# Today's project - one question



## NumberNine (Jul 19, 2005)

Someone brought me the dove you will see in the pics. The back of the head took a bad hit. The bird was found on the side of the road. It can fly, and I think vision is ok in both eyes. When the bird was found 3 days ago, the right eye (when facing the bird) was totally closed. Since then it has opened gradually. 

If you wish to make suggestions or other comments, you are more than welcome.

When I got it, the back of the head where there is no skin, was hard like a rock. It had completely closed.

I cannot tell about droppings, it only makes 4 1/2 hours I have it. It's on Baytril and Polysporin (3 antibiotics). The pics were taken after spending about 1 hour cleaning the wound with water/peroxide. The bird weights 415 grams (a pound = 454g).

Thanks.

http://community.webshots.com/album/468081003PZdkQx


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## upcd (Mar 12, 2005)

*Looks*

Like something chewed on its head. Or it got pecked pretty bad. I would think the eye closed dew to swelling. Then reopenned when swelling went down. Sometimes eye can be so badly damaged that it can't fully heal. Only meds and time will tell. God bless you for taking this little one in.


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## pdpbison (Mar 15, 2005)

Hi NumberNine,


Yahhhh...could be sympathetic reaction to local trauma or maybe the Eye itself had in fact also been injured.

Eeeeeeeesh...

Neosporin sounds good as a moistener-topical-antibiotic.

C'Baby's head showed skull variously as all the flesh on it's top died and shrivvelled and then fell off...


I kept it all moist for those weeks with the Neosporin, and slowly it all grew back, and now his head - three months later - after regorwing the top covering of thin flesh and skin, grew full normal Feathers on the top and sides.

Is the skull perforated there with yours?

I hope not, but was hard to tell in the images.

Wow..good luck!

Glad this Bird is in such good hands...

Quite an unusual injury...


This is a HEAVY Bird too!


Phil
Las Vegas


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## Skyeking (Jan 17, 2003)

Do you have any Arnica Montana (homeopathic)?

If you haven't used that, try it. It actually reduces any swelling, bruising and any injuries associated with trauma. I have used in on birds with head trauma and eye injuries and it heals things quicker and better. My friend had a hawk with major head trauma, she treated with the arnica (among other things)turned it around in 6 hours.


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## Pidgey (May 20, 2005)

Well, as the skull is exposed, I think you need to debride all that somewhat-dried scab material and get that wound stitched shut to keep the skull bone from desiccating. You may have to open it back up periodically to debride again and again until the wound wants to close down to the point where the skull's out of danger. What you really don't want is for an infection to set up in the bone of the skull as that could ultimately be life-threatening.

The skin surrounding the open area will likely not want to stretch back over the wound. In order to get it to do that you may have to break the underlying fascia (membranous, web-like connective tissue) to get it to pull over. You can read about how the vet did that to Pierpont in his initial closure (the first of many).

If it simply will not pull closed, then you have to close it as much as possible and debride the edges every day or two so that scar tissue will fill in the gap if nothing else.

Pidgey


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## NumberNine (Jul 19, 2005)

Update.

The bird has improved. The droppings are alright, but show the bird was empty. No damage to the vision. The right eye keep opening wider. The bird did his/her first grunt. More alert. 

Yesterday when I took the pics, I knew I wasn't finished cleaning the wound, but I wanted to provide pics before I leave town for 24 hours. I'll finish cleaning tonight and might post better pics as soon as I can. 

A big thanks to all who answered. Thanks Pidgey for anticipating the question I really wanted to ask, but forgot. Simple stitching is one thing, but breaking the underlying fascia might be above my skills. I'll see after I find time to read your posts.

Thanks Treesa for the recommendation. I wasn't aware of this product and will try to acquire it tomorrow. 

Thanks Phil for sharing your similar experience.

The gap is about 1 1/2" across and a max height of about 3/4". 


P.S. I live on the East coast, so I'm three hours ahead of the time indicated on the forum.


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## Skyeking (Jan 17, 2003)

Arnica Montana comes in the little pills, that you put down their throat. 3 for a large pigeon, 2 for a smaller one.


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## pdpbison (Mar 15, 2005)

Hi NumberNine, 


When C'-Baby had his initial head injury from the Crows pecking him almost to death...

I never cleaned or debrided any of it, but kept it moist with Neoporin.

The dieing flesh-skin all dried slowly and shrank with various cracks showing the underlieing skull, and I let all that be on it's own wisdom to do as it pleased.

The large 'bottle cap' scab remained a long time, as new growth began frm the periphery and slowly proceeded up, when the scab finally got loose and was dislodged by his own interest to knock it off. By then, there was almost complete covering of new skin there, and I continued to keep it all moist with Neosporin.

Now, since your's injury has been cleaned and debrided, you do not have the same option as I elected to follow with my C'-Baby...and, it would seem to me that Pidgey's recommend of the seperating the attatchments of the surrounding tissue, so that it can all be stretched up and sutured, would be the best way to go with this one.

I would imagine a Tool for doing this could be made up of a small length of Piano wire of small gauge. Carefully ground to have two opposing flat sides, terminating in a sharpened end and one edge sharpened. This could be bent then to roughly the arc one anticipates in the skull areas one is dealing with.

This would allow one to reach 'down' going paralell to the curvature of the skull, slideing against ir gently, to sever the little adhesions, and, to also go slightly sideways, going around to some little deapth on one round, then a little more on the next and so on untill one has enough elastic ptential for the closure.

Dentists in fact do a similar thing when intending to extract a Tooth, as there are many tiny ligaments which hold even a very loose Tooth to it's socket.

Good luck...!

If you had an experienced Avian surgeon, of course that would be a good option, but with care and patient sensitivity to the task, and the resolve not to become squeemish, I am sure one might do this quite well one's self, or, with someone to help hold the Patient...


Phil
Las Vegas


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## Lin Hansen (Jan 9, 2004)

NumberNine said:


> P.S. I live on the East coast, so I'm three hours ahead of the time indicated on the forum.



Hi Numbernine,

If you'd like the time indicated on the forum to reflect the time it is by you, you can click on "User CP," (Upper left hand corner of the top of the page), then find and click on "User Options" (on the left), then scroll down to "Date and Time Options." You can then set the time for the East Coast.

Just for your info...

Sorry I can't contribute anything helpful regarding the injured bird. Poor thing, it looks like you will have your hands full. Thanks for trying to help him.

Linda


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## NumberNine (Jul 19, 2005)

Thanks Linda for the tip. But I guess it means that my post would show up with a time stamp 3 hrs later than the others. And that could be confusing, in particular for the posts immediately before mine and after mine.

Yep, hands full alright. The poor bird had its ear canals full of blood!!! I mean, hard, dried blood filling the two canals. On one side, not only it filled the canal, but it is also sticking out. I spent 15-20 minutes to remove that one side. I managed to remove it in one piece and it is close to the size of a single sprouting barley seed. I'm afraid I will have have to spend 4-6 hrs in order to gently clean the whole wound, as well as the surrounding area. 

Hi Treesa, I got the Arnica Montana (boy those pills are small) and I would like to know how many days do you suggest I give it 3/day? Thanks.


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## NumberNine (Jul 19, 2005)

For those interested. After 5 hours of cleaning, that's what it looks like.

http://community.webshots.com/album/470167314vwkKqV

pic 2 gives you a side view from the left (when facing the bird).

I used the tip of a tiny pair of scissors and succeeded to detach the skin w/feather from some sort of crust. I can move the skin w/feather, but the small hard crust is an obstacle. I cut into it just a bit and the first cut was fine, but got a tiny amount of blood when doing the second cut.

pic 3 is a view from the right. What you see is the bottom part of the wound. You can see the pink skin and then the crust. I can almost move the skin the whole length of the wound.

pic 4 is a view from above and you can see my finger pulling down on the skin/feather and creating a gap with the crust.

pic 5 is a close up of the crust that needs to go. Water/peroxide won't help in this case.


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## TAWhatley (Mar 6, 2001)

Well done NN .. and good pics too. I have no advice at this point, but I know you will figure it out.

Terry


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## pdpbison (Mar 15, 2005)

Hi NumberNine,

The 'crust' then would be essentially what one might call scabbing? Dried Blood more or less and hardened skin-edges?

I think it may make sense then for it to 'go' for the edges of the to-be-sutured skin to be at their best for where they will be obliged to meet...

Wow...good work there! - all my best wishes for you both!

Phil
Las Vegas


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## NumberNine (Jul 19, 2005)

Pics after surgery at link below:

http://community.webshots.com/album/471264043ctXxqe (the oily stuff everywhere is polysporin)

Terry, 

I have a few questions for you: 1) When you use cipro in tablets, do you mix it with water or juice? All my life the Baytril has always been mixed with juice (from the vet). But for the sake of simplicity, I would like to use water. Do you know if it's ok? I guess it might be, but might taste awful for the bird???
2) There is some infection in the bones. It's yellow, not yet the dark green stuff, so I think the bird should be able to pull through. BUT, I would like to give the bird 14 days of cipro (starting today). It has been on Baytril for 4 1/2 days prior to switching it to cipro. Have you ever done anything like that? That's basically baytril/cipro for 3 weeks. I really think that the bird will make it, but I need it under antibiotics for longer. Is there anyone on your side you could ask? Please advise. Thanks.


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## Pidgey (May 20, 2005)

NumberNine, 

According to some really good info, it seems as though 30% to 40% of Baytril is metabolized to Cipro in the liver anyway. As long as you've got the dosage right, the birds and the bugs won't know the difference.

Nice job sewing it up. It may or may not result in a union at this point. If a thin layer of scab develops in between the edges, it probably won't and you may have to open it back up later OR use a fine pick to debride between the two edges between the stitches. You can abraid the edges a little to enforce bonding. It's possible that in a few days the edges might seem to retreat a little from each other but you've got a good density of stitches on the wound. 

It's really hard to say how it's going to do but at least the skin will stretch instead of shrinking and the bone is now inside the body, so to speak. Even if you do have to reopen it later to debride, clean, disinfect and re-close, it will still be a lot easier to do and the ends of the cut should heal towards the center some. I kept getting so disconcerted at Pierpont's chest wound trying to get it to close but in the end, it finally did--it just took a month and a half for it to do it completely.

Pidgey


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## NumberNine (Jul 19, 2005)

Thanks Pidgey for the info  

Now, if only Terry could tell me if I should use tomato juice, cranberry juice or water...


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## Pidgey (May 20, 2005)

Phil would tell you to give it (the powder) a small taste to see how bad (or not) it is before you make a decision. Tomato juice just doesn't seem right to me and water's certainly fine but it may need a bit of something. If you really put it way back in there, I don't think it matters, though.

Pidgey


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## NumberNine (Jul 19, 2005)

I was kidding about tomato juice.  It's way too acidic. I could get cranberry, which I believe was used with Baytril. But I don't have any at home and it was a long day... So, water it might be


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## TAWhatley (Mar 6, 2001)

Hi Numbernine,

I always use water when dissolving tablets or powder. Some of the meds do taste bad, but I use a crop needle to deposit the dose directly into the crop, so the taste doesn't matter. 

I have at times switched between Baytril and Cipro and haven't seen any problem in doing that.

Terry


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## Maggie-NC (Jun 22, 2005)

Hi Numbernine, grape juice can be used but it is somewhat acidic too. Our vet uses something called "syrpetta" which looks and kinda smells like grape juice.

A fellow rehabber who works at the state vet school told me they use water. After she told me that I started using water particularly in mixing the metronidazole. Distilled water is always the best but we use bottled water.

maggie


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## NumberNine (Jul 19, 2005)

Thanks Terry and Maggie!

Btw, I use tap water. I must have broken every rules you gals/guys have. I live in a major city with a very good filtration system. If I were to live in rural area, or if there would be known problems with the water, then I would use distilled water.

I read a report about 6-10 months ago about bottle water. One brand was nothing more than tap water from a large city located about 2500 miles from where I live.

Another rule I break, I never use a heating pad. Instead, I put the bird in a bedroom (door closed) with an electric baseboard heater. I set the temp at about 86F (~29C). Since the bird(s) is on the floor, it gets about 81F-82F. I did use an electric pad at the beginning, but once I ended up with 3 birds and only had 2 pads, so I improvised  Also, I buy collapsible, removable tray wire cages http://www.hagen.com/usa/dogs/product.cfm?CAT=7&SUBCAT=702&PROD_ID=07706860020101 (the link is very slow, so I uploaded a pic) to keep the birds. One bird per cage. I can even stack one on top of the other. Once folded, it is only a few inches tall. But once open, you have approx. 40" X 27" X 26". It is designed for dogs, but birds are quite happy in it (except maybe for doves - I put cardboard on the inside walls).

But first I must investigate Keflex.


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## pdpbison (Mar 15, 2005)

Hi NumberNine, Pidgey, all...

Far as I know, when mixed in Water to the desired concentration for a daily dose, that is, to be in their drinking water...the Baytril-Water does not taste unpleasant at all...it is very mild if even noticable at all.

While the medicine itself in full undiluted concentration may taste bitter.

Baytril and ( locally purified) Water, tastes MUCH better than the tap-water here, for that matter.

Really, the daily-dose of Cipro or Baytril or anything, when mixed in a day's drinking water for the Bird, is not going to have much taste at all.

Consider too the kinds of puddles they DO drink from in their feral situations..!


Phil
Las Vegas


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## TAWhatley (Mar 6, 2001)

I don't think you will find Keflex to be particularly effective with many things that Baytril or Cipro readily resolve. Here's a link .. sending mostly because this marvistavet site has been very helpful at times: http://www.marvistavet.com/html/keflex.html .. handy place to easily look up various drugs.

Terry


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## Pidgey (May 20, 2005)

I wouldn't use Keflex for salmonellosis. I use it more for an infected wound or post-operative prophylaxis. It has some activity against some anaerobes that Baytril isn't of much use for. They're all different and do different things.

Pidgey


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## NumberNine (Jul 19, 2005)

Thanks Terry for the great link. Maybe we could have a folder were all useful links could be stored?

Btw, I just checked my CPS (Compendium of Pharmaceuticals and Specialties) and was surprised to find Keflex. I think you might like to have this book, in particular when there is a power blackout or the Internet is not working like it is supposed to. I've been buying it since '86. 

It is Canadian, but still ok. Published every year. But I only buy it every 4-7 years since there aren't enough changes in drugs to justify buying it every year. The level of details about drugs is mind-boggling. I keep on buying the actual book instead of an electronic version since it is hard to use the computer to access the CD version when there is no electricity... 

http://www.pulsus.com/clin-pha/09_02/repc_ed.htm

P.S. On any drugs the CPS expands upon, you can rest assure that NOWHERE on the Net will you find the same level of details.


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## feralpigeon (Feb 14, 2005)

I have many medical texts on hand, one of which would be the PDR. The use of texts pre-dates my reliance on the internet and I couldn't imagine relying only on the internet as a source. That would be regardless of a power outage, although a good point. 

fp


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## NumberNine (Jul 19, 2005)

Given the current exchange rates, the PDR is a more attractive buy than the CPS. But some years ago and for many years, the CPS used to be cheaper than the PDR. Not any more! If I'm not mistaken, I have the PDR on a CD.


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## feralpigeon (Feb 14, 2005)

Here's an interesting link to an article on dosage rates for both PDR & CPS:

http://www.essentialdrugs.org/edrug/archive/199809/msg00064.php

Apparently, we still need to research our solutions thoroughly and not become complacent on any one source. 

fp


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## TerriB (Nov 16, 2003)

*Med Mixer*

My vet suggested mixing the crushed Baytril tablet with applesauce and this was well accepted by the birds. I also gave a bit of 'straight' applesauce afterward to leave a good taste in their mouth. I keep a jar of baby food applesauce on hand for emergencies. Just a suggestion.


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## NumberNine (Jul 19, 2005)

Thanks for the tip! I think what I'll do is mix it with water and then give the bird some applesauce. For this 250mg cipro tablet, I decided to crush it and mix it with 25ml of water. That will give me the same 10mg/ml I have always used with Baytril. I prefer this way as I am used to such concentration and it greatly reduces the possibility of mistakes and overdosing the birds. 

But I'll definitely give the birds applesauce. I might even buy a jar for myself! ROFL


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## TerriB (Nov 16, 2003)

NumberNine said:


> ...I might even buy a jar for myself! ROFL


Yep, I am in charge of finishing up the leftovers. 

When dosing multiple birds, the applesause kept the medicine from settling out so correct dosage was more assured. The vet alternately suggested cooked squash, which might appeal to some psittacines.


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## Skyeking (Jan 17, 2003)

TerriB said:


> Yep, I am in charge of finishing up the leftovers.
> 
> When dosing multiple birds, the applesause kept the medicine from settling out so correct dosage was more assured. The vet alternately suggested cooked squash, which might appeal to some psittacines.



Hi TerriB,

That is an excellent tip about the applesauce, and I was just thinking about pumpkin when I saw your new post. The squash or pumpkin provide extra pro-vitamin A for healing, as well as offering a digestive aid.


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## pdpbison (Mar 15, 2005)

Now, as far as Baytril goes...

I have the liquid kind, and my method has been either to mix it into their drinking water, or, to mix a dose in with the formula I will feed directly into their Crop.

Is this allright do we suppose?

I withold their ( Calcium Carbonate 'Crushed Shells' ) Grit when they are on this mediciation.

Does this sound allright?

Any other peramiters?


Phil
Las Vegas


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## NumberNine (Jul 19, 2005)

Phil,

it's worse than I expected, read this...

http://www.pigeons.biz/forums/showpost.php?p=88686&postcount=24


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## pdpbison (Mar 15, 2005)

Okay...good then, I have not allowed any of the usual Oyster and other Shell Grit for those caged convelescents on Baytril...and I head of this here somewhere in passing some while ago, and made sure to to abide...

This also I think may underlie the concern of having the very young on Baytril, since the drug may seek outavailable calcium in their diet, and leave them deficient?


Phil
Las Vegas


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## NumberNine (Jul 19, 2005)

TerriB,

I served Heinz baby food applesauce to two sick birds (canker & surgery) and they couldn't stop moving the tongue around the beak. One even danced and sang for me. 

Thanks for the tip


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## NumberNine (Jul 19, 2005)

UPDATE:

The bird is still alive, but I'm dead.  I just spent an hour and a half doing stitches and it was the FOURTH time this week that the bird was getting stitches. 

Because of the location and size of the injury, it has been a real nightmare. A large number of birds I rescue have an impact wound, but I never had one before exactly like this one. It's not so much the size of the wound, as the location. The bird stretches the neck, turn the head 180 degree, whatever. You can imagine how much pressure it is putting on the stitches. The skin breaks, the stitches come off.

I spent more than 4 hours trying to come up with a garment in order to prevent the bird from doing all those crazy movements with its neck. You cannot apply pressure on the opposite side of the neck, otherwise it cannot breathe or eat. In spite of my best creative efforts, I had to give up. I could have come up with something permanent to keep the head absolutely immobile, but I wanted the bird to keep eating in order to gain strength and fight this infection.

The infection is almost gone, thanks to baytril & cipro. The bird has put on 25g over the last two weeks. So I was winning on two fronts, the infection and the overall health of the bird, but I was beaten on the simple matter of stitching. What a nightmare it has been.

The only thing I've been able to come up with is to keep it in a smaller box in order to try to keep it on its feet, but with the head not fully stretched.

Btw, the polysporin I use has lidocaine.


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## pdpbison (Mar 15, 2005)

Hi NumberNine...


Hmmmmm...now, is there not some 'new' invention, some membrane material, one uses to cover such areas, where one patiently waits new growth to close or gradually continue?

It was discussed in our forum here some time ago...

As you may recall, my 2-week-old Pigeon-Baby of last May, who was lacerated and pecked badly by Crows, had all of the top of his head die and shrivel, and eventually the large scab of it all fell off, an area like a bottle cap.

But I just kept the whole moist with Neosporin and gradually, as the large scab of deceased skin and scalp tissue that died, dried and shrank, the new skin and tissue grew in from the sides and periphery...

Now, maybe this membrane stuff would effect a similar protection for the otherwise exposed skull...while the more loosely stitched side-skin areas can gradually grow in to meet and enclose what had been the wound area...

As long as the skull does not dry out or becme contaminated with germs, I believe it will be allright as it awaits the gradual and progressive enclosure of new skin and tissue...

Sorry to hear of how trying this one has been!

Hopefully someone here will recall what this material is called...

I saved links to it at the time, but lost all of that in some computer troubles.

Phil
Las Vegas


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## Pidgey (May 20, 2005)

Phil,

You may be thinking of hydrocolloid dressings. You can get hydrocolloid gel by itself and there's also hydrocolloid bandages.

NumberNine,

Did you loosen up the fascia underneath the skin before you sutured it back together? That could cause the kind of problem that you're describing. I'm not sure but I think that stuff forms fairly quickly.

Pidgey


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## NumberNine (Jul 19, 2005)

Thanks Phil for thinking about this type of product. As soon as Pidgey provided the name, I did a very quick Google search and was stunned to find out that it is now available to the general public. 

I haven't spent much time researching it, but I wonder if the growth of feathers would initially be slower or affected in any other way at the location of the injury? Anybody here used it repeatedly?

Pidgey, no, the fascia was not loosen up. You see, the first stitches held perfectly well in spite of whatever the bird did with its neck. But since additional cleaning of the wound was needed, the first stitches had to be removed. And this is where the problems started. 

The second stitches did not hold, the third stitches did not hold either. If the first stitches would have failed, I would have not been overly concerned. I mean, many times in the past I had to try a different strategy in order to heal a bird. I always assume that the bird will either die or I will save it. So failing on the first trial doesn't overly concern me. I've seen it before. 

Moreover, I've been averaging 2-4 stitching a year. And never had anything like that happen before. But if I'm not successful this time, I will loosen up the fascia. Really scary to work so close to the brain. I ain't a brain surgeon, nor a rocket scientist 

What worried me was the fact that the first time was successful, but couldn't be duplicated afterwards. Highly illogical. I even sent the original pics to that vet at the other end of the country. I told her what you had said about the fascia and she agreed (btw, she's the one who told me that I could have used Bactrim instead of Baytril... ). She even explained to me that at such location, it is especially dense and it serves to anchor the skin firmly to underlying tissues. While in other areas of the body, it is loose and the skin moves freely back and forth. But she couldn't pinpoint the reason(s) behind my situation.

It makes 10 hrs now that I did the stitching and I'm hopeful. I'm thinking that maybe the skin weakened after the first stitching and needed a few days to heal a bit before stitches are repeated. I let 4 days go by between the stitching done yesterday and the previous one. You can bet that I generously spread polysporin in order to prevent the tissues from drying up and dying.

Btw, in an earlier email you told me about using a heated and bent needle. I think I forgot to tell you that I'm using this,

http://surgo.com/product.htm?Produc...ategory&Category=C-DERMALON & MONOSOF SUTURES

It makes the job a lot easier. Though I guess that you don't care since you must have done so many with your own tools. I usually get the suture that is absorbed, but the store was sold out and had to use nylon (polyamide). I like the 12mm needle. The suture comes attached to the half-circle needle, nothing could make the job easier.

P.S. I think the "box thing" is really helping. The idea is as follow: The bird will naturally want to be up on its feet most of the time. In a natural position, the head is up and the neck is straight. This creates some pulling on the attached skin. So I made holes on all four sides of the box (and no opening in the cover), but the openings are lower than the bird's eye level. Such that the bird doesn't stretch its neck, but actually has to lower it's head in order to see through the holes. Also, the bird cannot see much through the holes if sitting flat in the box (this is not desirable as the bird has room to do whatever it wants with its neck once sitting). I positioned the box so that it can have a view outside the window (I have a view of the whole city). And it is working. The bird is lowering it's head in order to see outside and in so doing, the neck is kind of retracted. Therefore relieving the pressure on the stitches.


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## NumberNine (Jul 19, 2005)

Pidgey,

I thought you might enjoy seeing what kind of needle I've been using. The suture is attached to the needle. It works perfectly. The needle is the tiny silver thingy on the penny. Whenever possible, I like to use the smallest, 12mm, it works great on pigeons.

Set Adobe at 75% and you will get a sharp and clear pic.


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## Pidgey (May 20, 2005)

Okay, I saw it. That's pretty much what I use, too. Sometimes a heavier suture (3-0) will help when it comes to holding power. I don't mean the holding power of the suture, I mean the skin--a smaller suture can cut through the skin easier. Also, in a case like this, non-absorbable is probably better as they're: 1) cheaper; and 2) their tensile strength doesn't degrade with time. Some absorbables (Vicryl Rapide) get weak pretty fast.

Anyhow, the fascia is a lot easier to take care of than you might imagine. You don't need to worry about the brain because it's in the skull and you're not going to penetrate that. The way you ease the fascia is to insert a pair of blunt ended scissors under the skin with them in the closed position and then you open them and withdraw. When I watched my vet do it the first time, it was obviously disgustingly easy. 

It's the psychological barrier of inserting something or just being invasive that's so tough for us to do. But when you've repaired enough failed closures, you may eventually get over the reluctance. The suturing is nerve-wracking enough when you're holding a needle too close to the eye of a patient that's liable to turn its head at any moment.

How a hydrocolloid dressing would have worked is that a patch of scar tissue would have eventually formed over that entire area. Seeing as how it was pure bone underneath, it might have taken a VERY long time for it to do it, though, IF it would have completed the job. Very tough to say in that area as there was no underlying flesh per se there.

But, you're getting there, slowly but surely!

Pidgey


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## NumberNine (Jul 19, 2005)

Pidgey,

Today, the bird decided to attempt flying for the first time since I have it!!! And I don't know why, but it also started preening today!! I think it decided to test my stitches. Darn bird  I'm glad, but surprised by the sudden improvement in the behavior.

Your trick to cut the facia is brilliant. I would have never thought about it. To me, I was going to use a scalpel and slice through it. Now you understand why I didn't do it. 

I don't really have a problem with stitching a bird. I try not to think of the bird when I do it. I erase it from my mind and concentrate strictly on the task. My problem is working near the brain and eyes. Once I saw adult birds attack a hatchling on the head. I could see the beak penetrates the soft skull of the hatchling. Naturally it killed the baby. I have never forgotten. 

You might be interested to learn that the rehab centre in my area only uses the absorbale suture. They use the one absorbed in 14 days. I think I got a lot of my bad education from them, eh! eh!


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## Pidgey (May 20, 2005)

The vet showed me the fascia trick. Of course, he was just doing the job and I was watching. I think it's probably a very widely used medical technique that they just don't tell about in the book because it's absurdly simple and the practicianer (sp?) should already know it. That book I have was not written for folks like us--it's for vets.

I get expired sutures on eBay and paid about $50 (s/h included) for 50 sutures so about a buck a piece for ~30" double-needled. I'm set for quite awhile.

Rehabbers often go with the absorbable so they can let the bird go and not worry about taking the stitches out. I learned a leg splinting technique based on masking tape where they let the birds go, tape and all. It'll fall off about the time it's ready to. I've used it a few times although I've always kept the birds and seen how well it works. Sometimes, in rehabbing, if you think the bird might have a family that it needs to get back to, it's best to fix it in such a way that the bird can get back as fast as possible.

But sutures aren't created equal in other ways either. It's possible for a suture that's essentially a small woven rope to hide bacteria where a monofilament suture will not, aborbable or non-absorbable regardless. Sometimes, you WANT the stranded anyhow, but that's more for internal work anyway. Actually, different sutures are usually designed for different tissues and different surgical procedures. There are even times when you use a non-absorbable on the inside and leave them in. It's quite a study.

Pidgey


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## NumberNine (Jul 19, 2005)

Always fascinating facts...

I paid ~ $9 for two packs of 5-0 18" nylon. I didn't realize that you were doing so many "stitching jobs". Tomorrow I'll go back to the store. They should have received some 3-0. I guess I'll keep using nylon. Though I really enjoy the "stitch and forget it" approach. As long as they hold. Here's a link to a nice and brief summary about sutures (in case you don't know everything already...): 

Scroll down the page and click on Guide1, 2, 3...

http://www.vetmed.auburn.edu/~hendera/guide/


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## NumberNine (Jul 19, 2005)

Update (hopefully the last one):

Situation is similar to Pidgey's Pierpont where you do stitching, wait a week or more, undo the stitches, clean up the crap, re-do the stitches and repeat the whole process all over again.

I never mentionned it, but at the extreme left (when facing the bird) of the injury, there was a tiny perforation of the bone. It was about the size of a pimple. The bone was yellow.

Yesterday, after 26 days, the yellow of the skin has finally vanished. Another sign that there was still infection is that there were no feather growth where the skin was yellow. It has now started to turn pink and with a magnifying glass you can see blood vessels as well as some feathers seem to be appearing from under the skin.

Based on the bird's reaction when suturing at the back of the head, it was quite painful. But thanks to Xylocaine, it has drastically reduced the pain. Except when I did not apply enough...


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## NumberNine (Jul 19, 2005)

Problem with webshots!

Goodbye


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## pdpbison (Mar 15, 2005)

Hi NumberNine,


Good news then! - I am very glad!

Good going!

I was just thinking about him today, wondering how that noggin was comeing along...

Hows everything else with him?

Phil
Las Vegas


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## NumberNine (Jul 19, 2005)

The final pics...

http://community.webshots.com/album/507090576fTVKfo

Also provided in pdf format since webshots isn't always working. Set Adobe at 100% Zoom for sharpest pics. Make sure to scroll down since there are two pics.

In pic 1, you cannot even see the scar anymore. In pic 2, where infection was strongest, the feathers are the last ones to grow.


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## pdpbison (Mar 15, 2005)

Wow...!

Outstanding...!

Good Work NumberNine!

Post some pics of the rest-of-'im too!

I forgot what he looks like!


Phil
Las Vegas


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## TerriB (Nov 16, 2003)

Wow! Hard to believe this is the same bird! What a great job you have done treating such an extensive injury!


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## feralpigeon (Feb 14, 2005)

Excellent work, NumberNine, excellent results 

fp


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## Pidgey (May 20, 2005)

NumberNine,

I can certainly appreciate the time and effort that it took. I haven't read a ton with respect to why it has to work that way but I guess if a wound has been open too long the body is in the middle of reorganizing the circulation and tissue as if it's never going to close besides an ongoing battle with the undesirable microbial agents. 

They're busy killing and digesting the cells on the outliers that can't defend themselves due to the circulation shutting down to them and so you've got a perpetual Petrie dish situation. As such, you can't get it clean enough to close and leave it that way because it'll almost abscess although the bird usually tries to mineralize it in order to wall off the intruders. 

But, with each successive re-opening, debridement and re-closure, you get just a little bit further until the day comes when all the factors come together so that the bird can win the immunological war besides the tissues coming to the point where they're reorganizing as they should be. It just takes time and it's almost predictable--a month to a month-and-a-half. As long as you know that going in, it's easy enough to bear but it sure gets tedious when you don't know if it's EVER going to heal.

Pidgey


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## Maggie-NC (Jun 22, 2005)

NumberNine, congratulations on a job well done. You and Pidgey are heroes.

Maggie


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## mr squeaks (Apr 14, 2005)

*Well Done!*

Now you AND your pigeon can start breathing again!! 

Really outstanding job! Congratulations!


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## dnrslucky1 (Oct 13, 2005)

Wow Numbernine! Another miracle from what i seen!

Denise


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## NumberNine (Jul 19, 2005)

Thanks to all for the good words. I think others are having much more difficult cases than this one. The advantage of discussing a case is that it might allow others to learn a thing or two.

Most importantly, to show that rescuing birds is not a difficult thing to do. It is very time consuming and sometimes nerve wrecking, but the rewards more than justify the sacrifices.

Collectively, we can achieve great rescues.


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