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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 23813
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My dog 26pounds keeps getting ingection on paws and keeps chewing

Customer Question

my dog 26pounds keeps getting ingection on paws and keeps chewing at them
Submitted: 6 months ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 6 months ago.
Kathleen, you've described a stubborn pododermatitis often seen secondary to atopy (allergies to environmental allergens such as pollens, molds, dust, and dust mites) or food intolerance. Both Jack Russels and Westies are overrepresented with atopy as breeds. These allergic conditions cause pruritic (itchy) paws resulting in my patient's licking and chewing at the paws and predisposing the skin to both bacterial and yeast (Malassezia) infections (pododermatitis). Apoquel is a reasonable attempt to reduce pruritis but the treatment of choice for Malassezia is ketoconazole at 5 mg/lb daily for a minimum of a month. Terbinafine dosed at 2.3-18 mg/lb daily for a month may be effective. It's important that a cytology (microscopic exam of a small sample of Lizzy Loo's skin surface) be performed to see if abnormal numbers of either bacteria or yeast are present. There's a good chance that such paws are bacterially infected and will need a minimum of 3-4 weeks and 1 week past clinical signs of a systemic antibiotic in the cephalosporin class such as cephalexin dosed at 10 mg/lb twice daily. Skin scrapings should be performed as well in case adult-onset demodicosis (the mange mite Demodex) is present.Cleansing wipes (alcohol-free acne pads, baby wipes, chlorhexidine-containing pledgets, or other antimicrobial wipes) used every 12-72 hours work very well to hasten remission of secondary infection. Adjunctive topical therapies that may be helpful include daily foot soaks for 10-15 minutes in 0.025% chlorhexidine solution, 0.4% povidone-iodine solution, or magnesium sulfate (Epsom salts/30 mg/L water). Alternatively, foot scrubs with antibacterial shampoo containing chlorhexidine/ketoconazole or miconazole every 1-7 days as needed may be useful. These products can be found at Lizzy Loo's vet hospital or over the counter in pet/feed stores.Please respond with further questions or concerns if you wish.

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