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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 32885
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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My cavalier spaniel suffers from a recurrent cyst in between

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my cavalier spaniel suffers from a recurrent cyst in between his toes on his left foot.
the vet has operated on it once and it has reappeared he is currently being treated with antibiotics. what can we do to treat this and prevent it appearing again?
i would really appreciate your advice
I'm sorry that your question wasn't answered in a timely manner. I believe that you're describing the frustrating canine pedal furunculosis whose etiopathogenesis is unclear but one hypothesis is that sterile pedal furunculosis is a persistent, immune-mediated, inflammatory response to keratin and triglycerides liberated from ruptured hair follicles, sebaceous glands, and the panniculus (fatty layer of the skin). These aren't cysts. Here's a synopsis of this disorder for you:1) The clinician should make sure that the initiating cause of the furunculosis (e.g., food allergy, wet environment, dirt kennels, friction in short-coated breeds) has been identified and corrected if possible.2) If draining lesions are secondarily infected, appropriate antibiotics or antifungal medications should be administered for a minimum of 4-6 weeks.3) For solitary lesions, surgical excision or laser ablation may be curative. I understand that you want to avoid more surgeries, however, particularly at Charlie's age.4) Cleansing wipes (alcohol-free acne pads, baby wipes, chlorhexidine-containing pledgets, or other antimicrobial wipes used every 12-72 hours work very well. For developing bullae, topical dimethy sulfoxide (DMSO) combined with the antibiotic enrofloxacin (to make a 10 mg/mL solution) and steroid (dexamethasone or fluocinolone) should be applied every 12-72 hours until lesions resolve. To prevent recurrence, the feet should be wiped or scrubbed in the direction of hair growth to remove any "ingrown" hairs.5) Alternatively, treatment with combination tetracycline and niacinamide may be effective in some dogs. Please discuss this option with Charlie's vet. Anecdotal reports suggest that doxycycline can be administered every 12 hours until response occurs, then tapered to the lowest effective dose or doxycycline may be substituted for tetracycline.6) Anecdotal reports suggest that treatment with cyclosporine may be effective in some dogs.7) For severe, nonsurgical, or multiple lesions, treatment with glucocorticosteroids such as prednisone may be effective.Finally, consider having Charlie see a specialist veterinary dermatologist if you wish. Please see here: Such a specialist will know of the very latest approaches to this vexing disorder - approaches that haven't yet reached the veterinary literature.Please respond with further questions or concerns if you wish.
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Thank you for your kind accept. I appreciate it. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience.