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Case 1 in 2001. Interdigital
Cyst in a
Shih Tzu & Other Cases
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Dr Sing
Kong Yuen, BVMS (Glasgow), MRCVS
Case written: Nov 11, 2001
Case reviewed: Nov 4, 2009
 "Big swellings in his front paws"
said Mr Braun. "I guess you will be clipping
the hairs of the paws with a razor blade, but
please be gentle with my Shih Tzu. Mr
Braun recalled that his dog was held tightly
by strong hands while the veterinarian at
another clinic scrapped his facial skin
diseased area and he did not want this for his
dog. He was widely read and knew about
tranquilisers.
It did sound very painful for the gentle Shih
Tzu but veterinarians all over the world
seldom use tranquilisation for minor skin
scraping. As Mr Braun saw the dog
struggling, he felt the pain transmitted to
himself. He did not want this to happen
to his dog again and so he went to another
veterinarian.
 The swellings called interdigital cysts were
huge, as big as 1.5 cm in diameter. The cause
was unknown. Some dogs get it. Some
don't. It is not a common veterinary condition
in Singapore.
I tranquilised it, clipped the hairs of the
paws and injected an anti-inflammatory and
antibiotic drug into the cyst. The paws were
bandaged. Antibiotics were given.
Four weeks later, the dog came for
vaccination. It was a great surprise to see
the "old dog" with hair all grown at its paws.
The Shih Tzu was around 18 months old but he
looked older than his age due to his serious
demeanour.
 "He took off the bandage two days after
injection," said Mr Braun. "He did not
chew his paws and the hair regrows after two
weeks. Now he is biting his hip area,"
said Mr Braun. The area has very little hair
growth. His right arm pit had a large circular
patch of hair loss with some big pimples.
There was one pimple on his neck. Antibiotics
and a wash were prescribed.
Tear staining (wet hairs seen inside the black
circle) or epiphora was also present in his
eyes. The wet hairs ought to be clipped off to
prevent infection and itchiness. It
looked as if the Shih Tzu had rubbed its eyes
too . Some tartar formed on his back molar
teeth as he was given canned food too. He
would not stay still for tooth brushing.
He did not bite but he did not stay still.
Which dog will stay still to get their teeth
brushed?
 This Shih Tzu had a sensitive skin, just like
some people too. Regular grooming and
keeping the under part of the body dry and not
in contact with chemical on the floor or
permitting the dog to sleep on wet floors
should solve most skin problems.
Interdigital cysts are best treated early.
When they exists for a number of years and
harden or enlarged due to continuous licking,
surgical excision or medical treatment is not
going to be to the owner's satisfaction.
OTHER
INTERESTING CASES IN 2001
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Otitis externa.
Excessive thick brown wax inside the
ears in this Bull Terrier puppy. The
neck was brown with scratching.
Clearing ear mites and bacterial
infection solved the problem. As for the
"lazy" right ear, it may become upright
once the infection is gone. The Owner
must have patience to fix an ear support
to get the ear upright. Calcium tablets
recommended by the pet shop owners are
unlikely to solve this problem.
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Pustular dermatitis.
Skin pimples in the belly skin of a
6-month old Jack Russell Terrier that is
having her first heat and had been
bleeding.
Hormonal changes at maturity or
"puberty" can lead to an outbreak of
pimples in the female dog. |
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Persistent skin itch.
Brown stains indicated a persistent
licking by the Shih Tzu. The cause was
an anal sac impaction. |
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Anal sacculitis.
Itchy back and legs in a pug. The
itchiness had gone on for many years
resulting in a hyperpigmented black anal
region and all legs. Many owners do not
consult the vet and therefore the
itchiness continues. |
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Joint eczema in a
one-year old dwarf hamster. It had been
nibbling its joints till they were all
red. An anti-inflammatory
injection under anaesthesia was given.
He recovered. But the allergies recur.
Allergy in a hamster
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Case 2 in 2008. Epidermal Dysplasia
in the
West Highland White Terrier |
 In
Sep 6, 2008, a man in his late 30s brought in a Westie
for treatment on behalf of his brother. His brother found the Westie
abandoned in the industrial park and adopted him.
"This dog is very young, judging by his white teeth.
He would have an owner," I said. "The
owner probably could
not afford veterinary treatment and abandoned him to
fend for himself. He has a microchip and it may be
possible to locate his owner."
"Can you do it?" the brother asked. "The dog can
then be re-united with the owner."
"You can check with the veterinary authorities
with this micro-chip number," I
gave the young man the number after scanning the
Westie's neck. "I doubt that the original owner cares much
for him. Otherwise he will not be in this terrible
state. Most likely he will just abandon him again
when the authorities punished him with a fine. This
 abandonment
is a hope that somebody will adopt him instead of
sending him to the animal shelter. In the animal
shelter, he would be put to sleep after 2-3 days as
I doubt anybody would want to adopt him. In any
case, time will be against him in the shelter as it
has other abandoned pedigree dogs and
insufficient kennel space. Most likely, the
first owner abandoned him in the hope that a kind
person would adopt him, instead of letting the
authorities or animal shelter people killing him off
with a lethal injection."
This Westie had greasy and itchy skin in the ears,
neck and inguinal area. Treatment would be long and
expensive for this inherited skin disease well
documented in the West Highland White Terrier.
Clipping off the infected coat is important for
treatment. The new owner
consented to the Westie being clipped bald so
that it would be easier to shampoo and clean
his diseased skin.
"The dog
needs another review after one month," I
advised knowing full well that this would be
the one and only visit. Washes, drug,
veterinary reviews and recurrence after recovery
make this disease very expensive to treat. But the
owner's brother wanted to try.
In a bad twist of fate, the kind brother who found
this Westie was seriously injured by falling cables
at his factory. Now, it would be difficult to
find money to follow up on the treatment this
Westie.
 Singapore
does not have a charity for
owners who can't afford veterinary treatment.
This case would have qualified for free
veterinary treatment in the U.K as there is
the People's Dispensary for Small Animals.
Therefore many sick dogs of low income earners
in Singapore are put to sleep or
abandoned. Vets try to help as much as they
can but there are just too many of such cases.
If there is somebody interested in setting up
a charity, let me know. As for the
Westie, the new owner did not return for follow-up, due to economic
reasons.
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Case 3 in 2008. Interdigital
Cysts in
a Shih Tzu X Pekinese |
The wife recalled, "We had consulted
several vets but there was no cure for
our dog's condition over the past
years. On your webpage, there was a
case of an interdigital cysts and so
we came to consult you."
The educational webpage must be the
Case 1 of interdigital cyst I treated
in 2001. In the following 7 years, I
treated a handful of cases.
"I seldom see many cases of
interdigital cysts in the dog in
Singapore unlike in Glasgow during my
seeing practice there," I recalled my
undergraduate days some 3 decades ago.
British vets seem to encounter many
cases at that time in the 1970s. I
don't know about 2008.
"Most Singapore dogs are indoors and
seldom go out to paw the soil, causing
injury to the interdigital area."
 At
12 years of age, the dog was in
excellent condition and looked many
years younger.
The big black eyes in a snow-white
coat magnetised anyone passing by and
they would give this dog a
second look to admire the creature.
Yet there was something not right to
the spectator. The left front leg had
a huge swelling such that the black
pad which should be hidden and below
the paw was visible and made walking
difficult for this dog.
On closer scrutiny, this dog had
various interdigital cysts on the
other paws and had been continuously
licking the lower part of the paws.
Before I could ask, the man said, "The
dog used to go behind the bushes and
dig the grounds but he no longer does
it".
"Is there a cure for this dog?" the
older couple wanted to know as the dog
bites his left paw leaving at least 3
red bite wounds. "It is difficult to
say," I replied. "Many years have
passed and the cysts are solid and
hard. Surgical excision of the large
cyst on the left fore paw may be one
solution if it can shrink with
anti-inflammatory injections."
But this dog is past middle aged and
though it puts many of his peers half
his age to shame as regards a healthy
body, he is still considered aged and
therefore a much higher anaesthetic
risk. There is much more veterinary
costs for following up and in this
sub-prime mortgage crisis where almost
every business is done to the pits, it
has had been financially difficult for
many pet owners in Singapore. As for
this couple, this is the first time we
met and so I don't know whether they
are keen on follow ups.
VETERINARY INFORMATION
Interdigital cysts which do not heal
after the first treatment are likely
to be due to foreign body penetration
of the skin. Surgical excision
of the affected skin is very
successful. But surgery is done within
a few weeks and not after many years
of swelling to be successful. Paw
licking due to interdigital cysts may
be more common than presented to the
veterinarian in Singapore.
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TOA
PAYOH VETS
