# Injured Feral. Wounds Under Wing



## amyable (Jul 7, 2007)

I've brought another feral home today from the 'sanctuary' where it's been for the last two weeks.
When it first came in it just sat in a corner, but over the last two weeks seemed to be getting stronger and even managing to flutter up to sit on the top of a door to the shelter. While I was cleaning out the water bowls today it was helicoptering and I noticed it looked a bit dark under it's wing.
When I caught it and had a look, I found very large black crusty wound and so decided to kidnap it and bring it home to have a closer look.
It turns out there are at least two wounds but they must be at least two weeks old. I've bathed them a bit and plucked away the feathers around them. The black seems to be dried blood, but the area under this wing is very hot compared to the other, so there must be an infection going on under there.

Can you advise me on meds as I don't know which would be best. I have 50 mg Synulox or Baytril that Cynthia sent me for a previous bird. What would be best and is there anything else I should do with a wound this old or be looking for?

Thanks

Janet


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## Pidgey (May 20, 2005)

They don't usually get a fever with an infection. Use a human thermometer to check the temperature of the area by holding the wing down over the bulb and giving it a few minutes. It should be about 107-ish to be normal.

Pidgey


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## TheSnipes (Apr 9, 2007)

I am no wound expert but the wounded bird that I have been tending was put on baytril, and also trimethaprim/sulfa by the vet. the latter because it supposedly is good at penetrating into deeper tissue (muscle, bone).

I would sure use the baytril at least, since it seems there is something going on.

Also...the wound on the bird I had was similarly crusty and dried, and the vet cleaned all that scabby crust off. It does sort of reopen the wound but it was necessary to get at it so it can be cleansed and treated with some topical antibiotic ointment.

Is there any vet that could give you a hand figuring out what to do, or in debriding the wound(s) if need be?


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## amyable (Jul 7, 2007)

Hi,

Pidgey, unfortunately I don't have a conventional thermometer, I'll go get one tomorrow though. It was very noticable when I put my hand under each wing how hot it felt in comparison.

Snipes, Hi,
Yes I should probably try the vets. The last time I took a pigeon with a crop injury to them they just told me to bathe it and didn't give me any meds. Fortunately Cynthia sent me some. I am worried about the depth of the wound though and it's quite a large area for a bite wound. I just thought I'd better start it on something asap.


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## Pidgey (May 20, 2005)

Well, usually you've got feathers in the way and you'd said something about clearing the feathers off the bad side. That'd make it feel warmer than the other side.

Pidgey


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## amyable (Jul 7, 2007)

*Spooky*

Pidgey, you're just too clever!
I have just gone back to bathe it again and realise just that. You are quite right!!!


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## Feefo (Feb 8, 2002)

Hi Janet,

I prefer Synulox to Baytril for deep wounds as Baytril isn't very good with anaerobic bacteria. I would give 1/2 tablet of Synulox twice a day.

Remove all the feathers from the area surrounding the wound with sterilised tweezers . It would also benefit the pigeon if you would remove all the scabbing and flush the wound with sterile saline. They sell quite big bottles of that in Boots. Try to do that once a day

After the daily clean you could smear Intrasite gel over the wound, that will keep it clean and moist. 

Have a good look at the wound once it is cleaned to see whether there is a bone protruding. If there is that might need filing or trimming back (by a vet) before the wound will heal.

Cynthia



Let me know how you are doing for meds.

Cynthia


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## amyable (Jul 7, 2007)

Hi Cynthia,

Thanks Cynthia, (didn't want to phone you this late in the evening!).
I'm quite nervous about pulling this big scab off, it feels quite deep and very hard underneath.
I'll do the smaller one first and see how that looks. I'll get some Intrasite tomorow. I have Colloidal Silver in my box of tricks now aswell as the saline. Would that be any help to put on aswell?

I have 8 Synulox at the moment, I'll check back to Angel's thread, the white pigeon I had to remind me how long she was on it. That may not be enough.

I've posted a couple of pictures of the wounds.


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## Pidgey (May 20, 2005)

It's kinda' irritating sometimes--you need the flash function in order to see detail, but flash photography "flattens" the subject matter such that's it's often difficult to get perspective. I'm having a real hard time of figuring out exactly where that is. Don't suppose you could post the rest of the picture or more of the bird around the wound? It doesn't look infected, though.

Pidgey


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## kittypaws (Sep 18, 2005)

Hi Amy,

If you have Antirobe available, you could give him 25mg twice a day - where I am working we are currently giving a pigeon with a badly infected wing this particular antibiotic. Not very nice meds though as in a capsule and you have to push the capsule down his throat - alternatively you could empty the contents of the capsule into a syringe and gavage with some water or rehydration fluid - I would repeat this for at least five days ( twice a day) as well as daily woundcare applying in this case some Fuciderm or if there is a hole, intrasite gel.

Tania xx


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## amyable (Jul 7, 2007)

Hi Tania,
I have some Synulox that Cynthia sent me previously, I started it on last night.
Is the Fuciderm something I can buy over the counter. I am going to try and get some Intracite today anyway to keep on hand as the crusty bit seems quite deep so it might have a hole under there.
I am going to try and get the scab off the smaller wound that's higher up first to see what's under there.
Thanks for your help.

Pidgey, will get a better picture later. When I zoomed in on the picture later the skin did look nice and pink around the edge, so hopefully is the same underneath.
I'll bathe it some more today and see if I can get the hard lump off.

Janet


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## kittypaws (Sep 18, 2005)

Hi Janet,

I'm not sure if you can buy Fuciderm over the counter - if you are going to apply Intrasite then you don't need to do the Fuciderm. 

I guess best to ask at a chemist/vet if they have something similar. It is an aqueous gel containing Fusidic Acid and Betamethasone.

Synolux is good. I would give a pigeon 10mg twice a day again for 5 days whilst you are treating the infection.

Tania x


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## amyable (Jul 7, 2007)

Thanks Tania,
I'll just ask the vets, but I don't have much luck with getting meds around here.
I'm keen to try and get things on hand in case of emergencies, so it's good to have some names of things and what they are used for.
I've just had a couple of calls today to see if I can take on a baby Starling with a cat bite injury and a duckling to rear, things seem to snowball once you take on one.

Thanks again,

Janet


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## Feefo (Feb 8, 2002)

The Synulox is in tablet form, so we (I include Hallswood in this) give either 12.5 mg BID (1/4 tablet twice daily) or 25 mg BID (half a tablet). We reserve the 25mg a day dose for severe infections or larger pigeons.

According to Nooti the recommended dose for Synulox is _125mgs per kilo TID (three times daily) orally- up to 3 weeks. Dose and dosing interval determined by infection site, severity and organism involved._

The flesh around the scab looks healthy, but I would still remove the scab to ensure that there isn't a tracking abscess underneath it and to ensure that the wound heals from within. 

I have some antirobe somewhere (it was prescribed for Joan's cat), but that is old and comes in small pilules that would make measuring a dose difficult.

Cynthia


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## amyable (Jul 7, 2007)

Hi Cynthia,
I was just about to contact you about the dosage.
I was checking back to the white pigeon thread as that seems very much like this wound and I was giving 1/4 of 50gm twice daily of Synulox for that.
That's why I thought the tablets might not be enough as originally I was estimating usage at 1/2 tablet twice a day last night.

I'll carry on as you suggested with 1/4 twice daily.
I was going to ask the vets about the Fuciderm but hopefully if I can get Intecite I'll use that.

thanks

Janet


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## amyable (Jul 7, 2007)

This is where the wounds are. I'd taken a bit of the scab off on the edge.









I took off the smaller scab first right under the wing, to see what was underneath. There is a small hole left.
Then I took a deep breath and tried to loosen the large scab. I was really surprised at how deep the hole was. As I started to lift it out I stopped to take a picture. I really wasn't sure if I should be doing this and thought I'd better check with someone first!









Anyway I carried on and this is what came out, it is about 5cm long and not a solid chunk as I'd expected. There is still some more in there which I couldn't get. It is very deep. I spoke to Cynthia to see what she thought I should do next as I can't see how much further the hole goes. She thought it best leave it be for now.
The poor darling was so good and just sat there on my lap, wincing occasionally, such a sweetheart, I'm giving him/her a good rest for now. 









[/I]


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## Pidgey (May 20, 2005)

Seen a million things like that. Give or take a dozen. Anyhow, the holes tend to close surprisingly rapidly when you pull the crap out. Ideally, of course, you want to get it all out because if it seals in, it can become a nidus of infection that they can't get rid of. The body will try to form a granuloma around it, of course. I've had to dig in as much as two to three centimeters inside just grabbing the stuff and bringing it out. And then flushing with body-temperature saline. Sometimes, you gotta' repeat the performance until tissue granulates into the cavity and epithelializes. You'd almost think this guy got something jammed in there that dragged in feathers and all, like a BB or pellet wound.

Pidgey


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## TheSnipes (Apr 9, 2007)

Everything in that 2nd picture looks very slimy and unhealthy, good on you for getting that gunk out of there! It is an ugly, amorphous blob of YUCK. I hope you can get the rest of it out of the poor guy. It sure sounds like he knows you are there to help him, what a smart bird.


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## Feefo (Feb 8, 2002)

Hi Janet,

I would't poke around in the wound just yet, now that it is open and being cleaned with saline and dressed with Intrasite there is the possibility that the remaining gunk will rise to the surface as it would have if the wound had not scabbed over. Poking could make things worse. But you will have to remove any scabbing daily.

I think that the Les Stocker book that you have describes the healing process and how to help it along.

Cynthia


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## amyable (Jul 7, 2007)

*Yuck!*

Hi Snipes, I couldn't have put it better. When I asked my daughter to take the picture for me while I held the bird, she just shut her eyes and hoped she'd pointed the camera in the right direction. (she hadn't, so had to do it myself). Got no stomach these younguns!!!!!!!!

Sorry, I just looked at it myself and didn't realise how graphic it was, should have put a warning sign on for the queazy!


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## amyable (Jul 7, 2007)

Hi Cynthia,

Does that plug look anything like the tracking abcess you had before?

Janet


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## Feefo (Feb 8, 2002)

Hi Janet,

The plug that I took out of Little Red Feet was solid, but the wound was a lot older and I didn't look into the hole to see what else was there further down - this was in my early days of rescue, after that I learnt to keep the wound open and allow it to heal from within, I haven't had any tracking abscesses since then.

I put Little Red Feet on Synulox, then flushed the wound and debrided it daily until it healed properly from the inside.

Cynthia


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## TheSnipes (Apr 9, 2007)

What's a "tracking abscess?" Or do i just need to read farther back in this thread?


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## Feefo (Feb 8, 2002)

> What's a "tracking abscess?"


When an infection is sealed in then an abscess can form and create its own drainage track, that is when it becomes a "tracking" abscess.

Cynthia


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## TheSnipes (Apr 9, 2007)

cyro51 said:


> When an infection is sealed in then an abscess can form and create its own drainage track, that is when it becomes a "tracking" abscess.
> 
> Cynthia


Double yuck! Then...it can drain to..anywhere? I can't envision where an abscess 'knows' what direction to drain, so it leads inward rather than out?


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## Feefo (Feb 8, 2002)

As far as I remember it follows the route of least resistance. 

Cynthia


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## TheSnipes (Apr 9, 2007)

cyro51 said:


> As far as I remember it follows the route of least resistance.
> 
> Cynthia


That could be like a along a blood vessel, or ?? like I said, maybe inward rather than out. Not a good thing in any case. Well it's very interesting, and educational to read about this.


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## Feefo (Feb 8, 2002)

Janet, I know I have asked you this before, but would the vet treat this one as a pet and give you a consultation? I couldn't get off to sleep last night for worrying about it.

I really think that trying to clean out the the remaining gunk without the proper tools or painkillers and without knowing how deep it tracks, would be invasive and extremely painful for the pigeon.

Cynthia


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## amyable (Jul 7, 2007)

Hi Cynthia,

I've just been reading a previous thread that you posted for my last white pigeon regarding a tracking abcess. I did take that bird to the vet but didn't have much joy. It didn't have such a deep hole though as this one.
I will take it in and ask.
They will no doubt ask me to leave the bird with them as usual for the day but as long as they agree for me to have it back then that's what I'll have to do if they won't give me an appointment.
I'm just going to have a look at it myself before hand with my 20x magnifier. It was too dark last night. It shows up very close and I hope I can see how far it goes in.

I'll report back in a mo.

Janet


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## amyable (Jul 7, 2007)

I've just had another look and feel of the wound area.
The opening of the hole looks a bit smaller today and around the edge is a lot softer than it was. Can't see right in unfortunately, too dark, but flushed it with saline and gave a slight squeeze and some bits of tissue and pinkish blood came out. Where I could see, I picked out a bit with tweezers, it isn't coming out black this time.
Has got a slight smell not too over powering.
I'd say it was better and just maybe the flushing is helping but I probably would be best popping it to the vets to put my mind at ease.
Have given him half of Synulox this morning.

Janet


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## Feefo (Feb 8, 2002)

Hi Janet,

If you go to the vet can you ask them to sell you a small bottle of Metacam? It is always such a comfort to have a painkiller for pigeons when needed.

Cynthia


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## Pidgey (May 20, 2005)

If you've got any antibiotic ointment, you could pack some in there. I hate for them to have any kind of an odor emanating from such a hole although he might have it in the feathers around the wound from before.

Incidentally, I took my Pierpont in for the vet to do the same thing and discovered that my vet was far more heavy-handed cleaning those types of wounds out than I was, and no local anaesthetic, either. That's one of those deals where one vet's going to better and another's likely to be worse. Anymore, I do it myself if I think it's straightforward because I'm a helluva' lot kinder to the bird because I'm not constrained by "time-is-money".

I will say, though, that such a deep wound on this guy is in a very odd place. Do you have a sense of whether the hole goes straight in or does it track to the left/right? The corresponding hole on the web of flesh between the true wrist and the shoulder looks like it was in the way when whatever made the pierce was thrust in. In the top picture where you're holding the wing up, the tip of your middle finger is just about on the shoulder with the actual wound slightly below and behind. Now, the rib cage is under there somewhere and so are the muscles and tendons that pull the wing down in the power stroke. 

The picture just under that one is basically a close up that's rotated ~90 degrees counterclockwise. You can see the feather shafts that were to the left of the wound in the top picture. When you were pulling the thing out, did you manage to get a sense of which direction it pulled out from? Can you describe it with reference to the top picture? 

Pidgey


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## amyable (Jul 7, 2007)

I did spray some Coloidal silver into the hole. I've just been looking for what I might have. I do have some 30% and 40% volume peroxide that I have from hairdressing days which I could dilute, isn't that good for cleansing?
Or antiseptic wound spray, or Savlon cream.


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## Pidgey (May 20, 2005)

I'd probably go with the silver, actually.

Pidgey


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## amyable (Jul 7, 2007)

Pidgey, the wound goes narrower and tapers toward my thumb in the first picture.


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## Pidgey (May 20, 2005)

It'd be better than going straight in through the rib cage.

Pidgey


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## amyable (Jul 7, 2007)

I managed to get an actual appointment this time with a vet so was able to go in and see him with the bird which was great.
I showed him the pictures and also took what came out of the wound for him to see. 
He said it was necrotic debris and took a good look into the wound with a light and magnifier so could see much better that I ever could.
He reckoned it didn't look infected any more and the remaining necrotic stuff would gradually come away with flushing. He said it was the right thing to have taken it out which was good.
I asked about the possibility of a tracking abcess and he couldn't see any evidence of one, which was a relief.
So he said to continue with the flushing and expect to see some more stuff come away and could use the Intracite gel to help with the debridement just for a short while. If I see anything else that makes me think there is an infection starting up then to go back in and he will give me antibiotics. He said it might be better not to give him any at the moment as that in itself might set up a different problem if he becomes immune to them. ( I didn't tell him he was on Synulox).
The wound might have entered the muscle slightly due to the direction of the
entry which unfortunately might affect his flying slightly with that one wing.
He does flutter and can get up high in short bursts and uses his wing but I was surprised the other day as he escaped from the aviary briefly, and even when I was chasing him, he didn't attempt to fly at all. I'll have to take him back to the 'sanctuary' when he's better as much as I hate the thought so I can see if he does manage to fly once this is healed before thinking about whether he can be realeased.

By the way the vet seemed to think it was originally a bite wound but the hole had got so much bigger due to the initial infection and the amount of necrotic tissue building up in it. 

So for now I'll carry on with the treatment and see how it heals.
Any thoughts as to whether to carry on with the antibiotics though?

Janet


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## Pidgey (May 20, 2005)

I sorta' doubt that you need to continue with antibiotics. When they get to the point you're describing, simple debriding and saline flushes are pretty good. My vet originally told me that you don't have to worry very much with birds getting skin infections. We worry more about systemic infections in them like the Pasteurella but that worry's long over with this guy.

Pidgey


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## Feefo (Feb 8, 2002)

Hi Janet,

Thanks for the update, you have produced some really interesting information and photographs which will be useful references in the future.

I believe in finishing an antibiotic course once it is started, to avoid the risk of helping create resistant bacteria. I think that the shortest course for Synulox is 5 days.

Cynthia


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## amyable (Jul 7, 2007)

Hi Cynthia, Thanks for the meds, they arrived safely. Will carry on for another three days to make sure then.
The wound had closed up quite a bit this morning, but not inside so have done a flush and I think it looks ok.
Poor sole is quite wary of me at the moment so I've put him in a large cage on the other side of the potting shed to Danni so he can see him but not touch. I hope this is ok.
He's eating and pooping ok so I feel much more settled about him now.

Thanks so for much for all the help, and to Pidgey. will keep you posted on his/her progress. Don't know why I call it him, I have no idea really what it is so haven't come up with a name yet, apart from sweetheart, which they all are. 

Janet


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## chriss80 (May 6, 2007)

All the best wishes for this pigeon, if in need of baytril I have a small bit left that I can send.


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## philodice (Sep 30, 2007)

This is one of the harder threads to read and look at on this forum. Sometimes the hardest ones to not pull away from (yuck) are the most educational. I wonder if there is a BB somewhere inside this poor bird, even though there can't be that is what it looks like for all the world.

I wouldn't go with peroxide on a wound that is more than superficial. Peroxide can actually damage healthy, newly growing and healing cells internally. (Medical Journal, 1995) During surgeries they wash with saline solution. I would continue to wash with silver, no creams or stuff. Those first aid items aren't meant for intrusive body cavity application. Some advanced hospitals will use natural honey instead, even on deep infected wounds, or abscesses caused by staph.
Put silver in the drinking water. You might put a drop of Neem oil in the washing water and in the drinking water. Neem actually reduces swelling and dissolves puss, kills infections, worms, gently. Birds can't deal with swelling and infection the same way we can. They can hold up so well, bounce back from almost anything, but when swelling starts due to bacterial or protozoan colonization it seems that is what really gets them. (canker, bumblefoot)


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## amyable (Jul 7, 2007)

That's really interesting info, thanks Philodice. I've learned a lot from dealing with this injury so far, and knowing what to use in what situation is good. Helps to give you the confidence to try to help.
The Neem sounds incredibly useful, I have got some Manuka Honey which Cynthia mentioned was worth having in. I did wonder about using that. I haven't had anything I needed it for since I bought it and I'm afraid I've got to liking it on toast, an expensive luxury!!
I sprayed the wound with Silver again tonight and packed it with the Intracite Gel which the vet said was good for debriding. Canary Jayne first told me about Intracite a while ago, something else I hadn't heard of before. Having these items on hand means at least you have a fair chance of being able to deal with something quickly that comes your way.

I really hope there isn't anything inside him, I just think that although the vet said it looked like an enlarged cat bite, I would have thought a bite would have gone in at a slightly straighter angle as opposed to a forward direction, as this wound goes.

Thanks for the input.

Janet


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## Feefo (Feb 8, 2002)

> I'm afraid I've got to liking it on toast, an expensive luxury!!


LOL, Janet!!!! But even so, it would be more than a luxury as I think it is good for you.

Les (A Wing and a Prayer) swears by Mauka Honey for healing wounds.

I don't think it would be a BB gun because of there being two wounds so close together, and one shallower than the other. But if it was, then unless it was lodged somewhere in the digestive tract, it would be left inside.

Cynthia


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## philodice (Sep 30, 2007)

I just read in another thread about diluting the peroxide to a 1/10 solution (90% water purified) and totally slapped my forehead. duh, of course you can diluted it instead!
And why didn't I also think of Stevia extract, just the best dressing for deep wounds that I can think of beside Neem or that honey. And how will you keep the bird from tasting himself with all that on him? 
You follow too much of my advice he'll start smelling like Dim Sum.


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## amyable (Jul 7, 2007)

Stevia Extract, now that's a new one to me, I haven't heard of that.

I think that's where I read in a thread about diluting peroxide.
I'd still be a little wary of using it as I have two strengths at home and so it is would be hard to know if I had got the dilution correct and would take the risk of damaging the tissue. Honey sounds like a much 'sweeter' way to treat him.

Janet


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## TheSnipes (Apr 9, 2007)

I wonder, does anyone know if 'intracite' is sold in the US and under what name?

I am going to have to get some of this Neem oil to have on hand. However...I can't picture putting honey in a wound? Very intriguing.

That bird's wounds look very like what my Mooch had when she was rescued from a hawk. Enormous wound under her wing, in the same spot, as your bird's larger hole. I only have seen it as a healed wound, tho. It left a large divit.


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## Feefo (Feb 8, 2002)

> I wonder, does anyone know if 'intracite' is sold in the US and under what name?


As far as I can make out it is called IntraSite in the US. 

http://global.smith-nephew.com/us/INTRASITE_HYDROGEL_DRESSG_7260.htm


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## amyable (Jul 7, 2007)

Hi Snipes, Do you know how long it took Mooch's wound to heal over?

I've got what I think is the last bit of necrotic tissue out of the wound today.
It looked to be about the size of the piece I couldn't get hold of when I took the main plug out.
I used the Intracite for the first two days but have in fact used the Manuka Honey for the last two.
The wound still looks as large as it did initially but hopefully now it will be able to heal better.
I might carry on with the Intracite for a few more days to make sure it's as clean as possible in there.

I've put 'Charlie Farley', as he seems to be called at the moment, in the potting shed during the day now with Danni, so they both have company and can have a fly.

It's funny they seemed really pleased to see each other and spent ages preening initially. Danni always likes to sit on a shelf at the top of the shed. When Charlie went in, he flew straight up to the shelf and Danni was demoted to the next perch down. Then Danni decided he wanted his place back, so returned, then Charlie moved down. They mostly sit on separate perches and I although Danni seems to want to be friends and shuffles over to sit by him, there isn't much coming back from Charlie, although no hostility. I assume they must be the same sex, whatever that might be! 

Janet


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## Feefo (Feb 8, 2002)

Hi Janet,

That is good news!

My Delorious and her friend Holly seem to have the same relationship as Danni and Charlie. They seem to appreciate having another pigeon around.

Cynthia


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## amyable (Jul 7, 2007)

I don't know if this wound is going ok, hopefully it is. I am still flushing it twice a day and putting Manuka Honey in the hole. Since I got that last bit of gunk out, have just assumed it would start to heal up.
It looks as if it is, as the outer edge has closed in somewhat. However, when I bathe it, I can see the hole is the same.
Today I saw a small tissue like dot and decided to just pick it out to keep the hole clear. Don't cringe when I say I used a crochet hook instead of a pair of tweezers. It has a blunt end, so can't pearce the skin, and has a tiny hook. It worked well, so well in fact as when I picked at this small piece, I actually pulled another lump of 'gunk' out. So there is still more in there and so the hole is just as deep as before.

I don't know if I can explain myself well enough for anyone to understand, but I'll try. The edge of the wound is rounded, as opposed to jagged as a new wound would be like. It's a though the wound has healed around the edge when the black necrotic tissue was jammed in the wound. Maybe the skin has healed up around the stuff that was blocking the hole, does that make sense?
Do you think as this wound is old and quite deep that it will ever fill in and heal up to the surface, filling the gap, or is it possible that surface skin will just heal over, leaving a permanent hole underneath? 

I am assuming that I still have to try and stop the top from healing over while there is still a hole in his body.

I also started him back on to Synulox as it was bleeding very slightly, is that ok? I've bathed it, sprayed antiseptic wound spray into the hole, and also put Intracite Gel in it again tonight.

Thanks, Janet


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## Feefo (Feb 8, 2002)

Hi Janet,

The crochet hook was an excellent idea, just make certain that it is sterilised before you use it, "just in case".

I can only go by Little Red Feet's experience, the hole that the removal of the necrotic plug left was as thick and as long as the top portion of my thumb, but new healthy tissue started to build up at the bottom of the wound once it was clear of necrotic tissue. Her wound was at least a month old when I removed the plug. "Gunk" will continue to surface at the bottom of the hole until the wound is clean.

Synulox is OK, just remember to complete the course.

Cynthia


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## amyable (Jul 7, 2007)

I have just got another small piece of muck out.

Cynthia, the hole isn't as large as Little Red Feet's by the sound of it, it might be better if it was then it would make it easier to see when it is finally clean. Unfortunately the outside of the wound is now a slim line but once inside it goes wider, so I have to very gently probe with the hook to see if anything comes away. Of course when I thought I'd found the end of the hole before, I was probably still hitting the solid muck.
So really as long as muck is coming out I shouldn't expect it to heal then.

I'll keep at it though and treat the Synulox as if it's a new course, thanks.

Janet


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## Pidgey (May 20, 2005)

Yes, it won't completely heal until the garbage is out. I've had to do some of those like that with forceps and an otoscope to see inside. I figure that I'm doing the bird a favor when I do it because both my vets are a tad on the heavy-handed side due to time being money.

Pidgey


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## amyable (Jul 7, 2007)

I wonder if anyone can say how long it should take roughly for a hole like this pigeon had to heal up from inside. It seems to be taking longer than I expected.

I'm fairly sure there can't be any gunk in there now but at it's worst the hole went in at least 3cms.
I have been bathing and putting in the Intracite Gel each day, and taking off the scab from the surface. It did appear to be almost healed over a few days ago but today I can see a gap still around the edge of the wound. It goes in about 1cm deep now. I was just wondering if I should leave it well alone now or if I need to keep the debriding up until the hole is completely full.

Hope this question makes sense, I didn't know what would happen if it healed over with a small hole still evident.


Janet


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## Pidgey (May 20, 2005)

You might try defining the size of the thing in terms of the volume of something tangible like a grape, a raisin... something that's the same everywhere. Eventually, Pierpont's hole became like a tiny navel that had its own dry epithelium. I just let it go. You might just let this one scab over and handle itself for awhile to see how it does. You're always worrying that it'll make a tracking abscess but at this late date, I wouldn't be as worried about that. Picture?

Pidgey


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## amyable (Jul 7, 2007)

Hi Pidgey,

Just went to get a new picture. There is a hard white something running through the middle of the hole, almost bone like hardness as opposed to tissue or skin that would have some give in it. You might just see it on the picture. Any idea what would be there under the skin at that point. It hasn't always been there, it appeared the last week I would say.

Size wise, this is difficult, I would compare the hole now to a small raisin, (I've just eaten half a box while comparing the sizes which all vary somewhat). The hole is approx 1/2cm in depth, 1cm long. It really looked much more healed a couple of days ago, but today it looks a bit red. That's why I'm wondering if I should have left it alone.

Appreciate you may not be able to say much from my garbled description but here's the photo anyway. Thanks


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## amyable (Jul 7, 2007)

*Worried it's not healing right.*

I've left the wound well alone for the last few days as I thought it should just finish off and fill in.
I've just looked to see how it's going and it looks strange.
The last picture I posted shows the hole but I said there was a hard white something in the middle. Now the hole is filled by this hard 'whatever' but there is still a gap around it. (The hole looks like the last picture but is filled by this stuff).
Am I looking at a possible tracking abscess?
I got my tweezers and picked a piece out and looking at it under a magnifying glass, it is like yellow coloured tissue maybe, but hard. It goes deep so I'm thinking it might go in as far as the initial wound did.
How do I treat it if it is an abscess, I know my vet wouldn't operate so I don't know whether I should let him have a look. 
I wondered if I kept picking it out from the top, a bit of a time, would it work it's way up?


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## Pidgey (May 20, 2005)

Well, I'm sorry that I didn't see your earlier picture. Threads can get buried here pretty quickly anymore, it seems. That stuff is kinda' like... scab material, only a lot whiter. Say this mantra over and over to yourself: "Avian heterophils lack a proteinase necessary to liquify necrotic tissue." That means that they can't haul off certain garbage as well as we can and some debris can form objects that they can only try to form a granuloma around. I can tell you what my vet would do--he'd reach in with a straight hemostat or some very rugged forceps and drag the thing out by main force. Without an anaesthetic. I've seen him do it. Several times.

If you want to give that a shot, go ahead. I've usually tried to be a little less heavy handed, using lighter and more slender forceps to reach in and pull crap like that out in more manageable pieces. It often requires the use of an otoscope, head-mounted magnifier with light, jeweler's loup & flashlight or something like that to actually see what you're doing. You can irrigate it with saline and keep it that way to soften the debris up. Bottom line, though, is that it pretty much has to come out before the hole will finally fill in and seal off.

Pidgey


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## amyable (Jul 7, 2007)

Funny I had a feeling that's what you were going to suggest.
I did have a go with a medical pair of tweezers, long and thin, this stuff does seem to be stuck in very hard. I'll try softening first as it goes in at least 3cms but unfortunately narrows, and it goes forward into the chest, pretty well impossible to see the end.
I'm gutted as I have been debriding it every day and packing it with gel, I could have sworn it was clear.

Thanks, will give it a go. This could be a time to use Metacam.


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## Pidgey (May 20, 2005)

"Packing it with gel"? Hydrocolloid gel? That stuff hardens into dried glue in pocket wounds--I know, as I've "been there, done that."

Pidgey


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## chriss80 (May 6, 2007)

3 centimetres? That is quite deep! Isn’t there something that can put in that wound and then wash it after a while that will kill microbes that might be lurking in there and stop the healing of the wound. Just a thought.


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## Feefo (Feb 8, 2002)

> "Packing it with gel"? Hydrocolloid gel? That stuff hardens into dried glue in pocket wounds--I know, as I've "been there, done that."


I am sorry that your experience with hydrocolloid gel has been so unsuccessful, Pidgey. I use Intrasite gel, which I think is what Janet is using and it has never hardened into glue.

I am not the only one that has used it successfully. 

From Avian Wound Management:

_The wounds, including a puncture wound over the lower back, were packed with a hydrogel and dressed with a thin hydrocolloid dressing. _

From the chapter on "The treatment of wounds" , Practical Wildlife Care by Les Stocker:

_The aim of all wound dressings is to keep the wound in a moist condition so that any necrotic material can be easily removed either by the body's natural process or by further sessions of lavage. ..the types of suitable dressing for this debridement phase are:

Hydrogels

Intrasite Gel (Smith & Nephew - a convenient hydrogel in a re-sealable tube)...

These primary dressings will cover and keep the wound moist to aid debridement. They should be changed daily or every second day and 
will clean the wound without damaging healthy tissue._

A propos of nothing that has been said here, Les Stocker has also something interesting to say about the application of topical antibiotics and some other wound management practices:

" Much is written about adding antibiotics directly to the wound. Generally topical antibiotics may be effective during the first few hours but after that their use is pointless. Targeted systematic antibiotics are the only treatment that will be effective...there are some practices which are contraindicated in wound management. Powders of any sort should not be used in wounds except where maggots are present in large animals. Antiseptics and disinfectants, unless proven, cant be cytoxic to healthy cells in a wound. Povidine-iodine for cleaning is ineffective as it is de-activated by any debris. Wounds should not be mechanically scrubbed with swabs or cotton wool."

Cynthia


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## amyable (Jul 7, 2007)

Hi,
Just to confirm what Cynthia thought, it is Intracite Gel I've been using, sorry I should have put it in full.

It seems the wound stayed moist all the time I was using the gel, this hard matter appeared to form once I left it to hopefully heal.

I've just been bathing it with warm saline and picking out a bit more necrotic, but it is bleeding slightly so I've sprayed it with silver and put some more gel in, will leave it alone again for a couple of days. He's had a drop of Metacam too.

Christina,
If anyone knows of anything like that I'd think it would be ideal. I just can't see what's at the end, or even where it is.
I may have to try and see the vet he saw before and ask him if he'll have a look. Not got much faith in him though as when he looked before with his magnifier and light, he told me that he didn't think there was any more necrotic in there. Two days later I got some more out.

Ooh, I don't like this, it was all going so well.


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## Pidgey (May 20, 2005)

I'd used mine in either Pierpont or DD, can't remember which. In the healing process, they'd both developed pockets, where there was a hole about 1/4" big with a space inside that you could have stuffed a small grape, were the hole big enough. I pumped the stuff in there and eventually had to work it out as a very hardened piece like dried model airplane glue. Apparently, if the lining of a pocket wound is sealed off so that it's not constantly creating moisture, that stuff just might dry down. I expect it's like silica gel and will absorb water. If there isn't enough available locally, then perhaps it dries down like what I ended up with. And if the opening to the pocket heals down pretty small, you can really end up with a rough time getting it back out. I want to say that the stuff I used was DuoDERM Hydrocolloid Gel. Is that the same stuff?

Pidgey


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## amyable (Jul 7, 2007)

The Intracite I get is from a pharmacy, that's what it's called here. Comes in a sterile white cone. I notice just after I've put it in the wound it seems to almost disappear, seems to stay moist with the warmth of the body.

I've just been reading about Hydrocolloid, and obviously it is used for debridement aswell but it isn't the same product as Intracite. I notice it states that it's waterproof, maybe a thicker consistency. Don't know to be honest if the formula is the same.

It'll be interesting to see if this hardens up again in the wound if I don't bathe it for a couple of days.


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## amyable (Jul 7, 2007)

I have been keeping an eye on this wound for the last few days and not actually doing anything with it as it just doesn't seem to be healing up totally inside. I thought maybe I was stopping it by keep bathing it.

Pidgey I do wonder if the gel was what was going hard inside the pocket after all as I haven't used it for a few days and it hasn't got this hard stuff in any more. I have just been putting Manuka Honey on it.
I think this is now like the wound you described before in the last but one post about Pierpont or DD. You said if the lining of the wound is sealed off it might not be producing moisture, and that is what I think is going on here. All the way through the initial days of bathing the wound the gel was no problem as I was still getting necrotic matter out.
I do wonder if there is something still in there stopping it healing but I can't see and I just can't put him through anymore intrusive debriding as I don't get any more black necrotic out now. 
Is there any way to at least get the outside to heal together, at the moment basically there is still a small hole in his side.
The slit in the skin is small but it opens up into a small pocket inside. If the edge of the inside has hardened off is this ever likely to fill in as I imagine it needs to be rough skin to knit together now, if you get my drift!

If not I apologise! 

Janet


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## Pidgey (May 20, 2005)

Well, it might never heal closed if there's something still in there that the body can't push out. It's kind of a bad place, too, seeing as how that's where the working muscles are for the downstroke. That's why I use an otoscope for those kinds of things--to see what's going on deep in those kinds of wounds. I hate 'em when they get that deep and almost closed off! You're a lot better off to keep them cleaned out at the bottom so that they'll heal up more and more shallow.

Pidgey


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## amyable (Jul 7, 2007)

Charlie really got me worried today. I have been leaving the hole alone for a few days to see what came of it naturally as he was getting very agitated by me trying to clean it out every day.
I had treated him with Feather Drop just as a precaution against mites etc yesterday. Today when I went down to see him he was very wet. Initially I was pleased as he'd had a bath, the first one I've seen him take.

The only trouble he was acting very strangely. He kept running up and down his ramp and perches sideways. He kept falling backwards off his perch aswell, stretching out his wings to balance but not managing to keep up. He was very frightened and didn't try to get away when I picked him up, even snuggled into my hand and stayed there for ages panting.
He was holding the wing up slightly that the wound is under and lifting his leg up higher than normal as he walked.

I took him inside and had a look at the wound, got some more scabby bits out of it, again he didn't even try and get away like normal. I kept him in a smaller cage for a few hours to settle down.
He's back outside now with Danni and seems to be ok now he's dried out.

I have no idea what caused him to act like that, it was if he was trying to get away from his wound or something by walking backwards. Maybe just frightened of being wet, I just don't know. I'm just glad he's settled down again poor soul.


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## Pidgey (May 20, 2005)

Is he currently on any antibiotics? If not, how long has it been? And how hot is it there?

Pidgey


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## amyable (Jul 7, 2007)

I had him on Synulox again for six days last week finishing Wednesday just.

It's not very hot here, every day differs at the moment. Today was around
17c daytime, night 10c.

Janet


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## Pidgey (May 20, 2005)

The hole in the picture just a few posts up--that's the one that went into the body proper, right?

Pidgey


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## amyable (Jul 7, 2007)

Yes that's right, it's still the same.


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## Pidgey (May 20, 2005)

I never did like the look of that hole...

My biggest worry has always been that there's something worse under there somewhere that might rise up someday to cause an infection. I suppose that it's possible to get some miserable creepy, crawly bug in there that could itch real bad or worse. You wouldn't happen to have some medicine that can systemically treat blood-sucking insects, do you?

Of course, they can always get something unrelated.

Pidgey


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## amyable (Jul 7, 2007)

Gosh, I hadn't thought of that. I'll have to do some searching for a product like that.
Better try the vet again, even if I can only get him to see what's at the bottom of this hole somehow. They won't do much else.
I tried with my magnifier again today but it's too dark and goes in too far.

Better get back to the flushing out daily for the time being.

The stuff I put on him is systemic now I think about it, that's for mites and such infestations.
Could try garlic in his water too to put them off.


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## Pidgey (May 20, 2005)

Yeah, you can't beat an otoscope for work like that. Here in The States you can usually find a very inexpensive (we're talkin' "cheap"), but serviceable otoscope at many chain pharmacies (chemists) like this:

http://www.walgreens.com/store/prod...mp&navCount=0&skuid=sku1491329&id=prod1491340

Don't know if you could find one of those in the UK or not--they're extremely handy when you need one.

Pidgey


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## amyable (Jul 7, 2007)

Right I can see what you mean, what the vet used near enough. I'll check around on the net. Thanks.


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## Pidgey (May 20, 2005)

I've been trying on some UK shopping sites. Another thing you might try doing is "transilluminating" the area. What that means is that you take a very small torch (that's a "flashlight" to you Yanks) and literally push it against the skin close by. It will cause all of the nearby flesh to glow deep red. Sometimes, you can see a darkness if a foreign body is embedded inside. You might need some more hands to help hold the bird while you work with your fingers in parting the feathers.

Pidgey


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## amyable (Jul 7, 2007)

Yes ok, I get that. Will try the torch tomorrow.
Just got to pop out for half hour. When I get back I'm going to look for some medical supply places on the net to see about an otoscope. Great help, thanks.


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## Pidgey (May 20, 2005)

You might want to PM and/or email Cynthia about the creepy, crawly possibility and what to do about it. Best of luck, kid.

Pidgey


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## Pidgey (May 20, 2005)

Boy... tough shopping for something like that in the UK--best I could find was on:

www.ebay.co.uk

Put "otoscope" in the search bar.

Cheapest is the one from Hong Kong for about £6 by the time you add up the price and shipping. No telling how long it would take to arrive...

http://cgi.ebay.co.uk/Ear-Professio...hash=item120284528800&_trksid=p3286.m14.l1318

Pidgey


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## amyable (Jul 7, 2007)

You're telling me,The only ones I could find were serious money.
I did find a pen light with a mini otoscope attachment for £9.95 from uk. If I order today, won't get dispatched until Monday, everything stops at the weekend.

Just looked at the Hong Kong one, this looks similar. Going to send for it and give it a try.

Yes ebay had some I noticed too. 

Thanks so much for your input Pidgey. Will let you know how it goes.

Janet


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## amyable (Jul 7, 2007)

Pidgey,
Have ordered a pen type otoscope from uk source, hopefully will get here Tuesday.
Charlie got into a similar state yesterday, but milder, after I'd bathed the wound and he was a bit wet again. Seems this just might be triggered by being wet !


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## Pidgey (May 20, 2005)

Well, isn't that odd...

They usually try to form a granuloma around stuff like that. That's where there's a thickening of all the tissue around the irritant, kinda' like having something surrounded and enclosed by a callus.

Pidgey


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## amyable (Jul 7, 2007)

I got my otoscope but didn't have much luck with it, unless it's not suitable for this size wound opening.

It has three different sized attachments and I tried all three. The narrowest one was almost impossible to see through and even with that one I couldn't see any further into the wound site. I don't know if it is the type I have and if any of the larger types would be any better.

So I have just left the wound well alone and not bathed it or put any intracite or anything in it, but so far it still hasn't filled in from inside.

He had another bath today and strangely enough he only bathed the wound side of his body. He then went on to walking about on tip toes, going sideways up and down and almost falling backwards off his perch again. Definitely triggered by being wet as he had been ok for the last few days when he was dry !


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## Pidgey (May 20, 2005)

I never bathe for the very same reason.

There is a knack to looking through otoscopes. You might want to practice on your family's ears for awhile. You might also take whichever attachment that you favor the least and trim it so that it has a larger opening but play with it first. You might also want to practice with it in the dark so that what you see through it is about all that you can see--that sometimes makes it easier to see what you're looking at, silly as that may sound.

Pidgey


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## amyable (Jul 7, 2007)

That's what comes from bathing in alcohol 

I did try it out on the family ears and that was ok, the dogs weren't so amused.

Ok will experiment more first and try the dark, thanks.
Just let me ask one more silly question, you do just rest it on the skin don't you. All this talk about invasive procedures has got me jittery.

Janet

Good luck with your new patient, appreciate your answering as I can tell you're busy.


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## Pidgey (May 20, 2005)

Oh, there's no need to worry about sticking it in a sealed-up hole. Nobody on the forum is going to hunt you down for doing that.

Pidgey


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## amyable (Jul 7, 2007)

Hi,

Number three that went to the vets today.

At last it seems this may be starting to go the right way. I have been flushing the hole out twice a day with Hibiscrub from the vets. Don't know why but this seems to be making a difference. It still isn't healed completely but after seeing him a week ago, the vet reckons the pocket was slightly smaller than before, so worth keeping this up for another two weeks.

Last week she was contemplating opening the wound up again to restart the healing process if this hadn't worked, so let's hope it carries on like this.

Janet


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## amyable (Jul 7, 2007)

Hi,
Just thought I'd update Charlie's progress, (or not as it turns out).

It seemd to be doing well with the hibiscrub flushing that the vet put us on.
While I was on holiday a lasy who looked after him carried on with it and by the time I came back, I couldn't find the wound.
I even wet his chest area to hunt for it amongst the feathers, but never found it, so I assumed it had healed over at last.

Yesterday I caught him to give him a dose of probiotics, as his urates are just water recently. He has been having a heavy moult so I thought that might be the reason for that.

As I held him, I suddenly noticed the wound again. It is solid with hard necrotic stuff inside.
I bathed it with hibiscrub to see if it was just a surface wound but it turns out it goes just as deep as before. I wonder if the reason I couldn't find it for a while was that it had healed over, but opened up again now as whatever's inside hardened.

The vet that saw him before is on holiday so her boss is going to see him on Thursday. I hope he's pigeon friendly.
It needs to be got out professionally this time as it obviously goes in far deeper than I could see before. I don't know if Charlie's watery poops are connected to this. I do hope he's going to be ok.

Janet


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## Pidgey (May 20, 2005)

Well, then, something was left inside. Just looking at the original picture on the first page of this thread, you'd almost think that a pellet or BB went into the bird through the wing and then into his side. If that were the case, it'd pull feathers in with it. Therefore, you might need to fish inside for garbage--way further in than you want to, I can just about assure you.

Pidgey


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## amyable (Jul 7, 2007)

Maybe it was a BB after all, that would explain why it's so deep. It's always been awkward to see how far it goes because it slants forward into the chest.
I let him down there as I just couldn't dig that deep as he flinched if ever I tried.
The first vet to see him used an otoscope to look in and said he reckoned it was all out.
The next vet didn't even look into the wound, just said to try with flushing first.

This one on Thursday is apparently used to exotics, I told him the history on the phone and he thinks there is a possibilty of bone damage.
He's going to see him in the morning but he's told me not to feed him in case he needs to keep him in, so he might have to give him a shot of gas to get a good look.

I'll report back.

Janet


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## Pidgey (May 20, 2005)

One of the big problems with them is that the surface can heal somewhat closed rather quickly and leave you with a very small hole to work through--makes it pretty tough. As such, it's one of those lessons that you end up learning the hard way--to get in while the gettin's good. At this point, whichever vet's going to be looking, it might be necessary to use an endoscope. An old cystoscope would probably work.

Pidgey


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## amyable (Jul 7, 2007)

Update from the vet visit.

He didn't recommend pulling the 'stuff' out this time. He thinks, having looked at the position of the hole, there is probably bone damage, and that was why it isn't healing as he'd expect if it was purely tissue. He did explain why this happens but due to my short term memory problem, as usual, I walk out of the place and can't remember all he said.  

So, he recommends putting a blob of Sudacrem on the debris twice a day, (not sure if it is just a uk product). To keep wiping it off which should help remove a bit at a time. As it's very thick cream I have to wash the area occasionally to keep it from clogging the surrounding feathers. It's still a form of debridement but working away at the hard stuff from the top. Thinks it will be at least a month before we see any improvement.

Will give it a try.

Janet


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