Pododermatitis in Dogs: Causes and Effective Solutions

Canine pododermatitis typically affects one or multiple paws. Common clinical signs include swelling, redness, and discomfort, and often, affected dogs may also show excessive licking, which can worsen the condition. This article will help you learn what pododermatitis in dogs is and how you can effectively manage this condition.

What is pododermatitis?

Pododermatitis means inflammation in your dog's paws. It can affect the spaces between the toes, the foot pads, and even around the nail area. Often, it’s a sign that there’s an underlying skin or health issue, as this condition isn’t a disease by itself. In fact, the leading cause of pododermatitis in dogs is allergies.

What are the causes and risk factors for developing pododermatitis?

Pododermatitis can stem from a mix of primary and secondary causes. Here are some of the main contributors:

Infections: Both bacterial infections and fungal infections (such as Malassezia dermatitis) can cause inflammation. Deep infection caused by bacteria or fungi can lead to painful, swollen paws. Additionally, treating secondary bacterial infections is important to manage symptoms like itchiness and inflammation.

Parasitic infestations: Tiny pests, such as demodex mites, hookworms, and ticks, can irritate your dog’s skin and trigger issues.

Immune-mediated disorders: Allergies often play a part. Conditions like atopic dermatitis or food allergies can lead to inflammation. In some cases, the immune system may mistakenly attack the skin, as seen in disorders like systemic lupus erythematosus. Autoimmune skin diseases, such as pemphigus foliaceous and bullous pemphigoid, are also significant contributors.

Immunodeficiency and metabolic issues: Hormonal problems, like hypothyroidism or hyperadrenocorticism (Cushing's disease), can weaken your dog’s defenses. Metabolic conditions may also create an environment conducive to pododermatitis in dogs.

Genetics: Some breeds have unique paw shapes or inherited skin issues that make them more prone to irritation. For example, certain conformations in breeds like the English bulldog or inherited disorders seen in bull terriers can predispose them to paw issues such as pododermatitis. These conformational issues can lead to chronic inflammation in the paws.

Trauma: Repeated stress, minor injuries, or foreign bodies (like foxtails, plant awns, or wood splinters) can cause or worsen inflammation. Dogs showing signs of altered weight bearing on their paws might be more vulnerable.

Cancer: Rarely, tumors around the nail bed or on the skin can lead to persistent paw problems. These include conditions like a mast cell tumor or other types of cancer. Squamous cell carcinoma is another type of cancer affecting the feet, leading to proliferative and ulcerative skin lesions, commonly seen in certain breeds.

Other dermatologic conditions: Issues like acral lick dermatitis or specific types of hyperkeratosis can also contribute.

Each dog is unique, and often more than one factor is involved. Your vet will help determine the underlying cause so that the right treatment plan can be put in place.

What are the clinical signs and symptoms of pododermatitis in dogs?

Pododermatitis isn’t a single diagnosis, but rather a term for paw inflammation that can result from a variety of underlying conditions and appear in many different ways. The signs can range from mild to severe, and they might affect one paw or all four. Pay close attention to your dog’s paws and their behavior. Here’s what to look for:

• Licking and chewing: This is often the first and most obvious sign. Dogs will persistently lick, chew, or even bite at their paws because they’re itchy or painful.
• Redness (erythema): Look for redness, especially between the toes, on the paw pads, or around the nails. This indicates inflammation.
• Swollen paws (edema): The paws may appear puffy or swollen. You might notice this as a general puffiness, or as distinct lumps or bumps.
• Skin lesions: These can vary widely and include:
• Papules and pustules: Small, raised, red bumps (papules) or pus-filled bumps (pustules). These are like “pimples” on the paws.
• Nodules: Larger, firm bumps under the skin.
• Ulcers: Open sores or raw areas.
• Draining tracts: These are tunnels or openings in the skin that may ooze pus or other fluids.
• Crusting and scaling: Dry, flaky, or crusty patches on the skin.
• Deep infections: These can lead to painful, swollen lumps and excessive licking or chewing.
• Hair loss (alopecia): Bald patches, especially around the hair follicles on the paws.
• Changes in skin texture: The skin on the paws might become thickened, hardened (like a callus), or develop a darker color (hyperpigmentation). Scar tissue can also develop. This often happens with chronic, long-term inflammation.
• Nail problems (onychodystrophy): The nails might become brittle, misshapen, discolored, or even fall off.
• Paw inflammation and pain: Your dog may limp, favor one paw, or be reluctant to walk or put weight on their paws. They might also flinch or cry when you touch their feet. If the paws are tender to the touch this indicates pain and/or inflammation.
• Discharge: There may be discharge from any lesions, such as pus.
• Odor: Affected paws may have an unpleasant smell.

If you notice any of the above signs, it would probably be best to see your veterinarian so that you can proceed with figuring out the underlying cause.

How does your vet diagnose pododermatitis?

If your dog has symptoms of pododermatitis, such as swollen, red, and inflamed paws, and constant licking or chewing at their feet, then you should see your veterinarian. Diagnosing pododermatitis can be complex due to its many potential causes. A foreign body might be suspected during diagnosis, requiring X-rays and possible surgical intervention.

Here’s how your vet will likely approach this so that an effective treatment plan can be implemented:

History taking and physical exam

Your vet will ask about your dog's itching when the problem occurs, their lifestyle, and any other skin issues.

They'll examine all four paws closely, looking for redness, swelling, sores, nail problems, pain, and any changes in the skin's appearance. They'll also check which parts of the paws are affected.

Tests and procedures

One of the most valuable tests used to determine the cause, and one that I use daily, is cytology. Cytology involves using a cotton swab and rubbing the affected areas, such as between the toes. This is then rubbed onto a microscope slide where it is evaluated.

Here, we are looking for signs of yeast or bacteria that may be at play. If there is a heavy bacterial load present, your vet may recommend sending the swab to the lab to be tested to see which bacteria is present and subsequently which antibiotic will work.

Another test and one to rule out parasites, such as demodex mites, is skin scrapings or hair plucks. These tests are less commonly performed as modern flea and tick preventatives have off-label claims for demodex, which means they will unofficially work.

As pododermatitis can occur secondary to immunosuppression, blood testing may be recommended, especially to rule out hypothyroidism or Cushing’s disease.

Lastly and more so if there is treatment failure, your vet may recommend performing a surgical biopsy to determine the underlying cause.

How is pododermatitis treated in dogs?

Treating pododermatitis is often a multi-pronged approach. It’s not just about treating the symptoms you see on the paws, but also about finding and addressing the underlying cause (like allergies, parasites, or foreign objects).

Medical therapy

This category includes both topical (applied to the skin) and systemic (given by mouth or injection) treatments.

Topical therapy

These treatments are applied directly to the affected paws:

• Antimicrobial shampoos, soaks, sprays, mousses, and wipes: These help control bacterial and yeast infections, which are common with pododermatitis. Your vet will recommend the best product for your dog's specific situation. When applying, it is best to move in the direction of the hair growth to prevent any hairs from breaking.
• Anti-inflammatory medications: These can include topical steroids (to reduce redness, swelling, and itching) or other medications like tacrolimus, especially for dogs with allergies. Dimethyl sulfoxide (DMSO) in combination with corticosteroids can be used for mild interdigital follicular cysts.

Systemic therapy

These medications work throughout the body:

• Antibiotics: For deep bacterial infections, your dog will likely need a course of systemic antibiotics (oral), often for several weeks. Ideally, your vet will choose the antibiotic based on a culture to ensure it's the most effective one.
• Antifungal medications: If yeast is involved, your dog may need oral antifungal treatment, such as ketoconazole.
• Anti-inflammatory and anti-itch medications: These can include:
  • Corticosteroids (like prednisone for dogs): These are powerful anti-inflammatories, but they can have side effects, so your vet will use them carefully.
  • Cyclosporine (Atopica): This medication helps suppress the immune system and is often used for allergies.
  • Oclacitinib (Apoquel): This medication targets the itch and inflammation associated with allergies.
  • Lokivetmab (Cytopoint): This is an injectable medication that blocks a specific protein involved in the itch cycle of allergies.

To minimize paw trauma, encourage your dog to walk on soft surfaces like grass or carpet, and avoid rough terrain such as concrete, asphalt, or gravel.

It's important to remember that pododermatitis can be a chronic condition, often requiring long-term management. Finding the right combination of treatments for your dog may take time and patience, so work closely with your vet to determine the most effective approach.

Pododermatitis, inflammation of the paws, is a common issue in dogs, presenting with signs like redness, swelling, skin lesions, and often, intense licking and chewing. It's not a single disease, but rather a set of symptoms with various underlying causes, including allergies, infections, foreign bodies, and even autoimmune disorders. Diagnosis involves a thorough examination and potential tests like cytology, cultures, or biopsies. Treatment is multi-faceted, focusing on addressing the root cause, managing infections, reducing inflammation, and providing supportive care. Unfortunately, pododermatitis is a chronic condition in many dogs, often requiring ongoing treatment and monitoring to manage flare-ups and prevent secondary infections.

If you have any questions or are concerned about pododermatitis in your dog, please reach out to your veterinarian.