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.

 

[Little Chickadee]

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

 

[turkey girl 0964]

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

 

[wemimew]

Thank you It is a bit of a tricky situation and a difficult one to fix -but she is still looking bright and has a good appetite (eating puréed foods and oils only to try to get things moving) so there is still hope.

 

[dawg53]

That's severe impactation. You can try giving her tomato juice, it helps get things moving. However, I dont think it'll help in this situation. Good luck.

 

[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

 

[wemimew]

Update before putting her to bed tonight on day 6. She doesn’t look too good again and I am not expecting her to make it through the night - although I have thought this every night so far. Poops are back to looking thin and have turned light green. She is very interested in any food but not allowed anything that she wants - liquids only. I gave her some watermelon water with molasses in it in hopes that it will give her the boost she needs to get through the night. No crop bra tonight because her crop is sitting high enough and I want to see if it makes a difference tomorrow. Her gizzard still feels like it is reducing in size however her crop is still very large. Fingers crossed for something better tomorrow.

 

[wemimew]

Day 8. She’s somehow still going, although she seems to be much the same. Foods are still liquids only and I tossed up trying to get surgery for her - but I doubt she would make it through the anaesthesia, she’s so weak and thin. Despite that - she’s still full of sass and not afraid to pick a fight with a lesser chicken should they appear on the patio so that is good lol, she’s also still more than happy to eat everything she is not suppose to. She also seems quite happy with all the pampering and hugs with exception of the occasional crop feeding of treatments.
As for treatment of the impaction, I went over the X-rays and was fairly certain most of the bulk is grasses so decided to try a digestive enzyme (very reluctantly - I don’t like messing around with those sorts of things, the avian and mammalian digestive systems are very different), I found one that is mostly pre and pro biotics and cellulase so figured it was better than nothing. I took her off her antibiotics due to the possibility of drug interactions but kept her on the Sporanox to keep the yeasts at bay. I started them yesterday and saw nothing too special but today saw that she had started to pass bits of grass and grit where before it was mostly her pellet like foods. Her poops are still tiny and mostly urates but the fact that she is passing products of the impaction are good. Each one is checked. She is banned from her pen apart from sleeping as she was eating her bedding and has been spending her day wandering the house and the patio but chooses to mostly sleep or sit and observe things. Her crop is emptying fluids more quickly today but the food bulk is still there and doughy when drained. I am leaving the crop bra off tonight as the pooping is good and I want to see how it goes. Her gizzard feels smaller again but probably only by a fraction. I can feel her crop contractions starting again and also can feel peristalsis happening more frequently in the bowel - she is pooping small amounts but much more frequently. Foods today were only her pellets turned into a liquid mash, some yoghurt, some boiled mushy carrots and a couple of egg yolks. She is getting hand watered 10cc’s several times per day and takes the syringe eagerly - though refused to drink on her own for some reason. Lungs sound good, mouth and throat are clear and eyes are bright. She is still in sudden death territory but should hopefully make it through the night.

 

[LaFleche]

trying to get surgery for her - but I doubt she would make it through the anaesthesia, she’s so weak and thin.

Crop surgery is performed without any anaesthesia and for me, that would be the thing to have done in the first place. I hope she is still strong enough for it, but usually it does not take more than 10 minutes.
Your vet has to be careful not to injure the large blood vessel right across the front of the crop and she should perform two separate sutures: the crop tissue and then separately the outer skin.

Whishing you and your little Fluffy best of luck.

 

[dawg53]

Crop surgery is an option, but it would be too stressful since the hen is at death's door. Also there's no gizzard surgery, and that's the main issue in this instance.
If she gets constipated, applesauce acts as a mild laxative in chickens.