# canker or yeast?



## jenfer (Jan 7, 2008)

Hi all,

In the absense of microscope confirmation, does anyone have any ideas about how to distinguish canker from a yeast infection? 

I have a new patient who has a mass in the throat that looks like canker. However, there is no odor and she has been vomiting. She apparently had been able to eat some seeds because there were some in her crop when I picked her up, along with some solid droppings, but I've been tube feeding because seeds tend to back up in her mouth. 

She's vomited formula twice now, but also apparently has kept some down because there are enough solid droppings to account for it.

I'm giving her both Spartrix and Nystatin orally. If there's yeast in the mouth, will swabbing with Nystatin be enough to combat it?

Thanks,
Jennifer


----------



## Pidgey (May 20, 2005)

Add Baytril and you'll just about have it all covered.

Pidgey


----------



## jenfer (Jan 7, 2008)

Pidgey,

I've been meaning to ask--the 10% Baytril, is that the med that you use the insulin syringe minus the needle to dose? It ends up being such a small amount. Do you shoot it down the throat, or would it be equally absorbed on the tongue?

Jennifer


----------



## Guest (Aug 2, 2008)

Jennifer,
There are two categories of canker. One is called wet canker and the other is called chronic canker. The wet canker is acute and produces a great deal of fluid that causes the bad odor. In chronic canker, there is no fluid and no odor.

In yeast infections, there can be whitish deposits in the mouth but they can be wiped off with a cotton swab. The source of the yeast infection is coming from far deeper, in the gut. For that reason, I would syringe 1cc of Nystatin down twice a day.

Your bird has a case of chronic canker. The dose with Spartrix is one pill a day for 5 days. There is usually a preexisting condition for canker to rise to infection levels and it's usually an aerobic type bacterial infection. It can also be anything else including a yeast infection. There are always trichomonads in a pigeon's system but for there to develop a full scale infection, something else had to bring the bird down. That is why I do not believe that using Flagyl is sufficient to treat for canker. It is a drug only used for aneorobic bacteria but doesn't hit any of the aerobic bacterial infections that may have caused the canker to rise to infection levels. Use the Baytril.

Your bird is throwing up because of any number of reasons. One is severe dehydration. Another is bacterial and/or yeast infection. A third may be that there is canker in the crop. I would not use a liquid diet on a bird that is throwing up because the fluid can easily aspirate the bird. I also would not use seed because it's difficult to digest and even get by the mass you feel. They can get stuck high up and start to decay causing more problems.

I use Purina Puppy Chow, an easier food to digest, and a cotton swab. I throw the chow pieces into tepid water, not to turn them into a mush but just to get them wet and then put one piece into the mouth on the opposite side of where the mass seems to be. Using the cotton swab, I push the piece of Chow passed the mass. (Of course, it's dangerous to go too deep with the swab and very important to stay away from that mass.) A little push past the mass should be sufficient for the Chow to go all the way down. (Sometimes, one piece of Chow is needed to push the earlier piece down.)

If you get the bird through this episode, it's very important that you keep her at least three weeks after the canker is gone. It takes that long for the mucous membranes covering the tissue, reforms completely or else any opportunistic infection coming along, can burrow into the unprotected tissues.


----------



## jenfer (Jan 7, 2008)

Fred,

That's very interesting. I had not heard of chronic canker before. The mass is solid rather than just a film that can be wiped away, so based on that, I guess there's no yeast in the mouth.

I've been told that birds can get a bacterial infection secondary to canker, but from what you're describing, it sounds like it's the other way around.

On the vomiting, I had the thought that it might be because I was feeding too big a volume. Fed a small amount this morning, and she's kept it down so far. I don't have the sense she is dehydrated, but I could be wrong. Her poops at least are very moist.

How much Puppy Chow do you feed in one go?

Thanks,
Jennifer


----------



## feralpigeon (Feb 14, 2005)

Great post pigeonperson.

fp


----------



## Pidgey (May 20, 2005)

jenfer said:


> Pidgey,
> 
> I've been meaning to ask--the 10% Baytril, is that the med that you use the insulin syringe minus the needle to dose? It ends up being such a small amount. Do you shoot it down the throat, or would it be equally absorbed on the tongue?
> 
> Jennifer


Yep, on the syringe. I just shoot it down the throat and it works fine. In reality, it doesn't really "shoot" out, it's more of a drip.

Pidgey


----------



## Guest (Aug 2, 2008)

fp, thank you very much.

Jennifer, if a bird is tending to throw up, it's also throwing up the medication so whenever you encounter this kind of situation, it's best to medicate on an empty crop and wait at least one hour before feeding anything. During that hour, if you can safely get some hydrating solution down into the crop, it would go a long way in helping.

If a bird is throwing up, there's no sense in feeding it a lot of food. All it means is that a lot of food will be coming back up. In the beginning, I would only use ten pieces of Chow and see how the bird handles it, whether it throws it all up or only some, up, and also if you are seeing droppings. It takes at least 3 1/2 hours for food to digest and a dropping to form. I've encountered birds where it took up to 6 1/2/ hours for the food to process in a sick bird.

If the food stays down and you see droppings, give another ten and then wait. Sometimes, there is a certain volume of food the bird can tolerate before throwing it up and it can be different with every bird so this is trial and error. I don't know why this happens but sick birds tend to regurgitate the crop contents more at night so make sure the crop is not too filled up by about 6:00 PM.

Until the body is fully hydrated and/or the crop is beginning to function a little better, throwing up part of the food can occur over a few days so don't expect overnight miracles.


----------



## jenfer (Jan 7, 2008)

Is 3.5 hours the normal gut transit time, then? Another one of my birds seems to be processing more at the 12 h mark at least some of the time.

The Puppy Chow pieces are too big to push comfortably down the throat. The smallest piece just sits in the mouth, and I don't want to force it.

Since she kept down her 6 cc morning formula meal and there were lots of droppings, I tried tubing another 6 in just now. 

Does anyone know if there's any reason not to combine LRS with Exact? Does the Exact change the isotonicity of the LRS somehow?

Thanks,
Jennifer


----------



## philodice (Sep 30, 2007)

That IS an awesome post, pp. I may have to quote it for my research article collection.


----------



## Guest (Aug 2, 2008)

Philodice, thanks very much. I'm thinking about your little bird that has the wing problem and you know I'm hoping for the best.


----------



## Guest (Aug 2, 2008)

jenfer said:


> Is 3.5 hours the normal gut transit time, then? Another one of my birds seems to be processing more at the 12 h mark at least some of the time.
> 
> The Puppy Chow pieces are too big to push comfortably down the throat. The smallest piece just sits in the mouth, and I don't want to force it.
> 
> ...


Jennifer,
If the Chow is too big, don't forget you can cut them in half but if she is now holding food down, let's hope it keeps going that way and you can keep doing what you're doing.

LRS and Extract mixed together is a fine combination.

Are you saying that you have a bird that does not have a dropping until 12 hours from the point that the crop is empty? Something is wrong. I think you're in New York City and if that's correct, can you get the bird over to Animal General Hospital's Wild Bird Fund. They can check for a number of things that can cause the crop to slow down including an X-Ray to rule out some sort of obstruction. They will also give you the medication needed to solve the problem. This wonderful place does all of this for pigeons and although donations aren't requested, they are appreciated.


----------



## jenfer (Jan 7, 2008)

I found this interesting reference about canker: 

http://www.michigan.gov/dnr/0,1607,7-153-10370_12150_12220-27288--,00.html

I noticed that it states that the chronic form is the more progressed form (makes sense, I guess, if you think about the meanings of "acute" and "chronic") and that chronic lesions are hard and large whereas the acute stage presents with sticky exudate; if this is the case, then every one of my canker birds so far has had the chronic form, yet they all have had the typical canker smell except for the new one, whose lesions actually feel soft. She actually looks and feels like a much more mild case than every other one so far.

The description of "masses that may invade the sinuses of the skull, extend externally to the beak and eyes" makes me think of the bird here who I thought might have pox. I'm hoping the dry, hard mass in her upper beak can still dissolve. As I was holding her today, she saw a single seed on the table and tried to peck at it, which really broke my heart.

Jennifer


----------



## jenfer (Jan 7, 2008)

It seems that she's vomiting somewhere between 6-12 hours after being fed. The vomit is sprayed on the top and sides of the carrier. The first time she did it, it was even on the top of her head.

Trying to feed Puppy Chow, even cut in half, doesn't work very well. It's far less traumatic to her to tube feed, but I'm worried about the vomiting. Hand feeding seeds would also be very stressful for her, I think.

I'm doing meds and fluids separate from feedings now. She seems to be processing about half her food.

I'll call the avian vet for advice. Any other ideas?

Jennifer


----------



## Pidgey (May 20, 2005)

It's very common for them to regurgitate like that when they're full of worms. Get a fecal float done? When I've got a bird that's really sick with something and still needs worming, I go usually go with Levamisole because it has an added effect of boosting the immune system.

Pidgey


----------



## feralpigeon (Feb 14, 2005)

jenfer said:


> It seems that she's vomiting somewhere between 6-12 hours after being fed. The vomit is sprayed on the top and sides of the carrier. The first time she did it, it was even on the top of her head.
> 
> Trying to feed Puppy Chow, even cut in half, doesn't work very well. It's far less traumatic to her to tube feed, but I'm worried about the vomiting. Hand feeding seeds would also be very stressful for her, I think.
> 
> ...


Start the bird on 2-3 drops of Pepto Bismal down the throat a few times
a day until the meds start kicking in and the size of the canker growth
begins to wane. It does help w/nausea though you do still need to address
the core health issue.

fp


----------



## Charis (Feb 11, 2007)

I think pigeonperson's advice about taking the bird to Animal General is very good and I would encourage you to do that. They have the capability of diagnosing the problem without going through the guessing game which only costs precious time.
You are so fortunate to have Animal General as a resource. I am quite jealous.


----------



## jenfer (Jan 7, 2008)

Pidgey said:


> It's very common for them to regurgitate like that when they're full of worms. Get a fecal float done?


She turns out to have coccidia but no worms. (The sample had been refrigerated for two days; would worm eggs still be present at that point?)

Avian vet said, like Pigeonperson, to do the meds separately from the meals and feed small amounts. She thought it was likely that the trich could be elsewhere in the GI tract and cause vomiting. She said to add Baytril, but the gram stain (from the sample that was refrigerated for two days) didn't show a bacterial infection, so is it worthwhile to do anyway? (Stain also showed no yeast.)

So far today, it looks like the mass in the throat has already gone down in size. She got fluids this AM and a small meal just now. I'll see how she does.

Jennifer


----------



## feralpigeon (Feb 14, 2005)

jenfer said:


> She turns out to have coccidia but no worms. (The sample had been refrigerated for two days; would worm eggs still be present at that point?)
> 
> Avian vet said, like Pigeonperson, to do the meds separately from the meals and feed small amounts. She thought it was likely that the trich could be elsewhere in the GI tract and cause vomiting. She said to add Baytril, but the gram stain (from the sample that was refrigerated for two days) didn't show a bacterial infection, so is it worthwhile to do anyway? (Stain also showed no yeast.)
> 
> ...


Jennifer, the eggs should still be present w/refridgeration. Tests of soil from 
Siberia where the earth is frozen have shown worm eggs present and these
same eggs were able to mature into worms when the soil was thawed.

Levamisole can cause vomiting in birds especially in a debilitated condition, so
it may be just as well that you didn't treat for them w/that med. I remember posting about reports of Levamisole pumping the immune system in birds--I'd read this in an article by Gordon Chalmers. Apparently studies were only performed on chickens and there are no studies confirming these findings
for other birds yet.

From Avian Medicinerinciples and Applications
"Experimental studies in chickens suggest that a dose of 1.25-2.5 mg/kg administered PO or SC increases immune response in immunosuppressed birds. However, there is no work to confirm a positive immunostimulatory
effect in other birds. Suggested dosing when used as an immu-
nostimulant is 2 mg/kg IM or SC every 14 days for three doses.
May cause swelling at the injection site."



You should be able to get Moxidectin or Ivermectin over the internet at the Pigeon Supply Houses:

http://www.pigeons.biz/forums/f25/pigeon-supply-houses-usa-amp-australia-only-9455.html

Both Ivermectin and Moxidectin are from the Avermectin family and Moxidectin is considered gentler and as effective as the earlier generation Ivermectin. There are wormers that cover the range of worms that a pigeon
can harbor at the pij supply houses such as Mediworm from Medpet that comes in a pill form for future reference.

If your rescue has Coccidia, a better choice of antibiotic might be a sulpha
drug such as Trimethoprim Sulpha which is good with anaerobic bacteria and
additionally treats for Coccidial overburden. With the potential tissue damage from both opportunistic diseases, adding an antibiotic is a good idea. As pigeonperson mentioned, hold onto the bird for a few weeks beyond the treatment and pump up the bird's system w/vitamins and probiotics when the meds are complete.

fp


----------

