Blister In Between Toes - Possible Foreign Object

[Guest HTC504]

We've had our grey for 5 months ( he is 5 and stopped racing in Fall 2013) and we've been in and out the vet with him since we got him, he's either really unlucky or there is something more going on. He is a very gentle and loving dog and it is really hard to see him suffer. He just wants to chase squirrels in the backyard.

 

When we first adopted him he was already tripoding on the back leg. At the time xrays were taken of his back legs to rukle out arthirits/osteo, he was given metacam and dasaquin (covered by our adoption group). However a few days after we visited his foot swelled up, he ran a fever and we visited our vet. It appear to be a localised infection and after a course of antibiotics he was back to normal and running around again.

However mid March he sliped on ice/snow and injured his front right shoulder. After a few days we took him to see the vet again and he took Metacam for a week which seemed to fix the problem, however he then started to limp again and seem generally not himself. So he took Metacam again for another couple of weeks. Again whilst on the drug he was "normal" and happy to run around the backyard. However once we stopped the metacam he was limping again, however it appears to be the left front leg!

So back to the vet. She poked and prodded and could not get him to whimper or flinch. They took xrays to rule out arthiritis and one of the xrays showed a very small dot near his toe (possibly gravel?). She found a very small blister type thing between two of his toes. Eventually it started to swell up like a blister filled with fluid and would not pop. It is on the side of his toe, not actually on the webbing between his toes. We soaked it twice a day with epsom salts and he took antibiotics to hopefully bring to the surface the thing that was causing the infection. However the blister grew and eventually we had to get it lanced/flushed. It then reappeared and eventually we had to lance it again/flush it through. It would pop slightly after soaking but no pus ever came out, just clear or slightly bloody stuff.

So last Friday Ubet went in for surgery to see if they could find the gravel and explore/flush out the drainage channel, There appeared to be another drainage channel up through the bottom of his pad too. However after two hours they xrayed him again and could still see the dot. It is very hard to see a foreign object when you do exploratory surgery and our vet thinks it could possibly be in the pad, basically to extraat it they would have to slice up his pad. So far he is healing well but we are very scared it is going to start swelling up again. They are then talking about amputation of the toe which we want to avoid if possible because he already has lost one toe on this foot when he was racing. I am trying to see if I can get hold of any xrays from when he was racing to see if this dot has always been there.... another possibility is to do some kind of MRI scan but we are talking a lot of money....

Anyone have any ideas? Praying that it doesn't swell up again and the dot is completely unrelated....hopefully he is now used to sidewalks and gravel and will not have any more accidents.

[tbhounds]

Did your vet happen to culture the discharge??

[Guest HTC504]

No, would that be worth doing if it swells up again?

[Jiffer]

I'd have it cultured too, to see if it's a chronic infection. Sometimes infections can be antibiotic resistant... like MRSA, and other times, they just may need a different antib to get it under control.

So I'm just going to throw a whole bunch of thoughts your way....

 

 

So he took Metacam again for another couple of weeks. Again whilst on the drug he was "normal" and happy to run around the backyard. However once we stopped the metacam he was limping again, however it appears to be the left front leg!

 

While he was on metacam, did he have a period of rest before you'd let him run again?
Just curious because I know if we're dosing any of ours with any pain or inflammation inhibiting drug, I ensure they are kept quiet and on rest until the course of meds is completed to ensure they're full healed up. Sometimes letting them run while they "can't feel it" can cause more damage or prevent the damage from healing and therefore he'd limp again once the drug was stopped. For this injury, I'd also suggest you seek out a Veterinary Acupuncturist.. there are lots in the area.

 

If the blistering recurs, I think if it were me at this point, I'd be seeking out a second opinion or pushing your vet to research more rather than just throwing more meds at him. Things I'd be wondering about: Bacterial Skin Infection, SubQ/Bone Infection, skin/contact allergy, some weird seed wart, an odd reaction to a corn, foreign body.

 

If he's already lost a toe on that foot, it's entirely possible that you're dealing with a corn on the sore toe. They can be VERY painful and are not always immediately visible either. I've seen it cause such pain that the dog does tripod to avoid using that foot. There's a whole other protocol for treating corns; the easiest is to acquire a Therapaw Bootie for whenever you walk him. The weird thing is that I've never seen a corn blister before.. so perhaps it's multiple issues instead of just one.
Can you post a pic of his paw pads?

Edited June 4, 2014 by Jiffer

[Guest HTC504]

Thanks for your thoughts, waiting to see on Monday when we go for our next check up but it looks ok now. Mega paranoid it is going to start swelling up again. Trying to make sure he doesn't run on it, very short leashed walks and lots of rest. When he injured his shoulder before I don't think he rested enough, it happened a couple of days before we went on vacation and he went to stay with a couple of dog friends. I'm hoping the two events are completely unrelated and he was just not familiar with all the ice and snow we has this winter, plus tons of gravel/grit on the sidewalk. His paws were soft from being at the track and not used to the harsh Canadian winter - hence the injuries. At least that is my theory! He is missing one toe on this foot and part of a toe on one of his back feet, trying to get more history from his racing kennel. He has done 6 weeks of chiro since coming to love with us too.

 

Corns - initially wondered whether they were causing it but there is no sign on the bottom of the pads. Our vet did quite a bit of research into it. We tried a boot and it didn't make any difference.

 

Skin infection/allergy - surely it would appear in more than one place on his foot? Or another paw? No pus, discharge was clear

 

Grass seed - don't show on X-rays apparently, body should expel it or break it down over time, especially with antibiotics. This also happened well before the grass came back to life after the really harsh winter.

 

Antibiotic resistant infection/MRSA - could be a possible but he should have fever?

 

My vet has been doing lots of research and consulting with various specialists. We were so excited to get our first dog and it has been not exactly how we thought it would be, but that's how it goes.....he is definitely the 3rd child in our family!

[cleptogrey]

has your vet tried ichtammol?? it's a really good drawing salve, sometimes hard to find but it works. read some of the reviews and check it out online. recently felix had a puncture wound in his paw-a piece of cut down tall grass punctured the edge of the pad going straight up towards the webbing. i washed and soaked it in epsom's salts but it became hot and swollen. the vet injected the ichtammol directly into the puncture, had it come out the other end and reinserted a clean amount. for 5 days, i injected(a syringe with out the needle) it directly into the puncture. voil`a!!! it cleared up. i have used it on myself in the past to help w/ splinters, my parents used it for boils, ingrown hairs etc. it's an old time remedy. btw- no antibiotics for felix but it was a 2 person/muzzle needed job to insert daily....but it worked!

 

http://www.amazon.com/s/?ie=UTF8&keywords=ichthammol+ointment+20&tag=googhydr-20&index=hpc&hvadid=11430162347&hvpos=1t1&hvexid=&hvnetw=g&hvrand=209816371286530560&hvpone=&hvptwo=&hvqmt=b&hvdev=c&ref=pd_sl_4hgul8yw54_b

[Jiffer]

Thanks for your thoughts, waiting to see on Monday when we go for our next check up but it looks ok now. Mega paranoid it is going to start swelling up again. Trying to make sure he doesn't run on it, very short leashed walks and lots of rest. When he injured his shoulder before I don't think he rested enough, it happened a couple of days before we went on vacation and he went to stay with a couple of dog friends. I'm hoping the two events are completely unrelated and he was just not familiar with all the ice and snow we has this winter, plus tons of gravel/grit on the sidewalk. His paws were soft from being at the track and not used to the harsh Canadian winter - hence the injuries. At least that is my theory! He is missing one toe on this foot and part of a toe on one of his back feet, trying to get more history from his racing kennel. He has done 6 weeks of chiro since coming to love with us too.

 

Corns - initially wondered whether they were causing it but there is no sign on the bottom of the pads. Our vet did quite a bit of research into it. We tried a boot and it didn't make any difference.

 

Skin infection/allergy - surely it would appear in more than one place on his foot? Or another paw? No pus, discharge was clear

 

Antibiotic resistant infection/MRSA - could be a possible but he should have fever?

 

Wow, very unusual to have multiple toes missing!

 

Corns can sometimes take a long time to appear on the outside. They don't always grow in as one would expect either. I've seen them come out the side of the pad and not seem like anything until it grows bigger and you recognize the colour and texture of it.

 

Skin infection/allergy/ MRSA - I've seen skin infections without fever or pus before in these guys. I think it has something to do with it being "surface" as opposed to deeper in the skin.

 

My angel Orion used to have a weird reaction once or twice a year (recurred 3 years in a row) where his one foot would BALLOON up. From about midway between his hock and foot right down to his toes, he'd swell to 2x + the size, it was hot to touch, and his whole foot would weep clear or slightly pink fluid. For weeks, I'd have to soak his foot in epsom salts, use ice packs, and do frequent massages to bring it down. We never found out what caused it but the vet half wondered if it were some sort of insect bite or skin allergy. The problem was there was no consistency of when it would occur. All in all it happened five times and then just stopped happening. It was always on one of his back feet though.

 

Sending healing thoughts. I hope you can find out what this is and get it under control so you can enjoy having your boy. Sometimes it's these trials and tribulations that bring us to really love and cherish the hounds we have.

Edited June 6, 2014 by Jiffer

[Guest HTC504]

Good news - stitches were removed today and it is looking good so far. Hopefully it will not start swelling up again. My vet is very much on the same page as us, we'll try various things if it means he will keep the toe. Thanks for all the support and ideas. It's been 10 days since surgery and we have a happy dog who is no longer on painkillers or antibiotics.

[NeylasMom]

This is probably unlikely, but have you had a full tick panel done? You could have more than one thing going on here and the intermittent lameness in varying legs could certainly be a sign of tick borne disease. And if his immune system is compromised, it could mean more difficulty with other things healing. Like I said, probably unlikely, but I'd do it for peace of mind if it were me. Unless something has changed, NC State's lab is sort of the gold standard for TBD testing.

 

Hope you get it sorted out.

[Guest HTC504]

He had a full tick panel done in November by GINA when he first came off the track and it was clear. It was something we have considered as a cause and if intermittent lameness (without an obvious cause) keeps reoccurring we would do it again. I know some of the tick diseases can take a while to show up. All is good today.....

[Jiffer]

Keeping my fingers crossed

[Guest HTC504]

The good news - Ubet's toe is not swollen, fur is growing back and the skin has healed nicely from surgery.

 

The bad news – Ubet started to limp again on Friday, two weeks after surgery. So what now?

 

He doesn’t appear in any pain when you touch it. He flinches slightly if I push on his pad. He was chasing squirrels in the backyard and playing with his toys, running on it, over the weekend. We took him for walks and you could not even see the limp. Other times he gets up from lying down and won’t put his full weight on it or even holds it up slightly. Not sure how much of a drama queen he is being or whether he just forgets about it after a while. He is his normal happy self. Here is a photo of his pad, I’m beginning to wonder if that is a corn developing on the toe that had the blister….perhaps Jiffer is right and we have multiple problems….

 

He has been wearing a boot on that foot whenever we are outside for the past two weeks to protect it whilst he heals from the surgery. It is not a therapaw but a winter boot for greyhounds. Wondering whether to try a therapaw and see if it makes any difference.

 

My general thought is to wait it out and see if anything happens again with that foot. We’re off to the vet this afternoon for a check up of the foot after surgery. Unless it starts to swell, he gets fever or it is going septic I am reluctant to use any more antibiotics, perhaps his body needs to fight it naturally? Or could it be turning the foreign object into scar tissue (like soldiers with shrapnel) and it will no longer be a problem, just a little stiff. The small gravel like object was still in the xray after surgery. Not sure if you can see it on this photo of the xray. We think it is stuck in his pad somewhere and just can’t come out by himself, but further surgery would destroy the pad/toe. Amputation of the toe is a last resort if he is really suffering but neither myself or the vet want to go down that route unless there are no other options.

 

Will keep you posted.

 

http://s1275.photobucket.com/user/Helen_Texidor-Carlsson/media/imagejpg1_zps3928611f.jpg.html?sort=3&o=0

 

http://s1275.photobucket.com/user/Helen_Texidor-Carlsson/media/photo1_zpsf0948bd3.jpg.html?sort=3&o=2

[Guest HTC504]

Just got back from the vets.

 

There is slight swelling on the side of the toe. It is probably not corns, the thing we see on his pad is from when they operated, the pad was very soft and there was a drainage channel going down to it. Taking a wait and see approach now, possibly treat it with different antibiotics or a drawing salve if it gets worse again. She is going to talk to a vet that treats horses about the salves. They are also going to give laser therapy twice a week to see if that helps (free of charge).

[tbhounds]

The salve that your vet might be thinking of is ichthammol (black drawing salve)--I have used it often with horses-works very well. Humans use it too--cvs carries it..

http://www.cvs.com/shop/product-detail/CVS-Drawing-Salve-Ichthammol-Ointment?skuId=705149

 

Just re-read some of your posts. I looked at the photos you posted--would it be feasible for you to have a ct scan done on that toe?? It's obvious that there's a foreign body still in there.

Edited June 16, 2014 by tbhounds

[Guest HTC504]

Thanks tbhounds, we're in Canada so don't have CVS but I am sure I can get some from our pharmacy. My vet was familiar with ichthammol (someone else mentioned) but thought there might be another more recent product that is similar.

 

Whatever is causing the problem is still in there, it just won't come out of any of the draining channels it has made so far. Antibiotics did nothing. We were told it would be at least $2000-$3000 to do an MRI/CT scan of the foot at the specialist hospital. He would also need a general anesthetic. It seems like a very expensive and complicated option. Right now it is not causing as much of a problem as it did before so we are just waiting to see whether the body fights it off or eventually accepts it....Ubet seems happy and will run, he just isn't walking quite right.

 

Helen

[Guest HTC504]

Here is an update on Ubet's toe.

 

The blister keeps re-appearing despite our best efforts. We have tried the drawing salve (icthammol), and a horse product called Animallintex but nothing seems to make the foreign body come out. The thing that amazes me is that it has been almost three months and there is still no pus from the object. The blister just pops and refills. Partly clear bloody liquid comes out. When he first gets up from lying down he doesn't put his full weight on it. Then after a few minutes of walking it is almost as though it is not there anymore. We've only given him pain meds a couple of times. We've just been applying an ear infection medication (synotic) for two weeks onto it and kept his foot bandaged to stop him licking it. Apparently it has been used to treat interdigital cysts and we hoped it would keep the blister open long enough to let the foreign object come out. It seemed to be working to start with but there has been no improvement for a week and he is starting to develop sore spots from the bandage on his toes.

 

Beginning to wonder if amputation of the toe is the best solution, or mild pain meds until the thing either disappears or causes a major infection......

 

If they could guarantee that a MRI/CT scan would pinpoint the location, remove the object and it would be better I would happily spend the $2000-$3000 right now.....

[Rickiesmom]

Just seeing this thread for the first time.

 

Jaynie recently had a CT scan done for way less than that, in fact she also had a full-spine MRI done for less than that - suggest asking your vet to call around. Some options in Toronto are the Veterinary Emergency Clinic South, which also functions as a specialty clinic, Central Toronto Veterinary Referral Clinic, and TVEH - Toronto Veterinary Emergency Hospital. Also the Ontario Veterinary College in Guelph (Small Animal Clinic).

 

In addition to the scan you will have to pay a consult fee (well worth it at this point from the sound of it) as well as for sedation and the procedure. If you haven't had bloodwork done recently, they will want to do that too.

 

FWIW, if this were my dog, I would definitely pursue the non-invasive diagnostic option first, as once the problem is identified, it may be much simpler to deal with than an amputation.

 

 

ETA: Someone with more knowledge could comment on whether a CT scan or MRI would be better to pinpoint the problem - I believe CT scans are better for solid things, and MRIs for soft tissue. That said, if an MRI covers both, that might be the way to go. Jaynie's MRI was done at a hospital in London that does pet MRIs on the weekend - they have the best machine in the country, but you need to have a referral, as you would anywhere.

Edited July 28, 2014 by Rickiesmom

[DofSweetPotatos]

Hve you tried treating it with an antifungal? I'm wondering if it's a encapsulated fungal infection.

[Guest HTC504]

Rickiesmom - can I be cheeky and ask how much you paid for the CT scan/MRI?

 

Our closest place is in Mississauga/Oakville Emergency Vet Hospital, they quote $1600 for the scan only, plus you would have consultation fees, sedation etc. so that would be at least $2000 and I can imagine the ones in Toronto would be even more expensive. We're back at the vet today so I will ask her about getting an estimate from a couple of places, I know they all require referrals. She gave me a ballpark figure based on sending clients for the full-spine MRI. I imagine the MRI would be quick because the foot is small. Then hopefully they could remove the object there and then. Since the problem started before we got insurance for the dog I am sure it won't be covered, unless we can somehow get the vet to fudge the dates!

 

And I'll ask her to culture the discharge too....

 

My husband was doing some research online too. He read some articles on a dog hunting forum where someone said it took 6 months for a thorn to come out from the pad... it came out by the knee... and his dog was oozing for 6 months; they did do antibiotics and pain killers (after trying several things) and just treated the dog as usual (without hard core hunting, but was still hunting)... it's part of life, these things happen to dogs... it will either come out almost by itself, or it won't...

From the same forum:

- these thorns get in through dog's paws, unfortunately dog's paws heal too well, too easily, and then things remain embedded

- someone said as long as the piece does not become lodged on the bone, it will eventually either form a cyst or come out

- it's not that unusual a problem, they get it all the time in the US with glass and cactus needles

- even glass eventually clears (cyst or exits)

- there are (many) stories of organic thorns and corn stalks surfacing a year later, so they don't dissolve that easily

- the only problem is if whatever it is gets embedded on the bone, then it's game over for that toe...

Our cat just broke a canine tooth which needs surgery, not covered by our insurance because it was only discovered during a routine check up and not an emergency. Our pets are bankrupting us right now and causing more problems than our 5 and 7 year girls.....but we still love them very much......

Edited July 28, 2014 by HTC504

[BatterseaBrindl]

FWIW...when I was a kid I stepped on a thorn ...it was very painful, but nobody could actually find it embedded in my foot. The pain went away and we forgot about it.

A year later I developed a bump/cyst on my instep...it wasn't painful at all...just annoying.

They eventually operated and removed a large cyst.... With a thorn in the centre.

This was back in the 60's.

 

Hopefully Ubet has a similar happy ending.

[Guest HTC504]

Here is the latest photo. The blister is on the side of the toe, not on the webbing, hard to tell in the photo.

 

http://s1275.photobucket.com/user/Helen_Texidor-Carlsson/media/photo_zps3a6b0285.jpg.html

 

We have a lick lesion on the side of his foot which he made because the bandage was irritating him, the vet is more concerned about that right now. We've got antibiotics for a week and he has to wear his muzzle with poop guard for the next couple of days to stop him licking. There was a little bit of pus in the blister so perhaps it will be resolved soon.

 

As I said it is not getting worse, just not getting better...thanks for all the posts.

Edited July 29, 2014 by HTC504

[Guest mrs]

HTC504,

 

My dog has two cysts that look just like the last picture you posted. If you are still on the board, may I ask what's been going on? Has it healed? What have you done? My grey had one cyst pop up in between his toes. A round of antibiotic and it was better. Two weeks later, he developed the same thing on the bottom of his foot. A round of antibiotics did nothing. Changed antibiotics and it was starting to get better, but yesterday (a week after the second round of antibiotics was started) I noticed both cysts were returning. They are painful and red and look infected. I'll call the vet on Friday to set up another appointment. This is frustrating beyond belief. She had mentioned going in and looking for a foreign body on the one on the bottom of his foot, but now that the other one has appeared again, it makes me think it's not that.

[Guest HTC504]

mrs

 

Only just seen your posting, not sure why I wasn't sent an email with your post but never mind. We did a few more tries with various drawing salves and even ear drops to try and get rid of whatever was in there but nothing worked. Mid October we took him to a different vet because he had developed corns on his other front foot (the good one) to have them removed (our vet was not familiar with them). They took some of the fluid and did a culture and it turns out there were two types of bacteria in there. We were prescribed some very specific antibiotics (two different kinds) in consultation with the lab. After the first three weeks the blister has disappeared but there was still some redness so we continued for 6 weeks in total. I am pleased to report that we stopped the antibiotics mid December and the swelling/blister has not come back. Now we just have to deal with the persistent corns on the front right foot but that is another story, probably caused by favouring this foot for so long.

 

We will never know if a foreign body caused a huge infection or whether it was completely unrelated. I would suggest that your vet do a culture and can then prescribe exactly the right kind of antibiotics. We had a similar experience with a commonly used antibiotic, it would get a bit better and then come back. Good luck!

[Guest mrs]

HTC504,

 

Thanks for replying. My vet did flush out and clean his two blisters. She didn't see a foreign body. We did a culture and sensitivity and started giving him the appropriate meds. It wasn't looking great at first, but now he's doing so much better. He'll be on the antibiotic for another 10 days, but the blisters are gone and the area looks fantastic. Fingers crossed it stays that way. I'm so relieved as the one on the bottom of his foot was causing him a lot of pain.

 

Hoping for the best with your dog's corns.

[Guest HTC504]

Sounds very similar. Glad that it is to be getting better. Best wishes to you too.