As posted in our Bereavement section, Zaffer passed away on February 20, 2023. He was my best friend and a major element in my life. He had been with me since 2005. Herein, I present a chronology of his final plight. That struggle all began in January of last year (2022). I'm also including some video clips of Zaf from our earlier days.
CHRONOLOGY OF EVENTS
January 2022:
Zaffer developed an eye infection. His vet prescribed two weeks of the antibiotic enrofloxacin (Baytril). His eye infection seemed to resolve nicely. However, some slight disfigurement of the upper and lower eyelids of the eye occurred .
July 2022:
Zaffer began experiencing regurgitation impulses each time he attempted to eat his meals. These interruptions deterred his desire to consume much food. His weight thus began to decline. He saw his vet for the condition on July 15. Cytology testing revealed an excessive yeast presence in his upper digestive tract. He was prescribed and placed on the anti-fungal medication nystatin. I began giving him the nystatin on July 22. His regurgitation impulses stopped a few days after beginning the medication but he completed the full 7-day regimen. Unfortunately, subsequent cytology assessment indicated an enduring presence of yeast organisms.
July 29, 2022:
I sent an email to Zaffer's vet describing a worsening problem with his right leg. This was the leg upon which he'd suffered a tibiotarsus fracture in 2013 - it was an incredibly terrible experience for him! Despite that the bone ends had not been properly aligned by the vet providing his medical care back then, the leg healed adequately so Zaf was able to use it normally for many years. In late 2021/early 2022, Zaf began to experience worsening difficulty with the leg. He especially had trouble when attempting to bear his full body weight on it in order to hold food with his opposite leg. The leg continued to bother him and his level of discomfort continued to increase through the remainder of 2022. [Note: I'm unsure why, but the vet Zaffer utilized in 2022 mostly avoided discussion of his leg issue. I took the impression she didn't think it was a big problem; perhaps she thought it may heal on its own. It wasn't until October that she began to devote some attention to his increasing debilitation from the leg. By November, his right leg would become swollen to a girth of 5 times the size it should have been. The condition completely crippled him and was quite painful. Obviously, he was unable to get exercise and had extreme difficulty moving about in his home environment.]
August 17, 2022:
Zaffer managed to tear off a scab from the fleshy area beside his tongue. Recurring/oozing/scabbing lesions in his lower oral cavity had been chronically occurring due to a sublingual ulcer condition he had somehow acquired in early 2015 - multiple veterinarians had failed to identify the causal pathogen. When Zaf tore the scab away on August 17, it resulted in some vascular damage severe enough to produce an oral hemorrhage condition. When I noticed the blood pouring out of his beak, I rushed him to the vet clinic for an emergency admission. Thankfully, the bleeding stopped and he was re-hydrated intravenously. On the drive home, I noticed Zaf had begun intermittently coughing - he had never before coughed during his time with me. Apparently, he had aspirated some blood from the hemorrhage. During the following weeks, he would experience periodic violent coughing fits. They were especially bad in the late night/early morning hours. He was placed on the antibiotic enrofloxacin (again) for this new respiratory condition.
August 23, 2022:
Zaffer was prescribed fluconazole, a systemic anti-fungal medication, as a more aggressive treatment for his yeast problem. Each day, he received both fluconazole-treated drinking water and his oral syringe delivery of enrofloxacin to address his apparent respiratory infection. [Note: Zaf's coughing fits would intermittently occur until mid-October, at which point they seemed to fully resolve. His coughing had become so frequent and severe that I opted to postpone his water treatments of fluconazole shortly after starting them - there were simply too many things going on with him at once and I wanted to rule out any of them being medication induced.]
September 4, 2022:
While examining Zaffer's oral cavity, I noticed he had developed a prominent thickening on one side of his palate. I reported this asymmetry to his vet and included a photo. Since I had scheduled an appointment for him at another veterinary facility to undergo a diagnostic tracheal trace (in order to hopefully determine the cause of his frequent coughing), Zaffer's vet responded to my observation of the palate thickening by telling me to have it assessed during the tracheal trace appointment. She, therefore, did not offer to personally examine him at the time.
September 13, 2022:
Zaffer's treatment with fluconazole was resumed. Almost immediately, he developed severe polyuria and polydipsia (excessive urine discharge and water consumption). He also began demonstrating intense bouts of regurgitation.
September 14, 2022:
I reached out to Zaffer's vet via email about what seemed to be his adverse reactions to the fluconazole.
September 15, 2022:
Zaffer's fluconazole water treatments were discontinued per his vet's instruction - it appeared he may have been receiving too much of the medication since he was drinking so much water. As such, a measured oral administration of fluconazole via syringe was attempted instead. His severe PU/PD symptoms, however, continued. I advised his vet. She responded by telling me to completely discontinue the fluconazole treatments. I did so.
September 16, 2022:
I received an email from Zaffer's vet in which she told me she believed Zaffer's response to fluconazole had confirmed he could not take it.
September 20, 2022:
Via email, I reported to Zaffer's vet that despite being off of the fluconazole he was still pooping large puddles and drinking excessively.
September 21, 2022:
Zaffer's vet replied to my email stating I should get him to the clinic as a 'fit-in' appointment the following morning.
September 22, 2022:
Zaffer went in for the very stressful 'fit-in' appointment - the sedation used (midazolam) had little to no effect on him this time and the procedures were extremely hard on him. He screamed in horror through the entire session! His vet took some blood as well as performed a crop wash to extract fresh sample matter for cytology assessment. He was restrained and she probed and examined his distorting palate, after which she advised me she suspected the mass may be cancerous. [Note: Once returned, Zaffer's blood work results revealed his glucose level to be far above normal. The normal range for a bird like Zaf is 200-450 mg/dl. The blood taken from him on September 22 showed his glucose level to be at 978 mg/dl. Whereas his glucose level in July was only 393 mg/dl.]
September 24, 2022:
Zaffer's PU/PD symptoms appeared to have somewhat improved. I reported this to his vet.
September 27, 2022:
I received an email from Zaffer's vet in which she reiterated that since his PU/PD symptoms and his sudden onset of severe regurgitation happened concurrently with the fluconazole regimen, she had concerns the symptoms may have been related to this medication. The good news was Zaffer's improved PU/PD symptoms first observed on September 24 had been sustaining since that day. [Note: Sadly, his PU/PD symptom improvement turned out to be short-lived.]
September 28, 2022:
During the early morning hours, I received an email from Zaffer's vet. She reported that the cytology results for his crop wash sample looked much better in that the yeast presence had fully resolved. Her conclusion was that the fluconazole, even in its short duration and considering Zaffer's adverse reaction to it, seemed to have cured his yeast condition. This was very good news! And it was complemented by the fact that Zaffer's high urine output and excessive water intake (PU/PD) seemed to have mostly resolved as well - these positive developments, unfortunately, did not last.
September 30, 2022:
I noticed some dried blood in Zaffer's lower beak and coating his tongue. He had clearly experienced another oral bleed at some recent point. Further inspection revealed another scab at his sublingual lesion area that he'd partially torn away (again). I called his vet's clinic but was told there wasn't much they could do for him regarding his proneness to disrupt his sublingual scabs and experience the bleeds. I thus watched over him, frequently inspecting his partially adhered oral scab. I kept him as calm and distracted as I could.
October 3, 2022:
Zaffer's PU/PD symptoms had returned. He again started gorging himself on water and his poops became surrounded by puddles of liquid (as before). I had noticed his thirst building and his poops becoming more watery the previous day (October 2).
October 2022 (overall):
In addition to his severe PU/PD, his high blood glucose, his useless and severely inflamed right leg, and his apparent potential for subsequent oral hemorrhaging, Zaffer's coughing fits intensified during the first half of October. His coughing became so severe at times that he appeared to be suffocating. There were no known options to relieve him from these coughing episodes. He was on antibiotics and I otherwise followed his vet's advice and even reached out to a well-known avian specialist veterinarian in California. Sadly, no other accessible resources were available for Zaffer in my area. He had been on a waiting list for a tracheal trace at the only facility within driving distance equipped to perform that procedure. But his appointment wasn't until November 7. Thankfully, though, somehow his respiratory distress attacks (i.e., his coughing, wheezing/whistling sounds, gasping, etc.) had resolved on their own during the final weeks of October. [Note: Zaf was also scheduled for a full body CT scan during the same scheduled November 7 session. However, the day before the appointment (November 6) the facility's owner hostilely scolded me in an email for asking some important preliminary questions about the upcoming procedures. She as well imposed an ultimatum upon me, holding that the full body CT scan would not occur unless I paid in full (beyond the multiple thousand dollar deposit I had already paid) within 3 hours from the time the email had been sent to me. The email was received at approximately 11 AM and full payment was now required by 2 PM the same day. And this was on a Sunday. I was prepared to pay the balance in full at the time of service (as per the facility's written policy) and would have had no problem doing so. Yet the owner's rude and insensitive ultimatum stood. I thus lost trust in the facility and its staff - especially in its owner, who was the veterinarian who would have performed the procedures on Zaffer. I thus canceled the appointment.]
November 4, 2022:
I discovered that Zaffer had become blind in his right eye. My first indication was that he had suddenly started drinking from his water bowl in a peculiar way. That is, he began extending his neck across his water bowl and hooking the tip of his beak over the far rim of the bowl as if he could no longer gauge the water depth and feared dipping too far below the water's surface. Hooking over the bowl's far edge gave him some feeling of control. My focus on what may have been causing this new behavior resulted in my discovery that his right eye had somehow become sight impaired. My testing revealed he could not even see shadows or detect nearby movement of objects with the eye. [Note: The manifestation of this development seemed quite sudden. Was this unexpected state of right-eye blindness related to his high blood glucose levels? Or had he perhaps experienced a stroke from his coughing fits and the extreme stress he'd been under? Since his local vet and the specialist consultant vet were predominantly focused on gaining the diagnostic assessment of his palate mass, Zaf's sudden right-eye blindness was mostly ignored by both of them. I will add that when pressed multiple times for an opinion concerning his high blood glucose levels, his local vet finally responded stating she didn't believe those high levels indicated diabetes. That's all she would ever say on the matter.]
November 30, 2022:
After the long wait for an appointment, Zaffer finally went for his full-body CT scan at a local veterinary hospital. The results were ominous as far as his palate lesion being cancerous. However, according to the specialist consultant, who reviewed the scan image data thereafter, Zaf's situation was not hopeless. The consultant didn't believe the tumor had breached Zaf's palatine bone plate. It was a sorely needed boost of encouragement. However, it was extremely difficult to find a qualified local veterinarian who was willing to perform the surgical procedures Zaffer required (i.e., a punch biopsy followed by a debulking of the mass). Due to said difficulty locating the needed resources combined with constraints on scheduling procedure availability, there was a month-long period with no progress toward resolving Zaf's condition.
December 28, 2022:
In the early evening, before his punch biopsy procedure the next day, while Zaffer was drinking water I noticed some bloody drops running into his water bowl from his lower beak. The blood was emerging from the right side of his under-tongue lesion area. The blood-oozing continued throughout the evening and into the early morning hours. The bleeding would periodically stop, then it would start again. This cycle was persistent. I sat up with Zaf all night trying to distract him from agitating the wound and keep him calm. I pressed paper towels into his lower beak each time his bleeding restarted. I was worried about allowing him to drink much water because the more he drank, the more his clotting progress washed away. He was thirsty and really wanted to drink. But I only allowed him to drink small amounts at a time despite being unsure if doing so may result in another massive oral hemorrhage. Thankfully, prior to sunup, the wound was able to clot well enough to stop oozing blood. A bit later, since Zaf was quite thirsty, he drank a fair amount of water.
December 29, 2022:
Zaffer went in for a punch biopsy of his palate mass as well as an exploratory sampling of his right leg tissue. Prior to the surgery phase, the preliminary steps were sedation followed by gas anesthetization. He was again difficult to sedate with midazolam so the vet opted to combine it with ketamine (which seemed to work). The procedures were very hard on him this time. For the next several days he was exhausted and quite uncomfortable. It seemed to me as if he'd given up. The sweet, fun-loving bird that I knew and loved so much had seemingly vanished. Two surgical wounds rendered his right leg hopelessly impaired and it would not heal. The leg inflammation was clearly quite painful for him and he effectively had to drag himself to move around. His medications were gabapentin and concentrated meloxicam. The following 7 weeks were extremely difficult for both of us.
January 5, 2023:
Via telephone, I received word on the findings from Zaffer's palate mass biopsy. Those findings reported the tissue samples as being consistent with fibrosarcoma. The report described the mass as appearing unencapsulated and invasive to his palatine bone. I received the digital pathologist report the following day (January 6). [Note: I was advised by Zaffer's local vet, as well as by the specialist consultant vet, that Zaffer should be considered on palliative care and treated as such. I continued to administer his pain medications and I started him on a regimen of CBD oil - which dramatically improved his appetite. I maintained that course of treatment until his condition declined to an unmanageable point.]
February 19, 2023:
For the first time in weeks, Zaffer's morning appetite was gone. As recently as the previous day (February 18), his appetite had been quite good (beginning with his morning meal and continuing throughout the day). He had also been drinking large quantities of water due to his chronic PU/PD and blood glucose issues. But that great thirst had vanished as well. Additionally, his energy level had substantially diminished. Despite my persistent efforts, I was unable to get him to eat or drink and by late evening he had difficulty raising his head and began to experience sporadic wheezing and wing-flailing episodes.
February 20, 2023:
From midnight forward, Zaffer continued to experience random attacks of wheezing with wing-flailing. It seemed he was rapidly losing his battle. His suffering was incredibly torturous for me! I contacted every emergency veterinary facility within 30 miles, but none were equipped/willing to perform euthanasia on my cherished friend (should I feel it had become necessary). Zaf was agonized and exhausted and it seemed clear he was dying, but we had to wait hours while trying to locate a vet who was willing to intervene. His local vet had the day off and none of the other vets at her clinic were comfortable seeing birds. I finally located a vet who saw birds and was willing to perform the procedure. However, this vet was very busy on that day... we thus had to wait hours for a callback from his clinic. The callback finally came at mid-afternoon. Zaf was extremely weak! I placed him on a towel in his transport carrier. Coincidentally, just prior to our exiting the house, I received a phone call from his regular clinic advising me that his vet would be there briefly to perform another emergency procedure and would also be able to euthanize Zaffer as long as we arrived at the clinic very soon. I thus called the other vet clinic and canceled the appointment there, then left with Zaffer to visit his regular vet for the final time.
February 20, 2023 (Zaf's ending moments):
We were escorted into the examining room by a vet tech. (I was in a state of emotional shock through the following events.) The vet tech left the room and returned with a syringe containing a relatively large quantity of sedative which she said the vet had asked me to administer to Zaffer via his nares. The sedative mixture was a combination of midazolam and ketamine - I was told to deliver the whole amount. It seemed like an extremely large volume of fluid to convey through Zaf's sinus system; however, I followed the instruction. Zaf had no energy to resist. He was not flailing, wheezing, or gasping. But he gave me a look as if to say, "why are you doing this to me?" He was so very weak. I held him on my lap and caressed him for several minutes. I was in tears through the entire process. Within 10 minutes or so, the vet entered the room. The vet tech gently took Zaf from me and softly placed him on a towel on the examining table. The vet proceeded to inject the lethal dose under his wing. She then used her stethoscope to confirm his heart had stopped. It was the end. I was crying my eyes out! The vet hugged me and left the room. The vet tech and I remained in the room and caressed Zaf's lifeless body for a time. I eventually left without Zaf's body so the clinic could send him for cremation. This was the most difficult day of my life!
Thoughts:
Zaffer had a terminal illness. He was emaciated, very weak, and began suffering a great deal. Even though he'd been eating quite a lot in response to the CBD oil therapy, his weight had been consistently diminishing. During his final months, it became very difficult to weigh him because he could no longer stand on the scale. However, the most recent weight I was able to get from him was 1072 grams - his normal weight used to be 1400 grams. His keel bone had virtually turned into a razor blade. He could no longer walk. He could no longer play. He could no longer flap his wings. He was rapidly dwindling away, and it was beyond heart-wrenching. All of that, in conjunction with the fact that available veterinary resources were unable to effectively address his multitude of complications, created a painfully hopeless scenario. It was pure hell!
Zaffer was my perfect companion. I will never be the same.
VIDEOS
Rubber Ball 1
https://youtu.be/JmqRZKDdDP8
Rubber Ball 2
https://youtu.be/Y55WtikqDEQ
Bowl Play
https://youtu.be/d1rubE4rBGY
Slidey Bowls
https://youtu.be/h_JxLegfIVI
Who's that looking down on me?
https://youtu.be/2EgSTFaL8fA
Saying HELLO
https://youtu.be/x3tY5bpryZ0
Blue Chicken-flap Dance
https://youtu.be/SoL0Ps6RD3Y
Being Playful
https://youtu.be/UXRQWWyUDF0
Quality Relaxation
https://youtu.be/fa0Fj9sA3F4
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Originally Posted by Dragonlady2
