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Pidgey Pidgey is offline
Posted 6th June 2005, 04:35 PM
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Ruptured Oviduct--A Case History


This post is for informational purposes and is not suggested as a “good read” for anyone other than people who keep a lot of pigeons and are deeply interested in managing their health. It is in response to communications that I have had with another member who has been having difficulties with a hen relating to possible oviduct problems. It is provided to help others identify possible oviduct problems before they go too far. It is lengthy, somewhat clinical and almost totally devoid of anecdotal commentary. It would probably put most of you to sleep and I’m not kidding.

It was in the end of January that I returned from an 11-day trip and noticed that both Winter and her husband, Patches, were suffering pronounced weakness and had lost significant weight. I immediately brought them both in and ran a fecal to determine whether coccidia were present. They were in both birds in large numbers. There was evidence of serious fouling of the cloaca on Winter—her tail feathers were matted at the vent. I also felt that she had some kind of swelling or “fullness” in her abdomen but I couldn’t be for certain. Given that she had lost so much weight, it did seem out of proportion.

Patches had the classic symptoms of straight coccidiosis suggesting an uncomplicated treatment involving only Corid-treated water. His medication was 0.625 mL Corid per 8 oz of water. Winter posed a greater difficulty indicated by the mucoid quality of her feces. Her stools were very sticky and difficult to emulsify for the float test. I felt that indicated a concurrent bacterial infection at that time so I augmented her treatment with Baytril (I use a water-soluble version obtained from Quality Pigeon Supply here in Tulsa). So, her medications were both 0.625 mL Corid and 0.5 mL Baytril per 8 oz of water.

Both birds were in such a state that I tube-fed them Kaytee Exact for a couple of days before allowing them solid food. I mixed the Kaytee with the medicated water. I put them in the basement under a heat lamp shining over a board for a perch. They tend to park under the heat lamp in a case like that and if they get too warm they can move as needed to self-regulate their comfort.

Both birds got a lot better within a week. At the end of the week, Patches was ready to rejoin the loft so I took him out. Winter was better overall, but she still had some disturbing characteristics. Her mucoid stools persisted and she had an almost constant tremor. I tried isolating her under the lamp and it became obvious that it wasn’t a chill because she was quite warm.

In another week, she was still shaking sporadically but she began flying everywhere and pining to go back to the loft. I took her out for brief spells during the next week just to let her know that her home was still there. I have come to believe that it helps in the healing process if the patient can have some time to see that its world still exists. Even in the case of pigeons from elsewhere, it perks up their interest in life if they can sit and watch other pigeons. Too much isolation is bad for a bird.

The tremors never really went completely away but she certainly seemed strong enough so I let her go back out. The weather was typical winter for the Tulsa area—nights in the 20’s. She was out for a couple of weeks when I returned from another business trip and found her supporting herself with her wings while eating at the feeders.

She had relapsed so I took her back in and started over. I had to soak her tail in warm water to free up the soiled feathers. Her fecal was the same as before so I restarted her on the identical medications and treatment. She had taken to “hunkering down” more than during the first round, the swelling in the abdomen had gotten perhaps a little worse and there was an identifiably hard mass that felt egg-shaped and could be moved around.

After a week on medications, her condition had stabilized and the coccidiosis was over. Her stools had retained the mucoid consistency on a somewhat regular basis up to this point but they began to separate into a normal stool with an overlay of mucous. The overlay had a reddish tint so I took a fresh Q-Tip and worked to get a sample for a simple smear. The mucous did not want to adhere well to the Q-Tip (odd, seeing as how you normally can’t get snot off easily) so I had to roll it in the stool to finally get enough.

I rolled it onto a clean slide and then used a blow dryer to dry the slide. Examining it at 400x, I thought I could see red blood cells. I re-processed the slide using staining techniques to make them more visible and confirmed their presence. Not enough to indicate anemia, but there was certainly something not right. Coccidiosis can produce bloody stools but it generally would not persist this long after treatment.

She was still occasionally shaking and was more and more reluctant to stand. I took her to the vet as well as that slide and a fresh-floated 30-minute fecal. The vet confirmed the blood cells, agreed that the fecal was clean and performed another type of fecal to gauge the ratio of short-to-long bacteria (good bacteria to bad bacteria). It didn’t reveal anything of significance.

Upon palpating the hardness, the vet became concerned. She felt that it could be a tumor but that it would require a different vet to perform the surgery if elected. He wasn’t available and wouldn’t be in unto the next day for a half-day and then would be unavailable for three weeks.

So, we sat the next morning until he could squeeze us in. When he examined the bird, he said that cases like this were usually a 50/50 shot—if you open the bird there’s a strong possibility that what you see may warrant immediate euthanasia. There are some tumors that birds can get that don’t grow very fast and they’re usually not operable because you’re more likely to lose the bird than not. I decided not to.

Days later, I manipulated the mass and found that it could be moved out amost to the vent (well away from the kidneys). It seemed so much like being “egg bound.” That manifests in two ways—one where the egg is bound in the cloaca and blocks the feces from exiting the vent (that’s the really dangerous kind) and the other where the egg stops essentially in the uterus and doesn’t pass through the vaginal canal. I began to wonder if maybe it was the latter presentation. I irrigated the vaginal canal with mineral oil to aid in delivery if this were the case—it certainly couldn’t hurt—but it didn’t help.

(continued)

Last edited by Pidgey; 6th July 2005 at 07:15 PM..
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Pidgey Pidgey is offline
Posted 6th June 2005, 04:37 PM
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Within a few of days of the last visit to the vet, she wasn’t standing at all and didn’t seem to have much strength in her legs to stand. Since he was gone, I took her to a different vet that came highly recommended in the racing pigeon community. He heard her case history, felt the hardness and used an otoscope to peer into the cloaca for evidence of egg binding. He didn’t see anything.

And here’s where it gets rough: He looked at the bird and said, “well… there’s ONE way we can find out.” Holding her firmly he plucked feathers off of her abdomen to expose the lump. He then took a small syringe with a needle on it and plunged it into the mass. Withdrawing the plunger, he attempted to extract some fluid but only got a fraction of a drop, which he spread on a slide, examined and sniffed. Even he seemed a bit puzzled but he told me with no hesitation that surgery was going to be the only way to get to the bottom of it.

At that point, he believed that it might have been the same kind of cheesy growth that we normally associate with trichomoniasis (canker). He further explained that the “cheesy growth” we’re all so familiar with is actually the product of the inflammatory process in birds and is not, in fact, a colony of trichomonas themselves. Think of it as the bird-equivalent of pus.

When we opened the abdominal cavity (I attended but did not assist), there were several (about six) loose shapes about the size of individual pieces of gravel like that which is used on gravel roads. He explained that it is not rare in birds to rupture an oviduct for whatever reason: congenital weakness, infection, etc. When that happens, egg materials spill into the abdominal cavity and eventually become a calcareous mass. They do not themselves contain bacteria but do provide a perfect reservoir for a bacterial colony to grow in.

The leg weakness was due to the bruising of the kidneys by the hardened debris. The sciatic nerve in pigeons runs through the kidneys and when they swell it affects the motor control of the legs, paralysis or weakness being the chief symptom. Palpating her during examinations didn’t help, I’m sure.

The mucous discharge accompanying the stools was probably expressed from the abdominal cavity back through the scarified rupture of the oviduct. Antibiotics can hold off peritonitis and infection of the organs for a time, but not forever because they cannot control the bacterial colonies within the foreign bodies. And the foreign bodies will not be re-absorbed into the host.

Upon closure, Winter came to in short order but spent the next two weeks unable to stand. I kept her in a towel folded into a nest with diapers (folded toilet tissue) under her back end. I changed them about every two hours, day and night so as not to infect the surgical closure. I kept her food in front of her and offered her water every time I changed her diapers. Hugs and petting seemed to be appreciated as she was the only pigeon in the hospital at the time.

She stayed on Orbax pills (a quinolone derivative antibiotic similar to Baytril) for 10 days after the surgery (the entirety of her prescription) and then the doctor decided that she needed to stay on antibiotics for a month (telephone follow-up). So we shifted to the water-soluble Baytril that I had on-hand.

Two weeks after the surgery was when she began to start standing up. It took another week before her legs were restored to full strength. I began to notice an increase in the quantity of the blood cells in the mucal discharge and a general sense of diminishment of her wellbeing. That’s hard to quantify but I know her pretty well.

After a consultation with the vet, he decided to change her medication to Keflex (cephalexin, a cephalosporin derivative) for a time. I’m not sure, but the suspicion might have been that the discharge was due to a persistent kidney infection, which would likely be why he chose this drug. I have not questioned him about that. She did appear to get better, though. Her spirits and energy returned such that I didn’t see the need to keep her in the house any longer; she finished the last few days of that medication in the loft.

Over the next couple of months, some abdominal swelling had returned but there was no indication of hardness. She never seemed sick but I eventually began to notice that she wasn’t as energetic as a month before. She had gained most of her old weight back and it was difficult to tell if the abdominal fullness was more egg material or fat (she is quite fond of safflower seeds and Lin does tend to overindulge her). Since I had been watching especially for this indication we returned to the vet.

He palpated her abdomen and confirmed my suspicion. She was in much better pre-op shape this time so we went straight to surgery. This time most of the material removed resembled an egg yolk in color although somewhat thicker in consistency. I was surprised at how much there was—probably three ounces. There was also one piece of a calcareous formation that resembled the gravel-like chunks removed before. I opted for the removal of as much of the oviduct as was possible and so he ligated the ostium and the vaginal canal, removing the magnum, isthmus and uterus. The ovary looked too scarified to safely remove.

The ostium is a trumpet-like opening that resembles an orchid. A fertilized ovum (the yolk) is received into the ostium and passes to the magnum where it picks up the “white of the egg.” Next it travels to the isthmus where the inner and outer membranes are added. From there it goes to the uterus where the calcareous shell is produced. The vaginal canal is simply the muscular narrowing that helps provide the shape of one end of the egg and then dilates to allow passage to the cloaca.

As the uterus is responsible for much of the hormonal interplay involved in ovulation, we are hoping that this will be the last time that evacuation of the abdominal cavity will be required, but that remains to be seen. Post-op medication was as before, a ten-day course of Orbax. At this writing, she has one pill left. She only spent two days inside the house this time. The first day she was understandably discomfited but by the end of the second day she was feeling “wonderful, thank you very much—now may I PLEASE go back out to the loft?!?”

They really are very tough creatures. Virtually all of the conclusions to be gleaned from this case history can be taken at face value where they appear in the text to this point. The one heretofore unobserved conclusion that I find interesting to note is that Winter somehow infected Patches with the coccidiosis. That is not the typical manner of getting coccidiosis as I have understood it, so it’s something to ponder but I do not have an answer at this time.

Pidgey

Last edited by Pidgey; 6th July 2005 at 07:21 PM..
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Skyeking Skyeking is offline
Posted 6th June 2005, 04:39 PM
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I'm changing this one to a sticky.
Thanks for the information.

Treesa



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Pidgey,
You are wonderful!!!
Daryl
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Posted 6th June 2005, 09:11 PM
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Pidgey,

This is great...(not what happened, of course, but the story.) I can't speak for everyone, but I found it truly interesting and very informative. My sister-in-law just graduated vet school and even though she does not have a big interest in avian medicine (figures!), I will be emailing her the link to this thread because she will probably find it interesting as well...plus it may be good for future reference in her work.

Thanks,
Linda
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Posted 7th June 2005, 05:06 AM
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Thank you for that Pidgey, and thanks for making it a sticky Theresa. there is so much important and interesting information there.

My Juvie has never been completely well and suddenly passed several small uneven waxy lumps that the vet could not identify under the microscope. We both assumed egg related and she was put on antibiotics, she has been okay but barren since , so I just supply her with plastic eggs to keep her happy. I subsequently read in one of my reference books that the unidentifable lumps area symptom of a diseased oviduct or the contents of an abscess of the oviduct. I assume that these are conditions that can also progresss to ruptured oviduct ?

Cynthia
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Posted 7th June 2005, 10:48 AM
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Cynthia,

I wouldn't doubt it. I just expressed EVERYTHING that I have (recently) come to know about oviducts. When we opened her up this last time, there were some things kind of like you describe--can you give a little more detail like size, color and shape?

I think that it's possible for them to go barren without them ovulating anymore but I sure don't know how many possible scenarios there are. I did a search using "ruptured oviduct" in the browser and found the part about the nerves and weak legs/paralysis. Give it a try and add "symptoms."

Pidgey
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Posted 7th June 2005, 11:30 AM
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Hi Pidgey,

This is only slightly larger than actual size. It was paler when it came out and darkened on exposure to light. There were 4 among her droppings the first morning, then more when I had her isolated. Some a lot smaller than this one. They had ab an outer layer as soft as the inner layer and of almost the same color. The lump at the end looks like a head, but wasn't.

Cynthia
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Last edited by Feefo; 14th June 2006 at 11:19 AM..
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Posted 7th June 2005, 02:17 PM
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Cynthia,

My bird Sasha just dropped one of those jelly bean looking things with a tail on it. It is yellowish and inside there is tissue and blood.

I described it to Reti, who's bird Whitney had lost that kind of thing. Her avian vet told her that was an immature egg yolk sac.

I'm treating her for infection as well as with organic (gesterone) hormone cream. Matters got more complicated because she had classic signs of coccidiosis, so she is on treatment for that. This bird has had no mate until recently and has been fine all her life, never layed an egg before, and is 3 years old.

Since she just started laying or trying to lay an egg, I'm hoping to keep further complications from developing by seperating her from her newly acquired mate.

She is 5 days into treatment, no more signs of any weird droppings, and the wet cocci droppings are beginning to be normal again. She is regaining her energy, eating well, and picking and pruning.

I will keep her on the gesterone cream, recommended by my rehabber, and see if that will normalize what is going on in the oviduct as it balances out the hormones. Time will tell..... I have used this cream successfully with female with soft shell eggs, who didn't respond to any calcium treatments.

Treesa



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Posted 7th June 2005, 02:42 PM
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That is interesting, thanks Treesa!

Juvie dropped the "things" some weeks ago and has been okay ever since, but since we got her (she was a juvenile that Helen kept releasing only to find her soaked and starving afew days later) she has looked "odd", perching with her tail too far down and just looking slightly off colour so I think that there has beena problem from the beginning!

Cynthia
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Posted 7th June 2005, 02:46 PM
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Treesa,

It almost sounds like the rest of the egg didn't get installed. And, to boot, it must have stayed long enough in the oviduct to begin to grow. At least she passed it instead of it becoming lodged in the abdominal cavity.

The only thing that I can suggest is grab a completely normal and friendly hen of equal size (that isn't making eggs at the moment) and feel around the back end and abdomen to get a real good idea what's "normal" (anatomy lesson). Then pick up the sick hen and try to compare. The second time that I had to take Winter in, there was a watery feel and it felt "bigger" than it should have. She's just plain "svelte" now and the bones around the vent are easy to feel. They weren't before.

Hopefully, the infection hasn't done that kind of damage yet and she'll just be rendered barren at the worst. Is there any mucous discharge?

Pidgey
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Posted 7th June 2005, 02:52 PM
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Cynthia,

I doubt there's much difference between the two cases so you two ought to stay together on it before either gets as bad as Winter did. There's surely got to be something on the net regarding that. I certainly didn't see it coming with Winter, though.

Pidgey
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Posted 7th June 2005, 06:02 PM
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Hi Pidgey!

She had the "classic look of an eggbound female" before she dropped it, so I gave her a dropper full of olive oil, and that helped her pass it, although at the time, I was expecting an egg come out.

I just picked up Sasha and I can feel the bones around her vent, as well as another hen I just picked up. I ran my fingers up her abdomin and it is solid and slim.

There has been no mucus discharge, just the green and white droppings beginning to form again. Pidgey, she is not acting like a sick hen at all today, hopping off and on the perch, cooing all day, making a mess of her seeds and pruning and picking. She is almost like her old self. She is doing her little hop and strutt dance as she coo's! She is a little flirt! LOL

Seriously, though, she has two more days of treatment for the cocci, and I'm keeping up on all the natural healing, as I have been tought to do, and colloidal silver for any infection that may be left.
...so far..so good...

Treesa



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Posted 11th June 2005, 08:51 PM
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Hi Everyone,

My sister in law just graduated with her Doctorate in Veterinary Medicine from Tufts University and I forwarded this thread to her because I thought she would find it interesting.

I thought I would post her reply here because she mentions a few drugs and things that I thought some of you might find informative in reference to this condition:

-----------------------------------------------------------------------------------

Linda,

I found the email...The write-up was awesome...Actually, I had a few cases in school with this and right away they removed the reproductive tract...But, then again, at Tufts, they have bigtime specialists and have seen it all...another good thing though is to give Lupron shots to prevent follicles from forming...And, soon enough, when I pass the boards, I will find a vet to hook up with that does dogs, cats,exotics, and birds..I will know more about birds eventually....As far as changing from Orbofloxacin to Cephalexin, the vet probably wanted to kill off anaerobes...Cephalexin kills anaerobes, Orbax doesnt...Just a thought...

-----------------------------------------------------------------------------------

Okay, don't know if this will be helpful to anyone or not.....hope it is.

Linda
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Posted 13th November 2006, 08:52 AM
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I'm going to add more writeup to this thread because of Pattie Cakers' current problems. Her story is spread out over a longer period than Winter's and is a bit different: It was in the first half of November of 2005 that I found Pattie Cakers ill in the loft. Immediately upon picking her up, I could feel a heavy and solid mass in her abdomen. I knew surgery would be required so I started her on a course of Baytril. Even though she hadn't lost a lot of weight and her keel was very prominent--the mass in the abdomen was making up for the lost mass in the chest muscles. This is the mass as removed:



And this is it cut in half:



This is simply a mass of the same buildup that you see with canker, although from a different cause. The mass measured about 2-1/2 inches long by about 1-3/4" wide so it was roughly egg shaped although far larger. It's likely that an E. coli infection occurred in the oviduct and this was the result. It wasn't something that was noticeable until the sheer size of it began to interfere with respiration, I think. It never affected her legs but it was also much softer (almost spongy) than the garbage that we pulled out of Winter that first time. Also, this came on much faster, I think.

At the time (one year ago almost exactly from this writing), the vet felt that the oviduct, while ruptured, was still in good shape so he sutured it up with Chromic Gut (an absorbable suture) and expected that she'd still be able to produce eggs. She never did and I have kept a fairly close watch on her until this latest development. I again found her showing signs of illness in the loft and picked her up. This time, I could feel a pronounced keel demonstrating significant weight loss but no hard mass in the abdomen. Instead, there was a lesser, liquidy fullness as well as a soiled vent that smelled bad. I brought her into the house and caged her to wait for a fresh poop sample. It wasn't coming so I tubed some Kaytee down her to help out. In time, she deposited a fairly large plop of some diarrhetic solids mixed with a lot of catarrhal discharge (snot). I did a fecal float, a wet-mount smear and a Gram-stain. The wet-mount smear was the first to process and I could see an awful lot of bacteria of different kinds including some things that were moving in the manner of trichomonads. There were also long rods (bacilli) swimming by at a fairly good clip for that kind of thing. I've only ever seen that in very sick pigeons so I put her on both Metronidazole and Baytril at the same time. The float came back negative for both Coccidiosis and worms. The Gram-stain came back predominantly Gram (-) which isn't good (generally, you'd rather see mostly Gram (+)).

I also put her under a heat lamp:



Warmth can be extremely important to a sick bird and it's my experience that a heat lamp is the best way to pump it into them short of an incubator.

The new information that will eventually be included will have to do with the possibility of a hen actually having a live embryo partially develop inside to the point of dying and then becoming a source of massive infection. I need to do some labwork tonight on the part of the (what-I-think-was-an) embryo that was ejected and then I'll firm this post up. I'm only sticking this blurb in here right now to make sure that this thread doesn't go into "Archive" status before I've gotten a chance to insert the new material (and this event needs to unfold a little further).

I'm adding a link to a necropsy where a pigeon had formed objects in the abdomen similar to Pattie Cakers and Winter:

http://www.pigeonbooks.com/cases/eggretention.html

Last edited by Pidgey; 18th April 2007 at 05:39 AM..
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