Bumblefoot (Pododermatitis) in Poultry

Bumblefoot (Pododermatitis) in Poultry
By Asst. Prof. Dr. Somphoth Weerakul (Mor Kaew)

Pododermatitis, commonly known as Bumblefoot, is a frequent condition in poultry. Depending on the locality, it may also be referred to as a "callus" or "abscess."

Predisposing Factors
The condition is often triggered by poor flooring or environmental conditions that cause injury, such as:

Hard or abrasive flooring.
Plastic mesh or wire cages.
Physical trauma/impact.
Damp or soiled bedding/litter.
Advanced age.
High stocking density (overcrowding).
Nutritional deficiencies, particularly Biotin.

Clinical Symptoms and Progression
Early Stage: The footpad and toe pads show mild redness (erythema), swelling, and heat. The joints of the toes and feet may swell. Abrasions may or may not be visible. The bird will begin to show signs of pain and avoid putting weight on the affected foot.
Intermediate Stage: Large, deep ulcers develop. Excessive keratinization occurs in the stratum intermedium, or connective tissue forms beneath the wound. Pus develops, covered by a black necrotic scab. Common bacteria involved include Staphylococcus aureus and Streptococcus spp. The bird will be unable to stand on the foot.
Chronic Stage: The lesion hardens due to increased connective tissue and hyperkeratosis (callus formation). The bird may regain some ability to walk as acute pain decreases. Pus may harden into a "cheesy" (caseous) plug. In severe cases, infection can spread to the bone, causing osteomyelitis in the joints of the toes, feet, or even the hock (knee).

Treatment Protocol
Treatment depends on the severity of the disease. Anesthesia should be administered as necessary. Always clean the wound and surrounding area thoroughly.

Grade 1: Mild swelling and redness
Apply lanolin-based ointments or moisturizers to maintain moisture in the stratum corneum and protect cells.
Improve cage flooring.
Apply an interdigital bandage or ball bandage until healed.
Grade 2: Increased swelling and callus formation
Apply lanolin-based cream.
Administer Vitamin A (100,000 IU per kg body weight) via intramuscular injection: twice in the first week, then once weekly.
Apply a protective bandage.
Grade 3: Ulceration, infection, and black scabs
At this stage, use a topical mixture referred to as "DDA" (DMSO + Dexamethasone + Antibiotic) to reduce inflammation and keratinization:

DMSO: 5 ml
Dexamethasone: 4 mg
Antibiotic: Piperacillin (1 g) is preferred. Alternatives include Penicillin + Streptomycin (1 g) or Chloramphenicol (1 g).
Note: In human medicine, similar lesions are treated with Fluorouracil (anti-proliferative), Salicylic acid (softens skin), and DMSO (solvent). Use caution as these can burn healthy tissue. Clean the wound before applying 2–3 times daily. Treatment usually takes 6 weeks.

Grade 4: Severe necrosis and abscess
Infection may spread to the ankle or hock.
Follow the Grade 3 protocol until inflammation and infection subside before considering surgery.
Grade 5: Osteomyelitis (Bone Infection)
Confirmed via X-ray. This is a severe stage with a poor prognosis.

Surgical Intervention
Surgery is performed when the lesion is no longer acutely inflamed (the skin is not swollen or painful to the touch) or after Grade 3 medical treatment has stabilized the area.

Procedure: Remove the black scab and curette (scrape out) all necrotic tissue and the "cheesy" core.
Disinfection: Flush with diluted Povidone-iodine (1:100 ratio).
Antibiotics: While awaiting sensitivity results, initial options include:

Enrofloxacin: 15 mg/kg (Oral or IM, twice daily for 5 days).
Piperacillin: 100 mg/kg (IM, twice daily for 7 days).
Carbenicillin: 100–200 mg/kg (Oral, IM, or IV, twice daily for 7 days).
Post-Op Care: Apply the DDA mixture, cover with Povidone-iodine soaked gauze, and apply a ball bandage.

Change bandages 1–2 times daily for 2–4 days until swelling subsides.
Continue systemic antibiotics for 7–10 days.
Maintain ball bandaging for 6–8 weeks. Total healing time can take 4–6 months.