Apr 01 2015

Chronic Toe Pain and Licking Can Cause Secondary Bacterial and Fungal Infections. Dog Toe Amputation is Explored.

Our April Pet of the Month is Morgan, a 4 year old German Shepard mix who had one pesky problem, a toe that he just couldn’t stop licking.

Morgan 5 (413x381)Morgan had been treated with a couple rounds of antibiotics previously elsewhere, but they never seemed to help and his toe continued to bother him. Morgan had been chewing and licking at his right front paw for almost a year before he was seen by Dr. Wedde at Hawthorne Hills Veterinary Hospital.

During the exam, Dr. Wedde could see that his “pinky” toe had evidence of licking by the pink discoloration of his fur. The skin at the base of the toenail was swollen and painful and there was brown debris around the nail base.

Xray of toe 11.18.14 (214x450)Dr. Wedde was concerned about the possibility of an underlying bone infection or bone cancer, so she took an x-ray of Morgan’s toe to look for changes in the bone structure. She was very happy to see that there was no evidence of cancer on the x-rays!

She also scraped the nail bed and examined the debris under the microscope. She found many bacteria and some yeast on the slide. Nail bed infections can take a long time to clear up and often need to be treated long term with both topical and oral medications. For that reason, Dr. Wedde prescribed a two month course of antibiotics along with antifungal and antibacterial shampoos and wipes. Morgan’s toe improved on the antibiotics and wipes, but shortly after the 2 month course of antibiotics ended, Morgan began to lick at his toe once again.

At this point, Dr. Wedde was concerned that there was an underlying problem with the toe. Was it a deep fungal or resistant bacterial infection? Was it cancer? Or was it something else? Dr. Wedde knew it was time for more invasive testing. The options were to obtain a biopsy of the nail base or to amputate the toe completely. She explained that biopsy of the toe would require either heavy sedation or anesthesia and depending on the results of the biopsy, amputation of the toe may be the solution. However, toe amputation as the first step would give us a diagnosis and would get rid of Morgan’s pesky problem, but it would require a longer healing time after the surgery. After weighing the pros and cons of each, amputation of Morgan’s toe was elected.

Healed Toe 3.20.15 (396x450)Dr. Wedde performed the toe amputation and sent the toe in to the lab to be examined. The results indicated that there were long-standing bony changes, most likely caused from a previous injury or infection. The result was chronic pain in that toe, which resulted in incessant licking and secondary bacterial and fungal infections. This was a problem that would have continued to cause Morgan pain and discomfort for his lifetime, luckily, now that it was removed, it would never be a problem again!

Morgan 2 (550x375)Morgan recovered well from his toe amputation surgery and was even walking on his right paw the very next day. He is happy to no longer have his pesky pinky toe!

Dr. Shawna L. Wedde, DVM Hawthorne Hills Veterinary Hospital, Seattle WA | Diagnosis, Fungal Disease, Surgical Conditions, Toe Amputation

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