Pierpont-Fistula and Injury

[Pidgey]

I got a badly hurt pigeon Friday evening. It must have gotten hit by a hawk or had some run-in with a very sharp object. It's had this wound for long enough that the crop had formed a fistula--a scarified tunnel to the outside that has its own "lips." If I had to guess, I'd say that it occurred almost two weeks ago. Somehow, the bird has managed to survive since then by way of eating and drinking several times the normal amount to compensate for the leakage.

I've sutured the fistula closed (it was about 3/8" in diameter) although that's not the final solution for that but it's not as important at the moment as stabilizing the other portion of the wound. It is the size of a silver dollar and affects mostly the left breast. When I found him, the exposed breast muscle was covered with mud, essentially from crop contents that had flowed down his chest from the fistula. I even found seeds packed between the skin and the breast below the lowest point of the wound.

How on earth this pigeon has lived this long with this damage I will never understand. You would have thought that the infection alone would have gotten him long before now. He's actually doing okay although I've never had to deal with a wound that was this old and had been so dirty.

Although his ceres are beginning to whiten, I can tell by the feathers that he's barely past being a squeaker. He's had a hard life to this point. If anyone has had experience with a chest wound like that and how to help heal it the fastest, I'd appreciate any suggestions. It began with a rotten meat smell that I've finally gotten rid of and I've got him on Baytril to boot but that wound is nasty.

In order to keep him from messing with the dressing, I finally taped his feet together and then taped them around his tail and wing feathers to keep him stable. He really doesn't like that, but he's a real problem pigeon. I have to say that when I brought him home, I sat with him in my hands and just watched him for an hour trying to figure out whether to put him to sleep or not. He was just so lively and normal acting that I couldn't do it. When you add to that how the case with Snyder was going, I just couldn't bring myself to do it. If he had the heart to make it this far, I just have to try.

By the way--I named him "Pierpont" after the store that he was in front of. And here are the pictures. These are not for the faint of heart, by the way. In the first exam picture, you can also see the caked mud on the raw breast muscles--you just can't tell that those are breast muscles:

First Exam:



And initial treatment:



Pidgey

[pigeonmama]

Oh, Pidgey,
You sure have more courage than I have ! How's about flushing area with a diluted antibiotic solution, something picked up from hardware/feed store, and really diluted, then let area dry well. As to keeping the bird from undoing all of your hard work, tape his wings to avoid stretching and pulling your sutures and the bird's skin, and maybe fashion a little Elizabethan collar for him, like the vet would do for dog/cat.
This poor bird, , I can't imagine what it must have been like for the poor thing, til Uncle Pidgey found him and made life a little easier. If you can think of any supplies I can help you with, let me know.
The Carpetbagger

[feralpigeon]

Hi Pidgey,

There's just no rest for those intending to be wicked. What a horrible wound. I'm sending you a link from a recent thread where Cynthia posted alot of valuable information on antibiotics and wounds.

http://www.pigeons.biz/forums/showth...puncture+wound

Here's the link inside the link that she provided:

http://www.worldwidewounds.org/2003/...t-Part-2.html#

Sorry you didn't get your R&R, but this bird needs you badly

Thank god for you Pidgey,

fp

[cyro51]

This is how Helen (Nooti) treated Josefina. Josefina is still with me today.

The injury was to her crop which had been torn open and the vet team had stitched it up.

It looked to be a good job at first glance but a few days later as Laura, (my vet) and I were examining her, the stitched wound just fell apart and the most awful rotting smell filled our nostrils.

It seemed that the original vet team had stitiched up the outer skin - but not the crop lining, so as she had been eating seed it had slipped through the hole in the crop lining and lodged between the lining and the outer epidermis. (skin)

The resulting mess was horrifying as tissue became infected and died. Laura pulled a stinking, necrotic plug out of the wound which measured an inch across and tapered to 2 inches long. You could see right through into both chambers of the crop. She had never seen anything so bad before and her first thought was to put Josephine to sleep.

However I asked if there was any way we could try to heal this and Laura's thinking cap came up with the idea that we would put her on nil by mouth and inject fluids IP twice a day to maintain the major organs. Also inject antibiotics daily as close to the wound as possible, and flush the crop twice daily with saline and Metronidazole. An assessment for surgery to finally close the wound would be made in 4 days time.

This method was so successful that by the time the day came for surgery the wound had healed so well that three quarters of it had closed by itself. So we put surgery on hold - in fact it never went ahead and a week after we nearly euthanased her she was well enough to start taking food and drink by mouth again.
Now she is a fine healthy pidge - only her crop capacity is slightly compromised, that's all.

As far as I remember the antibiotic injected was Synulox (Clavamox).

Cynthia

[pdpbison]

Oye...

Gosh Pidgey, you are an inspiration...



Phil
las vegas

[Pidgey]

Thanks, all, for your info! This is a complicated enough injury that I'm going to try to get an appointment with the vet today and get those dressings and whatever else is suggested.

After reading the link about the hydrocolloid dressing, it seems the keel wound is the worst for the moment. It looks as though that type of bandage will probably be very helpful here. That, and I think that I probably need to design a special swingset that will hold him up without pressure on the keel or wound.

Actually, he can stand just fine but I think we need a lot more restraint. I might end up going with a collar to keep him from picking and something like a swing but low enough for him to either stand or sag as the mood strikes. Right now, he's laying in a pillow-formed towel and I lay him on first one side and then the other.

He grunts at me everytime I walk by and so I give him a drink and the food's always in front of him. He's got a good appetite and almost always goes for a little water so nutrition and hydration are not a problem, at least.

There also seems to be a knot around the left shoulder that's covered by perfectly good skin. I'm hoping that that doesn't turn into the kind of thing that happened to Josefina, but we'll just have to see.

Pidgey

[cyro51]

This is Boddy and Ridewood's injury harness, could be the basis for an adapted design?


http://www.everythingforpets.com/inj...1267.dept.162/

Cynthia

[Pidgey]

Cynthia,

That's a pretty nifty looking device there and that pigeon has the funniest expression--"Would you PLEASE just snap the %#$@ picture and get me the &*%$ OUT OF HERE!"

I got an appointment with the vet in an hour (10:30 AM) so we'll see what all we can get done. He'll probably want to do a more complete closure of the crop and I sure hate to see the little fellow get that added on but this vet does know what he's doing so I'll acquiesce. Of course, it probably won't bother the bird if he's under a general. I would have at the house IF that had been the only injury but this is too much.

Pigeonmama,

Well, if'n ya' gonna' be'a carpitbaggin' dohn' heah' an'at carpitbag's a' filt ta' thuh' brim' with'n vetnary fixin's, then thuh' carpitbag's welcohm' but ah' reckon' yo' carpitbag's plum filt wid' yo' nothuhn' butt-butts! Beware Yankees bearin' giffs, mah' granpappy oleways tole' me!

But, in 'cordance with Suthuhn' gentilitillitee (sumpin' lahk' that), ah' appreeshiates' thuh' offah'!

Suthuhn' Pidgey (to the last!)

[TAWhatley]

OMG! That poor pigeon! It never ceases to amaze me the horrific injuries our beloved pigeons can withstand. I hope the vet visit is a huge success.

Terry

[pigeonmama]

Pidgey,
Would you like some suture material? Self absorbable or silk?
Daryl
P.S. Had a hard time understanding your southern accent.

[feralpigeon]

Hi Pidgey,

Think that same sling is available @ Jedd's online (wholesale) and in catalogue
both retail and wholesale. So you'd have to give a call, might havta tok northern on phone.....

Try this link for catalogue info:

http://www.jedds.com/ProductDetail.a...ProductID=4178

For splints:

http://www.jedds.com/ProductDetail.a...ProductID=4176

fp

[Pidgey]

All,

Yes, the vet visit went well. I haven't had to suture anything like that before because most of the cuts I've seen weren't in a place that had the propensity for tension that a keel seems to have. When a cut goes longitudinally down the keel (and you'd think you'd see a lot more of those as it's a vulnerability in any kind of head-on scrape or belly-flop crash), the skin wants to separate outward from the center in the worst way.

The edges of the skin didn't seem to have the elasticity to handle the tension of being pulled together Saturday when I checked it out. What the doc did that I hadn't thought to do, was to push in with the scissors CLOSED all the way around the wound and then open them up to break the fascia. Fascia is the membranous, elastic webbing that forms as connective tissue in the body. So, the trick to sewing up the wound was to break enough of that webbing to free-up the natural elasticity of the skin. After doing that, a monkey could have sewn it up, but I didn't know to do it so having sutures wouldn't have helped me at all, or, more to the point, little Pierpont.

Anyhow, the vet basically said that the dehydration factor of the breast muscles was the worst and that's why it needed sewing up. Now, I expect that the hydrocolloid bandage would have worked in the long run but ultimately the skin that would have been generated would have been featherless scar tissue so this was undoubtably better.

Also, they didn't put little Pierpont under for this. He was one mad pigeon when they were through but he'll get over it--living with pain is better than dying under narcotic dreams any day of the year when you're young! I'm fully expecting a week of wing-flipping after that little episode. The doc said, by the way, that they really don't mind much when you're sewing up their crops but they get a little testy when you're sewing up the skin--it's apparently more sensitive.

Oh, and by the way, for a pricing comparison this only cost $45 so it was very informative and cheap at the same time. Every time I go, I always go back to watch or help when possible and ask all the questions that I can think of, so I see this cost as an educational investment. Whenever I see a nuance of technique that I feel is worth sharing, I'll always bring it here for ya'll. Isn't it funny, the difference between how I had originally planned to manage the healing processs in this case and how the vet did it? Shortcuts and tricks. It's all know-how.

Pigeonmama,

The vet actually gave me a bunch of non-absorbable sutures that he figures a hospital dumped on them and they'll never use. What have you got--an inexhaustable supply of the stuff? Are you in the medical field and have easy access to such materials? I do thank you for the offer and now I might have a better idea what to actually do with them (sutures) but in all fairness, if I'd had them before this, I'm sure I would have botched the job.

Pidgey

[Reti]

Well done, Pidgey.
And great news the pijie will be fine.

Reti

[pigeonmama]

Pidgey,
I'm a nurse, work obstetrics and endoscopy, so can always get a suture or two for a good friend.
I had a pigeon about 30 yrs ago, a little helmeted cock, who had free range outside during the day, and flew right in to the house and in to his cage when it started to get dark. Well, Henry never left the area, but, one day went up missing. I found him under the stairs, inside the garage one day. He'd been bitten in the breast, right in to the crop. I took him to the vet, and held him diring the repair, cried through the whole thing, and almost passed out, but held him myself. I also hold my animals for euth. If any one has a pet to be put down, and they won't stay with their pet for this, I will go to the vet's for them. Just can't stand the thought of someone saying " It's O.K. to go and I love you" These animals even end up buried at my house if their owners don't arrange for something rather than disposal by the vet's office
Well, back to Henry, he did fine, lived to be an old fellow, always remained friendly. He died one night , in his cage, not even a sign of struggle.
I know this bird will do fine now. Keep us all updated, pictures and messages, and give him a big kiss for me.
Daryl

[Pidgey]

Pigeonmama,

The kiss is gonna' wait until we've cleaned up a bit, but here's the Post-(photo)-Op showing the sewn up chest:



Pidgey