to be with me all the time. When he wasn’t sitting in my lap, I carried him around in a fanny pack that was strapped around my chest. At night, he slept in a basket in between our pillows. On October 9, he saw a significant improvement in his breathing, and, as we had hoped, his weight started falling rapidly. He had lost the excess weight almost as quickly as he had gained it, and his current weight is 460 grams. Because he was only using one foot, an additional x-ray was taken of his lungs and foot right away. We saw that he was only using one foot. His leg and ankle were enlarged, but it was unclear what caused the condition. Even though his lungs were not fully recovered, the x-ray revealed that he had made significant progress. By the 16th of October, Beauty’s weight had decreased to 390 grams, and when he murmured his first “hello” after three months of stillness, tears flowed down my cheeks. Beauty had been silent for the previous three months. He became brighter and more aware, but he did not move his foot at any point during the conversation. During the examination, Sheree discovered that his leg had become more swollen and that there was a very small bump on his ankle. She also noticed that he had an infection. She removed the lump in order to get it examined, and inside she discovered what appeared to be a single grain of white sand but was actually a uric acid crystal. It was discovered that Beauty was suffering from gout. On October 20th, we began treating him with aspirin as well as Allopurinol, which is sold under the trade name Zyloprim and is a xanthine oxidase inhibitor that is intended to reduce the amount of uric acid in the blood. Even though there was no change in his foot, his weight had returned to its previous level of 384 grams, and he continued to be bright, attentive and spoke more.

The first zinc test for Beauty was repeated on October 30. On November 14 we received the findings, and the reading turned out to be 2.4. (normal is .8-2.5 PPM). Although the result was within the high normal range, it was not high enough to warrant restarting the chelation medicines. After chelation therapy, it is not uncommon for levels to rise. The veterinarian said that this is because the metals that were held in bones and other tissue subsequently leak back into the bloodstream in order to be excreted from the body. Because of this, the amount of zinc in a person’s blood is measured again approximately every two months. In the event that levels rose above the usual range, chelation therapy would be required once more.

Beauty has been recovering well and is almost completely back to normal, with the notable exception that he is avoiding using the foot that was injured. Because he suffers from gout, it is imperative that his blood level of uric acids be monitored on a daily basis in order to forestall the formation of crystals on his kidneys and in other areas, such as his foot. It will be necessary to maintain him on a diet consisting of foods low in purine and to restrict the number of fats and refined carbs that he consumes. If the attacks do start up again, we will begin administering the allopurinol treatment once more. He has adjusted quite well to living with only one foot and has no trouble getting around. It is possible for him to regain the use of his foot in the future, but in the meanwhile, he scratches his head with it. He appears bright and awake, does a good job of communicating, and grinds his beak frequently, which serves as evidence of his happiness. Even though he is incredibly pampered, I still monitor everything he does, from the food he consumes to the activities he participates in. We are keeping a closer eye on him than we were before because I am concerned that he does not comprehend that having only one-foot results in some restrictions.

During this entire ordeal, we were supported by members of our family and friends, as well as by my extraordinary veterinarian, Dr. Sheree Everett, and by Carolyn, a close friend. Although Sheree had been practicing medicine in my town for more than fifteen years, she had never encountered a case of metal poisoning as severe as Beauty’s before. She is certain that Beauty already had this sickness when he first came to me, but that no one had identified it based on the results of his previous tests or the adjustments that were made to his regular routine. Since testing for metal poisoning is quite pricey, it is often only carried out as a last resort when there is significant uncertainty regarding the diagnosis. Since Beauty first moved in with me, he has never been confined in a metal crate and has never had any metal playthings or eating utensils (I use stainless steel). Since August, more birds that are suffering from metal and zinc poisoning have been brought to Sheree, and regrettably, this has caused her to become all too familiar with the unmistakable indicators of this condition.

If there is even the tiniest hint that there might be a problem with metal poisoning, then further testing needs to be done. If the results of the tests performed on your bird show that the levels of liver and renal enzymes as well as uric acid are “above normal,” you should request a test for metal toxicity, even if only to rule it out. It has only just dawned on a great number of veterinarians, including those who specialize in the treatment of birds, how serious this issue is, as well as how its symptoms can be easily confused with those of “other” conditions. Just try to imagine what might have transpired if I had simply kept administering the Baytril when it was first prescribed to Beauty. More importantly, please consider the habitat of your birds right now, before it is too late to do anything about it. You do not want to find yourself and your bird going through what Beauty and I have gone through, such as spending months battling for the life of your bird. This is something you do not want to find yourself doing with your bird. Remove hazardous metals. You can create your own toys by stringing materials such as leather, stainless steel wire, or natural tight rope together. The dinnerware ought to be made of stainless steel or be hard to wear (plastic or ceramic with a safe glaze). Steer clear of imported pottery products, as they might contain harmful metals. Cage saver washers can be purchased in either plastic or stainless steel, and perches can now be purchased with stainless steel hardware components. Stainless steel “Quick links” are also widely available. Cages should be constructed of stainless steel or have a safe powder coating, and they shouldn’t have any chips, corrosion, or exposed metal sections that aren’t made of stainless steel.

We need to locate veterinarians who are not afraid to test and investigate in order to find a solution, even if doing so requires them to ask for assistance. In addition to this, we need to be familiar with our birds’ behaviors as well as the symptoms they exhibit when they are sick. It is in the nature of parrots to disguise their disease until it is practically impossible to treat them, just as it is in the nature of any other prey species. Because we have removed these stunning birds from their natural habitat, we are now responsible for ensuring that it is suitable for them to live in.

As for Beauty and I, we try to enjoy every moment to the utmost and express our gratitude to those who have supported us throughout the years. In the year 2000, our Christmas gift arrived a week before the holiday. Beauty has resumed utilizing his foot and is doing it even more frequently with each passing day. We have a deep and honest hope that by sharing our stories, other people would be spared the anguish and suffering caused by this horrible disease. First and foremost, we want to encourage you to “NEVER GIVE UP”! Love is an essential component of the treatment.

As a further development of this narrative. After a period of two years, it is now clear that Beauty is in pristine physical condition. He is fantastic, and we consider ourselves extremely fortunate to be able to continue living our lives together. At the beginning of this year, we gave him a girlfriend that we named Kava. She has inspired him to get more exercise, despite the fact that he is not very interested in having a female companion. He has never been as active as he is right now, which is evidence that he has been sick right from the start of his illness. He chatters more than he ever has, and if you didn’t know better, you’d never guess that he’s the same bird. He truly is our own Boy Miracle!

A Glossary of Terms

Chelation is a process that binds a metallic element to another substance. The word “chelation,” which can be pronounced “key-lay-shion,” comes from the Greek word for “claw.” In most cases, the chelated minerals, which typically consist of iron and zinc, are linked to amino acids (the building blocks of protein)

** CBC stands for total blood count and is an excellent and sensitive measure of the overall health of a bird.

Panel — additional factors that are included in a blood chemistry panel, such as liver function, creatine phosphokinase, calcium, phosphorus, uric acid, glucose, and protein. Panels are performed on blood samples.

***Dietary Requirements for a Low Purine Level: Avoid Consuming the Following: Organ Meats, Shellfish, Fatty Fish, Red Meats and Poultry, Asparagus, Mushrooms, Spinach, and the Majority of Legumes, Dry Beans, and Peas