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Discussion Starter #1
Just got back from the vets- Murray had crusty brown stuff inside both his front foot pads, and some inflamation which I just noticed this evening. The vet diagnosed apocrine gland problems which have caused interdigital cystitis.

Right now he's on Clavamox and I'm using Genticin spray, but if it hasn't improved by Friday they'll start him on steroids.

The vet said this could become chronic- has anyone had a hound with this problem?
 

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A little over a year ago Bogie had this sort of slimey crusty dark brown stuff around the nails on one front paw, and it inflamed the skin around the nail, and spread to the toe pads so they were yucky as well. The vet said it was possibly a yeast infection (but didn't find much yeast in the culture), but could be due to other things as well. Clavamox was the antibiotic he was put on (i think for a week). I was also given this blue liquid that I had to dilute with water and soak his whole paw in for 10 minutes twice a day for two weeks, and a topical cream to put on. It has never grown back the same way, but I clean very carefully around and his nails regularly and have found the brown stuff occasionally.
 

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Thanks for your response- it's definitely not yeast, it's the apocrine glands between his toes. They are exuding a waxy brown substance, and there is alot of inflammation.


The vet told me that this is not uncommon in bassets and that it could become chronic.

I'll be talking with the vet again on Friday, and will have more questions for him then, but in the meantime I've been trying to get more information by googling "apocrine glands" and "interdigital cystitis" and am not coming up with alot of information.

One of mycomputer searches associated apocrine gland problems with mast cell tumors- I'll be talking with the vet about that on Friday- but in the meantime I just wondered if anyone has had experience with this condition-

Can anyone give me a helpful link about this condition? Mike? Betsy?
 

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I'll be talking with the vet again on Friday, and will have more questions for him then, but in the meantime I've been trying to get more information by googling "apocrine glands" and "interdigital cystitis" and am not coming up with alot of information.


Can anyone give me a helpful link about this condition? Mike? Betsy?[/b]

Cystitis? Cystitis is the medical term for inflammation of the bladder


I can only guess the vet is reffering to an infection between the toes that has often been miscaracterized as Interdigital cysts. and unfortunately is one of the condition more coomon in basset hounts than many other breeds


Interdigital Cysts

Diseases of the Claw and Footpad-A Problem-Oriented Approach
Interdigital pyoderma is a deep folliculitis and furunculosis caused by Staphylococcus intermedius bacteria. In addition to bacterial infection, hair shaft material trapped in the furuncles acts as a foreign body. If the condition becomes chronic, scar tissue may form and entrap hair material or foci of infection, worsening the prognosis for eventual cure.

Typically, the initial lesion is a firm or fluid-filled nodule between the toes. The nodule ruptures, draining a purulent, bloody discharge and forming a deep, draining furuncle in the interdigital area. The feet are usually not pruritic, but sometimes are painful. This disease was sometimes called "interdigital cysts," but this is not a correct because histologically, the lesions are deep pyogranulomatous dermatitis, not cystic. Initial diagnosis is made by physical examination. Do skin scrapings of the interdigital area to check for demodicosis. Discharge from intact or freshly-draining lesions should be examined cytologically. The expected result is many neutrophils, a few macrophages, and occasional cocci. It is important to verify that rod-shaped bacteria are not present, which might suggest secondary invasion by Pseudomonas or other bacteria. Bacterial culture and sensitivity are indicated for recurrent or resistant cases, or for cases where rods are identified on cytology. Biopsy of the interdigital area is indicated in recurrent or resistant cases, to look for Demodex mites.

Treatment consists of oral antibiotic administration. For routine cases, cephalexin or amoxicillin-clavulanic acid are preferred; lincomycin, clindamycin, erythromycin, or trimethoprim-sulfa may be effective. Fluoroquinolone antibiotics should be reserved for use if Pseudomonas is involved. It is important that treatment is continued for at least 2 weeks past clinical resolution. This means 6 to 12 weeks of antibiotics! In cases where chronic scarring or suspected immunodeficiency is involved, relapse may occur rapidly after antibiotics are stopped. In this case, there may be no choice but to treat the dog with antibiotics long-term. "Pulsing" the antibiotics (the full dose given one week on, one week off) rather than a daily, lower dose is preferred. Immunostimulant preparations have met with little success in chronic interdigital pyoderma.[/b]

Interpreting Canine Bacterial Dermatitis
Interdigital pyoderma -- often erroneously referred to as "interdigital cysts" though no cyst structure is present -- is located between the toes and pads of the feet. It is a type of cellulitis (a condition where inflammatory fluids are forced into the tissues, rather than being discharged on the surface) that is characterized in the active stages by deep draining tracts of large pustules in one or more interdigital spaces.

Due to the potential chronic nature of interdigital pyoderma, a thorough search for underlying causes is essential. All cases of interdigital pyoderma require skin scrapings, bacterial cultures and sensitivity tests. If no underlying cause is determined for persistent interdigital pyoderma, a genetic predisposition is suspected, and intermittent lifelong antibiotics will usually affect control of the symptoms.[/b]
INTERDIGITAL CYSTS
The underlying cause of interdigital cysts is usually unknown and in fact they are not true cysts, but they form as a result of inflammation.. Bacterial infection is thought to be a secondary complication if it is not associated with a foreign body penetration

...Diagnosis
Diagnosis is based upon the typical location and appearance of the swellings in the interdigital skin. XRays may be taken to detect foreign material eg metal, or underlying involvement of bone, and a biopsy may be taken to eliminate the possibility of cancer.


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Treatment
Medical treatment involves the use of corticosteroids (eg prednisolone) which are effective in some cases.

Surgical exploration of the cysts will help to identify and remove any foreign material eg grass awns.

Surgical removal (excision) off the swellings is the usual outcome if a patient does not respond to medical treatment. Unfortunately recurrence at the same site or in another interdigital web is common.


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Prognosis
Good if a foreign body can be identified and removed. Guarded if no primary cause can be found because recurrence is common.


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Long term problems

Recurrence
Osteomyelitis if underlying bone gets involved with infected "cysts".[/b]
 

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Discussion Starter #5
My regular vet is on vacation until Aug 11th and I'm dealing with his relatively inexperienced young colleague.No wonder nothing came up when I googled "interdigital cystitis"- :blink: - that's what he actually wrote on his diagnosis sheet and I just copied it without thinking about it!

After reading the info you posted, it sounds like this might be interdigital pyoderma rather than cysts, but the vet seems to be treating it to cover all bases- he didn't take any scrapings, but Murray is on Clavamox for 2 weeks and, as of yesterday, prednisone for the severe inflammation. It sounds like the weird brown waxy stuff caking on his foot pads could be the drainage described as characteristic of interdigital pyoderma.

I have an appointment with my regular vet the day he gets back. I have alot of confidence in him and the information you posted will really help in asking questions to make sure he's getting the correct treatment for whatever is going on.

THANK YOU!!!!
 

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Hope Murray gets better soon! Sending lots of healing drool your way! Please let us know what your regular vet says and what treatments he prescribes for him.
Are you saying the brown stuff is on the bottom of the foot, not between the toes? Yogi has problems in between his toes. I soak his feet when they flare up and dry them well. If the problem is really bad we resort to Panalog. It doesn't take long for that to clear it up. I do try to avoid steroids as much as possible but sometimes there is no way around them.
 

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Discussion Starter #7
The brown stuff is waxy, almost tar-like, and has been accumulating deep inside his footpads, although it is originating betwen the digits. I just noticed what was going on Tuesday evening, and feel bad that I didn't notice sooner.

I hate giving him steroids, but since he started yesterday ther's already an improvement in the inflammation. He seems zonked though, just sleeping alot- :(
 

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The brown, waxy stuff sounds like yeast. If he's been chewing on his feet, he may have created a warm, moist environment conducive to yeast infection. Steroids and other immunomodulatory medications appear to be effective in some forms of refractory pododermatitis. Have also had some success with betadine foot soaks.

1: Vet J. 2008 May;176(2):146-57. Epub 2007 Oct 4.Click here to read Links

Comment in:
Vet J. 2008 May;176(2):123-4.

Canine pododermatitis and idiopathic disease.
Breathnach RM, Fanning S, Mulcahy G, Bassett HF, Jones BR.

School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Dublin 4, Ireland. [email protected]

Pododermatitis is a common inflammatory skin disease of dogs. As pedal lesions are reported in many canine dermatoses, a methodical series of diagnostic tests is required to establish the underlying aetiology. However, laboratory/ancillary investigations may prove unrewarding, prompting a diagnosis of idiopathic disease. Various hypotheses have been proposed to explain the pathogenesis of idiopathic pododermatitis including pedal conformation, trauma, immunosuppression, bacterial infection, furunculosis and dermal granuloma formation. Idiopathic pododermatitis accounts for 0.5% of all dermatology referrals to the authors' clinic. A sub-group within this population is characterised histopathologically by epidermal hyperplasia, hyperkeratosis, spongiosis, dermal oedema and perivascular aggregates of lymphocytes and plasma cells. The term lymphocytic-plasmacytic pododermatitis (LPP) has previously been proposed to reflect the histological appearance of such lesions. Affected dogs, although systemically well, characteristically have pruritus, erythema, swelling, pain and alopecia of the feet. Although non-responsive to antimicrobial therapy, antiparasitic agents and elimination diets, these dogs typically respond well to immunomodulatory therapy.[/b]
PubMed link
 

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Discussion Starter #9
OK- thanks Betsy- I've printed this information and will bring it along to my vet appointment on the 11th

The vet I saw Tuesday is treating his symptoms with antibiotics and prednisone, but I want to get a correct diagnosis, and you and Mike have both been a big help-

I'll post again after the follow up appointment with my regular vet and let you all know what he says- I have alot of confidence in him-

I just wish this hadn't happened with my regular vet out of town, because I'm really questioning the other vet's diagnosis now :(
 
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