Bumblefoot still swollen after kernel removed

[inquisitivebird]

I have a speckled sussex hen about 46 weeks old. She's never laid an egg and a couple months ago she started sleeping in the nesting boxes and nothing I would do would break the habit. Then I noticed her begin limping and finally she could barely walk at all and it is then that I realised she had bumble foot. It's the first time I have had to deal with this condition so I feel really terrible for not noticing sooner and for the fact that she got so bad...

Anyway, I did some research and since the scab was so small, I had to cut it open to get out the kernel. I did this one week ago. A large yellow kernel came out and then I wrapped it with ointments after cleaning the area with iodine. I've been changing the bandage and applying new activated charcoal each day. The wound site seems to be improving and the swelling there is going down. The webbing on her foot next to the bad toe is visible again as the swelling goes down, but her foot is still hot and swollen around the ankle. I put charcoal there as well in an attempt to draw out the swelling but it's not helping.

I am wondering, is it possible that the kernel traveled up into her ankle and I didn't get it all? There is no scab on her ankle and I'm having a hard time imagining doing any more surgery on the unbroken skin there. Her limp is improved a little bit but she is still pretty bad. Perhaps the infection got into her bones? She lays around all day and sleeps, and doesn't want to use the foot unless she has to. Other than that she seems healthy. I am treating her for lice, as she's neglected to dust bathe with her sore foot. I am giving apple cider vinegar in her water and also trying to give goldenseal in her food as an antibiotic.

Also, am I correct in assuming that all this going on with her would stop her from beginning to lay eggs?

 

[coach723]

Yes, it could be a reason she's not laying yet. Or a combination of short daylight hours and other factors. Some birds are more sensitive to the daylight hours. It doesn't look like all the infection was removed the first time, there is still a lot of swelling around the original spot and more up the foot. I had a roo that had a similar infection that ran up the foot and into the ankle. I cleaned the lesion on the bottom and then had to lance the ankle to get it cleaned out completely. You may have to do a fair amount of squeezing and manipulation to get all the gunk out. In my roo's case, once I did that, when I flushed it out with a syringe it would go in one lancing and come out the other, so had obviously tunneled through the foot. Rather than charcoal if you want to try a more natural treatment, rather than antibiotics (and they may be needed here) then I would use sugardine. I will link to a thread where I explain that. I used it on my roo whom I thought I was going to have to euthanize because nothing else was working. He fully recovered. This is not a quick process, it may take weeks to months to get complete healing. You may have to clean and flush more than once. I reapplied the sugardine daily. If after all that you don't start to see some improvement you may need to add an antibiotic to the treatment. Most bumblefoot doesn't require antibiotics, but sometimes a secondary infection can set in from the digging around in there.
See post #8 here:
https://www.backyardchickens.com/threads/bumblefoot-not-healing.1443809/#post-23973555

 

[inquisitivebird]

Yes, it could be a reason she's not laying yet. Or a combination of short daylight hours and other factors. Some birds are more sensitive to the daylight hours. It doesn't look like all the infection was removed the first time, there is still a lot of swelling around the original spot and more up the foot. I had a roo that had a similar infection that ran up the foot and into the ankle. I cleaned the lesion on the bottom and then had to lance the ankle to get it cleaned out completely. You may have to do a fair amount of squeezing and manipulation to get all the gunk out. In my roo's case, once I did that, when I flushed it out with a syringe it would go in one lancing and come out the other, so had obviously tunneled through the foot. Rather than charcoal if you want to try a more natural treatment, rather than antibiotics (and they may be needed here) then I would use sugardine. I will link to a thread where I explain that. I used it on my roo whom I thought I was going to have to euthanize because nothing else was working. He fully recovered. This is not a quick process, it may take weeks to months to get complete healing. You may have to clean and flush more than once. I reapplied the sugardine daily. If after all that you don't start to see some improvement you may need to add an antibiotic to the treatment. Most bumblefoot doesn't require antibiotics, but sometimes a secondary infection can set in from the digging around in there.
See post #8 here:
https://www.backyardchickens.com/threads/bumblefoot-not-healing.1443809/#post-23973555

Thanks for that. I'm in New Zealand so we have 14 hours of sunlight at the moment.

So, would I re enter the site at the original scab and then squeeze the ankle? She pulls away when I squeeze the ankle now. Or, do I open up the ankle? How do I make sure she doesn't lose too much blood?

The toe has improved a lot since the original day, so I'm a little reluctant to open that part up again, but maybe it does still have infection re growing in there?

I'm going to need to get a scalpel. I did the original clean out using a sharpened kitchen knives as that was what I had, but it's hard to control.

 

[coach723]

You may be able to soak that and soften it enough, to open it back up, hard to say from just a picture. I would personally open up the original spot and see how much you can get out there. What you find will dictate what you do from there. I could feel the hard bits of pus in my birds foot and ankle, and they wouldn't move down the foot, so that's why I made a second lance at the ankle. I got a lot out there. If the infection stays in there it's going to eventually do the bird in, so as much as you don't want to do it, it really does need to get cleaned out. I personally like #11 scalpels as they have a very fine point, more useful on small bird feet and toes, if you can get those (I order mine on amazon). I also use a curette (link below) which is sometimes useful for cleaning out stubborn pus that doesn't want to move. Tweezers can work also. After that, if you've gotten it all out, then the swelling should start to gradually go down. Bumblefoot is unfortunately often not a quick fix, it can take some time.
https://www.amazon.com/Nifty-Medica...fix=curette,+bone,aps,149&sr=8-17-spons&psc=1

 

[inquisitivebird]

You may be able to soak that and soften it enough, to open it back up, hard to say from just a picture. I would personally open up the original spot and see how much you can get out there. What you find will dictate what you do from there. I could feel the hard bits of pus in my birds foot and ankle, and they wouldn't move down the foot, so that's why I made a second lance at the ankle. I got a lot out there. If the infection stays in there it's going to eventually do the bird in, so as much as you don't want to do it, it really does need to get cleaned out. I personally like #11 scalpels as they have a very fine point, more useful on small bird feet and toes, if you can get those (I order mine on amazon). I also use a curette (link below) which is sometimes useful for cleaning out stubborn pus that doesn't want to move. Tweezers can work also. After that, if you've gotten it all out, then the swelling should start to gradually go down. Bumblefoot is unfortunately often not a quick fix, it can take some time.
https://www.amazon.com/Nifty-Medical-Supplies-Surgical-Curette/dp/B072Q9F64L/ref=sr_1_17_sspa?crid=6KN73NPDRPNJ&keywords=curette,+bone&qid=1667772550&sprefix=curette,+bone,aps,149&sr=8-17-spons&psc=1

So I went back into the original wound. And there wasn't any more pus in there, I'm sure of it.

Next, I went into the ankle. I was very careful because I know there are tendons in there. I found pus on the right side and got it all out, then tried the left side and more put came out, hard kernel pus. I pulled on the last piece that shot out at me, and it was connected and wouldn't come out. I'm sure it started out looking like kernel. I cut a little farter in a d while trying to pull it out had the thought, 'Oh no... I hope this isn't a tendon. The puss like stuff seemed to come off of the stringy part and since all I had was a loose end, I just flushed it all out with sterile water, out in iodine bandaged it all up.

I am so scared that I accidentally cut a tendon... But I'm also confused because I didn't cut in that far at all... Anyway, she's ate a tiny bit of food as well as drank some water now. I have seen her walking, but you can tell she's exhausted now. Panting and resting and occasionally getting up and walking/limping a few steps.

I pray that she recovers ok. I don't think I could do anything more.

I'm pretty sure all the pus is out now.

 

[coach723]

I'm sorry, I know it was difficult. Sometimes the pus is stringy and ribbon like and winds through the tissue, rather than being a lump or kernal. Those are really, really hard to clean out, and thankfully less common. My roo's foot was like that and I had the most success with the sugardine packs daily. I would flush it and repack it. After 2 weeks of that it stopped generating more pus and started to slowly heal. Without being able to see it, that may be what you were seeing. Honestly, short of vet care, you really didn't have much choice, it needed to be cleaned out. So I'd let her rest. Have a look tomorrow, you can soak it in epsom salts which may make her more comfortable.

 

[inquisitivebird]

I'm sorry, I know it was difficult. Sometimes the pus is stringy and ribbon like and winds through the tissue, rather than being a lump or kernal. Those are really, really hard to clean out, and thankfully less common. My roo's foot was like that and I had the most success with the sugardine packs daily. I would flush it and repack it. After 2 weeks of that it stopped generating more pus and started to slowly heal. Without being able to see it, that may be what you were seeing. Honestly, short of vet care, you really didn't have much choice, it needed to be cleaned out. So I'd let her rest. Have a look tomorrow, you can soak it in epsom salts which may make her more comfortable.

So you would open it up every day and recheck for more pus? Does it keep bleeding when you do that like the first cut? Can I make sugardine? Google says it's just iodine and sugar.

 

[coach723]

Yes, sugardine is just white sugar and betadine. The link I gave you above has a video on it. It's very commonly used in horses. I would just check where you lanced, see if you see pus or it looks like it needs to be cleaned again. Just gentle pressure or manipulation should tell you. I wouldn't keep opening it up unless needed. On my roo, it did not start to close up until the infection was receding. I did not have much bleeding after the first time of lancing and cleaning. I would be gentle as possible, try not to damage tissue further.

 

[inquisitivebird]

Yes, sugardine is just white sugar and betadine. The link I gave you above has a video on it. It's very commonly used in horses. I would just check where you lanced, see if you see pus or it looks like it needs to be cleaned again. Just gentle pressure or manipulation should tell you. I wouldn't keep opening it up unless needed. On my roo, it did not start to close up until the infection was receding. I did not have much bleeding after the first time of lancing and cleaning. I would be gentle as possible, try not to damage tissue further.

So, today soaked the foot in another Epsom salt bath for 10 minutes, then tried to clean out any additional pus I could see. I squeezed it pretty hard and not much came out. I took a photo of the ribbon like think that popped out at me yesterday. It's still very well stuck. I pull on it with the tweezers and it first makes the chicken kick her foot and try and get away when I pull it hard. I can touch it with no reaction. Then I packed it full with the sugardine that I made trying to push it into the holes where the kernel were and banged it up until tomorrow.

What do you think? I've included photos this time. I really appreciate your help, I'm not sure what I would have done without your suggestions and previous experience.

She rests all day but still eats and drinks a little. Not eating a lot at all, but drinking enough I think.

Spoiler: Graphic wound

Spoiler: Graphic wound

 

[coach723]

Not sure what that is, but I would leave it be. Pictures tell a lot, but not everything. Hopefully the sugardine will help, looks like there was a lot of infection there. If you can get some duoderm bandages (I get them on amazon) they will help keep the sugardine where you want it and moist, while also protecting the wound. They are intended for open wounds. They come in a package of 5 which can be cut to the needed size and you end up with many for a foot. I would consider adding an antibiotic to the treatment, that is what I would do, since that is such a large area. I would probably use clindamycin or cephalexin, you can get them as fish clindamycin or fish cin, or fish ceph or aqua ceph. The price has risen substantially unfortunately, so search for the best price. If you have amoxicillin (fish mox or aqua mox) that is usually less expensive, and you could try to see if it helps.
My roo has some nerve impairment because his infection was so bad, but he gets around just fine and still can roost. I check his feet often.