Recurrent diarrhea/polyuria in cockatiel

by Melissa
(Burlington, Iowa)

We have a 7 y.o. male cockatiel, with a history of liver damage. We have treated this with diet (pellets), milk thistle, and lactulose. He has had recurrent diarrhea, with green coloration, which usually has been treated with metronidazole, and avian specific probiotics (initially there had been clostridium seen in his stool, however the vet hasn't seen any for some time, but is at a loss as to what is causing this).

Recently, his stools had become loose (honestly hard to tell if it is strictly diarrhea, there had been polyuria as well) and green again, had a couple of episodes of vomiting, and had become less active. He was started on metronidazole again, nothing improved, and had one day of serious vomiting, 5 days into treatment(at least 6-8 epidsodes). He was switched to Baytril and nystatin, the vomiting resolved, but we have not seen an improvement in his stool. Sometimes it appears to be diarrhea, but other times there is no doubt that there is polyuria. His activity level has increased somewhat, but he is not back to normal. He had lost 6 grams following the episode of vomiting, but has been eating good, and his weight has increased by 2-3 grams. Initially it appeared as if he was drinking more, but that seems to be lessening.

I have included pictures of what his stool typically looks like in the morning. Usually over the course of the day, this will improve, but lately, we aren't seeing much of any improvement.

We are working with two veterinarians who have dealt with birds, but I don't believe they have received formal training. Unfortunately, there is not a veterinarian in this area that has received much training in avian medicine that I have been able to find. So basically, I am looking for some advice on a course of action. Should we be looking in any specific direction, having any certain tests/blood work done?

Thank you for your help