Therapeutic Use of Regional Limb Perfusion in a Chicken

Abstract

A 2-year-old, 3.8-kg male Rhode Island red rooster was examined for lameness and progressive swelling of the right foot of several month's duration. Radiographs of the right foot demonstrated soft tissue swelling and a smoothly marginated periosteal reaction evident of inflammation affecting the bones. Results of a complete blood count showed a moderate leukocytosis and an elevated total protein concentration. Systemic antibiotic and anti-inflammatory therapy was started, but the bird had not improved at recheck examination. After intravenous catheterization of the medial metatarsal vein and placing a tourniquet at the femoral-tibiotarsal joint of the right leg, regional limb perfusion with amikacin and flunixin meglumine was performed. Dimensions of both feet were measured with digital calipers, and surface temperatures of the feet were measured with an infrared thermometer. The rooster had improved activity level with decrease in lameness and measurable decrease in swelling of the right foot. Regional limb perfusion with intravenous antibiotics and nonsteroidal anti-inflammatory drugs is a viable treatment modality in avian species for suspected distal limb infection and cellulitis. This technique has potential valuable implications for a variety of avian species. Fluid support should be provided if using nephrotoxic drugs.

Adjunctive Use of Intravenous Antibiotic Regional Limb Perfusion in Three Cranes with Distal Limb Infections

“…While manual occlusion of the ulnar vein was used in Case 3, the procedure could likely be performed using a tourniquet over the proximal wing as well. Previous reports in avian species have largely focused on infections of the distal hindlimb (cellulitis, osteomyelitis, tenosynovitis) and treatment with amikacin and ampicillin/sulbactam have resulted in resolution of these infections in combination with systemic antibiotics and anti-inflammatories in brown pelicans and a rooster [ 4 , 6 ]. Ceftiofur RLP has been investigated experimentally in chickens, which found the synovial concentration of ceftiofur exceeded therapeutic concentrations for most pathogenic bacteria [ 5 ].…”

“…Amikacin is a frequent first line RLP antibiotic in horses [ 9 ]. Anti-inflammatory drugs have also been used in RLP in combination with antibiotics in horses and a rooster [ 6 , 10 ].…”

“…The International Crane Foundation (ICF) has used meloxicam in 113 cranes of all 15 species; none were associated with significant antemortem morbidity or postmortem lesions [ 12 ]. Flunixin meglumine, paired with fluid therapy, was chosen in Case 3 based on its successful use in a RLP report [ 6 ]. While there are no published studies showing adverse effects associated with the use of flunixin meglumine in cranes, historical treatments with this drug in 14 cranes led to 5 of them developing fatal visceral gout at ICF [ 12 ].…”

“…This technique has previously been described in brown pelicans (Pelecanus occidentalis californicus), a loon (Gavia pacifica), and a chicken (Gallus gallus) [4,5]. The use of ceftiofur with intravenous RLP has been validated in chickens, and a recent pilot study evaluated the use of intraosseous RLP regional limb perfusion in chicken wings [6,7]. Regional limb perfusion allows much higher antibiotic concentrations at infection sites by creating a concentration and pressure gradient between intravascular and extravascular spaces, maintaining low systemic drug levels, and allowing for a decreased frequency of administration, leading to reduced restraint, which is advantageous in avian species [2,3].…”

Management of intertarsal septic arthritis in an ostrich (Struthio camelus)

“…(2.5 mg/kg IV, Med-Pharmex Inc, Pomona, CA, USA) and a tourniquet placed proximal to the intertarsal joint was also performed, utilizing the medial metatarsal vein as described in the avian model (Knafo et al, 2019;Ratliff & Zaffarano, 2016). The patient was recovered with ati-…”