What has she done in the past for your birthday? If she doesn't know what you want, she will resort to times in the past that seems like you were happy doing what you did on your birthday. If she doesn't say "Happy Birthday" to you, I would hope you would have a conversation about it.
I see what everyone is saying about how she seems to do nothing for you. But, I wonder if each time she didn't, if you would say something to her, if she wouldn't start getting better. She's not a mind reader. Yes, common courtesy, but she's who she is, you married her that way, she possibly grew up a certain way, and if you want some changes you need to tell her EACH and EVERY time. You are letting everything build, you are detaching more and more. You both won't ever have a chance with this cycle going around and around.
There are a million reasons why she could have been rude about the toothbrush. She's not a morning person, she was hormonal, she was cranky, she said something without thinking first, she had the "down" you have after a good weekend, etc. No one is perfect.
I know what you want. Everyone on this forum knows what you want. But, I don't really think she does. I really don't.
You continue to be nice to her, you continue to buy her gifts and go places with her. If I were her, I would think that things are going awesomely and you both are doing well. Because if you WEREN"T, you certainly wouldn't be taking me places and buying me things, etc.
TALK to her. Over and over. You are not in that "detaching" phase anymore. COMMUNICATE.
You say you have talked to her, but I don't buy it. Whenever you tell us on here that you talk to her about something specific (i.e. the lady she dumbs down to) she has agreed. When you sat down and talked, did you make a plan on things? Did you tell her your timeline and what you are waiting to see?
What I see happening, is you waiting on her to do something you want her to do. Things she doesn't know, and things that are not natural for her. When she doesn't do it, and when you have detached enough, you will throw the moving ultimatum at her. By this time, you don't really care what she does because you have detached beyond repair.
YOu say your wife is stubborn, but I see some stubborness in you as well. I'm stubborn, and my H can be, too. But....as Dr. Phil would say, "How's that working for ya?"