Corazon’s Prolapsed Vent

A few weeks ago my Apenzeller Spitzhauben x pullet, Corazon, had a close call trying to expel a soft-shelled egg. I did some basic first aid and ramped up her calcium intake: dissolved Tums in her water and fed her yoghurt, buttermilk, tofu and sweet potatoes, all in an attempt to prevent further laying issues. I thought we were in the clear when my worst fears came to fruition just eight days later.

When my Standard Poodle, Lola, experienced gastric torsion I googled it and the first article I read referred to it as the ‘mother of all emergencies’. It didn’t inspire a lot of confidence about her outcome, but she made a full recovery, in part, because of early surgical intervention. A major prolapse in a hen is the equivalent kind of emergency in chickens: prognosis is mixed and early intervention is a must.

I was in the process of integrating two flocks that had lived in adjacent pens for the better part of the last year. I had 15 teenagers in one pen and 19 hens and a rooster in the other. I started by moving eight pullets, at night, into the main coop. When I went out the next morning to check on them everything seemed fine until Corazon turned around and all I could see was red – blood and a huge bulge, that at first glance, I thought might be a case of egg binding, in which an egg was stuck inside her. She was walking normally and not hunkered down or standing upright in the telltale ‘penguin stance’ of an egg bound hen or one with a prolapsed vent.

I had already put my dog and coffee mug in the car, on our way out for a walk. Change of plans: I zipped into the house, ran a sink full of warm water with Epsom salts, got my first aid kit and set up my kitchen as an exam room. I gave her a bath and cleaned off her vent area and realized that she was experiencing a massive prolapse – her reproductive tract was pushed outside her body, often the result of straining to lay a soft-shelled, or very large, egg.

If you’ve never seen it prepare for a shock – it’s not called ‘blow out’ for nothing. There was blood on her feathers – I think a result of other hens pecking at her vent, attracted by the bright red colour. I didn’t see any major wounds, which was a good sign as I would have difficulty stopping the bleeding once the prolapse was back inside and it would be vulnerable to infection.

Once she was out of the bath I swaddled her in a towel, covering her head so she wouldn’t struggle, and laid her on her side. I usually work alone and need both hands, so a co-operative patient is imperative. A small prolapse is relatively easy to pop back in and generally stays there. Unfortunately her prolapse was extensive. I put my gloved hand on her vent – it was pulsing and she was actively pushing the prolapse out against me.

I needed to work with her, so I patiently rested two fingers on the prolapse and tried to calm her. After a few minutes she stopped pushing as much and I gently stated to ease it back in, incrementally. I pushed a bit, then waited, pushed a bit more. After a few minutes most of it was inside and stayed inside. She stood up and it didn’t pop back out. However her vent was quite floppy and open, the result of it being stretched by the prolapse. I put some witch hazel on the area – it’s an astringent that will shrink soft tissues.

The goal was to keep the prolapse from coming out again, which can affect the elasticity of the vent and can get infected. I have heard of people applying a bandage and holding it in place with a diaper to keep the prolapse inside. I put her in crate with high calcium foods and Tums in her water. The area of the coop she’s in (separated from the flock) is somewhat darkened, which I hoped would deter her from laying until she was totally healed.

I have dealt with a pullet with a major prolapse before – unfortunately I couldn’t get the prolapse to stay in, even for a minute, and several days later she was euthanized. If you can get the prolapse to stay in – even partially – it still may take two or three weeks for the tissues to recede and heal. In the interim, it’s important to keep the hen hydrated and well fed and the vent area kept clean and free from infection.

Not surprisingly, birds that are bred to lay a large number (or large-sized) eggs are prone to issues with their reproductive systems: laying weird, including soft-shelled, eggs; internal laying, egg binding, prolapse, infections, and ovarian cancers, tumours and cysts. Sometimes even the best prevention (giving oyster shells, calcium rich foods), monitoring for warning signs and applying first aid and medical care are not enough.

My hen, Mango, survived being egg bound last year, but was left with a vent that had lost its muscle tone from being stretched. Sadly, her vent never recovered and several months later she was euthanized. The consequence of a major prolapse is the same: the hen is left with a floppy vent which makes mating, laying and excretion more complicated. An open vent also leaves the hen vulnerable to infections like Salpingitis. Unfortunately, a severe prolapse which can’t be fixed also calls for euthanasia.

Corazon’s timing was bad. I was on the last day of 10 days off work and set to return to work the next day. That meant I could only do a thorough exam once a day, when I came home after work. Each day it was the same: I took her out of the crate, swaddled in a towel, and cleaned off her vent with warm water. For three days the prolapse stayed inside but her vent was still open, so I applied witch hazel on the tissue around it. While her prolapse showed improvement, her vent still seemed to lack muscle tone or control.

I posted her case on the Facebook group Crossbeaks, Special Poultry & Friends and got some solid advice:

• • Feed her mash and soft foods which would be easier on her vent when she pooped.
  • Apply cortisone cream (less than 10% cortisone) to the tissues around her vent. I had no idea where to get cortisone cream, but I went to the medicine cabinet and found a product prescribed to me (2.5% cortisone), which worked just fine.

• Preparation H is recommended for dermal injuries only. The new formulation contains Pramoxine, an anesthetic, which would be absorbed more readily through mucous membrane like a vent. If you require an astringent use Witch Hazel instead.
• For future reference, they suggested that white sugar can be applied directly on the prolapse to help shrink the tissues.

I did everything I was advised to do. By Day 5 I was surprised to see a huge improvement, even from the day before. The prolapse was no longer visible and her vent looked totally normal. She was perky and dust bathing in her crate. The fear was that the prolapse would recur with the next egg, so I decided to follow the advice of crating her until I saw she was okay after laying resumed.

Both Corazon and I were impatient to let her out of the crate, but the advice I got was that it would take some time for her internal tissues to heal so keeping her crated would deter her from resuming laying. If she was able to pass semi-formed poop without the prolapse pushing out again that was a good sign.

On Day 13, I let her out of the crate into a 4′ x 9′ pen within the larger 1200 square feet pen so she could stay connected to the flock and stretch her legs.

On Day 14, she was agitating to rejoin the flock so I opened the pen gate to allow her to spend the afternoon with them. I was surprised at how seamless the integration went: she grew up and was housed with 14 of the hens in the adjoining pen. Her prolapse occurred on the first day she was in with the main flock, so this was her first day in the new pen.

Her half-sister and hatch-mate, Skye, was anxious to give her the tour. I followed them around while they chatted together and Skye took her to the feeder and waterer, into the coop and around the yard. Within a few minutes she was eating with the other hens as though she’d always been there.

Here she is on her first night back in the coop. She’s on the left and Skye is on the right.

Day 17: She still hasn’t laid an egg post-prolapse which is a good thing as those internal tissues need time to heal. She’s back to normal in every way. Last night, her second night in the new pen, she found her way back to the coop and up on the roost bars with no assistance.

I’ll post an update once she starts laying again.

Update: Sadly, Corazon never laid another egg. Several days after I posted this piece she prolapsed again. I managed to get the prolapse back inside, crated her and just over a week later she prolapsed again. At that point, I had her euthanized. To read more about what followed, complete with necropsy photos and comments from an Avian Pathologist about her situation click here.