Friday, October 1, 2010

213. Vet Surgery - Fusion podoplasty - interdigital cyst

Perth Saturday

Interdigital cysts in dogs are sometimes ignored by the owner. The dog keeps licking till the cysts become infected. Conservative medical treatment does not help after a while.

SURGICAL EXCISION. Normally I advise surgical excision for infected i/d cysts. No more problems usually. But how about three big ones with all i/d webs affected and big scar tissue on the palmar aspect of the paw bridging the 3rd and 4th digit? A successful case report is at: Australian Veterinary Practitioner Vol 40 (2) June 2010, pg 53 - Fusion podoplasty in a dog with inter-digital furunculosis.

I will summarise the case. 10-year-old Collie X, chronic pododermatiiws of the right forepaw unresponsive to conservative treatment.

I/v cephazolin (20mg/kg) at anaesthetic induction. Tourniquet 0.4 Penrose drain clamped with a heemostat distally to the riht carpus. Marker outline the dorsal i/d skin to be removed, leaving 2-3 mm of digital skin adjacent to the nail. Dissection was kept close to the dermis (to preserve e dorsal and palmar digital nerves and bv). All abnormal tissues excised. Tourniquet removed. Bleeding successful controlled by electrocoagulation. Skin 3/0 simple sutures. Surgical time of one hour. Fusidic acid-containing onitment and non-adherent dressings wrapped with an absorbent bandage extending to above the elbow. A plastic spoon-like splint up to the elbow secured with adhesive tape. Bandage and dressing changed twice daily for 7 days and once daily for a total of 15 days. Discharged 3 days with antibiotics and carprofen (2mg/kg po bid).Suture removal 19 days afer surgery. Good granulation tssue.

Conclusion - fusion podoplasty is an effective procedure for the permanent cure for chronic i/d furunculosis in the dog. Considerable bandaging and maybe additional surgeries if more than one paw is affected.

Many dog owners will be unlikely to pay for the vet costs involved. In above case, detailed blood tests, histopathology tests and bandaging post-op. Surgical excision is successful but how many owners will want to pay for the costs?

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