I saw two dogs within a few days of each other who are unrelated but had a very similar disease. Here are their cases:
Case #1
The Patient
Huey, a 2 year old male neutered Portuguese Water Dog, came to see me when his owners noticed he was chewing his left front foot incessantly and seemed to be in pain.
On examination, the top surface of his left front foot was wet with saliva and he did not want me to touch it. With the owner's permission, I shaved all the fur off the skin so I could assess what was going on underneath. Huey's foot was very inflamed, ulcerated, and painful.
The Treatment Plan
I cleaned the foot with an antiseptic and prescribed an oral antibiotic, oral pain medication, oral sedative, a topical spray with a steroid, and made sure to fit him with an E-collar so he could not reach his foot with his tongue. I did not find a specific wound such as a foxtail, laceration, or other inciting cause for the intense itch leading to the skin infection. My best guess was he was exposed to a topical irritant such as a pesticide or insect/spider bite that made him want to chew at the skin causing the secondary "self-mutilation" that followed. This is called pododermatitis which really just means inflammation of the skin on the foot. It can happen very acutely, even within a few hours, and is similar to a "hotspot" elsewhere on the body.
The Outcome
One week later, I rechecked Huey's foot and it was amazing! His skin was completely normal and the hair was already growing back nicely. He was cured!
Case #2
The Patient
Louie, a 6 year old male neutered Golden Retriever, came to see me when his owners noticed he was chewing his left front foot incessantly and seemed to be in pain.
The Treatment Plan
I followed the same treatment plan as for Huey and found a very similar issue. One main difference was that Louie's 3rd digit (middle finger) at the nail base was very swollen and tender and appeared to have a small puncture wound or trauma induced lesion. It was not bleeding, but very angry. I cleaned the foot with an antiseptic and prescribed an oral antibiotic, oral pain medication, and made sure to fit him with an E-collar so he could not reach his foot with his tongue. I also instructed Louie's owner to soak his foot in dissolved Epsom salts to help with the swelling and pain and to keep the foot clean.
The Outcome
One week later, I rechecked Louie's foot and it was amazing! His skin was almost completely normal and the lesion on the 3rd digit was so much better with just a small wound present. I recommended he continue with the foot soaks and the E-collar for 1 more week and at the following recheck, his foot was all normal again.
For some reason, I often see about 3 similar cases within a few weeks so I've been waiting for my 3rd case of acute pododermatitis to walk in the door.....
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