Dr. wants to chop off part of dog's toe

tyler zambori

hi all,

I have a large dog, a pit bull/german shephard/chow mix. He's about 95 pounds. A couple months ago a toenail on his hind leg split in two,
and smelled rotten ,and he chewed it off. Since then the vet put him
on cephalexin two times for about 10 days each, which didn't work
because it was not enough time. Then the vet put him on Simplicef
for 28 days. That has helped, but it's not completley better. The swelling
in the toe has gone down, and the fleshy part of the would has gotten
smaller. The leftover toenail bits are gradually working themselvs out
of the toe. It's hardly gangrenous or anything. The vet never took any
x-ray. The skin between the toes is still a little red.

The last time we went, she told me the swelling in the toe was because
of granulation and scar tissue. Now she says it's infection in the bone.
How can she really determine that without taking any x-ray?

I'm not really feeling too happy with her right now. I asked for a switch
back to cephalexin because that is way more affordable for me, and she
agreed to that for two weeks, after which we go back, and then she will
make her pronouncement about surgery.

Hello, what about an operation merely to remove the remaining toenail bits?
I am very suspicious about this prognosis. It's not the first time this
animal hospital has recommended surgery, and I found a better medical
alternative for my dog (in this case adequan shots rather than surgery).

What do you think: does it really sound like a toe needs to be removed?
I am just very skeptical about it. You can bet I will get a second opinion.

applesmom

Here's a link to some information on the dangers and treatment of bone infections. Hope this will help you to be better prepared when you see another vet for the second opinion.

http://www.gopetsamerica.com/dog-hea...omyelitis.aspx

tipper

Hi,
will the remaining part of the toe alter the walking of the dog in anyway?

Is it more for cosmetic for the dog just to tidy the toe up?

Without seeing the toe ourselfs if had a picture hard to say. How old the dog to length of time the dog has to live, if help to have a better walk and looks neater then I'd say go for the removal so your dog get on the road to recovery. Nothing really stopping the second part getting infected anyway apart for paying for expensive tablets that might getting repeat after repeat. Which would end in the same result anyway.

Good Luck, Hope your dog gets better soon.

AkiraleShiba

If you do not agree with your vet why not ask for a second opinion ?

Ginny01OT

I can only speak for the human aspect but it may help---many diabetics have toes amputated--they have decreased sensation to begin with--bang or cut their toe and don't realize it--because of poor circulation the toe does not heal but gets infected---again they don't even realize it until their toe is black--then it has to be amputated it has travelled to the bone and can work its way upward, travelling and travelling------so what could be a "simple" (I am in no way minimizing this) toe amputation can become a below knee amputation or above knee amputation which is another can of worms. If the MD has said it has travelled to the bone and the toe is "necrotic" I would have it removed before it progresses (does the toe smell at all?) If you do want a second opinion get it quickly time is of the essence with something like this. Good luck and keep us posted.

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spotted nikes

I had a dog that had a benign tumor growing under the nail bed that was causing bone to die off. It was very painful. The vet removed the toe, and dog recovered uneventfully. No problem walking.
Bone infections can spread and cause a lot of serious problems. Get a second opinion if you need to, but if the second vet also recommends it, please do it.

lovemygreys

Aw...toes are so much fun to deal with

We had a recurring injury keep popping up in one of our greyhounds toes. He had surgery last Friday to remove the dead tissue and stitch back together the healthy tissue. We did one round of antibiotics seemed to clear it up, but then it came back several weeks later. Sometimes the dead tissue deep in the toe, debris or just deep infection can keep it from healing properly. Since dogs use their feet/toes all the time, every day that tissue constantly has pressure on it so it can be hard to heal.

One of my other greys may need two toes amputated due to severe dislocations and some arthritis that's developing. We are really trying to avoid that. If it were one toe, no problem - go ahead and lop it off. But two toes in a young, still very active dog I'm much more hesitant to be hasty with amputation. She goes back to the orthopedic specialist next week for a reassessment after two (very loooooong) weeks of crate rest and leash walks.

We adopted a dog once and she was missing a back toe...never realized it until I went to trim her nails and came up one nail short! Dogs can live just fine with a toe missing.

I would want an xray done - If it's purely an issue with the soft tissue you probably aren't going to see much, if anything. But, they're relatively inexpensive ($60-$75 around here) and will give you a more complete picture of what's going on with the bones inside the foot.

If you've now done three rounds of antibiotics and that hasn't resolved it, it's very possible there's now infection in the bone. At the very least you have some seriously infected tissue there. I would most likely opt for surgery to remove the toe without too much hesitation. Bone infection is not something to mess around with.

However, if you do not feel comfortable with your vet - get a second opinion. They may be able to refer you to a orthopedic specialist...I really prefer to have my dog seen by a specialist with toe/foot issues if it's anything more than a soft tissue injury.

Good luck...keep us posted!

tyler zambori

hi all,

I wanted to post a picture of his toe, but don't have a working camera
at the moment. The thing is, it really has gotten better over the last
month. The swelling went down, the fleshy part shrunk. The remaining
toenail bits do smell _if_ he does not get his anti-biotic, and if he does
not get an epsom salt soak, at least on the simplicef. On the cephalexin,
the anti-biotic alone was enough to knock out any smell. That is one
reason I liked it better. The skin around it is slightly red, but certainly not
sick-looking. He does not lick it much, and he walks just peachy fine. I'm
going to keep doing the epsom salt soaks even after he goes back on the
cephalexin, which is tomorrow. it has bled slightly a couple times since
I started the soaking, and I think that's actually a good sign.

The thing is, she proclaimed it had gone into the bone without doing any
kind of testing. Before, she had said the swelling was because of scar tissue
and granulation. Now that it is doing better, suddenly she's saying it
progressed?

Come to think of it, there was another weird thing: as she was trimming
his nails, she said to me that the dew claw she happened to be trimming at
the time was just about to grow into his skin. It most certainly _was_
_not_! I don't know what her problem is. He goes in every month for
an adequan shot, and he always gets a nail trim along with his shot. I'm
starting to feel like switching to another animal hospital entirely.

to applesmom: my b/f and I both read the article, thank you, but that
does not look or sound like what it is. I guess I'm just going to have tp
get a second opinion.

From what I describe, doesn't it sound like the first veterinarian has
an off-kilter perception of things? Geeez....

Wolfie is 8 years old. I most cetainly would not have an operation just
to make the toe look more neat.

tipper

is your dog not wearing a protected guard to stop the licking of the injury?. Nick name the lamp shade. Letting him lick it at all not the best idea with a injury like this sorry. I'd be asking the vet for a protected guard to stop your dog from doing this. While your dog is licking the injury , it infact can be making it worse alone.

My girl in a lamp shade for a absess on her paw in picture. She's just come out of it after 6 days

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tyler zambori

hi lovemygrays,

somebody gave me this article back in February:

http://www.lowchensaustralia.com/gro...conditions.htm

It sounds to me like it's this bacterial onyxis it mentions:

"Bacterial onyxis exists in the dog but is much rarer in the cat. In the latter, it is usually associated with an immunodeficient state (FeLV and/or FIV infection, diabetes mellitus etc...). In the dog, it may be idiopathic or secondary to an underlying disease (such as hypothyroidism, or even Cushing's disease). Perionyxis, onychoschisis, onychorrhexis and onychomadesis are usually seen on several nails, with pain as the primary complaint. Diagnosis is made by cytology-which reveals a bacterial pus (degenerated neutrophils, phagocytosis), bacteriology and the response to therapy. Treatment must be based on the removal of broken nails, topical antibacterial therapy and long term systemic antibiotic therapy (based on bacterial cultures and sensitivity testing, Staphylococcus sp. and Gram negative rods often being cultured). Months of careful therapy are needed, until the distal abnormal part of the nail has disappeared. In all cases, and particularly in chronically relapsing ones, an underlying disease should be suspected and, if found, treated. Bacterial pododermatitis, whatever the cause, often leads to bacterial onyxis. Good examples are interdigital pyodermas due to demodicosis and allergic skin diseases. Perionyxis is a prominent feature in such cases. Therapy appropriate to the causal pododermatitis will cure the nail problem if carried out for long enough."

Months, it says months of treatment with antibiotics. I think I'd better
take him to another place, and just have them take a culture, as a
starting point. I have severely limited funds, so this is not a good situation.

tyler zambori

Well, it isn't cancer or fungus. It's just a bacterial infection. Now I have
to wait until my next paycheck to be able to get a "culture and
sensitivity" test to find out exactly what kind of bacteria it is,
and target it very specifically by antibiotic. Then I will probably tell the
new vet to go ahead and do an x-ray too.

We went to a different new veterinarian yesterday morning, but they
made me wait an hour and 10 minutes past my appointment time,
so I left. I just don't want to put up with that. So one we went to
in the afternoon was much much better.

tyler zambori

here's an update, for anybody who actually thoroughly reads:

Wolfie is now on an antibiotic called baytril. The vet took a
culture and sensitivity, and said there are 3 kinds of bacteria,
and yes they are resistant. He said this is the only one
he feels confident will kill all three.

The x-ray is in the works, but he's been on it 2 days so far,
and this morning when I looked at his toe, I saw an accumulation
of pus. So this is good, the pus is starting to come out of the
toe after only two days. He's set to be on this antibiotic for
2 weeks, then go back to vet to see if he wants to be on it
for longer, or if we need to change the plan again.

Thanks for your comments and support!

lovemygreys

Thanks for the update! I'm glad to hear it only seems to be a bacterial infection. Baytril is a pretty good anti-biotic.

RRM_Mom08

Glad to hear it is only a infection

tyler zambori

Thank you lovemygrays, I hope it works. I'm sure there will be more
expenses to follow though.

well the vet still thinks he will at least need the toenail bits removed.
This is going to be a protracted thing.

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