11 yr old Beagle/Basset - Lip Issue

Question
Hi Dr. Gifford.  

I have an 11 1/2 year old basset hound/beagle that suddenly presented Friday with the "nodules" on his lips (both left and right sides) slightly inflamed and pink.  Unfortunately I don't know the right term, but it's the "mountainous" lip skin that is normally brown.  They're clearly bothering him as he keeps scratching with back paws to the point of them bleeding and crusting.  I took him to the vet immediately and he was put on Simplicef (100mg 1x day) and Hydroxyzine (25mg 3x day.)  My vet wanted to treat as a bacterial infection.  He's not improving at all and is constantly trying to scratch.  I bought a lampshade type collar for him this afternoon.  Any ideas or have you seen this before?  He's had no health issues at all, except for diabetes incipitus since he was 5 which is treated by unlimited amounts of de-ionized clean water.

Thanks so much for making yourself available for questions on this site.  I sincerely appreciate it.      

Heather in Nashville, TN

Answer
Hi Heather!
The lesions you are describing on your Basset's lips may well be a deep pyoderma or bacterial infection. You may need to give it a few days more  with the collar to see if you see improvement. If it does not improve then I would suggest the lesions be aspirated via a fine needle aspirate and the sample submitted to a pathologist for cytology. They can look at the cell type and give you a better idea of what the lesions are.

Out of curiousity, why is he not on DOCP for his Diabetes insipidus? This medication is the treatment of choice for that disease. Feel free to send a follow-up.

Dr. G.