Laddy's Aspergillus

As many of you know, Laddy fell very ill November 1st and had to be rushed to our vet Dr. Otka at Noank-Mystic Vet Hospital. It's extremely common for ducks and geese to hide their ailments until they simply can't disguise them anymore. One day Laddy was swimming and running around his pen withWeeBit and the next, he was lethargic and unable to walk without falling over.

During his initial emergency exam, our vet heard crackling in his lungs and moved forward with an immediate  x-ray. Images revealed that his lungs were in pretty rough shape--not clear at all. Swab culturing was enlisted to quickly get to the source of the problem.

A few days later, test results revealed that Laddy had aspergillus. He only has a spot of hay in his duck house and spends most of his time outdoors in his pen, so it's most likely that the spores were in the great outdoor environment and he became infected this way. Lab results also indicated that he had a severe secondary bacterial infection. Aspergillus commonly reduces immune function, creating a gateway for other issues.

We immediately moved Laddy to our indoor basement infirmary. The infirmary is lined with fresh pine shavings and includes a mirror for company. To help keep the shavings out of his food and water dishes, we set them inside a shallow storage bin.

Once settled, Laddy began an intense, around-the-clock medical regime to treat both of his medical issues.

Nebulizer Treatments

Nebulizer treatments were enlisted to address Laddy's aspergillus. While we began by placing 4 mls of F10 SC into 1 liter of sterile water and pouring it into a vaporizer, we quickly stepped things up by having our vet write a prescription for a nebulizer. We purchased Laddy's Philips Respironics Innnospire Deluxe Nebulizer Compressor (SKU#J-1110063) online through www.justnebulizers.com and it arrived within the week.

The nebulizer cup for this unit holds up to 10 mls of the F10 SC mixture (which is still mixed at the ratio of 4 mls of F10 SC per 1 liter of sterile water). This is more than enough liquid for a 30 minute treatment period. Laddy gets two of these thirty minute treatments every day. We open the door to the infirmary and he waddles into a medium-sized pet carrier draped in loose plastic; then, we start up the compressor. When his timer goes off at the end of the session, we turn off the nebulizer and open the pet carrier's door and he walks back to his infirmary again.

Antibiotic Medication

Laddy's antibiotic regime began with twice daily doxycycline tablets and trice daily amoxycillin caplets. Doxycycline can be especially hard on the tummy, so when he lost his appetite, we had to syringe feed Laddy to keep his strength up (Iams Maximum calorie canned food, Ensure Plus strawberry nutritional shake and Critical Care; for more info see:  MWS April 2011 Newsletter 76).

Doxycycline can be hard on the liver and kidneys, so weekly blood work should be done to monitor their function, adjusting dosages or stopping treatment as needed.

After a month of treatment, we took Laddy off these medications and switched him over to Baytril twice a day instead.

Probiotics

Laddy gets probiotics twice a day. In the morning we filled a gel cap with Manna Feast powder and in the evening, we filled it with Avi-Culture powder.

Pain Medication

Laddy was given Torbutrol for pain. This was originally dosed up to 4 times a day, but today he's comfortable on his own and doing great without it.

Anti-Fungal Medication

Laddy is also on anti-fungal medication for his aspergillus. Normally vets will prescribe itraconazole, but since Laddy's liver and kidneys were struggling with his antibiotics (which is why we switched him over to Baytril), we were afraid to compromise them any further and began him on Terbinafine instead. Terbinafine is far less risky albeit an experimental treatment, not proven to be effective against aspergillus.

Whether your vet prescribes itraconazole or terbinafine, blood work should be performed every 1-2 weeks to monitor liver and kidney function, adjusting dosages or stopping treatment as needed.

Dehydration

One of our main concerns with Laddy was dehydration. While follow-up x-rays were showing that his lungs and air sacs were responding well to treatment and clearing up nicely, he was becoming increasingly more dehydrated. Even well after his appetite had returned full-fledge, he just wasn't drinking normally and his kidneys were beginning to suffer because of it it (not to mention his peeling bill and scaly legs).

Weekly vet appointments were scheduled to re-hydrate Laddy and we're continuing with those treatments today.

In addition, we began filling his water bowl with warm water and changing it out frequently to keep it that way. Warm water often entices drinking as opposed to cold water.

Ducks and geese (like other animals) will often avoid drinking water when they're uncomfortable because hydration can increase the sensation of pain. We immediately increased his Torbutrol dosage, keeping him at 4 doses a day to address this root cause until he began drinking normally again.

Today

Today, Laddy is doing very well. He's no longer on antibiotics. His weight is up at every weekly vet visit, his lungs are continually clearing (monitored monthly by x-ray), his liver function is back to normal, his kidney function improves every week, he's eating and drinking normally and his energy levels are steadily increasing.

To keep Laddy happy, he goes out to a private pen with WeeBit a few times a week on sunny days where they enjoy an hour or two together before he returns to the infirmary. He also takes weekly trips to the bathtub.

Our main concern to date is his instability. Although he no longer falls over, he is still a little wobbly. We're hoping this remnant of his aspergillus improves as his treatment continues over the next month or so, but only time will tell.

Special Thanks