Impacted crop vs. Thrush (update post #28, pg. 3; treatments started)

[CUDA]

Something else you can try if you can't do the copper sulfate thing, is to go down to your local pet store, and buy some of that anti-fungal stuff for fish, and use that for treating her. I wish I could remember what it is called, but the clerk there should be able to help. I know some people swear by it. Good luck!

 

[raindrop]

Quote:
Thank you!

 

[raindrop]

What about ketoconazole? I could crush a fraction of a tablet and administer with the crop tube. Couldn't find anything in my formulary about using it for candida, only for aspirgillosis.

 

[d.k]

*RD, I looked at the links that sammi posted amd it says to admin. copper sulfate IN WATER, at the rate of 1/2tsp. to 1 gallon EVERY OTHER DAY. Don't know how that will work for your girl with so little passing beyond the crop at this point. Oh, they recommend a "molasses flush" first, which kinda puzzles me as molasses has iron in it and both m&iron are yeast feeders, if I remember. PS: Cuda? Are you thinking of Maracyn?

 

[CUDA]

Not sure about that, I just know it needs to be an antifungal treatment. You can even use monistat in the vent for fungal problems back there. Anything that is an antifungal should work, if you can figure the dosage out. Sorry I can't be more help, but I haven't had to deal with this personally yet, but know others who have...

 

[d.k]

* All this has me wondering: I used to keep a few old (PRE-198O's) pennies in my fish tank for the copper to keep the fish clear of fungals-- would it work as prevention in chicken's water???? Hmmm, ACV in it (with old pennies) might present an copper O.D. problem though. . . . Keep us posted on her, Raindrop, o.k.??

 

[dlhunicorn]

articles on crop stasis/sour crop:
http://dlhunicorn.conforums.com/index.cgi?board=emergencies&action=display&num=1161893898

Antifungal Drugs

- Polyenes -- Amphotericin B, nystatin
- Imidazoles - ketoconazole, fluconazole, itraconazole
- 5-fluorocytosine
- Griseofulvin
- In general, treatment is prolonged, cost is high, side-effects can be significant


Polyenes - Amphotericin B

- Macrolide ring - series of double bonds
- Mechanisms - bind to ergosterol in the fungal cell membrane
- Administration - poorly soluble , prepare suspension, no electrolytes, slowly infuse iv
- Toxicity -- absorbs to renal tissues, causes necrosis, loss of renal function


Imidazole Drugs

- Related family of drugs - all contain an imidazole, or triazole, ring structure
- Ketoconazole, fluconazole, clotrimazole
- Pharmacokinetics vary - in general easier to give, less toxic, sometimes less effective, Inhibit ergosterol synthesis
- Use for combined therapy with amphotericin


5-Fluorocytosine

- Converted to 5-fluoropyrimidine by fungal cells -- inhibits nucleic acid synthesis
- Chief use -- cryptococcal meningitis
- Crosses blood-brain barrier
- Resistance can develop


Iodides

- KI -- given orally or by injection
- Seems effective for various types of chronic granulomatous infections
- Mechanism unknown -- not anti-fungal in vitro
- Causes iodide toxicity -- but is reversible
- Low cost


Griseofulvin

- Dermatophyte infection
- Give with fatty meal (increases absorption)
- Concentrates in keratinized epithelium
- Inhibits fungal cell wall metabolism
- Usually non-toxic
-------------------------------------------------------------------------
An here is the relevant MERCK page on some antifungal drugs:
http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/191302.htm

http://www.cliniciansbrief.com/cms/portals/_default/pdfs/2006/06NOV_Cap1.pdf
Mycotic Infections in Psittacines: Some
Treatment Evidence
Mycotic infections are common in psittacines, yet safe and effective dose regimens for most antifungal agents have not been established.The synthetic,water-soluble antifungal agent fluconazole is well-absorbed from the gastrointestinal tract in the mammals in which it has been studied, with a reported oral bioavailability of 90% to 100%.Adverse effects are uncommon; gastrointestinal upset is the most common symptom in humans. In this study, the pharmacokinetics and effects of orally administered fluconazole in African grey parrots were investigated....... It was concluded that oral administration of fluconazole at 10 to 20 mg/kg every 24 to 48 hours will maintain plasma concentrations above the minimum inhibitory concentration for several common yeast species, including Candida albicans and C. tropicalis.The authors note that these results are promising, but further studies are needed to prove that this dose regimen is safe and effective in ill parrots and in other psittacine species.
COMMENTARY:With so many drug doses in avian medicine being based on empirical knowledge or data extrapolated from other species, this study provides valuable information for practitioners who work with birds.The study has the following limitations, as noted by the authors:
Only healthy African grey parrots were included, studies of IV administration to calculate bioavailability and volume of distribution were not performed, and pooled samples from several birds were used for calculating pharmacokinetic parameters.This, however, reflects the inherent difficulties in performing these studies in birds:They are often small, expensive, and difficult to handle, and there are a wide variety of species. Still, the data are useful. Fluconazole is now available to U.S. practitioners in generic form, making it a more practical and attractive option for
treating mycotic infections—especially when supported by scientific data that include the option of using a prolonged dosing interval in a species that is complicated to treat.—Jennifer Schori,VMD
Pharmacokinetics of fluconazole after oral administration of single and multiple doses in African grey parrots. Flammer K, Papich M.AM J VET RES 67:417-422, 2006.

 

[raindrop]

Alright, she is at work with me today and I just finished her treatments. Crop did feel a little emptier this am.

Passed 14 french red rubber feeding tube into crop and removed approx. 100cc of greenish/yellow fluid containing small bits of plant material, foul smelling. Flushed with 60cc sterile LRS, removed 20cc. Crushed 50mg ketoconazole and dissolved in approximately 20cc water with 4-5cc apple cider vinegar (needs acid solution to dissolve), administered via crop tube and flushed in with an additional 10cc water.
Gave 60cc LRS with B vitamin complex (0.2cc) subcutaneously.
Made a "crop bra" out of this really stretchy wound support/cover material (similar to vetwrap but wider and more stretchy).
Plan to continue ketoconazole/vinegar/water twice daily after emptying crop of any "leftovers."
I think I will try to make a gruel out of layer pellets/cooked egg/yeast/wheat germ to tube feed her with if she starts to be able to move things through the crop.
I will keep you posted and will try to post a pic of the crop bra.

 

[d.k]

* Does she seem any better after getting the junk out and some fluids for the dehydration, Raindrop??

 

[raindrop]

To soon to tell, I think. She is in a darkish corner of my office in a fairly small carrier, I'm trying to reduce stress levels. She may be a little more alert, but it may be wishful thinking on my part. I think I'll know more when I get her home.