Mutilating Paws - Out of Options - What do we do?

I'm only sharing my own personal experience with the darned things.
 
Sometimes steroids are needed to calm things down enough that you CAN explore the possible allergens.  So yes, while steroids serve a purpose, they DO mask the problem becuse it's harder to figure out what's going on.

Just to share my own experiences which are so similar to dog_lovers.  My saga with my lab, Sassy, has been very much parallel to what's been going on with Snowball.  So - in 8 months we've battled skin infections that the derm vet and I believe are completely allergy related.  We did a culture & sensitivity and then  started off with some heavy duty (and expensive) antibiotics in Jan.  When those didn't resolve the infection, we did a skin biopsy.  That ruled out lupus and pemphigus, but didn't tell much else than it was a "deep infection".  The infected tummy area finally started to heal when I said, and the vet agreed, we'd stop all antibiotics.  Strange, but true.  However, at the end of May, Sassy developed a whole new round of infections (paws and chin), so once again we did a culture & sensitivity and started a whole new round of antibiotics.  At this time, I asked for a blood panel that would look at, among other things, some possible endocrine problems.  It too came back just fine except showing high WBC, which was no doubt due to the infection.  I then insisted we do allergy testing and that showed that Sassy is basically highly allergic to everything in this area.  So...we've had her on 30 days of Atopica because my derm vet, like dog_lovers' vet, isn't a big believer in the benefits of allergy shots.  She doesn't discount their usefulness but cautions that they don't work for every dog and the results aren't always seen for several months (which could mean several more infections for Sassy).  I really hoped the Atopica would work, even though the cost is ridiculous.  Unfortunately, the last several days Sassy has started licking her paws again and I just finished the 30th day of Atopica yesterday.  I'm also just finishing up the 30 days of Ketaconazale and Clindamycin.  So, I'm guess I'm going to pursue the shots and hope like heck they work, but honestly, unless you've been down this road, you can't imagine what it's like.  It's not just frustrating to see your dog miserable, but the expense is really mind boggling.  I'm afraid to add it all up, but I'd guess it's been $4,000+ just since January.

I just wanted to add that although bloodwork is never a bad idea and a baseline is good to have, my vet didn't jump to do it either.  I don't know why, other than it's probably pretty typical to see allergy symptoms like Sassy's or Snowball's and rarely is a blood test going to provide much useful information.

ORIGINAL: glenmar

Yes, I did report him to the State Medical Board and nothing was ever done.

BUT, the point is that long term steroid use can really do a major number on the body.

 
Oh, man that is too bad.  You have to wonder why they would protect a guy like that.  The doctors do have a kind of alms to each other and it is like a brotherhood.  However,  if there are enough complaints, esp if you have a group get together on this, you can legally see it through.  I have seen this, but it took a long, long time to get the jerk.  Today people do tend to have more power than in the old days.  And one of the biggest issues folks may face is being their own advocate in health care.  (This includes the health of your little beasts, other than the children, LOL!!!)
 
I hear what  cacana and Dog_Lover are saying.  When you have been dealing with illness for a length of time it is aggravating.  And medical response is just not always adequate.  I  know that the love of the animal can drive you but you need to see the apples for the trees, and get to the root of the problem.
 
If You know the answer, then you don't have so much of a problem.  We just deal with it.  It is hard to treat long term illnesses period.  And you have a family as well to care for, so that is a lot of stress.
 
When you go in to the doctors or vets, sometimes it is a great idea to write down your questions...actually all of the time.  Your vet/doc may thank-you for it.  I like a thorough and approachable response to questions.  You should not expect less.  After all you are the paying client.  You expect the best service you can get for the money!

I would not say that the steriod shots are "masking" the problem. If allergies are causing Snowball's paws to itch, thus causing him to chew them to a bloody pulp, are the shots not helping relieve the symptoms - just as an allergy shot would relieve his symptoms?

 
no. Allergy shots actually cure the allergy by de-sensitizing the body to the trigger. Steroids just mess up the inflammatory response. Useful for short-term relief, or seasonal allergies, but with a chronic year-round problem? what's the point? the shot will wear off in a few weeks, you're back to square one, with no long-term benefit in exchange for the really quite scary side effects of steroids.
Allergies do not change from year to year. Let's say your dog becomes allergic to grass pollen. He will always be allergic to grass pollen, forevermore, unless you give him a course of allergy shots to desensitize him to grass pollen (which does indeed take months). An allergic response is caused by an over-active immune system inappropriately reacting to something in the environment. Dogs who have developed this immune system abnormality (which is not well understood) are prone to develop other allergies in the future. But they don't lose the old allergies. So your dog is allergic to grass pollen. And then a few years later he develops an allergy to house mold. In addition to his allergy to grass pollen. If you send him off to a new location, an allergy-prone dog will probably just develop new allergies to new things in his new area. Many folks think the way to go is to somehow "cure" the immune system dysfunction causing the allergies, but theories as to how to go about doing that are well, divergent.
There's no such thing as an "area" that is "bad in general" for allergies. One of the more common human allergies is to ragweed. If lots of folks in your area are suffering from allergies, most likely you just have rampant ragweed infestations.

If you send him off to a new location, an allergy-prone dog will probably just develop new allergies to new things in his new area. Many folks think the way to go is to somehow "cure" the immune system dysfunction causing the allergies, but theories as to how to go about doing that are well, divergent.

 
My derm vet mentioned recently that there is a newly forming theory that some dogs become allergic to various things and their system turns on in response, but even when the allergens are removed the system continues to react.  I don't know if that'd fall into the autoimmune disorder category, but I think the allergy/dermatology field is as frustrated by the disease or condition as we are. 
 
Since the majority of things Sassy tested positive for, including house dust mites and even a new one they test for - her own yeast on her skin (Malassezia), are going to be found in any area we could go, there's no running from it. 

Mudpuppy,
 
The vet says allergies can change (I know they can develop at any age in life.), but you say they cannot.  Who do I believe?
 
Yes, there is such a thing as a specific area being "bad" for allergies.  The Tennessee Valley has a LONG history of allergy illnesses and was once called by Native Americans "The Valley of Sickness."  Doctors in our area will tell you this, not just vets.
 
I understand how the effects of steroid shots are temporary, and my vet agrees that we cannot overuse these shots to treat Snowball's symptoms.  Without taking any antihystamines today, Snowball has been licking, but not chewing, his paws. 
 
Does everyone believe allergy testing and shots is the answer here?

Does everyone believe allergy testing and shots is the answer here?

 
Not me.  We have a few people, Dyan, Janice and Sally who've had excellent results with allergen shots.  I've also read here and other places where people tried them for a year or more without success.  I think that's why my vet is so cautious about pushing for it. 
 
Not sure I fully understood something else she said, but it went something like this - just because a dog shows high antibodies to an allergen doesn't mean THAT specific allergen is the one that's causing the problem.  For example, Sassy tested real high for grasses but that may not be her biggest trigger.  It could be the one she tested low-med on.  Yet they can only include 7 (I think) allergens in the serum, so they take a "best guess".  Having said all that, I think if you're in my shoes, there aren't a lot of alternatives.  We haven't ever used a steroid injection, but if I thought we could do that 1-2 times a year and manage it that way, I'd probably do it.  My vet doesn't like the longterm effect of the shot, but we did try some oral steroids for 2 weeks.  Oddly, it didn't seem to help Sassy.
 
 

The decision has been made that no allergy testing will be done.  In one week's time, we have spent $300 attempting to find the problem and treating it.  We have kids in college who need money, and lately we have spent more money on our dog than we have our kids.

Allergy testing and treatment provides no guarantee.  For dogs who have severe allergies, the success rate is lower. 

So far, Snowball is improving.  If his situation worsens again, we will contact a family member who has indicated an interest in taking Snowball to see if he does better where my family member lives. 

I appreciate all the advice.  I'm not giving up on what remedies I have left.  With fall in the air, I anticipate less allergy problems as summer has always been the worse season for our dog.

Cakana, I pray that you find a solution for your dog's situation.  If not, email me and we can cry on each other's shoulders.

So far, the fungal culture is negative.  Tomorrow will be the 10th day.  So we know it's not fungus or mites.  Snowball is now licking his paws quite often, and it appears the steroid shot is wearing off.  I'm still giving him the antihystamines.  I read that dogs' allergies get worse as they age, and that they can acquire new allergies as they age.  I'm fairly certain the paw-chewing is not a behavior issue since the steroid shot offered relief for quite some time. 

So far, the fungal culture is negative. Tomorrow will be the 10th day

 
Yep, I think something would've grown by now if it was a fungus.  Sassy's cultures started growing by about day 3, but continued to grow things for several days (nice sounding, huh?).
 
Sassy's just finished up 30 days of antibiotics last night, but several days ago, she started licking her feet again.  I know you understand what that sound is like and the dread that comes when you hear it.  I called my vet yesterday to see, yet again, what to do.  I guess we'll go with the allergy shots and hope they work well and quickly.

Snowball has been chewing his paws all afternoon and evening now.  The steroid shot has obviously worn off and the antihystamines are not working.  We are back where we started.  I am crushed.
 
I hope the allergy shots work for your dog, Cakana.  Keep me posted.

I've tried to read everything posted in the last few days...
 
Why, why, why are you not doing a blood workup and thryroid test on this dog?  You really seem to care about your dog but for a dog with these ongoing problems you need to see if there's an underlying issue here other than allergies and your vet bullying you into not running tests is ridiculous.
 
Totally anecdotal but my sister's dog chewed her feet for years before a vet finally tested her thyroid and found it to be extremely low.  You are ok with spending hundreds on antibiotics and steroids and antihistamines when you have no idea if the problem is allergies?  My sister though it was allergies too. 

Why, why, why are you not doing a blood workup and thryroid test on this dog? You really seem to care about your dog but for a dog with these ongoing problems you need to see if there's an underlying issue here other than allergies and your vet bullying you into not running tests is ridiculous.

This wasn't directed at me, or shouldn't have been, as I've done the bloodwork and the thyroid test.  What do people think a bloodwork-up shows? It's really pretty basic and much like a human test.  Cholesterol, RBC, WBC..etc.  It doesn't scream out "disease x is present".  It truly is pretty limited in the info it provides which is why we all get pap smears, mammograms, MRIs, Cat Scans, etc.  Sassy was very hypothyroid and yes, putting her on meds helped fill in some of her fur and brought her weight down, but did nothing to help with her allergies.  I'd put all my money on the fact that it won't help Snowball either.  If you look up signs of hypothyroidism, licking the paws isn't one of them...which why the vet probably hasn't recommended it.  Sure, could it be an additional problem?  Maybe. But I'm betting the vet is trying to keep the really severe problems, like the paw licking and infections that can/will come with it, under control.   I don't think it's a coincidence that both vets on different sides of the U.S. have approached this in much the same way.  Could they have run additional test?  Well, of course.  The list is endless.  Are the chances great that a blood test will explain why a dog is mutilating it's feet?  Not from what I've experienced.   There are folks on this forum that have done allergy testing and had success with it, I hope to be one of them.  I haven't heard from one that said a blood test answered their questions, and I've been around a long time.

ORIGINAL: cakana

Why, why, why are you not doing a blood workup and thryroid test on this dog? You really seem to care about your dog but for a dog with these ongoing problems you need to see if there's an underlying issue here other than allergies and your vet bullying you into not running tests is ridiculous.

This wasn't directed at me, or shouldn't have been, as I've done the bloodwork and the thyroid test.  What do people think a bloodwork-up shows? It's really pretty basic and much like a human test.  Cholesterol, RBC, WBC..etc.  It doesn't scream out "disease x is present".  It truly is pretty limited in the info it provides which is why we all get pap smears, mammograms, MRIs, Cat Scans, etc.  Sassy was very hypothyroid and yes, putting her on meds helped fill in some of her fur and brought her weight down, but did nothing to help with her allergies.  I'd put all my money on the fact that it won't help Snowball either.  If you look up signs of hypothyroidism, licking the paws isn't one of them...which why the vet probably hasn't recommended it.  Sure, could it be an additional problem?  Maybe. But I'm betting the vet is trying to keep the really severe problems, like the paw licking and infections that can/will come with it, under control.   I don't think it's a coincidence that both vets on different sides of the U.S. have approached this in much the same way.  Could they have run additional test?  Well, of course.  The list is endless.  Are the chances great that a blood test will explain why a dog is mutilating it's feet?  Not from what I've experienced.   There are folks on this forum that have done allergy testing and had success with it, I hope to be one of them.  I haven't heard from one that said a blood test answered their questions, and I've been around a long time.

 
No, it was directed to the OP.  Sorry, I didn't read your posts carefully so I have no idea what the problems were with your dog.
 
I don't have a dog with thryroid problems and all I was doing was offering anecdotal evidence of a dog I know who supposedly had severe allergies and had chewed all of the fur off of her paws - put her on thyroid meds and the chewing of the paws stopped.
 
No, a blood workup doesn't always "scream x disease is present" but you never know what you'll find with different values that are off.  Were it me, I'd want to spend the extra $$ and at least know whether there was some evidence of an underlying condition.