Peer-reviewed veterinary case report
Treatment of pulmonary hypertension in a 25-year-old mealy Amazon
By Brady, Sean M et al.·Published in Journal of avian medicine and surgery·2016·View original on PubMed →
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Original publication title: Successful Treatment of Suspected Pulmonary Arterial Hypertension in a Mealy Amazon Parrot (Amazona farinose).
- Species:
- bird
Plain-English summary
A 25-year-old male mealy Amazon parrot was brought in because he was very tired and not eating. He had a history of high red blood cell counts and liver enlargement, and tests showed he had severe polycythemia (too many red blood cells) and other issues. After his condition worsened, he was diagnosed with suspected pulmonary arterial hypertension, which affects blood flow in the lungs. The vet treated him with a medication called sildenafil and periodic blood removal to help manage his symptoms. Remarkably, within a week he no longer needed oxygen, and after 24 days, he was back in his outdoor exhibit, showing no signs of his previous nosebleeds since starting treatment.
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Abstract
A 25-year-old, male mealy Amazon parrot (Amazona farinose) with a history of polycythemia, hepatomegaly, and epistaxis was evaluated for progressive lethargy and anorexia. Clinical laboratory testing revealed severe polycythemia (71%), hypophosphatemia (1.6 mg/dL), and mild hypokalemia (2.8 mEq/L). Radiographs showed marked hepatomegaly and loss of air sac space. Despite supportive treatments, the bird's condition deteriorated, and it developed ataxia, was unable to fly, and became oxygen dependent. An echocardiogram, including an air bubble study, revealed a right-to-left atrial shunt and presumed pulmonary arterial hypertension. The bird was started on periodic phlebotomy (5-10 mL/kg q6wk) to reduce packed cell volume and sildenafil citrate (2.5 mg/kg PO q8h) for treatment of suspected pulmonary arterial hypertension. One week later, the patient was weaned off oxygen, and 24 days after initial presentation, the parrot was returned to its outdoor exhibit. Intermittent periods of increased respiratory rate and effort have been reported but have resolved without additional treatments. Epistaxis, once common in this bird, has not been noted since initiating treatment with sildenafil citrate 15 months ago.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/28107068/