# What can turn a toe necrotic in 3 days?



## Teresa (Jul 10, 2005)

A serious string injury I found last November was treated and released, and for months the surviving toes looked OK.
Then suddenly, in less than 3 days, one toe turned necrotic. I've never seen anything like this, it's like the toe exploded, it was split from end to end, shrivelled like a husk, and there was dried blood on his feathers. The foot was very warm to the touch.
Could some form of parasite have burrowed into the vulnerable toe?




























I soaked his foot in dilute hydrogen peroxide and put him on Baytril and Metacam. My avian vet is away till Monday, but if he takes a turn for the worse another vet will see him.
He's eating, drinking and pooping well, and he's very alert. But I found the progress of the necrosis highly alarming and would like to hear your opinions, as I don't want this to happen again -- to his remaining toes or to another bird.


----------



## Teresa (Jul 10, 2005)

*Background information on this bird*

These pictures show Geraldo before and after the string was removed, and also last Febrary when the condition of the toes was the same as 4 days ago.


----------



## Dobato (Jul 3, 2008)

Teresa, with constriction injuries even once the what is causing the constriction comes off the constriction ring can over time continue to further scar. With blood flow in and out of the distal segment of the toe already compromised in Geraldo's toe when you released him, over time, it may not have taken much more further constriction of the ring to reduce blood flow to the end part to no longer make it viable. Then on top of this, there is the possibility that a small, new injury to that foot/toe caused some swelling, again enough to shut down the little blood supply that was keeping it alive.

Karyn


----------



## Teresa (Jul 10, 2005)

Thanks, Karyn!
I had managed to remove all of the callous material under the string and mixed with it (5th photo), but I didn't realise that the compression that caused the base of the toe to become so thin might lead to this happening.
The toe did look swollen on the 14th. I thought a parasite might have burrowed into it, but from what you say any injury would have done it...
Thanks again! I'll keep monitoring the others.

This is the last constriction ring (callous) I had removed from his toes. I thought/hoped after that the flesh would just grow normally...


----------



## Teresa (Jul 10, 2005)

The bad toe fell off, leaving only a bit of dry skin that I trimmed. He is now standing very well and walking without showing any discomfort.










In this photo, it looks definitely like the callous constriction ring had grown back again after a few months. That's really disheartening, showing that sometimes no healthy tissue will grow after string+callous removal.
Has this happened to your rescues too?


----------



## Dobato (Jul 3, 2008)

Teresa, I don't do rehabbing or rescuing, but am familiar with the theory on number of methods and techniques that can apply to rescued birds. Ideally, for constriction injuries the scar tissue would be excised and then the fresh tissue margins, from both sides, brought together with a few stitches and relief incisions made to allow any swelling to expand out, instead of pulling the sutures apart. It's detailed in the Big Book, at the beginning of chapter 41, here's a link to it:

http://www.avianmedicine.net/ampa/41.pdf

Karyn


----------



## Libis (Oct 8, 2010)

Dobato said:


> It's detailed in the Big Book, at the beginning of chapter 41, here's a link to it:
> 
> http://www.avianmedicine.net/ampa/41.pdf
> 
> Karyn


This is a fantastic reference! Thanks for linking to it!


----------



## Teresa (Jul 10, 2005)

*Great link!*

Thank you so much for the link, Karyn, it's brilliant!

I wouldn't be able to do any suturing or incisions, and I don't know if my vet is familiar with the procedure, but I'll ask.
I noticed, however, the insistance on using hydroactive dressings to avoid "scab formation, which could result in reformation of the constriction". So that's what happened!


----------



## Dobato (Jul 3, 2008)

Teresa said:


> Thank you so much for the link, Karyn, it's brilliant!
> 
> I wouldn't be able to do any suturing or incisions, and I don't know if my vet is familiar with the procedure, but I'll ask.
> I noticed, however, the insistance on using hydroactive dressings to avoid "scab formation, which could result in reformation of the constriction". So that's what happened!


Teresa, I forgot to mention that Feefo (Cynthia) mentioned the use of Bach's Rescue Cream on string injuries. Its use would keep the string injured area moist (the concept with hydroactive dressings), to help prevent further scaring and constriction (should probably be applied a few times a day for a number of weeks if possible). The cream, or one like it, may also be of use before the string removal procedure to soften the area up as well, hopefully making for easier removal of the string.

http://www.vitaglo.com/ba0042.html

Karyn


----------



## Teresa (Jul 10, 2005)

Thanks, Karyn!
I've been using a cream to soften the area before string removal, and Bacitracin after, but if that one is more moisturising I'll definitely get some.


----------

