Dear FeathersNFur8, HomeTweet, Jeanne, Grandma & Jessalyn:

FeathersNFur8, thanks for reminding me about DMSA. I'll look into it again, but for some reason the oral chelating agent of choice, at least in Ruby's case, seems to be Penicillamine, perhaps because it is most likely a case of lead rather than zinc poisoning.

The problem with oral-only is, in Ruby's case, twofold: (1) As of his last radiograph, about two weeks ago, he still had metallic particles in his ventriculus (gizzard); this causes the oral chelating agent to chelate metal encountered in his digestive tract instead of his bloodstream; (2) Oral chelating agents fall into two categories: (a) Toxic, and (b) Inefficient in terms of absorption into the bloodstream. That means that he cannot be given very large doses of Penicillamine orally with any degree of safety, and, in the case of CaEDTA, which is non-toxic, he could not be given enough orally to substitute for the injections (the absorption rate of CaEDTA into the bloodstream through the digestive tract is a bit less than 5%).

I am in Brooklyn, NY, one of the five boroughs of New York City. Relatively speaking, there are plenty of DVM's nearby. I have been to a world-renowned, teaching animal hospital and to a local DVM vet clinic. Between the two, I've spent over $700 in consultations, radiographs and the like. In the case of the teaching hospital, the course of treatment was about the same as what the local DVM suggested, but the total price was substantially higher than $1,300.

The problem for me right now is as follows: I do not have the money! I can't even afford another $250 or more for a third initial visit and consultation with a third DVM, in the hope that this time around the course of treatment will be more affordable, or that he/she might be willing to teach me how to inject Ruby myself (with the help of a friend, of course).

Unfortunately, this situation has caught me at a particularly bad time in terms of my fiscal liquidity. If it had happened 6 months ago, or perhaps 6 months or so hence, I would have just paid the four-figure fee to get Ruby well and that would have been the end of it. Problem is, Ruby is sick NOW and, from what I've been told by the vets, the longer his treatment is delayed the worse his overall long-term prognosis will likely be.

Making twice daily trips to a veterinary tech so he/she can inject Ruby for a nominal fee, even if I could find such a tech, is simply not doable for me right now.

The vets I've dealt, who seem like very nice and caring people, both went off on long evasive ramblings when I told them that I could simply not afford the in-hospital course of treatment, asking if they would show me how to give the treatment, including any injections, to Ruby myself, citing the same concerns that you all, rightly so, have expressed, plus plenty of filler content intended to scare me and thereby banish such thoughts from any further consideration on my part.

However, as HomeTweet has intimated, it is a rather simple thing to do once you know how and where to do it, particularly, I believe, when one does have experience injecting other, albeit much larger and non-avian, species.

What I've been able to learn elsewhere is that, for avian subcutaneous injections, two good areas are the web of skin between the upper legs and breast, as well as the back of the neck. That's about it, though. I was hoping to get a little more detailed advise, which is why I started this thread.

If you or anybody else would be inclined to share their knowledge with me, I'd be most grateful. If, for safety's sake, it were preferred to keep the info out of these posts, which everybody can see, then please feel free to send me a private message instead, which I will, of course, keep private. Or, if you prefer, send me an email message to HelpingRuby@MaxDreamer.com.

To you and all members, thank you kindly for your loving concern as well as any information you may be able to provide regarding this topic.

Sincerely,

Max

I cared for a 'diabetic macaw' for several months (she turned out to have cancer, not diabetes), and I had to give her injections 2X daily. It's very hard to describe how to do it. You really need to be shown. Basically, you insert the needle into the breast to the side of the breast bone, and you alternate sides. I practiced first on a piece of fruit. It's very important to tap all the air out of , and that is a neat little trick.I was rather upset with my vet who did show me how to do it, but so rapidly it was hard to follow. Once you get the hang of it, it's not so difficult, but my bird was very easy and gentle... she was very sick. Another bird you may have to towel.

I wouldn't even do an instructional slide show to teach how to do this, same as I wouldn't do a slide show on flushing the nares... too many things can go wrong, and one little mistake can be fatal. Please try to find a vet who will show you how to do it. Birds are very individual and it's best you learn how to inject your bird with a professional guiding you.

Max, I just remembered that I know a very good person in Brooklyn who would probably help you, so I just sent you an email. She is a health care professional, completed medical school, and has worked for years as a vet technician.

Max, I will offer you this. If you can take the train (sneaking the bird on) I am in Huntington (train goes right there) I will take you to my vet Heidi Hoeffer (a WONDERFUL Avian Vet) and I will pay for the visit for you to learn how to give the injections. I will call her and ask her what you need from your vet to show treatment is correct- she won't do it unless that is the right meds...

Doreen

Max, I just spoke with my vet, she is happy to help. She thinks the price is INSANE !! She needs to know how high the metal level is. Do you have xrays, copies of the blood tests and the drugs? She is happy to help and so am I. Like I said, you can take the train here, I will pick you up and bring you to her office. Maybe we will even drive you back home.... Brooklyn isn't that far.

doreen

Dear Sweet Marie and HomeTweet:

Thank you both for your kind and generous spirit. You are true godsends!

HomeTweet: Thank you so very much, but I think I can scrounge up the money! : ) At any rate, I would not have you pay for me, a complete stranger, though I am deeply moved and do lovingly appreciate the offer beyond what my command of language can properly express. However, it is important to me that it be worth it. So, if you could find out from Dr. Hoeffer what she would need to do on my visit to her offices with Ruby, and how much it would cost, and whether she'd be willing to tell me exactly how to perform all the therapies myself at home, in order to save mucho money if I cannot afford the cost of her doing it (an apparent insurmountable obstacle with the other Avian DVMs I've been to), I'd appreciate it. Or, if she'd like me to send you and/or her an email message or fax with all the details of the case first, in order that she may be able to provide a good estimate of what she needs to do and charge, please let me know. Feel free to email me at HelpingRuby@MaxDreamer.com if this is more convenient for you. Please rest assured that any private communication from you shall remain strictly personal and confidential. (This holds true for anybody else as well, of course!)

I won't be able to post again until tonight or tomorrow morning -- too many other crucial things to do right now.

HomeTweet: Regarding your last post (you spoke with Dr. Hoeffer), I will reply tonight or tomorrow morning. Thanks!

Sincerely,

Max

This is great news! I am praying Ruby has a full recovery.

That is wonderful Doreen. A perfect example of what all these bird boards should be about = members pitching in, one way or another, to help the birds - by helping each other learn what each of us should know. Also great to see/hear there are a few A.V.s out there that care about the same rather than sticking their hands as deep as they can into their customers pockets. Shame on them!

Thanks so much this is the best outcome for Ruby.

Max, first- you aren't scrounging. (is that spelled right? where is spell check??). We can figure this out... We are all here to help each other. The life of each and every bird is important.

I was going to call her now BUT... I don't know what YOU have.. do you have copies of all the medical reports? Copies of the xrays? THOSE she WILL need..... Is he providing you with the medication? If not, then we will have to get it from Heidi....

Thinking more, it takes me a while sometimes... LOL. How about we have someone pay for this outright and you pay them back as you can? We will set up a loan paper- you pay $x.xx per week, month, whatever you can.. we will set it up in advance, so you aren't scrounging off anyone, ok? TIME is important here- we can't waste it being proud.

Pride is important- but time is MORE important. Rudy can't wait and I am sure Rudy would say "Max, buck up, take a helping hand, you can pay them back, get me help" I know Rudy would say that........

call me when you can.,

doreen

Max, it is just after 6pm EST I just called the hospital and spoke with Michelle (WONDERFUL TECH !!) She knows all about you and Rudy. Heidi will be in after 4pm tomorrow and you can call and speak with her. She will need you to get medical records: tests done- the lead level, copies of xrays if they were done and anything else you may have. I am so happy you posted on this board and I am thrilled to be able to help even in a small way.... this is what these boards are all about. Helping each other....