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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 33732
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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My dog has one very cracked toe pad on his front paw, the

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Hello, my dog has one very cracked toe pad on his front paw, the rest of them on his other paws look fine. He sometimes limps and cannot put this foot down. He is about 12 years old now and has arthritis and often now poos in the house, we think he can’t hold it as well now he’s old, I don’t know if the things are related at all but I wanted to give all the information. Is it possible to send a picture of the said foot?

You're speaking to Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

Yes, you can upload photos by using the paperclip or add file icon in the toolbar above your message box (if you can see those icons on your particular device) or you can use an external app such as dropbox.com/ Please check that the photo(s) is in focus prior to uploading it.

Customer: replied 9 days ago.
great thank you I've attached them here.

Thank you. Give me a moment to take a look, please...

All of the pads have some degree of hyperkeratosis. That one pad is severely affected. This is an idiopathic (unknown cause) condition characterized by the excessive formation of keratin. Keratin is a structural protein of skin. Thickened, hard, dry keratin accumulates on the paw pads and perhaps also on the dorsum of the nose. Secondary erosions, ulcers and fissures may be present in that pad and represent an autoimmune skin disease (the immune system is attacking my patient’s own tissues). Autoimmune skin diseases are confirmed only by biopsy.

Consider soaking the paw in warm water and then a softening agent should be applied every 24 hours until excessive keratin has been removed (~7-10 days). Treatment should be continued on an as-needed basis for control. Effective softening agents include the following: petroleum jelly, A&D ointment, ichthammol ointment, salicylic acid/sodium lactate/urea gel, and tretinoin gel. (The last three are available from his vet.) For fissured lesions, combination antibiotic/glucocorticoid ointment (Panalog, e.g.) may be applied to lesions every 8-12 hours until healed. Horny growths should be trimmed away before hydration and softening therapy are begun.The prognosis is good. Although it's incurable, this is a cosmetic disease that usually can be managed symptomatically. Please respond with further questions or concerns if you wish.

Customer: replied 9 days ago.
What would it mean if he had the autoimmune disease? would it be something that was treatable?

Yes, but it would involve more intensive therapy. An ointment containing a glucocorticoid (steroid) such as the Panalog I mentioned above would be indicated and either conservative or more rigorous therapy for autoimmune disorders would be initiated. Conservative therapies include essential fatty acids, vitamin E, and doxycycline or tetracycline plus niacinamide while rigorous therapy involves immunosuppressive doses of a steroid or chemotherapeutic drugs. It's unlikely I would resort to such intensive therapy for one paw pad in a 12 year old. Please continue our conversation if you wish.

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