Cockatiel bumblefoot?

RE: Cockatiel bumblefoot?

Gillian Mostyn — Mon, 31 May 2021 12:10:51 GMT

[quote userid="13186" url="~/001/veterinary-clinical/exotics/f/discussions/29143/cockatiel-bumblefoot/230527#230527"]Just to clarify, you place the wet-to-dry dressings twice weekly at the end of debridement until the area is cleared of gunk, and only after the wound site is clean, you start packing it with flamazine? [/quote]

yes

RE: Cockatiel bumblefoot?

Benjamin Alyoshkin — Sat, 29 May 2021 12:50:52 GMT

Hi Gillian, thank you very much! Just to clarify, you place the wet-to-dry dressings twice weekly at the end of debridement until the area is cleared of gunk, and only after the wound site is clean, you start packing it with flamazine? I wish I could share the bird's progress, alas I've moved on and not in the same practice, nature of locum work. Thank you again!

RE: Cockatiel bumblefoot?

Gillian Mostyn — Fri, 21 May 2021 08:54:15 GMT

Ideally take some radiographs - these have often progressed to osteomyelitis meaning the prognosis is pretty much hopeless. I've taken rads where there is very little calcified bone remaining in the foot.

If no osteomyelitis, I've found aggressive debridement, usually twice weekly, using wet-to-dry povidone soaked dressings until no gunk remains, then packing with flamazine and bandaging until healed, has been effective with some patients.

As far as QOL/euthanasia decisions - it would be based on how much time/money the owner is willing to commit as this needs aggressive and frequent treatments. Then if they do commit, I would want to to sustained improvement with a maintenance of body weight. And the owner needs to be able to monitor behaviour to assess pain scoring and distress - obviously birds show subtle indications.

RE: Cockatiel bumblefoot?

Benjamin Alyoshkin — Wed, 19 May 2021 17:30:23 GMT

Evening, Everyone! I would like to share this case, which was a real challenge as I did not feel I was getting anywhere. My experience of treating bumblefoot is limited, but from what I’ve seen over the years and what I’ve read, it is a challenging condition to treat. I would be grateful for any thoughts!

The bird is a pet adult female Common quail, whose eggs were excluded from human consumption since she has had Baytril. I saw this bird for a 4-week recheck of the pododermatitis on her left foot. She was not on medication at the time. She was initially treated with Baytril and Metacam, 7-14 days in total, and her left foot was debrided, yellow pus was removed. On PE, the pedal aspect of the left foot was now immaculate and well WNL. The dorsal aspect of the tarsometatarsus was moderately swollen. One way to describe it would be – multiple swellings along lateral and medial aspects of metatarsals, not seemingly affecting the joints themselves. Sadly, I don’t have photos from the first visit.

The owner declined C&S based treatment, and repeat meloxicam course wasn't particularly helpful. Within 2 weeks, the owner agreed for the foot to be debrided again. A large solitary mass of inspissated pus was removed. On Diff Quik, I could see coccal-looking forms inside heterophils.

The bird returned to me for post op checks and for bandage changes. I saw it twice at 2-day intervals. The bird was eating and maintained a relatively stable body weight, body condition was WNL. I suggested to limit access to sand bathing. On initial rebandaging, I placed a boot like bandage on the left foot, but did not rebandage the right foot which looked much improved.

Two days later, the left foot still remained swollen. You will see from the attached photos the post op bruising, which in my opinion did not improve since the op. I could also see now mild reddening on the pedal aspect of two digits of the right foot (the sounder foot). I thought that was early bumblefoot, which made me feel quite alarmed. I felt that by removing the bandage from the right foot 2 days earlier, this placed a higher load on the sound leg.

I started questioning if the strategy of bandage changing was actually doing much good. I advised the client that the treatment was likely to be long and my prognosis was increasingly more guarded. The owner initiated the conversation about euthanasia and I supported the idea especially if body weight started declining and other welfare parameters were suffering.

MY MAIN CHALLENGES:

Technically found it fiddly and wasn’t sure how long to continue or when to trial open wound care.
Trading off between reducing risks and restricting activities of daily living. As an example, the quail enjoyed her sand bathing. By restricting access to sand to reduce the risk of sand impaction inside the dressing and friction injuries, I wonder if the QoL suffered.
Anyone can recommend DMSO for pododermatitis?
What other objective markers of the quality of life, apart from the non-improving wound and BWT/ BCS would you be guided by in deciding when to stop?

Any thoughts would be gratefully accepted!

Thank you, Ben

RE: Cockatiel bumblefoot?

Bob Russell — Thu, 13 May 2021 16:49:40 GMT

Make sure there is a variety of perch/branch sizes. I find they quite appreciate fruit tree branches and these can be changed on a regular basis for a change of environment.

RE: Cockatiel bumblefoot?

Madonna Livingstone — Sat, 08 May 2021 20:34:04 GMT

I often find medication in water won’t help. However avipro avian in water is great. These birds often deficient in vit A. Are there sandpaper covers on perches? If so bin them!! How old is the tiel? Definitely need analgesia. Meloxicam 0.5mg/kg bid minimum. If owners gonna stand a chance of resolving they need to admin meds po

RE: Cockatiel bumblefoot?

Benjamin Alyoshkin — Sat, 08 May 2021 18:17:18 GMT

Hello Claire, just saw your post. How did it resolve in the end? I recently was involved in managing bumblefoot in a Common quail with very little effect. Really keen to discuss. Have you had much experience with DMSO? Cheers, Ben