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Bumblefoot

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

Bumblefoot, also known as footpad dermatitis or pododermatitis, is a general term for any inflammatory or degenerative condition of a bird's foot. The severity is graded using a 5-point scale and is usually related to whether or not there is an established infection present. Once an infection is established, the disease quickly becomes progressive and degenerative. It is a common problem for any birds kept in captivity and is similar to pressure ulcers or bed sores in humans.

The bacteria most often responsible for infections include Staphylococcus aureus, however Pseudomonas aeruginosa, Klebsiella sp., Clostridium sp., Corynebacterium sp., Nocardia sp., Actinomyces sp., Candida sp., Streptococcus sp., E. coli, Proteus sp., Pasteurella spp., and Aspergillus sp have also been identified as less common causes.

Bumblefoot is caused by a constant, uneven, or excessive pressure exerted on the bottom of the bird's foot, combined with conditions which lead to the breakdown in the outer skin barrier of the foot. The compromised skin layer allows whatever bacterial organisms present in the environment of the bird to invade the inner tissues of the foot.

Signs of bumblefoot in chickens


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. 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.

Bumblefoot Grades

  • Grade 1: Loss of definition of the epidermis (seen as a shiny, reddened surface or small lesion), with no apparent underlying infection.
  • Grade 2: Infection of underlying tissues in direct contact with the surface lesion with no gross swelling.
  • Grade 3: Abscess state; infection with serous or caseous fluid draining from a fibrotic lesion.
  • grade 4: Infection with swelling of underlying tissues involving deep vital structures. Usually a chronic wound at this stage, which may or may not be concurrently causing tenosynovitis, arthritis, and/or osteomyelitis.
  • Grade 5: Crippling deformity and loss of function.

Diagnosis of Bumblefoot


Diagnosis is based on history, clinical signs and physical examination. If in the later stages, radiographs might be needed to evaluate whether the infection has spread to the bone.

Bumblefoot treatment in chickens


Treatment of bumblefoot varies depending on the severity and the cause.
Early stages are much easier to treat, and may only even require simple changes to the environment and/or management practices. If infection is present (which is usually the case when there is any ulceration, swelling, and/or inflammation present), then surgical debridement, post-surgical care, and antibiotics are usually necessary.

Post-surgical care consists of bandage and wound management, supportive care and maintaining a very clean environment for healing. Often, irrigation of the wound is necessary with sterile saline or 0.5% chlorhexidine, and protective ball bandaging or application of a custom-made polypropylene foam shoe.
  • Environmental modifications: Modification of environment or management practices.
  • Foot soaks: Soaking the foot in warm water with or without Epsom salts or chlorhexidine solution helps to soften the hardened, proliferative, scabbed tissue as well as using keratin-softening agents.
  • Bandaging: Bandaging the foot with colloidal dressings or medical honey or similar product until it is completely healed also helps keep the area clean and moist to encourage healing. A variety of bandages have been described such as “ball” in which the foot is bandaged into a ball, a “snowshoe” in which the bandage is flat bottomed to disperse the weight over a larger surface area, or a bandage that puts no weight on the bottom of the foot by strapping a U-shaped bar to the leg or making a donut with a pool noodle or other material. Changing the bandage frequently to keep it clean and dry is necessary.
  • Debridement surgery, only performed by your veterinarian.
  • Antibiotics: Antibiotics are best selected based on culture (both aerobic and anaerobic) of the wound and antibiotic sensitivity results, to ensure compatibility. The most commonly used antibiotics include cephalosporins, fluoroquinolones, lincomycin, and clindamycin. If osteomyelitis is present, then enrofloxacin and chloramphenicol are often good choices.

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), sand, butyl rubber matting, small pebbles, Nomad matting, sport track surfacing, varying terrains, etc.
Application of skin toughenersSuch as Tuf Foot or camphor and benzoin
FOOT SOAKING
Soak foot in a small bucket of warm water mixed with Epsom salt or chamomile tea.
MONITORING
Perform routine foot checks and photographic documentation of active bumblefoot lesions.
DEBRIDEMENT
Surgical debridementPERFORMED BY A VETERINARIAN
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.
Cold laser therapy
Intravenous regional antibiotic perfusion therapy (IRAP)
Antimicrobial Photodynamic therapy (PDT)

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

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