Cysts on front paws

[mick]

Hi Guys,

The latest is that the vet put him on Prednicare steroid tablets 5mg about 4 weeks ago and they seemed to clear the cyts up but the side effects were awfull. He gained weight like crazy and had constant diaoria to the effect that he pooed in the house three times and had us up most nights because he had to go outside. Poor old lad he must have been frantic and the wife only left him for an hour at a time.

Took him back to the vets three weeks ago as he had not had an outbreak for 8 days and the vet told us to stop using the tablets. He was still out of sorts for about three days then he seemed okay and this lasted till a week ago when the cysts started to break out again.

Have just come back from the vets with him and the vet has told us that he may just have to put up with these cyst outbreaks. I remarked that he was limping and so must be in some pain and discomfort as they are between the pads of his paws but the vet again said that in some dogs they will never go away. I asked again why its only the front paws and he told us that this is how it sometimes happens. I told him I was not at all happy with this so he has now given him a course of Medrone V 2mg one a day tablets. Again more steroids but these are not so strong.

I am going to give this latest treatment one last shot and if they do not work or if they upset him in any way then I am going to get a third opinion. He has had them now since July and its stressing me out to see him this way. Mind you limping or no limping he still demands his three long walks a day and if we try to con him out of one he soon lets us know talk about a built in alarm clock .

I have to head back to Libya on Saturday but keep in contact with my wife and will let you know how he goes on.

Dont really know what to do if it continues as I am reluctant to just keep trying various vets and would like to find a specialist in this field. Anyone know of a vet in the Northamptonshire area that specialises in this field that they could reccomend to us.

Best regards,
Mick.

[PennyB]

You could always get a vet school referral

[mick]

Penny,

Whats a vet school referral and how do you go about it?

Regards,
Mick.

[PennyB]

Penny,

Whats a vet school referral and how do you go about it?

Regards,
Mick.

ask your vet as they would need to find the best one and refer you. If you think of your vet as a GP who then refers you on to a specialist at a hospital the vets would refer peopels pets to either a specialist vet practice or a vet school (which is like a teaching hospital). At the vet schools they have, like a hospital lots of different specialists and diagnostic facilities on site, and you are assigned a senior vet (who would be a specialist in a certain field) and a final year student.

As I said your vet has to refer you so best to speak to them --- they may even know of a specialist vet practice that's nearer to you (vet schools nearer to you are probably Bristol or London or I think there's now a new one in Notts).

I've been to Bristol with one of my cats and Cambridge vet school with Wilf my cocker (which in my case meant travelling from Cardiff to Cambridge and leaving him there for a week, but well worth it as their care of him was 2nd to none).

Obviously it costs more than a trip to the local vet but still worth it with or without insurance

[mick]

Hi Penny,

Many thanks, we will give Jess a week on these tablets and see how it goes but I fear that even if it clears the cysts up then as soon as we stop giving him the tablets then the cysts will start to break out again. If this occures then we will go back to the vet and will carry out your suggestion and get him referred.

I am nervous as to what long term damage these steroids could be doing to him as he is no longer a young dog

Best regards,
Mick.

[Jen256]

Has the vet not taken any swabs to find out if it is bacterial/fungal? Charlie has had some blisters on his elbow before and the first thing the vet did was take a skin sample to find out if there were any parasites, i think they also did a culture to see if it was a bacteria. We were given fuciderm which has an anti-biotic and steroid in and it really helped. Although it should not really be used on broken skin it did help.
Hope he is better soon.

[mick]

Jen,
Thanks for the good wishes.

No the vet has not taken a swab at all and I myself have spent hours on the net trolling through what could be causing it and to tell you the truth there was so many things it could be that it really started to get me worried. My wife told me I was turning into a dog hypochondriac.

The first thing we were told back in July was that it was a fungicide infection and was given Hibiscrub but that did no good at all and that was before the break outs.

Will let you know how the lad goes on.

Regards,
Mick.

[*Theresa*]

I don't have anything of any use to say as I am a new owner of a puppy I just read all these things in the hope I will learn something that might be some use to me in future. Got to the end of your posting and found I was in tears. You must be so worried by now. It is so frustrating that they can not just tell what is wrong and start healing it. Me my OH and Glen send our very best regards and hope this all gets sorted soon.

Theresa

[mick]

Hi Theresa,

Many thanks for your concern and please give my regards to your family.

Jess is coping okay allthough its probably worse this time around and he is tending to limp more than ususal as he now has a cyst on each of his front paws.

His priority at the moment is deciding which one to lick first:D.

I have just come back from his noon walk and he seemed to manage okay we just took it a little slower (both of us are getting on a bit now). He was siting on my knee nuzzling me for about 10 minutes before I just had to gve in and took him for his walk even though his feet are giving him some pain he still makes sure he goes at his normal time.

He is such a lovely boy and gives me masses of pleasure. I miss him dreadfully since I took this one year contract working in Libya and being away for three months and back for only two weeks he really cannot understand it as we have never been parted before.

Its good though when I come back for my two weeks as he goes mad when he sees me and will not leave my side and sticks to me like glue.

Keep smiling
Best regards.
Mick. 

[Penel]

I am guessing the vet thinks its auto immune - hence the pred and medrone (both steroids which suppress the immune system).
Are they interdigital cysts ?  is he on high dose evening primrose oil and vitamin E - or has the vet ever suggested that ?

[Annette]

I don't have much to offer except good wishes.

But, Hibiscrub isn't an anti-fungal preparation (as far as I recall) so how did your vet think it might help a fungal infection?

Malaseb, however, is antifungal and antibacterial. Have you tried that? (prescription only, I think)

[jann]

  I really don't want to alarm you but I would have thought the vet would have taken a swab at least. We had a Skye terrier incidentally called Jess as well who developed a lump between the pads on a back foot, after a biopsy we discovered it was a malignant tumour, it was removed but unfortunately had spread and she ended up with the leg being amputated. Unfortunately again after about 6 months secondary tumours were found in her liver and we were devastated that we had to let her go. As I said I really don't want to alarm you but I would definitely ask for more investigations to be done, good luck with it Jann
to Jess 

[mick]

Hi guys, Sorry for not responding to the latest posts ref our Jess but was flying back to Libya today so have only just read them.

Penal, I am really not aure if they are interdigital or not. As described before they come up as a red swelling normally between his paws and mostly towards the bottom of the paws but are not on the pads themselves. They then seem to (and this is the only description I can give) explode into a mass of blood and clear fluid leaving a raised gaping hole. the vet has never mentioned primrose oil or vitemin c but if these steroids do not work this time then I am open to try anything.

Annette, I will ask the vet next time we take him about Malaseb though he has never suggested this to us.

Jann, I really do not think it is a tumour as it regulary breaks out into what I decribed above and then heals up until the next outbreak and is not solid enough in my restricted opinion to be a tumour. As I say I am giving the vet this last chance and then I am going to do what Penny suggests and insist on him being refered.

It would of course happen now as I have never been away from him before and I dont half miss him and will not see him for the next three months and then only for two weeks.

In 2000 when I went to work in Dubai for two years we of course took him with us but you could not imagine the problems I had getting him back into the UK as the pet passport scheme was not in effect for the Emitrates. I could write a book about it except I really do not think people would believe me as to what I did and went through hence why my wife and  I made the decision for me to come here alone.

Its hard when you become so attached and this may sound a bit soppy but he and I are like soul mates and when I am in the UK we go everywhere together. He is quiet happy sitting in the car and I honestly get the genuine impression that he prefers to wait in the car then be at home alone. I know we all say the same thing but he really is not trouble at all. I am very very lucky to have him.

Best regards,
Mick.

 

   

[mick]

Sorry folks,

I forgot to ask a question on the above last post of mine and its not old age this time making the memory lapse but probably because I  have been up since 4.30am this morning.

This is a long shot seeing as he has these cysts break out on both of his front paws but just suppose he has grass seeds that have worked down to the bone and again supposing these could be causing the outbreaks would an x-ray show up these grass seeds so wouold it be worth having an x-ray done?

Best regards,
Mick.

[Penel]

Hi Mick,
it does sound like interdigital cysts to me.
Have a read of this link...
http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/70800.htm
Treatment:
Interdigital furuncles respond best to a combination of topical and systemic therapy. Cephalexin (20 mg/kg, PO, tid, or 30 mg/kg, PO, bid) is recommended for 4-6 wk of initial therapy. However, because the lesions are pyogranulomatous, it may be difficult for antibiotics to penetrate them; therefore, >8 wk of systemic antibiotic therapy may be required for lesions to completely resolve. These lesions are often complicated by concurrent Malassezia spp infections. Oral ketoconazole or itraconazole (5-10 mg/kg) for 30 days may be indicated. The presence of Malassezia can be documented by cytologic examination of nail bed debris and/or impression smears of the skin. Topical foot soaks in warm water with or without an antibiotic solution (eg, chlorhexidine) and the application of mupiricin ointment are recommended. Some dogs may benefit from antibiotic wraps and bandaging. Antihistamines given for the first several weeks of treatment may partially alleviate pruritus, if present. Glucocorticoids are contraindicated.  
Chronic, recurrent interdigital furunculosis is most often caused by inappropriate antibiotic therapy (too short, wrong dose/dosage, wrong drug), concurrent corticosteroid administration, demodicosis, an anatomic predisposition, or a foreign body reaction to keratin. Lesions that recur in spite of therapy can also be a sign of an underlying disease, eg, atopy, hypothyroidism, or concurrent Malassezia infection. Lesions in confined dogs are likely to recur unless the dog is removed from wire or concrete surfaces. In some chronic cases, surgical excision or surgical correction of the webbing via fusion podoplasty may be needed. Alternatively, pulse antibiotic therapy (full dosage therapy 2-3 times/wk) or chronic low dosage antibiotic therapy (eg, 500 mg/dog, PO, sid) may help maintain clinical remission and provide pain relief in dogs with chronic lesions. This therapy is recommended only when the inciting cause cannot be identified (eg, idiopathic pyoderma), treated (eg, anatomic predisposition), or resolved (eg, chronic infection caused by foreign body material or keratin

So it may well be that your vet hasn't got the treatment exactly right yet....

ps - yes it is possible that it could be grass seeds but I am not sure they would show up on an x ray...