tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS

Date:   30 September, 2008

 Small animals - dogs, cats, hamsters & rabbits

*10 a.m - 5 p.m (Mon - Sun, except Sat). Dr Sing Kong Yuen. By Appointment Only.

*6 p.m - 10 p.m (Mon - Fri). 10am - 5pm (Sat). Dr Jason Teo. House-calls available.

Appointment preferred.
Tel: 6254-3326, 9668-6469
11 p.m to 6 a.m
Dr Teo
9668-6469, 6254-3326
Fax: +65 6256 0501
Be Kind To Pets
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Toilet training your puppy in Singapore  Dr Sing's research book to be published

Toa Payoh Vets Clinical Research
Making veterinary surgery alive
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using real case studies and pictures

Case written: Jun 25, 2001. Case updated: Sep 30,2008
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS.

Dog bites whenever you try to wash its paws and face. Tranquilised by vet."Do you have confidence to treat this case?" the Owner of the 3-year old Shih Tzu queried. Obviously, he had been to several veterinarians for treatment of his best friend. 

Dog tranquilized but the effect would wear off in 30 minutes after injection if the groomer was too slow to work on the face and paws. The dog had been groomed last week but the groomer could not do much about the paws and face as the dog moved and would not allow the groomer to touch his painful face.

All four paws had been licked till they showed blood.  The face was pigmented black and grey due to persistent scratching over several months. Nails were long since the dog would bite anybody who tried to clip his nails.

Facial folds needs daily cleaning but few owners have time to do so. "Skin diseases are not treated by one injection and some tablets." I explained patiently. Somehow, many Singaporeans believe that injections and tablets cure all skin problems.  "Chronic skin diseases are expensive to treat as there is a need to be many follow ups by the vet and nursing care  by the Owner."

It is not that easy to reverse the pruritus or itchiness as the dog has been biting its paws for hours every day for years. The owner knew it was costly. 
"Fungal and bacterial infections would have established themselves on the paws and the Owner has to play a proactive role in cleaning the wounds and keeping them dry." 

Facial itch in short-nosed dogsInfections always set in when the skin is damaged, leading to more irritation and itch and more licking.  To break the lick cycle, there are several ways but there is no guarantee that the dog will stop its habit.

It was a well loved dog and the Owner would not want it to be put to sleep.

The dog came back from the groomer without much being done at the paws and the face as it bit the groomer.

"Easier said than done," said the Owner exasperatedly. "My mother got bitten when she tried to wash the paws with the medicated solutions."   It was not possible to muzzle a flat faced dog to prevent biting when washing the paws with medicated solutions as it would be painful.  However, the face could be4 red paws and a black itchy face. Dog tranquilised. covered with a fishing net type.

For the moment, the Shih Tzu must be clipped to get rid of all infected hairs.  A tranquiliser had to be given before any clipping of the infected hairs of the paws and face could be done.
One hand of the groomer should be placed on the head to prevent dog biting as the tranquiliser does not knock out the dog completely. The skin of the cheeks should be pulled sideways to give a closer shave.

After clipping, an anti-fungal wash was given to the face and all four paws. All crusts removed from the skin of the paws and face so that new hair can grow uncontaminated by fungus and bacteria. An anti-fungal wash must be applied for at least 10 minutes.

An Elizabeth collar was worn.  This was not the end of the treatment.  The dog was on antibiotics for the next 30 days and a follow up would be required in 14 days' time. The Owner would continue washing its paws and face, if possible. Otherwise, it would need to be tranquilized at the vet to continue washing.  It could take sleeping tablets. 

Less neck and facial itch. Paws still bitten.
Paw licking is said to be similar to the nail biting or thumb sucking of people.   Boredom or lack of exercise.  Bitter paste on the paws, Elizabeth Collar, dog training courses, drugs and exercise have been recommended.

2nd clipping
To break the cycle in serious paw licking case, the Elizabeth collar must be worn 24 hours a day and much follow up with the veterinarian is necessary.  This may stretch over several months for chronic skin infection cases. 

Unfortunately, many Singapore Owners are just too busy to break the lick cycle, leaving the dog to the domestic worker or the aging mother to do some washing. 

The skin became smelly and the dog needed a bath daily. Flies are attracted to the blood in the ulcerated skin and overall, the dog does not feel well. 
Over the years, the skin of the paws and face become hardened and toughened but the licking cycle usually continues.  It is not a matter of confidence in the vet but a matter of patience and tender loving care of the owner in trying to break the lick cycle. No Elizabeth collar was worn. The paw itch recurred after two months.  The facial pigmentation is not so black. Clipped again 2 months later. Much depends on the Owner to follow up on this case.

The exact cause remained unknown but allergies were one possibility.
Allergens could be the dry dog food, water, shampoos, surroundings and chemicals. Therefore, it takes a long time to eliminate the causes by trial and error.

0907singapore_flag_gif.gif (9239 bytes)UPDATE IN 2008. Seven years had passed since I recorded the above case. Skin problems still predominate the number of medical cases seen at Toa Payoh Vets.

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