Tuesday, March 15, 2011

Infected toenail or cancer?


Meet Sierra, an 8 year old spayed female flat coated retriever.  Sierra came in to see Dr. Garnett on 1-30-11 for a swollen toe with a nail that was at a "funny angle."  Dr. Garnett was concerned about the toe; in addition to infection, dogs can have tumors of the toe nails that start where the nail joins the paw.  These tumors can be cancerous and can progress very quickly.  Here is a picture of how the toe looked after the nail was removed – pretty angry and infected.



Dr. Garnett’s next step was to take an x-ray of the toe to see what the bone and soft tissues underneath the nail looked like.  Notice the missing nail as well as the lack of bony tissue (needle pointing to the toe in question).  The x-ray was read by Dr. Chuck Pugh, a board certified radiologist who interprets all of our radiographs (x-rays).  He confirmed that the disease process that was destroying the nail was also destroying the bone of the toe.  This was a concern since infection and cancer can both cause the destruction of bone.



It was concluded that the best option would be to amputate the toe.  Before surgery, Dr. Garnett had her technicians perform chest x-rays since some tumors metastasize (move from one part of the body to another).  The lungs are a common body site for metastasis and if Dr. Garnett had seen problems on Sierra’s x-rays, it would have been a serious problem.  Luckily, the lungs were clean.

The toe was removed by Dr. Garnett and submitted to Colorado State University for histopathology.  Within one week, Dr. Garnett received a report from the pathologist stating that the toe did have a malignant tumor that was destroying the bone holding the nail in.  It was a squamous cell carcinoma.

Dr. Garnett was relieved  that the toe was removed quickly and hopefully Sierra is cured of this cancer. The moral to this story is that a swollen toe with a toenail that looks infected can be a sign of cancer and should be taken very seriously.

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