Showing posts with label barbie foot. Show all posts
Showing posts with label barbie foot. Show all posts

Thursday, November 21, 2013

Barbie's foot diagnosis - Focal Metatarsal Fistulation (of the German Shepherd Dog)

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!

before

after

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! 

Sunday, September 15, 2013

Barbie's foot injury saga

For a few months now Barbie has had an issue with her rear left foot. It started off looking a bit like this after we had a good run around the park. I noticed it was draining a bit of clear fluid and blood, and took her to the vet. We tried a couple of courses of different antibiotics but it didn't fix the problem. It would heal up, the fluid would accumulate and it would open and drain again.


After the antibiotics I thought perhaps we would have to take more drastic action, so I consented to the vets doing surgery to see if they could find a foreign body in her foot causing the problem. They made a small incision though they needed many stitches because there wasn't a lot of skin for closure in the area. 


The vets didn't find anything in there on this first try and believed that they had cleaned it up enough that it would just heal normally. We had to change our weekend activities and Barbie spent more time riding in the car with us to visit cafes and go on very short walks.


Unfortunately a week or so after her stitches were taken out, I took her for a normal leash walk and her foot puffed up and was quite swollen. It was hurting her too, so I took her to the vet that night. A shot of Metacam bought it back down, but the skin on the bottom of her foot split open and it weeped quite a bit of fluid. N took a photo of it when it was particularly weepy. By now it was being referred to as a 'chronic draining sinus'. 

Our vets put her on a long course of Baytril, which was a third antibiotic. Unfortunately it didn't change much and so I went back in for a referral to Perth Veterinary Specialists to do some imaging. 

She was off the antibiotics for a week when she was admitted for a CT scan. The contrast dye didn't move very far from the local area but they didn't see the foreign body either. 

The surgeon then told me the next step was surgery.

His plan was a more aggressive debridement of all the damaged tissue in her foot, at the same time taking samples in case of an a-typical infection and looking for the root cause of the damage. I looked him up on the internet before I said yes, he has a very long string of achievements in his specialty, so I decided I could trust her with him. 

Unfortunately he didn't find the foreign body, but the superficial nature of the damage gave him some cause to be optimistic but he was overall quite guarded in his prognosis. He isn't the kind of Vet to tell you what you want to hear. The skin on the bottom of her foot was too damaged to close so he had to leave an open area, which means that she is going to be in a bandage for a couple of weeks, or longer.



They tell me she did well at PVS, and she stayed three nights in total. When I took her back in on Saturday for a bandage change she was pretty happy and seemed to want to go out the back. I don't think she enjoys their crates though as she has a sore bit on her nose, I think from shoving it into the bars. She does really enjoy all the attention from the vet nurses, and now she is home I am pretty sure she loves all the sympathy she elicits when people see her out on her toilet breaks in a cone, with a big bandage and a plastic bag on her foot. 

Her next checkup and bandage change is on Tuesday. The surgeon will be having a look at healing and adjusting the stitches as well. I believe she will have to go back one or two more Tuesdays after that, depending on how it is going. 


At the moment she is supposed to be contained, the rules are NO running, NO jumping, NO stairs, NO playing, NO getting on the furniture...etc etc. The only way to get into the Vet surgery is to go up stairs, so I have been carrying her in directly from the car. It has also been raining frequently and heavily so I have been spotted jogging through the car park carrying a totally ragdoll floppy 26 kilogram greyhound. I am only 158cm tall and it must be a pretty amusing sight. All the rain has made timing our toilet breaks very important at home as well and it doesn't look like letting up any time soon with rain forecast all week!!

I'll update on Tuesday when I get more info from the vet and I'll try and get a photo if it's not too gorey. I am not sure exactly how many stitches she has but I think there are a lot! 




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