My regular followers would know that Barbie recently had issues with her back foot (here is the blog entry). It started off as what looked like a scrape but it wouldn't heal. After 4 x courses of different antibiotics, a CT scan and two surgeries, the vets were left scratching their heads. We were finally referred from the surgery department to a dermatologist (Dr Rusty Muse @ Perth Veterinary Specialists). He came up with a diagnosis that seemed so off the planet I was sceptical.
Focal Metatarsal Fistulation
Here are some links about the disorder.
A condition seen in German Shepherds, where the immune system attacks the tissue of the metatarsal pad. It results in a chronic draining sinus and often the dog will go lame. They really don't know what causes it and thought it was perhaps something genetic. She is the right age for it and all the clinical signs point to it. We have been through an exhaustive diagnostic process to arrive at this conclusion.
The dermatologist prescribed Tacrolimus ointment (0.1%) which needed to be made up for us by a compounding pharmacy. It is a very expensive little tube of ointment! She was on it twice a day for a couple of weeks and the dermatologist was very impressed with her progress. Now we are down to once a day treatment. She is able to run at top speed more now and it's great watching her zoom around again. Just before the last surgery she could only do one sprint of maybe 10 seconds before she would pull up sore with bloody serum weeping from her foot.
Due to the surgeries there will be scar tissue so the foot is never going to look exactly like the other one. The condition can often be bilateral - at least if she gets it in her other foot we will know what it is!
Now that she has been diagnosed with an autoimmune disorder it's given me reason to review vaccinations for both dogs. Our boarding kennel accepts a titre test certificate in lieu of a vaccination certificate so we did a titre test for Barbie this year and she came back with acceptable immunity levels, so no jabs for her. Yay!