Hello, my name isXXXXX am a licensed veterinarian and I will try and help you as best as I can.
Has a biopsy been done yet (this is where they surgically remove a piece out and send it to a pathologist)?
a biopsy has not benn done. My wife does not want Sammy to have a full narcosis due to his Age, 12 years six months.
I see. The only way you will ever get a correct diagnosis for a condition like this would be to have a skin biopsy done. This is the most accurate way to diagnose pretty much any skin disease as it allows the pathologist to look at the individual cells and determine what exactly is wrong with them. If you are really looking for an accurate diagnosis, this is what should be done next. Otherwise there really is no way to diagnose what is going on besides guessing that it is some type of immune mediated disease
Is your dog scratching at these areas or are the areas breaking down, or is there just a color change?
If the color change is occurring without any other change, it could just be vitiligo, which is a change in pigmentation and is benign. Otherwise, a biopsy is really needed to diagnose what else it could be
the areas are breaking down ie he has no black parts and only wounds.
I see. This definitely is some kind of immune mediated disease like discoid lupus erythematous (DLE) or pemphigus complex. Unfortunately, like I said earlier, a biopsy is needed to diagnose the problem. I am sorry I cannot provide any further information for you today. I would definitely pursue the biopsy if you can
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can we do a biopsy on his paws with a local anaesthestic? Will vitamin e help?
A biopsy could potentially be done with heavy sedation and local anesthetic. The paws are very sensitive, so it would be best to at least have some sedation on board. Since we don't know what is going on for sure yet, it is hard to say if any vitamin E would be of benefit.
Wife has finally agreed to a biopsy. It is being done now. More later this week when we have the results.