The Derm Vet

Claw avulsion... When we get cases of Symmetrical Lupoid Onychodystrophy (SLO), the claw can be coming off which causes a lot of pain/discomfort for the pet. We just discussed this disease in a previous post... and then a case came in that same day for a claw avulsion!

So, I wanted to show you how I perform these. I use heavy IV sedation and perform a ring block of lidocaine/sodium bicarb locally for a little extra comfort. Then, use a large alligator curved pair of forceps and pull it off.

You can’t pull off all SLO claws, but the ones that are starting to lift run the risk of catching on something and bleeding. It is nice to remove it in a controlled fashion and they tend to feel a lot better.

Have you done this procedure?

Pododermatitis is one of the more difficult clinical symptoms to manage. This is because the underlying cause can be multifactorial.

Though we blame allergies (and often that is true)... there are usually other causes that contribute as well. These causes could include conformation, endocrinopathies, obesity, foreign body reaction, etc.

Controlling inflammation and infection is important... but also make sure to consider why it is happening.

Otitis can occur from things BESIDES allergies. This dog has a history of bilateral otitis that was indeed from allergies. However, the left ear started being significantly worse than the right.

Things change... and this dog decided to develop a mass in the left ear. No matter how many ear drops you stuff into the ear canal... the infection will keep coming back if the mass doesn’t go away.

A polypectomy snare was used through the video-otoscopy unit to “lasso” the mass out and it came out in four different pieces.

The mass ended up originating from the middle ear. After removal, a lot of thick discolored material was removed from the bulla and submitted for culture. Since the mass had been present for awhile, a secondary otitis media developed.

You can appreciate the stenosis in the horizontal canal in the “after” picture and ruptured tympanum. We are using oral steroids to help open up the canal and will treat with oral antibiotics based on C/S results. Make sure to look deeper when clinical signs start to worsen or change!

This sweet girl has a Twofer... two different skin diseases.
Years ago, she was biopsied with vasculitis but already had ongoing atopic dermatitis. Luckily, Apoquel has been helpful in managing both diseases! She has stable for a few years now and I always love when she comes into the clinic... I think about to where she started.

Update on my Trichophyton case... After 2 months on terbinafine, this sweet girl has been doing awesome! First negative DTM and we are going for one more before stopping treatment.

I have had a run of Trichophyton cases and it is so amazing to see how much better they can look with treatment. Remember, Trichophyton comes from rodent and many of these dogs contract the fungus by sticking their faces into rodent holes!

SLO (Symmetrical Lupoid Onychodystrophy) is an autoimmune nail disease in dogs that can be incredibly painful and frustrating for both pets and owners…

This condition causes inflammation at the nail bed (“lupus pattern” inflammation), leading to abnormal, brittle, cracked, or lifting nails. In severe cases, the nail can partially detach, creating significant pain and pressure on the nail fold and toe.

Key things to know about SLO in dogs:

• SLO usually affects MULTIPLE nails — if only one nail is involved, trauma or infection should still be considered as differentials. (Hence the term symmetrical.)

• If a nail is lifting or loose, removing (avulsing) the nail is often one of the best ways to provide immediate comfort. Under heavy sedation or anesthesia, the abnormal nail can be removed to relieve pressure and pain — and most nails will regrow over time.

• You typically do NOT need to amputate the toe for diagnosis. Histopathology can be difficult to interpret with SLO, so diagnosis is often made clinically based on history and appearance.

• There are MANY treatment options depending on severity, including:
🐟 Omega-3 fatty acids
💊 Doxycycline + niacinamide
🩺 Cyclosporine
💉 Steroids
🧬 JAK inhibitors… and more.

One of the MOST important long-term management tips? Keep nails trimmed SHORT. Longer nails hit the ground harder, increasing pressure, discomfort, and the risk of additional nail trauma.

Have you managed a dog with SLO before? What treatment protocols have worked best for you?

Interdigital furunculosis is a difficult disease process to manage. We often consider the acute phase of very swollen, draining paws that need steroids and antibiotics. But what can happen with more chronic cases?

Chronic interdigital furunculosis can lead to scar tissue and soft tissue proliferation. This can result in false paw pad formation. This occurs when the palmar interdigital skin becomes thickened and calloused. False paw pads can lead to deeper palmar interdigital pockets, leading to trapped keratin and infection.

Remember that interdigital furunculosis and false pad formation often have multiple contributing factors. This sweet guy has chronic allergies, angular deformity and is overweight leading to these lesions but has wonderful owners dedicated to managing his multitude of issues.