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Hello and thanks for trusting me to help you and your pet today. I am a licensed veterinarian with over 25 years experience and would be happy work with you.
Has any sort of testing been done on the skin in that area? Skin cytology, skin scrape for mites?
How long were the antibiotics used?
Does he have any other issues with his other feet? Foot licking? Redness?
Does he have any other skin issues elsewhere on his body or ears?
Thanks and I will respond further after you reply. There may be a slight delay while I formulate and type a thorough response or I may be offline, but if so, I will respond as soon as I am able.
Thank you for the reply.
Yes, you are correct that the pain meds are not going to get to the root of the problem, but definitely are needed as they are painful lesions.
It sounds as if the skin condition called an interdigital cyst is what he is dealing with. These are in inflammed cystic lesion that involves an enlarged or ruptured hair follicle between the toes referred to as a folliculitis or furunculosis. They often become secondarily infected, can become very painful and can take a long time to resolve ( 4- 6 weeks or longer) on the appropriate antibiotic therapy. It may be that it was simply not treated appropriately or long enough on the first treatment. The inflammed "cyst" can preset like a tumor or mass and can be difficult to differentiate from one and there may or may not be drainage from the lesion. Other causes can include mange mites, foreign body penetration and tumors. If it is a recurrent problem not responding to appropriate therapy after skin scrapings for mites, skin cytology and sometimes even bacterial culture to rule out a resistant infection have been performed, it is a good idea to surgically explore for a foreign body and to get a biopsy sample for histopath analysis. You are also correct that allergies are often an underlying factor in these dogs, but even if he is identified as a dog with allergies, this particular lesion still needs to be treated, the the above steps are most important. I find that besides the proper antibiotics, these dogs will often respond better when part of the treatment involves topical daily foot baths with antibacterial shampoos as well as alternating foot soaks with epsom salts or dakins solution (dilute bleach). It is also essential that he is not allowed to lick the site excessively.
Here is a link that explains more about diagnosing and treating these challenging lesions. LINK HERE
I hope this is helpful. Please let me know if you have ANY other questions. My goal is to give you 100% satisfaction and if you are not yet satisfied, please reply so I can clarify for you.
I am sorry the link did not work. Let me try send it again to you. LINK HERE
I have treated plenty of these lesions and they require long term care unlike what most ER docs are used to seeing as they are more experienced with acute and trauma type cases versus chronic dermatologic cases. Your best bet is to work closely with your regular vet and make sure they rule out all of the other possible inciting factors like mites or foreign bodies as well as use diagnostic testing results to prescribe the appropriate medications based on the results of those findings. I work in a practice alongside a veterinary dermatologist and he is presented with numerous cases weekly of antibiotic resistance due to inappropriate treatment so if you feel you are not making progress, you may want to seek the expertise of a board certified veterinary dermatologist.
If he is still uncomfortable tonight, an epsom salt soak may offer some temporary relief as well as decrease some of the inflammation.