What is a cerebral apoplexy?
Explained in a roughly simplified way, tiny blood clots which settle in the brain cause an apoplexy. Depending on which area of the brain is affected the effects can be different. Such blood cluts decrease or even totally block the blood circulation what leads to a lack of oxygen in the affected part(s) of the brain. The cells immediately die and a severe damage of the brain can be observed in different symptoms such as heavy neuromuscular disturbances or paralyses. If the affected brain area is too large the bird's life can't be saved, the apoplexy leads to death within a few seconds.

Symptoms
Very often an apopledy happens at night while a bird is calm and relaxed or even asleep. Without any warning the above mentioned symptoms like paralysis or neuromuscular dysfunctions appear from one second to another and the bird is no longer able to perch on a branch or swing. Most birds start to panic when they fall off their perch and they try to fly what is impossible due to a paralysis in most cases. Many affected birds scream out loud because they don't have any idea of what is happening to them.

The most frequent symptom of a cerebral apoplexy is that one half of the body is completely lamed. That means the toes, the foot, the leg and even the wing are paralysed. This can easily be explained: In general only one brain hemisphere is affected by the lack of oxygen and therefore the opposite half of the body is paralysed due to a stroke. Many birds also go blind, but in general only one eye is affected (the one on the side where the limps are lamed). After falling off the perch the bird lies on the ground and is hardly able to move. The animal seems to have lost orientation and many birds are in panic. It is very hard for a bird owner to calm a budgie down right after an apoplexy occurred.

In the first days after it happened most birds suffer from an absence of appetite and therefore they could starve if their owner doesn't give them special care such as taking them to an animal hospital immediately.

How to diagnose a cerebral apoplexy
If you think that your bird might have suffered an apoplexy you have to take it to an avian vet or an animal hospital as soon as possible (even at night!). In general it takes an avian vet to find out whether a bird suffers from an apoplexy or not. After the symptoms appeared one should hurry up because the sooner the therapy begins the better the prognosis will be.

Therapy
In Germany where the author lives, avian vets treat budgies and other pet birds with cortisone, a homeopathic drug called "Cerebrum compositum" and a heavy dosed vitamin b complex injection. After one or two days in general there will be a second injection and the vitamin b complex must also be added to the drinking water. After an apoplexy birds have to be kept in a warm, quiet and calm surrounding because they need rest.

Depending on how well the therapy takes effect, the bird is out of the woods within a week. If the drugs still show no effect after one week the brain damages caused by the apoplexy are too heavy and therefore are immedicable. In this case you should think about putting the poor bird down even though this might be a very hard decision for you. Sometimes life becomes a torture for a bird who survived an apoplexy and there is no hope that things will turn to good account. Even though it hurts it's better release the suffering little soul.

Accommodation of apoplexy patients
Many birds suffer from a disturbance of equilibrium within the first days after an apoplexy occurred. Therefore they can't perch on their swings or twigs as usual. Some birds keep on trying to perch but fall down to the floor because of the paralysis of one leg and the disturbance of equilibrium. Others are too weak to climb and remain seated on the ground. It is advisable to pad the bottom of the cage with cloth (e.g. a towel) and cover it with paper towels which have to be removed at least once per day because of the staining (the bird's droppings). Swings should be removed from the cage since the sick bird would fall off and could hurt itself even more. The photo in this paragraph shows a budgie several hours after suffering an apoplexy. Unable to reach the perches, the bird remained on the ground lying on its belly.

Other things you can do to help your bird
Especially within the first few days after suffering an apoplexy a bird has to eat enough what is not easy for most patients. The disturbance of equilibrium in some cases is so heavy that the birds are not able to eat. Such birds have to stay in an animal hospital and be fed by the medical staff or else they will starve. Those birds who are able to move their head and hold it still while eating can be cared for at home.

A diet of soft and healthy food is very important for the birds. You should offer them soaked or sprouted seeds. Since birds are in need of vitamin b you should add wheat to the seed mixture. Sprouted wheat contains lots of healthy nutrients and also vitamin b. Fresh food like fruit or vegetables should also be part of the daily diet.

Some avian vets recommend adding vitamin supplements to the drinking water. As long as the water dishes are cleaned at least once a day this is a good advice. Most liquid vitamin supplements contain lots of sugar and therefore the drinking water can easily be contaminated by pathogenic germs. Therefore it is so important to clean or even disinfect the dishes carefully.

Even though most birds feel cold after an apoplexy you should never warm them with an infrared lamp (warmth therapy). Due to the heat, the blood vessels dilate and especially inside the brain this causes an increase of the blood pressure. Higher blood pressure can cause irreparable damage to the already battered brain sections and worsen the bird's health status.

In order to re-establish the mobility of the paralysed limbs, it can be advisable to carefully train the bird (physical therapy). Please ask your avian vet about this training and do not start too early. The sick bird should not be trained within the first week after it suffered the apoplexy.

A bird's life after a cerebral apoplexy
Unfortunately not all feathered patients convalesce completely. In some cases a leg or wing palsy remains for the rest of the bird's life. This affects the everyday life and the bird's special needs should be fulfilled. For example some birds are unable to perch on twigs, they need small platforms they can stand on or even lay down on at night when they go to sleep. Also a malposition of the head can be a remaining health problem (see photo on the right).

To be honest the hardest part of all is to decide whether the bird can lead a good life with a remaining handicap or not. An objective decision is so hard to make that it is always better to ask at least one other person for help. And of course one should discuss the case history and the prognosis with an avian vet. Sometimes a feathered patient survives the apoplexy and even seems to recover within the first few weeks. But then the health status does not improve anymore and the bird for example would never be able to eat without the help of its owner. Even though one is full of hope on the one hand and on the other hand full of fear of losing a beloved pet, sometimes it is necessary to take the final step and put a bird to sleep.

This chapter in Turkish on muhabbetkusu.org