Case Study: Prolapsed Vent

I think when my flock feels I need a new challenge they conspire to come up with an issue. Last week, I noticed that two of my hens – the only two pullets from a hatch of ten last August – both had poopy butts. I resigned myself to pulling caked poop off their feathers and then would sit down for a coffee.

I prepped my kitchen by covering half of my L-shaped counter with a sheet and towel and ran a sinkful of hot soapy water.

I’m experienced at giving chickens a bath so I plopped the first hen in and was taken aback when she started struggling to get out. I tried grabbing her, pulling out a couple of small feathers before she flew down to my living room floor. But not before spraying my entire other uncovered counter, my face and glasses with dirty water. I found that her only issue was some big clumps of dried poop on her feathers which I managed to work off and returned her to the flock.

Salmon, Easter Egger, 7 months old

On to patient number two: Swaddling her in a towel, I covered her head in order to examine how much poop there was and if, by chance, I might be dealing with vent gleet. I was pretty surprised to see she had a prolapsed vent – a condition usually caused by straining to lay a soft-shelled or very large egg – which I didn’t think was there the day before. I’ve twice dealt with prolapsed vents, both times with new layers, and unfortunately there wasn’t a happy ending in either case.

Then it was into the bath. Fool me once, shame on you, fool me twice, shame on me. Unbelievably, she too jumped out of the sink! I tried pushing the prolapse back in, but she was determined to push against me. I put Preparation H on the prolapse and finally managed to get it in with the plan to cover the area with white sugar later in the day, in an attempt to shrink it. It wasn’t the worst prolapse I’d seen, but having your reproductive tissues outside your body for any length of time is never a good thing. Luckily it was intact and hadn’t been pecked by the flock, attracted by the red colour.

Of course, discovering the prolapse had to happen on a Sunday just as I was ready to head back to work the following day. I could check on her before leaving in the morning and again in the evening and hoped that we could work together to manage the prolapse. I crated her by my woodstove with a towel over the openings to darken it in an attempt to discourage her from laying until she’d healed.

I scrubbed all my counters and sink. Then I washed the kitchen floor, which was dotted with dried soap spots.

Day 2: I wasn’t able to check Salmon (so named because she resembles a Salmon Faverolle) because I left for work @6:15am. When I came home I found she had eaten all her yoghurt, some of the crumbles and most of her water – good signs, as she needed to keep her strength up. Bad news: she laid an egg, which would cause more stress on her prolapse. Silver lining: I was able to confirm she laid a blue egg.

I took her to my makeshift exam room on my kitchen counter. Unfortunately the prolapse had not receded but still looked healthy. I tried pushing it in with no success and I could tell she was in some discomfort. Some of the white sugar I put on her vent the night before was still in place. I soaked some cotton balls in witch hazel and applied them directly to the prolapse. It’s an astringent also used to shrink tissues, including mucous membranes and as a liquid it’s easier to apply than sugar. Not good that there was blood on them although I didn’t see any active bleeding. Then I sprayed her vent with Vetericyn, an antibacterial, to protect the exposed tissue. Last of all, I applied some Preparation H, but as a cream it just seemed to slide around.

Day 3: I managed to wolf down my breakfast in order to have time to check on my patient. Her appetite was good and she pooped a lot, but the prolapse looked the same. I snapped on some gloves, squirted a liberal amount of witch hazel on the prolapse and laid two fingers on it without applying any pressure. I just wanted her to get used to feeling my presence without struggling. Then I whispered over and over “work with me” while I gently pushed the prolapse bit by bit. I tried to time my pressure against her pulsing vent. Once she relaxed I gave one more push and it popped in and appeared to stay in.

I crushed up one Traumacare pill, a homeopathic remedy used to treat pain and inflammation, and dissolved it in her water. In addition to crumbles I gave her some canned cat food. Then I was out the door at 6:45am to catch my bus and ferry.

When I got home I found she’d laid another egg (despite being in a darkened crate) and the prolapse was back out. I don’t know if the egg resulted in pressure on the vent or it had come out prior to that. Although she was alert she wasn’t active which was a good thing.

More witch hazel and Vetericyn spray and I was able to get it back in and hoped she wouldn’t lay another egg for a while so it might stay in.

FYI: Although it’s called Epsom salt it is not derived from sodium like table salt, but rather from magnesium, which is considered an effective anti-inflammatory.

Day 4: I felt disheartened because the prolapse wouldn’t stay in. More cleaning the site and picking off a bit of clotted blood. It’s critical that the tissue not get damaged or necrotic which would increase the chances of a bacterial infection if, and when, I could ever get it to recede.

Repeated the routine in the afternoon as well as the evening. I started to wonder how long I could do this before conceding that I might not be successful. The only good news was she didn’t lay an egg.

Day 5: Morning routine same as usual: prolapse back out, pushed it back in and hoped for the best.

Crazy hen laid another egg despite being in a darkened crate. Mid-afternoon I decided to ramp up my efforts: bath time followed by a trim of the feathers around her vent. Although she was eating and drinking a lot, there didn’t seem to be normally formed poop but lots of urates collecting in her feathers. That’s acidic and I didn’t want it to irritate her skin so the feathers had to go.

Then I swaddled her in a large, heavy towel and laid her on her side. Ordinarily I would have just put Preparation H and/or witch hazel on the prolapse, popped it back in and returned her to the crate. Change of plan: do that, plus added Viaderm, an anti-inflammatory corticosteroid cream, recently prescribed for my dog. I also added a generous amount of Aqua Lube to the prolapse to keep it hydrated and made it easier to push inside.

I decided to keep her on her side for as long as I could (16 minutes) to allow the prolapse to stay in place. Chicken vents tend to pulse on their own so I had the inspired idea to work with her as a form of physiotherapy. One of the risks of the reproductive tract being outside the body for so long is that it distends the vent which then can’t fully close. I’d hate to have a hen that recovered but no longer had full control of her vent. I discovered that if I gently touched her vent Salmon would start a series of contractions, tightening and loosening her vent. I figured it might be akin to chicken Kegel exercises. I don’t have children and have never been keen on changing diapers and there I was with my nose inches from a hen’s pulsing butt. I have to say it made me feel a bit creepy, but it was all in the name of helping Salmon recover.

Day 6: Same old morning routine, but now she was less cooperative which implied she was in discomfort or pain. I managed to get the prolapse in, but she wouldn’t lay still for long (6 minutes) so I assumed it wouldn’t be long before it popped out.

Her appetite was good and she continued to drink a lot of water. When I cleaned out her crate I found a number of very small, black tarry poops, which was not a good sign. My dog Simon had a penchant for swallowing foreign objects and underwent five (yes, five) intestinal surgeries to remove them. Each time post-recovery his poop was black for days, indicating blood in his digestive tract from the incision in his intestine.

I wanted to try one last ditch effort: to attach a steri-strip (adhesive bandage) across part of her closed vent in order to hold the prolapse in, but leave enough of an opening so Salmon could still poop. I never even got the chance because she was so feisty that I didn’t want to force her to submit to any more of my valiant efforts. I felt like we’d both given it our best shot and this was the end of the road.

When I first met my mentor, Dr Vicki Bowes, avian vet/pathologist she said that most folks wait too long to euthanize a bird and that culling she be considered if the patient isn’t making some clinical improvement within 48 hours. I think ending the life of another creature, no matter your motivation, is often a difficult decision. I hated admitting defeat, given how hard I’d tried to help her, but I also didn’t want to prolong any suffering knowing that the prolapse would never be fixed.

Being skilled in humane euthanasia (i.e. cervical dislocation) is probably something every chicken keeper should know, but I haven’t felt that I could do it properly or that I wouldn’t suffer for it. I have several friends that are willing and able and I called on Margaret to help. We first met when I posted in our online community bulletin board asking for help with another hen that required those services and we’ve subsequently become friends. I brought her over to Margaret’s place and I said my good-byes to the hen I hatched just a few months ago. Then my friend held Salmon as she walked through the garden, chatted with her and sent Salmon, who was calm and quiet, on her way.