Case Study Emergencies/Illness Health Issues Video

Case Study: Egg Binding & Spay Surgery

My introduction to Seleta was when she sent me this message:

“This is by far the coolest website I’ve ever come across regarding the health conditions of chickens!! I stumbled upon it looking for information (and some hope) for my hen who has several masses in her abdomen. She is scheduled to have radiographs and ultrasound to hopefully determine what the masses are and if we can do anything. Keep your fingers and toes crossed for Amethyst please.”

I’m afraid I wasn’t of any help, but I did hope for a happy outcome. Seleta and I have chatted back and forth and I found I was aware of her without knowing it. Another of her hens, Blue’s story went viral when she was the first avian species to be diagnosed with Patent Ductus Arteriosus and underwent surgery to fix the congenital hole in her heart.

Amethyst’s story might not be headline grabbing, but there are some interesting aspects to it, namely her atypical presentation.

This case study is comprised of emails from Seleta, the reports from the Colorado State University Veterinary Hospital that performed surgery on Amethyst, as well as my explanation of hormones and spay surgery.

Amethyst, Lavender Orpington, 19 months old

Amethyst had shown none of the signs of being egg bound or any other obvious signs for that matter. For about a week I thought she seemed ‘off’: her feathers were fluffed up and she wasn’t quite as ornery as she usually was. I had seen her eat and drink, her stools appeared normal, and by all other standards she looked fine. She wasn’t laying eggs, but then neither of her sisters was either.

There had been a lot of stress in the past few months with winter weather, the addition of a spicy little Sebright rooster and a move from town to a five-acre property. Several of my other birds had gone, or were going, through a molt.

Last spring she was laid large eggs every other day. She never had any soft shells or other abnormalities so I really didn’t think much about her not laying.  Amethyst wasn’t roosting in the nest box or walking like a penguin, the telltale signs of egg binding. 

Day 1: Amethyst was still fluffed up so I looked her over and her belly seemed enlarged. Not squishy like ascites, more hard. I know just enough to make me dangerous when it comes to chicken health, but far from everything. I palpated her abdomen and felt a couple of hard lumps. It didn’t feel exactly right to me, but what the hell did I really know? I set Amethyst down and picked up one of her sisters of the same age and breed and felt her belly, which was soft and pliable, nothing like hers.

I decided I would take her to work with me at the Colorado State University Veterinary Teaching Hospital and see if I could catch one of the exotics vets before they left for the day. Luckily, one of the faculty doctors agreed to “squish her belly and see if it was weird”. She agreed that her abdomen didn’t feel normal and could feel one large mass on one side of her abdomen and what felt like a multi-lobed mass on the other side. She suggested that Amethyst be seen by a vet to figure out what was going on. My mind had already gone to cancer or a raging case of salpingitis with her abdomen full of lash eggs and I prepared myself for the worst.

Day 2: As luck would have it, they were able to squeeze me in for an appointment the following morning at the unholy hour of 8:30am. It is, of course, unholy when you work nights. At any rate, I dropped her off for the day for the radiographs (and ultrasound, if needed). They told me that they had found three fully formed eggs and potentially other egg material in her coelom (abdomen), but they couldn’t tell from the radiographs if they were still contained in the oviduct or if they were free.

The vet explained that chickens have the crappiest reproductive systems in the animal kingdom. When a yolk is released, the infundibulum is supposed to catch the egg and funnel it into the oviduct where it continues on its journey to become a fully shelled egg. She said parrots are great at it; their catcher’s mitt (infundibulum) is the perfect size for the yolk and it holds it tightly to funnel it into the oviduct. Chickens, however, are like having a peewee catcher up against a professional major league baseball star. This lack of awesomeness can cause internal laying. However, in Amethyst’s case, since the eggs were already shelled, something else was going on entirely.

I was actually thrilled with the news. It wasn’t cancer and didn’t appear to be salpingitis either. Whatever caused the eggs to end up in her coelom could possibly be fixed. Without even a second thought, my husband and I opted for attempting surgical treatment. The only problem was Amethyst would require some stabilization and nutrition to get her strong enough to endure such a risky surgery.

The vets also had to contact FARAD (Food Animal Residue Avoidance Databank) and ask for their blessing in giving either the Suprelorin implant or Lupron injections to help reduce the size of Amethyst’s ovary and stop her from continuing to release yolks.

Both medications are expensive and can sometimes be used in special circumstances off-label. The implant would have been preferred, but FARAD only approved the use of Lupron as long as they knew for certain that I was never going to eat Amethyst or any eggs she would produce from then on.

Hormone Implants

  • Suprelorin (Deslorelin acetate) is a hormone implanted under the skin, similar to a microchip, in order to prevent a hen from laying eggs. It is used off-label for chickens and many veterinarians don’t have experience using it in avian species. In hens, the duration of effectiveness can be anywhere from two weeks to two years. It may be administered to a hen pre-spay surgery to stop ovulation and to decrease blood supply to her reproductive organs.
  • Lupron (Leuprolide acetate) is a synthetic hormone administered as intramuscular injections used for the treatment and prevention of a variety of reproductive tract conditions in poultry.

Amethyst was isolated and received Meloxicam and Trimethoprim Sulfate (TMS) until she could have surgery in six days. She was quite uncomfortable and we did the best we could to keep her as inactive as possible to keep any of the eggs from rupturing. While it was still a scary diagnosis, at least we had some hope to be able to save her. It beat some of the alternative diagnoses. 

Day 5: To prepare for surgery, Amethyst was prescribed Gabapentin and Tramadol to help better control her pain. Since she had all but stopped eating over the weekend, they hospitalized her so they could begin gavage (tube) feeding her a critical care formula to keep up her strength. They also administered her Lupron injection so that it could begin working prior to surgery.

Day 6: Our area was expecting up to a foot of snow and the exotics staff weren’t sure that they would be able to make in to the hospital. We agreed that I would take Amethyst home to continue the gavage feedings and medications until her surgery. 

Day 8: I shuttled Amethyst and my Jersey Giant, Attila the Hen, whom we just call Tilly, to CSU. They had asked if I could bring one of my other large, healthy birds just in case they needed a blood donor.

Amethyst had been put under around 11-11:30 am and was not out of surgery and being recovered by the anesthesia team five hours later.

She was a complete rockstar. Surgery went well overall. The vet team recovered three huge intact eggs and a fourth broken shelled egg from inside her coelom. They were free because her oviduct had actually ruptured at some point near the infundibulum.

Surprisingly, there was not much inflammation and no indications of Egg Yolk Peritonitis or other infection brewing. There was a lot of adhesion though, which was why the surgery took so long. Time, precision, and skill allowed the vet to successfully remove the great majority of the oviduct except for the portion that was very near the ovary itself.

Amethyst’s Surgery

What Is Spaying In Chickens?

  • Surgery of any kind is a big undertaking both financially and because of the risk of complications, infection or death. Many small animal veterinarians don’t deal with chickens, and those that do may have limited surgical experience.
  • Spaying a hen usually involves the removal of the oviduct rather than the ovaries, which is more risky due to their increased blood supply and close proximity to the aorta. Removal of the oviduct usually prevents the ovary from producing egg follicles, therefore it’s unnecessary to remove them as well.
  • The risks of this procedure include: overdose of the anesthesia, bleeding out, and complications with the removal of the oviduct due to tumours or adhesions and the necessity to cut through ribs if there is a lot of material to be removed from the oviduct. Post-surgery risks are: infection and the possibility of internal laying if the ovary continues to function. If those eggs aren’t absorbed it can lead to egg yolk peritonitis.

Then it was Tilly’s time to shine. She stood patiently as they removed 20mls of blood from her to donate to Amethyst who had lost a fair amount during surgery. 

I saw her when she was still intubated and being recovered by the anesthesia department. She had an IV catheter in one wing receiving the blood Tilly had donated. The lower half of her body was totally naked of feathers and a long incision snaked along her abdomen.

She spent that night in the Critical Care Unit in a warm incubator with a nest made of blankets for her to sit in. Sadly, at some point during transport to her kennel, she had accidentally pulled out her IV catheter before she could receive the entirety of Tilly’s blood donation. Concerned about stressing her and causing more pain, the vet opted for not replacing the IV catheter and to monitor her condition closely. It took her quite a while to really wake up and start standing on her own.

Day 9: At 9am she was still the same, but had eaten some mealworms, which was the first food she had willingly eaten in the past week. We had been tube feeding her prior to that to keep her strength up for surgery.

By the afternoon she looked miraculously better. She was up walking around some, drinking on her own, and picking at some food. I brought her home that night on a regimen of Tramadol, Gabapentin, and Meloxicam and with instructions for tube feeding up to three times a day if needed.

The vet told me that they would have kept Amethyst for a few more nights in the hospital, but they knew that I was capable of providing the high level of care she needed.  I housed her in my Rubbermaid ICU where I continued to monitor her, gavage feed and administer her medications. 

The vet did aerobic and anaerobic cultures of the remnants of the egg in order to confirm if there were organisms that were likely to grow in her coelom and would guide appropriate antimicrobial therapy. The awesome news was they all came back negative.

Day 11: She continued to improve and ate a few sunflower seeds and some tuna. I was still giving her medications and having to tube feed her about 1-2 times per day, but she was making progress. She visited her sisters through the gate, was preening, and could be heard purring from her Rubbermaid ICU.

Day 13: Amethyst came to work with me so I could continue to give her care at the prescribed times. Her incision looked great. There was a significant amount of dark green bruising on her abdomen and down her leg and of course swelling. She still wasn’t eating enough to sustain herself, though I could get her to peck at a couple bites of various foods periodically, so we continued to gavage feed her when there was not enough in her crop. I tried to count her sutures and promptly lost count. The incision started on her left side up toward her chest and went down to the inside of her left leg and then extended back over her abdomen. It was probably 10”-12” long. 

Week 3: I was out of town this week for work. Amethyst was medically boarded at the vet clinic. She wasn’t eating much on her own. They added a medication called Entyce which is an appetite stimulant, and an anti-nausea medication called Cerenia. They still had to tube feed three times a day. They did a CBC (complete blood count) on her to check her hematology values. Since I was in another state and my husband couldn’t tube feed or give injections she hung out at the vet hospital. 

Week 6: Amethyst, overall, had recovered beautifully from her surgery: her incision had healed and she was growing new feathers back although she looked like a purple porcupine for a while. The one thing that remained was her refusal to eat so I had been tube feeding her for a little over a month at this point. Sometimes we got her to eat a little bit on her own and I could reduce the number of times or amount that I tube fed, but we weren’t quite there yet. Otherwise, her attitude was good, she was drinking on her own, she enjoyed sunbathing and hanging out in the aviary with the rest of the flock.

The only other complication that had arisen was her ridiculously swollen hocks on both legs. Previously we had confirmed the presence of Mycoplasma synoviae and Mycoplasma gallisepticum in our flock which we treated. We were able to get rid of the M.G., but not the M.S.

Immediately after surgery, Amethyst was put on a 10 day course of trimethoprim sulfa (TMS) antibiotics to prevent infection. While it’s not used to treat M.G. or M.S., I believe it suppressed it to some extent, but once off the antibiotics post-surgery, the Mycoplasma was allowed to go rogue and caused the swelling in her hocks. We put her on injections of oxytetracycline to treat the M.S. around two weeks ago, but her hocks remained incredibly swollen. She was also still on pain medication, now for the hocks more than the surgery, which were making her more comfortable.

Week 8: Once we managed the pain of her swollen feet she began to eat again. We tried her on a course of injectable oxytetracycline, the go-to treatment for Mycoplasma (two injections/day for two weeks) but it didn’t seem to make any improvement in her feet. Last week the vet sent a needle aspirate for cytopathology; it showed signs of inflammation but no bacteria. I opted not to test for reovirus at this time, and did Epsom salt foot soaks twice a day to see if that helped with the inflammation and treated her with oral Enrofloxacin twice a day for 7-10 days.

Week 10: She was still doing really well and was completely back to her normal, piggy self. Her hocks seemed to be getting better, so maybe they just needed additional time to heal. For some reason, Amethyst, had joined a flock but not her original flock. She was also off all medications and just back to being a spoiled chicken: happy and healthy and doing well. 

Bio for Seleta Nothnagel: I work nights in the Clinical Pathology Department at the Colorado State University Veterinary Teaching Hospital (VTH) as a Medical Laboratory Scientist (MLS). We do blood work like chemistry panels and CBCs, urinalysis, coagulation studies and blood banking for all of the animals seen at the VTH. Before that I worked in the microbiology department in human medicine at a hospital for 10 years and in veterinary medicine as a Registered Veterinary Technician for 10 years. My job now is the best of both worlds. 

Many thanks to Seleta for sharing her story and photos of Amethyst, used with permission.

1 comment on “Case Study: Egg Binding & Spay Surgery

  1. Sadiq dabo

    Very interesting story. l learned a lot and will share to my friends. We in the third world could not get such services for many reasons but we will get there. Thanks

    Liked by 1 person

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