Successful Treatment of Desert Rose (Adenium obesum) Toxicosis in a Blue and Gold Macaw (Ara ararauna).

Desert rose (Adenium obesum) is a plant from the family Apocynaceace that can cause cardiac glycoside toxicosis if ingested. A 33-year-old male blue and gold macaw (Ara ararauna) ate a desert rose flower from an indoor houseplant. After ingestion, the patient fell onto the floor, regained its balance, and then ran to its owners who witnessed the patient "foaming at the mouth" with its "cheeks turning blue." The macaw proceeded to collapse, continued to foam at the mouth, and had what appeared to be a seizure. Upon presentation 2 hours postexposure, the macaw was moribund, in shock, and recumbent with rigid limbs and had dark blue cheeks and severe bradycardia (40 beats per minute). The bird was placed in flow-by oxygen in a warm incubator and, shortly thereafter, began regurgitating frank blood and passing melena. The patient's treatment protocol included atropine, parenteral fluids, dextrose, calcium-gluconate, vitamins, anti-inflammatory therapy, antibiotics, and activated charcoal gavage. The initial plasma biochemistry panel revealed a severe hyperkalemia (>10 mmol/L) that was treated with furosemide. Diagnostic testing and supportive treatment continued for 12 days, including hyperbaric oxygen therapy. Continuous incubator flow-by oxygen coupled with multiple hyperbaric oxygen treatments significantly improved perfusion, facilitating recovery. Three years following exposure to the desert rose flower, the owners consider the bird to have normal behavior and no clinical signs associated with the toxicosis.