*UPDATE* Advice Needed! Eggbound/ Prolapsed Hen???

We noticed yesterday that one of our hens, (1 1/2 y.o. Wyandotte) had a bloody bulge near her vent. Yesterday, the bulge was about half the size of an egg, and seemed to protrude. There was a small amount of blood on her outer feathers, which is what we noticed. She isn't a big layer, and recently came off a VERY long broody stage, (Immediately following her molt) where she lost a lot of weight. She has a very fluffy rear, and the feathers had a lot of feces stuck to them. After bathing her in warm water this morning, the bulge is much smaller. I have released her back out in the yard away from the other chickens. She appears to be feeling fine, but I'm wondering if this will resolve on it's own, or if I need to do something to help?

Read all of this, it might help:
https://www.backyardchickens.com/t/738201/goose-what-is-this-how-did-it-happen-what-do-i-do-about-it

That looks like a prolapse. It could also involve being eggbound, trying to push a large or a soft egg out. I have no experience with this, but here is a thread (linked in our Emergencies sticky) about prolapse:

https://www.backyardchickens.com/t/793/please-help-my-chicken-with-prolapse/0_20#post_5932

OK, I read both links - and I'm still not sure which condition this might be. As of today, the red area in the picture above appears to have semi scabbed (???) but now she has more red area, and her vent is very runny and she has a lot of wetness/poop on her feathers. She is still eating and walking around fine. The other chickens are pecking at her, which I have not noticed before.
Would appreciate more feedback from anyone who has seen/dealt with a similar situation.

I can post more pics if that's helpful.

I am going to put her back in the bath... then try the honey tip from one of the threads. Apparently it kills bacteria and shrinks the "bulge."

http://www.avianweb.com/Prolapse.htm​

Prolapsed Cloaca​

by Terry Martin, BVSc - Australia​

Breeding Challenges ... Bird Health Care ... Glossary of Avian Medical Terms ... Medications Used in Avian & Exotic Medicine and Pharmaceutical Terms ... How to administer oral medications to a bird​

There are a number of potential causes for this condition and a number of possible solutions depending on the cause.
Egg binding can be a cause, and remember egg binding is not simply the physical presence of an egg, it is the deficiency of calcium in the blood and tissues. Therefore it may occur any time before, during or immediately after egg laying. Even when adequate Calcium is available, it may still occur because the amount of calcium required for egg shell production is greater than the amount of Calcium a bird can eat in a 24hr period. This is why the breeding hen must be in perfect condition for breeding, this ensures she has adequate calcium stored in her bones prior to breeding, readily available at an instance notice.
Because egg binding is really hypocalcaemia (low blood calcium) all muscles of the body become weak and contract poorly. The uterus cannot contract enough to deliver the egg, the cloacal sphincter muscles may be too weak to hold close and the general body muscles may not be burning energy to keep the bird warm - hence they go into shock. Therefore any bird with a cloacal prolapse should be kept warm and given calcium in some form to hopefully increase cloacal muscle tone. I favour crop dosing with liquid calcium as well as in water calcium sources in these cases. Of course cuttlefish never goes astray.

Cloacal prolapse is also contributed to by uterine or cloacal infection that makes the area irritated and causes straining, resulting in expulsion of the cloaca. Therefore, it is standard to give these birds antibiotics in case of infection. If a prolapse is exposed to the air for any length of time, infection is almost certain to develop, and with time the tissue dries out which causes further irritation and more straining -end result bigger prolapse.
Potty training is another contributing factor. Training birds to "hold it in" and poop on command puts pressure on the internal organs as the droppings build up inside. It is a dangerous practice.

Lubricating and gently replacing the prolapsed tissue is important, but be careful what you use. Water soluble lubricants designed for people are good. Sometimes mild antiseptics are indicated, but be careful not to cause further tissue damage.

In many cases, the prolapse will not resolve and treatment becomes Veterinary in nature with surgery the only option. A purse string suture may be placed around the vent under general anesthesia to keep things inside. But this also often fails. If the bird is a pet, the best option is desexing to remove the swollen uterus and if necessary a procedure called cloacapexy to stitch the cloaca back inside the body. These procedures are quite successful but obviously prevent the bird from further breeding. I have never performed these procedures on birds smaller than a Cockatiel, obviously the stress and length of surgery have to be considered when dealing with a finch.

If the tissue looks healthy, that is important, if it looks dried and dying, things are probably too late. Mineral oil is not a good idea, either in this situation or in egg binding. It is part of the common misconception that egg binding, or straining equals constipation. There is no physical obstruction in either case, so mineral oil will only cause diarrhea at best. At worse it can cause a GI tract upset that can make the bird even more unwell. I have always been amazed at the number of people who think oral oil will lubricate the reproductive tract. (not a personal criticism of you, but an observation of aviculturists writing bird books).
If an egg is in the lower reproductive tract or cloaca for any length of time, the uterus and cloaca can dry out and require lubrication, but it must be applied in a retrograde fashion up the cloaca. When I was referring to human water soluble lubricants, I was not meaning for hemorrhoids, but for reproduction - that is K-Y jelly or similar, not oil based lubricants
Hemorrhoids is a different problem totally to what the bird is suffering. In the human case there are badly swollen blood vessels that need to be constricted - hence the phenylephrine in it. In the case of the bird, there may be some small vascular swelling that could benefit from constriction, however the risk is the bird may absorb large quantities of the phenylephrine and this could have a systemic effect (whole bird).

So no, I would not normally recommend this type of ointment.
The calcium solution I use is called Calcium Sandoz. I would give a Zebra 0.1ml orally with a crop needle if it was eggbound or prolapsed. I might repeat this if I felt it was necessary, sometimes 3-4 times daily. I often also use it in water at the rate of 10ml/liter. It needs to be made fresh at least daily. It has the added benefit of being high in sugars, making it palatable and being useful for a bird in shock/stress, however it will grow bacteria in the water supply so this must be considered.

I would normally always use antibiotics in these cases, as I explained infection is sometimes the causative factor. However pet shop type antibiotics should never be used in any situation as they have little effect on pathogens (disease causing bacteria). This is the reason why they are available without prescription - they are useless. The choice of antibiotic and dose rate is obviously the decision of the Veterinarian treating the case.
For the aviculturists faced with a prolapsed cloaca, you must stop short of the antibiotics, relying only on the calcium, cloacal replacement and supportive treatment. If this does not work, then it is a Veterinary matter, or else humane euthanasia.

Have you given her any calcium?

Edited to add:
FWIW, I give 500mg to my small hens and 2000mg to my turkeys.

Chicken Egg Binding. Causes, Symptoms, Treatment, Prevention



When a hen is unable to lay an egg she has created and the egg is stuck inside her oviduct, she is referred to as being egg-bound. Egg-binding can be a life-threatening condition that must be addressed quickly, preferably by a seasoned, avian veterinarian. If the egg is not passed within 24-48 hours, the hen is likely to perish.

Causes:
Calcium or other nutritional deficiency
Obesity
Excessively large or misshapen egg
Oviduct infection
Premature layer (hen began laying eggs before her body was fully mature)
Egg retention due to lack of sufficient nesting areas

An overview of a hen's reproductive system is important in order to know where an egg may be stuck.*


A hen's uterus (aka: shell gland) is the muscle responsible for squeezing the egg out of the vent. Since muscles require calcium to contract properly, if a hen has a calcium deficiency, the egg can get stuck in the uterus.


Symptoms:

• Loss of appetite
• Disinterest in drinking
• Shaky wings
• Walking like a penguin
• Abdominal straining
• Frequent, uncharacteristic sitting
• Passing wet droppings or none at all (egg interferes with normal defecation)
• Droopy/depressed/pale comb and wattles

Dangers:

• Infection
• Prolapsed uterus
• Damage to oviduct
• Bleeding
• Death

Prevention:

• Avoid supplemental lighting with young pullets to avoid premature egg-laying
• Feed layer ration, which is carefully formulated to provide balanced nutrition to laying hens
• Make available oyster shell (or another calcium source) free-choice (never add to the feed)
• Avoid excess treats that can interfere with balanced nutrition in layer ration
• Avoid treats in the summer heat when feed intake is reduced & supply additional oyster shell containers

Treatment:
Calcium (injection, liquid or via vitamins & electrolyte solution)
Warm bath
Apply KY jelly
Massage
To assess whether a hen is egg-bound at home, gently feel on either side of her vent with one hand (think: squeezing the cheeks of a cute kid). If an egg is felt, giving the hen calcium is the first course of action. Absent liquid calcium, vitamins and electrolytes in the water contain calcium and can help. Even if she's not interested in drinking, try to get some into her with a dropper or syringe carefully. If she is too weak to drink, don't try it. The calcium may be enough to get her to pass the egg on her own within a half hour or so.

Put the hen in a tub of warm water for 15-20 minutes, which will hydrate her vent and relax her, making it easier to pass the egg.

After a warm bath, some KY jelly applied to the vent can also help hydrate the cloaca to allow for ease of passage when the egg gets to that point (don’t use olive oil, as it can become rancid). Massage the area around the egg gently towards the vent, being careful not to break the eggshell.


At this point, put her in a crate in a darkened, quiet room. If a truly egg-bound hen does not pass the egg within an hour of these measures, the egg may need to be manually removed, which can be dangerous but is possible but proceed at your own risk.

"If she still hasn't expelled the egg, and you don't think she's going to on her own, then you can move to manual manipulation. This only applies if she is still bright and not in shock. Palpate the abdomen to find the location of the egg and gently manipulate it in an effort to move it along. GENTLE is the key word here. If manual manipulation fails and you can see the tip of the egg, another option is aspiration, implosion, and manual removal.

"First, get someone to help you hold the bird very securely while you work (preferably not upside dwn). Then, using a syringe and a large needle (18ga.), draw the contents of the egg into the syringe. After aspiration of the contents, gently collapse the egg all around. You want to do this gently in order to keep the inner membrane of the egg in tact, which will keep the eggshell fragments together.

Last, gently remove the egg. (Copious amounts of lubrication would be good here.) Go slow and try to keep the shell together (although broken). If all fragments do not come out, they should pass, along with remaining egg content, within the next several days."


Additional reading and resources:
http://www.avianweb.com/Prolapse.htm
http://www.avianweb.com/eggbinding.html

*Anatomical illustrations and photo reproduced for educational purposes, courtesy of Jacquie Jacob, Tony Pescatore and Austin Cantor, University of Kentucky College of Agriculture. Copyright 2011. Educational programs of Kentucky Cooperative Extension serve all people regardless of race, color, age, sex, religion, disability, or national origin. Issued in furtherance of Cooperative Extension work, Acts of May 8 and June 30, 1914, in cooperation with the U.S. Department of Agriculture, M. Scott Smith, Director, Land Grant Programs, University of Kentucky College of Agriculture, Lexington,and Kentucky State University, Frankfort. Copyright 2011 for materials developed by University of Kentucky Cooperative Extension. This publication may be reproduced in portions or its entirety for educational and nonprofit purposes only. Permitted users shall give credit to the author(s) and include this copyright notice. Publications are also available on the World Wide Web at www.ca.uky.edu. Issued 02-2011

Common laying hen disorders
Prolapse in laying hens


The problem:


The average hen lays about 300 to 325 eggs per year. Once hens reach reproductive age, most will lay an egg almost every day without any complications.
During oviposition (the process of laying an egg) the shell gland (the lower part of the hen’s reproductive tract where the egg shell is formed) is temporarily everted (turned inside out) along with the egg. This allows the hen to lay a very clean egg. Sometimes the oviduct will not immediately retract once the egg has been laid. This condition is known as prolapse. If not noticed immediately, other birds will pick at the protruding material, often causing hemorrhage, infection, and death if quick action is not taken.
What causes prolapse?

Management of laying hens during the rearing and laying period can play a significant role in prolapse problems. Some laying hen strains are more prone to pecking, which can increase the damage to the bird, but this is generally not considered a major cause of prolapse. Following is a summary of conditions where prolapse related problems are more likely to occur.

1. Over or underweight Birds
   • Overweight birds are more prone to prolapse due to general muscle weakness and a tendency to lay larger eggs. Too much fat around the reproductive organs can also lead to prolapse.
   • Birds that are underweight (according to management guide recommendations) when the birds begin lay are more likely to suffer prolapse because they may begin laying before the reproductive tract has completely matured.
2. Early Photostimulation –(increasing day length to stimulate sexual maturity)
   • Birds that are exposed to increasing day length before the reproductive tract has fully matured are more likely to prolapse, because the reproductive tract may not be fully matured when they begin lay.
3. Unbalanced feed rations
   • Insufficient calcium in the diet will cause problems with eggshell formation but can also result in poor muscle tone. Poor muscle tone may cause problems with oviduct retraction once the egg has been laid. The longer the oviduct remains outside the body, the greater the chance other birds will peck at the material, which could cause irreversible damage.
4. Reproductive age of the flock
   • Prolapse is more likely to occur at peak production and peak egg mass, simply because of the large demand placed on the birds metabolism.
5. Laying double yolked eggs
   • The excessive size of these eggs will stretch and possibly weaken cloacal muscles. Weakened cloacal muscles will lead to an increase in the amount of time the oviduct is outside the body.
6. High light intensity
   • Under high light intensity conditions, birds are more likely to see and be attracted to the everted oviduct—and thus more likely to peck at it and cause damage.

Prevention:


One of the first signs of a prolapse problem is the presence of blood-streaked eggs. As always, careful and vigilant management will lower the rate of prolapse as well as most other flock health problems. If possible, isolate affected birds to prevent further damage. Some reminders:

• Photostimulation should occur when the birds reach the weight and age recommended by the breeder.
• Balanced feed rations are required to sustain egg production and maintain body weight at recommended levels. Consult with a feed provider if you are not certain.
• Ensure that the light intensity in the barn is at the breeder recommended level. Consider reducing the light intensity by covering windows, or replacing bulbs with lower wattage bulbs.
• If the flock is laying a lot (more than 4%) double-yolked eggs, gently restrict feed intake (about 5-10% less than they eat ad libitum).
• Spend time with your birds to observe vent-pecking behaviour, and isolate them from the flock.
• Last resort only: consider a very low wattage red-colored bulb. If birds can not distinguish the color of the everted shell gland from the background of colors, they may not be as prone to cause damage.

This information is maintained by Martin Zuidhof
Last Revised/Reviewed July 18, 2002

Okay, I think it's a prolapse from an egg that was in there or one that's still in there and it may or may not have a shell. You are going to need sterile gloves, a water based lube like KY Jelly, calcium and a place indoors for her.

Step one - Bring inside
Step two - Clean vent area.
Step three - Glove up, apply generous amount of lube and gently perform an exam.
Step four - Give a 500mg calcium pill orally.
Step five - Give her a long, warm soak. If she pants, it's too hot.
Step six - Dry off.
Step seven - Push prolapse back in.
Step eight - Place in place with access to food water and a heat source.
Step nine - observe for 12 hours

If anyone thinks this should be modified, please, don't be shy, make your suggestions or tell me I'm wrong.