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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 25239
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My Rottweiler has been limping on his front leg. About a

Customer Question

My Rottweiler has been limping on his front leg. About a week ago I noticed a quarter size open sore on the top of his paw. My vet took rxrays about 6 months broken bones. What could the open sore be. I am in-between jobs now and don't have cash for vet. They demand cash up front. My Rottweiler is 75 lbs and will be 14 years old in Feb.2017.
JA: I'm sorry to hear that. This sounds like it might be serious. I'll let the Veterinarian know what's going on ASAP. Is there anything else important you think the Veterinarian should know about your dog?
Customer: He has arthritis but has always kept moving. Lately he stills eats but seems to be loosing some weight.
Submitted: 15 days ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 15 days ago.

You're speaking with Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

Expert:  Dr. Michael Salkin replied 15 days ago.

Can you tell me, please, if you've seen your dog licking at this sore - perhaps excessively? If so, acral lick dermatitis/granuloma is likely and I'll discuss this disorder with you more fully.

Customer: replied 15 days ago.
Ok I am waiting.
Expert:  Dr. Michael Salkin replied 15 days ago.

I posted above your "OK, I am waiting." If you can't see what I posted, here it is again:

"Can you tell me, please, if you've seen your dog licking at this sore - perhaps excessively? If so, acral lick dermatitis/granuloma is likely and I'll discuss this disorder with you more fully."

Customer: replied 15 days ago.
he licks at it once in a while. It has seeped blood a little bit sometime he drags it and I thought he cut it open on the ground. I keep cream on it so it doesn't get infected
I wrap it up once I a while. .
Expert:  Dr. Michael Salkin replied 15 days ago.

Can you upload a photo(s) of it to our conversation? You can upload photos by using the paperclip icon in the toolbar above your message box (if you can see that icon) or you can use an external app such as

Here's my synopsis of what is likely to be the problem:

Acral lick dermatitis is first noted as excessive, compulsive licking at a focal area on a limb, resulting in a firm, proliferative, ulcerative, alopecic lesion. Causes of the licking are multifactorial and although environmental stress (e.g., boredom, confinement, loneliness, separation anxiety) may be a contributor, other factors are usually more important - hypersensitivity (atopy - allergies to environmental allergens such as pollens, molds, dust, dust mites, etc.; food), fleas, trauma (cut, bruise), foreign body reaction, infection (bacterial, fungal), demodicosis (Demodex mange mite), hypothyroidism, neuropathy, osteopathy, arthritis). The dermatitis is common in dogs with the highest incidence in middle-aged to older, large-breed dogs, especially Doberman pinschers, Great Danes, Golden retrievers, Labrador retrievers, German shepherds, and Boxers.

The lesion usually begins as a small area of dermatitis that slowly enlarges because of persistent licking. The affected area becomes alopecic, firm, raised, thickened, and plaque-like to nodular and it may be eroded or ulcerated. With chronicity, extensive fibrosis (scarring), hyperpigmentation, and secondary bacterial infection are common. Lesions are usually single but may be multiple and they most often are found on the dorsal aspect of the carpus ("wrist"), metacarpus, tarsus, or metatarsus.

The underlying causes should be identified and corrected (see above) with the help of his vet. One should treat for secondary bacterial infection with long-term systemic antibiotics (minimum 6-8 weeks and as long as 4-6 months in some dogs). Antibiotic therapy should be continued at least 3-4 weeks beyond regression of the lesion. The antibiotic should be selected according to bacterial culture and sensitivity results. Anecdotal reports suggest good efficacy with combined antibiotic, amitriptyline (2 mg/kg every 12 hours), and hydrocodone (0.25 mg/kg every 8-12 hours) administered until lesions resolve. Then one drug should be discontinued every 2 weeks until it can be determined which drug (if any) may be required for maintenance therapy. Topical application of analgesic, steroidal, or bad tasting medications every 8-12 hours may help stop the licking but response is unpredictable and often disappointing. When no underlying cause can be found, treatment with behavior-modifying drugs may be beneficial in some dogs - anxiolytics, tricyclic antidepressants, endorphin blocker, and endorphin substitutes are all available through his vet. Trial treatment periods of up to 5 weeks should be used until the most effective drug is identified. Lifelong treatment is often necessary.

Alternative medical treatments such as cold laser therapy or acupuncture have been beneficial in some patients. Mechanical barriers such as wire muzzles and side braces may be helpful. Surgical excision or laser ablation isn't recommended because postoperative complications, especially wound dehiscence, are common. Laser ablation may help sterilize the lesion and deaden nerve endings; however, response is highly variable. The prognosis is variable. Chronic lesions that are unresponsive or extensively fibrotic and those for which no underlying cause can be found have a poor prognosis for resolution. Although the disease is rarely life-threatening, its course may be intractable.

Please respond with further questions or concerns if you wish.

Customer: replied 15 days ago.
But why would it cause not being able to put weight on his foot. The limp was first then the sore
Expert:  Dr. Michael Salkin replied 15 days ago.

Thank you for the additional information. One of the causes of acral lick dermatitis arising is underlying pain as is being demonstrating by his lameness. Geriatric osteoarthritis and cancers of the bone become important considerations at his very advanced age for his breed.

Please continue our conversation if you wish.

Customer: replied 15 days ago.
Tried sending pic. Not good at thiswhat can be done if it is cancers
Expert:  Dr. Michael Salkin replied 15 days ago.
or can help you get a pic to me.

A cancer would be addressed by hospicing him on a potent narcotic analgesic such as buprenoprhine, fentanyl, or morphine.

Customer: replied 15 days ago.
How do they find out if it is cancers
Expert:  Dr. Michael Salkin replied 15 days ago.

Imaging in the form of X-rays initially and ultrasound or CT scans if X-rays are equivocal but there remains a high degree of suspicion for a cancer.

Customer: replied 15 days ago.
Is it treatable or is this a death sentence? I know he is old but I've had him since he was born. I don't want him to suffer. What should I do?
Expert:  Dr. Michael Salkin replied 15 days ago.

I'd be putting the cart before the horse by prognosing at this time. I don't know what prompted the appearance of that sore nor do I know why he's limping. Osteoarthritis isn't a death sentence and can be treated with nonsteroidal antiinflammatory drugs (NSAIDs) such as the prescription carprofen or meloxicam as well as supplements such as fish oil which are readily available over the counter. A cancer, however, should prompt having the final kindness performed.