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Dr. Andy
Dr. Andy, Medical Director
Category: Dog Veterinary
Satisfied Customers: 30036
Experience:  UC Davis graduate, emphasis in dermatology, internal medicine, pain management
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So I noticed my dog licking her paw a couple days ago. I looked

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So I noticed my dog licking her paw a couple days ago. I looked and between the metacarpal pad and only one of the digital pads I saw a red raw sore. It was not open and was dry. I decided it just looked sore and left it alone.

Tonight I noticed she was still gently licking it (not biting it). So I looked again and in the same spot where the sore was it's still red but now most of it is covered in a yellow thick crust.

She isn't limping but and didn't mind me touching it. But Is it fungal? or an Allergy? It also is not on any other paw, just the one.
Welcome! My name isXXXXX am a UC Davis graduate, and currently, a Medical Director of a veterinary hospital.

I am sorry to hear about this concern for Nala.
Great questions!
Let's think of the differential list first.
Possible causes could include:
1. A pododermatitis (bacterial and/or yeast infection)
2. A pododermatitis as a result of a primary environmental or food allergy. Quite common as 50% of dogs with allergies are feet lickers
3. A hypersensitivity reaction like from an insect bite or sting
4. A migrating foxtail. This is always a bit worrisome. This is when a piece of plant material, like a thorn, can get caught up and migrate under the skin.

With it only being one foot, certainly some type of previous injury that is not getting infected from all the licking is a consideration as well.

Now what?
It clearly sounds like it is infected. So, the wound will need to be thoroughly cleaned and very likely both topical AND oral antibiotics should be started.

Second, the paw must be protected. So, this can either be by using a conehead to prevent licking and/or you could buy a rubber velcro boot to help paw injuries to heal at many of the larger petstores. These are great for injuries like this or when paw pads are torn.

You can clean the wound with hydrogen peroxide or dilute betadine (dilute the dark brown betadine to a light brown tea color using warm water).

You can also apply triple antibiotic like neosporin three times a day until you can get into the vet.

That yellow crusty discharge can suggest that the wound ulcerated or that it may have ruptured letting some stuff out.

Please let me know if there is anything I did not cover for you. I hope that information has been helpful.
Please remember to select Reply to Expert, if for any reason you need further clarification, have more questions, or were expecting a different type of answer. My goal is to try and provide you the best answer possible.
Dr. Andy

Customer: replied 3 years ago.

That is a picture of her paw. She has been itching her nose and seemed to be allergic to her past food. So I changed it and she has been on a limited ingredient diet for a couple of months now. She still occasionally itches her nose but never licked her paws.


But now she has been licking this one paw but it just started a few weeks ago, if that.


Does it appear she needs to go to the vet? Does it look urgent? Is there anything I can do at home for it? Or will she need oral antibiotics?

That almost looks like there was a previous abrasion to the paw or a paw pad injury.

I can't 100% rule-out a fungal infection like ringworm (which is contagious/zoonotic to you), but less likely under the paw.

I still vote for a injury that has simply been worsened by licking.

Well, its been going on awhile, so based on duration, worth the vet visit for sure.

Urgent? Well, just based on the picture, no.

I'm greatly leaning towards the vet visit because I do think a much better topical ointment and oral antibiotic is necessary.

Vets prescribe many topicals that are often a combination of a steroid, antiyeast, and antibiotic, which would be good here.


As a separate answer, just so you have it, here is all my general information about both environmental and food allergies. Just thought you would like to have it.

Allergies will 80% of the time be an environmental allergy, with only 20% or less representing food allergies. Some pets, suffer from both environmental and food allergies:
Atopy (environmental allergies)

If you want to actual diagnose what in the environment may be causing the allergy, you can do an allergy test. Now, you don’t have to shave half the body and do the old grid test on the skin. There is now a blood test that looks for allergies to weeds, trees, grasses!, molds, even house dust mites. You can read more about it here:

Testing for Environmental Allergies

If your veterinarian does not offer VARL,
VARL testing
they may offer a comparable company to perform the blood test like Heska.

It is important to also recognize, once the skin is inflamed or has an odor, there is likely a secondary yeast or bacterial skin infection present. It is critical for any secondary infection to be treated aggressively, as the infection itself will contribute to the pruritus (itching or increased licking).

Now, I did say that up to 20% of pets can actually have food allergies. So, to rule-out food allergies you need to do a diet trial.
Summary: The primary protein in most dog foods is lamb, chicken, or beef. The primary carbohydrate is rice or corn. So, you need to change both. The most popular alternative diets are Venison and Potato, Duck and Potato, or Fish and Potato. It is available in prescription formulas (i.e. Science Diet D/D) or you can find some similar foods at the big pet stores like PetSmart or PetCo. I always recommend picking a “limited-ingredient diet” from your vet to ensure you are doing the trial properly. Just make sure that when they say Venison is the "main ingredient" they don't sneak in other stuff like lamb meal or fish meal. A non-prescription option would include Dick Van Patten's brand called Natural Balance. Keep in mind, holistic or all-natural foods are not necessarily any better when trying to remove a food allergy. Chicken is chicken, and rice is rice. When you perform a diet trial, you must stick with the food for 2-3 months to see if there is any benefit. NO OTHER treats or human food can be given during this time period. Remember, a grain-free diet is not necessarily any better. Over 75% of the time, it is the protein in the diet that is the problem. Lastly, even a limited ingredient diet, as explained above, is not good enough. Sometimes, you need to use a food that is processed in such a way, that the body cannot react to it. A popular choice is Science Diet Z/D low allergen or Ultra allergen. They utilize hydrolyzed protein. The body cannot react to the protein in the food.
Food Allergies

TREATMENT OPTIONS (A small representative list - some suggestions you may have already tried)
1. Steroids. Veterinarians will either give an injection that can last from hours to weeks, or send home oral steroids like prednisone or dexamethasone. Steroids can be safe if not used long-term (several months) and if used as directed by your veterinarian. Frequently, the oral steroids will be weaned down to the lowest dose necessary to keep the allergy suppressed.

2. Antihistamines. A prescription of hydroxyzine is common. Sometimes, over-the-counter Benadryl will help. However, for many allergies, antihistamines alone frequently are not good enough to control allergies. But, if your pet is already on steroids, they can help to reduce the necessary dose to keep the comfortable.

Benadryl can be given at a dose of 1mg per pound of body weight. Keep in mind, Benadryl tablets and liquids come in different sizes. So, an approximately 25 pound dog can get a full 25mg tablet or a half of a 50mg tablet. I usually avoid the liquid Benadryl in larger dogs (you would have to give too much of it). You can give Benadryl every 8-12 hours.

Another antihistamine to consider is zyrtec (cetirizine). It's advantage is that it is only given once a day. The dose is about 1mg per 2 pounds of body weight. So, a 20 pound dog would get a 10mg dose. It comes over the counter as 5mg or 10mg tablets. Another resource suggests starting with no more than 10mg even for medium to larger dogs.

3. Essential fatty acid supplements. Definitely, if you plan to give an antihistamine long-term, combine it with an EFA.
I prefer the veterinary products, which are already dosed for pets. Your vet should carry a product on their shelf, or over-the-internet you can look for Aller G3, 3V caps, EFA-z, or Derm caps.

4. Atopica. A immunosuppressive medication, that help regulate the way your pet’s body reacts to allergens. Neat stuff. It is important to note that it can take several weeks before benefit is observed, and tends to be a bit more expensive than typical allergy treatments. Read the link below for more information. Although Atopica is not readily available, your veterinarian can order a generic cyclosporine. Not quite as good, but it is an alternative.

5. Your vet should also carry some special sprays and shampoos designed for whatever skin condition your pet may have. One of my favorite product lines is called Douxo. They carry various shampoos designed to calm the skin, treat bacteria infections, and help with seborrhea (dry, scaly or scabby skin)
Douxo products

6. Lastly, oral antibiotics and/or anti-yeast medication, if indicated. Generally, your vet will recommend a simple skin cytology test to see what is on the surface of the skin. This should be inexpensive, and can be perform in the hospital. This is a key test especially when the skin is itchy, as secondary infections will actually exacerbate the degree of pruritis (itching) of your pet.

Hope that additional information helps. Definitely, reply to me if there is any other way I may assist you. I hope my responses have been satisfactory?
Dr. Andy
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