Tikki, a 14-year-old female sulfur crested cockatoo, was brought to the Veterinary Center for sudden lameness. Tikki came in dragging her beak on the ground in order to move, as she could not use her right leg at all. The veterinarians at the Veterinary Center examined Tikki and saw that she couldn’t bear any weight on that leg, so they decided an x-ray was the first step to figuring out what was going on.
The x-ray revealed that she had no broken bones. However, her right hip was dislocated. Coxofemoral luxation – dislocation of the coxofemoral, or hip, joint - occurs when the thigh bone (the femur) is pulled from its hip socket and rests outside the socket inappropriately. Dislocation of the hip occurs most commonly from trauma, such when a bird gets its leg stuck in a cage and tries to pull it free. During traumatic events like this, the ligament that holds the femur into the joint socket is damaged, allowing the femur to dislocate. In Tikki's case, no one knows what exactly happed to cause her injury, but the x-rays confirmed that her hip was clearly dislocated.
Getting the femur back into its socket is not an easy task. The problem is that in birds, the hip joint socket is very shallow, and even when the femur put back into place in the socket, without the ligament to hold it there, it can pop back out easily. With this injury, surgery is often needed to suture the femur into the hip socket, effectively recreating the ligament, to ensure the femur stays put. This type of surgery, called an open reduction, is very involved not only because the skin and muscles around the hip must be cut through to access the joint, but also because there is risk for nerve damage, bleeding, and infection of the hip joint. In Tikki's case, before taking the risks associated with an open reduction procedure, the vets performed a closed reduction - attempting to get the femur to stay in place without surgical intervention. If the closed reduction didn’t work to keep the femur in the hip socket, the doctors would move to an open reduction, but since birds are at risk for significant blood loss at surgery, less invasive procedures in these animals are generally preferred methods of treatment.
The vets and technicians anesthetized Tikki so that her leg could be touched without hurting her. They carefully manipulated her femur back into its socket. Because the femur ligament was severed, the femur would not stay in place in the hip joint without a little help. The vets made a cast for Tikki's leg that extended from her toes to up and over her hip to help keep her femur in place in the socket. Ideally, the cast would prevent her leg from moving and her hip from dislocating again. Over time, Tikki’s hip muscles would strengthen, and scar tissue would form in the joint where the torn ligament was, helping effectively to keep the femur in place, as the ligament would have.
After the closed reduction, Tikki was placed on strict cage rest and remained in her cast for 3 long weeks! This was difficult, as cockatoos are very active and don’t like being caged. After 3 weeks, the cast was removed. Without the cast on, Tikki still had to rest for another 1-2 weeks, but she began standing on her leg and using it to perch. Like a human who has had a cast on and has not used his leg for a long period, Tikki was very weak on her leg when the cast first came off. With the vets’ guidance, Tikki’s owner started Tikki on daily physical therapy consisting of several cycles of passive range of motion exercises in order to strengthen her leg muscles and increase flexibility of her injured leg. Once she was gripping well with her foot and able to perch normally, Tikki was allowed to walk for only short periods of time each day at first. Initially, she was very tired from walking just a few feet. Slowly, over a few weeks, Tikki’s walking time was increased, until she regained normal function of the leg without getting tired.
Today, Tikki is happy and healthy, once again standing on her own two feet. She was one lucky bird to have avoided surgery! Thanks to the team at the Veterinary Center and to the dedication of her owner, enforcing both the cage rest and physical therapy, Tikki can now live a normal active bird life again.