Chronic foot infection- trying to avoid second surgery

[muscovylove]

Hi all-
My 2 year old Easter Egger came to me last year (owner didn't like her egg color) with a mild foot infection. I treated it, or so I thought, and then about 6 months ago it blew up. There was/is no obvious plug or site of injury. I attempted to treat it for a month with epsom salt baths, some tetracycline, but I couldn't get it under control. By the time we went to the vet it was in the bone. It was a VERY expensive surgery with x-rays, but I went ahead and did it because I thought it was over.
I did the follow up care, kept it wrapped, gave her the antibiotics and it looked healed. 2 months later and her infection is showing up again, a different part of the foot.
The vet told me that she would likely need surgery again, and that she would quite possibly need to have it again in the future.
I told her that I just can't afford it, so she was kind enough to give me 30 days of amoxicillin 100mg, 1.5 tablets every 12 hours. She also gave me 30 days of meloxicam, but I'm very wary of that due to risk of harm to the liver.
Currently we are on day 12 of antibiotics, and one of her lumps opened up and liquid pus came out.
Here is where I'm in need of help, advice, support.
What I've learned is that foot infections are slow to treat and treatment can take months. Apparently it is a good thing that there is now an opening for pus to drain- and the antibiotics should keep a worsening infection at bay.
What I'm doing in addition to keeping her on amoxicillin is epsom salt bath 1tbsp to 1 cup water daily for 30 minutes.
Squeezing as best I can the pus, and then using a long nosed syringe to flush opening with a 1:9 ratio of betadine to water.
After that I'm spraying a Silver Manuka spray on the open wound, and at night covering with gauze and vet wrap. In the morning I wash the area with a diluted Tea Tree soap and redress.
She is eating fine, can put weight on her foot, can walk on it but it's obviously bothering her. Still laying eggs which I'm tossing.
I'm giving her high protein foods, flax seed, supplements with Vitamin A and E. She is with a smaller flock of older birds, she doesn't like to be alone at all. I'm keeping her inside at night after her bath and wrap.
What else can I do? There is no accessible plug to remove, the pus that is draining is very liquid. The swelling is not getting worse over all, and if the infection goes haywire I definitely have no choice but to take her back to the vet.
The vet will not entertain an amputation due to quality of life issues, but I can't imagine putting her down- I'm too invested at this point and she honestly is a great chicken. Very sweet, very docile.
Does anyone have a similar experience? I understand that I need to commit to treating her every day for a while, but I also want to be realistic. I don't think her quality of life is poor by any stretch and I don't want to see her suffer. At this point I don't believe she is.
Attaching most recent photo of her foot.

 

[alinas2010]

Sorry to hear about this hen’s issues. I know how frustrating bumble foot can be to treat. It can take quite a while, you are correct. Months sometimes to draw the infection out. A lot of times even antibiotics are tough to get to work on bumblefoot for some reason.

By chance can you get some clearer pictures of her foot? The bottom of it and the drainage site, also, if possible.

Have you tried using Prid to draw the infection out? A lot of us have had good luck with that. Is the swollen area soft or hard? Chicken pus is usually solid and cheese-like in texture. When you said liquid pus is draining out I’m wondering if it is tissue fluid mixed in with pus?

 

[muscovylove]

Sorry to hear about this hen’s issues. I know how frustrating bumble foot can be to treat. It can take quite a while, you are correct. Months sometimes to draw the infection out. A lot of times even antibiotics are tough to get to work on bumblefoot for some reason.

By chance can you get some clearer pictures of her foot? The bottom of it and the drainage site, also, if possible.

Have you tried using Prid to draw the infection out? A lot of us have had good luck with that. Is the swollen area soft or hard? Chicken pus is usually solid and cheese-like in texture. When you said liquid pus is draining out I’m wondering if it is tissue fluid mixed in with pus?

Thank you for replying so quickly! I will get clearer photos tonight after I give her her foot bath. The pus smelled horrid and was definitely liquid, that was the case before her surgery as well, but it was a lot more and there were signs of some of the tissue becoming necrotic which is definitely not happening here. When her foot first swelled up again it seemed more of an issue of Mycoplasma synoviae and I found a couple images on Google of hens with MS and it looked exactly like that, one of the images is from this site actually. I gave her a round of Tylosin and her foot swelling went away almost completely- and then a few months later it got huge again and the Tylosin had no effect- and from there things got horrible. So I don't know- is it possible there is joint fluid along with the pus?
I have heard of PRID! I will order some.

 

[alinas2010]

Thank you for replying so quickly! I will get clearer photos tonight after I give her her foot bath. The pus smelled horrid and was definitely liquid, that was the case before her surgery as well, but it was a lot more and there were signs of some of the tissue becoming necrotic which is definitely not happening here. When her foot first swelled up again it seemed more of an issue of Mycoplasma synoviae and I found a couple images on Google of hens with MS and it looked exactly like that, one of the images is from this site actually. I gave her a round of Tylosin and her foot swelling went away almost completely- and then a few months later it got huge again and the Tylosin had no effect- and from there things got horrible. So I don't know- is it possible there is joint fluid along with the pus?
I have heard of PRID! I will order some.

Oh wow! She’s had quite the journey with this infection. I did not realize it was more of an issue with MS. Let me tag some others who may have some treatment advice. @coach723 @Wyorp Rock

I am wondering if you are dealing less with an infection caused by an open wound then, such as we’d expect to see with bumblefoot. That could help explain the more liquid type pus - my guess is it could be fluid that accumulates from the MS infection. Not 100% sure, but I think MS causes edema at the joints. My understanding is that MS is only treatable with antibiotics, otherwise you’re looking at supportive care. Did your vet do testing by chance?

Do still treat any open sores and get some more photos for us.

Edit to add, also, is there swelling in any other areas? Any other signs that could point to MS?

 

[coach723]

Yes, I've had birds with similar feet. I will link to a thread where I explain how I treat. I use sugardine, a mix of plain white sugar and betadine, very inexpensive and easy to get, works well. Has saved a couple of birds with terrible infections. Use it daily until the infection clears up and it starts to heal. The link also has a video on sugardine.
See post #8 here:
https://www.backyardchickens.com/threads/bumblefoot-not-healing.1443809/
I've circled a spot on one of your pictures below, is that dirt/mudball between the toes? If so, it needs to be removed as it will continue to get bigger over time. They can be hard like concrete, a mix of droppings, dirt, moisture building up over time. Or if it is a scab, also needs to be removed as a possible source of bacteria.
The second picture is very blurry, but there appears to be a small lesion on the side of it, is that where you are squeezing from? That is where I would be putting the sugardine in if so. If you are not able to squeeze and clean well enough through the small opening, it may be neccessary to lance with a small scalpel, just enough to make it large enough to really get it cleaned out well. You may have to repeat cleaning daily, and redoing the sugardine for a week or so before you start to see the infection reducing. The sugardine also helps it to heal from the inside out, reducing the risk of the surface healing first and trapping pockets of infection inside, that regenerate.
Is your flock MS positive confirmed?
Looks like she could use a nail trimming as well.

 

[muscovylove]

Oh wow! She’s had quite the journey with this infection. I did not realize it was more of an issue with MS. Let me tag some others who may have some treatment advice. @coach723 @Wyorp Rock

I am wondering if you are dealing less with an infection caused by an open wound then, such as we’d expect to see with bumblefoot. That could help explain the more liquid type pus - my guess is it could be fluid that accumulates from the MS infection. Not 100% sure, but I think MS causes edema at the joints. My understanding is that MS is only treatable with antibiotics, otherwise you’re looking at supportive care. Did your vet do testing by chance?

Do still treat any open sores and get some more photos for us.

Edit to add, also, is there swelling in any other areas? Any other signs that could point to MS?

Hello! Attaching 4 photos from tonight. I don't know if she had MS, and I'll email the vet to see if they did any testing. I thought she might have MS because originally 1) there was no plug or obvious injury 2) when I tried to cut into an initial what I thought was an abscess on the top of her foot, there was no pus, only blood and fluid. 3) using google images, what popped up were photos of chickens with MS 4) she responded initially well to the Tylosin.
She has no swelling in other joints, nor did she have any respiratory issues. I got her with 2 other EE'rs- same reason, the owner did not like their egg colors for their breeding program. The others are not ill- but it doesn't mean they at one point didn't have any MS symptoms.
By the time I took her in to the vet, she had a major abscess that would not respond to the tetracycline I purchased from a falconer and I was starting to see necrotic tissue. X-rays showed bone infection and surgery was the best route. Her foot currently is nowhere near that state, and hasn't worsened since the abscess on the side opened up.
Thank you for taking the time to read this and answer!

Yes, I've had birds with similar feet. I will link to a thread where I explain how I treat. I use sugardine, a mix of plain white sugar and betadine, very inexpensive and easy to get, works well. Has saved a couple of birds with terrible infections. Use it daily until the infection clears up and it starts to heal. The link also has a video on sugardine.
See post #8 here:
https://www.backyardchickens.com/threads/bumblefoot-not-healing.1443809/
I've circled a spot on one of your pictures below, is that dirt/mudball between the toes? If so, it needs to be removed as it will continue to get bigger over time. They can be hard like concrete, a mix of droppings, dirt, moisture building up over time. Or if it is a scab, also needs to be removed as a possible source of bacteria.
The second picture is very blurry, but there appears to be a small lesion on the side of it, is that where you are squeezing from? That is where I would be putting the sugardine in if so. If you are not able to squeeze and clean well enough through the small opening, it may be neccessary to lance with a small scalpel, just enough to make it large enough to really get it cleaned out well. You may have to repeat cleaning daily, and redoing the sugardine for a week or so before you start to see the infection reducing. The sugardine also helps it to heal from the inside out, reducing the risk of the surface healing first and trapping pockets of infection inside, that regenerate.
Is your flock MS positive confirmed?
Looks like she could use a nail trimming as well.
View attachment 4211352

Thank you- agree on the nail trimming, only so much handling I want to do with her, but I'll work on it for sure. Where you circled is where her original abscess was, where the surgery occurred. It just looks dark, but it's not dirt fortunately.
No on confirmed MS, I was just guessing. How do you get testing? I just noticed on my older Barred Rocks we have some footpad swelling, an older Rhode Island does seem to have a swollen ankle but I attributed that to age, she is about 7. The Barred Rocks came to me due to a friend's divorce, maybe I need to rethink how I get my hens....

 

[coach723]

At this point I would treat it with the sugardine, as I indicated in my previous post with the link. I can't express enough how helpful it was in a couple of really bad, really stubborn cases. I was going to euthanize a roo rather than put him through any more, and tried it as a last ditch effort. It cleared up in about 5 months completely and he never had a recurrence after that. I had a hen whose foot looked very similar to yours, I lanced it and cleaned it out well, and used sugardine. Her foot healed up much faster, within a month. It's pretty much my go to treatment now.
There are blood tests and swab tests that can be done to test for mycoplasma infection. You can ask your vet, or have a bird tested that is symptomatic.

 

[muscovylove]

At this point I would treat it with the sugardine, as I indicated in my previous post with the link. I can't express enough how helpful it was in a couple of really bad, really stubborn cases. I was going to euthanize a roo rather than put him through any more, and tried it as a last ditch effort. It cleared up in about 5 months completely and he never had a recurrence after that. I had a hen whose foot looked very similar to yours, I lanced it and cleaned it out well, and used sugardine. Her foot healed up much faster, within a month. It's pretty much my go to treatment now.
There are blood tests and swab tests that can be done to test for mycoplasma infection. You can ask your vet, or have a bird tested that is symptomatic.

Okay, thank you. She is definitely less comfortable than yesterday which is concerning but maybe it's from all the handling, squeezing. I tried lancing it- the problem is nothing is there to come out, and it bleeds. I squeeze some pus, then there is nothing left coming out- I just don't feel a plug, it feels like a small mass. I will start the sugardine this morning. Fingers crossed.

 

[coach723]

The small mass you feel is likely a mass of pus. You can often feel it as hard bits in there, where they should not be. Sometimes they adhere to tissue and take a fair amount of manipulation to get loose and out. Use the sugardine for a couple/few days, let it rest and see if the swelling comes down any. Then you can try again to see if you can clean anymore out.

 

[alinas2010]

The small mass you feel is likely a mass of pus. You can often feel it as hard bits in there, where they should not be. Sometimes they adhere to tissue and take a fair amount of manipulation to get loose and out. Use the sugardine for a couple/few days, let it rest and see if the swelling comes down any. Then you can try again to see if you can clean anymore out.

This is very true. And sometimes those masses are farther away from a wound entrance than you’d think they should be. I once had a chicken with a scab in the middle of her foot, but the mass/swelling was up between her toes. I did not think I could get the pus out without cutting into her, which I really did not want to do. One day I had someone hold her wrapped in a towel and I just went to work trying to push that piece of pus towards the open wound. I’ll tell you. Very suddenly that piece of pus shot right out. It bounced off the wall next to my head and I was just shocked.

All this to say, sometimes you don’t get anything but blood out of the open wound and it’ll take a lot to get the infection out. That can be discouraging, but keep soaking and trying to work that pus up to the surface. The prid drawing salve may help, too. That did bring some pus up for me. I’ve recommended @coach723 s sugardine trick to others and they’ve had success with that, too. Keep us posted!