Q&A: issues with an amputated toe in a dog

One of my more popular posts is on the topic of toe amputations in dogs and cats.

Recently, one of my readers, Heather Z, posted a question about her lab's post-surgical toe issues that I thought was worth separating out as its own post.

Brady Hi. We have a 111 lb black lab and just had his third (III) toe removed on the front right paw in the middle of October. He still walks with a limp and holds it up when he stands. We keep it wrapped in a sock with a cone on his head all day every day because he wants to lick it. When he goes out, we wrap it to keep it dry.

He has been on antibiotics and about the 2nd week it started to pus and the swelling of his fourth (IV) toe was still huge and didn't go away. Brough him in and they upped his antibiotic. Nothing was said if it was infected but that's what I think. We also put a drying solution mixed with water on it twice a day and blow dry it as recommended.

I'm just worried that something else could be wrong with swelling not going down still going on a month. It is a pain. I think we did the right thing but its just hard seeing him like this and there's no improvement with the swelling! Anybody know of this?

I passed the question on to Dr. Heather Carleton, one of Embrace's veterinary advisors and this is what she had to say in response:

My question would be why was it initailly amputated? Was is broken, arthritic, had a tumor, etc? If it was amputated because of a tumor, I would be concerned that there is recurrence. If not, I would have the foot x-rayed and make sure there is no bony involvement with the infection (i.e. with the bone above the ampuatation site). If there is, the area may need to be debrided. If it is just soft tissue that is infected, antibiotics should take care of it.

Heather Z's got back to me with an answer for Dr. Carleton:

We had it amputated because it had a hard tumor growing connected to the bone. We had it sent into the lab and it is benign. He has been on cephalaxin and ciprofloxacin, which did not work, and now we went to clindamycin. I took him in last Thursday and had the desolvable stitches they left in taken out. I started to cut them out and they took the rest out. Our vet says it should clear up and to call and talk to him Monday. Well, that is tomorrow and it is still swollen. He said the next thing will do is move up to a more expensive antibiotic that costs $100 bucks or so.

This is still really frustrating because it is not getting that much better and he still limps. I hope this next option he has in mind works or else the next move will be going somewhere else and getting a second opinion and probably an x-ray and possible debridement as you suggested.

Here's an update from Heather Z.

When I brought him in last Wednesday, the vet thought he was doing much better now that the desolveable stitches had been romoved and the swelling around the scar tissue started to heal better. I just don't get why they left them in there. I heard from other people that desolveable stitches can cause inflammation. I also think when they wrapped his foot postoperately with the sticky wrap they did it too tight and was supposed to remain that way for 7 days. I also talked to other people and they said that they rewrap and change around the 3rd day.

The vet said he looked like he was healing well and the inflammation of his big toe should not be a concern because it is part of his healing process. He is moving around better and the outside toe looks almost back to normal size but the middle toe is still very swollen but may have improved a tad since suture removal. I am supposed to check back with him in two weeks and keep giving him his clindomycin 4 pills twice/day.

So, somewhat better but he still has to have a cone on his head when we are gone and something on his foot so he doesn't lick it like mad. I left the house for an hour and he somehow pulled it off and yanked his booty off and was licking it till it bled. Uh. But that is how it is going so far. It is now one month and 1 day. Buddy is a crazy licker anyway and is always grooming. I just hope things start getting better faster!

Have you found yourself in this situation? Let us know what happened in the comments...

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