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Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
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Experience:  Hello, I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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My 10 year old, healthy, male, pug has a front left paw

Customer Question

My 10 year old, healthy, male, pug has a front left paw deformity and therefore has been having recurrent swelling of the paw since a few years now. The swelling with abscess lasts 1-3 months during which he cannot put pressure on it and is usually limping. Last time (9 months ago) the local vet cut and drained it, after which he became fine for a few months. The problem is that the swelling / wound is recurrent and as per the doc, he would need to put him under anesthesia to be able to fully clean the wound. My concern is to have to put him under anesthesia, especially at this age. Is there any other non-invasive way to heal him? Please refer to the attached photo. Thank you.
Submitted: 11 months ago.
Category: Dog Veterinary
Expert:  Dr. B. replied 11 months ago.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today. I do apologize that your question was not answered before. Different experts come online at various times; I just came online, read about your situation, and wanted to help.

Again I do apologize that my colleagues could not aid you sooner. If you would still like assistance, can you tell me:

Was pus actually removed from the lump?

Has he vet every culture the pus? Every treated with antibiotics?

Does your lad have any other health issues?

Unfortunately your photo didn't attach, could you try uploading it again? To post them online, you can use the paperclip icon on the tool bar above your text box. Or if you can't see that on your computer/phone, then you can post them on any other site (ie Flickr, Photobucket, imgur, etc) and paste the web link here for me to check.

Customer: replied 11 months ago.
Hi,Yes pus was removed. It was checked and was not malignant. He was treated with antibiotics with local antiseptic while the wound was healing. No other health issues. I have reattached photos, please let me know if you can see them now.Thank you
Expert:  Dr. B. replied 11 months ago.

Thank you,

First, I do want to note that age is just a number when one is considering anaesthesia with older pets. So, we don't want to just rule it out based on his age. Instead, it'd be better to consider having a general geriatric blood sample tested. If his organ function is all normal for his age, then he actually could have an anaesthesia without worry to clear this out once and for all. And of course, his vet would be sensitive to any anaesthetic concerns you had and would make sure to use lower doses of safe drugs and could even put him on IV fluids during the procedure to ensure he flushed the anaesthetic drugs out without issue. So, that could be an option despite him being ten.

That aside, while I am glad to hear that the sample were not found to be malignant, I would note that it would be best to have a pus sample not just checked for cancer but sent for bacterial culture and sensitivity. The reason is because that way the lab would identify the species of bacteria causing this abscess and what drugs it is vulnerable to. And that way you could treat this as effectively as possible with antibiotics to try and clear this for him.

Finally, just further to what we can do with these situations, I would also consider discussing the use of antibiotic impregnated beads for him. This is something we use with rabbit abscesses (which can be even more challenging then what we face with dogs). Specifically, we actually put plastic beads infused with our antibiotic of choice into the tissues to treat more locally. And that can be of benefit if we found that his abscess was so walled off in the body that systemic/oral antibiotic could not reach it.

Overall, these would be our options at this stage for your lad. And again being 10 years old doesn't really make him any less of a safe anaesthetic candidate. So, its worth checking bloods to see if he is in prime health and that would be an option to get this cleared for him. Otherwise, these other steps would our best alternatives for him. Finally, just since you didn't mention any pain relief, I would suggest pain relief here as well as antibiotics. That way if we use a dog safe anti-inflammatory, we can manage his discomfort, help him use the foot, but also reduce inflammation/swelling with this infection.

All the best,

Dr. B.

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If you have any other questions, please ask me – I’ll be happy to respond. Please remember to rate my service once you have all the information you need as this is how I am credited for assisting you today. Thank you! : )

Customer: replied 11 months ago.
Thank you. Regarding the embedded beads with antibiotics, the local Vet opines that they are likely to lead to a fistula and then the beads have to be surgically removed.....what is your opinion on this ?
Expert:  Dr. B. replied 11 months ago.

You are very welcome,

Now it is a possibility to see fistulas, but it is uncommon. To develop one, the body would have to be reacting to the bead (which is not often seen since they are designed to non-tissue reactive and are biologically inert). So, one is more likely to have a fistula or draining tract with an untreated abscess then in response to the beads.

Of course, if your wee one was unlucky in that respect, then your vet need only to have strung the beads on to a small piece of orthopedic wire (making a "string of beads") when inserting them. That way if they did need to remove them for any reason, they need only locate one bead and the remainder can be removed by pulling the string. And that likely could be done with a bit of sedation or potentially even local anaesthetic. But again we often have no issue with the beads and they can just be left after we have cleared the infection.

All the best,

Dr. B.

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If you have any other questions, please ask me – I’ll be happy to respond. Please remember to rate my service once you have all the information you need as this is how I am credited for assisting you today. Thank you! : )

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