Many years ago, I was privileged to witness
the following scene. A young vet, recently graduated from veterinary school, was dealing
with the owners of an EXTREMELY over-weight beagle. He was trying to explain to them about
putting their dog on a diet, and launched cheerfully into a rather extraordinarily complex
lecture on calories as a unit of heat quantity, calories burned via exercise vs. calories
stored due to inactivity, kilocalories, etc., etc.. His explanation, sprinkled liberally
with medical terms and 3-4 syllable words, went on for several minutes. When he finished,
he asked the owners if they had any questions. The couple shifted uncomfortably and
exchanged bewildered looks..…… then the husband spoke up.
"That mean she cain't eat no taters no more?" he asked.
Communication Breakdown
Needless to say, that newly-graduated veterinarian had completely lost his clients
with his explanation. He not only failed to communicate, but actually increased the
owners' confusion. Since that was obviously not the veterinarian's purpose, why did he do
it? Simple. In the process of going through veterinary school, students have to learn the
incredible complexities of a medical vocabulary. Multisyllabic Latin words replace common
ones, so a nosebleed becomes "epistaxis", and a simple and unattractive thing
like a hairball becomes a fantastic, romantic-sounding "trichobezoar. " (Think
I'm kidding? Hey, I haven't the imagination to make up these words! Look them up in a
medical dictionary, if you don't believe me.)
In the process of getting fluent in this new language, many veterinary
students seem to lose track of their regular, everyday vocabulary. Speaking medical jargon
becomes so second nature that they no longer realize they are not speaking a language
understood by everyone.
Once graduated, they often have a terrible time communicating with
their clients -- not, as many people assume, because they want to make the layman feel
stupid, but because they simply no longer know how to talk any other way.
Therefore, should your vet use an unintelligible word in a conversation
with you, do them a favor -- ask what that word means. That is the only way the vet
will learn what words are or are not understandable to their clients. It also reminds them
to speak English!
Other Apparent Weirdness
Veterinarians, especially avian veterinarians, do other strange and unintelligible
things as far as their clients are concerned. For example, you are a brand new bird owner
and you take your new friend to be checked by your friendly local avian veterinarian.
While taking the history, he or she asks you where you purchased the bird.
Your answer to that question may very well affect the way your animal
is treated medically. In other words, your vet may wish to do minimal testing if the bird
came from some sources -- whereas from other sources, your vet may want to do every test
known to avian medicine. The reason for this is obvious....once it is pointed out. Your
vet is often aware of disease problems associated with certain stores and/or breeders, but
he/she cannot explain that to you without risking expensive liability suits.
Avian Medicine Still In infancy
Avian medicine is still more an art form than a science. The Association of Avian
Veterinarians (AAV) is the only national (and now international) organization dealing with
birds and veterinary medicine, and it has only been in existence for about 15 years.
Considering how young avian medicine is, it is absolutely incredible how far it has come
in such a short time.
But there is still so much to learn, so much unknown.
Consequently, some diseases are more difficult to diagnose than others,
and some are absolutely impossible. Some of the diseases that are in the "impossible
to definitively diagnose" category include many viral diseases such as Pacheco's,
which is generally diagnosed only on autopsy.
A very common disease that is in the "difficult to diagnose"
category called psittacosis or chlamydiosis... better known as "Parrot Fever".
There are a variety of tests that avian vets can use to rule out this disease, but most of
them are capable of producing false negatives or false positives. This means that the
tests are not always conclusive in themselves -- the avian vet often needs additional
information in the form of other testing. Often, good avian vets will chose to treat a
bird for psittacosis even when all testing comes back negative. This is because their
experience indicates the potential, despite test results. So much of avian medicine is
still based on the instincts and experience of the veterinarian, rather than concrete test
results.
Controversy in the Avian Veterinary World
One subject considered controversial among avian vets has to do with the
interpretation of culture results. A culture is a test where-by the doctor takes a sample
(with a sterile cotton-tipped applicator) from bird's mouth (specifically the slit in the
roof of the mouth called the choanal slit or choana) and/or the vent (cloaca). Simply put,
any potentially disease-producing bacteria, yeast or fungus found are grown out in a
laboratory and identified.
The controversy has to do with what are called "pathogenic"
(disease producing) bacteria. Some avian vets feel that the finding of any
pathogenic bacteria (no matter how few) necessitates treatment with an antibiotic. Others
feel there are other variables to consider. These would include the following:
1) where the bacteria are found (mouth or vent);
2) the amount of growth (very light growth? heavy growth?);
3) the age of the patient
4) the general condition of the patient; and
5) (and this is really important) the know-ledge and experience
of the owner.
Let me explain each of these variables in more detail, because it's
important that bird owners understand.
Location: Most avian vets expect some light growth of
pathogenic bacteria from the vent or cloaca. After all, the GI tract of any animal is far
from clean, and by itself this result does not necessarily indicate disease. Many avian
vets feel one can also find light growths of pathogenic bacteria from the mouth if the
bird is eating fresh vegetables and fruits, no matter how carefully these foodstuffs are
washed. These bacteria are considered "transitory" -- in other words, they are
on their way through the GI tract (as we say, "in Column A and out Column B")
and are not causing a medical problem.
Amount of Growth: As stated, light growth is often
transient, but heavy growth of a pathogenic bacteria, from either end, is generally
considered significant.
Age of the Patient: As with all animals (humans, too),
babies are more at risk than adults because their immune system is not as experienced at
combating disease. Also, when they get sick, the illness can progress at much greater
speed. Consequently, bappies generally get treated with antibiotics more often than adult
parrots.
General Condition of the Patient: A clinically normal,
bright and alert parrot at good weight is less likely to need treatment with antibiotics
than a bird that is obviously ill. However, the bird may look clinically normal, but the
owner may describe a decrease in noise level, mess, etc. -- all indications that a problem
is developing. In this situation, the vet may (will probably?) choose to treat. If a bird
looks clinically normal but has been on a nutritionally poor diet (i.e., predominantly
seed), the odds are also better that the vet will elect to treat the animal. After all,
sooner or later a crummy diet will catch up with the bird (and the owner), and odds
are that is what is happening now.
The Knowledge & Experience of the Owner: Someone who
is an experienced bird owner, who is well versed in the subtlety with which birds show
symptoms of illness, can be trusted to recognize tiny changes in a bird's demeanor that
may indicate the bird's physical condition is going downhill. With owners like this, a
veterinarian is safe adopting a "wait and see" attitude, trusting the owner to
respond if there is a change for the worse. On the other hand, an inexperienced owner may
fail to recognize the gravity of the situation as a bird's condition disintegrated, often
waiting too long to seek veterinary assistance. In situations like this, it is ALWAYS the
animal that pays the highest price.
But she SAID she understood….
An experience I had many years ago illustrates this. A very nice lady brought her sick
budgie to the avian veterinary hospital where I worked. My vet put the little bird on
medication, and arranged for a reexam the following week. The lady SEEMED to understand
when my vet explained she should keep a close eye on the bird and CALL IMMEDIATELY
if it seemed to get worse. Under NO circumstance should she wait until the scheduled
reexam if there was any question about the bird's condition. We didn't hear from her at
all that week, so we assumed that no news is good news, as they say.
However, when she walked in for the reexam
appointment, we learned we were very, very wrong. The little bird was in terrible
shape, MUCH sicker than he'd been the week before. It was the end of the day, so we
admitted the budgie and sent the lady home.
Much to my horror, that little bird became one of the few birds (one of
five in twenty years, actually) that died in my hand as the vet and I worked frantically
to save it. My older sister happened to be visiting from out of town that day, and that
was when she learned that her little sister could swear like a sailor when she was really
angry! I was absolutely FURIOUS with the owner -- I simply could not believe she
didn't realize the little bird was getting worse......
However, the reality was that the lady was neither evil nor uncaring --
she really DID NOT understand. We thought we'd explained it properly, but for whatever
reason, the information had not penetrated. Moral of the story? When it comes to avian
medicine, if the vets are not sure, they have to ASSUME THE WORSE as to the level of the
owners' understanding. Therefore, when it comes to an inexperienced owner, it is probably
better to over-treat a bird, than it is to under-treat.
To Treat Or Not To Treat
So what do I mean about "over-treatment" and "under-treatment"?
Simply put, to "over- treat" means to use medications too much, to treat animals
with medicine who probably would do fine with no treatment at all. Over-treating can cause
serious problems, since any strong medicine has potential side effects. For example, human
doctors using antibiotics too freely has resulted in more and more strains of bacteria
that are resistant to most commonly used antibiotics. This has forced human medical
research to come up with stronger and stronger antibiotics – and stronger and
stronger drugs generally mean worse potential side effects.
To "under-treat" is to do the opposite -- to not prescribe
medications when medications should be used. This situation is perhaps not too
dangerous, as long as the animal's owner is experienced enough to recognize the dangers
and get help if the bird starts getting worse.
Whether or not a vet is quick to treat or more comfortable with a wait
and see attitude will be based on his or her experience. For example, after that sweet
lady didn't call my vet when she should have, I know my vet tended to
perhaps treat too quickly for awhile -- which in my mind is very understandable,
considering the circumstances.
Conclusions...............?
If at any time you think there may be something wrong with your pet bird, you should
immediately take it to your avian veterinarian. While you are there, make very sure of a
couple of things. Give your vet as complete and honest a history as possible -- there is
no telling how useful a detail might be -- but try to be succinct, please! If the vet
thinks your bird needs treatment, it is your right to discuss your treatment options -- if
something does not make sense, or you don't understand, ASK. Your vet wants you to make
educated decisions if decisions need to be made. They want you to understand what they
are telling you!
The bottom line is that no veterinarian is a god, incapable of making
mistakes. Avian medicine is still a very young field, with a tremendous amount to be
learned. If you are lucky enough to have a good avian vet, then trust them to do the best
they know how. If you don't trust your vet, then you need to do some looking around.