Foot and Nail Problems


Itchy feet

Question: Dr. Richards,

Both my Poms scratch and lick their paws. At the kennel their staple food was some brand of kibbles. Here at home they have been fed rice and chicken. Is it possible that the rice could be the cause of their licking and scratching? They are combed for fleas but we have been unable to find any, though that's not to say there are not any.

Tony A.

Answer: Tony-

Any food that contains proteins, and some that don't, can lead to food allergies. So rice is a possible food allergen. It is not high on the list of potential allergens. Chicken would be more likely to be the culprit in a diet consisting of these two ingredients.

Licking at the feet occurs with both food allergies and atopy (generalized allergies). There is some evidence at this time that dogs may react to contact allergens much more frequently than we thought in the past and that some of the pollen allergies, formerly believed to occur due to inhaled pollens, may actually be contact allergies where the pollen lands on the skin and causes a reaction. If this is true, rinsing the dog's feet after they go outside might help. I don't know what percentage of the itchiness in cases of atopy relates to inhaled versus contact stimulation from allergens, though.

It is a good idea to use a flea treatment with a good track record, such as fipronil (Frontline Rx), imidocloprid (Advantage Rx), selamectin (Revolution Rx) or lufenuron (Program Rx) in combination with an adulticide (Capstar Rx, any of the others mentioned before) in any dog that has itchiness due to allergies or other causes. Itching is considered to be threshold event, in which the stimulation has to reach a certain level before itching is triggered. All contributors to itching make up the level of irritation the pet is feeling, so decreasing one source of itching might be enough to keep a pet below the threshold for itching, even through there is another source of irritation that is still trying to cause itchiness. So if you are just checking for fleas but not using a flea prevention product you might see some improvement by using one of these products even if fleas are not present in large enough numbers to make them easy to find.

Mike Richards, DVM 8/24/2001

Brittle nails in Lab

Question: Hello. Our 85 lb. chocolate lab Bailey has brittle nails, according to the groomer. Please advise what this may mean and what we can do.

Allow me to give you some background. We adopted her three years ago as a one-year old. She is fed 4.5 cups of ProPlan Chicken and Rice per day. We also give her broccoli stems and occasionally carrot. For occasional treats, liver treats and pigs ears.

Thank you.

Answer: Linda-

The answer to this question depends on exactly what is happening with the nails.

If you are seeing dry nails that crumble easily when they are trimmed, but are not sloughing off, not causing pain or other discernible problems, then there are lots of anecdotal recommendations for treatment. I am not aware of any studies that show that any of these things actually work, but anecdotally they are recommended:

Gelatin administration is a common recommendation for treatment of brittle nails. I have seen a fairly wide range of recommendations for the amount of gelatin to give. For an 85 lbs. dog the total dosages would be 2 to 5 packages per day (Knox Gelatin (tm) is the most commonly recommended brand name). I suspect that this is rarely helpful but haven't seen any reports of it being harmful.

Some sources recommend supplementing biotin when nails are brittle. I can't recall whether I have seen a study in dogs but I know that in horses there have been studies that haven't shown much benefit for hoof care, which should be similar. The recommended dosage is around 5mg/kg (about 200mg for your dog) of biotin per day, if you want to try this.

Zinc supplementation helps in some dogs. The usual dosage is zinc gluconate 5mg/kg daily. This probably only works when there is a zinc deficiency, although some dogs just seem to need more zinc. I don't think of this as a really common problem but we have seen at least a couple of cases of zinc deficiency in our practice over the years.

The best bet is probably to supplement with omega n3 fatty acids. This is usually done using fish oil (3V Capsules tm) and giving 180mg/10lbs of body weight per day, which is a pretty high dosage. For just dry nails a lower dosage might be helpful but for the condition discussed next you would need the higher dosage.

If the nails are actually cracking back to the nail bed, if they are falling off or if they are deformed, it is likely that there is a medical cause for the problem. The most likely cause would be lupoid onchodystrophy, followed by food allergies or other allergies, ringworm, bacterial infections and immune mediated diseases. Except for the ringworm and bacterial infections all of these conditions might respond to the high end dosages of 3V Capsules. It is likely that your vet can give you some idea of the possibility of an infectious cause following an examination.

I hope this helps some.

Mike Richards, DVM 8/7/2001

Symmetrical lupoid onchodystrophy in Rottweilers and Greyhounds

Question: Dear Dr. Mike,

I have enjoyed being able to use the free portion of your website for quite some time now and am very glad you are doing it. I have found it to be an excellent place to go for more information when something is going on with my dogs.

Now that I am a subscriber, I have been going through the newsletter archives and found a short article about symmetrical lupoid onchodystrophy, and the fact that it affected your rottie.

I have a greyhound who may have the same thing. At this point it is hard to know because we just got him from the track a few weeks ago and after having him for only a few days I noticed that his nails looked odd. The very next day he completely lost one and bled all over. The nail basically just crumbled and left the live, exposed quick. Poor fellow! And he is a young dog yet and really needs exercise, so it's been a bit difficult for him having a big bandage on his foot until the thing heals enough to leave it unprotected (the vet had to remove the remainder of the nail under sedation).

He's had a fungal culture done, but the results will not be back for awhile yet. Our vet feels it could be fungus, SLO, or maybe even both. Right now the boy is on Keflex until the nailless toe heals over, and has also been put on 2 3VCaps per day, plus 500 mg. of niacainamide 3 times a day. We have been told he may need the oil caps and the niacinamide for the rest of his life. The next step will be to soak the toe after the bandages come off and then treat with a fungal ointment if the fungal test comes back positive. Most of all, she has told us to be patient because the nails grow so slowly it is going to take time to see if anything works.

The questions I had to ask where these: is there any new information around about SLO? Our vet is a recent graduate and seems to think there is a component of nutritional deficiency in all this, and the little bit of info I could come up with about this condition seems to treat it as an immune-mediated thing similar to pemphigus - some vets even seem to feel it is a limtited form of pemphigus. Is it? or is it something new? Or something old no one really paid much attention to before?

So I'm a bit confused about what this condition may really be and what the best thing we can do for our dog. The only thing I know for sure is that if this stays limited to the toenails only and he can still live a comfortable life after losing the diseased nails and growing new ones, I definitely don't want to put him on steroids. We have had bad experiences with that in our older dogs and this one is definitely too young to have to go that route.

Add to that the complicating factor that we just found out today that he has a moderate positive titer to babesia canis. Is this something that could be adversely affecting his immune system?

Thanks for any time you can give providing some information.

Sincerely, Nancy

Answer: Nancy-

The breeds that appear to be most commonly affected by lupoid onchodystrophy are rottweilers and greyhounds, so given this it is a good idea to maintain a high degree of suspicion for this condition. German shepherds and giant schnauzers may also be affected more commonly than other breeds. The nails are usually painful prior to falling off and the toe remains painful for a few days to several weeks after the nails fall off, at least in the cases we have seen. I don't know about all dogs, but our dog was pretty sensitive about having her toes touched for the rest of her life, although it didn't seem like they were constantly in pain. More like she remembered the pain for a long time.

The only way that I know of to diagnose the problem is to biopsy an affected nail bed. There is a description of how to do this in one of the Clinics of North America and that would be worth looking into if you would consider biopsy, because the alternative technique is removal of the last digit of an affected to to get a biopsy specimen and I would be really reluctant to do that. If this does progress to other nails it is also reasonable to assume that this condition is present and treat for it, at least in my opinion.

I have not seen any indication that this is a nutritionally related problem, except that some dogs with food allergies are reported to lose toenails if there is severe inflammation of the feet but I don't think that just nail bed inflammation occurs much with food allergies. Treatment could be considered to be nutritional, though. Many dogs are reported to respond to high doses of omega n-3 fatty acid supplementation. High dose is about 18mg/lb of body weight or about 1 capsule of most of the fatty acid supplements per 10 lbs of body weight. This is a usually much higher than the dose recommended on the label.

Other treatments that sometimes work, and are currently used in addition to fatty acid supplementation are pentoxyfilline (Trental Rx) administration at 10mg/kg or 400mg/dog once a day or once every other day; niacinamide and tetracycline administration (usually 500m of each medication given two to three times a day) and corticosteroids at immunosuppressive dosages. The corticosteroids should be a last resort because often the other medications work if given for at least a couple of months.

Antibiotics are not usually helpful but it is hard to resist using them, especially for the first one or two nails when it is tempting to hope that the problem is a nail bed infection.

My impression is that this is a discrete condition that is an immune system disorder. This would put it in the same class of problems as systemic lupus erythematosus and phemphigus disorders but I think it is considered to be a completely separate entity. I'm not absolutely certain of that, though.

I don't know what to tell you about the long term situation with this condition. We did not keep our rottweiler on medications long term because we didn't see much response to the tetracycline/niacinamide protocol and the dosage of fatty acids we used was too low by today's standards and perhaps consequently they didn't seem to help much, either. I didn't want to keep her on steroids, so we just treated her when the nails were painful. She lost all her nails over the course of about a year or two and and then was comfortable but nail-less for the rest of her life. So our experience with treating one dog was that she did OK without long term medication as long as you consider having almost no toenails (she had short stubs) acceptable. I am not sure that this would be acceptable in a greyhound since they seem to dig their toes in more when they walk, but again I am not sure of this, either.

Mike Richards, DVM 6/23/2001

Cold feet and ears in

Question: Dear Dr. Richards,

My 12-year old lab is in the midst of yet another urinary tract infection (heavy growth, E. coli). Her temperature is normal; she has been eating well but sleeping more than normal.

In the past few days, I've noticed that her extremities (foot pads and ears) are icy cold to the touch -- despite the fact that she has not been outside and the house has been comfortably heated. Does this mean anything? I can't recall this ever happening before.

Thanks, Carol

Answer: Carol-

I have not seen a list of causes for cold extremities in pets. I know that they are sometimes reported to occur with the hormonal illnesses (hyperadrenocorticism (HAC), hypothyroidism) but usually there are other signs that are a stronger tip-off for these illnesses, such as increased drinking and urinating for HAC and hair coat thinning or loss of hair for hypothyroidism. They can occur when there are blood clotting disorders and when vasculitis is affecting circulation but these are not usually conditions that affect more than one or two limbs and the patient is usually doing pretty badly when these conditions are present. I hesitate to say that this isn't something to worry about but I can't provide a good list of possible problems for it, either. I'm sorry I can't help more with this.

Mike Richards, DVM 3/5/2001

Will a dog regrow a lost nail

Question: Dr. Richards, If a dog essentially 'rips' out of one it's toe nails, should a new one grow in it's place ... in time? Or, if the nail was pulled out (unintentionally) by the "root" or "core", and there is only a small *nub* visible, would a new nail be unlikely to grow in?

Answer: Vox In almost all cases a nail will grow back when it is ripped off the nail bed. Once in a while we have a dog who does not develop a new nail, presumably because the nail bed was too traumatized when the nail was torn off or crushed. Mike Richards, DVM 12/12/2000

Constant biting at feet in Labs





Answer: Mary Ellen-

By far the most common cause of biting or chewing on the feet is allergy. The two most common allergic reactions that lead to this are food allergies and inhalant allergies ( atopy). Less commonly this can occur due to flea allergy or contact allergy.

Food allergies usually, but not always, show up before a year of age. If your chocolate Lab started chewing her feet before she was a year of age, it would be a good idea to consider a dietary trial to see if food allergies are the cause of the itchiness.

To do a dietary food trial for allergies, it is necessary to find a protein source that your dog has never eaten during its lifetime. This can be something like venison or duck, or it is possible to use newer allergy diets with manufactured proteins that do not occur in nature. In addition, it is a good idea to use a carbohydrate source that is unfamiliar to your dog, as well. Rice sometimes works for this, but potato or some other carbohydrate is a better choice since it isn't used in dog food, usually. This diet must be fed for at least six to eight weeks to be sure that a dietary ingredient is not the cause of the itchiness. It is important to remember that food allergies are to specific ingredients, such as beef, lamb, milk, chicken, etc. -- not to a brand of dog food. Food allergies tend to be a continuous problem, so itchiness that is not seasonal is another hint that this might be the problem.

Inhalant allergies can be tested for by serology (blood tests) or injection of suspected allergens into the skin (intradermal skin testing). The skin testing is considered to be more accurate. Inhalant allergies tend to show up later than food allergies, but sometimes show up as early as eight months or so. They tend to be seasonal at first, but then to occur over more and more of the year, as dogs develop allergies to additional irritants. Dogs can be allergic to tree pollens, weed pollens, dust mites, fungi and other allergens that affect people, too. Testing for allergies is a really good idea when it is necessary to use cortisones frequently. It is often possible to design a program of allergy shots using small doses of the substances the dog is allergic to that help to "desensitize" the dog to the allergic substances. This has much less side effects than cortisone. The success rate of allergy desensitization programs is between 60 and 80%. Allergy testing and injections can be expensive, especially the first year, but they are much better for the dog and if they work, may be less expensive in the long run.

Antihistamines help some itchy dogs. The antihistamine most likely to work for allergies in dogs is clemastine (Tavist (tm) or TavistD (tm)). Other choices are diphenhydramine (Bendryl tm), chlorpheniramine (Chlortrimeton tm), hydroxyzine (Atarax Rx) and several other antihistamines. Even if antihistamines won't totally control the itching they might extend the length of time between cortisone injections.

Most veterinary pharmacologists recommend using oral corticosteroids on an every other day (or greater interval) basis rather than using injections. When it is necessary to give injections close together, this is even more important to consider.

Hope this helps some.

Mike Richards, DVM 2/1/2000

Footpad cut

Question: Upon closer inspection, the injury to the toe pad is almost like a horizontal slice, could be as much as 1/16 inch deep, circular, maybe 3/8 inch diameter. It is not a puncture, abrasion , incision or laceration. It is as if someone took a paring knife and sliced off a layer of skin, on one of the two front toe pads of his front paw, toward the middle (next to the hair between the pads, but not into the crevice). It is not bleeding or bloody, just pink and nasty looking. And it is very painful. It is horrifying to watch him walk, and he cries if I wash it with soap and water, although rinsing with water is better tolerated, and all is forgiven with bits of cheese. I cannot picture how such an injury occurred. If you have any thoughts on what might have caused such an injury, and/ or how it should be treated, I would be most grateful to have them.

Answer: I don't have any ideas about what might have caused the slice on the footpad but I do see a lot of these types of injuries when people have no idea what might have happened, so they must be pretty easy to make. I like to use Facilitator (tm) on these now but have used things like NuSkin (tm) in the past. Bandaging the foot can make them more comfortable, too, but I just don't like to use bandages unless it is absolutely necessary.

Mike Richards, DVM 5/22/2000

Cracked footpads

Q: I've been running my dog, partly on asphalt and partly on grass, for up to 6 km at a time. Her pads seem to be cracked but don't otherwise appear dry or damaged, and she doesn't seem to be in pain or discomfort. Any ideas on what this might be? Many thanks for your assistance.

A: s- Cracking of the footpads can occur as a use injury (seems somewhat likely in your dog's case) or it can occur with some disease problems, especially the immune mediated problems like phemphigus. Your vet can help determine is there is a problem such as that.

There are boots made for working dogs if the problem does seem to be repetitive injury from running. It might also help to apply a moisturizing lotion to the pads after running.

Mike Richards, DVM

Toenail Maintenance

Q: I have two dogs that do not get out to walk very often, as we "play" in the back yard tossing balls, etc. The problem is... their toenails have gotten very long. I am terrified to trim them (they are black) and I'm worried I would cause them great pain and discomfort. Is trimming their very long nails something I would as a vet to do, or would a groomer be able to do this without the dogs having to much pain. Thanks in advance Mary

A: Mary- Nail trimming is done at most veterinary hospitals and I'm sure at all grooming facilities. Unless your dog is aggressive enough to require sedation or anesthesia or has some other problem requiring special care it is fine to have this done at the groomer's, too. We sometimes cut nails too short, which does cause short term pain and I am sure that groomer's do this occasionally, too. If you are careful and don't do it too often, it is certainly OK to cut your dog's nails yourself, too.

Mike Richards, DVM

Cold Feet

Q: Dr. Mike, I have a 6 1/2 year old Beagle mix, who is strictly a house dog. The past week the whether has been 0 or below. When I take my dog out to do his thing, his feet get too cold for him to walk. After looking at the pads on his foot they seem dry and slightly cracked. Is there anything I can do for him to help prevent this ???? Does the fur in between the pads have anything to do with this problem??? Someone told me to trim the hair between the pads on his foot ?????

A: I have the good fortune to practice in an area where extreme cold is not a very common problem -- but that makes it hard for me to give you "expert" advice on your problem. I have gathered some information from the literature on these problems. Several veterinarians have written that it is best to wash any road salt or other chemicals to keep ice down off your dog's feet after each walk. There seems to be some disagreement about the value of trimming the hair between the toes but the majority of advice seems to follow the lines that if the hair is long and collects ice balls it might be better to remove it. The dryness could just be from constant exposure to wetness. If this is the case, it might help to apply petroleum jelly or bag-balm to the pads prior to walking your dog. There are several companies that make boots for dogs out of neoprene or similar materials -- and I have some clients who spend part of the time in colder climates who really like these.

That's the sum of my knowledge on this matter -- sorry I can't give you the benefit of experience! Your vet, who practices where cold weather is more common, probably knows lots more than me.

Mike Richards, DVM

Torn toenail

Q: you wrote: My Yorkie and I were out today and he got his toenail caught in something and tore it near the quick. It was bleeding and I soaked it in Hydrogen Peroxide. He is limping and seems to be in a lot of pain. Is there anything I can do, or should I take him to the vet and have it cut off?

A: Christine- In most cases it is better to have the remaining nail removed when a nail breaks near the quick. It continues to cause pain as the unstable nail edges rub on the quick. If you didn't take him to your vet and the nail isn't causing pain it will probably be fine after this much time, though.

Mike Richards, DVM

Split toenail

Q: I have a 15 month old yellow lab that is very active. 4 or 5 days ago he split a toenail. he came real close to tearing the nail off. the top part of the nail is split in two pieces and both pieces are separated from the bottom portion of the nail. i trimmed back the top part of his nail hoping it would grow out normal. is this something i need to go to a vet about or just have a little patience. the nail has grown out but it is still separated from the bottom part. will this heal on its own? the reason i ask if it was my own toenail i would pull it off so a new one could grow in. my dog does not appear to be in any pain over this except he constantly licks it trying to clean it. i have put neo-sporian on it which he promptly licks off. i cannot really afford a vet bill except when it is absolutely unavoidable. thank you david

A: David- It would be best to have your vet remove the remaining portions of the torn nail if you have not done so already or this has not happened on its own. The nail is more likely to grow back with a normal appearance if you do this and I think your dog may be licking this because it is painful and that is all he can think of to do. You could remove the torn portions yourself but he won't like it. In some cases the remaining attachment is deep enough that anesthesia is a good idea since removal can be VERY painful if there are still some strong attachments. Think how much it hurts when you jab something under your nail or it is torn and the ends move around. He'll really appreciate the relief.

Mike Richards, DVM

Clipping nails to short - bleeding

Q: Dr. Mike: Just today my husband clipped my Yorkie's thumb nail and clipped all the way down to the vein. My Yorkie was bleeding and licking at her paw and went to bed early. Is there anything I can give her, or put on the cut to relieve some of the pain? Hurry! Please respond as soon as possible. I'm really concerned about her.

A: Pete and Stephanie- It is not unusual for people to clip a toenail too short and for bleeding to occur. We clip toenails every day in our practice and we still manage to clip one too short at least once or twice a week. We use a product called Kwik-Stop to control the bleeding but there are many alternatives. One of the better "home remedies" is just to dip the foot with the bleeding toenail in a bowl filled with flour. This will often cause rapid blood clotting to occur. A styptic pencil is OK to use to stop bleeding. Putting a dab of tissue on the bleeding nail will sometimes work. So far, in eighteen years of practice I have not seen a dog bleed to death from a toenail clipped too short so it is important to remember that this is not a desperate situation when it occurs. If bleeding were to go on from more than 10 or 15 minutes it would be a good idea to bandage the foot and to contact your vet or an emergency clinic. Testing for a blood clotting disorder may be necessary if bleeding goes on for that long.

Mike Richards, DVM

Footpad injury

Q: I have a one year old shepherd mix who is very active. Yesterday she was limping and favoring one paw. We looked at it and noticed that an area (a little smaller than a dime) was missing at the center of her large pad. We think she may have gotten some tar or something stuck there and then pulled it off herself. We would rather not take to to the vet, unless it is absolutely necessary. What can we do? Thanks.

A: Theresa- Most traumatic injuries to footpads will heal within two to three weeks, with or without treatment. Using an antibiotic ointment can be helpful in keeping the pad a little moist and in preventing infection. If the injury does not show steady progress towards healing it would be best to see your vet because one possible problem is an abscess that has ruptured through the footpad. This would be less likely to heal without veterinary attention.

Mike Richards, DVM

Pain in paws, loss of toenails

Q: Dear Dr. Mike, About 3 months ago, I adopted a dog from the ASPCA. It is a wonderful and sweet dog and I'd give him the world. His name is Toby, he's a siberian husky-of a purebreed. Within the last month and a half, Toby has been having problems with his paws. He would be in pain in either his left or right front paw for quite a while and would be limping. We took him to the vet who told us he had an infection in his paws and gave us some antibiotics- Cephalexin. It seemed to take his "infection away" and Toby was fine for about a week. Then he had the same pain and reaction in his other paw. So we got more medicine. It happened again. Finally it went away for about 2 weeks and we thought everything was fine. During the times he had been limping he had been constantly licking his paws and he actually did loose an entire nail. About 2 days ago, Toby started limping on his hind leg and he has been in constant pain. We took him to the vet, who gave him some lyme disease tests. However, Toby has been whining and crying ever since and his leg is so tender that if you brush the hairs he'll start almost screaming for about 5 minutes. We don't know what to do, it is awful to watch Toby suffer. The vet has been of no help. We think that Toby might be in pain because his nails need to be clipped. The doctor told us that it is possible he has some kind of autoimmune disease. Please write me back with your opinion, we are in desperate need of a 3rd opinion. Thank you for your time. Natasha

A: Natasha- It is not unusual for infections of the feet to be difficult to treat and to cause a significant amount of pain. It seems possible to me for this to cause the amount of discomfort you are describing. Many dogs strongly resent having their feet touched or examined when they have infections between the toes or on the bottom of the foot. It would be unusual for a dog to resent even having a leg touched but some dogs do not want to be touched anywhere near their feet.

Usually a more general problem, such as allergies or immune medicated disorders such as phemphigus or lupus leads to the interdigital (between the toes) infection. Demodectic mange can be a problem in some dogs with interdigital pyoderma, as well. It is important to try to rule out these underlying causes if at all possible. Loss of toenails does make it more likely that an immune system disorder is present. I do not practice in an area in which Lyme disease is prevalent but I am assuming that your vet tested for this more for the lameness problem than the foot infection.

Regardless of the underlying cause it will often take very long term use of antibiotics to control an interdigital infection. I usually start out with twenty days of antibiotic therapy as a minimum and then adjust upward from there. We have used antibiotics for as long as six months straight in some particularly difficult cases.

If your vet is unable to resolve this problem you may wish to ask for referral to a veterinary dermatologist for a second opinion. They see the most difficult cases and sometimes can discern an obscure underlying cause that a general practitioner just doesn't see often enough to recognize.

Good luck with this. I am sorry for the delay in replying and hope that Toby has improved a great deal in the meantime.

Mike Richards, DVM


Michael Richards, D.V.M. co-owns a small animal general veterinary practice in rural tidewater Virginia. Dr. Richards graduated from Iowa State University's College of Veterinary Medicine in 1979, and has been in private practice ever since. Dr. Richards has been the director of the PetCare Forum...