Onycho-something, all claws affected

Re: Onycho-something, all claws affected

Richard Fox — Mon, 28 Nov 2011 14:10:31 GMT

Great - for the dog and for the update - thanks :)

Re: Onycho-something, all claws affected

Alice Courtney — Mon, 28 Nov 2011 13:49:18 GMT

Just to close the case (or I hope so!), skin scrapes were negative, cultured Pseudomonas from lip fold & E.Coli from toes, histology of amputated dew claw was consistent with chronic dermatitis but no autoimmune disease, toes & lip folds are much improved on marbofloxacin, clipping the toes & hibiscrub under GA then O using malacetic wipes on them 2-3x/week (seems to help, & I got malassezia on cytology if not on culture), & dietary trial for suspected underlying allergic component...

Re: Onycho-something, all claws affected

mariette asselbergs — Tue, 27 Sep 2011 16:38:25 GMT

This sounds weird and I myself would not pay much attention if somebody suggested it to me. BUT, I inherited an English Bull Terrier 6 years ago, aged 9 years old with lifelong "eczema", and secondary pyoderma. On antibiotics and malaseb forever. Whenever we stopped she would break out in pyoderma again, all feet, belly, front, lips etc. Then one day in Dec 09 she happened to work her way into our organic vegetable box and ate everything in it, including a load of beetroots. (visible in the urine......Three days later all her skin was back to normal and stayed so for months. Whenever she flares up now we feed her beetroots (any beetroots, doesn't need to be organic or anything) and it stops immediately. No antibiotics or malaseb anymore for 2 years now (she is now 15). No explanation, but for her it has worked miracles and I would love to see if it would do any good for any other pyoderma case. Good luck!

Re: Onycho-something, all claws affected

Richard Fox — Tue, 27 Sep 2011 16:17:35 GMT

Yes - a skin scrape would be a good idea and bx's of course if refractory to AB's ?

Re: Onycho-something, all claws affected

James Laidlaw — Mon, 26 Sep 2011 23:08:51 GMT

Hi Alice,

I've had a similar sounding case recently in a shih-tzu with an owner that doesn't really do follow up visits for anything then leaves things too long to get on top of them properly. Turned out to be demodex. All 4 feet, crusting and scaling around nail bed and proximal to nail, with very painful feet and bleeding once lesions and crusted fur were clipped under sedation/ga. Responded well to aludex washes and advocate, but came back fairly much deteriorated again today (hasn't been in for 2 or 3 months since last advised for a revisit so no idea on the time frame to recurrence.

Hope you can get to the bottom of it!

James

Re: Onycho-something, all claws affected

Richard Fox — Mon, 26 Sep 2011 20:51:56 GMT

Hope you get it sorted :)

Re: Onycho-something, all claws affected

Robin Grimmer — Mon, 26 Sep 2011 20:46:13 GMT

http://www.vetsurgeon.org/forums/t/9098.aspx?PageIndex=1

Re: Onycho-something, all claws affected

Alice Courtney — Mon, 26 Sep 2011 18:54:14 GMT

Hi all, thanks for your thoughts. I think my brain came up with tetracyclines because of the lupoid link, but I don't think that that's what is wrong with the dog, at least not now I've had time to think about it...The nails felt firm and none have fallen off, plus my impression was the skin around the nail base was inflammed & sore, & the owner reports the dog being irritated by its nails. So I'm thinking secondary pyoderma +/- underlying atopy/dermatophytes/demodex/other! I'll keep you updated on what the followup & workup reveals...

Re: Onycho-something, all claws affected

Michelle Tapp — Mon, 26 Sep 2011 18:34:16 GMT

I treated a case of Onychodystrophy a few years ago in a young Bearded Collie - very painful condition!! I've only seen it twice (the other was a Bull Mastiff) but I would say it would be difficult to confuse with anything else.Don't remember it being particularly pruritic - over the course of a few days she just stopped wanting to walk and on exam there was purulent discharge at the nail beds and loosening/lifting of the claws over all 4 feet. Most claws either fell off or were removed under sedation for comfort. It's suggested that removal of a digit (usually a dewclaw) is required for definitive diagnosis but the lab were able to confirm from exam of one of the claws. This dog responded well to tetracyclines, EFA, niacinamide and NSAIDs for comfort and the claws gre back very well (sometimes there can be deformities). Don't thinks she came off treatment while I was at that practice and I was treating her for well over a year. This dog had no other skin lesions and was well otherwise. Not sure your case sounds too similar so this probably doesn't help you much!

Re: Onycho-something, all claws affected

Richard Fox — Mon, 26 Sep 2011 18:27:10 GMT

Lupoid Onchyodystrophy (interface onchyitis, etc etc) is unlikely to present as you have suggested - it usually causes episodic onchymadesis and splitting etc rather than digital dermatitis/Paronychia? I would suspect mucocutaneous pyoderma esp if lip fold dermatitis is present or perhaps allergy with 2ndy pyoderma. 1st thing prob culture and sense and then perhaps change AB.

Cytology to ext lab maybe for detection of acantholytic cells maybe in order as suggested above.

P.S. For SLO I usually recommend removal of affected dew claws if poss for histopath (less traumatic etc).

Re: Onycho-something, all claws affected

Michael Woodhouse — Mon, 26 Sep 2011 17:05:21 GMT

[quote user="Alice Courtney"]I think I had senile moment when I picked doxycycline, normally I would have reached for the cephalosporins without a second thought...Hhhmmm...[/quote]

Alice - i think you had something lodged deep down in your brain somewhere. tetracyclines have been used as a specific therapy for the SLO ( symmetric lupoid onychodystrophy)

Linky 1

Linky 2

These things we file in our brains even if we have forgotten we knew them.

Re: Onycho-something, all claws affected

Alice Courtney — Mon, 26 Sep 2011 15:55:20 GMT

Thanks Stephen for your thoughts (good surname by the way ), there weren't Malassezia on the cytology of the feet but there were in the ears when he had otitis. I'm phoning the owner this week to discuss the plan further. I think I had senile moment when I picked doxycycline, normally I would have reached for the cephalosporins without a second thought...Hhhmmm... Still, the owner & I came up with a plan that kept us both happy, and a further workup is at least now on the cards.

Re: Onycho-something, all claws affected

Stephen Courtney — Mon, 26 Sep 2011 15:15:14 GMT

It could be pemphigus...though he's a little old. You can sometimes diagnose with cytology - look for acanthloytic epiderma cells - but it's not easy.

It sounds like you need to knock him out to examine, so I'd do scrapes ( could be demodex) tape strips, plucks and biopsies all at the same time. don't forget bacterial and fungal culture.

Doxycycline would not be high on my list of skin antibiotics, I prefer cephalosporins followed by potentiated amoxycillin, then antirobe.

The supplements you suggest won't do any harm but are unlikley to make much difference in the short term. I would add in analgesia if he is very sore.I think it is very unlikely to be a food allergy as it is just his feet - atopy is possible certainly. I don't think things will be much different in 2 weeks, but if the client wants to go slower fair enough. just make sure you keep warning them these things can take a long time to resolve.

I take it you didn't see malasezia on the cytology? I like malaseb wipes for helping with skin fold and crevice situations - a few drops of neat shampoo on a damp cotton wool pad, and gently wipe the folds out. can be helpful between the toes but obviously not a good idea if he is sore.