# hole through the foot-string goes right through



## Jules (Nov 28, 2003)

Caught a feral today with a bad case of string foot. Bless his heart, he was so good as I painstakingly removed "most of it".
Oh...thanks Fred, for your past suggestion for using a dental hook as it worked marveleously to get at the deeply imbedded string.

The problem: it seems that there is a hole through this guy's foot. Around the heal area. And of course there is string coming from both sides of the hole/foot. Both sides seem to have a hardened scab/infection and I'm not quite sure how to proceed.
I don't want to pull on the string of course.
My thoughts are ranging from making a small make-shift baggie and fill it with a salt water solution and wrapping it around his whole foot for a couple hours a couple times a day.. or I could use a polysporin... but I don't want it to heal. I need to see what's going on and see if it is actually a hole and of couse get the string out.
Thoughts and suggestions would be gratefully appreciated. 

Julianne (-:


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## Whitefeather (Sep 2, 2002)

Hi Julianne,
Thanks so much for helping this most unfortunate pij.
I would just like to suggest one thing before you attempt to remove the string that appears to be 'through' his foot.

Years back I had a bone graft performed on my foot because of arthritis & the Dr. tried a 'new' suture method where he used one long suture. When it came time to have it removed the skin had grown around the suture. The only way to remove it was to pull it out. I must tell you the pain was so intense I almost passed out. That was twenty years ago & I remember it like it was yesterday.

Perhaps someone can suggest some type of pain killer you can give your little patient prior to pulling out the string, IF that is the only way to get it out.
Cindy


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## dano7 (Feb 10, 2004)

If it doesn't come out it will eventually cause more pain, tissue loss, and perhaps infection. 

I can't acually visualize this situation. Is the string here wrapped and tied or is it a straight piece going through? 

That booty could have a liquid antibiotic or at least hydrogen peroxide.


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## Jules (Nov 28, 2003)

Visually I guess it would be like a pierced ear where instead of an earring on both sides of the ear there is loose string on both sides and the hole is an infected scab.

I shudder to think of pulling out the string.
The hole is 1/8" in diameter on each side. One side looks round but not the other. Hrmm.. the hole is probably a little smaller than your typical TV cable wire.


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## Whitefeather (Sep 2, 2002)

Julianne,
Is there any way you can post a picture of the pigeons foot? Maybe on webshots or if you have a place that you post pictures.
A photo will help us to better understand what is going on.

How does the pij seem to be doing?
Please keep us updated.
Cindy


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## Jules (Nov 28, 2003)

Yes, a picture would be good but I'don't have a digital.
Imagine a 1/8" to 1/4" scab on the tip of either side of your ankle bone. Now imagine loose string coming out from the scab on both sides.
Does this help at all?


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## pigeoncare (Apr 8, 2004)

Jules,
Right now,it's very difficult to visualize what you are seeing but one thing I can tell you. There is no hole, only an illusion of one.
What you may be seeing is a piece of string on top, a scab covering it and then a piece of string trailing from the bottom. 
Don't try to lift the string but grab one end with tweezers and try to unravel it in one direction. Don't pull too hard. See if it gives a little bit. If it does, keep going in that direction. If it doesn't unravel, try it in the other direction and see if that works.
If it doesn't work, there is probably a knot under the scab. Wrap the foot in a small, cut down baggie and fill it with an antibiotic ointment. It may serve to loosen the scab so that you will be able to remove at least part of it and get to the string.
Let me know what is going on.


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## dano7 (Feb 10, 2004)

Yes, Fred has seen a lot of this; the string is pulled deeply under the skin when the bird flies away initially. It is entangled enough to form a slip knot which cinches upon flight. Subsequently bleeding, swelling and scabbing cover the string even more. Since it can't be seen, the only chance is to get a loose end, as Fred said and unravel it. The problem is, you will come against several knots and getting them all is tricky (that's why he recommended pulling both ways - it has to unwind opposite to the way it went on) - if you leave even one turn of thread on the bird it's no deal - there will be a lot of pain for several days and the best thing that can happen is the toe(s) affected bloat, turn palish, then black, and then they fall off. If you get all the string, the limb will be saved if the cuts were not too deep. The best method I found was to wrap the bird in a towel, under a very bright light, use a magnifying glass, and get a thin sewing needle underneath the string, lift a fraction and slide a razor blade down the needle to slice the string. When you have any loose threads proceed as Fred suggested until you get to the next knot or you think it is all removed. Then clean with hydrogen peroxide and apply the antibiotic boot. 

My apologies for any redundancy. Fred: is this right? Do you have any better method or tricks with this problem?

I have to think the birds are nest building and they think the string is just the most interesting material and that's why the knots occur.


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## pigeoncare (Apr 8, 2004)

Dano,
You're right on with this. If I read the post correctly, the string is on the leg and just above the feet. There is no ankle on a bird but I know what is meant. That string has to be gotten off or it will take the entire foot.
I know how to stop the bleeding while working with string but there is no way of explaining this over the web.
A vet could get it off by cauterizing any bleeding but I don't think many people know how to work in blood and this thing will bleed heavily.
Maybe if ointment is used, the scab and string will soften enought to be able to safely work with it. Let's hope.

[This message has been edited by fred130 (edited May 20, 2004).]


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## Jules (Nov 28, 2003)

Okay, I've tried unravelling the string, actually it's thread and it's not budging.
There are three threads coming out of the middle of the scab on the left side and there are three threads coming out of the middle of the scab on the right side of his foot (no where near his toes). No thread joining them, but I do understand what you are saying. The scabs on both sides are deeply depressed (lower than the skin).
I have put on a healthly dollop of polysporin with pain relief on each scab, stretched one cotton ball over the scabs and then taped it with that 3M Coran (Self-Adherent Wrap) that Vet's use. I'll leave it like that and replace it in the morning.
I have some Chlor Palm 250 liquid that I got from my Cat Vet ( My Vet doesn't treat birds-but I got a tech to look at another string pigeon). Should I give him this or wait until I can remove the thread?
By the way, he's doing well (pigeons are such gentle birds). They seem to know when they're in so much pain that we're trying to help. He's eaten and now he's settled down in the box for the night.
I do appreciate (as always) the great advice you all give.

Julianne


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## dano7 (Feb 10, 2004)

Yes, when it is this advanced, I don't have the experience to go in there deep, control the bleeding so you can see the field clearly, and oprate. I wish I did. But my biggest problem is there is no good way to catch all impacted pigeons I see - I have one now that doesn't stand much, and it knows me for food but it is fit and will not let me get within four feet and it stays away from bird crowds. So I watch it in extreme pain - I may bring the big fishing net and probably get arrested (not lol's)


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## KIPPY (Dec 18, 2003)

i'm not an expert. if it's safe i would try to clean it with hydrogen peroxide. i get big splinters in my hands all the time and when i clean it with hydro the splinters come out easier the next day. why? i don't know. maybe once the infection and swelling goes down it leaves more room for the splinter to come out. 
the scab formed around the string. so i think the scab is going to prevent you from being able to pull that string out.


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## Feefo (Feb 8, 2002)

HI Jules,

I wrote a long post and lost it so I will have to keep this brief!

I had a similar case 2 weeks ago, a pigeon with both feet tied together, lots of knots, deep fissures and the back toe of one foot tied in so tightly it was severing another toe! There was also one bit of thread than seemed to go right through the toe.

After cutting the obvious bits like the strands tying the feet together I gave the pigeon a single drop of Metacam (painkiller as recommended by my vet) and then rubbed Bach Rescue Cream into both feet and left for half an hour. The Bach Cream softened the scabs and loosened the thread. A job that would have normally taken 3 hours and several attempts took 10 minutes with every last strand removed. Even the bit that was embedded came out as if it was trapped in cheese.

I have done so many string removals I couldn't believe how easy the Bach Cream had made the job.

The foot needed splinting to straighten out the back toes, but Helen said not to splint while there is infection so I put the pigeon on Synulox and rubbed Bach Cream in initially about three times a day, gradually reducing it. The feet, which had felt dead and cold, came to life again (must have been painful for the pigeon!), even one toe which was already cold and limp recovered. And best of all is that the back toes also straightened themselves out naturally without splinting as the pigeon perched on the curtain rail.

I will post "before" and "after" photos on my website tonight so that you can see just how bad the feet were to start with and what a miraculous improvement there has been in less that 2 weeks.

BTW the person that recommended the use of Bach Cream deals with a horrible quantity of pigeons with fishing line and thread injuries. She uses those scissors that are used to cut nostril hairs to get deep into fissures and cut embedded thread. She says that she has never had a bleed! Unfortunately I haven't been able to find anywhere that sells them, but if you come across some they are worth having.

Cynthia

[This message has been edited by cyro51 (edited May 21, 2004).]


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## Whitefeather (Sep 2, 2002)

Great information Cynthia.
Where can one purchase 'Bach Resuce Cream'? That is definitely one for the avian medicine cabinet.

Surprisingly enough, as I live on a lake & people do fish here, I have never come across a pigeon or duck with string entangled in their legs. However the Back cream would be a great tool to have on hand, just in case.

I can relate to the pain a pigeon goes through having string dug out of it's foot. I appreciate the fact you are able to give a bit of painkiller to the pigeon. 
For those of us who don't have access to painkillers, your method is a Godsend as it takes very little time & eliminates pain & stress on both the pigeon & the caregiver. 

Your suggestion is, without a doubt, the most compasionate way to proceed with this type of procedure. Most importantly, any one of us would feel more comfortable attempting this complex procedure knowing the outcome would most probably be uneventful.
Thanks again.


Julianne:
How is your little patient doing this morning?
Just a suggestion: Is there any way you can get him to the wildlife center Mary takes her pijjies to?
Cindy


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## Feefo (Feb 8, 2002)

Hi Cindy,

In the UK you can buy it just about anywhere: pharmacy, natural remedy shop...
I found this link for mail order in the US
http://www.kalyx.com/catalog/mailorders.htm 

The painkiller that I use was actually prescribed for the dog's arthritis, but my pigeon vet is always very anxious to ensure that pigeons with injuries are treated for the pain immediately. 

Cynthia


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## Jules (Nov 28, 2003)

He's doing well. I do have Bach's rescue cream. I have removed the bandage and applied the cream. I will attempt removal in a couple of hours when my business closes for the day (too hectic to start with interruptions).
I'm not sure about using hydrogen peroxide as Fred had previously said that it is extremely painful and I don't want to cause any more grief to this bird than absolutely necessary.
The only reputable wildlife rehab here in Toronto doesn't officially open till the Fall. They won't take any rescues till then.
I have no problems attempting this but I am concerned about stopping blood flow if it starts. I know to apply pressure but how else to proceed I do not know. Fred, your valued words of wisdom would be appreciated.

Julianne

[This message has been edited by Jules (edited May 21, 2004).]


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## dano7 (Feb 10, 2004)

Any vet will tell you hydrogen peroxide is the correct choice, and it does not cause any pain whatsoever.

The reason the strings will not come out has nothing to do with scabs which cannot hold a free string with moderate pressure - it's the knots deep inside that cause the problem. The trick is to cut the string below the knots since if you cut them above the knot, the knot remains and you lose your thread.

The Bach cream sounds like it gives you a winning chance to make the right cuts, I will be looking for some. good luck.

You can have some Alum powder on hand to help with blood clotting.

[This message has been edited by dano7 (edited May 21, 2004).]

[This message has been edited by dano7 (edited May 21, 2004).]


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## Feefo (Feb 8, 2002)

Hi Jules,

I have observed Helen dealing with a severed artery so calmly and so efficiently that I imagine that a bleed from the toe would be childs play to her. A short time after that one of my string injured pigeons suffered a spontaneous bleed at the top of the foot (where it eventually severed) and Helen talked me through what to do:

Hold the foot up, and apply direct pressure to the wound. Pack the wound area tightly, preferably with a sterile swab. If it comes to the worst tie above the wound to stem the bleed...I don't think this would be necessary with a bleeding toe but you might need to do it if you are faced with dealing with a severed artery. 

Treat the pigeon for shock afterwards. Quiet and a heatpad or lamp are essential. As the bleed I dealt with was particularly heavy I injected Hartmann's IP. That is a useful aid to have around and if you can you should get someone to teach you how and when to inject IP.

Cynthia

[This message has been edited by cyro51 (edited May 21, 2004).]


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## pigeoncare (Apr 8, 2004)

Jules,
Isopropyl alcohol is extremely painful. Hydrogen Peroxide is ok.


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## pigeoncare (Apr 8, 2004)

Dano,
I've found the product, Clotisol to be the best coagulent. It can be found an any number of places on the web.


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## Whitefeather (Sep 2, 2002)

Thanks for the info & link Cynthia. I will check it out.

"The painkiller that I use was actually prescribed for the dog's arthritis, but my pigeon vet is always very anxious to ensure that pigeons with injuries are treated for the pain immediately."

God bless your vet! 

Realizing probably about 98% of us have no 'professional' medical experienced in the 'avian' field, rather learning as we go, having the knowledge of which procedures are the least detrimental, yet most effective, is invaluable. 

If, & when, a reference section is initiated here, your method of 'string removal' should most certainly be incorporated as should your 'recipe' for hydration solution.

The more 'proven' home remedies we can offer our members the better. After all, our goal is to treat ill & injured pigeons as quickly, painlessly & safely as possible.

Having the knowledge of what household products we can utilized immediately will certainly expedite treatment & recovery time.
Cindy




[This message has been edited by AZWhitefeather (edited May 21, 2004).]


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## Feefo (Feb 8, 2002)

Hi Jules,

You said that the scab is nowhere near the toes and that it is in the place that on us would be the ankle. Birds do have ankles but in them is the bit that looks like a knee and bends backward. So it sounds as if it is half way along the foot...that is the long bone between the ankle and the toes (see link to diagram) http://www.kidwings.com/bodyparts/feet/. 

Am I right? Because if so then go carefully. The thread needs removing because if it is knotted and left I suspect it is likely to sever the artery...this is exactly what happened to Danny. But then you will be delving in the area of the artery and need to be very careful...I assume that the pigeon's artery runs down the inside of the leg, but I am not certain! 

Cynthia


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## pigeoncare (Apr 8, 2004)

The ankle on a bird is called the hock joint. It is the equivalent of where our knee would be. There is no "ankle" on a bird where we have ankles.
Jules is trying to describe where the string is and it seems to be where our ankle would be.


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## dano7 (Feb 10, 2004)

Right on Fred - when birds first fly when tangled in string, there is some point when the loose end of the string attaches to some ground structure, the string is pulled tight by the birds flight, and the string is then cinched and pulled down the leg as the string breaks and the bird flys away. that's why the string ends up on the toes and/or the base above the toes branching. I've never seen any string up near or above the ankle.

Thanks for the tip on the clotisol.


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## Feefo (Feb 8, 2002)

So to clarify, Jules: is the thread on the long bone between the ankle/hock joint/heel and the toes? Whatever you call the joint in question the danger of the artery being severed remains the same. When Danny's artery was severed the blood spurted so suddenly, so hard and high that Helen's glasses were saturated in blood. This is what I am trying to warn you to be prepared for. If it had happened before I reached Helen (a five hour cross country drive) I would have panicked and lost him because I simply would not have been prepared for that. Now I am.

Cynthia


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## Jules (Nov 28, 2003)

Well those details sure got me prepared (and nervous).
Went and got some styptic powder and lined up all my surgical tools and away I went.
Sadly, I didn't get far. Just attempting one at a time and the scab is so deep. I've been trying to gently break it down layer by layer where the thread is and trying not to lift the scab out and have it bleed.
He needed to take a poop break so I've put on more bach's cream and and going to try again in a few minutes.


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## Whitefeather (Sep 2, 2002)

Julianne,
I agree with Cynthia, if you are working any where near an artery you are treading on this ice.

Hopefully Helen will be by & can shed some light on the situation.

Glad to hear the little one is holding his own. I hope you are doing OK as well.
Please keep us updated.
Cindy


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## Nooti (Mar 14, 2002)

Well someone screamed an email to me that I was needed - but when I arrived it seemed that everyone has offered outstanding advice and I'm a little short of what I can add! 
I think the only thing I can say is that if you get a bleed stop what you are doing immediately and apply an elasticated bandage very tightly and leave for 24 hours. Soak in warm water before removing the following day.
If you are at all nervous about this then you need a vet. Blood pressure in a bird can drop very quickly during a bleed and unless you know how to treat for shock and replace the lost fluids fast then the bird is usually a goner. Best to be cautious. Good luck.


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## Feefo (Feb 8, 2002)

Hi Jules,

Thread removal can be an exhausting process for both of you!

John and I thought it would be a good idea to photograph the thread removal step by step, but setting up the first photo was so stressful for Ravenclaw that we only managed the first photo. 

The photos are in the Foot Repair Album. http://community.webshots.com/user/cyro51 

I use the last one (and others like it







) to remind myself how important it is to remove thread even when it looks loose.

I have never used stryptic powder, but read somewhere not to use a stryptic pencil on birds because it burns. Cornflower, however, is very good for stemming minor bleeds, particularly if they are in places where it is difficult to apply direct pressure like the beak.


I have to admit that when I found Foxy she had thread tightly embedded near a blood vessel and even looking at her seemed to make it bleed. I couldn't tackle that because I couldn't see what was happening so we drove her 5 hours across the country so that Helen could deal with it.


Cynthia


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## Jules (Nov 28, 2003)

It's done.
I can breathe now. When I started again, I went for the other side because I thought it wasn't so deep. Boy was I mistaken..it was 1/2 cm deep. Thank goodness for that dental hook as it was fine enough to get in there. It look like the thread had semi-disolved into one infected mess. I took my time and keep cleaning the area with the hydrogen peroxide. Honestly though I don't know if I got it all. The other side, although the thread was 1 1/2 cm long inside him, was a breeze as it came out with the scab. I've covered the wounds with polysporin with pain relief stretched a cotton ball over them and taped up his foot with the coban. 
There was no bleeding. I was really patient and carefull but most of all, lucky.
Bless his little heart.
I felt as if I had all of you here with me and guided me though. Thank you.
Now...how do I know if I got it all? What signs do I watch for? His foot is already quite hot to the touch.
Should I start administering the Chlor Palm liquid?

Thank you all, you are the best!!! 

Julianne


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## Whitefeather (Sep 2, 2002)

"Well someone screamed an email to me that I was needed"

Yes, I emailed you asking if you could assess the situation & offer any advice.
It certainly wasn't meant to sound like this was a life threatening situation.

Your experience certainly out weighs ours, & I just thought if you hadn't retired for the night perhaps you could let us know if everything that could be done, was being done for this sweet pij, that's all.
Cindy




[This message has been edited by AZWhitefeather (edited May 21, 2004).]


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## Whitefeather (Sep 2, 2002)

"It's done. I can breathe now."

That's great news Julianne.
I hope you & your little patient have a restful night.
Cindy 

[This message has been edited by AZWhitefeather (edited May 21, 2004).]


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## pigeoncare (Apr 8, 2004)

Jules,
Great job. We can all take a sigh of relief. 
The injured area is best kept dry now. Do you have any antibiotics that can be given orally?


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## dano7 (Feb 10, 2004)

Good going - I know that is one nervy operation. You can't be sure you got it all, of course. Here are some scenarios:

* You got it all, it was not too deep, and the toes (area below the cut) develop scar tissue, maybe some perminent swelling, but the color stays nice and red and functionality returns and the limping disappears with healing. that's the hope.

* You got it all but some or all of the below-cut tissue has lost blood supply or nerve continuity. Then these areas will atrrophy (nerve damage) or pale, swell, turn black and fall off (blood supply cut off). The pain will pretty much end when the parts fall of.

* If you didn't get it all, the sub cut tissue will fail as in the second scenario, but it could be worse because the blood supply may remain and the bird will always be in pain, and infection will be an ongoing issue.

Again, great effort. You should have a clue pretty soon if the news is good. The main thing is to end up with one good leg with at least two toes.

Interesting sidelight is birds use the blood supply to the feet to regulate body temperature: in winter they cut off the blood flow to the feet to conserve body heat, and in summer they increase blood flow to the toes to cool - so your bird is actually OK in winter.

[This message has been edited by dano7 (edited May 21, 2004).]


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## Lin Hansen (Jan 9, 2004)

Julianne,

***** BRAVO *****

God bless you and all the others who gave you the advice and instructions on how to help this bird....I do not think I would ever have the courage to do it..

Again, KUDOS, and best wishes

Linda


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## Jules (Nov 28, 2003)

Have started him on Chlor palm 250 liquid and will change dressing tomorrow morning to a water resistant rolled gauze to keep it dry.


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## Nooti (Mar 14, 2002)

Yes, I emailed you asking if you could assess the situation & offer any advice.
It certainly wasn't meant to sound like this was a life threatening situation.

*********************
Sorry Cindy - was having a little joke there!


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## Whitefeather (Sep 2, 2002)

Not a problem Helen.
Cindy


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## Feefo (Feb 8, 2002)

Excellent job Julianne!!!!

I bet you are relieved now but that is nothing compared to the relief that you have brought this poor pigeon!

When I did Ravenclaw his feet got very hot as soon as all the thread was removed, I assume that was due to the increased blood flow. Keep rubbing in Bach Rescue Remedy (3 times a day) to soothe and restore! Believe me, it helps a lot! I have done so many foot repairs but Ravenclaw is the first I have treated with the cream and he has made the best recovery so far.

If there is yellowing of the feet and swelling he will need antibiotics to clear the infection, preferably Clavamox (?) (Amoxycillin and Clavulanic Acid). I use the 50 mg tablets, cut them into quarters and give a quarter of a tablet orally a day. Helen says that you can use up to twice that dose but it should not be used in conjunction with tetracycline, erythromycin and chloramphenicol.

Cynthia


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## Whitefeather (Sep 2, 2002)

How is your little patient doing this morning Julianne?
Cindy


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## Jules (Nov 28, 2003)

So far...so good. Fiesty, hungry & his foot seems a little cooler to the touch.
When I changed the dressing the wounds appeared clean and dry and healing over.
I'll tell you, I sure thought that thread went straight through the little guy's foot.
Even feeling a tad foolish for thinking that. *doh*


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## Feefo (Feb 8, 2002)

No need at all to feel foolish! You described exactly what you saw and later exactly what you did to resolve the problem. That will be of tremendous help to members who are faced with the same problem and there will be plenty of those in the future!

There is nothing like a first hand and honest description of a real life situation to help and encourage others facing the same circumstances.


Cynthia


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## KIPPY (Dec 18, 2003)

Julianne,
i think you did a great job. i would have freaked out and then made a phone call.
all that matters is this guy is doing better then he was.

Kim


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## dano7 (Feb 10, 2004)

If the string is gone and the tissue is not critically damaged you will see some walking by tomorrow - hope so - you deserve some good news


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## Jules (Nov 28, 2003)

Let's hope so. I have him in a box right now to limit his movements. Tomorrow after I change the dressing, I'll transfer him to one of the cages.


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