Gut Stasis AND Kidney Infection

oscarMeet Oscar
Oscar was a patient of mine who came in because he had some mild abnormalities – soft droppings, decreased interest in hay and some possible weight loss.  His owner had started Critical Care before bringing him in.  On exam he was definitely thin and his abdomen felt soft and doughy.

Diagnostics/Treatment
We took an xray of Oscar and found a ton of gas in the intestines!  Definitely gut stasis.  His blood work was normal and we started Oscar on various medications.  When he returned for his followup appointment, he wasn’t back to normal – more weight loss, still not eating well…Xrays showed improvements but not what we wanted to see so back onto treatments he went.

But Wait, There’s More
We saw Oscar for other issues 2 months later – but the xray still showed gas!  Since Oscar’s blood work was even better than previously we moved on to the next step.

PyelonephritisUltrasound
We found Oscar’s problem – both kidneys showed changes consistent with pyelonephritis (kidney infection).  We put Oscar on 6 weeks of heavy duty antibiotics and his kidneys improved.  There were no further episodes of weight loss or appetite changes.

How Can That Be?
Most of the time we aren’t able to identify the cause of gut stasis in rabbits and rodents like Oscar.  Pain, fear and stress are common causes that may be already gone by the time we see our patients.  Trying to figure out why the gut is slowing down is why we want to run tests like xrays and blood work.  Basically – what is going on inside and is there anything else we need to worry about…

Some diseases, like pyelonephritis, are hidden.  They don’t show up on xrays and they don’t make changes in the blood work until they’ve caused serious damage to organs.  That’s where advanced imaging such as ultrasounds, CT scans and even MRIs can make all the difference.

But, just like with Oscar, we don’t start there!  Oscar didn’t get better as fast as he should have and he had the gut stasis return.  At that point we could tell something wasn’t right – we were able to investigate further and find his hidden problem.

The Rhinolith or “Nose Stone”

 

What is it?

A rhinolith is an accumulation of debris in the nose that hardens.

Here is an amazon who came in with a “nose problem”. You may be able to see the enlarged opening and the brownish material plugging it. This abnormality had been growing and the owners weren’t sure how long it had been there.

 

Rhinolith Rhinolith after removal

I was able to tease it it out and you can see the result leaves a big empty hole behind.

Anatomy

Birds don’t have nostrils but instead have nares. That may be semantics since the dictionary definition of those 2 terms is pretty similar (or the same depending on the dictionary!).   In general, I’ve always heard people use the word nostril if there is a fleshy protuberance (otherwise known as the nose) and naris for just an opening into the head. Regardless, we use the term nares (plural) or naris (singular) in birds.

normal nares

 

 

 

 

Just behind the opening – whatever you want to call it – is a hardened flap of keratin called the operculum. This flap is sometimes mistaken for foreign material. It should be smooth and dry. However material can accumulate between this flap and the tissue on either side. This build-up can distort the tissue and even cause permanent damage to the bone.

big opening

What Causes This?

Quite a few things can result in a rhinolith – bacterial or fungal infections, hypovitaminosis A (or too little Vitamin A in the diet), foreign material or poor air quality.

Prevention includes:

  •  Good air quality – avoid smoking (any substance) and scented candles, keep fireplaces clean by hiring a chimneysweep as recommended, changing filters for heaters or air conditioners and providing an air purifier.
  • Preventing hypovitaminosis A – get your bird off of seeds and onto a good quality pellet, provide a source of fresh veggies.
  • You can’t eliminate bacteria or fungus from the environment but you can reduce it. Clean the food and water dishes daily, change the papers on the bottom of the cage daily (make sure they are under the wire grate) and wash the cage frequently. Use papers rather than litter at the bottom of the cage since they are easier to clean. If you must use a litter avoid walnut and corn cob – both of these substances may be contaminated with fungus that can infect and kill your bird.

What to Do?

Bring your bird to the veterinarian as soon as you see an abnormality. Once physical changes to the structure have occurred, they don’t go back to normal. Disruption of the normal structure means your bird may be more susceptible to sinus infections in the future.