# Lethargic, metacam, panacur, heart disease, parasites



## Howard Nye (Oct 14, 2009)

Hi all,

I have a pigeon (Philly) who was just diagnosed with a few problems: possible heart disease, arthritis, and intestinal parasites (the vet saw an enlarged heart, inflamed intestines, and possibly inflamed right intratarsal joint on x-rays after Philly's heart sounded muffled and I'd noticed him limping a bit). Yesterday I started giving Philly metacam for the arthritis and panacur for the intestinal problem (and we have an appointment with a cardiologist next week). Philly had been a bit lethargic before, but last night (about 6 hours after metacam administration & 3 hours after panacur administration) he started acting *really* lethargic. He was lying down in places other than his perching area and didn't get up and go over to the food when I brought in fresh seeds. He was also having droppings that were almost pure water - no feces and very little urates. He did, however, eat when I brought his seeds to him, and he was preening (including scratching his ears), but I don't think he's been drinking as much as usual. This morning he seems a bit less lethargic, but still pretty tired.

I'm trying to figure out if this is just a result of Philly's health problems (or possibly the stress of all the transportation and handling - he's not that used to being handled), or if it might be a side-effect of either the metacam or panacur. So I was wondering if anyone had had experiences giving either of these medications to pigeons who subsequently experienced lethargy, watery droppings, and / or decreases in appetite and thirst.

Thanks very much,
Howard


----------



## Dobato (Jul 3, 2008)

Howard, can you please tell us what the dose was of each medicine you gave Philly. Just so you know, we don't really recommend the use of Panacur (Fenbendazole) here at Pigeon-Talk, as there are studies it is toxic to pigeons.

http://www.birdmedicine.org/
http://www.jstor.org/pss/30133222
http://www.ncbi.nlm.nih.gov/pubmed/17089995

How much experience does your vet have with treating pigeons?

Karyn


----------



## pdpbison (Mar 15, 2005)

Hi Howard,


Moxydectin Plus is a much better Wormer to use for Pigeons.


How old is this Pigeon, and, what is their History?



Phil
Lv


----------



## Grimaldy (Feb 25, 2007)

You might want to take it easy with the meloxicam, particularly if you don't know if the limping is related to cardiac problems or not. The dose is 0.1 mg/kg, which means that a 300 gram bird takes 0.03 mg, or three one-hundredths of a milligram, a very small amount indeed. Meloxicam is also highly toxic to birds when given in large doses, so it might be better to err on the side of caution until you hear from the caridologist.


----------



## Howard Nye (Oct 14, 2009)

*Thank you!*

Hi all,

Thank you so very much for the help. I've suspended the metacam and panacur and I'm going to show the studies to our vet. I think that she's very experienced treating pigeons; I think she does all the pigeon rehabilitation in my city. 

Philly was on 0.04 ml per day of the Metacam and 0.11 ml per day of the Panacur (although she's only had one dose of each).

I don't know much about Philly's history; he was found about a bit over a year ago with a broken wing (that had actually healed in the wild), which left him flightless. Since he came from the wild we assumed that he was young, but he was always reasonably docile. We actually thought he was female, but his failure to really bond with my other male pigeon, Bird-Bird (who is definitely male), and his newly discovered health problems have led us to suspect that he is actually male, but less aggressive on account of being a senior bird.


----------



## Charis (Feb 11, 2007)

Howard...
Fenbendazole[Panacure] should not be used for Pigeon or Doves because it is toxic to them. Most vets don't realize this.
A couple of years ago a generic was prescribed for a rescue Pigeon in my care. After the second treatment, the poor Pigeon was very ill and I worried she wouldn't survive. Fortunately the problem was figured out before the third dose.
The vet looked it up and confirmed what I have just shared with you.
Avoid wormers with dosing instructions for more than 1 day in a row.


Also...metacam can cause bleeding or the two though, the most worrisome is the panacure.
I agree with Phil that Moxydectin Plus is a safer wormer.


----------



## Dobato (Jul 3, 2008)

Howard, the 0.04cc of the Metacam is a hair less than 1 drop and would be a safe and appropiete dose for an adult pigeon to help with an arthritic condition, I think what caused the sudden decline in condition was the Panacur.

I would consider heart conditions in pigeons to be uncommon, especially in a young bird, as you think Philly is. I know myself, I would be looking at an etiology that could cause an enlarged heath and also arthritic type conditions and the first thing that comes to my mind is a number of bacteria that can do this. With Philly also being diagnosed with a parasitic intestinal infection as well, this is also indicative to me that his immune system may be run down making him susceptible to other types of infections. By the way, did the vet mention what the parasite was?

Was any blood work done to check infection or disease?


Karyn


----------



## Howard Nye (Oct 14, 2009)

Thanks again; we're definitely off the panacur now. I'm so sorry to hear about your pigeon who was in such bad shape, but very glad to hear that she was alright. Philly is still a bit sluggish but he seems to be doing better.

Thanks so much for the idea about the bacteria - no, we didn't do any blood work (which I thought was strange, since that's one of the first things we do with our cats when anything goes wrong, but since I'm new to birds, Bird-Bird and Philly being my first companion birds, I just assumed it wasn't a common diagnostic). I'm definitely going to ask about getting blood work done when I talk to our vet.


----------



## Jaye (Mar 13, 2008)

I agree I don't think that dose of Medacam is a problem at all....I use the stuff ll the time and have never seen that sorta reaction.

I agree w/ others that you should ask your vet for a replacement to Panacur (although, if memory serves....when I have been prescribed it...it was a single dose then repeated several, several days later). That first dose probably did no harm, matter of fact it likely knocked the crap outta any parasites which it targeted; but as noted, there are better alternatives....

There are several possibilities for the enlarged heart including heart disease, parasites, or even some sort of toxicity in the environment....and several remedies ranging from meds to fish oil.....

Hang in there, I am sure you and your vet will find the right combo of meds.....


----------



## Charis (Feb 11, 2007)

Jaye said:


> I agree I don't think that dose of Medacam is a problem at all....I use the stuff ll the time and have never seen that sorta reaction.
> 
> I agree w/ others that you should ask your vet for a replacement to Panacur (although, if memory serves....when I have been prescribed it...*it was a single dose then repeated several, *several days later). That first dose probably did no harm, matter of fact it likely knocked the crap outta any parasites which it targeted; but as noted, there are better alternatives....
> 
> ...



Panacure is prescribed as a 3 days in a row treatment. Ivermectin,Moxydectin , worm out are one day treatments followed by an additional treatment in 10- 14 days.
As for metacam, some patients can have internal bleeding. Hard to say if this bird was in the percentage of birds that have a reaction. I tend to think it's the wormer. I have know birds to die as a result of given that wormer.
You can look in the mouth and if the mouth and throat color is pale [white or gray], the bird is probably bleeding internally.


----------



## Howard Nye (Oct 14, 2009)

Thanks once again! His mouth looks pretty pink - the tip of his tongue looks a bit white, but that's it. He'll be seeing the vet tomorrow for some blood-work and a checkup, and I'll ask to make sure the coloring of his mouth is O.K.


----------



## Grimaldy (Feb 25, 2007)

In the interest of resolving any confusion about drug dosage and amounts, when a drug is listed in the formulary as mg/kg that is the intended dose in milligrams of drug per Kg of body weight of the recipient. 
If the drug you have is in a liquid form, that means that a specific weight of the drug is found is a specified amount of the liquid suspension. So if you have Meloxicam in liquid suspension the bottle should specify the amount, usually in mL of drug, often something like 5mg/mL. If the required, or safe dose is .05 mg that means you have to give 100th of a mL. If the concentration is greater, say 50 mg/mL you have to give 1000th of a mL. Giving a "drop" on the assumption that the concentration is known and correct may be hazardous.

Charis is right that Meloxicam, a non steroidal pain reliever, also works by modulating the immune system's platelet, or blood clotting response. So if you have a bird you suspect has been subject to trauma, like having been hit by a car, if you give Meloxicam for relief of pain, you may have the terrible experience of watching them bleed to death right in front of you as a result of your being a dumbass.


----------



## Howard Nye (Oct 14, 2009)

Hi Grimaldy,

Thanks very much for this; for dosing I've been entirely reliant on instructions from my vet - in fact for the Meloxicam they just gave me pre-measured syringes. The current syringes contain 0.02ml of solution, and the only information I might have on concentration strength is that the label says: "0.28 Metacam DIN 22377 15/ml in Syringes," which I unfortunately don't understand (although I can ask next time I talk to my vet). Philly had originally been on 0.04ml of the same solution, but after he reacted so badly on Thursday we suspended the Metacam along with the Panacur, and re-started him on a halved dose of Metacam after he seemed to be doing better (and his locomotion seemed much improved, which we suspect may be the Metacam at work but it could be that the one dose of Panacur knocked off some parasites in addition to making him really sick.) 

That's really good to know about the dangers of Metacam. Do you know if Buprenorphine is safe in trauma cases? (Or would there be another analgesic you'd recommend for such cases?)

Thanks again!
Howard


----------



## Grimaldy (Feb 25, 2007)

Hi Howard,

The most likely explanation of .28 DIN 22377 15/mL is an industry standard, Deutches Institute fur Normung specification 22377. What exactly the composition of the med might be is not given at all. That is too often a problem with meds where the bottle will say something like "give half a tablet daily" with no clue as to what that amount is exactly. Small wonder that so many birds die in rehab.

Buprenorphine is derived from the opium poppy, a byproduct actually, used to treat moderate pain and wean morphine addicts. A controlled substance under the laws of the United States, meaning you can not get it without a prescription and you had better not be caught with it otherwise. Other than that, the opioids are the first choice for pain relief wherein controlled bleeding is a problem. 

The strange thing about our society is that so many people are intent on abusing themselves that the regulatory process makes it near impossible for good faith users to acquire it. At one time I recall a person could purchase animal tranquilizer at any good feed store until the goofys got on to it and started peddling it on the street.


----------



## Dobato (Jul 3, 2008)

Howard, as I mentioned before, I don't think the problem in Philly's sudden decline had to do with the Metacam (Meloxicam), but lay with the administration of the Panacur. The Meloxicam product almost all vets use, Metacam, is compounded at 1.5/mg/mL, is mostly used QD (once a day) and the suggested avian dosing range is 0.10-1.0mg/kg. To make this easier to understand for you this means a pigeon weighing 360g (fairly average weight) at the high end of dosing would get 0.24cc (.36mg of Meloxicam) and this a a hair under roughly 5 drops. The dose you are now giving, 0.02cc, is roughly 1/4 drop and if would be right on the nose for the very low end of dosing 0.10mg/kg (0.02cc = .03mg) if Philly weighs 300g, if he weighs more, he would not be getting enough, even for the low end. I have used Metacam many times in the past, typically at 1-2 drops a day, with good results and never no adverse affects.

I know the Moxidectin Plus has been mentioned, and as I think you are aware, this is Moxidectin with the addition of Praziquantel to treat for tape worms. Since being on this forum I think I can only recall one instance of tape worms, most common is Round Worm then Thread Worms (a distant second), so unless in the float tape worm eggs were specifically identified, I would not worry about trying to use Praziquantel, Moxidectin or Ivermectin alone would be fine. I know I asked before, but what is the name of the intestinal parasite identified?

I, myself, am unfamiliar with the use of Buprenorphine in avians, I am familiar with the use of Butorphanol (Torbugesic), another synthetic opioid and have used it before and it is effective. The thing is with Butorphanol, while being effective at pain relief, it is not an anti-inflammatory, as Meloxicam is, so while you will get relief of pain, you will not relief of inflammation. However, there are times where you want to give pain relief, but a NSAID like Metacam is contraindicated, like where there there is a chance of bleeding to occur, such as in trauma injuries or post surgery and this is where Butorphanol is of benefit.

I did see your other post and a suggestion for you would be to keep all issues pertaining to a bird that has a thread being advised on, confined to one thread, as it can get confusing for people offering suggestions to be current on everything, if the information is spread out.

The one thing I would do, if Philly where mine, and it's not based on any one concrete point, but more just the list of non-specific ills he is experiencing, everything from inflamed joints to possibly swollen liver would be to treat him for 10-14 days with a penicillin drug like Amoxicillin (thanks Pidgey) or better yet Clavamox (Amoxicillin/Clavulanate) as there are a number of bacterial infections that can cause a number of symptoms, while not being able to be tied to a specific illness/pathogen. I know with cases like this a great deal of time and money can be spent trying to pinpoint something specific, and in the end you come up short with a bird that did not survive, empiric antibiotic treatment in these cases is not a bad way to go and see if he responds. 

These are my thoughts, good luck,

Karyn


----------



## Howard Nye (Oct 14, 2009)

Hi Karyn,

Thanks very much. Sorry about the multiple posts; I was thinking about them topically but it makes a lot of sense to keep them centralized (it isn't possible to change the title of a thread once it's been started, is it?)

Sorry I missed the previous question about the parasite. Actually we never identified a specific parasite; my vet guessed it was likely parasites in light of Philly's watery droppings, lethargy, and intestinal inflammation on X-rays. We did a smear and a float of Philly's droppings but didn't seem to find anything. The reason my vet had wanted to start Philly on Panacur was that Philly had been wormed about a year ago with Ivermectin, and especially since Philly and my other pigeon are strictly indoor pigeons (both had broken wings and are unable to fly) I think she was thinking it was likely that any parasite Philly might have would be one that wouldn't have been hit by the Ivermectin. For some reason I though that there were more parasites than just tapeworms that could be missed by Ivermectin but hit by Panacur or Moxidectin with Praziquantel, but maybe that's wrong. 

I'll find out Philly's weight (they've been keeping track of his weight at my vet's but they never seem to tell it to me), but he isn't a huge bird so I suspect that they're probably giving him enough. But yes, all indications seem to be that Metacam is perfectly safe for Philly. I was mostly asking Grimaldy about Buprenorphine for trauma cases in particular should I encounter one (as I did when I found my other pigeon). I think that my vet said that it was safe but, just like you said about Butorphanol, it doesn't have anti-inflammatory properties. 

Thanks in particular for the idea about the empiric antibiotic treatment; I'll definitely ask my vet about it when I talk to her!


----------

