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She is licking the top of her foot at her toes. The second…

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She is licking the...

She is licking the top of her foot at her toes. The second and third toe the middle joint looks swollen and she has some raw skin at the base of the toes. This has been going on since May after being boarded for 2 weeks. She is very accustomed to the environment as she has grown up in daycare . She is 10, Doberman. We have tried 2 different antibiotics as well as prednisone twice and Metacam . Her foot hurts as she sometimes holds it up. Xrays if her foot were negative.

Veterinarian's Assistant: I'm sorry to hear that. What is the dog's name?

Jewel

Veterinarian's Assistant: Is there anything else the Veterinarian should be aware of about Jewel?

She takes Proin for 2 years. Eats taste if the wild for many years.

Submitted: 4 months ago.Category: Dog Veterinary
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Answered in 4 minutes by:
12/1/2017
Dog Veterinarian: Dr. Kara, Veterinarian replied 4 months ago
Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 18,137
Experience: Over 20 years of experience as a veterinarian.
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Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help. Please give me a moment to review your concerns.

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Dog Veterinarian: Dr. Kara, Veterinarian replied 4 months ago

I'm sorry to hear that Jewel has an infection on the top of her foot at her toes that she will not stop licking, despite the use of antibiotics, prednisone twice and at one point Metacam.

An area of skin that a dog persistently licks leading to loss of fur and thickened skin, often turning darker or purple/red in color than the surrounding skin, is likely a lick granuloma. These areas of chronic inflammation and thickened skin usually are infected. They often need several months of antibiotic therapy and an elizabethan collar so that they can't be traumatized and will heal. Other therapies may be needed as well depending upon the cause.

The underlying cause that started the whole licking process must be addressed as well or she will never leave it alone.

Underlying causes can be arthritic changes as dogs use licking, and the serotonin neurotransmitter it releases, as a way to self comfort and "medicate" themselves. It can also be a stress response if she is stressed by other animals or changes with her beloved family. It can also be due to a foreign body in the tissue or a puncture wound and/or deep infection. Allergies are often a possible cause as well.

Radiographs of the joints in that leg may help determine if there are arthritic changes. If so then using omega 3 fatty acids and glucosamine/chondroitins like Dasuquin or Cosequin DS may be enough, or he may need nonsteroidal anti-inflammatories like Rimadyl, Metacam, or Deramaxx and sometimes a drug called Tramadol as well. I understand that she had radiographs done and Metacam was tried without success. Was there any sort of improvement? How long has it been since the radiographs were taken? If it has been more then 6 weeks or so they may be worth repeating. Soft tissue changes/tumors and some osteolytic (break down bone) tumors/infections can have radiographic changes that lag behind clinical changes in condition/symptoms. So when symptoms persist repeat radiographs should be done. I am concerned about her joints looking swollen.

Long term antibiotics and a possible surgical exploration of the area to look for a foreign body may be needed. If you live in the southwest a grass awn is sometimes the cause and removal of the awn and inflammatory tissue and antibiotic therapy will help.

If allergies are possible then antihistamines, omega-3 fatty acids and possibly a topical medication are indicated. One that may help is a mix of DMSO+Capsaicin +bitter apple as a topical. The capsaicin is a pain reliever, the DMSO is an anti-inflammatory and bitter apple just tastes bad. This is a prescription product so your veterinarian will have to formulate this for you. Wear gloves when you apply the mix as DMSO is absorbed easily through human skin and will give a nasty garlic taste in your mouth. You may want to explore a food allergy or allergy testing as well since she is focusing on a paw. Dogs with food allergies often have very itchy feet. I know she has been on a "low allergen" food for a while, but perhaps she has developed an allergy to something in that food.

Another option is laser removal of the lesion. This has been great for some dogs as it cauterizes nerve endings too, which will greatly decrease the stimulus to lick for many dogs.

No matter what caused this lesion antibiotic therapy is essential. They must be given for weeks to months. I tell owners for 4 weeks after any sign of the lesion being present. If you stop too early you will have recurrence.

Leave the e-collar on at least for 1 month after any lesion is present.

Sometimes mood altering drugs like Prozac are needed. We think in dogs that lick due to anxiety Prozac helps relieve the anxiety and thus helps to stop the licking habit.

I have heard acupuncture may help but I have no personal experience with that.

This is a tough condition and requires lots of patience on everyone's part. I understand that you may have been dealing with it for several months but that isn't an uncommon history because these lesions take lots of time to treat and investigate the primary cause.

Best of luck with your boy.

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Dog Veterinarian: Dr. Kara, Veterinarian replied 4 months ago

Hello, I wanted to make sure that you didn't have any further questions for me, and I'd like to know how things turned out for your pup. If you could give me an update that would be great, thank you, ***** *****

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