Guess the diagnosis, please

[Cinnamontoast]

Bear split his right offside dew claw last week, lengthways all the way up. On Friday, he started chewing at it so he had the buster collar on. On Saturday, the others helped so it looked quite sore. He was therefore crated yesterday so nobody could chew it. He was also suddenly lame. This morning, his paw was ver swollen and he was none weight bearing on it.

So, bearing in mind that he was running round the woods on Friday in no apparent discomfort, diagnose and treat, please.



(He's been to the vet this morning, I'm just interested in an objective course of treatment given this history)

 

[NeverSayNever]

infection? antibiotics? or is the lameness something unrelated... in my experience they can go hopping lame with a ripped claw though and it can take 4-6 weeks to completely heal.

hope he is better soon

 

[Sparkly Snowdrop]

Infection and Antibiotics, in my opinion. Possibly spray with Allamycin/Terramycin but I tend to use that for everything including myself! Had one with a ripped dew claw before, it was very swollen and she was hopping lame.

 

[Murphy88]

Difficult to say without actually seeing the dog, palpating the foot, checking temperature etc, but based on history and if I couldn't find any other obvious cause of severe lameness on exam then I would treat as a nail bed infection. First line treatment would be antibiotics (probably amoxi-clav) and metacam/rimadyl for pain relief, if no better re-ex in 3 days, if improving then 5 day re-check with possibility of extending the antibiotics depending on how the foot is looking.

 

[galaxy]

Harley tore his nail and has only just now back to normal after 4 weeks!

Was very stubborn to heal. I was told if the toe intself became swollen/painful to touch or he went lame that was a very bad sign. There was a possibility of the nail having to be removed or worst case, if the infection tracked up into the toe the whole toe being removed (although apparently that is very rare). Luckily although it took ages to heal (and had to be covered when out and him on a lead = nightmare!) and was on antibiotics for 3 weeks it did heal.

I found standing his foot in salt water for a few minutes twice a day really helped dry it out

 

[Alec Swan]

I think that you've already given a diagnosis, but what the vet said, could be anyone's guess!!

What would I do? As the dog's not in front of me, that would be difficult. Having a stab at it, I'd say, have the dew claw, and the seat, removed, but for now, Oxytetracycline (purple spray), or warm salty water immersed three or four times a day, or in an emergency, Savlon!!

I'm not a vet. What did yours suggest?

Alec.

 

[lexiedhb]

Whip dew claw off, treat for infection?

 

[Cinnamontoast]

Vet's first diagnosis was a broken leg . I nearly wet my pants at this!

Now, I understand the swelling of the paw/none weight bearing may have led to thoughts of a fracture, although the running round may have made me query that.

I'm a little concerned that an x ray was the first thought and I wasn't thrilled for him to have another GA (ripped off main pad last Christmas and needed stitches). The vet said he'd never seen such a huge swelling and didn't think it was only the dew claw affected. I thought being crated meant fluid had gathered like my 'cankles' when I do long coach journeys

I'd have thought taking off the dew claw would have been useful while he was under, although I suppose the healing would take ages. It's not straightforward like when it's dnoe at a few days old.

I'm happy he's home but I do query the original diagnosis/treatment. Last time I saw this vet, he gave Bear an injection which was an anti-emetic then said he might have been poisoned. I didn't think that stopping him being sick was therefore ideal?

Much as I loved the bloke for his sympathy when he came to PTS Jake, I don't think he's the right vet for the others. I dunno if I'm being a bit stupid, but I think the diagnosis was badly wrong.

We've been given Metronidazole and Synolux (latter being bog standard antibiotics) and I'm a bit worried about the first drug. Is it just because there was a lot of infection? The contraindications are quite scary. Shouldn't he also have a hepatic support in place?

I won't be able to speak to the vet tomorrow as I'm wall to wall lessons/meetings/oral exam re-sits til 6. No toilet breaks, help!

 

[NeverSayNever]

but did the xray show a fracture

 

[Cinnamontoast]

but did the xray show a fracture

No, because the issue appeared to be the broken dew claw and a nail bed infection. I've just found the receipt: £68 for a bacteria culture! WTF?! No idea why that's been requested? It was a localised infection, surely, which will clear up with the meds. I don't see the point? OH says the vet wants to see what infection Bear is fighting! So confused!

 

[EAST KENT]

One of mine ripped a dew and the infection doubled her leg width up to the elbow.That was the very last litter that had their dews left on! The metro-whatsit is the best for nail bed infections,the synulox is an excellent broad spectrum with clav acid in it to prevent resistance.Dog will be right in no time

 

[CAYLA]

I would think the dog had caused infection whilst licking and chewing (perfectly normal for him to do it) I would have pulled jew claw off (I do this with all mine if they are partially torn) so you can see how sympathetic I am then placed a sock on the foot if they where chewing and licking non stop, would have to be really bad for me to put on anti biotics and I have plenty variety at home, prob synulox would be 1st choice
I would expect lameness, the nail hurts and the pain no doubt radiates and they are wimps my whippet boy hopped like mad when he caught and half tore of his front jew claws, no Ab's, I pulled both out, they healed.

 

[NeverSayNever]

im either really confused or being stupid the vet xrayed, the xray didnt show a fracture but the vet thinks he has a broken leg?

sorry hun, im not getting the facts in my head very well

 

[Cinnamontoast]

The metro-whatsit is the best for nail bed infections,the synulox is an excellent broad spectrum with clav acid in it to prevent resistance.Dog will be right in no time

I should thinkhe would with all this meds!

Trouble is, OH took dog. I'm a horrible cow at the vets and I tell them what I think needs doing No way did he need a general or an x ray: it was swollen due to infection.

I would think the dog had caused infection whilst licking and chewing (perfectly normal for him to do it) I would have pulled jew claw off then placed a sock on the foot if they where chewing and licking non stop, would have to be really bad for me to put on anti biotics

I would expect lameness, the nail hurts and the pain no doubt radiates and they are wimps

Ouch! How do you pull them out? It was really bad, the paw and wrist area were swollen to three times normal size, it defo needed antibiotics but not the rest of the treatment!

im either really confused or being stupid the vet xrayed, the xray didnt show a fracture but the vet thinks he has a broken leg?

Probably me being confusing! The vet saw the swelling and immediately said possible fracture, even tho Bear was leaping like a ruddy salmon in the woods a day ago. He then insisted on an x ray (if I'd been there, I'd have insisted on a second opinion or I'd have taken Bear elsewhere or demanded just antibiotics. Bloody job!) According to my vet mate, a broken leg is quite obvious Had I been there, I would have told him it was only an infection, in my opinion.

I have totally lost confidence in this bloke. Shame. Might register where the horse is then at least we're all together.

 

[CAYLA]

If the paw was swollen then I would def use AB's and taken into work for a check.
I can kind of see why the vet xrayed if that swollen as a precaution.
I have pulled them out with my fingers or nail clippers, obs not to clip just to grip and pull, literally grab and pull as quick as hell you get a high pitched screach and it's over.

 

[Cinnamontoast]

If the paw was swollen then I would def use AB's and taken into work for a check.
I can kind of see why the vet xrayed if that swollen as a precaution.
I have pulled them out with my fingers or nail clippers, obs not to clip just to grip and pull, literally grab and pull as quick as hell you get a high pitched screach and it's over.

Ooh, lordy! Bear might be OK, Zak would probably kill me! I clipped all three last night, just their ears cos they were raggy ass. You'd think I was cutting Zak's ears off with a blunt spoon, the noise he was making! Plus if I do anything he doesn't want, he will squeak and whine in a very frustrated manner. Hilarious!

 

[CAYLA]

I have a good head lock method and a vice like grip

 

[SusieT]

Given how swollen it is better safe than sorry-he could well have done a fracture whilst ripping the dew claw off if that badly damaged.
Antibiotics are good.
It probably could have waited until the antibiotics had had a chance to work but we can't see the dog. if you don't trust your vet, change vets

 

[Cinnamontoast]

Think I will change vets: I'm too paranoid about the dogs. I know it's a bit mad, but they're so damned important to me and I'm really upset that Bear has had a GA.

 

[Boulty]

I'm guessing the xray will have been to check whether he fractured anything in the process of ripping the dew claw off and it was likely one of those "better safe than sorry" things if the leg was really swollen. Maybe if you had been there you would have been able to emphasize how he was still tearing round immediately after the injury and been able to persuade him to hold off on the xrays alas you weren't able to be and so the xrays have been done and found nothing, which I guess in the vets view is better than him not suggesting them and missing a fracture. (although obv the unnecessary GA isn't so great!) The bacterial culture will have been taken so that the vet can find out exactly what bacteria are causing the infection and which antibiotics are effective against them. The information gained from doing this is most accurate and reliable if it's done before starting treatment. Your vet will already have taken a guess as to what's likely causing the infection and what antibiotics will work (in this case the metronidazole and synulox) as given how long the test takes to carry out (several days usually) it isn't ethical or practical to delay treatment until the results are in and a large percentage of the time he'll be right the antibiotics will work and the results won't be used for anything other than interest but if it just so happens that the infection is caused by a different bacteria than expected or a strain resistant to the usual antibiotics used and the treatment prescribed does not work then he already has the info to (hopefully) know where to go next. At the end of the day though you have to trust your vet and if you don't feel that you do then as you say it may be best for you to change

 

[Chestnuttymare]

No, because the issue appeared to be the broken dew claw and a nail bed infection. I've just found the receipt: £68 for a bacteria culture! WTF?! No idea why that's been requested? It was a localised infection, surely, which will clear up with the meds. I don't see the point? OH says the vet wants to see what infection Bear is fighting! So confused!

re sending off for testing, my cara had a nail that split and we were in and out of vets with infection. |Eventually the decision was taken to remove the toe. They sent it off and i didn't think anything of it, it came back that it was malignant melanoma! we then went and had her lymph glands checked, never been so terrified in my life. The lab is happy that the vet got it all and there is no sign of it having tracked anywhere else so all is good but it has been a terrible few weeks for us. I am sure it won't be anything like that with yours, caras was a problem for a while, but your vet will just be covering all bases.
I really trust my vet as she has made all the right decisions so far.
Hope it heals quickly, it must be really painful for the wee soul.

 

[EAST KENT]

I should thinkhe would with all this meds!

Trouble is, OH took dog. I'm a horrible cow at the vets and I tell them what I think needs doing No way did he need a general or an x ray: it was swollen due to infection.




The vet saw the swelling and immediately said possible fracture, even tho Bear was leaping like a ruddy salmon in the woods a day ago. He then insisted on an x ray (if I'd been there, I'd have insisted on a second opinion or I'd have taken Bear elsewhere or demanded just antibiotics. Bloody job!) According to my vet mate, a broken leg is quite obvious Had I been there, I would have told him it was only an infection, in my opinion.

I have totally lost confidence in this bloke. Shame. Might register where the horse is then at least we're all together.

NEVER NEVER send an OH with a dog,esp to a male vet,they come over all chatty and juvenile,totally forget why they are there at all.Sent my retard to the vet to vaccinate a litter of puppies..first one..on asking him if the heart check went ok,he looked mystified.SO then I asked if the vet put a stephoscope on their chests,looked in mouths/eyes /ears and stuff...Nooooo! SO, puppies had to have another journey for a vet check (free) to cover the first one `s stupidity.
Not wanting to be rude..but we all know where their brains reside.