Chronic infection of multiple paws

I wish I had some wonderful words of wisdom but all I can offer is my experience. I have a lab and she'd always had ear infections that we worked hard to treat and prevent from the time we brought her home from the shelter. About 2 yrs after she entered our life, she developed a skin infection that reminds me of what you're describing but her's was on her tummy. We threw every antibiotic we could at it and the cost was a bit mindblowing. We did a culture and sensitivity on it and pseusomonas was one of the things listed. We changed antibiotics and still she didn't get better. They finally did a punch biopsy and it just came back with "deep infection", which was a relief. By then, we'd had her on heavy duty antibiotics for about 3 months. I finally said "enough" and we stopped everything (with my derm vets agreement). Lo and behold, she cleared up soon after. I'm not suggesting you do that but just wanting to let you know that I've been where you are. Once my girl, Sassy, was back to good health, we did allergy testing and found that she was highly allergic to just about everything in our local area. We chose to use Atopica and other than one flare-up (feet - treated with a round of pred), she's never had another skin infection and that's been several years. Just something to consider and I do wish you the best. I know how frustrating, heartbreaking and expensive this can be.

If she were my dog, I would do the biopsies.  I know that psuedomonas is very difficult to clear, & it does take a while to treat, but this has been going on way too long.

Fingers crossed that you find something that helps Shine.

A biopsy will certainly tell you more - it's like a pathology report on a piece of skin!

Grr -- typed this all out and LOST the danged thing!!  forgive the font -- I did this in Word and brought it over here.

I've been there done that with pseudomonas -- NOT fun.

But the first thing I thought when I saw that laundry list of drugs is WOW -- I wonder what the liver looks like!  Every single one of those drugs is ALL very very hard on the liver.  Particularly Keto.  Any time you look at the potential side effects of a drug or the package insert says 'Don't give to a patient with liver problems' -- if it hasn't been diagnosed they will give it.  But that MEANS "this drug is HARD on the liver!"

If the liver is off balance -- even in a relatively minor way -- you are NOT going to get skin issues to resolve.  And just the toxicity of some antibiotics and antifungals actually CAN trash the liver enough so they can't get better.

In fact, that's actually how a situation like Cathy described with her dog can happen -- so much gets thrown at the dog that stresses one particular area of the body that it takes the absence of all the irritants on that part of the body to allow the body TO recover -- even tho all the drugs were intended TO heal.

The other thing that would make me wonder is the thyroid.  Now the age of this dog make it a prime target for thyroid.  And not all dogs get the classic "can't lose weight, bilateral patterned hair loss" -- some dogs can show virtually no symptoms at all -- OTHER THAN the lack of the ability to regulate or clear skin problems!!  The thyroid and the skin are HUGELY tied.

Now I **DO NOT** mean a typical lab thyroid panel.  Particularly not with a dog with such a difficult history drug-wise.  I mean do a breed-specific thyroid panel -- either thru Dr. Jean Dodds at Hemopet.org or thru Michigan State University (they use Dr. Dodd's breed-specific protocols and are very helpful, too).

After we first got

Billy he had th WORST skin and I could not get it to resolve.    it just seemed like nothing we did worked.  Finally my holsitic vet suggested we send off a breed-specific thyroid panel to Michigan State (that was before Dr. Dodd's was doing  full blood panels).

We'd done FOUR  thyroid panels thru the regular lab.  Hoping and praying we'd find SOMETHING -- but it always came back pretty well over into "normal' ... a bit low but not at all in the "LOW range to supplement.

UNTIL we did the breed specific panel.  Wow -- it most definitely came back LOW.  Started supplementing and wow -- results right away.

Yes, this is a mix, but it's a mix of two pretty active breeds -- dog breeds vary a LOT metabolically - do you expect an akita and a basset to have the same type ofmetabolism?  How about a Maltese and a Rottweiler?

Of course not.   But the typical labs like Antech just use the same list of values for ALL breeds -- so they see  all those breeds as supposedly having the same metabolism.

I'd also suggest finding a complimentary therapy vet -- NOT to leave your current vet, but rather ADD a vet to try to see what may be going on INSIDE the dog that is causing the failure to respond and get over the infections.  What in the body is causing this to derail so much that the dog can't fully kick the infection?

http://www.tcvm.com is the Chi Institute.  There's a locator on the left -- I've had really superb results using Traditional Chinese Veterinary Medicine (TCVM) for skin issues  with my dogs.

Or even if you want to try the http://www.holisticvetlist.com/ of the American Holistic Veterinary Medical Association -- homotoxicology (it combines TCVM with homeopathy for some pretty cutting edge stuff) would also be incredibly helpful to help you.  But a good holistic vet (not just whoever is close -- find someone **good** and very well recommended) can really help turn chronic illness around sometimes.

 I would certainly do the biopsies - anything to try to figure the problem out and give the dog some relief.  But, I also second Callie's suggestion of running the full thyroid panel.  Skin infection is one sign of hypothyroidism, and in some dogs it can be the only outward sign.  At your dog's age, I would also run blood work and check for any signs of systemic problems.  Older dogs with allergies or persistent infections might be fighting something else that is affecting the ability of their immune system to fight them off. 

spiritdogs

 I would certainly do the biopsies - anything to try to figure the problem out and give the dog some relief.  But, I also second Callie's suggestion of running the full thyroid panel.  Skin infection is one sign of hypothyroidism, and in some dogs it can be the only outward sign.  At your dog's age, I would also run blood work and check for any signs of systemic problems.  Older dogs with allergies or persistent infections might be fighting something else that is affecting the ability of their immune system to fight them off. 

 I agree with Anne. There's a chance this is auto-immune; a disease called Pemphigus can cause symptoms like you're describing, and it is diagnosed with a skin biopsy. If it is Pemphigus, it will probably be treated with steroids.

Thanks everyone!  You all encouraged me to start doing some more research.  I found that acetic acid, 3-5 % vinegar has been used to clear up pseudonoma infections in people not responding to traditional therapies.  Also honey appears to be effective in the same populations.  I have decided to be diligent about application of vinegar soaks & irrigation & then do a Manuka honey poultice at night at least for the next week.  The vet wanted me to wait at least a week anyway before doing the biopsy so that his system would be free of any antibiotic residue.  Of course what I am hoping for is that honey & vinegar will accomplish what all the drugs could not.  I agree that the keto is super toxic, now that Shine has been off the antibiotic & antifungal for a couple days his digestion & energy seem way better.  He did have a liver test before this last round that showed a slight elevation, it's probably worse off now.  So I will try this homebrew for a bit, but if it dosen't show any positive effect then biopsy & thyroid & allegy disscussions will ensue.  I will post my results.

I wish you the best of luck and we'd all love to hear the results. For more minor paw inflammations/infections, I'd had good luck with using a brew of very strong tea on my girl. I can see where the vinegar would also work though. We learn from each other, so whatever you gather from this will help all of us. I have my fingers and toes crossed for you.