Gizzard impaction - X-ray confirmed. How to proceed?

[wemimew]

I have a 6 m old silkie pullet that had coccidiosis and has been treated. I look her to the vet today for an X-ray looking for a tumor or another blockage as her crop will not empty and a mass can be felt in her lower abdomen.
This girl has a massive gizzard impaction full of grit, her crop is also full of grit. She has been eating it for a reason because every corner of the run has a feeder in it to prevent this from happening and there is only one grit station. I’m guessing that the coccidiosis slowed everything down - she could feel that and ate grit to compensate or something along those lines.
I tried to empty the crop and failed yesterday the vet also tried today and couldn’t move it - it’s like a sludge even after adding fluids. She can’t be vomited - we both tried that as well.
Its not looking good for this little one and now I have to MacGyver a way to remove the gizzard blockage stopping everything. I was thinking that I could do massages and try to dislodge the grit but the gizzard is 3-4x the normal size so it is pretty tight in there.
My question is - what area does the gizzard empty into the intestines? I would need to try to work it through a piece at a time but need to know what area to work on and which direction to push/poke. I’m guessing the very bottom but could be wrong. Any help would be amazing.

 

[wemimew]

Day 10 - oh my gosh it was on today! Little Moe (don’t think I have actually mentioned her name yet lol) got booted out of her pen at dawn before she could eat the bedding and everything overnight looked the same - I was tossing up the idea that euthanasia may be a better way for her to go instead of dragging whatever this is out any longer. I left her in the kitchen area with her egg yolk for breakfast and left to run some errands... I came home to a poop catastrophe! I don’t mind when hospital chickens poop in the kitchen/family area, I developed a very strict disinfecting routine after my last girl that was ill long term but this definitely triggered me. There was poop everywhere - I was gone for all of 30 minutes and she would have gone around 20+ times. Shortly after I got back she started pooping larger volumes, slightly larger than the good one she did last night. These ones had green urates/fluid in them and then her little tail stayed up like she was trying to push out an egg. I did a vent exam and saw that she had prolapsed - so put that back in and felt around for any large object that may be sitting there but found nothing. Her abdomen was also very warm to touch today where it wasn’t yesterday. I put her on painkillers/anti inflammatories for the prolapse and antibiotics for whatever was causing her to be warm. I did a smear of the green watery substance around the large poops thinking an abscess or something had ruptured but found nothing unusual. The day progressed well, she was much more alert and wanted to roam everywhere and was not as slow as she had been. She did keep prolapsing during the morning but it seemed to stop after lunch. Her poops were 60% large and full looking with watery urates and 40% were small and thin like they had been previously. She is still on liquid foods and hand watered electrolyte water. Tonight her gizzard is now much smaller and her abdomen is starting to feel soft to the touch again (where before it was rock hard) so she is expelling. Most poops contain grasses and grit still so once again not all digestive enzymes. Just before I put her to bed she passed this amazing poop - I was so excited I called my daughter in and we did a little happy dance . She also seems to be regaining function in her crop as it is forming then normal crop shape and holding tension better (where before it was easily manipulated and distended). She is still at risk of sudden death though as she is skin and bone - I would be surprised if she weighted more than 600 grams with all the impactions cleared. That’s pretty much it for today and hopefully tomorrow brings more good news.

 

[wemimew]

Next update - day 12. She has been a lot more lively and wanting to move around more but does still have the odd period where she fluffs up and stays still for a while. Poops are more ‘normal looking’ although they are a very dark green. I have noticed that to get her pooping she has to be moving so she gets patted a bit when she is staying still so she starts wandering again. The poops still are not as thick as a normal so something is still constricting them. When I look at a poop smear under the microscope it’s clearly all plant material so not too concerning. She is still passing a few urate only droppings but nowhere near as many as she use to. More oocysts were found in larger numbers than I would like on tonight’s smear so she is having another 2 days of baycox starting tonight (I am so sick of battling this - nothing seems to knock it out) her poops are also a little more mucous covered today which makes sense considering. She gained 22 grams over 24 hours which is promising and she is eating and drinking on her own again. Diet is 3 eggs (yolk and white) per day, some mashed pellets, apple mash (won’t eat apple sauce anymore) and anything she finds in the patio when I’m not looking. Her gizzard has retracted further up again today but is still larger than normal (yes I have poked many other chickens to draw comparisons lol) her abdomen is also feeling softer again today but given the weight gain and her problems I can’t rule out fluid. The warmth of the area seems to have faded to normal range today too. Crop massages are backing off as it’s holding a good position and shape (still not fully emptying overnight though) and abdominal massages are only when I am doing my daily checks. She is off the anti inflammatories today as I am worried about organ damage and the prolapses have finished but will resume if they start again. She had multivitamins in her water today for an extra boost. Although she is in hospital she has been visiting the flock daily so they don’t forget about her - today she decided to have a dustbath. That’s pretty much all the news for today .

 

[wemimew]

Day 16. Moe was doing well thismorning but I decided to push her vet appointment for her next X-ray ahead because I honestly felt that this was more than just a gizzard impaction. Things were just not right even though she was improving. I took her for a (very long) drive to an avian specialist this time who seemed to know his stuff. Everything that I have written here was mentioned and he felt that prognosis really was not good and that this was most likely not going to end well. He agreed that things in her abdomen had been moved around and that X-rays were needed. They called me later on after they had done it (had to leave her for an overnight stay due to time and school runs) and in short said that there was a mass near the ovaries and something else large where the liver was. I knew from day one that this was probably cancer but it really hurt to hear it - I love my babies. We had a chat and there really was nothing I could do to save her so agreed that euthanasia was the best option. To rule out Mareks or other contagious diseases they are going to do a necropsy on her and will let me know their findings when I go down there to bring her home for a burial.
This honestly is the worst part about owning chickens. My poor little Moe - I’m heartbroken that I couldn’t save her, it seems like every time you think to yourself ‘I know what I am dealing with - I can fix this’ you get thrown a curveball. I will make another post tomorrow summing up my treatment for the impacted gizzard (that was working really well) to hopefully help someone else out that has this problem. I will also post my necropsy results.

 

[Little Chickadee]

I dont have any advice, but my husband and I are praying for you and your little bird.

 

[wemimew]

Day 15. Moe’s still going... somehow. Did a complete turn around the day after my last post and seemed to be having the best day yet, also improved today. Poops are now either solid with a good white cap (though still completely green and full of plant material) or she has the odd poop that is watery urates with a tiny bit of faecal material in it. Air sacks are much better though not 100% - there is still a slight rattle. Breathing is also more normal and nowhere near as laboured as day 13. Her temperature is down to normal ranges (going by feel - thermometer does not get high enough to measure them).
The impactions are improving - the crop is emptying more and more each morning - though there is still an accumulation of grit in there that I can feel (had absolutely no access to any for weeks) so I have started giving her oil again and upping the massages to help things along. The gizzard unfortunately does not seem like as much good news. It is definitely smaller, but has somehow shifted to a more medial position pointing and encroaching towards the vent. Palpating it you can feel that it is bulbous in some areas which could perhaps be abscesses, cancer, etc or just it trying to move into a more normal shape with obstructions present. It was hugely distended so i imagine full recovery (if possible) will be a long process. I also can’t rule out another organ like the liver pushing it in this direction. She will be going back to the vet in a couple of days for another X-ray to see how things are going so hopefully have more information then. She is still on her medications and a liquid diet - she would probably kill for a mealworm right now lol.

 

[wemimew]

I thought I would write down some more information about what happened and updates about the situation as it seems there is very little reading material about this online. Hopefully this helps someone someday.

Day 1
Noticed that she had slowed down when let out of the coop in the morning, checked her crop and felt that it did not empty overnight. Brought her inside to chicken hospital and saw that her poops were small, very thin and dark green with alot of watery urates. I have been dealing with an outbreak of coccidosis in my flock and looked at a sample under the microscope - I had never seen so many oocysts. The whole flock was already on Amprolium (treatment dose) so she was switched over to Baycox for treatment. I assumed this was the problem at first as I had been dealing with it for a while. She is not laying yet though her little mates have all started - did a vent exam and found nothing but wanted to make sure as she had started showing interest in the nesting boxes prior getting sick. Her weight is 810g and she feels thin (Silkie bantam)

Day 2
Crop still did not empty overnight and was very doughy when massaged. This is something that I have come across many times in the past with sick chickens and was not too worried at the time. Continued treatment with Baycox and poops had not changed (sorry I dont have a picture). Noticed she was open mouth breathing more than stress from being inside warranted. I checked her airsacks with a stethoscope and heard rattles so put her on antibiotics (doxycycine). I also hoped that this would help with any infection that had formed in the bowel as part of coccidiosis. Did multiple crop massages per day and monitored food and water intake. Did a full body check over and noticed that the lower abdomen was hard with a large palpable mass in the lower left side - first though was Mareks had gotten into the flock somehow. She was still interested in food and decided to see how she was in the morning.

Day 3.
Crop did not empty overnight again. Started to get concerned. Burping started during massages and the smell was like poop. No Baycox today as treatment finished the day before. Assumed that there is something more than coccidiosis going on and more paranoia about Mareks set in. Tried to flush and drain the crop myself but could not get anything out. She cannot be vomited. Palpated the mass again and could feel lumps and abnormalities in it so assumed it was probably a tumor, it is roughly 9cm long and 5cm wide pointing towards the ground. It is pushing against the skin just below the base of the keel. Decided to take her to the vet for an xray and euthanasia if a tumor is discovered as she seems very uncomfortable. If it was not a tumor I wanted the vet to flush the crop out as I had no luck. Looked at a faecal sample under the microscope again (smear - not enough for a float) and did not find many oocysts but did see what looked like yeasts. Started treatment for yeasts with Sporanox as it is no doubt causing her crop to smell so bad. She willingly at alot of frozen coconut oil, apple sauce and pureed (and washed) catfood. She is no longer on any solid foods. Crop massages every hour or so and a crop bra was put on to add a little bit of pressure. Did not expect her to make it thorough the night but made a vet appointment anyway. Still on Doxy.

Day 4.
Took her to the vet first thing - not an avian specialist but an interest in birds. Xray showed no tumor but a very large and impacted gizzard. Her weight is 780g. Vets opinion was that it was all full of grit going off the xray as was the crop. She gave her some IV fluids and attempted to flush and drain the crop with no luck - she could not movie it either (said it was a thick paste, the same i experienced even after adding fluids). At the time I was disheartened and took her advice to heart and posted the post above. After I got home I raided the pantry looking for ways to dissolve the grit and found several - but decided against it as that could cause too much calcium to enter the blood and kill her. Later, after comparing it to the doughyness of the crop to the crop on the xray and then comparing the crop on xray to the gizzard I felt that there may not be as much grit in the crop as the vet said - I was hoping there was alot of food material in there too and the coccidiosis inflammation in the bowel is what is stopping everything from moving. Still on sporanox and only on liquid foods and oil. Poops are still thin, small and full of watery urates. Looked at another sample and still saw oocycsts so decided to start Baycox again the next day. Still on Doxy and crop bra is still on. Doing both crop and gizzard massages (gizzard massages are very gentle and I am careful to make sure the bowel is not in the way).

Day 5.
Crop still not emptying. Pooping changed overnight to slightly larger with alot of oil. Considered doing a molasses flush and bought some, but decided to hold off to see how the pooping progressed. Still on liquid foods, Sporanox, Doxy and Baycox. Still getting massages of the crop and the gizzard every hour or so. Still on liquid foods and manually given water when the crop feels more doughy than squishy although she does drink on her own. I assumed that this was enough time for her intestinal inflammation to go down if this is what's causing the backing up. Saw that pooping is more regular when she is left to roam the patio - so she can roam and poop all she wants. Given an all you can eat offering of pureed pellets for dinner to see if the gorging will help with pushing the food though her system. Felt that was a huge mistake as her crop went to tennis ball size before putting her to bed. Also felt that while she is seeming to get better (more brighter, making some noise again) she is in sudden death territory now because her system would be full of rancid food and am running out of time.

Day 6 (today).
Poops are much larger and have visible food matter in them. Some grasses are starting to pass through and some droppings have urate caps on them instead of being a runny mess (this could also be dehydration though). Giving liquid foods only today as the crop is still very large from the gorging last night. Hand watering before each massage to try to help it through. She is not interested in eating any coconut oil and refusing all food with oil mixed in it so tossing up whether or not to crop feed her some. She will happily eat anything and everything else though and keeps trying to get off the patio onto the grass so needs constant supervision. Had morning Doxy and Sporanox. I should mention that I was advised against giving her nystatin by the vet as it works best on an empty crop which is not the case for her.

I will post again later on and let you know how today goes

 

[dawg53]

It sounds like your persistence is paying off.

 

[wemimew]

Thank you everyone for your support - it really meant alot to me. I spoke with the vet this evening and got an update on the necropsy results - it was the right decision. She had tumors in her liver, kidneys, proventriculus, intestines and pancreas. Her liver was also 3-4x its normal size. She had a small grass impaction in her crop but my guess is that is just material that could not pass through because of all the obstructions. Her gizzard was also hugely impacted with grass material. Her abdominal air sacks were all but collapsed from what I understood from the mounting pressure on them. The oviducts and the rest of the organs were as expected.

Mareks was ruled out and the vet has taken pictures of everything and will give me a copy when I go to collect her body. They are also confident that what she had was not a threat to the rest of the flock and that I need not worry about it - it was an unfortunate play of genetics. I will still be careful though - the grossly enlarged liver is concerning and I will close my flock for at least a year to see how things play out.

The tumor growth over the last week was quite aggressive in hindsight - it literally moved the position of the enlarged gizzard towards the vent over 4 days, which was also the same time the respiratory struggles started. This probably also accounts for why nothing was seen on the first xray, it was not a good xray by any means but we should of been able to see at least some of this - so it may have grown exponentially over the two weeks of treatment I gave her in chicken hospital. Everything kind of adds up. The frustrating ordeal I had with coccidiosis with her was also probably attributed to the cancer, her body was not in a position to fight it off (it has been very wet here - so there would of been sporulating oocysts absolutely everywhere) and she was dependent on the medications to get rid of it. The fluid that started collecting in her airsacks was probably the beginning of the end and untreatable because her organs would of been ready to fail (my guess is the kidneys caused this). The mucous covering her poops were probably caused by the tumors/associated inflammation in her intestines, this also explains why they were often so narrow (though does not explain the improvement at the end). I am not 100% sure of the function of the pancreas but think it has to do with digestive enzymes - which explains why her poops were always such a deep green color - I was under the impression it was colored that way from the plant material. The cancer in the kidneys may have caused the irregularity with the urates - some droppings had a nice white cap on them, others were a watery urate mess. The cancer in the proventriculus would of stopped her crop from emptying as it should and caused it to back up. The cancer in her intestines would of stopped the gizzard from emptying and caused a backup there. The weight loss - while probably mostly caused from the blockages, would of been accelerated by the issues with the liver and her bodies inability to process and store fats (a month ago she was quite the heavy little girl), she had very black skin and eyes so unfortunately I was unable to see if she was jaundice and there was no evidence of bilirubin build up from her droppings (probably because they were so green - if chickens even show that).

I find it amazing - she had all this going on and only had one day where I was convinced she was in pain. All the other days she was actively walking around, hunting for bits and pieces, attacking anything that dared step onto her patio and acting like her normal self. In hindsight - her normal self may very well have been sickly and because it was her normal way of being - it did not strike me as odd. Even though she did have sass - she had never been a hyperactive girl, even as a chick (which is not uncommon) and I never saw her running around playing - she had more of a 'I'll come to you when I'm damn well ready' attitude and would ignore me and anyone else over the other more interesting things getting about. For reference though - her poops in the past were completely normal and healthy looking, this was the first time she had ever seemed ill - three weeks ago she had a bill of perfect health.

I will make a final post for this thread when I have the pictures and xrays in hopes it helps someone else out in the future. I will also make a post about clearing a gizzard impaction tomorrow when I have a little bit more time.

 

[turkey girl 0964]

Poor baby. I will be praying for her as well.