ABSTRACT: In Part Two of 'Nursing in Kuwait', I have been reunited with my luggage and continue my adventures working as a VN abroad. African Grey parrots are one of our most common patients and I outline one of the main health problems we saw in practice – malnutrition leading to hypocalcaemia.

The phone rang. I jumped, banged my head, cursed, backed out of the kennel and reached up to get the phone. I answered. There was no one there. I returned the phone and resumed my position crouched down in the corner of the kennel, scrubbing.

The phone rang out again. I repeated the performance, no one there. I returned to the kennel. The phone rang yet again … then wolf whistled and wished me a good morning. I knew 1 had been taken for a fool. 

I walked through to the ward containing our African Grey patients, and the least sick bird cocked his head, looked me in the eye and with some evident delight, made the phone ring again, mimicking perfectly.

Prior to working in Kuwait, I had limited experience with birds. Now, on a daily basis, I was handling them, feeding them and treating them. On each encounter, the birds – in particular the African Greys – charmed me beyond all my expectations.

Friendly birds who liked nothing better than bending down so that I could scratch the back of their heads (Figure 1); then sick birds who seemed to almost understand we were trying to help them and eagerly took their oral medication kindly and gently. Even the angry Greys, ‘wild-caught’ and bitter with the world, seemed to simmer down eventually.

Figure 1: Welcome scratch

It appeared that a huge percentage of our parrot patients in Kuwait were ‘wild- caught’; there were rumours of drain pipes full of birds being imported into the country – a shipping style that meant only a third survived to sale. How they prospered as a pet after such a traumatic experience can only be speculated.

The most common condition we saw in these birds was severe malnutrition (Figure 2). Time and time again Dr Jill would admit a parrot, and we would both look sadly at the poor specimen crouched at the bottom of his cage, unable to even lift his head – his diagnosis apparent through the huge bowl of sunflower seeds next to the bird.

Figure 2: Malnutrition was common

Exclusive seed-based diets usually contain low levels of calcium and vitamin D with high levels of phosphorus, severely destabilising the complex homeostasis of these elements. Hypocalcaemia can cause signs ranging from mild inco-ordination and depression, to status epilepticus.

Generally the care plans for these patients involved intensive supportive care, fluid therapy, parenteral and enteral calcium therapy and force feeding. I found nursing these birds extremely challenging. I would watch them practically curled up on the floor of their cage. They would often rally for an hour, sometimes sit on their perch, but inevitably waves of illness would hit them. 1 felt like I could almost see how it engulfed them, making them feel utterly miserable.

Many of these birds arrived for treatment too late, some were fitting when they arrived. The one problem that I found particularly frustrating was trying to encourage them to eat anything – apart from sunflower seeds – once they were well (Figure 3).

Figure 3: Sunflower seeds were the underlying problem

I took delight in picking out tasty morsels from the markets for recuperating birds – everything from fresh bananas and pomegranate, to broccoli and asparagus. Often my freshly prepared offerings were rejected because the birds were so accustomed to their single-source diet. We were fighting a losing battle with sunflower seeds.

As with all husbandry issues, education is key and the staff at the practice had rallied to produce multi-lingual leaflets to be handed out with all the essential information. I hope it will begin to filter through, so that malnutrition can be avoided.

On a daily basis, we nurses are asked all sorts of questions and my role continued in the same way in Kuwait – pet passport queries, behaviour, nutrition, all the usual things – plus every now' and then, something a little more unusual.

Mary Anne, our trusty receptionist turned to me, fluent in English and Arabic, she was translating and I could see from her face that I was not going to like what she was about to say. She took a deep breath, “He wants a sleeping tablet to give to a cat so he can throw it away.” I looked at her, and then at the elderly gentleman who was standing at reception. I was immediately confused and appalled.

I have always been taught to try and empathise with people and here I was struggling. When I dug deeper, it turned out that there was a male ‘street cat’ hanging around the man’s house (Figures 4-6). His novel method of getting rid of it involved drugging it, putting it in his car, driving for an hour in the opposite direction and then dumping it so it wouldn’t find its way back!

Figures 4-6: Feral cats abound in Kuwait

Figure 5.

Figure 6. 

I almost smiled, admiring such a plan – a plan carefully put together so as not to harm the cat in any way, but to simply get rid of it.

I gently explained that I was sure if he got rid of that cat another would take its place and we were not able to prescribe the drug he needed. “Cats hate water,” I said, “Try a water gun. Maybe that will keep him away from your garden?” He seemed to like that idea and headed out of the building earnestly explaining the new plan to his wife.

Working abroad can cause a real roller coaster of emotions, the most mundane activities can become an adventure, even going to the supermarket can become a journey of exploration – and that can make life exciting. In Kuwait, driving was my adventure, my nemesis. At home I drive long distances regularly, have a clean licence and obey the rules.

The roads in Kuwait were chaotic – the hard shoulder reserved for Ferraris, Bugattis and Porsches. Stop signs were ‘advisory’ only, and giving way at roundabouts was the intent
ion, but only really performed when police cars enforced it.

Kuwait was such a hybrid of the familiar and the unfamiliar. A huge ‘ex-pat’ population meant I was often chatting with clients from the UK. There was a Starbucks on every corner, Boots, Marks & Spencer – and with all the signposts in English, I was occasionally fooled into believing I was somewhere recognisable.

The next minute, a prayer call would ring out, loud and haunting and a chattering monkey would come into the consulting room – and I would remember exactly where I was. 


Helen Ballantyne BSc RVN

Helen qualified as a VN in 2005 whilst working at Mill House Veterinary Hospital, Kings Lynn. She has worked with giant pandas in China; with wildlife, in practice and at the University of Melbourne in Australia; and with an animal charity in India.

Back home Helen is a locum veterinary nurse and has just started the Postgraduate Diploma in Adult Nursing at Sheffield Hallam University. She is currently the BVNA Honorary Secretary.

To cite this article use either

DOI: 10.1111/j.2045-0648.2011.00114.x or Veterinary Nursing Journal Vol 26 pp 413-414

Veterinary Nursing Journal• VOL 26 • November 2011 •