{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T06:33:55Z","timestamp":1793428435970,"version":"4.5.0"},"reference-count":34,"publisher":"Association of Avian Veterinarians (AAV)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Avian Medicine and Surgery"],"published-print":{"date-parts":[[2023,3,13]]},"abstract":"<jats:p>A 2-year-old female American white pekin (Anas platyrhynchos domesticus) was assessed for a 2-month history of chronic lameness and swelling involving the left leg. Radiographic images of the left leg showed soft tissue swelling of the digits and tarsometatarsus with osteolysis of the tarsometatarsal-phalangeal joint. A complete blood count revealed marked leukocytosis and hyperproteinemia. A Streptococcus species was isolated from a bacterial culture of fluid obtained from the left tarsometatarsal-phalangeal joint. Biweekly intravenous regional limb perfusions of the left leg with ampicillin-sulbactam and amikacin were performed on the patient. Despite initial improvement in left leg lameness and swelling, follow-up radiographic images showed progressive osteolysis of the tarsometatarsal-phalangeal joint and associated digits. Surgical placement of antibiotic-impregnated calcium sulfate beads into the left tarsometatarsal-phalangeal joint was next performed with concurrent, repeated intravenous regional limb perfusion using the same antibiotic. Following the placement of antibiotic-impregnated beads and continued intravenous regional limb perfusion, the duck had decreased lameness and swelling of the left leg. Repeated antibiotic treatment through intravenous regional limb perfusion and concurrent placement of antibiotic-impregnated calcium sulfate beads is a practical treatment option for complicated distal limb infections in avian species. This therapeutic protocol has great potential in treating aggressive distal leg infections in many avian species because regional limb perfusion alone may not penetrate the joint adequately to achieve complete resolution of infection.<\/jats:p>","DOI":"10.1647\/21-00056","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T00:52:32Z","timestamp":1678668752000},"page":"414-420","source":"Crossref","is-referenced-by-count":4,"title":["Treatment of Septic Tenosynovitis and Osteoarthritis in an American White Pekin (Anas platyrhynchos domesticus) with Repeated Intravenous Regional Limb Perfusion and Antibiotic-Impregnated Calcium Sulfate Beads"],"prefix":"10.1647","volume":"36","author":[{"given":"Andrew","family":"Lacqua","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Helmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1222","reference":[{"key":"28","doi-asserted-by":"crossref","unstructured":"MP Hartley  and S Sanderson  \"Aust Vet J.\"  81, \"Use of antibiotic impregnated polymethylmethacrylate beads for the treatment of chronic mandibular osteomyelitis in a Bennett's wallaby (Macropus rufogriseus rufogriseus).\" 742 (2003)","DOI":"10.1111\/j.1751-0813.2003.tb14604.x"},{"key":"1","unstructured":"MG Hawkins, HW Barron, BL Speer,  \"Exotic Animal Formulary.\"  \"Birds.\" 348 (2012)"},{"key":"2","unstructured":"\"Mixing instructions and set time chart.\""},{"key":"3","doi-asserted-by":"crossref","unstructured":"LM Van Veenendaal, MF Madu, MET Tesselaar,  \"Eur J Surg Oncol.\"  43, \"Efficacy of isolated limb perfusion (ILP) in patients with Merkel cell carcinoma (MCC): a multicenter experience.\" 2157 (2017)","DOI":"10.1016\/j.ejso.2017.07.015"},{"key":"4","doi-asserted-by":"crossref","unstructured":"G Kelmer, A Tatz, T Bdolah-Abram,  \"Vet Surg.\"  41, \"Indwelling cephalic or saphenous vein catheter use for regional limb perfusion in 44 horses with synovial injury involving the distal aspect of the limb.\" 938 (2012)","DOI":"10.1111\/j.1532-950X.2012.01006.x"},{"key":"5","doi-asserted-by":"crossref","unstructured":"CV Fiorello, J Beagley, SB Citino,  \"J Zoo Wildl Med.\"  39, \"Antibiotic intravenous regional perfusion for successful resolution of distal limb infections: two cases.\" 438 (2008)","DOI":"10.1638\/2007-0177.1"},{"key":"6","doi-asserted-by":"crossref","unstructured":"F Ollivet-Courtois, A Lecu, RA Yates,  \"J Zoo Wildl Med.\"  34, \"Treatment of a sole abscess in an Asian elephant (Elephas maximus) using regional digital intravenous perfusion.\" 292 (2003)","DOI":"10.1638\/01-103"},{"key":"7","doi-asserted-by":"crossref","unstructured":"A Finsterbush, M Argaman, T Sacks,  \"J Bone Joint Surg Am.\"  52, \"Bone and joint perfusion with antibiotics in the treatment of experimental staphylococcal infection in rabbits.\" 1424 (1970)","DOI":"10.2106\/00004623-197052070-00016"},{"key":"8","doi-asserted-by":"crossref","unstructured":"KM Simpson, RN Streeter, JD Taylor,  \"J Am Vet Med Assoc.\"  245, \"Bacteremia in the pedal circulation following regional intravenous perfusion of a 2% lidocaine solution in cattle with deep digital sepsis.\" 565 (2014)","DOI":"10.2460\/javma.245.5.565"},{"key":"9","doi-asserted-by":"crossref","unstructured":"CV. Fiorello,  \"J Zoo Wildl Med.\"  48, \"Intravenous regional antibiotic perfusion therapy as an adjunctive treatment for digital lesion in seabirds.\" 189 (2017)","DOI":"10.1638\/2016-0045.1"},{"key":"10","unstructured":"C. Ratliff,  \"Proc Annu Conf Assoc Avian Vet.\"  \"Regional limb perfusion in avian species.\" 61 (2016)"},{"key":"11","doi-asserted-by":"crossref","unstructured":"SE Knafo, JE Graham, BA Barton,  \"Am J Vet Res.\"  80, \"Intravenous and intraosseus regional limb perfusion of ceftiofur sodium in an avian model.\" 539 (2019)","DOI":"10.2460\/ajvr.80.6.539"},{"key":"13","unstructured":"N. Harcourt-Brown,  \"Avian Medicine.\"  \"Bumblefoot.\" 525 (2008)"},{"key":"14","doi-asserted-by":"crossref","unstructured":"P Agarwal, PK Agrawal, D Sharma,  \"J Eur Acad Dermatol Venereol.\"  19, \"Intravenous infusion for the treatment of diabetic and ischaemic non-healing pedal ulcers.\" 158 (2005)","DOI":"10.1111\/j.1468-3083.2005.01058.x"},{"key":"15","doi-asserted-by":"crossref","unstructured":"DG Cvitkovitch, YH Li, RP Ellen,  \"J Clin Invest.\"  112, \"Quorum sensing and biofilm formation in streptococcal infections.\" 1626 (2003)","DOI":"10.1172\/JCI200320430"},{"key":"16","doi-asserted-by":"crossref","unstructured":"S Gitelis  and GT Brebach  \"J Orthop Surg.\"  10, \"The treatment of chronic osteomyelitis with a biodegradable antibiotic-impregnated implant.\" 53 (2002)","DOI":"10.1177\/230949900201000110"},{"key":"17","doi-asserted-by":"crossref","unstructured":"E McPherson, M Dipane, S Sherif,  \"Reconstr Rev.\"  3, \"Dissolvable antibiotic beads in treatment of periprosthetic joint infection and revision arthroplasty-the use of synthetic pure calcium sulfate (Stimulan) impregnated with vancomycin & tobramycin.\" 33 (2013)","DOI":"10.15438\/rr.v3i1.27"},{"key":"18","doi-asserted-by":"crossref","unstructured":"JW Gorvetzian, RP Kunkel, CP Demas,  \"Adv Wound Care.\"  8, \"A single center retrospective evaluation of a surgical strategy to combat persistent soft tissue wounds utilizing absorbable antibiotic beads.\" 49 (2019)","DOI":"10.1089\/wound.2018.0795"},{"key":"19","doi-asserted-by":"crossref","unstructured":"MD McKee, LM Wild, EH Schemitsch,  \"J Orthop Trauma.\"  16, \"The use of an antibiotic-impregnated, osteoconductive, bioabsorbable bone substitute in the treatment of infected long bone defects: early results of a prospective trial.\" 622 (2002)","DOI":"10.1097\/00005131-200210000-00002"},{"key":"20","doi-asserted-by":"crossref","unstructured":"SS Aiken, JJ Cooper, H Florance,  \"Surg Infect (Larchmt).\"  16, \"Local release of antibiotics for surgical site infection management using high purity calcium sulfate: an in vitro elution study.\" 54 (2015)","DOI":"10.1089\/sur.2013.162"},{"key":"21","doi-asserted-by":"crossref","unstructured":"MD Helgeson, BK Potter, CJ Tucker,  \"Orthopedics.\"  32, \"Antibiotic-impregnated calcium sulfate use in combat-related open fractures.\" 323 (2009)","DOI":"10.3928\/01477447-20090501-03"},{"key":"22","doi-asserted-by":"crossref","unstructured":"LC Peterson, SE Kim, DD Lewis,  \"Vet Surg.\"  2021, \"Calcium sulfate antibiotic-impregnated bead implantation for deep surgical site infection associated with orthopedic surgery in small animals.\" 748","DOI":"10.1111\/vsu.13570"},{"key":"23","doi-asserted-by":"crossref","unstructured":"K Ham, D Griffon, M Seddighi,  \"J Am Anim Hosp Assoc.\"  44, \"Clinical application of tobramycin-impregnated calcium sulfate beads in six dogs (2002-2004).\" 320 (2008)","DOI":"10.5326\/0440320"},{"key":"24","doi-asserted-by":"crossref","unstructured":"SS Trostle, DA Hendrickson, WC Stone,  \"J Am Vet Med Assoc.\"  208, \"Use of antimicrobial-impregnated polymethyl methacrylate beads for treatment of chronic, refractory septic arthritis and osteomyelitis of the digit in a bull.\" 404 (1996)","DOI":"10.2460\/javma.1996.208.03.404"},{"key":"25","unstructured":"SJ Divers  and MPC Lawton  \"Proc Annu Conf Assoc Reptile Amphib Vet.\"  \"Antibiotic impregnated polymethylmethacrylate beads as a treatment for osteomyelitis in reptiles.\" 145 (1999)"},{"key":"26","doi-asserted-by":"crossref","unstructured":"TM Booth, RJ Butson, PD Clegg,  \"Vet Rec.\"  148, \"Treatment of sepsis in the small tarsal joints of 11 horses with gentamycin impregnated polymethylmethacrylate beads.\" 376 (2001)","DOI":"10.1136\/vr.148.12.376"},{"key":"27","unstructured":"KS Tobias, CT Robbins, WT Ferner,  \"J Zoo Wildl Med.\"  27, \"Treatment of cellulitis in an American black bear with antibiotic impregnated implants.\" 109 (1996)"},{"key":"29","doi-asserted-by":"crossref","unstructured":"LE Dahners  and CH Funderburk  \"Clin Orthop.\"  219, \"Gentamicin-loaded plaster of paris as a treatment of experimental osteomyelitis in rabbits.\" 278 (1987)","DOI":"10.1097\/00003086-198706000-00038"},{"key":"31","unstructured":"NA. Forbes,  \"Echuca.\"  \"Antibiotic-impregnated polymethylmethacrylate beads in the treatment of bumblefoot, osteomyelitis and other localized infections in birds.\" 81 (2000)"},{"key":"32","doi-asserted-by":"crossref","unstructured":"GL Huckins, RR Sim, B Hartup,  \"Animals.\"  11, \"Adjunctive use of intravenous antibiotic regional limb perfusion in three cranes with distal limb infections.\" 2673 (2021)","DOI":"10.3390\/ani11092673"},{"key":"33","doi-asserted-by":"crossref","unstructured":"RP Howlin, MJ Brayford, JS Webb,  \"Antimicrob Agents Chemother.\"  59, \"Antibiotic-loaded synthetic calcium sulfate beads for prevention of bacterial colonization and biofilm formation in periprosthetic infections.\" 111 (2015)","DOI":"10.1128\/AAC.03676-14"},{"key":"34","doi-asserted-by":"crossref","unstructured":"M Forte  and R Pellegrino  \"W V Med J.\"  \"Severe hypercalcemia following the implantation of antibiotic impregnated calcium sulfate beads for prosthetic joint infection.\" 2698 (2017)","DOI":"10.21885\/wvmj.2017.18"},{"key":"30","doi-asserted-by":"crossref","unstructured":"JD. Remple,  \"J Exot Pet Med.\"  15, \"A multifaceted approach to the treatment of bumblefoot in raptors.\" 49 (2006)","DOI":"10.1053\/j.jepm.2005.11.003"},{"key":"12","doi-asserted-by":"crossref","unstructured":"CM Ratliff  and BA Zaffarano  \"J Avian Med Surg.\"  31, \"Therapeutic use of regional limb perfusion in a chicken.\" 29 (2017)","DOI":"10.1647\/2015-149"}],"container-title":["Journal of Avian Medicine and Surgery"],"original-title":[],"deposited":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T06:10:41Z","timestamp":1793427041000},"score":1,"resource":{"primary":{"URL":"https:\/\/bioone.org\/journals\/journal-of-avian-medicine-and-surgery\/volume-36\/issue-4\/21-00056\/Treatment-of-Septic-Tenosynovitis-and-Osteoarthritis-in-an-American-White\/10.1647\/21-00056.full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,13]]},"references-count":34,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,12,1]]}},"URL":"https:\/\/doi.org\/10.1647\/21-00056","relation":{},"ISSN":["1082-6742","1938-2871"],"issn-type":[{"value":"1082-6742","type":"print"},{"value":"1938-2871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,13]]}}}