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 "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.
 "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."
 Infections 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 be 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.
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.
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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.
 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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TOA
PAYOH VETS
