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Osteomyelitis

Bone Infection

Osteomyelitis is an infection in the bone. Infections can reach the bone by traveling through the bloodstream or spreading from nearby tissue. The infection is most often caused by the bacteria Staphylococcus aureus. Bone infections can happen suddenly or develop over a long period of time. If they’re not properly treated, bone infections can leave a bone permanently damaged, resulting in a need to amputate the affected bone(s).

Ducks can develop osteomyelitis in their feet and legs if they have an existing injury or wound, such as bumblefoot. Bacteria can enter at a surgical site, such as during a bone fracture repair. Anytime a bone breaks, it increases the risk for bacteria to invade and lead to osteomyelitis.

Osteomyelitis is diagnosed through radiographs (xrays). Most cases of osteomyelitis are treatable in ducks, as long as it is recognized quickly by the owner, and treatment is aggressive, and in accordance with a veterinarian's specific instructions. Otherwise, surgical amputation of the affected limb may be necessary by your veterinarian.

Symptoms

Lameness
Lethargy/depression
Loss of appetite
Behavioral changes
A lump formed over the leg bone
Pain and tenderness over the bone
Swelling of the leg

Diagnosis

  • History
  • Clinical signs
  • Physical exam
  • Radiographs
  • Blood test

Support/Treatment

MethodMethod Summary
Supportive careIsolate the bird from the flock and place in a safe, comfortable, warm location (your own duck "intensive care unit") with easy access to water and food. Limit stress. Call your veterinarian.
AntibioticsStarted immediately and chosen based on culture and susceptibility testing in order to target the specific organism.
PROMOTE HEALING OF HEALTHY TISSUE
Antibiotic intravenous regional perfusion therapy (IRPT)A treatment method that has been used often for treating extremity infections in humans and horses. It has the advantage of achieving very high antibiotic concentrations in affected tissues. Recent research shows this method of treatment to be promising for rapid recovery of birds. Three out of four birds that received the treatment underwent a rapid recovery.
Amputation surgeryMay be necessary in many cases.

Reported Cases

  • Case 1: Septic Arthritis and Osteomyelitis in a Falcon An adult female gyrfalcon was presented with a right-wing droop and weight loss. Radiographic images revealed osteolysis and osseous proliferation of the right shoulder and the mobile vertebra between the notarium and synsacrum. The tentative diagnosis was vertebral osteomyelitis secondary to septic arthritis. The bird did not respond to antibiotic and anti-inflammatory therapy and represented 10 days later, with feathers soiled with feces, an impacted, dilated cloaca, and an inability to stand due to spastic paralysis of the hind legs. The bird's condition did not improve with 24 hours of supportive care and its quality of life was considered poor; therefore, the patient was euthanized and submitted for postmortem examination. Multicentric septic osteomyelitis and arthritis were confirmed in the mobile vertebra between the notarium and synsacrum and the right shoulder. Despite 10 days of antibiotic therapy, Staphylococcus aureus was isolated from within the 2 locations in which septic osteomyelitis and arthritis were identified. Ref

  • Case 2: Septic Arthritis and Osteomyelitis in a Swan A 20-year-old female mute swan originally in a flock of free-living swans on a Long Island, New York, lake, was presented for facial swelling and decreased appetite. An adult male ring-billed gull was also presented to the same wildlife rescue center for bilateral lameness of 1-week duration. Once referred for veterinary evaluation and care, both species were diagnosed with septic arthritis and osteomyelitis caused by Chryseobacterium indologenes and treated with orbifloxacin until complete recovery. Ref

  • Case 3: Vertebral osteomyelitis and septic arthritis in a Falcon A 6-week-old, parent-reared peregrine falcon was presented with spastic hypertonus of its hind limbs of unknown origin and duration. Radiologic examination revealed smooth periosteal reactions ventrally at thoracic vertebrae 5 to 7. Contrast-enhanced computed tomography identified the swelling as inflammation; antibiotic, antimycotic, anti-inflammatory, and analgesic treatments were initiated, and vitamins and minerals were supplemented. Because the bird's condition did not improve after 10 days, it was euthanatized and submitted for postmortem examination. On histopathologic examination, chronic, active osteomyelitis was diagnosed in thoracic vertebrae 5 to 7, and chronic, active arthritis was present in both the right shoulder and left elbow joints. Staphylococcus hyicus was isolated from these 3 locations, as well as from lungs and liver, indicating a chronic septic staphylococcosis. Ref

  • Case 4: Osteomyelitis and septic arthritis in a Duck A duck was housed in a large outdoor enclosure with several other male pintails. The bird was noted to have a drooping left wing and apparent inability to use this wing. Physical examination revealed severe swelling of the carpal joint of this wing associated with the presence of yellow caseous material. The wing was amputated at the distal radius and ulna and submitted for histopathologic examination. There was diffuse swelling (up to 3 times normal) of the soft tissues surrounding the carpal and carpometacarpal joints. Caseous yellow nodules measuring up to 1 cm diameter were scattered throughout the joints and periarticular soft tissues. Ref

  • Case 5: Septic arthritis and Osteomyelitis in a Swan and Gull A 20-year-old female mute swan originally in a flock of free-living swans on a Long Island, New York, lake, was presented for facial swelling and decreased appetite. An adult male ring-billed gull was also presented to the same wildlife rescue center for bilateral lameness of 1-week duration. Once referred for veterinary evaluation and care, both species were diagnosed with septic arthritis and osteomyelitis caused by Chryseobacterium indologenes and treated with orbifloxacin until complete recovery. Chryseobacterium indologenes is infrequently diagnosed as an opportunistic pathogen in human medicine, and less so in veterinary medicine. In human patients, this bacterium is the cause of various infections, including meningitis, pneumonia, and implant failure. However, in veterinary medicine its pathogenicity has only been reported in fish, and sporadically mentioned as a culture result in tree frogs and turtles, where it was generally considered insignificant. Ref

Prevention

  • Maintain good flock hygiene.
  • If one of your birds receives a cut or wound clean it thoroughly using an antiseptic. Be sure to keep the injury clean. Take your duck to the vet if the wound is deep, becomes infected or not healing properly.

References

Blogs

Risk Factors

  • Ducks with chronic bumblefoot
  • Ducks which have recently broken (fractured) their leg
  • Ducks which have had a previous episode of osteomyelitis
  • Ducks which recently had surgery to a bone
  • Ducks with a poor immune system

Case Stories