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Dr. John
Dr. John, Texas Veterinarian
Category: Dog Veterinary
Satisfied Customers: 4995
Experience:  Over 14 years of clinical veterinary experience
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My 8 year old Papillon recently had a biopsy completed on the

Customer Question

My 8 year old Papillon recently had a biopsy completed on the pads of his feet. That biopsy came back with the pathologist diagnosing him with hepatocutaneous syndrome. He then had a liver and pancreas sonogram as well as a biopsy done. That pathologist did not see any problem with the liver. My vet has During the course of time has done several blood panels. Where his white count initially was extremely high, it has now gone into an acceptable range. He has been on clavamox for 3 weeks. Where my vet said his paws were looking better, my Papillon does not want to get up and walk. The vet has him on
pain killers (Tramadol) and Metacam None of this seems to be helping. I am not very big on keeping the dog medicated when it only seems to make him lethargic. Do I start over with another vetand put him through more testing or keep him medicated. At this point I don't even know what is wrong.
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Barbara replied 1 year ago.
Hi, Welcome to JustAnswer. My name is ***** ***** I'll be very happy to help out today.If you think that Oscar doesn't want to get up and walk because of his pain medication, then I wouldn't give him anymore and see how he responds to this. Neither medication has to be tapered. After about a day, the medication should not be affecting Oscar at all, so you'll be able to tell if this was the cause of his lethargy. Oscar does seem to be responding to the Clavamox very well and this is great. Sometimes we don't know exact causes, but find the cure to ?. Right now for Oscar this does seem to be the case!A more direct answer would be that I don't think you should start over with another vet, and I don't think you should keep him medicated. I think we should wait and see how Oscar responds to having no painkillers on board.Does this make sense to you too?Dr. Barbara
Customer: replied 1 year ago.
I didn't mean to infer that Oscar did not want to get up and walk because of the pain meds. He clearly doesn't want to get up and walk because the pads of his feet hurt. When I get him to stand he lifts each of his paws. And then when he lays back down his paws begin to tremble. Where I do feel the pain meds are making him lethargic, I do not feel they are helping with the pain. He has been on these pain meds for 3 weeks Is there anything I can put on his feet that could help.
Customer: replied 1 year ago.
(Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call. Let me know if you need more information, or send me the service offer(s) so we can proceed.
Expert:  Dr. Barbara replied 1 year ago.
Oh!!!!! Now I understand. . .thanks. ***** will cause discrete lesions in the liver as well as on the skin. The foot pads are just one area of skin that can be affected. If in the liver biopsy a sample from one of these discrete lesions was actually missed, the the biopsy wouldn't confirm Hepatocutaneous Syndrome. It could be however that Oscar has necrotizing dermatitis.
Expert:  Dr. Barbara replied 1 year ago.
I see your request to speak on the phone. I have to place that request with the administration on my end to get the ball rolling. I'll do that now.In the meantime, can you describe or take a picture of the appearance of his pads now? Are the biopsies healed with sutures or staples removed? Is there and drainage from these biopsy sites. Are they swollen? Also, how much does Oscar weigh and what are the doses of his Tramadol and Metacam? Thanks!