# What to do about the dew claw?



## LisaT

When I was drying Max's paw tonight before coming in, he yelped and wanted to nip at me (poor boy -- he never does that!). I looked down and his dew claw is at almost a 90 degree angle with his paw. I looked around it a bit -- VERY SENSITIVE, and VERY bloody up in that area where the nail goes into the paw. I can't tell if the nail has been pulled out in a weird way, or if the nail itself if kinda broke/bent, but not clear through.

He goes out in the yard and runs in circles barking at the birds and the planes, and I suspect that he caught it on something. I think it started a couple of days ago, as he has been licking that paw a bit.

Okay, so now, about 20 minutes later, he is walking on it, playing on it if I let him, and completely leaving it alone.

So, let's say he hasn't torn it out, but it's kinda bent, and probably hurts when it gets banged. What would the vet do with that?

So, let's say it's a bit torn out, what would the vet do with that?

He keeps smelling it (the blood probably?). We have an acupuncture appointment on Tuesday -- I'm not sure there is anything they can do?


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## BJDimock

If you brought him to my work, we would try to clip or pull the nail shell off and tell you that it will hurt him for a couple of weeks.
Kind of a bummer.
Its just like bending your nail all the way back or breaking it really low. Try not to bang it. You can wrap it. It will eventually fall off.
The nail may actually hurt him more if you don't have it taken off. It will continue to get stuck on things.
Poor boy. Nail injuries make me cringe.


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## LisaT

Crumb, looks like I need to bring him in then. I suspected that would be the case. 

I hate having to take him to a vet that is not his typical vet. He's always good with the vet, but they always worry about him, wondering if he should be muzzled, etc., (he's a butthead with other dogs in the waiting room) and they typically don't know that I *don't* typically let techs or vets take my dogs to the back without me there, and then I have to be assertive, etc. etc. etc. And I always have to dodge the vaccination question too. Way too complicated.

ETA, where are my manners -- thanks for the info, I really appreciate it!


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## BJDimock

Hey, I work for a vet! And I know Sheps! Its why I love them and nobody else wants to touch them!








You could try wrapping it if he'll leave it alone. If he'll behave enough, you could pull it off and then use a stypic powder for any blood that might flow. (generally there is not very much. And this hurts for that split second)
You can also try to clip the nail as far down as you can get. This might prevent it from getting caught up on anything.
Good luck and may his toe feel better soon!


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## LisaT

Thanks! I'll see if I can get in to look at it later tonight. The absolute worst case is that it doesn't get looked at until Tuesday. If I sense that he is hurting, I will bring him in. I have a feeling that this has been there awhile now that I think of it -- it's just been aggravated by his recent "bark at the plane" this evening. Doofus.

Planes and motorcycles drive him nuts. I often wonder if it was the flight out here from Oklahoma when he was bought as a pup (we didn't have him as a pup







).


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## LisaT

http://www.goldenretrieverforum.com/gallery/displayimage.php?imageid=8337

Okay, so here is a pic of a dew claw removed. This length is just about where the split in the nail is on Max's dew claw. If you look on the inside of the Max's actual nail, it splits even closer to the body -- where it is split, you can see pink fleshy stuff, and you can tell it was bloody before he licked it clean. Max's split on the inside looks right next to the skin.

I'm afraid to wrap it tonight -- I'm afraid of forcing it into an uncomfortable position. But he does keep snagging it, particularly when he gets up on the coach. Duh, then don't let him get up on the couch......


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## LisaT

Okay, I put a guaze over it and gently wrapped it in Vet Wrap for the night. We have an appt at 4.


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## WiscTiger

Lakota almost tore his off, The legiments that attached it to the leg were so stretched, the nail was almost pulled out. I opted to have both dew claws on the front legs removed. I wouldn't have had them removed but his was just flopping on his leg and I and the vet figured if he tore one lose it would just be a matter of time before he did the other one. Besides I didn't want him to be lopsided (giggle). I posted pictures of him in his sweat bands with his basketball in him mouth wondering why I wouldn't play with him.

Val


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## LisaT

LOL -- sounds like a great pic!! I know what you mean about symmetrical -- I worried about that when Max had to have a canine tooth removed. But I left him lopsided









The crack in the nail didn't go all the way around, so they had to lightly sedate him in order to get that piece off. No mention of actually removing the thing entirely -- I'm glad, but if it happens again, might have to think about it.

While he was sedated, they also drained a sebaceous cyst that keeps filling up but won't open. With any luck, it won't refill.

Man, late Saturday afternoon at the vet's office. It really is a different world than the times that I"m usually there. Talked awhile to someone who just got their Pomeranian puppy yesterday - they bought him off the internet from Missouri







He was a very very sick puppy -- they are not sure he's going to make it.









Isn't Missouri one of the big puppy mill states?


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## LisaT

If the quick was exposed for an extended period of time (open and bleeding), can it get infected and cause an infection in the toe/paw?


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## Myamom

I really can't offer any advice to your current problem Lisa...just letting you know that at age 7 we had Mya's big floppy dew claws removed and it was an easy recovery for her. Dr. always stated that there was a big concern with them getting caught on something...so at the first chance we had (dental)...we had them taken off. Good luck!


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## aubie

My Dal did something similar to hers--it was bent in a horrible 90 degree like way. We took her to the Vet and they clipped it off. Bless her heart! We wrapped it up for a day or two (she had to wear the lampshade because she would pull the bandages off) and later it ended up growing back, kinda. It was just like a little nail-nub and it never gave her anymore problems. 

The doc also gave us an antibiotic pill and cream to prevent any infection.


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## LisaT

We had Cephalexin after they cut back the nail (which his digestive system still hasn't recovered from), and all looked good. Just in the last few days, it is huge and red and he won't leave it alone. I could see the quick where it was red from blood, so I'm hoping this is just infection. 

myamom, good to know about the recovery time, in case it comes to that! We have an appt tuesday morning.


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## 3K9Mom

> Originally Posted By: LisaTIf the quick was exposed for an extended period of time (open and bleeding), can it get infected and cause an infection in the toe/paw?


Yes, my trainer had exactly this problem with one of her dogs years ago. The dog ended up with osteomyelitis. I'd treat for infex prophylatically.


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## LisaT

Great. 

It looks terrible right now. If I didn't know what happened, I'd be afraid it was a tumor, part of it has become red and angry. (Still won't be completely convinced until the vet sees it.) 

Thanks for the info, I will mention the bone infection. Nothing is easy with these dogs - can't get a simple hang nail? Of course not!


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## LisaT

Vet thinks it's cancer, and that the nail cracked more from weakness than trauma. 

She also sail that nail bed carcinomas are pretty aggressive. 

I left him there just now to have it removed. Small chance it's not, but I've been thinking cancer for the last two days. 

Fingers crossed. 

I will try to post pictures at some point.


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## natalie559

Oh no Lisa! My fingers are crossed for your pack too!


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## DancingCavy

Oh no. I'm hoping it's nothing too worrisome. Best of luck to you both. We'll be thinking good thoughts here.


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## LisaT

Thanks, the vet sure wanted to get that off NOW. I will post as soon as I know more.


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## Myamom

Oh...WOW! Praying for good results!


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## LJsMom

Sending positive thoughts your way.


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## Northern GSDs

Paws crossed that all goes well!


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## LisaT

Thanks for the good wishes and crossed fingers and paws









I just heard from the vet. She took an xray and it appears that there is no bony involvement. It is the more aggressive cancers that will have already spread to the bone.

She's still pretty sure it's cancer, but now she said that she is feeling better about it. And then the fun part -- we wait until the end of the week for the report.

It must be weird working in a lab where you receive body parts in the mail all the time???


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## 3K9Mom

Oh gosh, Lisa. I'm worrying right alongside with you. Lots of caring thoughts, good energy, prayers...everything I can possibly send south, it's heading there as fast as it can. I hope Max doesn't get bowled over when it all hits him at once.









And yeah, pathology is an odd science. And bless pathologists for what they do.







I really respect pathologists. You get a disembodied piece; never meet the dog, and make a call/diagnosis. An odd profession. 

Kind of like radiology in a way. My radiologist has watched all my dogs age (he often asks for old films), knows them, and me by name ... he knows my dogs inside and ... well, mostly their insides.


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## aubie

Awwww Lisa! Good paw mojo headed your way!
















One of the standard poodles in our therapy dog group had the same/similar thing, except it was on one of his toes, not the dew claw. They removed it, tested it and it wasn't the "bone" cancer and he's doing very well and still visits with the group. I'm praying this for you and Max!!


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## LisaT

Thank you aubie, for the mojo and also the positive information -- all is needed!!

3K9, I'm glad that Max must have been in the kennel at the vet when that hit so it didn't knock him off his paws









I'm jealous of your radiologist -- I don't have much faith in the one that they have up here. But yes, another odd profession!

Max is home, with a big ol' bandaged paw, so he's limping and feeling rather out of sorts -- he can't follow me room to room right now either!!

It's good to have him home, it's just not the same without him


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## 3K9Mom

Poor Max. Poor Lisa. 

I'm sure Indy is glad to have Max home, bugging her.


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## Strongheart

Oh my gosh, I started reading this thread thinking 'oh just a snagged dew claw' and it turns into a cancer thread! 

The whole time I was reading I thought, 'gee isn't there a little bone part of that dew claw like for the other claws?' But I guess there isn't? Or is there? Cuz my first thought on reading the first post was that maybe he'd broken the 'dew toe' and then didn't know if there was a toe there or not. I wonder too if some dogs might have them and others don't.

Holy Moly! I'm so sorry to hear about Max's dilemma!


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## JeanKBBMMMAAN

Wow, I am with you Strongheart. I was thinking take it off, his leg will look like a chicken wing for a bit, and done. Yikes. We should have asked for a picture-it must have had a different look about it, right Lisa?

Sounds like things went well though, right? Gives you the chills. Please take care.


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## WiscTiger

Oh Lisa, I am so so sorry. Paws all crossed here for a good pathology report.

Hugs to Max. Lakota send special thoughts for Max, Lakota says to tell Max to play the sympathy card with Momma as long as the bandage is on, he hopes Max gets lots of goodies that way.

Val


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## LisaT

It has been a shocker to me too. I thought about changing the name of the thread, but I guess I'll wait and see. Terrible week, and tomorrow I have to go to a chemo class with Dad so he can start next week. THAT whole process is a bit more complicated than one realizes!

Indy is rather suspicious, and not happy at all when Max gets more attention - I have to walk him outside each time he needs to go potty, and he isn't that good about telling us, so he gets extra trips out front!!

There is bone in there, and I thought, since the xray is clear, get a clean margin, and that might be it. Until I read last night that some nail bed carcinomas tend to metasticize (sp?) even after surgical removal and clean margins. I realized I don't have any of the good cancer stuff here at the house (I'm 20 miles from anywhere with a good health food store), but I have some tagamet, and that has potential, so I have him on that. I'm a big believer in acting before and right after surgery, when the possibility of spread might be the highest. 

With any luck, this is just gonna be something else. 

I do have pictures, but probably won't have time to get them on photobucket and viewable till the weekend. DH actually took some time off this week, so we are trying to make use of that. 

To me, there was an angry red spot that I thought was developing weird. To the vet, she didn't like the actual feel of the lump - said it didn't feel like infection, and felt more like cancer. She said if it were her dog, she would remove it immediately. So we did. 

Val, tell Lakota that Max is working on that sympathy thing. He looks so sad with that big ol' bandage on his paw. They used green - I think the color suits him


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## 3K9Mom

Camper severely sprained his toe this week. His wrap is neon pink. He seems particularly upset -- hard to look like a strong confident male dog hobbling with a bright pink wrap. All the dogs in the neighborhood are making fun of him. 

So Max has that going for him, at least.









Tagamet for cancer, Lisa? Tell me more.


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## 3K9Mom

Lisa, do we have the path report back yet?









From WA to CA, we're still sending all our good thoughts and wishes down for wide, clear margins (how's that for a specific prayer?), and quick and complete recovery. 

(There's probably a backload of good energy at the northern base of Mt. Shasta, backing up traffic right now







). 

Max.


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## aubie

Anna wants to know how that hunk of dog Max is doing (I know I know, he's too old for her, but I think it's her first crush







!) and she wants to make sure he is being spoiled rotten. 

Think you'll hear anything tomorrow? I'm sure you're driving the vet crazy, as you should be!


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## LisaT

No news yet. Did look at the pics again, and it looks like the lump was there when the claw was removed and was made no smaller after a round of the antibiotic Cephalexin, which is really pointing at NOT infection









3K9 - tagamet has some powerful anticancer activity:

http://www.second-opinions.co.uk/cimetidine.html

http://www.lef.org/magazine/mag2007/may2007_report_cimetidine_01.htm

http://www.lef.org/magazine/mag2002/jul2002_cover_cimetidine_01.html

http://www.townsendletter.com/FebMarch2007/warcancer0207.htm

I had Indy on it after her mast cell tumor removal. It has been the only thing that improved the depigmentation on her nose, only while she was on it, but it also jacked up her vaccine issues, so I had to take her off of it. 

Ahhhh, poor Camper. You would think that the vet office would know better. Pink? Really? I still know what a tough guy he is!! Well wishes are being received doen here - Max is getting pretty bouncy on that paw, though I know it's still sore! You might have to include some common sense with those well wishes









aubie, Max knows that he has those classic black and tan handsome features - and he knows how to use them - I will make sure that he minds his p's and q's!! Tell Anna that he sure appreciates the attention!!

He really kinked his neck in this whole thing to add on top of everything. I can even feel how out it is, and it is hot. Chiro is in over a week. 

The vet warned me results wouldn't be until Friday, and then revised that to the weekend. She is not working those days, so I hope she doesn't forget to check for the report.


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## JeanKBBMMMAAN

Threadjack alert-
If Kramer's already on Pepcid, I wonder if I could switch him to Tagamet. He's on the Pepcid for the prednisilone. 

Was looking for comparisons, found this: http://www.article99.com/reprint-article/?art=12688

And this: http://www.peteducation.com/article.cfm?c=0+1303+1459&aid=1388 Tagamet

http://www.peteducation.com/article.cfm?c=26+1303&aid=3253
Pepcid

But I am not sure if there is a reason for Pepcid. Huh. Because I'd switch to Tagamet...

Is Max feeling better? His neck unkinking from mom-massage?


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## LisaT

In grad school, before I got my allergies and thyroid under control, I had terrible stomach problems. Back then there was tagamet, and zantac had just come out and was still protected under patent. 

They gave me tagamet, and it didn't help. They paid a lot for me to try zantac, and it helped a lot. These things all seem so individual. I do not know what cancers tagamet helps for, and I don't know if it would work the same or better for Kramer. I think the switch is worth considering though. 

That darn neck - this used to happen whenever he used to see the old vet - something about the way he was lifted onto the table. I haven't found a way to undo it yet, but there's one trick I haven't tried, and will have to try tonight.


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## LisaT

Three afterthoughts. 

Tagamet appears to interact with more meds than the others, so the docs tend not to use it as much. I think it's increased interactions and maybe side effects is precisely because it's a pretty powerful drug in some instances (like fighting cancer).

On the cancer list, most of the folks with dogs that had mast cell tumors used pepcid to either protect from pepcid, or deal with the cancer side effects (mast cells involve histamine response). About 10% of us there really understood the advantages of using tagamet in those situations (triple effect for that cancer), but most folks didn't switch over since the vet recommended pepcid. I NEVER understood that, in spite of such compelling evidence --

Third, I guess Kramer won't chug from an open bottle of cherry flavored mylanta that you keep in the fridge? That was my personal favorite!


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## LisaT

*Re: about the dew claw? (image heavy!)*

*<span style="color: #006600">His normal dewclaw:</span>*












*
<span style="color: #006600">The trimmed dewclaw -- the "nail nub":</span>*












*<span style="color: #006600">the "nail nub" ulcerated:</span>*






















*<span style="color: #006600">Ah, what a life







(notice his droopy eye - the chiro will fix that) </span>*






















*
<span style="color: #006600">Don't forget about me!!:</span>*


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## DancingCavy

*Re: about the dew claw? (image heavy!)*

D'awww poor Max. I hope he's feeling better soon and that you here good news from the pathologist soon.

Indy is a cutie too.


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## LisaT

*Re: about the dew claw? (partial results)*

Thanks Jaime









Well, we have a <span style="color: #000099">*partial pathology report*</span>, and <span style="color: #000099">*so far the news is good*</span>, yet baffling. Looks like the lump itself has all sorts of reactive inflammatory things in it, NO bacteria, NO cancer so far. The bone is reactive, so they are doing an extra test to rule out cancer there, and we will know those results by Monday.

*MICROSCOPIC INTERPRETATION* 
Ulcerative pododermatitis, lymphoplasmacytic, neutrophilic and histiocytic

*COMMENTS* 
Dermal and subcuticular inflammation is observed within the sagittal section. There is also reactive bone, but no evidence of neoplasia. As a precaution, the remaining digit is being decalcified to evaluate a midline section of the digit to further exclude an underlying neoplasm. The inflammation is associated with superficial ulceration and surface trauma.

----

I'm a bit confused about the inflammation being associated with superficial ulceration and surface trauma, as the inflammation occured first. Unless maybe they mean the initial dew claw clip the first time. I'll have to ask the vet.


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## 3K9Mom

*Re: about the dew claw? (partial results)*

Well, that's great news. 

Is it possible that Max snagged his dew claw weeks/months ago and you never noticed it? 

Zamboni had a rather large lump in her foot/pad after she got a huge blackberry thorn in it. (We have giant killer blackberries up here). I got most/all of the thorn out. But the lump made me think I may have left some in, and the body capsulized it. It was hard, and we thought it might possibly be cancer too. We blasted it with abx at first; then when it didn't respond biopsied it several times and kept coming up with the same sort of path report. A vague inflammatory, not bacteria we-don't-know-what-it-is cell growth (with zero evidence of foreign matter). 

The surgeon thought that maybe the original injury and whatever bacteria that got in there caused a strong autoimmune reaction and her body over-reacted. Instead of sending a platoon of white blood cells, it sent the whole darn Army (and the Marines, just in case. Then, they set up a base, complete with a volleyball court, Burger King and movie theater. That's why it was so big and hard.)

She had that darn thing for 2 years. Then about 4 months ago, I noticed it had just sort of shrunk. And now, it's pretty much gone. There's no reason I can think of why it left. It just did. 

Weird autoimmune stuff. I'll be thrilled the day that we actually begin to understand the autoimmune system. 

I do hope that's "all" it is. Max is entirely too sweet for it to be more than that. 

I'll be waiting on pins and needles for the rest of the report.


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## LisaT

*Re: about the dew claw? (partial results)*

It sounds like perhaps nearly an identical type of thing (I hope). Yep -- what's with sending everything in to fight this stuff???? I love your description -- very apt.

And he is just too sweet. Now I hope I just didn't amputate part of his paw for no good reason.....or I guess that's exactly what I hope for???!!!

Thanks, pins and needles here - I think the vet is holding her breath too.


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## 3K9Mom

It's his dew claw. I would have done the same. My surgeon wanted to remove Zamboni's lump, but we would have had to remove most of the bottom of her foot. I scheduled surgery two weeks out; then the day before, I got freaked out and cancelled. She was 13 years old and anesthesia scared me too much. Plus, she had those ACL surgeries years ago, and she puts a lot of weight on her front paws. What if her front foot didn't work quite right after surgery? My surgeon and my vet, both whom I know well and trust a lot, felt the surgery was the best option. But I had too many what-ifs? So we didn't go through with it. 

But she was in pain with that darn foot up until -- as I said -- 4 weeks ago. I'd hear her licking it in the middle of the night. She started taking Tramadol just because of that. I often doubted my decision. 

We make the best decisions we can. Yours, IMO, was a good one. Even if not malignant, it was bothering him. Re-read your first post. He could have had that inflammation and pain for years. I'm a big fan of dew claws, but they're not essential equipment. He will heal and he really won't miss his. 

I think you did exactly what Max needed, regardless of what the pathology turns out to be.


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## Strongheart

Well I am so sorry to hear this but it doesn't sound like the worst report you could have gotten. And what a handsome but sad looking fella! So very handsome!

Any possibility it could be a spider bite? Cuz sounds just like another one I heard about recently, but those reports have the same wording, oddly, that my cockatoo had for PDD, an inflammatory autoimmune disease.

What does it mean 'the bone is reactive'? inflamed? 

Doesn't the waiting make you crazy? Let's keep upbeat though. No bad news is good news, would think if it was cancer it would have been readily apparent or is that flawed thinking?

Hang in there dude! You'll be romping again soon!


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## LisaT

> Originally Posted By: 3K9MomIt's his dew claw. I would have done the same. My surgeon wanted to remove Zamboni's lump, but we would have had to remove most of the bottom of her foot. I scheduled surgery two weeks out; then the day before, I got freaked out and cancelled. She was 13 years old and anesthesia scared me too much. Plus, she had those ACL surgeries years ago, and she puts a lot of weight on her front paws. What if her front foot didn't work quite right after surgery? My surgeon and my vet, both whom I know well and trust a lot, felt the surgery was the best option. But I had too many what-ifs? So we didn't go through with it.
> 
> But she was in pain with that darn foot up until -- as I said -- 4 weeks ago. I'd hear her licking it in the middle of the night. She started taking Tramadol just because of that. I often doubted my decision.
> 
> We make the best decisions we can. Yours, IMO, was a good one. Even if not malignant, it was bothering him. Re-read your first post. He could have had that inflammation and pain for years. I'm a big fan of dew claws, but they're not essential equipment. He will heal and he really won't miss his.
> 
> I think you did exactly what Max needed, regardless of what the pathology turns out to be.


It sounds like I would have made the same decision in your situation too.

DH really thinks that I jumped the gun when I gave the okay to remove the dew claw, I was having second thoughts, particularly because right now he seems to be hurting.

Now that you mention the licking -- he was licking that paw for weeks before the dew claw split. I bet that is what caused it to split.

Thanks 3K9, I really appreciate the support, and the proper perspective.


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## LisaT

> Originally Posted By: StrongheartWell I am so sorry to hear this but it doesn't sound like the worst report you could have gotten. And what a handsome but sad looking fella! So very handsome!
> 
> Any possibility it could be a spider bite? Cuz sounds just like another one I heard about recently, but those reports have the same wording, oddly, that my cockatoo had for PDD, an inflammatory autoimmune disease.
> 
> What does it mean 'the bone is reactive'? inflamed?
> 
> Doesn't the waiting make you crazy? Let's keep upbeat though. No bad news is good news, would think if it was cancer it would have been readily apparent or is that flawed thinking?
> 
> Hang in there dude! You'll be romping again soon!


I suppose that spider bite is always a possibility -- or any other kind of bite. I've also thought about some weird new autoimmune condition -- he already has thyroiditis and pannus -- heck, he's set for more. Interesting that the wording was the same as it was for your cockatoo.

The vet isn't sure about that "reactive bone" thing either. I have a feeling that she will be calling the pathologist on Monday to get more details. I think, if it's just the beginning of a cancer, maybe it would be isolated to the inside of the bone? I was reading that bone cancer starts inside the bone and works outward. I think the chances are getting slimmer that they will find anything, and that's would be a huge relief.

He thanks you for the grand compliments -- in his winter coat, he looks more sturdy and strong. In his summer coat, he is redder, which brings a different look. And he never tires of hearing how handsome he is


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## WiscTiger

Lisa while the recovery from the removal of a dew claw can be painful, the swelling and infection(?) that was present and not responding to treatment had to be painful also. I think you did the right thing. I also think that cancer can play hide and seek with biopsy material, if they miss a cell in their sample they are examining then they say it wasn't present. We don't know what caused the inflammation and if it was able to be gotten under control this time would it surface again. This way Max has some healing time but I think once he gets healed up it will be better in the long run. Of course this is just me and my non-veterinarian opinion.

Val


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## LisaT

Thanks Val, I value your non-veterinarian opinion







I think what you say about that hide and seek make sense. Now that you guys have mentioned the pain, I have noticed a funny gate in the last several weeks that didn't change after the chiropractor -- I"m curious to see if that will go away now.

We left the bandage on an extra day because we knew we would be gone all day today. It took us about 30 minutes to get it off tonight -- there was a lot of dried blood, and it was packed tight, and he was very touchy. Every layer had to be pried off from the blood, and when we got to the initial layer, it was dried tight to the skin. He was a very brave and trusting boy. 

He couldn't put any weight on it for awhile, but now, several hours later, it already seems tons better. 

Okay, so I'm ready to hear some good news tomorrow!


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## WiscTiger

Lisa you might want to put one Non-sticky gauze pad and a wrap or two of Vet wrap for a few days. 

Val


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## LisaT

That's a great idea. Right now I have him coned and I've been letting it get some air, but I certainly want to protect it.


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## 3K9Mom

Nervously awaiting Pathology Report, Part II


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## DancingCavy

Same here! We're hoping all is well for Max.


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## aubie

Ohhh! Here's hoping the good news continues! Anna is very hopefull that her Sugar Daddy gets back to full speed soon!


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## LisaT

The vet left a message on my cell phone and I couldn't tell if she got the report and there was no new news, or if the new news was that there was nothing to add from the information. Darn phone messages -- why do they always call right when you have stepped outside for a couple of minutes?!?!?!?

She did say that she has left a message with the pathologist and he hadn't called back, but that he could have had the day off since today is a holiday, and she will most likely speak to him tomorrow.

Thanks for checking in, keeping fingers and paws crossed for another day!


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## LJsMom

Argh. I was so hoping for some news.


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## LisaT

LOL, me too. It's very frustrating.


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## 3K9Mom

I have to wait another day? My head might explode.










Still sending good thoughts and







to Max. 

Indy too







I'm sure she's anxious for Max to get back to his usual (if a bit pushy) self.


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## LisaT

I think that you hit the nail on the head, or exploded the head









We are all waiting for him to get back to normal -- there is nothing more pathetic than a GSD with those sad droopy eyes because he can't do what he is used to doing!!

He's getting around on the paw much better. The vet said I could take the stitches out myself in a couple more days. I guess I'll wait and see. When Indy had a dental done in Dec., the vet removed a funny looking skin tag that she didn't like (we have to be extra careful with Indy because of the mast cell tumor that she had). The lump wasn't anything, but it was at the base of her skull, and the tech said to go ahead and take the single stitch myself. Indy is quite squirrely, and it wasn't very easy just getting it snipped. Then it wouldn't pull out because of the scabbing, so I left if for a bit. Later I got up the nerve to just yank it, and that worked, luckily I yanked it just right. I was not meant to be the medical type.


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## LisaT

A quick update. 

No news. Hopefully by the end of the week, for sure by next week!!?!?!!!

They have to decalcify the bone in a way that they can still preserve the tissues so that they can be somehow thinly sliced and looked at. 

The vet did call the pathologist today. Pathologist said that since there was no bothering with the paw before the dew claw was split, he doubts cancer. I reminded the vet that he was licking it for a couple of weeks before the split, so that might negate that. At least, she said, that fibrosarscoma was ruled out, as that is particularly nasty and conventional treatment for that would be to amputate the leg. Wow. 

The pathologist seemed to think they will find a minute prescence of deep-seeded bone infection. 

I guess *within a week*, we will know the answer. 

Can this possibly take any longer?


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## DancingCavy

I can't imagine how frustrating it is to be waiting on the results for so long.







I hope Max is feeling better at least.


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## LisaT

Thank you Jaime. Max is doing better -- not licking much, a bit of a limp though. I guess I'll just go back to waiting patiently......


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## JeanKBBMMMAAN

Wow! I've gotten confused in all the information but this is a lot of waiting. I understand why, but gah. 

You get pee with a soup ladle, you take out stitches yourself, you're a regular old fashioned prairie woman! 

I don't even look for the Adequan shots...


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## LisaT

Gaaahhhhhh is right!!

prairie woman --







When I was a kid, our animals NEVER went to the vet. Once every 3 years we would stand in line at the rabies clinic at the SPCA, maybe, but I never saw a vet's office until I had a very sick cat that we had to neuter at the age of 10 probably. Anyway, I remember regularly having to hold the cat down while Dad would be pouring peroxide in his wounds, which were typically big gaping holes somewhere. I would rather NOT be a prairie woman...

At least I can't complain that the pathologist is not being thorough, eh?


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## LisaT

There is a new lump forming, at the top of the digit closest to the dew claw. This is in spite of being on Clavamox. 

Fingers crossed. I just want to know what the heck this is.


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## DancingCavy

Keeping fingers and paws crossed for good news.


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## WiscTiger

Lisa it still could be just a really weird infection and from the surgery it has moved around. 

Val


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## 3K9Mom

> Originally Posted By: LisaT Max is doing better -- not licking much, a bit of a limp though. I guess I'll just go back to waiting patiently......


Who's waiting patiently???







]


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## 3K9Mom

Can we biopsy the lump? A needle aspiration? Have you run a CBC? Is his WBC up? That might tell us if there is infex (esp along with the needle aspirate). 

A lot of bacteria is not sensitive to Clavamox. Assuming the lump is infex, if we knew what it is, we might be able to treat it more efficiently.


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## Strongheart

Did they ever do a culture at any point? 

You know that disease my cockatoo had is seen in wild animals now too, and there are more parrots in Calif. than any other state (who brought the disease to the US), it has been proven to be caused by a virus...


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## LisaT

No bloodwork, no culture yet -- this all started out as something "easy" -- wasn't supposed to go this way!!

My regular vet only works on Mondays and Tuesdays, which is one reason I had a couple of vets for such a long time, but now we are down to one in town. I have emailed her tonight.

I hope that you are right Val -- "migrating infection". Max always does great on doxycycline -- I think since we are done with the Clavamox, I'll try the doxy, only because everything about him gets better on it, and the vet thinks it works as an immune system regulator in him.

I've been thinking all sorts of weird things - fungal, lupus (haven't a clue whether it can do this, but I think I'd rather fight lupus than bone cancer?), etc. Can anyone think of weird inflammatory autoimmune things that can cause something like this, similar to what happened with Strongheart's parrot?

I was starting to feel okay about this biopsy, but I'm a bit freaked out by this new lump. No wonder his limp is not getting better. The lump is sore and right where the paw bends at the top of the digits.


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## WiscTiger

Lisa I was googling some things last night from Max's Prelim Report.

Some place in all my reading Doxycycline was mentioned, so I think that would be a good choice.

There are Anti-Funal drugs none of them are inexpensive.

I should have posted some of the links but I didn't want you to freak out, parts of what I read had to deal with cancer.

If I have time I will try to see if I can find some of the info again. 

Val


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## aubie

Good lord!







Okay,

a. glad they think it's not cancer
b. waiting sucks
c. maybe it's just a sympathy bump for the one he lost?

Lisa, hang in there! i'm sure it will all work out for the Max-ter!


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## Strongheart

Sheesh, no word yet?


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## 3K9Mom

Where IS this lab? I'm hopping on a plane right now. Where am I going?


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## LJsMom

Still no word? I'm with 3K9Mom. Time to hunt down this lab dude.


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## DancingCavy

Wow. I would probably be calling them every couple hours if I had to wait this long. . .


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## WiscTiger

just like everyone else checking in for results.


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## LJsMom

I'm starting to worry - Lisa hasn't been on since Saturday.


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## Strongheart

Yea I was wondering where she was too. Sounds like she's in a rural area? maybe her internet is down.


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## aubie

Oh, I hope Max and Lisa are okay!?!


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## DancingCavy

Let's hope she pops in for an update soon. I hope she and Max are okay.


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## aubie

I'm concerned....


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## LJsMom

Me too.


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## aubie




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## 3K9Mom

Hopefully, Lisa is just swamped because we're right around the end of winter session and/or the beginning of the spring quarter/semester.

And Max is keeping her busy with walks and hikes and runs...


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## LisaT

Hello all, I am SOOOOOOOOOOooooooo sorry that I haven't checked in earlier. Dad started chemotherapy at the end of last week, and this has been the first week of a new semester, and then dealing with Max, I haven't been on the internet for anything but work -- and that SUCKS. 

<span style="color: #3333FF">They found nothing new on the pathology report.</span> Here it is:

*MICROSCOPIC INTERPRETATION* 

Ulcerative pododermatitis, lymphoplasmacytic, neutrophilic and
histiocytic


*COMMENTS* 

Dermal and subcuticular inflammation is observed within the sagittal
section. There is also reactive bone, but no evidence of neoplasia. As
a precaution, the remaining digit is being decalcified to evaluate a
midline section of the digit to further exclude an underlying
neoplasm. The inflammation is associated with superficial ulceration
and surface trauma.

* ADDENDUM*
A midline section through the decalcified dewclaw is evaluated. At the
base of the nailbed there is mild reactivity of the bone along with
slight hyperplasia of the underlying synovium. There is also low grade
lymphoplasmacytic inflammation. More intense lymphoplasmacytic
inflammation is located just lateral to the nailbed. There is no
evidence of underlying neoplasia. As we discussed on the phone, these
findings are consistent with trauma to the nailbed resulting in
reactivity, swelling and inflammation which has been propagated and
intensified by self trauma. Amputation of the dewclaw should be
curative.

=========

First a couple of thoughts -- I am so relieved that they found no evidence of cancer. Of course now I will worry about cancer forming from persistant inflammation, but that's A LOT better than currently having cancer.

There are now two lumps -- one that I described earlier, and also the lump at the dew claw has returned. He has not been bothering with it, so this is all his immune system, and not him licking, etc. Both lumps seem to vary in size. I did find out that there are some stitches under there, where they had to cut the veins when they removed the dew claw, so that might be part of the reason, but I still think that we haven't figured out the underlying cause. The pathlogist didn't know that Max had been bothering with the paw for a couple of weeks before I saw outward signs of a problem with the claw. It is reasonable that he could have hurt his paw I guess.

I took him in on Tuesday and had them run blookwork. For the most part everything looked normal, well, except that his kidney values are rising. His BUN is just out of the normal range, and his creatinine, while normal, has risen. I told the vet it's because I've been feeding dog food for the last six months







She is always so happy when I try dog food instead of the homecooking, so I just had to throw that in. I am going to back off on the canned food and figure out what to do after we retest in two weeks. 

Val, I actually didn't stay with the doxy -- he kept panting, and I wasn't sure what to do, so I just waited. Once that dew claw lump came back, I knew it was a weird inflammatory process. HOWEVER, I have read some encouraging stuff about doxy and bone cancer.....do you remember any of what you saw?

Again, sorry to disappear in the middle like that. I really appreciate all the support -- the good vibes are great for Max too


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## WiscTiger

Lisa. let me go Googleing again today or tommorow. I think I will remember when I see the sites. I might go check my history files also.

Sorry to hear about your dad and Chemo. Sounds like you have a lot on your plate this past week.

Val


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## LisaT

Thanks for checking Val.

Yeah, it's been a really long week. It feels like I haven't been here for about a month.


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## LJsMom

Really glad you're ok and that Max doesn't have cancer!


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## WiscTiger

OK Lisa here you go.

This might be printing out and take some sit down reading. 

pododermatitis
inflammation of that portion of the skin which continues downward within the horny structure of the hoof. Most common use is with reference to cattle where it is used synonymously with footrot, but also used increasingly to describe dermatitis or pyoderma of the feet in dogs.
http://medical-dictionary.thefreedictionary.com/Ulcerative+pododermatitis
neutrophilic Stuff:
This is very Medical…
http://www.zzcat.com/TumorTidbits/Neutrophilia.txt
More General
http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/10705.htm 
https://www.vetconnect.com.au/5min/data/02520253.htm

histiocytic
http://www.vet.uga.edu/vpp/clerk/lamp/index.php
http://www.histiocytosis.ucdavis.edu/public.html
http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/72232.htm

If I remember correctly the Antibioitic info was in the zzzcat/TurmorTidbits link


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## LisaT

Thanks Val, I will be checking out the links. Max always does so well on doxy, yet he tests negative for everything, so it's a mystery.

This last summer he was licking his paws alot, I figured it was the weeds that we were neglecting







Maybe it's something else going on. Guess I better figure out a time when I can get to my new reading list









Thanks a bunch for the heads up.


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## LisaT

Val, had to go look up those links. I will have to look again later -- started reading sentences three times in a row with no retention -- I think i"m tired.

Just a few things though -- 

That neutrophil link above from the zz site I had to save and then open in word so that I could read it right --it's much like the vetconnect one, but it was incredibly interesting -- who knew that stress and fear can dramatically spike the neutrophils?

That vetconnect site -- https://www.vetconnect.com.au/5min/ is from the big book called something like the 5 minute consult -- I have the book -- a great reference, but it's nice to have the link above too. Thanks for finding that, on both accounts









The vet stressed that she wasn't as worried about cancer when she saw the "plasma" cells in the report, as those are typically from immune mediated stuff. So I did a search on _plasma cell pododermatitis_ from your first link, and came up with this: http://vp5.afip.org/wsco/wsc_showcase2.php?id=15 and the sentence that stuck out was: _In some cats concurrent plasmacytic stomatitis, renal amyloidosis or immune-mediated glomerulonephritis have been reported _, and Max's gums have been pretty inflamed lately (stomatitis), and now we have these odd kidney blood values....He also gets these weird solitary skin nodules that the only thing I can find it linked to might either be cholesterol or kidney disease. The search on the pododermatitis also brought up the marvista site http://www.marvistavet.com/html/body_plasma_cell_pododermatitis.html I would have never known to look for that word. Those two sites on the pododermatitis also mention the modulating effects of doxy.

I think my brain is spent for the day.


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## LisaT

> Originally Posted By: LJsMomReally glad you're ok and that Max doesn't have cancer!


Thanks LJ, I'm glad too!!


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## WiscTiger

I tell'ya Lisa reading that stuff the first time made my head spin also. But I must have retained some of it. 

It really sounds like Max has some thing brewing. I get really concerned when I see lots of little things that one in itself isn't bad, but you start adding them all up and my gut tells me there is some thing brewing. I don't like to scare or alarm people but when I see multiple strange things going on I think for Jean's Nina. She had all kids of little or big things cropping up, that when looked at as just that it was this or that. But add up all the little things and my gut tells me there is some thing bigger brewing.

Val


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## LisaT

I'm with you Val -- something is brewing. Vet doesn't quite see it that way, but something isn't right. Hadn't made the connection with Nina, but I think that you are right on. I guess I just keep adjusting his supplements to fight _something_ -- my list includes cancer, immune-mediated, weird infection(?), and now kidney disease. Am I forgetting anything?

I talked to the vet about running the immune stuff -- ANA, etc., but her thought was that those are too unreliable, even in dogs with symptoms where it should be clearly positive. We need a blood panel that you run when you don't know what to run


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## WiscTiger

The ANA is really only a partial, it works well in conjunction with a skin lesion biopsy to rule out Lupus.

The only thing I can think of right now is to start charting. Chart any changes. Check those two new lumps, chek him daily for any new lumps. Maybe start taking a daily Temp if Max won't get to upset, my dogs hate that. Look for low grade spikes.

Not sure if any of it would do any good except you could go in and say, this and that to the vet with notes to support.


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## LisaT

Sure wish those ear thermometers worked on dogs.

I will be more diligent about taking notes -- hopefully something will become clear before it gets to a serious stage.


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## WiscTiger

They have ear thermometers for dogs. 

http://www.drsfostersmith.com/product/prod_display.cfm?pcatid=9011

Val


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## DancingCavy

What a tough week. Glad to hear it's not cancer.


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## LisaT

Thanks Jaime









Those ear thermometers, do you really think they work better than the ones for humans -- do they stick way down the ear?


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## aubie

Oh thank goodness!!! Go Max! 

















I'm so sorry to hear about your dad. I'll be sending goo mojo his way!


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## LisaT

Thanks aubie, on both accounts


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## aubie

Oh, and that was supposed to be "good" mojo, not GOO! Ewww!


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## LisaT

LOL, I must have known what you meant -- i didn't bat an eye!


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## JeanKBBMMMAAN

Lisa-I haven't posted here because I haven't understood a lot. 

What did they mean when they said that it was histiocytic?

But glad that overall he is doing well. 

My vet said the BUN can go up and down a lot. 

Hoping everything else is going smoother for you too.


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## LisaT

Jean, I'm not so sure I understand a lot of this either!

I was thinking that histiocytic just meant that there were histiocytes, and that goes along with strange inflammation. 

BUT, I just googled and found the following: 
http://www.merck.com/mmpe/sec11/ch140/ch140a.html#CACCFCEI
http://www.bmdca.org/health/Cancer/Histiocytic_Diseases_of_the_Bernese_Mountain_Dog.php

and I recall that I've looked at that Bernese site before. Is this related to something that Nina had?

And thank you, things are running a bit smoother, but will flare-up each time Dad starts a new cycle. So far, so good (fingers crossed).


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