Very swollen toe, lumpy foot, and infection in 7 mo old Pekin - probably NOT bumblefoot

MotherOfDuckens

Chirping
Jun 24, 2020
71
233
96
TL;DR: 7mo old Pekin duck has severe swelling the length of left middle toe. Online avian vets doubt bumblefoot or break/fracture. Has responded well to antibiotics, but toe remains swollen and lumpy and now foot is also getting hard lumps and overall condition appears to be worsening.

Loooooong version:
Pig has a very swollen middle toe and foot. She is over the worst of an infection, but I need some help/advice and I will try to provide as many pertinent details as possible (so sorry for the length). I'll attempt to make this organized.

Usual suspects we have mostly ruled out:
Bumblefoot
Niacin deficiency
Nutritional deficit
External injury laceration/cut/puncture, etc
Poor lifestyle

Known/suspected:
Infection - certain
Hidden injury (like a sprain) - suspected, at least for initial cause

Unfortunately we do not have access to an in-person avian vet (believe me, I tried). The only place I could find that would even see her was an upscale exotic animal clinic, and I was told not to expect to walk out the door for under $1000 - BEFORE any actual treatment. We have the flock for meat and eggs, but I still care about them and want to provide the best possible life with the best possible care. As much as I am willing to go through many lengths and invest what I can afford, $1000+ for a utility duck (even though she is admittedly my favourite) is not something I can justify taking Care Credit out for at this point in pandemic craziness. So, here we are.

Meet our patient, Pig Duck:
_MG_3394.jpg
Pekin
7 mos old (current), ~5.5 mos (time of injury)
Started laying around 4.5 mos, and has layed consistently since (except during peak infection). No soft-shelled or deformed eggs until very recently.
No previous health issues or injuries
Fed restricted diet while growing so she would grow slowly and remain smaller to help with future join issues
Supplemented with extra Niacin* as a duckling
*I have recently read here that flush-free Niacin supplements are not properly absorbed by ducks. Unfortunately, I didn't know this at the time and the Niacin supplement I gave Pig was flush-free. However, what is going on with her foot does not look like a Niacin deficiency, and no other flock members show signs of Niacin deficiency.

I believe that feed/nutrition and lifestyle are more or less fine and probably not the cause of whatever is going on here. I will provide a detailed description at the end if anyone wants to check.

Current treatment:
0.6ml LA 200 given IM once daily
Draining fluid buildup in foot
Long warm baths
Extra straw bedding, lots of whispered soft nothings, and of course extra treats

So, what happened?
Around 7 weeks ago Pig went from moving around seemingly carefree in the morning, to laying down separate from the flock and clearly limping later in the afternoon. I know ducks are notorious maskers of their injuries and pain, but this seemed to be a major and immediate change rather than a gradual or subtle decline. I am lucky to be home all day and I observe them frequently, so I try to note any small changes in behaviour early on.

I wrapped her in a towel so I could closely examine her feet. I couldn't find any cuts, scrapes, splinters, thorns, signs of puncture, bruising, lumps, or severe swelling. She may have very well had some minor swelling - I wouldn't have noticed because I was focused on puncture type injuries and bumblefoot. To be safe, I put some antibiotic ointment (without pain relief) on it.

I decided to let her stay with the flock and keep a close eye on it. I'd had a couple other ducks heal from limps on their own, and the times I'd tried separating them it seemed to do more harm than good. She showed marked improvement over the next week or two, then suddenly during treat time December 9th she started walking away from the flock and plopped down. It was difficult for her to stand.

At that point I put her in a pen and began giving her warm baths and epsom salt soaks. She still showed no signs of external injury on her foot, but her middle toe was visibly swollen. Every internet search suggested bumblefoot, even though she didn't have the usual isolated lumps or black spot. After a few days of the soaks a very small black dot did form in the middle of the swollen toe, and I pulled a very small sliver out of it. There was no additional infection around the sliver, or beneath it in the tissue I had pulled it from. She also had a couple small surface-level scratches that were barely starting to turn dark on the edges and to be safe we removed the tissue there. At the time I hoped maybe this was the culprit and I had just missed it originally. Now I believe she may have picked up the sliver and scratches after the initial injury or whatever caused the swelling in her toe.

Here's what the top of her foot looked like:
_MG_3564.jpg

And the bottom (you can see the two scratches in the middle of the swelling and one of the black specks is the sliver - the rest are just debris):
_MG_3566.jpg

After a few days of wraps, continued soaks, spraying with Veterycin, and TLC, we released her back into the flock. Her foot was completely healed where we had removed the sliver and scratch tissue. We continued to check her foot and spray it with Veterycin daily. The swelling wasn't going down, but she seemed happy to be moving around with her peeps.

By December 23rd her limp was back, and the swelling in her toe started to get worse. I pulled her indoors in a dog carrier that I set up with lots of fresh straw, and set her next to the pen of ducklings we were brooding she could have some company. There were no isolated lumps, no black marks - no traditional signs of bumblefoot. No cuts, scrapes, etc. Almost the entire length of her middle toe was very swollen. Then things started to move quickly. By evening on Christmas Eve her whole foot started to swell. By Christmas day the swelling was moving up her leg. It was all hot to the touch, and inflated like a balloon. I was worried her skin was going to split. The baths were doing nothing other than give her a short reprieve from having weight on it. She let her leg hang limply while she floated.

_MG_3862.jpg
_MG_3858.jpg

You can kind of make out where we removed the scratches and sliver, which had healed (at least externally):
_MG_3860.jpg

The info I could find on Penicillin G with Procaine (what is available at TSC) was inconclusive and I feared causing toxicity with the Procaine. I'd read about some other antibiotics people had found OTC, but the only one I could find available at the time was the Penicillin.

In desperation I signed up for justanswer.com and asked a certified avian vet what I could do. I had to explain that I could not take her to an avian vet in my area, and plead for anything I could do on my own. He said that at the dose PigDuck would need to be effective, the Procaine in the Penicillin G would cause toxicity. He recommended 0.3ml per 4lbs bodyweight LA 200 given IM into the chest once a day, for 10-14 days. Said it should take about 3-5 days to start seeing improvement. He did not believe we were dealing with bumblefoot, either. He recommended we continue giving the warm baths, but epsom salts would do no good. He couldn't think of anything else to help with pain or comfort, unfortunately, saying that he found aspirin to be generally pointless in ducks. I asked about Preparation H, as I had seen others suggest it for swelling on this site, but he said it wouldn't help for anything purely internal. I dashed out to TSC and got everything I needed (22g needle and 3ml syringe, for anyone who is reading this for their own reference) and started treatment that evening.

The swelling continued to get worse the first couple days of treatment. Pig had still been laying off and on, eating and drinking normally. By this point her appetite and thirst had slowed down, she was no longer laying, and was more lethargic than normal. Thankfully by day 4 the swelling stopped getting worse, and by days 5 and on it started to recede. It first left her leg where it was moving up toward her ankle. Then it mostly left her foot. The signs of serious infection went away and her appetite and thirst came back in full force. Unfortunately, she also started laying again (I was really hoping her body would put that energy toward healing). As the infection and swelling receded, she started developing these soft sacs of fluid on the top and sometimes the sides of her foot. We started draining them by poking them with a needle. A clear, water-like fluid (not very viscous) would do anything from drip to gush out, depending on the day and puncture location.

By 14 days she was acting much more lively, putting weight on the foot and using it frequently, but still had fluid pockets building back daily in her foot, and her toe was still swollen. Draining the fluid sacs seemed to help with her comfort and use of the foot.

I was afraid of losing progress if we stopped the antibiotics, and concerned about the remaining swelling. I followed up with the same vet on justanswer, and he said I could continue the antibiotics for another 14 days if it had helped. He said if the fluid we were draining was more water-like (which it was), it was probably a cyst that was refilling each day. If it was more viscous (which it was not), then it was probably joint fluid and we had bigger issues. He recommended holding off on draining the sacs for a few days to see if they started to go down on their own. Continue draining if they only got worse.

I asked if it would be a good idea to try to encourage Pig to go broody, so she could stop laying eggs and stay off of her foot allowing her more energy and rest to recover. He said anything I could do to get her to stop laying would be for the best, but didn't really offer any suggestions on what I could do. I asked if reducing her protein intake would be a good idea, and he thought it would probably do more harm than good and suggested I continue feeding her as I was. He also suggested trying aspirin to help with the swelling (this is the same vet that said aspirin was useless, but he didn't have any other suggestions for the swelling).

That night I placed 9 eggs in Pig's crate. I stopped petting her (I was following the recommendations on how to get a duck to go broody off of this page). I didn't start the aspirin yet because I needed to go get some. I continued to feed her normally and provide free-choice oyster shell.

A few days later Pig layed a soft-shelled egg after we drained her bath (her first one ever). I was worried that given her situation, this might cause additional problems or be related to treatment, so I consulted with a different avian vet on justanswer. He said not to worry about the one-time instance causing any infection or problems, but suggested putting her on a very low protein diet. I mentioned that vet #1 had strongly advised against that. Vet #2 also said he would absolutely avoid the aspirin that vet #1 recommended, and instead try applying DMSO topically. Different strokes for different folks, I guess. I opted out of the aspirin but have not yet had a chance to get the DMSO.
Her foot at this point:
20210112_142638(1).jpg

Vet #2 looked at pictures of her foot and agreed that it did not look like bumblefoot, and it also did not look like any sort of break or fracture to him. He did have some excellent advice:

I can see the swelling around the middle toe. For free fluid to build up it is likely to be inflammatory. You can consider performing a cytology from the fluid you are draining to see if there is still signs for infection. This is something that any veterinarian can do. If you have a veterinarian that has some minimal experience, they can submit the cytology to the lab. A culture and sensitivity is the other thing that can be done to make sure that there is not infection. As for now, it is ok for you to consider doing what you are doing.

It has been about a week since I talked to the second vet. I met in the middle and reduced her protein intake some, and am gradually tapering it back more. Every night we give Pig her LA 200 injection, drain her foot if there is a big enough fluid pocket, give her a nice long warm bath, and clean her carrier and give her fresh bedding. I place all the eggs back (9 staged eggs plus whatever she lays, minus whatever she has crushed of course). Vet #2 recommended keeping her in low lighting as much as possible to stop the laying, so I place a blanket over her carrier and it is a nice shady cave in there.

The swelling has not come back above her foot, but her middle toe now has gone from feeling solid lumpy to being solid lumpy with separate hard lumps - like a small marble forming alongside the toe lumps, if that makes any sense. Her foot seems even more swollen. It seems like the main fluid sac has gradually been hardening up, and now it's more solid mass than fluid sac. We haven't been able to drain it for a few days since it's mostly hard now. She seemed to be doing really great - using her foot to move around her carrier, very lively and talkative, ravenously attacking any new/fresh food I put in there. The past few days she has been avoiding putting weight on her foot again, tucking it up into her side, laying on her right side, etc. She doesn't have nearly as much of an appetite and she is not drinking as enthusiastically (though she is still eating and drinking). She is lower in energy. She's acting like she did at the peak of the infection, except her leg is so much better than it was then, and she is very far into this round of antibiotics.

Swollen foot. You can see larger and smaller fluid sacs. These are still soft and fluid-filled on that side, but others have started turning solid.
20210120_130117.jpg

Lumpy (hard) toe and swollen foot. The largest lump toward the inside of her foot was the largest fluid sac, but now (and at the time of this pic) is practically all solid to the touch:
20210120_130330.jpg

Different angle - you can see how bad the swelling is. I also need to trim her nails:
20210120_130411.jpg

The only changes in the past few days have been that we moved the ducklings to a shed outside, so Pig no longer has company (they are not her ducklings), and we haven't been able to drain her foot. Before this point, the times she was inside alone or when we put the ducklings outside for the day, she would call for her buddies. She isn't doing that this time. She did seem to use her foot a lot more after we would drain it. When we took the break from draining it to see if the fluid sacs receded on their own, she acted more like this - withdrawn, inactive, keeping weight off of her foot. Once we started draining them again, she perked up again. Unfortunately we have nothing to drain right now. I will have a chance to buy the DMSO this weekend. She has spent a little more time laying on the eggs (she is definitely not broody yet) - could this be part of a mellowing stage before sitting on them?

UPDATE: I was able to get an appointment on Monday with a local vet who might be willing to take a sample for a cytology! I was warned that the vet knows pretty much nothing about ducks, and wouldn't be able to help me beyond something very simply and obvious. At least I can get some lab results and hopefully convince her to prescribe me something a little more appropriate, if needed.

More detaily things that most probably don't care about, but someone inevitably asks:

Before injury:
Lifestyle:
In the morning I let the ducks out to free-range on 3 acres of pasture. There they have access to a large kiddie pool and a smaller bathing tub. In the evening I put them into the garden/run and give them food and fresh water. They have a lot of space to move around and a small pond that we built for them. Late night they go into a shed to sleep.
Substrates: Kiddie pool is on pea gravel. Bathing tub is on a cement landing. Garden/run is straw and mud. Shed gets a thick layer of straw. The rest is the yard which is mostly grass/moss, dirt, some gravel, etc. Other than the cement landing where the bathing tub is, and the gravel paths (which they can easily avoid), they are walking on forgiving substrates.
Feed: They mostly eat a mixture of fermented whole grains, soybean meal, and alfalfa/forage pellets. When I am too lazy to restart the ferment I cut everything but the soybean meal into Purina Flock Raiser. I recently switched them from the flock raiser to a flock layer pellet, but Pig's issue occurred before this switch. I do feed kitten/cat food as a more-than-occasional treat, but not a ton at a time. They have access to free choice oyster shell in multiple locations throughout the property and run.

Overall the flock has seemed healthy and we haven't had any issues outside of a couple soft-shelled eggs when the Pekins started laying (Pig did not have this issue), and a couple of limps due to injuries. I just noticed our first case of true bumblefoot today, which is very small but I will be treating that Pekin immedately. I'm trying to cut the protein and richness in their diet (without cutting nutrients) so they will ease up on the laying.

Pig's current feed: She's currently eating a mix of Purina Flock Raiser, whole oats, wheat, and barley, forage pellets, a little Calf Manna, a little Mazuri Waterfowl Starter, and some Rooster Booster Poultry Booster top dressing. She gets kitten food, mealworms (dried and live), and BOSS for treats. I'm just trying to get as munch nutrient-dense and nutrient-diverse foods into her as I can. Periodically I will add Durvet brand vitamins and electrolytes to her water. If I give her fresh water on the side, she won't drink the electrolyte water, so I try to give that to her before she has a bath where she can clear any residue from her nostrils. I change her water multiple times a day and often add a few drops of raw unfiltered ACV, and sometimes a small splash of water kefir. The Mazuri, cat food, and poultry booster also have probiotics - something I am trying to make sure she gets, especially while on antibiotics. I have both chick grit with probiotics, and adult-size grit available to her, and oyster shell available at all times. I try to give her fresh greens floated in her water when I can - homegrown kale, grass, weeds, whatever is available.


I guess for now my questions are:

Any ideas what happened or what is going on?

In case the vet is useless and/or we can't determine a different course of treatment, is there any sort of treatment/antibiotic/anything I can try that is available OTC for infection/swelling/pain?

Any thoughts on the whole broody thing? Is this even a good idea to be trying right now? Is the blanket shading potentially helping or harming? Is it better or worse to have her separated from the ducklings or other flock members? Any other ways to halt egg production? I'm keeping her inside in the carrier alone for now because it's calm, quiet, safe, and honestly a little easier for me to get her into the bath and deliver her treatment, but I am more than willing to set her up with company outside and bring her in for her bath - though then should I worry about the change in temperatures?

Any recommendations for dealing with the in-person, non-avian vet? I am hoping that I can tell her about my access to actual avian vets on justanswer, that way I can relay the results of any lab work to them and get the best possible treatment suggestion from them back to her, but I can see this not going as smoothly as I hope.

I am going to ask for the cytology. Is it also worthwhile to ask for a culture and sensitivity at the same time? If the cytology doesn't come up with anything helpful, it would be difficult and expensive to get back in to then do the culture and sensitivity (the vet who is willing to meet is only there once a week, and I have to pay for each appointment). But if they are mostly going to serve the same purpose, I'd rather not spend hundreds more than I need to. The cytology is over $100 and I forgot to ask about the culture and sensitivity. Unfortunately, x-rays are not in the budget right now because they want $400+ for those (on top of the exam and lab fees).

Even if we diagnose what is going on, it doesn't sound like this vet would be willing or able to perform any sort of procedure that might help. Short of new antibiotics, we would be on our own. What should I start preparing myself for, here? This doesn't look like any sort of surgery we would want to try and attempt on our own, mostly for Pig's sake. I don't want to give up on this girl, though.


Thank you all for slogging through this mess with me. I know it's a lot and we are all flying blind. I just want to be sure I am doing every possible thing I realistically can. And thank you in advance for any input or advice!

Pig thanks you too!
20210120_124947.jpg
 

Isaac 0

Enabler
Jul 19, 2016
23,415
95,425
1,321
Iowa
I did not read the whole thread so please excuse any redundancy. I would personally be inclined to think the origin of the swelling is related to some sort of infection. Even if the vet is not familiar with birds, he/she should be able to do fine aspiration on the swelling, and send that to have C&S done, to determine one, if bacteria are present, and what bacteria are most prominent, and what antibiotic she would should most improvement with.

If there is an infection, antibiotics such as Enrofloxacin, clindamycin, or ciprofloxacin would be indicated. Bone infections may require weeks work of antibiotics to show improvement.
 

MotherOfDuckens

Chirping
Jun 24, 2020
71
233
96
I did not read the whole thread so please excuse any redundancy. I would personally be inclined to think the origin of the swelling is related to some sort of infection. Even if the vet is not familiar with birds, he/she should be able to do fine aspiration on the swelling, and send that to have C&S done, to determine one, if bacteria are present, and what bacteria are most prominent, and what antibiotic she would should most improvement with.

If there is an infection, antibiotics such as Enrofloxacin, clindamycin, or ciprofloxacin would be indicated. Bone infections may require weeks work of antibiotics to show improvement.

Thank you! This is very helpful!
 

MotherOfDuckens

Chirping
Jun 24, 2020
71
233
96
I did not read the whole thread so please excuse any redundancy. I would personally be inclined to think the origin of the swelling is related to some sort of infection. Even if the vet is not familiar with birds, he/she should be able to do fine aspiration on the swelling, and send that to have C&S done, to determine one, if bacteria are present, and what bacteria are most prominent, and what antibiotic she would should most improvement with.

If there is an infection, antibiotics such as Enrofloxacin, clindamycin, or ciprofloxacin would be indicated. Bone infections may require weeks work of antibiotics to show improvement.

Do you think I should keep her on the LA 200 until we get to the vet? It has helped with some of the issues and I don't want her to slip in progress with those. That said, given her recent slump I also don't want to cause her the stress if the antibiotic is no longer useful.

Also, should I stop draining any of the fluid pockets on her foot, so there is some built up for the vet to draw? Should they be taking samples of the fluid, the harder lumps, or both?

Thank you!
 

Isaac 0

Enabler
Jul 19, 2016
23,415
95,425
1,321
Iowa
Do you think I should keep her on the LA 200 until we get to the vet? It has helped with some of the issues and I don't want her to slip in progress with those. That said, given her recent slump I also don't want to cause her the stress if the antibiotic is no longer useful.

Also, should I stop draining any of the fluid pockets on her foot, so there is some built up for the vet to draw? Should they be taking samples of the fluid, the harder lumps, or both?

Thank you!

If you want to continue with it you could, but I feel that might not be the best antibiotic to use for such an infection. The fluids they need for aspiration is very minimal, so maybe continue on draining the fluids, and leave a bit for them when they go to draw.
 

MotherOfDuckens

Chirping
Jun 24, 2020
71
233
96
If you want to continue with it you could, but I feel that might not be the best antibiotic to use for such an infection. The fluids they need for aspiration is very minimal, so maybe continue on draining the fluids, and leave a bit for them when they go to draw.

Again, THANK YOU!
 

Pollo Blanco

Crowing
10 Years
Jun 8, 2010
379
576
286
Western Washington
TL;DR: 7mo old Pekin duck has severe swelling the length of left middle toe. Online avian vets doubt bumblefoot or break/fracture. Has responded well to antibiotics, but toe remains swollen and lumpy and now foot is also getting hard lumps and overall condition appears to be worsening.

Loooooong version:
Pig has a very swollen middle toe and foot. She is over the worst of an infection, but I need some help/advice and I will try to provide as many pertinent details as possible (so sorry for the length). I'll attempt to make this organized.

Usual suspects we have mostly ruled out:
Bumblefoot
Niacin deficiency
Nutritional deficit
External injury laceration/cut/puncture, etc
Poor lifestyle

Known/suspected:
Infection - certain
Hidden injury (like a sprain) - suspected, at least for initial cause

Unfortunately we do not have access to an in-person avian vet (believe me, I tried). The only place I could find that would even see her was an upscale exotic animal clinic, and I was told not to expect to walk out the door for under $1000 - BEFORE any actual treatment. We have the flock for meat and eggs, but I still care about them and want to provide the best possible life with the best possible care. As much as I am willing to go through many lengths and invest what I can afford, $1000+ for a utility duck (even though she is admittedly my favourite) is not something I can justify taking Care Credit out for at this point in pandemic craziness. So, here we are.

Meet our patient, Pig Duck:
View attachment 2498110
Pekin
7 mos old (current), ~5.5 mos (time of injury)
Started laying around 4.5 mos, and has layed consistently since (except during peak infection). No soft-shelled or deformed eggs until very recently.
No previous health issues or injuries
Fed restricted diet while growing so she would grow slowly and remain smaller to help with future join issues
Supplemented with extra Niacin* as a duckling
*I have recently read here that flush-free Niacin supplements are not properly absorbed by ducks. Unfortunately, I didn't know this at the time and the Niacin supplement I gave Pig was flush-free. However, what is going on with her foot does not look like a Niacin deficiency, and no other flock members show signs of Niacin deficiency.

I believe that feed/nutrition and lifestyle are more or less fine and probably not the cause of whatever is going on here. I will provide a detailed description at the end if anyone wants to check.

Current treatment:
0.6ml LA 200 given IM once daily
Draining fluid buildup in foot
Long warm baths
Extra straw bedding, lots of whispered soft nothings, and of course extra treats

So, what happened?
Around 7 weeks ago Pig went from moving around seemingly carefree in the morning, to laying down separate from the flock and clearly limping later in the afternoon. I know ducks are notorious maskers of their injuries and pain, but this seemed to be a major and immediate change rather than a gradual or subtle decline. I am lucky to be home all day and I observe them frequently, so I try to note any small changes in behaviour early on.

I wrapped her in a towel so I could closely examine her feet. I couldn't find any cuts, scrapes, splinters, thorns, signs of puncture, bruising, lumps, or severe swelling. She may have very well had some minor swelling - I wouldn't have noticed because I was focused on puncture type injuries and bumblefoot. To be safe, I put some antibiotic ointment (without pain relief) on it.

I decided to let her stay with the flock and keep a close eye on it. I'd had a couple other ducks heal from limps on their own, and the times I'd tried separating them it seemed to do more harm than good. She showed marked improvement over the next week or two, then suddenly during treat time December 9th she started walking away from the flock and plopped down. It was difficult for her to stand.

At that point I put her in a pen and began giving her warm baths and epsom salt soaks. She still showed no signs of external injury on her foot, but her middle toe was visibly swollen. Every internet search suggested bumblefoot, even though she didn't have the usual isolated lumps or black spot. After a few days of the soaks a very small black dot did form in the middle of the swollen toe, and I pulled a very small sliver out of it. There was no additional infection around the sliver, or beneath it in the tissue I had pulled it from. She also had a couple small surface-level scratches that were barely starting to turn dark on the edges and to be safe we removed the tissue there. At the time I hoped maybe this was the culprit and I had just missed it originally. Now I believe she may have picked up the sliver and scratches after the initial injury or whatever caused the swelling in her toe.

Here's what the top of her foot looked like:
View attachment 2498112

And the bottom (you can see the two scratches in the middle of the swelling and one of the black specks is the sliver - the rest are just debris):
View attachment 2498115

After a few days of wraps, continued soaks, spraying with Veterycin, and TLC, we released her back into the flock. Her foot was completely healed where we had removed the sliver and scratch tissue. We continued to check her foot and spray it with Veterycin daily. The swelling wasn't going down, but she seemed happy to be moving around with her peeps.

By December 23rd her limp was back, and the swelling in her toe started to get worse. I pulled her indoors in a dog carrier that I set up with lots of fresh straw, and set her next to the pen of ducklings we were brooding she could have some company. There were no isolated lumps, no black marks - no traditional signs of bumblefoot. No cuts, scrapes, etc. Almost the entire length of her middle toe was very swollen. Then things started to move quickly. By evening on Christmas Eve her whole foot started to swell. By Christmas day the swelling was moving up her leg. It was all hot to the touch, and inflated like a balloon. I was worried her skin was going to split. The baths were doing nothing other than give her a short reprieve from having weight on it. She let her leg hang limply while she floated.

View attachment 2498124
View attachment 2498125

You can kind of make out where we removed the scratches and sliver, which had healed (at least externally):
View attachment 2498126

The info I could find on Penicillin G with Procaine (what is available at TSC) was inconclusive and I feared causing toxicity with the Procaine. I'd read about some other antibiotics people had found OTC, but the only one I could find available at the time was the Penicillin.

In desperation I signed up for justanswer.com and asked a certified avian vet what I could do. I had to explain that I could not take her to an avian vet in my area, and plead for anything I could do on my own. He said that at the dose PigDuck would need to be effective, the Procaine in the Penicillin G would cause toxicity. He recommended 0.3ml per 4lbs bodyweight LA 200 given IM into the chest once a day, for 10-14 days. Said it should take about 3-5 days to start seeing improvement. He did not believe we were dealing with bumblefoot, either. He recommended we continue giving the warm baths, but epsom salts would do no good. He couldn't think of anything else to help with pain or comfort, unfortunately, saying that he found aspirin to be generally pointless in ducks. I asked about Preparation H, as I had seen others suggest it for swelling on this site, but he said it wouldn't help for anything purely internal. I dashed out to TSC and got everything I needed (22g needle and 3ml syringe, for anyone who is reading this for their own reference) and started treatment that evening.

The swelling continued to get worse the first couple days of treatment. Pig had still been laying off and on, eating and drinking normally. By this point her appetite and thirst had slowed down, she was no longer laying, and was more lethargic than normal. Thankfully by day 4 the swelling stopped getting worse, and by days 5 and on it started to recede. It first left her leg where it was moving up toward her ankle. Then it mostly left her foot. The signs of serious infection went away and her appetite and thirst came back in full force. Unfortunately, she also started laying again (I was really hoping her body would put that energy toward healing). As the infection and swelling receded, she started developing these soft sacs of fluid on the top and sometimes the sides of her foot. We started draining them by poking them with a needle. A clear, water-like fluid (not very viscous) would do anything from drip to gush out, depending on the day and puncture location.

By 14 days she was acting much more lively, putting weight on the foot and using it frequently, but still had fluid pockets building back daily in her foot, and her toe was still swollen. Draining the fluid sacs seemed to help with her comfort and use of the foot.

I was afraid of losing progress if we stopped the antibiotics, and concerned about the remaining swelling. I followed up with the same vet on justanswer, and he said I could continue the antibiotics for another 14 days if it had helped. He said if the fluid we were draining was more water-like (which it was), it was probably a cyst that was refilling each day. If it was more viscous (which it was not), then it was probably joint fluid and we had bigger issues. He recommended holding off on draining the sacs for a few days to see if they started to go down on their own. Continue draining if they only got worse.

I asked if it would be a good idea to try to encourage Pig to go broody, so she could stop laying eggs and stay off of her foot allowing her more energy and rest to recover. He said anything I could do to get her to stop laying would be for the best, but didn't really offer any suggestions on what I could do. I asked if reducing her protein intake would be a good idea, and he thought it would probably do more harm than good and suggested I continue feeding her as I was. He also suggested trying aspirin to help with the swelling (this is the same vet that said aspirin was useless, but he didn't have any other suggestions for the swelling).

That night I placed 9 eggs in Pig's crate. I stopped petting her (I was following the recommendations on how to get a duck to go broody off of this page). I didn't start the aspirin yet because I needed to go get some. I continued to feed her normally and provide free-choice oyster shell.

A few days later Pig layed a soft-shelled egg after we drained her bath (her first one ever). I was worried that given her situation, this might cause additional problems or be related to treatment, so I consulted with a different avian vet on justanswer. He said not to worry about the one-time instance causing any infection or problems, but suggested putting her on a very low protein diet. I mentioned that vet #1 had strongly advised against that. Vet #2 also said he would absolutely avoid the aspirin that vet #1 recommended, and instead try applying DMSO topically. Different strokes for different folks, I guess. I opted out of the aspirin but have not yet had a chance to get the DMSO.

Her foot at this point:
View attachment 2498140

Vet #2 looked at pictures of her foot and agreed that it did not look like bumblefoot, and it also did not look like any sort of break or fracture to him. He did have some excellent advice:



It has been about a week since I talked to the second vet. I met in the middle and reduced her protein intake some, and am gradually tapering it back more. Every night we give Pig her LA 200 injection, drain her foot if there is a big enough fluid pocket, give her a nice long warm bath, and clean her carrier and give her fresh bedding. I place all the eggs back (9 staged eggs plus whatever she lays, minus whatever she has crushed of course). Vet #2 recommended keeping her in low lighting as much as possible to stop the laying, so I place a blanket over her carrier and it is a nice shady cave in there.

The swelling has not come back above her foot, but her middle toe now has gone from feeling solid lumpy to being solid lumpy with separate hard lumps - like a small marble forming alongside the toe lumps, if that makes any sense. Her foot seems even more swollen. It seems like the main fluid sac has gradually been hardening up, and now it's more solid mass than fluid sac. We haven't been able to drain it for a few days since it's mostly hard now. She seemed to be doing really great - using her foot to move around her carrier, very lively and talkative, ravenously attacking any new/fresh food I put in there. The past few days she has been avoiding putting weight on her foot again, tucking it up into her side, laying on her right side, etc. She doesn't have nearly as much of an appetite and she is not drinking as enthusiastically (though she is still eating and drinking). She is lower in energy. She's acting like she did at the peak of the infection, except her leg is so much better than it was then, and she is very far into this round of antibiotics.

Swollen foot. You can see larger and smaller fluid sacs. These are still soft and fluid-filled on that side, but others have started turning solid.
View attachment 2498144

Lumpy (hard) toe and swollen foot. The largest lump toward the inside of her foot was the largest fluid sac, but now (and at the time of this pic) is practically all solid to the touch:
View attachment 2498147

Different angle - you can see how bad the swelling is. I also need to trim her nails:
View attachment 2498152

The only changes in the past few days have been that we moved the ducklings to a shed outside, so Pig no longer has company (they are not her ducklings), and we haven't been able to drain her foot. Before this point, the times she was inside alone or when we put the ducklings outside for the day, she would call for her buddies. She isn't doing that this time. She did seem to use her foot a lot more after we would drain it. When we took the break from draining it to see if the fluid sacs receded on their own, she acted more like this - withdrawn, inactive, keeping weight off of her foot. Once we started draining them again, she perked up again. Unfortunately we have nothing to drain right now. I will have a chance to buy the DMSO this weekend. She has spent a little more time laying on the eggs (she is definitely not broody yet) - could this be part of a mellowing stage before sitting on them?

UPDATE: I was able to get an appointment on Monday with a local vet who might be willing to take a sample for a cytology! I was warned that the vet knows pretty much nothing about ducks, and wouldn't be able to help me beyond something very simply and obvious. At least I can get some lab results and hopefully convince her to prescribe me something a little more appropriate, if needed.

More detaily things that most probably don't care about, but someone inevitably asks:

Before injury:
Lifestyle:
In the morning I let the ducks out to free-range on 3 acres of pasture. There they have access to a large kiddie pool and a smaller bathing tub. In the evening I put them into the garden/run and give them food and fresh water. They have a lot of space to move around and a small pond that we built for them. Late night they go into a shed to sleep.
Substrates: Kiddie pool is on pea gravel. Bathing tub is on a cement landing. Garden/run is straw and mud. Shed gets a thick layer of straw. The rest is the yard which is mostly grass/moss, dirt, some gravel, etc. Other than the cement landing where the bathing tub is, and the gravel paths (which they can easily avoid), they are walking on forgiving substrates.
Feed: They mostly eat a mixture of fermented whole grains, soybean meal, and alfalfa/forage pellets. When I am too lazy to restart the ferment I cut everything but the soybean meal into Purina Flock Raiser. I recently switched them from the flock raiser to a flock layer pellet, but Pig's issue occurred before this switch. I do feed kitten/cat food as a more-than-occasional treat, but not a ton at a time. They have access to free choice oyster shell in multiple locations throughout the property and run.

Overall the flock has seemed healthy and we haven't had any issues outside of a couple soft-shelled eggs when the Pekins started laying (Pig did not have this issue), and a couple of limps due to injuries. I just noticed our first case of true bumblefoot today, which is very small but I will be treating that Pekin immedately. I'm trying to cut the protein and richness in their diet (without cutting nutrients) so they will ease up on the laying.

Pig's current feed: She's currently eating a mix of Purina Flock Raiser, whole oats, wheat, and barley, forage pellets, a little Calf Manna, a little Mazuri Waterfowl Starter, and some Rooster Booster Poultry Booster top dressing. She gets kitten food, mealworms (dried and live), and BOSS for treats. I'm just trying to get as munch nutrient-dense and nutrient-diverse foods into her as I can. Periodically I will add Durvet brand vitamins and electrolytes to her water. If I give her fresh water on the side, she won't drink the electrolyte water, so I try to give that to her before she has a bath where she can clear any residue from her nostrils. I change her water multiple times a day and often add a few drops of raw unfiltered ACV, and sometimes a small splash of water kefir. The Mazuri, cat food, and poultry booster also have probiotics - something I am trying to make sure she gets, especially while on antibiotics. I have both chick grit with probiotics, and adult-size grit available to her, and oyster shell available at all times. I try to give her fresh greens floated in her water when I can - homegrown kale, grass, weeds, whatever is available.


I guess for now my questions are:

Any ideas what happened or what is going on?

In case the vet is useless and/or we can't determine a different course of treatment, is there any sort of treatment/antibiotic/anything I can try that is available OTC for infection/swelling/pain?

Any thoughts on the whole broody thing? Is this even a good idea to be trying right now? Is the blanket shading potentially helping or harming? Is it better or worse to have her separated from the ducklings or other flock members? Any other ways to halt egg production? I'm keeping her inside in the carrier alone for now because it's calm, quiet, safe, and honestly a little easier for me to get her into the bath and deliver her treatment, but I am more than willing to set her up with company outside and bring her in for her bath - though then should I worry about the change in temperatures?

Any recommendations for dealing with the in-person, non-avian vet? I am hoping that I can tell her about my access to actual avian vets on justanswer, that way I can relay the results of any lab work to them and get the best possible treatment suggestion from them back to her, but I can see this not going as smoothly as I hope.

I am going to ask for the cytology. Is it also worthwhile to ask for a culture and sensitivity at the same time? If the cytology doesn't come up with anything helpful, it would be difficult and expensive to get back in to then do the culture and sensitivity (the vet who is willing to meet is only there once a week, and I have to pay for each appointment). But if they are mostly going to serve the same purpose, I'd rather not spend hundreds more than I need to. The cytology is over $100 and I forgot to ask about the culture and sensitivity. Unfortunately, x-rays are not in the budget right now because they want $400+ for those (on top of the exam and lab fees).

Even if we diagnose what is going on, it doesn't sound like this vet would be willing or able to perform any sort of procedure that might help. Short of new antibiotics, we would be on our own. What should I start preparing myself for, here? This doesn't look like any sort of surgery we would want to try and attempt on our own, mostly for Pig's sake. I don't want to give up on this girl, though.


Thank you all for slogging through this mess with me. I know it's a lot and we are all flying blind. I just want to be sure I am doing every possible thing I realistically can. And thank you in advance for any input or advice!

Pig thanks you too!
View attachment 2498156
Red iodine (Lugols solution) is so effective that I would call it a miracle preparation.
I also believe that foraging is essential for a healthy diet and there is no substitute for exercise and sunlight combined with the natural fauna in the grass and soil both internally and externally for your ducks.
 

MotherOfDuckens

Chirping
Jun 24, 2020
71
233
96
Red iodine (Lugols solution) is so effective that I would call it a miracle preparation.
I also believe that foraging is essential for a healthy diet and there is no substitute for exercise and sunlight combined with the natural fauna in the grass and soil both internally and externally for your ducks.

Would red iodine help with an internal injury/infection? The vet prescribed an antimicrobial foot soak but as a precaution since there is likely nothing going on on the outside of the skin.

All the ducks get to free range on a large property during daylight hours. At night they go into a large and well-fenced garden where they forage until they are locked up in another pen for added safety during the night.
 

MotherOfDuckens

Chirping
Jun 24, 2020
71
233
96
The vet was more helpful than I was warned she might be. She drained as many points on Pig's foot as she could and got 3ml fluid from one extraction alone. We have both cytology and culture/sensitivity labs ordered and those results should be back in a few days.

In the meantime she's started Pig on Doxycycline and Amoxi-Clav for antibiotics, and Metacam for pain. Also wants me to soak her foot in Nolvasan solution for 10 minutes a day as an added precaution. She wants me back in a week to check on Pig's progress but that seems like a short time. I'll be thrilled if we see any improvement with the swelling/infection by then.
 

New posts New threads Active threads

Top Bottom