Under pressure to save a life, veterinarians at Penn Vet’s Ryan Hospital found a creative solution that not only gave an African grey parrot a second chance, but also had him on his feet and talking again within a day.
With support from other vets, Dr. Dana Clarke removed his tracheal scar tissue with a laser. While the procedure has been performed in birds, it is extremely unusual, having been mentioned just briefly in one paper, said Dr. Clarke.
In possession of a 150-word vocabulary, Bocelli the African grey parrot is talkative and “extremely smart,” says his owner, Marilyn Gural of Valley Forge.
The species lives about 50 years. At age nine, Bocelli has already proved he is a fighter, after surviving a life-threatening disease of the intestinal tract three years ago.
In September, veterinarians in Ryan Hospital’s Exotic Companion Animal Medicine service noticed that Bocelli, who was boarding with them while Gural was on vacation, was having trouble breathing. They immediately inserted an air sac cannula, a tube that taps directly into the bird’s air sac, to provide Bocelli the oxygen he needed.
Dr. Nicole Wyre, a senior clinician, peered down his throat with a scope and noticed a problem that can be fatal in birds – a stricture, or inflamed scar tissue, in his trachea. Unlike people, birds have rigid tracheal rings, which when partially blocked by scar tissue, can lead to severe difficulty breathing. Normally, birds’ tracheas are prone to scar tissue formation after trauma during medical procedures such as endotracheal tube insertion. However, vets aren’t sure what caused Bocelli’s tracheal stricture, said clinician Dr. Sharonda Meade, who worked on his case.
An air sac cannula is a temporary measure, but it quickly became apparent that the bird wasn’t going to make it without removing the stricture.
“His mom was away and we had to figure out what to do to break it down,” said Dr. Meade.
Dr. Dana Clarke, an interventional radiologist and criticalist at Ryan, rapidly devised a plan that, while highly risky, seemed the only possible way to save Bocelli. They would insert a laser down Bocelli’s tiny trachea and cut away the stricture, a procedure that has been performed for humans and other animals, but has not been well reported for birds.
“We were in uncharted waters but felt we had no other options,” Dr. Clarke said.
Typically, doctors use a laser to remove strictures that develop in people who have had a lung transplant. The laser stops bleeding while cutting and, because laser fibers are so small, the instrument allows doctors to access narrow places.
In dogs and cats, balloon dilation to stretch and open up scar tissue can also be used, but that option is not well tolerated by birds.
One of the biggest risks of the procedure was that the laser fiber inserted down Bocelli’s throat could tear a hole in his trachea, said Dr. Clarke.
Other risks included anesthesia complications. Vets were able to hook up anesthetic gases directly to Bocelli’s air sac cannula. They injected another necessary anesthetic once he was asleep.
They then inserted a rigid glass scope, such as one used on a cat or dog, into his trachea. The scope has a channel through which Dr. Clarke inserted the laser fiber.
“Once we could see the stricture, we literally touched it with the laser fiber, fired the laser, and slowly, slowly cut away small bits of the stricture. We were able to open up his trachea to 80 to 90 percent of what it was normally,” she said.
The day after the surgery on September 16, vets left the cannula in place for safety, but it was clear Bocelli was feeling much better. He was eating and his lively personality was reappearing, Dr. Clarke said. Two days after the surgery, vets covered the cannula with some tape and saw that he could breathe through his trachea.
Bocelli went home on September 20, looking and feeling back to normal. He is on antibiotics and anti-inflammatory drugs and is being closely monitored, Dr. Clarke said.
Because birds develop tracheal strictures with the slightest trauma, it’s likely that the procedure will have to be repeated, she said.
“The fact that he has gotten as far as he has, though, is awesome. To see him up and eating the next day was unbelievable,” she said.
Since coming home, Bocelli is back to talking, strutting on top of his cage, calling to Gural’s dogs by name and bopping up and down when his own name is mentioned.
While staying at Ryan Hospital, Bocelli developed a great relationship with his doctors, says Gural. “He loved them. He would walk up on their arms and nuzzle them. I was jealous,” she says with a laugh.
His apparent affection for his doctors is both surprising and touching, she adds, since African greys tend to bond only with one person. For Bocelli, that person was Gural’s husband, who died less than two years ago. With other people, including Gural, Bocelli tends to be a curmudgeon. He seems to make a point of talking only when nobody is in the room.
“But I love him,” she says. His presence is especially comforting because, when Bocelli speaks, he mimics Gural’s husband’s voice exactly.
“I’m so thankful they were able to help him,” she says. “Now we’re hoping for the best.”
Want to help companion animal patients like Bocelli at Ryan Hospital? Make a gift today to the Friends of Ryan Hospital Fund!