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Q - MY NINE-YEAR-OLD SHIH TZU HAS BEEN TREATED FOR CYSTS BETWEEN THE TOES OF HIS PAWS FOR SIX MONTHS WITH ANTIBIOTICS, FOOT BATHS, EPSOM SALTS AND AN OPERATION. NOTHING SEEMS TO WORK IN THE
LONG TERM. WHAT WOULD YOU ADVISE? _A - These are not true cysts but deep bacterial infections called pedal pyoderma._ _As you have found, they are very difficult to treat._ _You have
mentioned that long courses of antibiotics succeed only for a short time and that your vet has tried to remove the infected tissue surgically. _ _The problem with these cases is the
intensive and expensive treatment required just to get some improvement. _ _Then there is the frequent relapse after apparently successful treatment. _ _This occurs because there is an
underlying disease, often one that diminishes the immune system, or because the infected area is itchy, causing the dog to lick constantly. _ _The latter can be caused by allergies such as
hay fever and food intolerances. _ _Diseases affecting the immune system include demodicosis, caused by the Demodex mite, hypothyroidism and Cushing’s disease. _ _Treatment and investigation
of underlying causes will inevitably be expensive. _ _Sometimes getting help and advice from a specialist can prove to be economical in the long term. _ _It is likely more antibiotics are
required with some investigations to rule out the most common underlying causes. _ _If it is not possible to diagnose, the infection might be kept at bay with regular antibacterial washes of
the feet._ _DAVID GRANT MBE WAS A VET AT THE RSPCA HARMSWORTH HOSPITAL FOR ANIMALS. WRITE TO HIM AT EXPRESS YOURSELF, 10 LOWER THAMES STREET, LONDON EC3R 6EN. HE IS UNABLE TO ENTER INTO
INDIVIDUAL CORRESPONDENCE._