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Bumblefoot

Pododermatitis, Foot Pad Dermatitis, Paw Burns, Foot Pad Ulcers

Bumblefoot (also known as footpad dermatitis and pododermatitis) is an infection on the bottom of a chicken's foot. It is a common problem in birds kept in captivity, and is very similar to pressure ulcers or bed sores in humans. Bumblefoot is usually associated with impaired integrity to the integument of the foot.

What Bumblefoot Looks like


During the early stages of bumblefoot, it may initially appear as a small, superficial lesion, rough abrasion, or mild discoloring of the foot. However, once there is a breakdown in the skin barrier, it provides a direct opening for opportunistic bacteria to enter and cause infection. The most common microorganisms found are Staphylococcus aureus, Pseudomonas spp., Enterococcos spp., Staphylococcus spp., and E. coli. Once the foot is infected, chickens may often begin to show slight behavioral changes (associated with onset of pain caused by the infection), and varying degrees of lameness. If left untreated or not treated appropriately, the infection often becomes chronic and progressive, eventually spreading into the underlying tissue---the bone, tendons and joints and resulting in osteomyelitis, tenosynovitis, septicemia, and arthritis. The only way for your veterinarian to determine whether the infection has spread to the bone is by taking radiographs.

When to Schedule an Appointment with your Veterinarian


Initially, if it is a relatively mild or early stage bumblefoot, daily Epsom salt soakings, topical antibiotic cream, bandage management, nutritional support, and strict sanitation of the environment to ensure the chicken's foot stays clean and dry may be sufficient. However, if after 1-2 weeks you see no improvement, or it gets worse, then you need to schedule an appointment with you vet as debridement of the wound and antibiotics for the infection may be necessary. Because this procedure can be very painful for the animal, for humane reasons, we really encourage that only veterinarians perform this procedure. If cost is a concern, seek a nearby teaching hospital, small animal clinic, or large animal vet who may be willing to perform the surgery on your chicken.

How is Bumblefoot Treated?


Successful treatment of bumblefoot generally involves a combination of topical and/or systemic antibiotics, debridement of necrotic tissue, post-operative protective foot casting, and environmental modifications.
Debridement can be autolytic (provided by the wound’s own drainage), enzymatic (collagenase is commonly available and well tolerated), mechanical (whirlpool), or surgical (sharp debridement, which should only be performed by a veterinarian.). Debridement is important to promote healing and decrease the risk of infection.

Post-operative wound management involves a combination of:
  • Promoting granulation and healing by appropriate dressings and bandaging, depending on the stage of healing.
  • Alleviating pressure on the bottom of the bird's foot by using a variety of padded dressings and/or custom-made shoe or donut.
  • Eliminating pathogens and protecting the wound from further infection.
Environmental modifications are important to help prevent bumblefoot from reoccurring. Therefore, you need to try to figure out why your chicken developed bumblefoot. Evaluate how flock members get along with one another (is one bird getting excessively chased or mated with?), the environment (are they constantly stepping in feces or is the bedding always wet?), diet (are they able to get plenty of green forage or is their feed stale?), their health status (do they have an existing illness or intestinal parasites?).

Clinical Signs

Brown/black scab on the bottom of foot
Swelling
Lameness (limping)
Reluctance to move
Loss of appetite
Depression
Behavioral changes

Diagnosis

  • History
  • Clinical signs
  • Physical exam
  • Radiographs - May be needed to verify whether the infection has spread to the bone.
  • Culture & Sensitivity - for selection of antibiotics.
  • Thermography

Treatment

NameSummary
ENVIRONMENTAL MODIFICATIONS
Better sanitationClean coop and enclosure frequently to decrease accumulation of feces. Also consider increasing the size of the outdoor enclosure so birds have more space to exercise and perform natural foraging activities. Establish good drainage and prevent puddling.
Provide softer ground surfaceUse natural or artificial grass (Astroturf), butyl rubber matting, small pebbles, Nomad matting, sport track surfacing, varying terrains, etc.
FOOT SOAKING
Soak affected feet in a small bucket of warm water mixed with Epsom salt or chamomile tea.
DEBRIDEMENT
Debridement can be autolytic (provided by the wound’s own drainage), enzymatic (collagenase is commonly available and well tolerated), mechanical (whirlpool), or surgical (sharp debridement, which should only be performed by a veterinarian.). Debridement is important to promote healing and decrease the risk of infection.
ANTIBIOTICS
POST-OPERATIVE CARE
Wound managementCleaning with 2% chlorhexidine or povidone-iodine (Betadine) solution, applying dressings and protecting foot while alleviating pressure.
CONCURRENT THERAPIES
AcupunctureAfter eight acupuncture sessions, a bald eagle showed a drastic improvement in lameness score (decreased from Score 5 to Score 0-1) and a full recovery from bumblefoot lesions.K Hwa Choi., 2016
Antimicrobial Photodynamic therapy (PDT)Is based on the photooxidation of biological material. In a study done on 10 captive Magellanic penguins with pre-existing stage III Bumblefoot lesions (according to the 5-stage system of Oaks). They were divided into two groups--the photodynamic therapy (PDT) and the antibiotics groups. A culture sample was taken from the debrided wound and sent to a lab for analysis.
  • For the PDT group, PDT was applied to the wound, then protected with gauze, and adhesive bandage. Each penguin had their feet washed in a 4% aqueous solution of chlorhexidine, PDT, and a fresh protective dressing 3 times a week.
  • For the ATB group, a culture sample was taken from the debrided wound and sent to the lab for analysis. Neomycin/bacitracin ointment was applied on the wound and enrofloxacin (15 mg/kg; Baytril) was administered by IM injection. The affected limb was then protected with gauze and adhesive bandage. Carprofen (4 mg/kg; Carproflan) was administered in the food and enrofloxacin (15 mg/kg IM; Baytril) was injected every day. Each penguin had their feet washed in a 4% aqueous solution of chlorhexidine, application of antibiotic ointment on the lesion, and a fresh protective dressing 3 times a week.
  • The penguin’s feet were photographed every 14 days to keep track of the size of the lesions.
  • Lesions were located on the footpad (84%) or tarsometatarsus (17%).
  • The PDT group showed pronounced decrease in size of lesions in the first 28 days of treatment. There was a significant difference in healing rate, where for PDT it was 64% of healed lesions where only 9% healed in antibiotic only.
Nascimento CL et al., 2015
Cold laser therapy
Intravenous regional antibiotic perfusion therapy (IRAP)

Support

Prevention

  • Maintain a sanitary environment for birds to live in
  • Provide soft and even floor substrate
  • Design outdoor runs with proper drainage to prevent flooding and mud accumulation
  • Feed a balanced diet

Prognosis

Birds with mild, early-stage bumblefoot have a good prognosis if treated promptly and aggressively.

Scientific References

Good Overviews

Blogs

Risk Factors

  • Previous foot or leg injury
  • Hard, muddy, flooded, uneven or rough floor surfaces
  • Damp or unsanitary bedding litter
  • Vitamin A deficiency
  • Overweight
  • Excessively dry skin
  • Lack of activity
  • Excessive activity due to fighting among flock members or guarding behavior
  • Leg or conformation abnormality
  • Improperly designed perches (plastic, sharp-corners, or not wide enough)
  • Excessive accumulation of feces
  • Poor diet
  • Overgrown toe nails