Thank you Denise,
Now head shaking (as opposed to tremors that one may see with neurological disease or toxicity), is most commonly caused by respiratory based disease in this species. I am glad to see that her respiratory rate appears comfortable just now indoors, but we do have to still tread carefully since it is likely that she is managing at the moment but any increased activity or stress (like that outdoors) could lead to rapid decompensation and development of those other respiratory signs (like the open beak behavior).
In regards to her current state, we often see this near nodding off lethargy due to a combination of reduced activity to reduce oxygen demands of the body and fatigue due to low blood oxygen levels. Now if she is this depressed, then we do have to again worry about advanced disease but if she is breathing at a normal rate while so subdued then hopefully we can get this under control before this progresses any further.
Furthermore, while Trina is the most severely affected, I would advise also keep an eye on the rest of the flock (+/- prophylactic treatment). The reason is because these types of issues are often a flock one and are often airborne. So, it is good that you have isolated her now but need to have an eye out for any already exposed birds.
The reason why close monitoring is always advisable is because as I am sure you can appreciate, birds to that they do a very good job of covering up when they are sick. This is because as a prey species, attention to your illness will make you a target for predation. And this means too often we only see signs of our birds being severely unwell (like she is now) when their condition is just too advanced for them to hide any longer. Therefore, bird instinct puts us human owners at a disadvantage for catching things early, so we need to be very aggressive with Trina’s situation but also act quickly with the others if necessary so they don’t get to this point as well.
Now back to Trina. With one bird affected, this does mean we need to consider a range of respiratory signs. This includes the conditions that would only affect an individual (ie throat obstruction, tumor, organ disease, etc) as well as infectious processes. Now as I am sure you can appreciate upper airway signs like this can be seen with a number of respiratory agents. Therefore, we have a lot of agents to consider here. Some of concerns include Infectious Coryza (less likely with no odor, discharge or comb color change), Acute Fowl Cholera (Pasteurella multocida), Influenza, ILT IRT, infectious bronchitis, Chlamydiosis, and mycoplasma (Mycoplasma gallisepticum). Furthermore, since you noted that she has had some open mouth breathing when outside, we do have to consider that she could have swelling, discharge, possibly infectious material or worms blocking up the throat. In that case, we'd need to be thinking seriously about localized throat based disease due to Trichomoniasis (canker), Fowl pox (wet form causes canker lesions in the throat) and Syngamus trachea (gape worm) infestations. And of course as the only bird affected, foreign bodies or tumor partial obstruction in the throat.
Now any respiratory infection of the bird must be taken seriously since respiration is critical to life. If you are comfortable handling her (and she doesn’t get to distressed with this), then you can potentially narrow down a few of these differentials at home. If you are comfortable doing so, you may consider having a peek down her throat to rule out you gapeworms. You may be lucky and see them or one of the other causative agents (ie the plaques of Fowl Pox or discharge of canker). If you can't see anything, since you can only look down a chicken throat so far, then you can try the "Q-tip test". To do this, you need to place the bird in your lap, gently open her beak, and swab a Q-tip down her throat (twirl it as you do this). Twirl as you bring it back up, and if she's got gapeworm, you'll see thin, red strings on the q-tip. This way you will know if this is the cause. But if you end up with a cheesy discharge then canker or pox would be higher on the differential list. And if there is any other discharge, the bacterial causes would be suspect. And once you have identified what is present, you will be in a better position to know if you are treating them appropriately.
Otherwise, further measures to pinpoint the causative agent and increase your treatment success, you do want to consider involving your vet. They can listen to her lungs, examine her airway, remove any caught items, and help you determine the disease local and therefore rule out some of these agents. Furthermore together you can collect some respiratory secretions from this bird to be cultured. This will tell you what agents are present and what treatment will actually clear them . As well, you might consider having a fecal exam (even though the diarrhoea might just be a secondary issue) performed as well to tell you if parasites are playing a role (directly or via compromising the immune system).
Since you have note mentioned worming, it would be best to consider worming now. Specifically, we’d want to use a preparation that will make sure you can rule out the gapeworm (ie Flubenvet). That way you can directly address one terribly common differential that very commonly manifests with these signs. And if you are keen and have a microscope, some poultry owners do check fecal samples themselves, and this may be an option for you to see if there is any sign of gapeworm eggs to help you determine if they are a threat here. You can find a good Fecal Sample Evaluation Guide here.
Furthermore, once you have samples for culture (which will tell you what drugs any pathogenic bacteria present are vulnerable to), you can consider a broad spectrum treatment to try and tackle as many of the bacterial causes as possible. There are a range of options that would include erythromycin, oxytetracycline, or fluoroquinolones (useful if Mycoplasma is diagnosed), macrolides. Other options may be tilmicosin, tylosin, or spiramycin.
Otherwise, supportive care is that key facet that we need to make sure you are addressing since she has gone off her food. First step, just as you have, is always to separate clinical sign showing birds from the shared airspace of the flock to limit further exposure to healthy birds. Ideally, you want to have moved Trina to a quiet, warm hospitalization pen for close monitoring. You can keep their pen warm with a heat lamp or heating pad under half the pen (so they can move from the heat if getting too warm). Alternatively, you can use a clean sock, and fill it 2/3 with uncooked white rice. Tie it closed and microwave (approx 1-1.5 min). Make sure to shake it before adding it to the cage, to allow the heat to distribute. Make sure it is not too hot (as we don’t want to burn her). If it cools, you can re-warm as required. Whichever means of warmth used, do keep an eye that she doesn’t get overheated.
If you think she sounds congested in the upper airway and trying to clear it, then consider a bit of steam treatment here. You can achieve this by putting her in a carrier in the bathroom while you run a hot shower. Or if you have a nebulizer/humidifier you can set up a wee steam tent (by putting her into a carrier and covering it and the humidifier with a bed sheet). This can just help reduce some of those airway clogging secretions and help her to breathe easier.
Now since you noted that she is not eating/drinking, we do need to start supportive care with her now. In regards to fluid intake, we want her water intake to be ~ ½ a cup daily. While you are keeping an eye on this, you also want to monitor her for signs of dehydration (skin tenting or sunken eyes). To maintain hydration, in a drinking bird, you can offer water with electrolytes instead of plain water. There are readily available electrolyte solutions available on the market (ie. Vi-tal) or you can use Pedialyte or diluted Gatorade (diluted 50/50 with water). You can offer these in a bowl or if she isn’t drinking then you can administer fluids (and hand feeding) via towel restraining and a syringe or dropper. Wrap bird “burrito style” and hold securely upright in lap. You can drip water on top of the beak, as reflex will cause them to catch the droplets with their tongue. (some will even drink from the syringe directly). In doing this, do make sure not to get water into the nares.
Feeding wise, offer favorite foods. You can also get Nutrical paste to supplement her diet (either mixed in food, water, or via syringe) which will provide extra calories or nutrition. Offer fresh foods, high in nutrition and water content like cucumbers, Romaine, grapes, melon, oranges, etc. Hard boiled eggs mashed shell and all are extremely nutritious and delicious to birds and cooked brown rice is good for them too. If you are comfortable hand feeding birds you can make a handfeeding paste with handfeeding powder (ie Nupreen Hand Feeding Formula) and your electrolyte solution. Ideally, if you haven’t hand fed a chicken before, you should have your vet show you how to do this safely (as aspiration is a serious risk that is best avoided). Do monitor the crop by gently palpating to make sure its emptying into the gut, (normally 2-3 hours post eating). If it feels more like a hard tennis ball, that is an indication of dehydration and crop impaction or cop stasis. Give fluids and massage crop. But if it doesn’t improve, then veterinary intervention may be required
Overall, there are a range of agents that can be to blame for the signs you are seeing with wee Trina. Therefore, isolation was the first step but now you need to initiate the above supportive care, monitor her breathing, and take some of the above diagnostic steps to determine which is to blame for her signs. If you narrow down the differentials but cannot identify a cause (ie if its one of those more subtle ones or is lurking in the lungs), then it would be ideal to follow up with her vet. Overall, by treating her but also identifying the agent present, you will be able to ensure you are treating her as effectively as possible and make sure you are able to limit the disease in the others and prevent spread to any other birds.
If you don't have a specialist avian vet, you can check where you can find one at near you at the RCVS Register (HERE), http://www.aav.org/search/, http://poultrykeeper.com/poultry-vets, or Avian web (LINK).
I hope this information is helpful.
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