What is pododermatitis?
Pododermatitis in dogs is a complex condition that affects and involves the inflammation of the skin of the dog's distal extremities (paws) or footpads, often involving multiple paws. Affected areas may include the spaces between the toes, footpads, nail folds (paronychia), and nails. This condition can vary greatly in its manifestation and severity.
What are interdigital Cysts?
In some instances, sizable bumps or nodules are seen located between a dog's toes, and these are then referred to as Interdigital cysts, interdigital furuncles, follicular pododermatitis, or podofurunculosis. These cysts typically present as red nodules filled with blood and/or pus and are most often seen on the front paws. Due to the pain, dogs may limp, especially on uneven surfaces, and may lick or chew at their paws.
Research into pododermatitis and interdigital cysts has shown that it typically affects two paws in over half of the cases and all four paws in about a quarter of cases. Most lesions occur in the interdigital spaces or on the plantar surfaces of the pasterns, with less frequent involvement of the claw phalanx.
The plantar surface on a dog refers to the bottom part of the paw, specifically the area that comes into contact with the ground. This includes the pads of the toes and the larger central pad, also known as the metacarpal or metatarsal pad, depending on whether it is the front or rear paw. The plantar surface provides cushioning and traction for walking, running, and other activities. It is also the area where conditions such as pododermatitis can occur, leading to inflammation and discomfort for the dog.
Lesions associated with the condition can resolve on their own, fluctuate, or persist indefinitely. Known also as pedal folliculitis and furunculosis, this complex and multifactorial condition can be challenging to diagnose and treat.
What Causes Pododermatitis and Interdigital Cysts?
Pododermatitis can be influenced by a variety of factors including infections (bacterial, fungal, or viral), parasitic infestations, allergies, systemic issues (hormonal imbalances, autoimmune diseases), or even cancer. Interdigital cysts on the other hand are nodules between a dog's toes, caused by irritation or injury to the furry skin of the paws, leading to dilated hair follicles that can rupture and cause further irritation and infection.
With interdigital cysts the factors that contribute to the condition include hair Coat (Short, coarse hair coats increase the likelihood of inflamed and ruptured follicles and the breeds affected include English bulldogs, Great Danes, Basset hounds, mastiffs, bull terriers, and boxers), paw shape (wider paws put more weight on the skin between the pads and breeds with such paw shapes include Labrador retrievers, English bulldogs, German shepherds, and Pekingese), obesity (extra weight increases pressure between the toes during walking), difficulty walking (arthritis or joint problems cause dogs to put more pressure on interdigital spaces), licking and itchy behavior (licking or chewing the paws due to itching can irritate the skin and lead to cysts), and environment (trauma from cages or rough surfaces can damage hair follicles, leading to cysts).
What are the clinical signs of pododermatitis?
The symptoms typically include swelling, redness, pain, and sometimes discharge from the affected areas. Dogs might lick or chew their paws excessively due to discomfort.
The typical signs include erosive and ulcerative inflammation, hair loss, and the presence of pus-filled papules and pustules, along with redness, bleeding, and lichenified skin.
How is pododermatitis diagnosed?
The incidence of pododermatitis in dogs is on the rise, and its diverse causes necessitate a comprehensive diagnostic and treatment approach.
Differential diagnoses (other conditions) to be considered when evaluating a canine patient presented with pododermatitis or interdigital cysts
Infection | Superficial bacterial pyoderma Deep pyoderma and furunculosis (actinomycosis, actinobacillosis, nocardiosis, mycobacteriosis) Superficial fungal (dermatophytosis, Malassezia, candidiasis) Deep fungal (phaeohyphomycosis, sporotrichosis, blastomycosis, cryptococcosis) Parasitic (demodicosis, trobiculiasis, hookworm dermatitis, Pelodera dermatitis, tick infestation) Viral (canine distemper) |
|---|---|
Allergic | Atopic dermatitis, cutaneous adverse food reaction, contact dermatitis, flea allergy dermatitis |
Immune-mediated | Atopic dermatitis, cutaneous adverse food reaction, contact dermatitis, flea allergy dermatitis |
Endocrine (Hormonal imbalances) | Hypothyroidism, hyperadrenocorticism |
Acquired/Traumatic | Sterile interdigital pyogranulomatous pododermatitis Foreign body pododermatitis (plants, wood splinters, nail, thorn, foxtails, wood slivers) |
Genetic/Inherited | Familial paw pad hyperkeratosis, lethal acrodermatitis of bull terriers |
Metabolic | Superficial necrolytic dermatitis |
Neoplastic (Cancerous) | Nail bed squamous cell carcinoma, epitheliotrophic lymphoma |
A multifaceted diagnostic approach is necessary to identify the primary and contributing causes. This might include physical examinations, skin scrapings, histopathology, and imaging techniques such as CT scans if deeper structures are involved
How is pododermatitis treated and managed?
Pododermatitis in dogs is a multifaceted condition with its rising incidence requiring a comprehensive approach for effective management and treatment. Its diverse causes necessitate a comprehensive treatment approach with strategies depending significantly on the underlying causes, which can range from infections to allergies or autoimmune disorders.
As the treatment for pododermatitis depends on the underlying cause, some common approaches include:
1. Infection Control:-
Inflammation due to infections, antibiotics or antifungals may be prescribed. Effective treatments for infections caused by agents like Staphylococcus intermedius, Demodex canis, and Malassezia pachydermatis include medications such as Bravecto, Cefuroxime, Orungal, Apoquel, and Derinat, which help reduce the duration and extend remission periods. Parasitic infections are treated with special shampoos, topical treatments, and environmental hygiene measures. Bacterial infections require antibiotics chosen based on culture and sensitivity tests, while fungal infections like Malassezia are treated with antifungals such as itraconazole or ketoconazole.
2. Allergy Management:-
Allergic pododermatitis or interdigital cysts are essentially managed by identifying and avoiding the allergen. Treatment may include medications to control the allergic reaction, such as steroids, antihistamines, and cyclosporine. Dietary management through elimination diets can help pinpoint and avoid allergens. In severe cases, allergy injections or specific fatty acid supplements might be necessary.
3. Improved Hygiene:-
Keeping the paws clean and dry can help prevent further irritation or infection.
5. Topical Treatments:-
Ointments or medicated shampoos might be used to soothe and treat the paws.
6. Immunomodulatory Therapy:-
For autoimmune causes, medications that modulate the immune system may be necessary.
7. Obesity Management:- also includes addressing any predisposing factors such as obesity, which can exacerbate the strain on the paws. Protective measures like using barrier creams and wearing protective boots during exercise can help manage symptoms and prevent worsening of the condition. Systemic treatments may also include anti-inflammatory drugs to reduce paw inflammation and manage pain.
Overall, the treatment of pododermatitis or interdigital cysts often requires a comprehensive and tailored approach that addresses both the clinical signs and the underlying causes. Regular follow-ups with a veterinarian are crucial to adjust treatment plans and manage this often persistent condition effectively.
Ongoing research aims to standardize the diagnostic criteria for pododermatitis or interdigital cysts by correlating clinical signs with morphological and biochemical markers in the blood.
References
Bajwa J. (2016). Canine pododermatitis. The Canadian veterinary journal = La revue veterinaire canadienne, 57(9), 991–993.
Hnilca KA. Small Animal Dermatology: A color Atlas and Therapeutic Guide. 3rd ed. St. Louis, Missouri: Elsevier Saunders; 2011. pp. 60–62.
Miller WH, Griffin CE, Campbell KL. Muller and Kirk’s Small Animal Dermatology. 7th ed. St. Louis, Missouri: Elsevier; 2013. pp. 201–203.
Duclos, D.D., Hargis, A.M., & Hanley, P.W. (2008). Pathogenesis of canine interdigital palmar and plantar comedones and follicular cysts, and their response to laser surgery. Veterinary dermatology, 19 3, 134-41.
Yevtushenko, I.D., Bilyi, D., Tsymerman, O., & Nepochatova, A. (2021). Clinical manifestation and methods of treatment of pododermatitis in dogs. Scientific Horizons.
Kommentare