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My 6 year old Golden Retriver named Max is getting a growth…

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Hello, my 6 year old...
Hello, my 6 year old Golden Retriver named Max is getting a growth on his paw that we're concerned about. We're getting him an appt with a local vet this week but I was wondering if you can take a look at it and maybe give us some idea of what it might be?
Submitted: 10 months ago.Category: Dog Veterinary
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Answered in 5 minutes by:
10/3/2017
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 10 months ago
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 35,511
Experience: University of California at Davis graduate veterinarian with 45 years of experience
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You're speaking to Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 10 months ago

Yes, Anthony, you can upload photos by using the paperclip or add file icon in the toolbar above your message box (if you can see those icons on your particular device) or you can use an external app such as dropbox.com/

Please check that the photo(s) is in focus prior to uploading it.

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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 10 months ago

Thank you. Give me a moment to take a look, please...

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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 10 months ago

The pics are a bit out of focus. How long has this been present on his paw, please?

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Customer reply replied 10 months ago
We noticed the growth about two weeks ago
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 10 months ago

I can't be as specific as I would like to be with this. If you brought Max to me, I would needle aspirate this and examine the aspirate microscopically. It I couldn't determine what the cells I saw represented, I would send the aspirate to my pathologist for review. Make sure Max's vet aspirates this and doesn't just send home an ointment for you to apply in the hopes that this will go away. Please continue our conversation if you wish.

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Customer reply replied 10 months ago
That's what we figured, I just wanted to double check if a vet could clearly identify it as something serious/not serious before we took him in. Obviously we're concerned it could be something malignant, but I can't seem to find anything that looks like it on any google search. I should also mention that he has a much smaller growth on the side of the same paw that is similar to the larger one.
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 10 months ago

Hyperpigmented growths concern us because they can represent benign melanocytomas but also malignant melanomas and it's very difficult to differentiate one from the other without a biopsy. I don't like to hear that there's more than one of the same type because that suggests metastasis. I want very much to hear the upshot about this growth, please.

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Customer reply replied 10 months ago
I think we'll be taking him in Wednesday and I'll be sure to keep you updated. I had a yellow lab that had a malignant growth on his paw when he was 9 years old, it looked much worse than what Max has now, the vet cut it out along with a bit of his toe and he went on to live to be 14. Hopefully if this is malignant we'll be catching it even earlier.
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 10 months ago

I appreciate it.

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Customer reply replied 10 months ago
Hello sir,
Just letting you know that we took max today and the spot on his paw was diagnosed as a lick granuloma. If you have any advice on how to best treat that condition I’d be interested to hear .
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 10 months ago

Thank you for the update but had you ever seen him lick this area? Here's my synopsis of acral lick dermatitis:

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.

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