Strange mutant nail condition - any ideas?

Re: Strange mutant nail condition - any ideas?

vs0u — Sat, 28 Jan 2012 22:58:01 GMT

Just to let you all know, I amputated the toe and sent it off - came back as a nailbed squamous papilloma. The dog never looked back - now leaping about like a puppy, no lameness and the wound healed really quickly. One of the most satisfying cases I've had in a while!

Fantastic to be able to get a second opinion so quickly on this site - thanks!

Re: Strange mutant nail condition - any ideas?

Luciano Nebiante PGCertSAS — Fri, 06 Jan 2012 13:42:12 GMT

Many thanks for your suggestion Richard.

Re: Strange mutant nail condition - any ideas?

Richard Fox — Tue, 03 Jan 2012 21:22:20 GMT

sorry i was suggesting fungal in the cat case. i would be 90% sure its a nailbed papilloma

Re: Strange mutant nail condition - any ideas?

vs0u — Mon, 02 Jan 2012 21:36:08 GMT

Many thanks for all the answers. I think I'll offer them toe amputation with the risk that it may turn out to be something nasty - after all if it is something nasty, 3 cm margins would effectively mean a leg amputation - not really ideal in an 11 y o dog. Biopsy could be a another option - however as the toe is swollen and painful, healing after surgery could turn out to be more painful than just taking the whole toe. Leaving it alone would probably end in euthanasia before long as the pain is already stopping the dog going for walks. Although I haven't come across many fungal nail infections in dogs, do they usually cause the nail to grow at excessive rate and cause a massive toe swelling? A tumour seems much more likely, now I know they exist....

Re: Strange mutant nail condition - any ideas?

Richard Fox — Mon, 02 Jan 2012 20:19:02 GMT

Maybe fungal ? However just because I haven't seen a subungual benign tumour in a cat causing a giant nail doesn't mean it can't be the first ;)

Re: Strange mutant nail condition - any ideas?

Luciano Nebiante PGCertSAS — Fri, 30 Dec 2011 21:17:11 GMT

Financial limitations didn't allow me to do x-ray. But actually the nail is giant, that's why I thought my case could be similar to the one presented in this thread.

But I think I will offer surgical removal.

Re: Strange mutant nail condition - any ideas?

Richard Fox — Fri, 30 Dec 2011 20:33:23 GMT

I am afraid I have never seen on in a cat - Subungual tumours in cats are uncommon in in my experience of most often SCC's but these would not produce a giant nail - tend to be obliterative, ulcerating and cause osteolysis - Any changes on radiography? If its a dew claw then would surgical removal maybe the quickest form of diagnosis and treatment?

Re: Strange mutant nail condition - any ideas?

Luciano Nebiante PGCertSAS — Fri, 30 Dec 2011 19:30:12 GMT

I have a similar case, in a Cat, but the dew claw is the only one affected.

Any experience or reports of this kind of tumour in cats?

Luciano

Re: Strange mutant nail condition - any ideas?

Richard Fox — Fri, 30 Dec 2011 14:01:07 GMT

I have a pretty good idea what that is - its a subungual inverted squamous papilloma - it produces a giant soft flaky nail - it's a tumour of the nailbed epithelium and benign in nature but requires amputation.

There is a good few pages on the tumour in Thelma's book :) we get these invariably submitted after amputation.

http://books.google.co.uk/books?id=VKa2Wo3Wc-kC&lpg=PA696&ots=Gc8ArdtBYi&dq=subungual%20inverted%20squamous%20papilloma%20dog&pg=PA696#v=onepage&q=subungual%20inverted%20squamous%20papilloma%20dog&f=false

Re: Strange mutant nail condition - any ideas?

Michael Woodhouse — Fri, 30 Dec 2011 13:11:51 GMT

To get a 3cm margin you might leave 1 toe behind - not really 'doable'.

I removed a dew claw looked exactly the same, we spent ~2 years clipping it until it got to the point where it wouldn't fit inside the clippers. Been gone ~2 years and completely cured.

A biopsy would be 'inconclusive' or not deep enough and you are creating much greater expense for little gain IMO. If it was my dog I'd chop it off then send it off.

Re: Strange mutant nail condition - any ideas?

Braden Collins — Fri, 30 Dec 2011 04:02:54 GMT

I think you top two differentials would be fungal infection or neoplasia. I feel that a biopsy plus a radiograph would be more appropriate than removing the toe before diagnosis for several reasons. Firstly, if it is fungal, amputation may not be needed. Second, if it is a neoplastic lesion it is worth knowing what type of tumour it is so the surgery can be properly planned - if it is a soft tissue sarcoma or a squamous cell carcinoma 3cm margins would be needed to give a good chance of the surgery being curative. Remember that the first cut is the best chance to cure, and if it is one of these agressive tumours, and you don't get clear margins on the first surgery, you have to take an additional 3cm on any revision surgery, which in this case would mean amputation.

By doing a biopsy first and getting an accurate diagnosis you will also know the likely behaviour if it is a tumour. If it has a high chance of metastatic spread then it needs staging before surgery as if it has already spread a toe amputation would be a painful surgery with very few benefits.

Re: Strange mutant nail condition - any ideas?

Lorna McHardy — Thu, 29 Dec 2011 22:04:42 GMT

I'd remove that toe, ideally with histo if the owners can afford it. Alternatively, you could try a FNA to see what it is first. I'd have thought a nail bed tumour, with or without secondary infection, was quite likely... I've had that diagnosis before on things that looked like this.

Re: Strange mutant nail condition - any ideas?

Anonymous — Thu, 29 Dec 2011 21:57:17 GMT

Hi,

does look like a nail tumour to me. could try a biopsy but probably wont show anything as you probably wont get any meaningful tissue sample, may be better to amputate the toe(+ histopath ) . if I remember right they are probably benign but can grow to extrreme sizes.

good luck

chris

Re: Strange mutant nail condition - any ideas?

Utlendigur — Thu, 29 Dec 2011 21:26:12 GMT

Yes - I had one virtually identical on the hind paw of a middle aged terrier mix dog earlier this year. It was like that for about 12months before the owner agreed to surgery - unfortunately as far as I can remember, they declined histo. but I'll have a look tomorrow to see if I can dedge up the details. I assumed it was most likely some sort of isolated neoplasm since none of the other claws were abnormal - and none have developed problems since. IMHO I'd amputate the digit and send for histo - 1. it's not likely to get better 2. it will cause the dog discomfort 3. it will get bigger and more difficult to remove 4. even if other claws do become affected, at least you would know what you are dealing with 5. it would be nice to know what it is