Pododermatitis is a potentially devastating disorder of the avian foot characterized by ulceration and abscessation of the planter epithelium. Commonly known as bumblefoot, this disorder is well documented in raptors but is also a disease of concern for captive aquatic birds, particularly penguins. Without treatment, pododermatitis may lead to osteomyelitis and arthritis of the affected limb or fatal systemic sequellae such as endocarditis. Several medical and surgical regimens for bumblefoot have been described and have met with variable success. In this presentation, combined medical and surgical management including radiation therapy and intralesional cisplatin are described for a case of severe bilateral bumblefoot in a captive adult rock hopper penguin.

Two schedules of daily orthovoltage radiation therapy performed under general anesthesia were implemented eight weeks apart. The right foot, in which radiographic evidence of osteomyelitis was documented, required surgical intervention between radiation treatments. Initially, radiation was administered at a dose of 3 gray (Gy) SID for 10 days. During the second course of radiation, a schedule of 3 Gy SID for 7 days was combined with intralesional injections of cisplatin into the more severely affected right foot. 5 mg. of cisplatin were injected into the right foot at the beginning of the second course of radiation followed by a 3 mg. injection seven days later.

Thorough patient monitoring was essential for the successful outcome of this case. Judicious use of antimicrobials was directed by repetitive cultures of foot lesions, alimentary and respiratory tracts. In addition to hematologic and serum biochemical analyses, serial evaluation of serum protein electrophoresis proved to be a useful monitoring tool.

The positive therapeutic outcome realized in this very severe case of bumblefoot suggests that radiation may be a valuable component of therapy for pododermatitis in select cases. Efficacy of radiation treatment may be affected by several factors, including number and species of microbes present as well as the degree of granulomatous inflammation and scarring. Determination of the most appropriate time to begin radiation therapy during the disease warrants further investigation. Early intervention may be more quickly effective and reduce undesirable inflammatory response as well as the risk of osteomyelitis.