foot/leg paralysis in lovebird - more info sought
For the past 3-4 days, my 16 year old pf lovebird has been seeing a critical care vet who specializes in exotics. Although my bird is in critical condition, this question is not an emergency, as his medical needs are being met...rather, I'm looking for additional opinions and more info to better understand the physiology of the problem. I'm also wanting to know if you have seen this before, what the primary causes are, and if anything more can be done.
5 days ago, my lovebird vomited in the am and his ureates were green with slightly watery stool. I knew this was probably trouble. He was fluffed up, eyes closed. It was July 4th (holiday) and we had just moved to this state 1 week prior - I hadn't yet found a new vet. I held him on a low heating pad for a couple hours. He perked up - back to his normal self (eating, drinking, flying all over, vocalizing, etc) but stool still watery w/ green ureates. I kept a close eye on him all day and researched vets. By next morning, stool hadn't changed so I brought him to an ER/critical care clinic. He stayed for 24 hours, got sub-Q fluids, incubator, antibiotics injection, extensive bloodwork, and Xrays. Vomited once after receiving initial sub Q fluids upon arrival. Weight was 44g - a little low, he's usually 46 - 48g.
Bloodwork was normal. XRays showed a mass/swelling in abdomen...on, or pushing on, the liver. So liver is enlarged, or looks enlarged from pressure. Xrays did not show any lead or zinc paticles (we live in an old home so the vet was suspecting lead ingestion). Other than Xray results and initial vomiting, he acted normal -eating drinking, etc. I was instructed to pick him up 24 hours later. He came out of the incubator and flew to my shoulder, peeped, ate, climbed all over his travel cage, hung upside down, etc. He looked great.
But...as I waited in the lobby 15-20 min for my bill and a prescription to be prepared, I noticed that he seemed "slow" to use his left foot. It was as if he had to be very deliberate about placing his foot and wrapping his toes around his perch. But once perched, he was fine - could walk back and forth, etc.
Over the next 10 minutes it seemed to be getting more frequent. I thought maybe he strained his foot.
I left the clinic. On the ride home, within about 5 minutes, he would no longer use his foot, and held it up in a fist. Within another 5 minutes it hung limp and twisted at his side. I assumed neuro. I called the vet and turned around. by the time she saw him (15 minutes later?) both feet were paralyzed. Back into the incubator he went and he received 0.015mL lactulose mixed with milk thistle.
He has now been at home for about 36 hours. No change in the paralysis. Other than the paralysis and limitations it causes (e.g. he can't drink by himself, sometimes needs help eating, etc) he is the same perky, outgoing bird, albeit tired and frustrated.
The critical care vet feels it is the liver or the mass/swelling pushing on a nerve causing the paralysis.
Here are my questions...
1. Have you seen this diagnosis before?
2. What are potential outcomes/prognosis?
3. Does it seem normal that paralysis would have such a sudden and severe on set?
4. What is the physiology behind such fast paralysis?
5. Assuming the mass isn't going away, what is the prognosis for reducing the swelling?
6. What if anything can be done to help with or alleviate the paralysis?
any other thoughts or info you might provide would be greatly appreciated.