Metal Toxicity

Drug Reaction to Calcium EDTA

A friend of mine had a Pionus that was on treatment for zinc die in her hands a few mornings ago. 

CaEDTA was used for treatment, in addition to several other things prescribed from the vet. The prescribed treatment was RIGHT, but some birds (rare) can have reactions to the medication. The first alert to a reaction is the bird will become weak and staggering. I advised her to
let Sam know immediately, but somehow there was a 'misunderstanding' between client and vet on the phone and the bird was not hospitalized.

I HAVE had reactions from CaEDTA.  A more serious reaction is seizures If something isn't done the bird WILL die.

If you ever have to treat for zinc...please be AWARE that you can get reactions.  If the bird becomes weak and staggers...STOP....and get to the vet for fluid therapy and an alternate treatment.

In my case (Stinker, last fall) I had no time to get to a vet because the cockatiel went into seizures. The ONLY thing that can bring them out of this is Epinephrine (Stop Shock)  Then SubQ'ing Lactated Ringers. Then I force (tube) fed BCC 3X aday, a mixture of Aloe Detox (as the water), Exact handfeeding formula, Charcoal-Kaolin, Psyllium, and Lactulose. After 3 days I reduced the 'treatment to 2X a day, and after 10 days to 1X a day. Shots of B complex were given weekly.

I'm sitting here feeling very guilty, because if it was a cockatiel I would have had her bring it here...but it was a Pionus...so I didn't insist.  I tried to encourage the Aloe Detox, and charcoal.... or hospitalizing.  I phoned the vet's office to let them know she was bringing in the body and to PLEASE give her a hug.

I just wish people would be warned that with this particular drug there can possibly be side effects and or death.

Susanne

Metal Toxicity
Since often times the test for metal toxicity comes back with a false
positive, it won't hurt to treat the bird anyway. I have heard of several
cases of birds improving just from this treatment. Also apple pectin,
sodium alginate, and psyllium, along with peanut butter helps flush the system.
Here is a site for a natural metal detox that sounds pretty good, although I am
not familiar with this particular product. 

http://www.nutrimed.com/EXTOX.HTM
 

FYI, vets use calcium EDTA, or calcium versonate, or cuprimine. I believe
cuprimine can be purchased over the counter for fish. I am definitely not
recommending that anyone should do this, without first consulting with
their vet.

Linda 

Peanut Butter is used to help pass the particles in birds. However Chit Chat was allergic to peanut butter. She would throw up big time so that was not an option. She was perfectly healthy. It was all the zinc that did this. When Zinc is ingested it throws the whole body out of wack and makes bacteria run rampant. It affects every aspect of a birds body. I have her blood
count also. Here it is:
SGOT should be 20-350 and is 4240
Uric Acid ...Should be 2-10 and is 130.4
CPK enzyme 50-400 and is 23000
Protein 3-5.5 and is 2
Calcium 7.6-12 and is 5
Sodium 140-160 and is 132
Potassium 3.0-4.5 and is 2

We were even trying to get a hold of this special magnet to try and pull the pieces out of her gizzard. Dr Moore washed the ones out of her crop. But when her digestive system shut down, there was no hope and I knew it.

Ang

From Susanne:
When my cockatiel Stinker first had the allergic reactions to the
CaEDTA, and then he also stopped digesting because of metal, the ONLY
way to save him was subcutaneous fluids of Lactated Ringers.  It took 30
hours before he could finally pass droppings again!! Use of fluid
therapy gives a no hope bird a 50% chance.

Susanne

From: gloria scholbe <>

In her book Homeopathic Treatment for Birds, Beryl Chapman lists two
homeopathic treatments for heavy metal poisoning in birds.  One is for
lead poisoning the other is for mercury poisoning.  I didn't find any
for zinc, but I wonder if anyone knows if the homeopathic treatments for
the lead or mercury could be used for zinc poisoning or if there is a
homeopathic specific for zinc?

The homeopathic might not get rid of the metal particles, but it should
be able to cure the toxicity as it develops. Homeopathic treatment would
have to be continued until the metal particles were cleared.

Another approach would be to use blood purifiers to clear the toxins out
of the blood and liver.  Again, he metal particles still remaining would
have to be eliminated, but the immediate reaction to metal poisoning
might be alleviated.  At least the toxins wouldn't be able to build up
to lethal levels.

Either treatment, homeopathic or herbal would have to be continued until
after the metal was eliminated from the body. A few final treatment course to
purify the blood and other organs would be necessary once the metal was
gone.

Along with that, As Susanne mentioned, rehydration therapy would be
administered to compensate for electrolyte and fluid loss through
vomiting and diarrhea. (The body's efforts to rid itself of the toxins.)

gloria 

Diarrhea is also another means of ridding the body of toxins, and if
zinc/metal is suspected don't treat (kaopectate, etc.) it...let it run
it's course. I learned this from the Ritchie book. In the interim, still
give fluid therapy.

I've found that fluid therapy is vital...whether it is minimal loss or
to the extent of digestive shutdown.  Anemia is another serious threat.
Weekly Vit. B complex suppliments/shots will be very beneficial. Vit. A,
C and E help.

I've personally had success with mixtures of Charcoal-Kaolin, pysllium,
Lactulose in handfeeding formula and crop feeding this mixture 2 times a
day. At various times I would also use Prozyme, nutri-cal, yogurt, and
citric acids...dependant on how the bird was responding and the
droppings. I have also saved 1 cockatiel that had Sarco with this
mixture. My only experience is with cockatiels.

Susanne

From: "Marnie" <>

I've seen far to many  distraught bird owners on the Bird Lists, many
very experienced who never believed that if they took precautions such
as washing with vinegar weekly, that their bird would succumb to Zinc
poisoning.  Personally I don't feel that economics should not play a
part in whether it is safe to gamble on whether you slowly poison your
birds or not...  we know the dangers of Zinc and Lead; why take the
chance?
-Cheers! Marnie

Okuda T; Mori K; Shiota M; Ida K 
                     Yakugaku Zasshi 1982 Aug;102(8):735-42 

                     The precipitate formation in the solution of geraniin 
                     (I), punicalin 
                     (II), tannic acid 
                     (III), or (-)-epigallocatechin gallate 
                     (IV) mixed with that of cadmium, chromium, copper, iron, mercury, manganese, lead or zinc ions at pH 5.4, was investigated. The amount of precipitate decreased with an increase in concentration of I or III but precipitate increased with an elevation of tannin concentration. The precipitates formed were solubilized upon further increase of tannin concentration and when the amount of heavy metal in the supernatant liquor together with the ratio of tannin to heavy metal in the precipitate were increased. Extensive reduction of  chromium, ferric, cuprous ions and complex formation occurred in the presence of tannins  such as I, II, III and IV. These results indicated that the toxicity of metal ions could be reduced in the presence of tannins and polyphenols. 
                                                     *************

Zinc toxicity in birds results in gastroenteritis, necrotizing ventriculitis, as well as damage to the pancreas, kidneys and the liver. Treatment consists of supportive care, chelation therapy and endoscopic or surgical removal of the foreign body. Small foreign bodies may pass with the addition of laxatives to the diet.

Zinc is extremely toxic to birds. Sources include galvanized cage wire, clips or staples, bird toy snaps, zippers, keys, nails, plumbing nuts, nuts on animal transport cages, hardware cloth, padlocks, and some antirust paints, shampoos and skin preparations.

Padlocks are frequently used on bird cages. Other types of locking
devices should be considered on cages of large birds who may attempt to
chew on the padlock. Chrome-plated cages should be avoided for larger
birds.

Reference: Romagnano A, Grinden, CB, Degernes, Mautino M. Treatment of a
Hyacinth Macaw with Zinc Toxicity. J Avian Medicine and Surgery.
1995;9:185-189.

The effects of maize-bran phytate and of a polyphenol (tannic acid) on iron absorptionfrom a white-bread meal were tested in 199 subjects. The phytate content was varied byadding different concentrations of phytate-free and ordinary maize bran. Iron absorptiondecreased progressively when maize bran containing increasing amounts of phytatephosphorous (phytate P) (from 10 to 58 mg) was given. The inhibitory effect wasovercome by 30 mg ascorbic acid. The inhibitory effects of tannic acid (from 12 to 55 mg)were also dose dependent. Studies suggested that greater than or equal to 50 mg ascorbicacid would be required to overcome the inhibitory effects on iron absorption of any mealcontaining greater than 100 mg tannic acid. Our findings indicate that it may be possible topredict the bioavailability of iron in a diet if due account is taken of the relative content inthe diet of the major promoters and inhibitors of iron absorption. 

By Matthew W. Bond, DVM
Zinc Toxicity
I have been a parrot breeder for about five years, which has given me
enough time to evaluate how I (and other breeders) keep my stock. My
first concern is using galvanized wire for cages. Many of my parrots
walk the wire of their cages using their beaks as they move. Because
most parrots are very oral, the ingestion of this metal could be a
problem. I have checked with my local veterinarian, and he could not
think of any known problems with this metal as a toxin. I am seeking
your advice.

For many years, I, too, have pondered over the effects of zinc in a
parrot's environment. Many breeders keep their birds in galvanized wire
cages (including my collection). Galvanized metal is commonly used in
dishes and as part of toys. An excellent paper was presented at the 1997
Association of Avian Veterinarians Conference by Fern Van Sant, DVM
called "Zinc and Clinical Disease in Parrots." (Session #900)

Besides the ones already listed, other sources of zinc include C clamps
or hog rings that are used to hold the cage together. Birds are often
fed a diet rich in acidic foods (such as citrus). The acidic nature of
the fruit reacts with the zinc actually leaching it into the food,
creating a food source high in zinc. Birds are notorious for taking food
from the dishes, dropping the food on the cage floor and eating it
later. The cage floor is often galvanized wire, and the same reaction
occurs. If galvanized water bowls are used, the metal may also leach
into the water source.

Let us not forget how many parrots turn chewing into a fine art, which
is a direct way to ingest this metal. What happens to the zinc after
ingestion? This is actually a key question. It appears that the longer
the zinc stays in the body by the increased time for absorption from the
GI tract into the body, the more chance of creating problems. Therefore,
if the gastrointestinal transit time is slow, there will be more problems. This simply refers to the time from eating to the time that it passes out of the body.

Slow transit time can be related to a number of things. Diets high in
fat take longer to digest and are therefore slower in transit time. High
fiber increases the transit time while low amounts slow the process. So
those diets high in seed and low in vegetables and fruit can be a
problem. Many soft toys lead to the ingestion of threads that pass
through the digestive system slower, and small pieces of plastic will
create the same problem.

What are the signs of zinc toxicity? Zinc in high levels can lead to
rapid death, though the slow, chronic exposure can be more subtle. The
major symptom would be slowing down of the GI motility, which, as
previously discussed, can compound the problem. However, this is not a
clear-cut symptom for zinc but a common problem in the sick bird! It is
not unusual to find chewing or plucking of feathers, and pasty vents are
common in smaller birds. Neurologic signs may be present, such as
seizures and ataxia (poor coordination). Following death, the necropsy
may be quite unremarkable, though microscopic examination of the tissues
by a pathologist will show degeneration of the liver, kidneys and
pancreas.

How do we screen healthy birds for this potential problem? While
radiographs have been used to detect metal quite commonly, not all
problematic birds will show metal particles. A small blood sample
(greater than 50 microliters of serum or plasma) can be taken, and your
veterinarian can submit it to the Louisiana Medical Diagnostic Lab at
Louisiana State University School of Veterinary Medicine, 1909 S.
; . Breeders may want to
randomly check birds in their collections during the yearly exams to
help assess the potential problem in their collection.

There is treatment, and the recovery is quite dramatic. It involves
chelation therapy and flushing the GI tract, both of which can be
initiated by a veterinarian and continued by the aviculturalist.
 

Matthew W. Bond, DVM, received a doctorate in veterinary medicine from
Tufts University in 1986, and holds degrees in medical technology,
biology and chemistry. He has extensive experience in avian medicine,
especially pediatrics.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Heavy Metal (Lead & Zinc) Poisoning:
Are Your Birds At Risk?
by Robin Roscoe, DVM, Dipl.ABVP (Avian)

Birds love to chew and explore with their beaks. Are there accidents
waiting to happen in your home? Objects that, if chewed & swallowed, may threaten the life of your feathered friend? A toxin (poison) can make your bird very ill very quickly, so it helps to know how to recognize the symptoms or, better yet, avoid the possibility altogether.

Sources
  Lead may be present in many familiar objects such as the weights used
in curtains, penguin bird toys, wheel balances, and for fishing and diving.
Shiny objects such as costume jewellery, stained glass (lead seam), bells with
clappers, and foil from some champagne and wine bottles are also
potential sources. If your bird is into home renovations, he may be exposed by
chewing on plaster, older lead-based paints, linoleum, and PVC blinds. Other
possible household sources are: batteries, hardware cloth, solder, glazed
ceramics, galvanized wire, and seeds intended for planting.

  Zinc may be present in various items such as galvanized wire & clips,
and the powder coating applied to some lawn furniture and some bird cages.
Galvanized wire has been used for many years for aviary cages. Exposure
to zinc (& lead) will vary with the quality of wire used, the
preparation of the wire (brushing off zinc "tags" on the wire and curing
the wire outdoors and/or with a vinegar solution), and the amount a bird
chews on the wire. Whether the wire is galvanized before or after
welding makes a difference as well. American pennies minted after 1982
contain zinc. Canadian coins do not. Toys may be a source of zinc
depending on the types of chains and hardware used.

Clinical Signs
  Toxicities may be acute (a sudden exposure to a large quantity), or
chronic (a long-term low-level exposure). As acute toxicities are the most
life-threatening, we will discuss these first and in the most detail.

  Symptoms are usually sudden in onset, and include depresson, weakness,
loss of appetite, polyuria (excess liquid in the droppings) and diarrhea. So far
this sounds like the stereotypical sick bird. Two important clues are the
sudden change from an active & vocal bird to a fluffed-up & quiet one, and a history
of chewing on unusual items. Having said this, there are times when we never do
find the source, but it will help your avian veterinarian come to a faster
diagnosis if you tell him or her that your bird was seen recently chewing on your
favourite stained-glass tiffany lamp or other suspicious object.

  There are other  clinical signs that will also cue your avian vet to
consider a possible poisoning. These are: sudden vomiting (especially in adult
parrots), loss of balance, a head tilt, circling, blindness, head tremors, and
convulsions. Some parrots may also pass red-tinged droppings.

  When a bird swallows particles of lead or zinc, they travel to the
stomach where the muscular portion (the ventriculus) starts to break them down. When
the heavy metal is absorbed into the bloodstream the bird begins to feel ill. Once
absorbed, the nervous system, the gastrointestinal system, the kidneys, and
blood-producing organs are affected. This is reflected in the clinical signs already
mentioned.

Diagnosis
  Several tests may be done to aid diagnosis. Metals show up well on
X-rays, but not all metals contain lead or zinc. A complete blood count may also
show an increased white blood cell count and/or a mild to severe anemia (low red blood cell count), but this again is not specific. Blood lead and zinc levels
may be measured. This is the most definitive test. Its only drawback is the
relatively large amount of blood required. For smaller birds, or very anemic birds,
this test may not be an option.

  As you can see, a diagnosis is often based on several factors
including history, clinical signs, and test results.

Treatment
   The first goal of treatment is to relieve the signs of illness. This
is best done by chelating (binding) the toxin in the bloodstream using
injectable drugs.The second goal is to prevent absorption of the toxin. This may be done by using various binding agents given by mouth. The third goal is to remove the particles. If large, they may be surgically removed using an endoscope. If small, they can be "encouraged" to leave the stomach and pass through the intestines more quickly using lubricants. The length of treatment will vary depending on the number and size of particles.

Chronic Lead or Zinc Poisoning
  In cases of chronic poisoning there may not be metal visible on
X-rays. These birds may show vague signs of illness such as weight loss, lethargy, and depression. This is when the specific blood test for lead or zinc is
critical in making the diagnosis.

  Recent studies have linked some cases of feather picking to chronic
low-level zinc toxicity. These birds may not appear ill in the classical sense
(fluffed-up & lethargic). Interestingly enough one of the sources has turned out to
be the powder coating used on some cages. Zinc is sometimes added to the paint
to prevent it from chipping. Birds may end up swallowing small pieces, or absorbing small quantities as they grasp the bars of their cages with their beaks &
tongues. A blood test will determine if the bird has elevated zinc levels. Cage
paint and other toys may be tested for zinc content.

  Most manufacturers are now aware of this situation and have corrected
it. The problem lies in the many cages that are in peoples' homes that were
produced before the danger was recognized (1996). If your bird is a feather
picker then you may want to consider having its zinc level checked. (Remember there are many causes of feather picking and this is only one of them). If your bird is not a picker, but you are concerned about the possibility of zinc in the
powder coating, then you may want to contact the manufacturer or have a sample of the paint analysed. Metal parts of toys may also be analysed.

  Enjoy your birds and allow them as much supervised freedom as you can.
Give them a wide variety of safe objects to chew on. I hope that I've made you
aware of some of the more subtle hazards. As is so often the case, "An ounce of
prevention is worth a pound of cure".

  ASK THE VET (Zinc Toxicity)

                           by Linda Pesek, DVM
                        Westbury Animal Hospital
                             319 Union Avenue
                              Westbury, NY
                              

This article first appeared in SQUAWK, the newsletter of the Big
Apple Bird Association, and appears here with permission.

 In my last column, I wrote about lead poisoning. In this column I would
like to talk about a second type of heavy metal toxicity -- zinc. Birds
can be exposed to zinc if they are housed in flights or cages made of
galvanized wire, since zinc, and sometimes lead, is  often a component
of this wire and the clips used to construct these flights. Zinc is also
a component of galvanized food dishes,  certain game pieces, and pennies
minted after 1982. In addition, the white rust that can form over zinc
is also toxic to birds.

  The signs of zinc toxicity may be variable. Birds exposed to a large
amount of zinc may display ataxia (loss of balance), green  diarrhea,
and may die suddenly. Chronic exposure may be expressed as depression,
intermittent lethargy, neurologic signs such as   seizures and ataxia,
and increased thirst and urination. Death may occur as a result of
anemia and damage to internal organs.

  Just like the diagnosis of lead toxicity, diagnosis of zinc toxicity
can be very difficult. Radiographs may demonstrate metallic  densities
in the gastrointestinal tract. Blood levels for zinc may be run in a
laboratory.

    Radiographic and clinical signs are the same for zinc and lead
toxicities; thus one can't be differentiated from the other.
Fortunately, treatment is the same for both.

         1. Cathartics may aid in the passage of small particles.
         2. A magnetized instrument may be employed to remove galvanized
wire pieces from   the digestive tract.
        3. Chelating agents may also be used, either given orally or by
injection.
        4. Surgery or endoscopic removal may be necessary to remove zinc
particles that are visible radiographically.

            As with lead, the best way to avoid zinc toxicity is by
preventing your bird's exposure to it.

Lead Poisoning

Symptoms of lead poisoning can range from lethargy and depression,
inability to perch (unexplained falls from perches) to seizures
and death.

The initial treatment will depend on whether it is an acute case of lead
poisoning (usually after ingestion of a lead-containing foreign body) or
chronic lead poisoning (repeated small exposures - often from eating
food or drinking water from lead-soldered dishes.)

Gastrointestinal decontamination using an adsorbent such as activated
charcoal and a cathartic such as lactulose is instituted for acute lead
poisoning but is usually of little value in chronic lead toxicity. An
x-ray should be done to confirm the presence of metallic particles.
Repeat s-rays should be performed to ensure that the metallic particles
have been eliminated from the gastrointestinal tract.

Specific antidotes for lead poisoning should be administered for both
acute and chronic lead poisoning. These are called chelating agents
which bind circulating lead in the blood. These drugs include Calcium
EDTA (given by injection), d-penicillamine (given orally) and more
recently, Succimer (DSMA), also given orally.

Because these chelating agents, possibly with the exception of Succimer,
only bind circulating lead in the blood, repeat courses may be required
because lead is released slowly from soft tissues such as the brain back
into the systemic circulation.

The testing kits for lead are called Lead Check Kits and are relatively
inexpensive. In Canada, a kit contianing 2 test vials currently retails
at $9.40 but is probably cheaper in the U.S.

Gillian Willis

 

ASK THE VET (Lead Intoxication)

                           by Linda Pesek, DVM
                        Westbury Animal Hospital
                             319 Union Avenue
                              Westbury, NY
                              

 This article first appeared in SQUAWK, the newsletter of the Big
Apple Bird Association, and appears here with permission.

Lead intoxication is a fairly common problem in pet birds. Lead may be
present in many places in the home, and birds allowed out of  their
cages may be accidentally exposed. Common sources of lead include
solder, batteries, galvanized wire, hardware cloth, bells
with lead clappers, linoleum, paints (lead-based, and those with
leaded drying agents) stained glass, curtain weights, fishing and
diving accessories, certain ceramic pieces, foil covering on wine
bottles, leaded gasoline fumes, and penguin bird toys.

 Lead poisoning may occur as an acute or a chronic problem. Clinical
signs of lead intoxication in psittacine birds may include   lethargy,
depression, anorexia, regurgitation, diarrhea, loss of balance,
blindness, head tremors, convulsions and death.
Hemoglobinuria (bloody urine) may occur in Amazon and African Grey
parrots. Some birds may develop anemia.

 Diagnosis of lead poisoning can be difficult. The radiographic presence
of metallic densities in the gastrointestinal tract of birds  with
clinical signs of metal intoxication is supportive of the possibility of
lead poisoning. Not all metal densities are lead, and the absence of
metal densities in the presence of clinical signs does not rule out lead
intoxication.

 Blood lead levels may be determined by laboratory. If a strong
suspicion of lead intoxication exists, therapy is often begun while
awaiting laboratory results. Treatment for lead intoxication involves:

              a) removal (if possible) of lead particles by means of
endoscopy or surgery.
              b) chelation therapy (both oral and IV) to remove lead
circulating in the blood   stream.
             c) intravenous fluids and dextrose
             d) iron dextran, antibiotics, tube feeding (if necessary)
             e) cathartics (mineral oil or peanut butter) to aid in the
passage of small particles out of the G.I. tract).

The prognosis for lead intoxication is guarded if the bird has severe
neurological signs or if chronic exposure has occurred. Valium  may be
necessary to control seizures if they occur.

The best way to deal with lead poisoning is to prevent it. Remove
possible sources of lead in the environment. If accidental  exposure has
occurred, seek veterinary assistance as soon as possible. 

Laboratory tests with three dozen keys found that if people handledtheir keys twice a day, the amount of lead that rubbed off on their
fingers was an average of 19 times the state's "no-risk" level. Most
color keys - such as car keys - contain only trace amounts of lead. 

Companies cited in the suit include Kwikset Corp., Schlage Lock Co. and Master Lock Co.

the price on the alpha lipoic acid is $30 for 60- 100mg softgels.  i am having to slice the lid off of them and suck the liquid into a .5 cc pipette.  my goffin gets 1 drop each day and we recheck her levels in 3 weeks.
 

the results of treating with alpha lipoic are great according to my vet.  i guess that there are not as many side- effects to treating with alpha lipoic as well.  he says that the risk of doing damage to kidneys and liver are drastically reduced.
hope this will help you in your search and you are able to make use of this information.
Aimee

Contaminated Collection Tube

This discussion of zinc tests made me recall a situation that only some vets
seem to know about -- the vials used to hold the blood samples for zinc
tests must be chosen carefully.  *Green lids* contain zinc and may actually
contaminate the sample and you'll be told that your bird has outrageously
high zinc levels and must be treated....and retested...and treated...

This happened to Robbie Sprechman in NJ (he's a super guy and I don't think
he'll mind my using his name) -- some of you may know him from macaw and
cockatoo lists.  His birds were repeatedly treated for zinc unnecessarily.
A lab in Louisiana finally helped him clear up the mystery. I sent Robbie's
post to my vet, who replied: 

Thanks for the heads up. I have been using microtainer lithium heparin
tubes for blood Zn levels for quite some time and have been aware of the
potential for Zn contamination if samples are handled or submitted
incorrectly.  This has been a hot topic in the veterinary community for a
couple of years

I felt relieved about this until I looked up "microtainer lithium heparin
tubes" and found that they're the ones with green lids!  So apparently there
are some handling guidelines that must be observed to avoid zinc
contamination.

So, then, what can we do?  I guess, if any of you are having your birds
tested for zinc and your vet is unaware of the green-lidded vial problem,
let me know and I'll put your vet in touch with my vet so they can discuss
it.  Or, contact Robbie, who may have the details at hand.

Sue vG