Difficult bumblefoot - how to proceed?

[Serotonin]

Hello everyone, I was hoping to get your input. I've been treating a couple of my chickens for bumblefoot with foot swelling and I've run into a bit of a wall, with no clear idea on how to proceed.

I've been doing nightly soaks in warm Epsom salt water, spraying with Vetericyn, applying Neosporin, applying Prid, and then bandaging. The first chicken I treated went well and very "according to instructions." She had a fairly large scab that came off easily, revealing a hole in her foot with almost no bleeding that I was able to pull a large, hard kernel out of. The swelling immediately went down and her foot is healing well. But I have two other chickens whose cases unfortunately aren't so simple.

They have noticeable swelling, but only had small scabs. After a week or so of soaking, the scabs came off, but it either revealed normal-looking skin underneath or was a hole too small to get anything out of the foot from. I tried to widen the hole a bit on one of the chickens, but it started bleeding quite a lot so I quickly had to shut that down. I've attached pictures of what they currently look like, a week or so after removing the scabs.

I'm particularly concerned about one foot, which is rather swollen between the toes on the top and whose scab has now given away to an almost pimple-looking bump (in the last picture). After getting the scab off, I was able to squeeze some white liquid (pus?) out of it, but it was way too small to get any kernels out of.

What do you think I should I do in these cases? Will another scab form if I just keep carrying on with the Epsom salts/Vetericyn/Neopsporin/Prid? Is cutting it open the only option?

 

[azygous]

In a couple of those photos, it appears there may still be a pus plug that needs to be soaked and pulled out.

I think you have been at this long enough to understand the difference between a yellow, waxy pus plug and the healthy tissue under it. Once you remove the pus plug, all the solid waxy material, you're done cutting. But leaving any of that solid yellow pus in the wound will prevent healing.

I've found Dawn dish detergent added to the soak water does wonders to soften tissue so that it's very pliable and easily removed. It dissolves hard scabs into mush that can be scraped away.

It seems you're doing a very good job. Just focus on getting the yellow stuff out and be confident you've done a good job.

 

[Serotonin]

In a couple of those photos, it appears there may still be a pus plug that needs to be soaked and pulled out.

I think you have been at this long enough to understand the difference between a yellow, waxy pus plug and the healthy tissue under it. Once you remove the pus plug, all the solid waxy material, you're done cutting. But leaving any of that solid yellow pus in the wound will prevent healing.

I've found Dawn dish detergent added to the soak water does wonders to soften tissue so that it's very pliable and easily removed. It dissolves hard scabs into mush that can be scraped away.

It seems you're doing a very good job. Just focus on getting the yellow stuff out and be confident you've done a good job.

The problem I think is that the plugs/blisters are too small to get anything out of and the kernels aren't directly underneath them. When I tried to open the hole up a bit on one foot, it started bleeding a lot so I got spooked and has now blistered over again. Is making an actual incision the only way? If the kernel is in the toe or elsewhere in the foot, is it better to make an incision there rather than where the blister is?

Also, one foot doesn't have any pus plug or blister or anything, but there's clearly a kernel between two toes (it's swollen and hard), so I'm wondering if an incision is the only option there too.

 

[azygous]

You do what you need to do to treat each lesion. Only rarely have I had to do any actual cutting, but if that's what it takes to get all the pus out, then do it.

Many novice bumblefoot surgeons mistake the "serum" that occupies the tissue under the pus plug as part of the infection. It's sometimes white and stringy, and people easily mistake it for pus. The actual pus is almost always a solid plug and lifts out fairly easily. If you go far enough into the tissue to make it bleed, you're going too deep.

 

[lizo97]

I usually make a shoe. I cut an inch off a jumbo pool noodle and vetwrap it with 1" wrap onto their foot. I have tried PRID, surgery, and soaks, but the pool noodle is the only thing that works. You do not need to soak or do surgery!

 

[marymas245]

I usually make a shoe. I cut an inch off a jumbo pool noodle and vetwrap it with 1" wrap onto their foot. I have tried PRID, surgery, and soaks, but the pool noodle is the only thing that works. You do not need to soak or do surgery!

How does the pool noodle work?

 

[Ladyj33604]

I usually make a shoe. I cut an inch off a jumbo pool noodle and vetwrap it with 1" wrap onto their foot. I have tried PRID, surgery, and soaks, but the pool noodle is the only thing that works. You do not need to soak or do surgery!

How does your pool noodle procedure go?