{"id":35145,"date":"2025-01-20T16:16:54","date_gmt":"2025-01-20T16:16:54","guid":{"rendered":"https:\/\/todaysveterinarypractice.com\/?p=35145"},"modified":"2025-02-04T21:00:01","modified_gmt":"2025-02-04T21:00:01","slug":"management-of-bumblefoot-in-chickens","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/exotic-medicine\/management-of-bumblefoot-in-chickens\/","title":{"rendered":"Management of Bumblefoot in Chickens"},"content":{"rendered":"<p>This article is part of an exclusive NAVC book dedicated to chicken and poultry care and medicine, <a href=\"https:\/\/shop.navc.com\/collections\/books\/products\/poultry-in-general-practice-digital-ebook\" target=\"_blank\" rel=\"noopener\"><em>Poultry in General Practice: Veterinary Medicine for Chickens in Small Flocks<\/em><\/a>. As backyard flocks become more popular and owners seek out preventive and emergency care, general and mixed animal practitioners should be prepared to oversee their basic care and refer cases as necessary.<\/p>\n<div class=\"su-note\"  style=\"border-color:#d8d8d8;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><div class=\"su-note-inner su-u-clearfix su-u-trim\" style=\"background-color:#f2f2f2;border-color:#ffffff;color:#333333;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><strong>Abstract<\/strong><\/p>\n<p class=\"p1\">Pododermatitis, also known as bumblefoot, is a common condition affecting the feet of poultry, including chickens and ducks. Pododermatitis can range from mild erythema on the epidermis to severe infections with arthritis and osteomyelitis. This chapter aims to provide an in-depth understanding of pododermatitis, including its underlying causes, diagnostic methods, treatment approaches, and preventive strategies.<\/p>\n<p class=\"p1\"><strong>Take-Home Points<\/strong><\/p>\n<ul>\n<li class=\"p1\">Pododermatitis is multifactorial, often associated with husbandry practices. Identifying predisposing factors helps owners understand how to prevent the condition and practitioners provide effective postoperative care.<\/li>\n<li class=\"p1\">Proper weight management and a balanced diet are crucial for preventing pododermatitis. Overweight birds are more prone to pressure sores and infections.<\/li>\n<li class=\"p1\">Radiographic imaging is necessary for advanced staging to assess the extent of soft tissue and bone involvement and guide treatment decisions.<\/li>\n<li class=\"p1\">Ensure to apply proper bandaging techniques, such as a donut bandage, to avoid putting pressure directly on the incision. This helps protect the wound and promote healing.<\/li>\n<li class=\"p1\">Successful recovery depends on comprehensive postoperative care, including proper bandaging, management modifications, and appropriate antibiotic and analgesic plans.<\/li>\n<\/ul>\n<p><\/div><\/div>\n<p><span class=\"s1\">Pododermatitis is characterized by inflammation and infection of the footpad, most commonly affecting the large central metatarsal pad on the plantar surface and potentially extending to the interpad spaces and interdigital joints. In early stage of pododermatitis, the condition often presents as a small, superficial lesion or mild discoloration of the footpad. Inflammation begins when the epidermis breaks down, allowing bacteria (e.g., <i>Staphylococcus aureus<\/i>,<i> Escherichia coli<\/i>) to enter the dermis and cause an infection, leading to abscess formation and swelling. This can result in behavioral changes and varying degrees of lameness. If left untreated, the infection often progresses and eventually extends to underlying tissues, including tendons, bones, and joints.<\/span><\/p>\n<hr \/>\n<p>Buy the e-book, <em>Poultry in General Practice: Veterinary Medicine for Chickens in Small Flocks<\/em>, <a href=\"https:\/\/shop.navc.com\/collections\/books\/products\/poultry-in-general-practice-digital-ebook\" target=\"_blank\" rel=\"noopener\">here<\/a>.<\/p>\n<hr \/>\n<h2 class=\"p1\">Causes and Predisposing Factors for Bumblefoot<\/h2>\n<p class=\"p2\"><span class=\"s1\">The condition is multifactorial. Some of the common contributing factors can be found in <\/span><span class=\"s2\"><b>Box 1<\/b><\/span><span class=\"s1\">.<\/span><\/p>\n<p><div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">Box 1 Factors Contributing to Pododermatitis <\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\"><strong>Compromised skin from poor environmental conditions<\/strong><\/p>\n<ul>\n<li>Poor hygiene with feces and moisture buildup in the coop and flooring <strong>(Figure 1) <\/strong><\/li>\n<li>Dirty perches and\/or suboptimal perch design<\/li>\n<li>Hard or abrasive surfaces<\/li>\n<li>Lack of swimming water available (ducks)<\/li>\n<\/ul>\n<p><strong>Malnutrition <\/strong><\/p>\n<ul>\n<li>Poor feed quality<\/li>\n<li>Lack of biotin and\/or vitamin A<\/li>\n<li>Diets that promote obesity. Obesity is a common factor in pododermatitis in hens.<\/li>\n<\/ul>\n<p><strong>Excessive or uneven weight distribution<\/strong><\/p>\n<ul>\n<li>Reduced physical activity due to obesity or illness<\/li>\n<li>Large, fast-growing breeds<\/li>\n<li>Existing foot deformity such as injury to other leg<\/li>\n<\/ul>\n<p><strong>Other<\/strong><\/p>\n<ul>\n<li>Malnutrition and\/or damage to the skin due to ectoparasites<\/li>\n<li>Excessive activity such as from chasing and guarding behavior<\/div><\/div><\/li>\n<\/ul>\n<div id=\"attachment_35231\" style=\"width: 360px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.1.jpg\"><img fetchpriority=\"high\" decoding=\"async\" aria-describedby=\"caption-attachment-35231\" class=\" wp-image-35231\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.1.jpg\" alt=\"bumblefoot stage 1\" width=\"350\" height=\"469\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.1.jpg 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.1-224x300.jpg 224w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.1-765x1024.jpg 765w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.1-768x1028.jpg 768w\" sizes=\"(max-width: 350px) 100vw, 350px\" \/><\/a><p id=\"caption-attachment-35231\" class=\"wp-caption-text\">Figure 1 Chronic pododermatitis from prolonged exposure to wet manure. If no ulcerations are present, then stage 1 may be assigned. Thorough cleaning of the wounds for evaluation would be the first step to assess the condition. If ulceration with soft tissue swelling and pain are evident, radiographs would be advised to evaluate for tendon and bone involvement. Reviewing flooring substrate, routine litter changes, and body condition score would be part of the evaluation to prevent the condition. Basic treatment for stage 1 to 2 pododermatitis would include husbandry changes, analgesics, and bandaging to decrease pain and allow for tissue healing. Antibiotics may also be selected if deeper soft tissue involvement is evident.<\/p><\/div>\n<h2 class=\"p1\">Bumblefoot Species Differences<\/h2>\n<p class=\"p4\"><span class=\"s1\">Although pododermatitis can affect many poultry species, it manifests differently due to their unique anatomical and behavioral characteristics. Ducks are more susceptible because their wet living conditions favor pathogen buildup, making them more prone to infection when the epidermis is damaged. Unlike chickens, domestic ducks do not roost and spend more time on the floor. Additionally, their webbed feet distribute pressure more evenly when they walk. However, this even pressure distribution can lead to more extensive damage on the foot pads, including the plantar surface of their digits, when they are exposed to hard and coarse surfaces (<strong>F<\/strong><\/span><span class=\"s2\"><b>igure 2<\/b><\/span><span class=\"s1\">). For these reasons, treatment for ducks focuses on maintaining a dry flooring, soft bedding, and a balanced diet.<\/span><\/p>\n<div id=\"attachment_35232\" style=\"width: 360px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.2.jpg\"><img decoding=\"async\" aria-describedby=\"caption-attachment-35232\" class=\" wp-image-35232\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.2.jpg\" alt=\"duck bumblefoot stage 3\" width=\"350\" height=\"467\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.2.jpg 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.2-225x300.jpg 225w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.2-767x1024.jpg 767w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.2-768x1025.jpg 768w\" sizes=\"(max-width: 350px) 100vw, 350px\" \/><\/a><p id=\"caption-attachment-35232\" class=\"wp-caption-text\">Figure 2 Severe pododermatitis in a duck. Note the swelling of the plantar surface of the digits. Minimum pododermatitis score of 3.<\/p><\/div>\n<p class=\"p4\"><span class=\"s1\">In contrast, chickens have nonwebbed feet with 3 forward-facing digits and 1 backward-facing digit, which allows them to scratch and perch. Their roosting behavior can contribute to pressure sores if perches are not appropriately designed and maintained. Variable sizes and heights of perches are recommended. The nonwebbed feet of chickens also allow more pressure on their central metatarsal footpads, making this area more susceptible to erosion. <\/span><\/p>\n<p class=\"p4\"><span class=\"s1\">Heavy, broad-breasted turkeys can be a special consideration due to their weight. While the foot structure is anatomically similar to chickens, turkey pododermatitis cases can prove to be very challenging due to constant compression of the soft tissue of the central foot pad. Treatment should be aggressive with flooring substrate management, bandage management, and body condition evaluations to prevent additional damage.<\/span><\/p>\n<hr \/>\n<p>Buy the e-book, <em>Poultry in General Practice: Veterinary Medicine for Chickens in Small Flocks<\/em>, <a href=\"https:\/\/shop.navc.com\/collections\/books\/products\/poultry-in-general-practice-digital-ebook\" target=\"_blank\" rel=\"noopener\">here<\/a>.<\/p>\n<hr \/>\n<h2 class=\"p1\">Clinical Presentation of Bumblefoot<\/h2>\n<p class=\"p4\"><span class=\"s1\">Presenting signs may include limping, ataxia, weight loss, and self isolation. Evaluation for other musculoskeletal and neurologic conditions should be part of the physical examination.<\/span><\/p>\n<h2 class=\"p1\">Diagnosis of Bumblefoot<\/h2>\n<p class=\"p4\"><span class=\"s1\">The diagnosis of pododermatitis is primarily clinical but may require additional diagnostic tests to rule out other differential diagnoses. Begin the assessment with a distant examination and, if available for chickens, the use of perches to assess the degree of lameness. Next, perform a thorough examination of the foot, including palpation of the hock joint and interphalangeal joints to assess tenderness, crepitus, and deformities. Examine the metatarsal pad, interpad spaces, and interdigital webs for scratches, redness, warmth, and swelling. Assess the size and extent of the lesions and the presence of abscesses or necrotic tissue. It is helpful to evaluate the degree of swelling by comparing the affected foot to the contralateral foot. <\/span><\/p>\n<p class=\"p4\"><span class=\"s1\">Finally, check for tendon involvement by examining the range of motion and response to palpation. Radiographic imaging is often required to detect osteomyelitis and assess the extent of soft tissue damage to help stage the condition and plan treatment strategies (<\/span><span class=\"s2\"><b>Figure 3<\/b><\/span><span class=\"s1\">). Fine-needle aspiration, culture, and sensitivity should be warranted, especially in cases that are not responsive to empirical antibiotic treatments and\/or used to guide initial antibiotic treatment plan.<\/span><\/p>\n<div id=\"attachment_35233\" style=\"width: 359px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.3.jpg\"><img decoding=\"async\" aria-describedby=\"caption-attachment-35233\" class=\" wp-image-35233\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.3.jpg\" alt=\"chicken bumblefoot\" width=\"349\" height=\"362\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.3.jpg 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.3-289x300.jpg 289w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.3-768x797.jpg 768w\" sizes=\"(max-width: 349px) 100vw, 349px\" \/><\/a><p id=\"caption-attachment-35233\" class=\"wp-caption-text\">Figure 3 An example of stage 3, 4, or 5 pododermatitis in a chicken. This image represents chronic irritation that can lead to infection with swelling of the soft tissues and possible involvement of the tendons, joints, and bone. Radiographic imaging is needed to distinguish these stages, recommend appropriate therapy, and best predict outcome.<\/p><\/div>\n<h2 class=\"p1\">Bumblefoot Differential Diagnoses<\/h2>\n<p class=\"p4\"><span class=\"s1\">Articular gout, arthritis, and tendonitis can initially present similarly to pododermatitis, as patients show varying degrees of lameness. Articular gout is characterized by the buildup of tophi (urate crystals) around joints, which can be diagnosed by aspiration and identification of crystals. Arthritis and tendonitis can result from various causes without pododermatitis. Taking a thorough history, performing a comprehensive physical examination, and using radiographic imaging can help to localize the joint and\/or tendon involved to determine the next diagnostic and treatment approach.<\/span><\/p>\n<hr \/>\n<p>Buy the e-book, <em>Poultry in General Practice: Veterinary Medicine for Chickens in Small Flocks<\/em>, <a href=\"https:\/\/shop.navc.com\/collections\/books\/products\/poultry-in-general-practice-digital-ebook\" target=\"_blank\" rel=\"noopener\">here<\/a>.<\/p>\n<hr \/>\n<h2 class=\"p1\">Bumblefoot Staging and Management Approach<\/h2>\n<p class=\"p4\"><span class=\"s1\">Pododermatitis is classified depending on the chronicity, tissue involvement, and severity of the lesions. Accurate staging is crucial for determining the prognosis and appropriate treatment approach, and it helps guide discussion on prognosis and treatment expectations with owners (<\/span><span class=\"s2\"><b>Table 1<\/b><\/span><span class=\"s1\">).<\/span><\/p>\n<p><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_Table1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-35244 size-full\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_Table1.jpg\" alt=\"bumblefoot staging\" width=\"1152\" height=\"936\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_Table1.jpg 1152w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_Table1-300x244.jpg 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_Table1-1024x832.jpg 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_Table1-768x624.jpg 768w\" sizes=\"(max-width: 1152px) 100vw, 1152px\" \/><\/a><\/p>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-4-5 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:70%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69d4f77d25f1d\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.4.jpg\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 4. An example of stage 2 pododermatitis in a chicken. Ulceration of the epidermis with localized inflammation and infection but without gross swelling.\"><img loading=\"lazy\" decoding=\"async\" width=\"666\" height=\"1024\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.4-666x1024.jpg\" class=\"\" alt=\"chicken bumblefoot stage 2\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.4-666x1024.jpg 666w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.4-195x300.jpg 195w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.4-768x1180.jpg 768w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.4.jpg 864w\" sizes=\"(max-width: 666px) 100vw, 666px\" \/><span>Figure 4. An example of stage 2 pododermatitis in a chicken. Ulceration of the epidermis with localized inflammation and infection but without gross swelling.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.5.jpg\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 5. Radiographic image of stage 1 to 2 pododermatitis with soft tissue swelling, localized or no tendon involvement, and no gross bone involvement.\"><img loading=\"lazy\" decoding=\"async\" width=\"815\" height=\"1024\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.5-815x1024.jpg\" class=\"\" alt=\"bumblefoot stage 1 to 2 radiograph\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.5-815x1024.jpg 815w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.5-239x300.jpg 239w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.5-768x965.jpg 768w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.5.jpg 864w\" sizes=\"(max-width: 815px) 100vw, 815px\" \/><span>Figure 5. Radiographic image of stage 1 to 2 pododermatitis with soft tissue swelling, localized or no tendon involvement, and no gross bone involvement.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.6.jpg\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 6. Radiographic images of stage 3 to 4 pododermatitis with severe encrustation and swelling of the central foot pad and deep tissue swelling, resulting in malalignment of the joints, increase of the intra-articular space, and possible synovitis noted.\"><img loading=\"lazy\" decoding=\"async\" width=\"864\" height=\"980\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.6.jpg\" class=\"\" alt=\"bumblefoot stage 3 to 4 radiograph\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.6.jpg 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.6-264x300.jpg 264w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.6-768x871.jpg 768w\" sizes=\"(max-width: 864px) 100vw, 864px\" \/><span>Figure 6. Radiographic images of stage 3 to 4 pododermatitis with severe encrustation and swelling of the central foot pad and deep tissue swelling, resulting in malalignment of the joints, increase of the intra-articular space, and possible synovitis noted.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.7.jpg\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 7. Additional radiographic images of stage 3 to 4 pododermatitis with severe swelling of the deep soft tissues and increase of the intra-articular space. These images show more advanced \u201cbumble\u201d (abscess)  formation with deep soft tissue swelling versus deep ulceration and encrustation of the central footpad noted in Figure 9.6.\"><img loading=\"lazy\" decoding=\"async\" width=\"836\" height=\"1024\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.7-836x1024.jpg\" class=\"\" alt=\"bumblefoot stage 3 to 4 radiograph\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.7-836x1024.jpg 836w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.7-245x300.jpg 245w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.7-768x940.jpg 768w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.7.jpg 864w\" sizes=\"(max-width: 836px) 100vw, 836px\" \/><span>Figure 7. Additional radiographic images of stage 3 to 4 pododermatitis with severe swelling of the deep soft tissues and increase of the intra-articular space. These images show more advanced \u201cbumble\u201d (abscess)  formation with deep soft tissue swelling versus deep ulceration and encrustation of the central footpad noted in Figure 9.6.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.8.jpg\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 8. Stage 4 pododermatitis with osteomyelitis in the P1 and P2 joints of digit 2.\"><img loading=\"lazy\" decoding=\"async\" width=\"641\" height=\"1024\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.8-641x1024.jpg\" class=\"\" alt=\"bumblefoot stage 4 radiograph\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.8-641x1024.jpg 641w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.8-188x300.jpg 188w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.8-768x1227.jpg 768w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.8.jpg 864w\" sizes=\"(max-width: 641px) 100vw, 641px\" \/><span>Figure 8. Stage 4 pododermatitis with osteomyelitis in the P1 and P2 joints of digit 2.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.9.jpg\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 9. Osteomyelitis of digit 3 at the tarsometatarsal (P1) joint with fracture of both bones. While treatment options exist for this stage of the disease and success can occur, owners need to be advised of the extended duration and intensity of treatments, as well as diminished rate of success (defined as ability to walk normally without pain).\"><img loading=\"lazy\" decoding=\"async\" width=\"715\" height=\"1024\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.9-715x1024.jpg\" class=\"\" alt=\"bumblefoot osteomyelitis radiograph\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.9-715x1024.jpg 715w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.9-209x300.jpg 209w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.9-768x1100.jpg 768w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.9.jpg 864w\" sizes=\"(max-width: 715px) 100vw, 715px\" \/><span>Figure 9. Osteomyelitis of digit 3 at the tarsometatarsal (P1) joint with fracture of both bones. While treatment options exist for this stage of the disease and success can occur, owners need to be advised of the extended duration and intensity of treatments, as well as diminished rate of success (defined as ability to walk normally without pain).<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.10.jpg\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 10. Stage 5 pododermatitis with severe soft tissue swelling and osteomyelitis with fractures. These images show osteomyelitis in digit\u00a03 (P1 and P2 joints) with fracture of the P1 joint and intra-articular swelling of digit 2 at the tarsometatarsus (P1 joint).\"><img loading=\"lazy\" decoding=\"async\" width=\"763\" height=\"1024\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.10-763x1024.jpg\" class=\"\" alt=\"bumblefoot stage 5 radiograph\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.10-763x1024.jpg 763w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.10-223x300.jpg 223w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.10-768x1031.jpg 768w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.10.jpg 864w\" sizes=\"(max-width: 763px) 100vw, 763px\" \/><span>Figure 10. Stage 5 pododermatitis with severe soft tissue swelling and osteomyelitis with fractures. These images show osteomyelitis in digit\u00a03 (P1 and P2 joints) with fracture of the P1 joint and intra-articular swelling of digit 2 at the tarsometatarsus (P1 joint).<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69d4f77d25f1d_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69d4f77d25f1d\"))}, 0);}var su_image_carousel_69d4f77d25f1d_script=document.getElementById(\"su_image_carousel_69d4f77d25f1d_script\");if(su_image_carousel_69d4f77d25f1d_script){su_image_carousel_69d4f77d25f1d_script.parentNode.removeChild(su_image_carousel_69d4f77d25f1d_script);}<\/script>\n<h2 class=\"p1\">Prevention of Bumblefoot<\/h2>\n<p class=\"p4\"><span class=\"s1\">Preventing pododermatitis involves a multifaceted approach addressing several key factors (<\/span><span class=\"s2\"><b>Box 2<\/b><\/span><span class=\"s1\">).<\/span><\/p>\n<p><div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">Box 2 Pododermatitis Prevention Strategies <\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\"><strong>Environment and substrate management:<\/strong> The housing environment should be designed to be cleaned properly to avoid accumulation of moisture and manure.<\/p>\n<ul>\n<li>Avoid overcrowding; consider the breed and size of the birds.<\/li>\n<li>Assess water drinker placement and invest in water drinkers that are less likely to cause water spillage.<\/li>\n<li>Provide appropriate substrates to minimize pressure and prevent moisture accumulation. For ducks, avoid hard surfaces and ensure substrates allow adequate drainage. Use soft, clean bedding materials such as wood shavings and rice hulls that reduce the risk of abrasions and infections.<\/li>\n<li>Remove wet bedding and manure regularly to avoid ammonia burns and infection.<\/li>\n<li>Ensure proper ventilation and drainage to reduce humidity and moisture levels.<\/li>\n<li>For ducks, provide a swimming area to reduce contact time with hard floor substrates.<\/li>\n<li>Inspect the coop and outdoor pasture regularly to remove abrasive materials such as wires, wood chips, and nails.<\/li>\n<\/ul>\n<p><strong>Weight management, diet, and overall health:<\/strong> Ensure a balanced diet for the type and life stage of the birds to avoid nutrient deficiency that compromises skin and intestinal health.<\/p>\n<ul>\n<li>Avoid overfeeding to reduce the risk of obesity.<\/li>\n<li>Encourage owners to monitor the birds\u2019 gait and health of the footpads regularly.<\/li>\n<li>Address intraflock aggression immediately to prevent chasing and guarding behavior.<\/li>\n<li>Provide enrichments to avoid boredom and stimulate physical exercise.<\/li>\n<\/ul>\n<p><strong>Perch management (for chickens):<\/strong> Ensure perches are of appropriate height, structure, and location to prevent excessive pressure on the feet.<\/p>\n<ul>\n<li>For a flock of mixed breeds and ages, provide multiple perches with various diameters and heights. Older birds can benefit from perches placed closer to the ground to avoid injuries from hard landings.<\/li>\n<li>Use perches with rounded edges and sufficient diameter to distribute weight evenly. The bird\u2019s toe should be able to wrap around about three-quarters of the perch.<\/li>\n<li>Inspect and clean perches regularly to prevent accumulation of manure and remove damaged perches. <\/div><\/div><\/li>\n<\/ul>\n<h2 class=\"p1\">Bumblefoot Treatment Options<\/h2>\n<p class=\"p4\"><span class=\"s1\">Depending on the severity and stage of pododermatitis, treatment may involve a combination of conservative and surgical approaches. In addition to addressing any secondary infection, the treatment plan must involve addressing underlying causes, improving the overall health and nutritional status of the birds, and implementing modifications in husbandry to speed up recovery and avoid relapse. <\/span><\/p>\n<p class=\"p4\"><span class=\"s1\">Successful treatment of pododermatitis is defined as a return to the ability to walk without discomfort. This may require use of a multimodal treatment protocol and flexibility in changing treatment as necessary. There is no \u201cone treatment fits all\u201d for this condition, and flexibility with treatment options and dedicated attention to success are paramount. <\/span><\/p>\n<p class=\"p4\"><span class=\"s1\">Treatment failures are often attributed to lack of follow-through with treatment protocols or inability to treat. <\/span><\/p>\n<h3 class=\"p6\">Treatment Timeline<\/h3>\n<p class=\"p4\"><span class=\"s1\">Stage 1 and 2 cases may only require conservative treatments and typically involve shorter treatment durations. Chronic and severe cases in stages 3 to 5 may require prolonged treatment that may involve multiple debridement surgeries. In addition to surgical intervention, techniques such as intravenous regional limb perfusion, placement of long-term antibiotic-release beads, and flushing with a fenestrated butterfly catheter may be warranted in some cases and increase the rate of success in treatment. <\/span><\/p>\n<h3 class=\"p6\">Conservative Treatment<\/h3>\n<p class=\"p4\"><span class=\"s1\">For early changes in stage 1 cases, modify husbandry practices to address underlying factors, such as redesigning perches and implementing a weight loss plan. For stage 2 lesions with mild localized inflammation and minimal involvement of underlying tissues, management changes and cleaning and soaking the foot with antiseptic solutions to soften the callus may be adequate. If an infection is suspected, topical antibiotics with bandaging may be considered. However, conservative treatment is not effective for stage 2 or higher lesions that involve a penetrating callus or scab. <\/span><\/p>\n<hr \/>\n<p>Buy the e-book, <em>Poultry in General Practice: Veterinary Medicine for Chickens in Small Flocks<\/em>, <a href=\"https:\/\/shop.navc.com\/collections\/books\/products\/poultry-in-general-practice-digital-ebook\" target=\"_blank\" rel=\"noopener\">here<\/a>.<\/p>\n<hr \/>\n<h3 class=\"p6\">Empirical Antibiotic Choices<\/h3>\n<p class=\"p4\"><span class=\"s2\"><b>Table 2<\/b><\/span><span class=\"s1\"> lists some commonly used empirical antibiotic options. Additional choices and dosages are available in poultry formulary resources listed in <\/span><a href=\"https:\/\/shop.navc.com\/collections\/books\/products\/poultry-in-general-practice-digital-ebook\" target=\"_blank\" rel=\"noopener\"><span class=\"s2\"><b>Chapter 1<\/b><\/span><\/a><span class=\"s1\"> of this publication. If possible, perform culture and sensitivity first to determine an appropriate antibiotic plan. In general, the most common bacteria isolated in pododermatitis cases are <i>Staphylococcus<\/i> species.<\/span><\/p>\n<p><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_Table2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-35245 size-full\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_Table2.jpg\" alt=\"bumblefoot antibiotics\" width=\"1440\" height=\"718\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_Table2.jpg 1440w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_Table2-300x150.jpg 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_Table2-1024x511.jpg 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_Table2-768x383.jpg 768w\" sizes=\"(max-width: 1440px) 100vw, 1440px\" \/><\/a><\/p>\n<h3 class=\"p6\">Surgical Treatment<\/h3>\n<p><span class=\"s1\">Surgical intervention is necessary for debriding caseous cores and necrotic tissues. (See <\/span><a href=\"https:\/\/shop.navc.com\/collections\/books\/products\/poultry-in-general-practice-digital-ebook\" target=\"_blank\" rel=\"noopener\"><span class=\"s2\"><b>Chapter 5<\/b><\/span><\/a><span class=\"s1\"> for anesthesia and analgesia of poultry.)<\/span><\/p>\n<ol>\n<li class=\"p7\"><span class=\"s1\">If available, perform culture and sensitivity testing a few days prior to surgery to determine an appropriate antibiotic plan. A sample may be obtained by fine-needle aspiration or collected aseptically during surgery if necessary. <\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">Clean the entire foot and prepare the surgical site aseptically. Administer local anesthetic around the incision site. Sedation or anesthesia may be utilized on a case-by-case basis. <\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">The structure and location of any thinner areas of an abscessed area should be evaluated. It is helpful to understand that the deep ventral side of the foot is highly vascularized. If a hard core is present, aggressive debridement is necessary to remove this tissue. Avoiding the vessels and nerves can be challenging. <\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">When an abscess is present, a dorsal incision at the thin area of the abscess (frequently between the digits) followed by a ventral incision with blunt dissection used to connect the 2 may be performed (<\/span><span class=\"s2\"><b>Video 1<\/b><\/span><span class=\"s1\">). Gentle to firm pressure, combined with blunt dissection, may be necessary to remove lytic bone fragments and caseated exudate. This material can serve as a nidus for infection and reduce successful treatment rates. <\/span><div class=\"su-youtube su-u-responsive-media-yes\"><iframe width=\"600\" height=\"400\" src=\"https:\/\/www.youtube.com\/embed\/1LQ-rt6jkRs?\" frameborder=\"0\" allowfullscreen allow=\"autoplay; encrypted-media; picture-in-picture\" title=\"Surgical Incision for Pododermatitis (Bumblefoot) Treatment in a Chicken\"><\/iframe><\/div><\/li>\n<li class=\"p7\"><span class=\"s1\">Flush the wound multiple times with 0.5% chlorhexidine solution.<\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">Place antibiotic-impregnated beads, such as PMMA (polymethylmethacrylate) and antibiotic-impregnated calcium sulfate (AICS) beads, into the wound. These beads dissolve over time, releasing antibiotic to areas that are not well perfused. Alternatively, consider administering antibiotics through intravenous medial metatarsal regional limb perfusion techniques or placement of a drain flush (described below), especially in cases with deeper tissue and bone involvement. <\/span><\/li>\n<li class=\"p8\"><span class=\"s1\">Apply dressing and bandage.<\/span><\/li>\n<\/ol>\n<h3 class=\"p6\">Dressing and Bandaging<\/h3>\n<p class=\"p2\"><span class=\"s1\">Following surgery or in the case of an open wound, bandage the foot to protect the lesion, provide support, and promote healing. It is important to use bandaging techniques that avoid putting pressure on the incision.<\/span><\/p>\n<ol>\n<li class=\"p7\"><span class=\"s1\">Cover the incision with hydrocolloidal dressing or medical-grade manuka honey until the wound is completely healed. <\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">Bandaging techniques that help relieve pressure from foot pad lesions include:<\/span>\n<ol>\n<li><span class=\"s1\"><b>Donut bandage:<\/b> Make a donut-shaped cushion with a pool noodle or gauze and strap it on the bottom of the foot to position the hole directly beneath the lesion (<strong>F<\/strong><\/span><span class=\"s2\"><b>igure 11<\/b><\/span><span class=\"s1\">). <\/span><\/li>\n<li><span class=\"s1\"><b>Snowshoe technique: <\/b>Use a flat-bottomed bandage such as ones made with a foam disk to disperse the weight over a larger surface area (<strong>F<\/strong><\/span><span class=\"s2\"><b>igure 12<\/b><\/span><span class=\"s1\">).<\/span><\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<div class=\"su-image-carousel  su-image-carousel-has-spacing su-image-carousel-crop su-image-carousel-crop-1-1 su-image-carousel-has-lightbox su-image-carousel-has-outline su-image-carousel-adaptive su-image-carousel-slides-style-default su-image-carousel-controls-style-dark su-image-carousel-align-center\" style=\"max-width:50%\" data-flickity-options='{\"groupCells\":true,\"cellSelector\":\".su-image-carousel-item\",\"adaptiveHeight\":false,\"cellAlign\":\"left\",\"prevNextButtons\":true,\"pageDots\":false,\"autoPlay\":5000,\"imagesLoaded\":true,\"contain\":true,\"selectedAttraction\":0.025,\"friction\":0.28}' id=\"su_image_carousel_69d4f77d2674c\"><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.11.jpg\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 11. A donut-shaped cushion made with gauze.\"><img loading=\"lazy\" decoding=\"async\" width=\"877\" height=\"1024\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.11-877x1024.jpg\" class=\"\" alt=\"bumblefoot bandage\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.11-877x1024.jpg 877w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.11-257x300.jpg 257w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.11-768x897.jpg 768w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.11.jpg 1008w\" sizes=\"(max-width: 877px) 100vw, 877px\" \/><span>Figure 11. A donut-shaped cushion made with gauze.<\/span><\/a><\/div><\/div><div class=\"su-image-carousel-item\"><div class=\"su-image-carousel-item-content\"><a href=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.12.jpg\" target=\"_blank\" rel=\"noopener noreferrer\" data-caption=\"Figure 12. Snowshoe bandage technique: A flat-bottomed bandage made with a foam disk to disperse the weight over a larger surface area. This is an example made for a duck, but this technique also works well for chickens and turkeys.\"><img loading=\"lazy\" decoding=\"async\" width=\"1008\" height=\"986\" src=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.12.jpg\" class=\"\" alt=\"\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.12.jpg 1008w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.12-300x293.jpg 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.12-768x751.jpg 768w\" sizes=\"(max-width: 1008px) 100vw, 1008px\" \/><span>Figure 12. Snowshoe bandage technique: A flat-bottomed bandage made with a foam disk to disperse the weight over a larger surface area. This is an example made for a duck, but this technique also works well for chickens and turkeys.<\/span><\/a><\/div><\/div><\/div><script id=\"su_image_carousel_69d4f77d2674c_script\">if(window.SUImageCarousel){setTimeout(function() {window.SUImageCarousel.initGallery(document.getElementById(\"su_image_carousel_69d4f77d2674c\"))}, 0);}var su_image_carousel_69d4f77d2674c_script=document.getElementById(\"su_image_carousel_69d4f77d2674c_script\");if(su_image_carousel_69d4f77d2674c_script){su_image_carousel_69d4f77d2674c_script.parentNode.removeChild(su_image_carousel_69d4f77d2674c_script);}<\/script>\n<h3>Postoperative Care<\/h3>\n<p class=\"p2\"><span class=\"s1\">Postoperative care is crucial and may impact clinical outcomes.<\/span><\/p>\n<ul>\n<li class=\"p12\"><span class=\"s1\">Change bandages daily (at least the first 48 to 72 hours) to assess wound healing and evaluate bandaging techniques. The frequency of bandage changes can be reduced to every 2 to 5 days after the first few days.<\/span><\/li>\n<li class=\"p12\"><span class=\"s1\">Flush or soak open wounds with 0.5% chlorhexidine, rinse, and reapply medical-grade manuka honey until scabbed. The bandage can be removed once the scab starts to fall off. <\/span><\/li>\n<li class=\"p12\"><span class=\"s1\">Send the patient home with an oral analgesic (e.g., meloxicam) and oral antibiotics (<\/span><span class=\"s2\"><b>Table 2<\/b><\/span><span class=\"s1\">).<\/span><\/li>\n<li class=\"p13\"><span class=\"s1\">The owner should prepare a hospitalization pen to allow recovery and close monitoring. The flooring should be dry to avoid moisture buildup and soiling the bandage. <\/span><\/li>\n<\/ul>\n<h3 class=\"p6\">Regional Limb Perfusion Techniques<\/h3>\n<p class=\"p2\"><span class=\"s1\">In avian species, oral and or injectable antimicrobial penetration may be inadequate due to various factors, such as severe bacterial infections, deep tissue infections, or synovial and joint involvement. The regional limb perfusion technique has become a popular and viable treatment option for administering antibiotics and nonsteroidal anti-inflammatory drugs, especially in cases where systemic antimicrobial and anti-inflammatory therapies alone are ineffective.<\/span><\/p>\n<ol>\n<li class=\"p7\"><span class=\"s1\">Place a tourniquet on the pelvic limb, proximal to the location intended for perfusion. <\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">Disinfect the skin with chlorhexidine scrub and alcohol. <\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">Aseptically catheterize the medial metatarsal vein using a 25-gauge butterfly catheter. <\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">Administer the intermuscular systemic dosage of therapeutic agent(s) through the catheter. One study suggests adding enough sterile saline solution to achieve a total injection volume of 3 mL.<sup>4<\/sup><\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">Flush with 0.3 mL of heparinized saline to ensure the entire dose is administered. <\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">After injections are completed, withdraw the catheter and apply a bandage over the injection site. <\/span><\/li>\n<li class=\"p8\"><span class=\"s1\">Leave the tourniquet in place for 15 minutes after injection to allow the drug to perfuse into the distal tissues. To avoid hematoma formation, ensure the tourniquet is removed before taking off the bandage over the injection.<\/span><\/li>\n<\/ol>\n<hr \/>\n<p>Buy the e-book, <em>Poultry in General Practice: Veterinary Medicine for Chickens in Small Flocks<\/em>, <a href=\"https:\/\/shop.navc.com\/collections\/books\/products\/poultry-in-general-practice-digital-ebook\" target=\"_blank\" rel=\"noopener\">here<\/a>.<\/p>\n<hr \/>\n<h3 class=\"p6\">Surgical Placement of AICS Beads<\/h3>\n<p class=\"p4\"><span class=\"s1\">In complex cases, AICS beads can be used to increase antibiotic concentration perfusion to the infected tissue.<span class=\"Apple-converted-space\">\u00a0 <\/span>Lacqua et al detailed the procedure for the surgical placement of AICS beads in combination with repeated intravenous regional limb perfusion in a duck with septic tenosynovitis and osteoarthritis.<sup>1<\/sup><\/span><\/p>\n<h3 class=\"p6\">Placement of Fenestrated Butterfly Catheter Tubing for Drain Flush<\/h3>\n<p class=\"p2\"><span class=\"s1\">Using a butterfly catheter as an active drain is a practical technique for poultry species in cases where a drain is required to facilitate regular, deep flushing of the wound to aid healing. This technique should be done with sterile technique, under deep sedation or anesthesia. This procedure is outlined in depth elsewhere.<sup>5<\/sup> Below is a summary of the process. <\/span><\/p>\n<ol>\n<li class=\"p7\"><span class=\"s1\"><b>Prepare the butterfly catheter.<\/b> Cut off the needle adapter from the butterfly catheter. The tubing should be formed to have a loop of approximately 15 to 20 cm. <\/span><\/li>\n<li class=\"p7\"><span class=\"s1\"><b>Incise the foot. <\/b>Make 3 small incisions on the dorsal side of the foot: one lateral and proximal to the swollen site, followed by a distal incision, then another proximal incision on the contralateral side. These will be used accordingly to insert the tubing; pull the tubing through, make a loop, and reinsert; and exit the tubing from the foot, respectively. <\/span><\/li>\n<li class=\"p7\"><span class=\"s1\"><b>Use forceps to insert, grasp, and reinsert the tube. <\/b>The tip of a pair of straight, blunt, locking forceps is pushed through the distal incision to exit the proximal incision using blunt dissection. The cut end of the tube is grasped and pulled through the incisions. A loop, approximately the length of the digit, is made with the tubing. The forceps are then inserted through the contralateral proximal incision to the same distal incision. The forceps are used to grasp the cut end of the tube and reinsert it into the distal incision and pull it through the proximal contralateral incision while leaving a loop at the distal end (<\/span><span class=\"s2\"><b>Figure 13A<\/b><\/span><span class=\"s1\">).<\/span><\/li>\n<li class=\"p7\"><span class=\"s1\"><b>Check length of the tube ends.<\/b> The tube ends (both cut end and syringe adapter end) should extend in length beyond the scaled shank of the bird to allow tying of the open end and coiling of the syringe adapter end in bandaging. The tubing should be movable through the incisions at this time. <\/span><\/li>\n<li class=\"p7\"><span class=\"s1\"><b>Prepare for the drain.<\/b> A syringe containing 0.5% chlorhexidine or sterile saline should be attached to the adapter and used to flush the tubing. <\/span><\/li>\n<li class=\"p7\"><span class=\"s1\"><b>Fenestrate the tubing. <\/b>Fenestrate the tubing by sliding the tube through the incisions and making small incisions along the portions that will remain internal in location. This will allow fluids to be forced through the fenestrations into the internal soft tissues and drain through the incisions. Move the tubing to allow alignment of the fenestrations with the most affected internal areas. The loop should remain at the level of the skin to remain visible and accessible (<\/span><span class=\"s2\"><b>Figure 13B<\/b><\/span><span class=\"s1\">).<\/span><\/li>\n<li class=\"p7\"><span class=\"s1\"><b>Flush the wound.<\/b> Fluid should flood the soft tissues and drain through the incision sites. The tubing can be slid or moved between the incision sites to allow for direct placement of the fenestrations. Test the flushing action within the affected site.<\/span><\/li>\n<li class=\"p7\"><span class=\"s1\"><b>Anchor the tubing. <\/b>Secure the tube to prevent movement and maintain location of the fenestration sites. Use 3 single, small, nonabsorbable sutures. These can be placed through the tubing at each incision and attached to the skin. Finally, tie off the cut end of the tube upon itself at the level of the scaled area of the leg shank and secure with a small piece of tape for bandaging (<\/span><span class=\"s2\"><b>Figure 13C<\/b><\/span><span class=\"s1\">). Repeat flushing action for accuracy.<\/span><\/li>\n<li class=\"p7\"><span class=\"s1\"><b>Prepare for bandaging.<\/b> The incisions should be left partially open to allow proper flushing<span class=\"Apple-converted-space\">\u00a0 <\/span>and drainage of fluid. Any extra tubing at the cut or syringe adapter ends can be folded upon itself and the syringe adapter placed in an easily accessible location. A final bandage is placed to secure the tubing and keep the apparatus and wound clean. <\/span><\/li>\n<li class=\"p7\"><span class=\"s1\"><b>Maintain the wound.<\/b> Periodic unwrapping and flushing of the drain with sterile water, dilute chlorhexidine, or an antibiotic solution should be done. Frequency of this procedure depends on the severity of the condition and should diminish as healing occurs (ranging from twice daily to every other day). The area should be dry before bandaging is replaced. <\/span><\/li>\n<li class=\"p7\"><span class=\"s1\"><b>Relay aftercare instructions to owner. <\/b>If the patient is not hospitalized, instructing the owner on how to flush the drain at home and to monitor for signs of infection, blockage, or irritation around the insertion site are necessary. Treatment may last for 1 to 2 weeks with the intention of allowing healing from the deeper portions of the infection to the external skin. If signs of infection, increased pain, or reaction at the drain placement sites are noted, removal of the drain will be necessary. Rechecks should be made weekly and if any of the signs listed above are reported. Removal of the drain will require cutting the tied end of the tubing and pulling of the drain from the dorsal incision site. Sedation is recommended.\u00a0<\/span><\/li>\n<\/ol>\n<div id=\"attachment_35243\" style=\"width: 360px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.13.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-35243\" class=\" wp-image-35243\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.13.jpg\" alt=\"bumblefoot drain\" width=\"350\" height=\"450\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.13.jpg 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.13-233x300.jpg 233w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.13-796x1024.jpg 796w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2025\/01\/TVP-2024_SmallFlock_Chapter-9_Pododermatitis_9.13-768x988.jpg 768w\" sizes=\"(max-width: 350px) 100vw, 350px\" \/><\/a><p id=\"caption-attachment-35243\" class=\"wp-caption-text\">Figure 13 Placement of a fenestrated butterfly catheter tubing for use as an active drain flush.<\/p><\/div>\n<h3 class=\"p6\">Treatment Success Rates<\/h3>\n<p class=\"p4\"><span class=\"s1\">Stage 1 and 2 cases can generally be treated with great success provided management of causative factors can be addressed (e.g., weight, environment). More advanced cases require aggressive surgery and medical interventions that can require weeks of active treatment. Successful treatment cannot be guaranteed and management of owner expectations for treatment success in advanced cases is advised. Follow-up visits are strongly recommended.<\/span><\/p>\n<hr \/>\n<p>Buy the e-book, <em>Poultry in General Practice: Veterinary Medicine for Chickens in Small Flocks<\/em>, <a href=\"https:\/\/shop.navc.com\/collections\/books\/products\/poultry-in-general-practice-digital-ebook\" target=\"_blank\" rel=\"noopener\">here<\/a>.<\/p>\n<hr \/>\n<h2 class=\"p1\">Indications for Euthanasia<\/h2>\n<p class=\"p4\"><span class=\"s1\">Euthanasia should be considered in cases with stage 4 and 5 lesions with extensive and irreversible osteomyelitis and\/or arthritis in which aggressive treatment is not an option, and in cases where the bird demonstrates severe, unmanageable pain and its quality of life is significantly compromised. This includes situations where owners are unable to provide postoperative care and debilitated birds are at a higher risk of being bullied by others.<\/span><\/p>\n<div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">In-Depth Resources <\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\">\n<ul>\n<li>Greenacre CB. Musculoskeletal disorders. In: Greenacre CE, Morishita TY, eds. <em>Backyard Poultry Medicine and Surgery<\/em>. 2nd ed. Wiley-Blackwell; 2021:234-255.<\/li>\n<li>Crespo R. Developmental, metabolic, and other noninfectious disorders. In: Swayne DE, ed. <em>Diseases of Poultry<\/em>. 14th ed. Wiley-Blackwell; 2020:1311-1313.<\/li>\n<li>Doneley B. Soft tissue surgery. In: Poland G, Raftery A, eds. <em>BSAVA Manual of Backyard Poultry<\/em>. 1st ed. BSAVA; 2019:263-280.<\/li>\n<li>Doneley RJT, Smith BA, Gibson JS. Use of a vascular access port for antibiotic administration in the treatment of pododermatitis in a chicken. <em>J Avian Med Surg<\/em>. 2015;29(2):130-135. doi:10.1647\/2014-023<\/li>\n<li>Fitzgerald B. Common diseases of backyard poultry: bumblefoot. Presented at: Atlantic Coast Veterinary Conference; October 12-15, 2015; Atlantic City, New Jersey. Accessed July 20, 2024. <a href=\"http:\/\/vin.com\/members\/cms\/project\/defaultadv1.aspx?pid=12673&amp;catId=&amp;id=6991097&amp;said=&amp;meta=&amp;authorid=&amp;preview=\" target=\"_blank\" rel=\"noopener\">vin.com\/members\/cms\/project\/defaultadv1.aspx?pid=12673&amp;catId=&amp;id=6991097&amp;said=&amp;meta=&amp;authorid=&amp;preview=<\/a><\/li>\n<li>Martrenchar A, Boilletot E, Huonnic D, Pol F. Risk factors for foot-pad dermatitis in chicken and turkey broilers in France. <em>Prev Vet Med<\/em>. 2002;52(3-4):213-226. doi:10.1016\/s0167-5877(01)00259-8<\/li>\n<li>Seligson D, Mehta S, Voos K, Henry SL, Johnson JR. The use of antibiotic-impregnated polymethylmethacrylate beads to prevent the evolution of localized infection. <em>J Orthop Trauma<\/em>. 1992;6(4):401-406. doi:10.1097\/00005131-199212000-00001<\/div><\/div><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Pododermatitis, also known as bumblefoot, is a common condition affecting the feet of poultry.<\/p>\n","protected":false},"author":236,"featured_media":35255,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":14553,"footnotes":""},"categories":[342],"tags":[],"class_list":["post-35145","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-digital-exclusive","clinical_topics-exotic-medicine"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 (Yoast SEO v27.3) - 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