my dogs paw

Question
I have two German Shephard mix dogs(Thor and Samson).  They are 7 1/2 years old.  Thor's paw has been red and inflamed and he licks it all the time.  One of his knuckles was swollen and as soon as it was almost healed(after approx. a month) the knuckle next to it became inflamed.  In between his toes is very red and inflamed as well.  
I have had him at my vet's office two times so far.  He did an x-ray thinking it is arthritis.  But the x-ray was normal.  So my vet told me it is just a behavior thing.  I do not think this is it.  I have soaked his paw in soapy water, washed with his medicated shampoo, peroxide, epsom salt.  And I have used Ottomax, neosporine and Ameri-gel.  I have kept it wrapped for several days, several different times, I have also kept just one of my socks on him.  Nothing is helping.  My other dog is diabetic and I just can't afford to take him to another vet.  Any advice you can offer would be much appreciated!

Answer
Hi April,

One thing that might not be helping Thor, is the wrapping of his paw. Letting it be exposed to the air can help it heal. Be sure you dry the paw well after bathing it, since warm moist skin be a breeding ground for bacterial and yeast infections. Using a hair drier on the warm setting is a good way of drying. You should be using an Elizabethan collar to restrict Thor's access to his paw.
There are "soft-e" collars that are a good alternative to those hard plastic "lampshade" collars:

http://www.arcatapet.com/vendor.cfm?vendnum=414&Source=GA-Trimline

http://dogkneeinjury.com/2008/alternatives-to-an-e-collar/

It's very possible that this is a habitual thing with Thor, as your vet suggested. Some dogs develop a condition called "Lick Granuloma" which is caused at first by the habit of licking, but due to the dog's persistence and secondary skin infections, the licking evolves into a serious skin condition. The German Shepherd breed is prone to develop this condition. This condition is frustrating and often will take several approaches to find the one that will work. You can read more about Lick Granuloma here (the first site has some graphic images of wounds):

http://www.thepetcenter.com/exa/lick.html

http://www.sniksnak.com/doghealth/lick-gran.html

Try applying Tea Tree Oil to the wounds. Tea Tree Oil is natural antiseptic, has pain-numbing properties, and has excellent anti-fungal properties. You should be able to find Tea Tree Oil at health food stores. Mix 1 teaspoon Tea Tree Oil with 1 cup of water. Always dilute Tea Tree Oil, as full strength can cause irritations. It should not be used on open wounds, and should not be licked off, so it should be used when your dog is wearing a protective collar.

Desenex foot powder sometimes works pretty well for moisture between the toes and around the footpads. Again, you wouldn't want Thor to lick this, so he should be wearing the protective collar.

Many dogs develop food allergies and sensitivities, licking their feet in an allergic response. Lick granulomas can occur secondary to allergies, in this case, treatment for the allergy is often successful. It is a good idea to consider allergy testing in dogs with persistent lick granulomas or recurrent ones.Doing a "food trial" takes at least a month, but it's how you'd go about checking to see if Thor's problem is related to his diet. You can read more about doing a food trial diet here:

http://www.peteducation.com/article.cfm?c=2+1664&aid=143

When itching is at it's worst, an over the counter antihistamine can help, but it may also have a mild sedative effect on your dog, so it might be best used at night. Ask your vet for a brand and dose recommendation.

Some dogs develop chewing or licking behaviors as a form of obsessive compulsive disorder. There is medication available to help dogs with this behavior.

Your best bet for successful treatment lies with your veterinarian. If finances are a problem, you can ask your vet if you can pay the bill off over an agreed upon period of time. Many vets are open to this, as long as it's something you discuss before bringing your dog in for the exam. Another payment option is to apply for CreditCare (http://www.carecredit.com ). It's a special credit line especially for medical bills, and it can be used for vet bills.

I know how frustrating it is to deal with a dog with persistent skin problems. I hope I've been a help.

Best of luck,

Patti