# Infected Toenail Bed



## Emily1970 (Apr 21, 2011)

Riley is just having a rough time of it. We think his infection in his jowls and ears are cleared up, but his one toe he's been having problems with is not healing even after a month of lots of different meds. We will have to go back into the dermatologist, but I was just wondering how many others out there have had this issue and what has worked for you?


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## redrover (Mar 17, 2011)

Jasper has had multiple toenail bed infections. What works for us is Malotic, which is an anti-biotic, anti-inflammatory, anti-fungal wonder cream (IMO). I think it's normally prescribed for outer ear infections, but it can be applied to any open wound that may be infected with bacteria or yeast. It comes with a little applicator that's long and thin, so I squeeze out a little right on the nail bed twice a day while I'm gently squeezing the nail bed (like if you're trimming his nails). If the only thing the vet has been prescribing is antibiotics, you might want to ask for an anti-fungal, since it could be a yeast infection. 

For his first infection I had to keep his foot wrapped, or he would constantly lick it. It's impossible to keep a cone on this dog. I put a sock over his foot, then wrapped it with that self-adhesive first aid wrap to keep the sock on. At first I went over that with duct tape, because I wasn't sure if he'd try to get it off on me, but he never did. If he was bleeding, I'd add in some bactine-soaked gauze between the sock and the toe. It resulted in a wet sock (and wet spots on the floor), but prevented the sock from getting stuck to a drying scab.


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## Emily1970 (Apr 21, 2011)

Thanks for the advice. We do know it's a yeast infection. He has been on Simplicef, Fluconozole, zyrtec, and amitriptyline for a month. He had the yeast in his ear flaps and jowls too, but those seem to be better. Riley won't go for a cone either. We're good about staying on him if he tries bothering it, but he's on the go so much he doesn't want to stop and lick.


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## texasred (Jan 29, 2012)

Emily has you vet ever mentioned rinsing him with a 50/50 mixture of apple cider vinegar & water. Then drying him. Its something I would do with my dogs, but with Riley I would talk to the vet first.


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## Emily1970 (Apr 21, 2011)

I will ask the vet about that definitely. Just rinse his foot?


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## threefsh (Apr 25, 2011)

Have you tried epsom salt baths? Very natural and gentle. We gave Riley epsom salt baths when she had a large sore on her side and her leg. It worked wonders.


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## SteelCityDozer (Aug 25, 2011)

We use Epsom salts on ourselves too. For our feet when we have toenail issues (ie removal, etc.) do a salt water bath everyday for 20 min. Instructions are on box.


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## texasred (Jan 29, 2012)

Emily1970 said:


> I will ask the vet about that definitely. Just rinse his foot?


Yes. It helps maintain the right PH balance, and can be used anywhere on a dog except its eyes. Just make sure to dry afterwards, yeast loves moisture.
I use Epsom salt for other types of infection not yeast.


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## Ozkar (Jul 4, 2011)

I think Redrover has a succesful method to deal with it. Astro had this issue. the only solution was to put antiseptic on it, then cover it. I started with socks, but they lasted half a walk before they were wrecked. So I ended up buying some booties to cover it up. A week of not being able to lick it sorted the issue and it hasn't returned.


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## Emily1970 (Apr 21, 2011)

I appreciate all the advice. Poor Riley has had such a rotten health year. I hate keeping him on all these meds for such long periods of times because our vet did say it will take a toll on his liver eventually. Natural remedies are welcome to me.


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## redrover (Mar 17, 2011)

Has everything the vet been subscribing been topical or some form of pill? Or has there been a combination treatment? Topical in addition to full body (pill) might be helpful, just because you have treatments coming at the infection from two sides, so to speak. Jasper's medicine had clotrimazole, which is the same stuff in Lotrimin. 

Just wanted to note--I didn't have to wrap Jasper's foot when I was home with him. I did it while he was in his crate during the day, and at night when we were sleeping (he'd wake up in the middle of the night and lick, and I wouldn't notice). 

I did determine that Jasper's recurrent infections were caused by his nails splitting quite a bit when he runs and then things like woodchips catching on those and poking up into his nail bed. Constantly using a dremel instead of a clippers helped this, since I can round off the edges of his nails instead of getting the sharp corners we got with a clippers. His nails grow like weeds--I have to dremel his nails at least once a week, twice is ideal! Since we started using the dremel, we haven't had another infection. 

You might also try a gentian violet solution. I've never used it for these infections, but I've heard of other people using it (again, also used to treat/prevent ear infections). I know people use yogurt with live cultures to fight things like vaginal yeast infections--maybe you could just plop his foot in a yogurt bath for a while? If you do, take lots of pictures, because I feel like that would be hilarious. As yummy as he might find it, I wouldn't let him lick the yogurt after his foot has been in it (no need to introduce yeast into the mouth). Just adding live cultures to his diet might help too, but I know humans use it topically as well.

Some yeast infections can last for a few months before symptoms clear, so you may need to just wait this out? Poor Riley!


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## Emily1970 (Apr 21, 2011)

They were just trying the pills so far. Simplicef and the generic form of diflucan. We are going back this coming Friday. This dermatology facility is top notch I guess, but for some reason, I just don't have full faith in them. They're already talking about treating his environmental allergies, but I'm more concerned with the current infections. I'm just afraid to throw too many more meds at him too fast because in part I'm afraid he's going to develope a tolerance for them and meds aren't going to work anymore. And poor Riley is absolutely sick of getting poked at. He's getting very neurotic about medical facilities, strange people, and anything that has any resemblance to a medical instrument.


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## flynnandlunasmom (May 28, 2012)

Emily, so sorry to hear about Riley's issues. Re: his liver, have you asked your Vet about Denamarin? 

It's not another medication. It's a nutritional supplement meant to maintain a healthy liver. I have mentioned it on here before because I really think it helped Flynn. It's made of a combination of Sam-e and St. Johns' Wart. 

Flynn had issues with his liver because of long term doses of immuno-suppresants (Prednisone and Imuran). At the Vet's recommendation, we gave him Denamarin daily and his liver enzymes really improved. 

It's expensive though! My Vet sold us 90 pills for $90! But, I found it online for half that price. It may be worth asking your Vet about it, if his liver is a concern.

Wishing Riley all the best.


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## redrover (Mar 17, 2011)

Emily1970 said:


> They were just trying the pills so far. Simplicef and the generic form of diflucan. We are going back this coming Friday. This dermatology facility is top notch I guess, but for some reason, I just don't have full faith in them. They're already talking about treating his environmental allergies, but I'm more concerned with the current infections. I'm just afraid to throw too many more meds at him too fast because in part I'm afraid he's going to develope a tolerance for them and meds aren't going to work anymore. And poor Riley is absolutely sick of getting poked at. He's getting very neurotic about medical facilities, strange people, and anything that has any resemblance to a medical instrument.


Oh, poor baby! If it were me, with my experience with Jasper's infections, I would ask for a topical ointment too. It can't hurt. Or maybe ask if the OTC stuff you can buy for fungal infections are your local pharmacy are okay to apply. To be totally honest, I'm not a fan of pills for localized infections (I'm sure they were the right choice when Riley had infections in other parts of the body, though)--as long as the infection is still localized, it seems unnecessary to treat the entire system, especially considering systemic application of anti-fungals can also affect the natural flora in the rest of his body. Every body has yeast on it, and if it's not causing a problem, killing it off with anti-fungals can just leave room for more opportunistic, "bad" yeast to re-colonize the area. Also, if Riley was on long-term use of antibiotics, that can kill off "good" bacteria that normally inhibit the overgrowth of yeast (bacteria and yeast have an age-long, epic "war"), leading to a yeast overgrowth. This is the same reason secondary yeast infections are a side-effect for people when they're on antibiotics for extended periods of time. This coupled with a possibly underactive immune system you mentioned in other posts might have resulted in a opportunistic infection for your poor boy. How long was he on the Simplicef, and when did the yeast problem develop in relation to the timing of the antibiotics?

This is all super complicated, especially if Riley does have an underactive immune system. I know in previous posts you mentioned they wanted to treat Riley with interferon due to a possibly underactive immune system--the interferon would basically "ramp up" his immune system. Interferons are molecules released during infections and signal to the rest of the immune system, "Hey, we're infected, get to work!" They do this in a variety of ways that I won't bore you here with. Interferon also has anti-viral properties.

I now want to preface the following paragraph with a HUGE DISCLAIMER: I am not an immunologist. I understand only the basics of immunology. I am not a vet. I do not know the results of all of the tests, so this is just me rambling. 

If they also think he has allergies, that indicates an over-sensitized immune system with a release of lots of histamine, which is why they prescribed the Zyrtec. Maybe there's something specific going on with his immunoglobulins (aka antibodies), since IgE is the one most associated with allergies, while IgG and IgM are most associated with infection by pathogens--IgMs are required for initial reaction against a foreign pathogen, while IgGs are used to establish long-term immunity (why you don't have such a severe illness when re-infected with the same pathogen). Have they tested his immunoglobulin levels? Maybe it's just that his IgG and/or IgM levels are low? If it's a problem with the body recognizing there's an invader and them presenting the proteins to the immune system to make antibodies, then interferon therapy might help. Then again, if that's the issue, I don't know that he'd have that many allergies. If it's a problem with the body not being able to produce enough immunoglobulin, interferon therapy might not help. I actually don't know if they can even do these tests in dogs. I'm not an immunologist, so I'm going to stop speculating here because, frankly, there could be lots of things going on concurrently. All I can really say is that a second opinion couldn't hurt, particularly if you're even just a little in doubt about your current vet's treatment regimen or the tests they have performed.

Wishing you lots of luck and health for Riley--he sure is lucky to have such a good owner! Keep us updated!


PS: I hope I didn't overwhelm you with information or freak you out or anything. I think whatever Riley has going on with his immune system is likely very treatable/controllable with the right medicine and given enough time to see if the treatment is effective. But unless there's no other option, I don't like the approach some vets (and human doctors!) have of throwing everything at the patient to see what sticks, without any idea of what the exact underlying condition is. Sometimes it's impossible to know, but other times it is, and I don't think every vet/doctor does their due diligence in that regard.


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## Emily1970 (Apr 21, 2011)

You're not overwhelming RedRover, I really appreciate all of the info. He has been on the Simplicef and Diflucan for a month now. His jowls and ears do seem better. I just wonder about this specialist because he throws that out about the immune system, then they say environmental allergies. The only thing that they've stayed true about is he has an infection going on. I just do NOT want him overtreated because they "think" he should have this or that. I really think maybe we need to get the infection cleared up and let him be for awhile. See if things calm down a little on their own. He has had no time to be off meds and just be a pup. 6 pills a day right now and at its peak this year 16 a day. Maybe his immune system needs some time to build itself back up on its own?


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