Claw Amputation

[Guest mayyayyee]

Hi all, I'm new here.

 

I was hoping I might find someone who has experienced a claw/nail amputation.

It's a bit of a long story but about a year and a half ago my greyhound had a a front weightbearing toe amputated and at the same time had a previously healthy claw (front middle, D3) cut off right at the base, there was basically no claw left. This got infected a few weeks later, treated with antibiotics. The nail never grew back normally and is now causing a lot of problems. My vet wants to amputate the claw, so that it won't grow back. From what I understand that will mean removing the entire nailbed as well as some bone. Keeping in mind that she only has this one weightbearing toe on this paw and she's already been through a lot I am terrified of putting her through another operation on that foot, another amputation no less. She is extremely uncomfortable on the foot so something needs to be done, but I'm worried something could go wrong or she'll get depressed again - she lost all spirit when she had her first amputation and took a long time to recover.

 

Does anyone have any experience with this kind of amputation? Any alternative ideas? The only other option was to cut the nail off again and hope it grows back differently, but the vet doesn't think it's likely. And if we do that and it doesn't grow back properly we still have to do the amputation...

 

[greysmom]

What do you mean by "not growing back properly" and "causing a lot of problems?" And why was it cut off in the first place?

 

I've had several dogs who lost claws through the normal course of things - running and playing mostly - and had several amped toes too. Some on main toes, some on side toes or dew claws. Some have grown back just fine, some have grown back a little deformed, some haven't grown back at all. None of them has ever caused problems with gait or movement.

 

My first feeling, without any additional info, is that toenails can take forever to grow back, and that it hasn't had enough time to completely get beyond the first cut off, down to a normal nail. I would probably hold off on doing anything to that foot, particularly since the amped toe was so recent as well.

 

Keep up on the maintenance of the toenail - clipping or demelling the nail as much as possible every week. You might even be able to use a regular nail file to keep it as short as possible, which would lessen the pain and anxiety around dealing with it.

 

One caveat: If she's losing nails and they are splitting and falling off exposing the quicks, you may be dealing with an autoimmune disease called SLO (I forget what the initials stand for, but it's a form of lupus). It's very easily treatable with common supplements. There is a great Facebook group called "Greyhounds with SLO" you can join for tons of good support and info.

[Guest mayyayyee]

Hi greysmom, thanks for your response (I'd already written a reply then accidentally deleted all of it...)

 

Basically the nail was cut off for no reason at all (by my vet without my consent/knowledge). It's been growing back for over a year and a half, I've been filing it down as much as I can but any movement of the nail is causing her pain because the nailbed is damaged. Her nailbed is rock hard (even with regular moisturising) and small bits of her pad where the pad meets the base of the nail get hard and fall off, every few weeks. She has been uncomfortable since day one but we've been hoping as the nail grows back it'll get better, but it looks like it's only getting worse. She now often chooses to not put any weight on the paw, hopping on three legs, and holds it up whenever she stands still. She's avoiding using the leg as much as she can.

 

I don't want to put her though another surgery at all but we've been waiting and hoping it would get better for so long, and especially as she is now choosing to hop I feel it's gotten to a point where maybe something needs to be done. :'( I've spoken to a few different vets and none of them think there's any chance of the nail regrowing nomally as the nailbed is so damaged. Even right at the base the nail isn't growing straight.

[macoduck]

Not sure I'm understanding this. By "amputated at the base" do you mean only the last joint of the toe was removed? My girl had 2 joints removed by vet recommendation. That way the nub wouldn't keep rubbing the ground, hindering healing.

[Guest mayyayyee]

Not sure I'm understanding this. By "amputated at the base" do you mean only the last joint of the toe was removed? My girl had 2 joints removed by vet recommendation. That way the nub wouldn't keep rubbing the ground, hindering healing.

 

No the nail wasn't amputated, only cut off level with the surrounding toe (she had the adjacent toe amputated fully at the same time). My current vet now recommends amputating the claw (permantently) because of how much discomfort she is in due to the damaged nailbed

[BatterseaBrindl]

Can you show us some pictures of what her nail/foot looks like?

I am having a hard time picturing what this looks like...

[greysmom]

So, just to understand, her foot has two toes on one side (the outside toe and the remaining weight bearing toe), a space where the first toe was amped, and then the other outside toe, with the toe/nail in question being the nail on the remaining weight bearing toe? And the new vet is wanting to take the remaining middle toe?

 

I have seen a few dogs with both middle toes gone and they seem to get along just fine. What you'll be doing then is removing the source of pain and hoping she can use her foot again somewhat normally. Have you been doing pain relief during this last year 1/2? An nsaid and/or pain reliever? Does he do better wearing a bot like a Therapaw or other supportive footwear?

 

If that's the case, then *I* would probably seek out one more opinion from a canine orthopedic specialist to see what they say about the status fo the remaining toe/nail, and if there is any hope to repair the nailbed. If this vet is in agreement that removing the remaining toe will help rather than hinder, then I would probably go ahead and do the surgery. Ask whoever is doing the surgery if they are aware of the current protocol for anesthetizing sighthounds, and what you can do to help ease her anxiety during and after. FWIW, mine have always been way more mobile and active following an amp surgery (sometimes more than they should be).

[Guest mayyayyee]

Hi, sorry I don't seem to be explaining very well. The new vet doesn't want to amputate the toe, only the claw (so the nail and the very first joint) which will leave the toe and pad intact.

I wanted to add some pictures but don't see an option to upload any

[Guest mayyayyee]

Here are some pictures now.

 

1) what the nail/paw looks like now

 

 

[Guest mayyayyee]

[Guest mayyayyee]

 

 

[greysmom]

Yeah that's about what I thought.

 

Is she getting any pain meds or nsaids? Have you tried a boot of any kind? Soaking the foot in epsom salts? Trying to moisturize the nail bed at all (if she'll let you)?

 

I'm probably also sticking with my last post - another opinion (and trying some pain relief if you're not).

 

I'll amend my advice though regarding the amp option - I've seen *very* mixed results from the type of surgery suggested, and it can often cause more problems later on. The issue seems to come when the dogs runs and plays, and the stump of toe that's left gets really beat up. Often people end up having to amp the rest of the toe anyway. Sometimes it works for quite a while, years even, and then some change will re-impact that toe stubb. So it's basically a sort of gamble if it's successful.

[FiveRoooooers]

I havent read through so apologies if this is redundant: has the infection been cultured and has she been on a course of appropriate antibiotics?

[Guest mayyayyee]

Yeah that's about what I thought.

 

Is she getting any pain meds or nsaids? Have you tried a boot of any kind? Soaking the foot in epsom salts? Trying to moisturize the nail bed at all (if she'll let you)?

 

I'm probably also sticking with my last post - another opinion (and trying some pain relief if you're not).

 

I'll amend my advice though regarding the amp option - I've seen *very* mixed results from the type of surgery suggested, and it can often cause more problems later on. The issue seems to come when the dogs runs and plays, and the stump of toe that's left gets really beat up. Often people end up having to amp the rest of the toe anyway. Sometimes it works for quite a while, years even, and then some change will re-impact that toe stubb. So it's basically a sort of gamble if it's successful.

 

We've tried all of that The boot used to help a bit but she's not tolerating it anymore. I think it aggravates the problem now by putting even more pressure on the nail and nailbed (it actually made it bleed at one point). She's currently on Previcox but NSAIDs we've tried before haven't made a difference, so I'm not expecting much now - but definitely wanted to try it again before making any decisions. She's very precious about the foot but does let me put cream and vaseline on, but I've not noticed a difference in her from that.

 

Are you referring to the surgery to remove just the claw? Would you anticipate those problems even if the pad is left intact? I'm trying to see about getting another opinion, I may have to get a specialist referral.

 

We could just let the vet cut the claw back again and wait another 6-12 months for it to regrow, but I don't see how that would solve the nailbed issues

 

 

I havent read through so apologies if this is redundant: has the infection been cultured and has she been on a course of appropriate antibiotics?

 

Thanks for relying The infection was about 1 1/2 years ago and was treated with an osteomyelitis dose of ABs and cleared up. I don't know if the infection caused the damage to the nailbed or the cutting of the claw but it's not come back since then.

[FiveRoooooers]

In some of the pics the nail bed looks to me as tho there is some current infection? Might be worth asking about that.

[greysmom]

Are you referring to the surgery to remove just the claw? Would you anticipate those problems even if the pad is left intact? I'm trying to see about getting another opinion, I may have to get a specialist referral.

 

Yes. The remaining toe pad gets impacted much more than it should, and can get torn and injured, and it won't heal up properly due to the heavy use it's under. Then you have the same issue - the dog won't use that foot because the toe is painful - and the only option left is to take the rest of the toe.

 

I agree with Jan that *part* of the reason for the second opinion (with an orthopedic specialist) would be to discuss the nailbed itself, and if there is anything to be done to heal it. None of mine has ever had *any* trouble following their lost claws, which makes me think there's something more going on - either some internal injury to the toe or an infection which is making it painful. Have you had an xray done recently?

 

Epsom salt soaks can help sooth it and draw out any remaining infection, and might help her toe feel better. 2 cups water as warm as she can stand, plus two TBLSP epsom salts, soak for 10 minutes two or three times a day. If she's not comfortable standing for soaking, you can wrap a wash cloth soaked in the liquid around her foot, put the foot/wash cloth inside a plastic bad and then vet wrap or loosely rubber band the bag shut so it doesn't leak all over.

 

You also might find that non-petroleum based moisturizing creams will help a bit more. I use Burt's Bees Hand Salve on my boy's feet for his corns and it really seems to work better than vaseline or bag balm in keeping things soft and supple.

[Guest mayyayyee]

In some of the pics the nail bed looks to me as tho there is some current infection? Might be worth asking about that.

 

Interesting, I hadn't thought of that... There's no pus or anything but the toe is slightly swollen, the vet thought from inflammation to the ligaments from the constant pressure of the nail.

It's definitely very sore

 

Are you referring to the surgery to remove just the claw? Would you anticipate those problems even if the pad is left intact? I'm trying to see about getting another opinion, I may have to get a specialist referral.

 

Yes. The remaining toe pad gets impacted much more than it should, and can get torn and injured, and it won't heal up properly due to the heavy use it's under. Then you have the same issue - the dog won't use that foot because the toe is painful - and the only option left is to take the rest of the toe.

 

I agree with Jan that *part* of the reason for the second opinion (with an orthopedic specialist) would be to discuss the nailbed itself, and if there is anything to be done to heal it. None of mine has ever had *any* trouble following their lost claws, which makes me think there's something more going on - either some internal injury to the toe or an infection which is making it painful. Have you had an xray done recently?

 

Epsom salt soaks can help sooth it and draw out any remaining infection, and might help her toe feel better. 2 cups water as warm as she can stand, plus two TBLSP epsom salts, soak for 10 minutes two or three times a day. If she's not comfortable standing for soaking, you can wrap a wash cloth soaked in the liquid around her foot, put the foot/wash cloth inside a plastic bad and then vet wrap or loosely rubber band the bag shut so it doesn't leak all over.

 

You also might find that non-petroleum based moisturizing creams will help a bit more. I use Burt's Bees Hand Salve on my boy's feet for his corns and it really seems to work better than vaseline or bag balm in keeping things soft and supple.

 

Thank you, I will try the salt soaks again. Poor thing can't be arsed with all this messing with her poorly foot ((

 

Not had any recent xrays but we did some last year which didn't show any problems. We may now have a more acute problem to deal with as her urine has been bright orange for a few days or possibly longer... Waiting for results from the vet on that, so we might end up at the referral vets very soon anyway so can probably address the foot/nailbed issues at the same time.

[tbhounds]

Have the nail removed-otherwise this will be a continuous source the inflammation and pain.

[Guest mayyayyee]

Just thought I'd give a quick update. The anti inflammatories didn't do much as expected and she got worse by the day, she pretty much completely stopped putting weight on the foot and has been hopping around on three legs.

 

So yesterday we ended up doing xrays of her foot - it showed that the bones are all healthy but where on the other two toes the nailbeds look clean and well defined, on her problem toe it's a blurry undefined mess. The vet says it only looks like from either chronic infection or chronic inflammation. They've cut the nail back again and cleaned her nailbed/pad up a bit. She's now on painkillers, antiinflammatories and antibiotics. Of course this might not be enough and we may still have to look at the other option again in the future but since she only has one middle toe left on this foot I want to try as much as possible to avoid having to chop more bits off, especially because amputating the claw doesn't exactly come with a guaranteed improvement either.

[XTRAWLD]

Thank you for the followup. What a frustrating situation!