What Ails the
PAWS AND CLAWS
It is generally recommended that dermatophytosis be treated with a combination of topical and systemic antifungal agents in addition to environmental clean-up. Often, the recommended treatment goal is to obtain two consecutive negative dermatophyte cultures and/or PCR tests prior to discontinuing antifungal therapies. An excellent and free access resource is Diagnosis and Treatment of Dermatophytosis in Dogs and Cats by Moriello KA, Coyner K, Paterson S, Mignon B. Vet Dermatol 2017.
Linda Messinger | DVM, DACVD
Atopic dermatitis in a Great Dane.
Image courtesy of Dr. Linda Messinger
Pododermatitis has many underlying causes and can present in a variety of ways in dogs and cats. Allergies are the most common cause of pododermatitis in dogs. Allergies can also be the cause of pododermatitis in some cats. Other causes of pododermatitis include infectious, immune-mediated, nutritional, neoplastic, idiopathic, and other causes. We will discuss several causes of pododermatitis in cats and dogs, along with diagnostics and therapies. The most common causes of nail disease will also be discussed.
PAPILLOMAS Papillomas can affect the paws. Those affecting the footpads can be challenging to treat. Diagnosis can be made by clinical presentation; histopathology can help confirm the diagnosis. Several treatments have been recommended including surgical
ALLERGIES Allergies, especially to airborne and food ingredients, are the most common cause of pododermatitis in dogs. Pedal pruritus tends to be the most common sign noted in dogs presenting with pododermatitis secondary to allergies. Secondary yeast and/or bacterial pododermatitis are common and can exacerbate pedal pruritus and dermatitis. Skin cytologies are most commonly used to determine the presence of yeast and/or bacteria on paws. Treating secondary infections and controlling the underlying allergy is important. If secondary infections continue to recur, then the allergy treatments need to be reassessed in addition to evaluating for possible other causes.
MITES Mites (especially Demodex mites) and dermatophytosis can also cause pododermatitis. Demodicosis is typically diagnosed via deep skin scrapings/hair plucks. Dermatophytosis can be diagnosed via ringworm culture and/or PCR. Histopathology may also be helpful in diagnosing demodicosis and dermatophytosis.
Demodicosis in a Mastiff mix.
Image courtesy of Dr. Linda Messinger
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More recently, isoxazolines have been the mainstay for treating demodicosis. Given the high success rate of isoxazolines, trial treatments have also been performed by some. However, most dermatologists agree that it is best to perform diagnostics (deep skin scrapings/hair plucks) to better know what you are treating, especially as Demodex mites are usually easy to find when diagnostics are performed properly. This is especially true in immunocompromised patients where more isoxazoline treatment failures may be seen. Treatment should be continued until two to three consecutive negative skin scrapings/hair plucks are obtained. Underlying causes should be addressed when possible.
