Nail & Nailbed Disorders

Nail & Nailbed Disorders – An Overview

  • Nail and nailbed disorders are a group of abnormalities or diseases that affect the nail or claw and/or the tissues surrounding the nail or claw (that is, the nailbed)
  • “Onycho-” or “onych-” refers to the nail or claw
  • Inflammation of soft tissue around the nail or claw (known as “paronychia”)
  • Fungal infection of the nail or claw (known as “onychomycosis”)
  • Brittle nails or claws that tend to split or break (known as “onychorrhexis”)
  • Sloughing of the nail or claw (known as “onychomadesis”)
  • Deformity of the nail or claw caused by abnormal growth (known as “nail dystrophy” or “onychodystrophy”) that is often the result of a nail or nailbed disorder
  • Softening of the nails (known as “onychomalacia”)

Genetics

  • Certain breeds appear to be more susceptible to nail and nailbed disorders than other breeds, suggesting a possible genetic basis

Signalment/Description of Pet

Species

  • Dogs
  • Cats

Breed Predilections

  • Brittle nails that tend to split or break (onychorrhexis)—dachshund
  • Symmetrical deformity of the nails or claws caused by abnormal growth (nail dystrophy or onychodystrophy) that is related to the autoimmune disease, lupus, or a lupus-like disease (condition known as “symmetrical lupoid onychodystrophy”)—German shepherd dog, rottweiler, possibly giant schnauzer and Doberman pinscher
  • Deformity of the nail or claw caused by abnormal growth (nail dystrophy or onychodystrophy) of unknown cause (condition known as “idiopathic onychodystrophy” [“idiopathic” means unknown])—Siberian husky, dachshund, Rhodesian ridgeback, rottweiler, cocker spaniel
  • Sloughing of the nail or claw of unknown cause (condition known as “idiopathic onychomadesis”)—German shepherd dog, whippet, English springer spaniel

Mean Age and Range

  • Symmetrical deformity of the nails or claws caused by abnormal growth (nail dystrophy or onychodystrophy) that is related to the autoimmune disease, lupus, or a lupus-like disease (symmetrical lupoid onychodystrophy)—3–8 years of age

Signs/Observed Changes in the Pet

  • Licking at the feet and/or nails
  • Lameness
  • Pain
  • Swelling, redness of the skin and tissues (known as “erythema”), and discharge from the nail or the area where the skin and nail or claw come together at the top of the toe (known as the “ungual fold” or “nail fold” or “claw fold”)
  • Deformity or sloughing of one or more nails or claws
  • Discoloration of the nail
  • Bleeding from the nail
  • Loss of one or more nails
  • Being “tender-footed”

Causes

  • Inflammation of soft tissue around the nail or claw (paronychia)
  • Infection or infectious disease—bacteria, fungus (known as “dermatophytosis”), yeast (Candida, Malassezia), demodectic mange mites (condition known as “demodicosis”), leishmaniasis
  • Immune-mediated disease—types include the following: pemphigus, bullous pemphigoid, systemic lupus erythematosus, drug eruption, symmetrical lupoid onychodystrophy
  • Tumor or cancer—types include the following: squamous cell carcinoma, melanoma, eccrine carcinoma, osteosarcoma, subungual keratoacanthoma, inverted squamous papilloma
  • Abnormal communication between an artery and a vein (known as an “arteriovenous fistula”)
  • Fungal infection of the nail or claw (onychomycosis)
  • Dogs—Trichophyton mentagrophytes (usually generalized fungal infection of the skin, involving the nails)
  • Cats—Microsporum canis
  • Brittle nails or claws that tend to split or break (onychorrhexis)
  • Unknown cause (so-called “idiopathic disease”)—especially in dachshunds; involves multiple nails
  • Trauma
  • Infection—fungal infection (dermatophytosis), leishmaniasis
  • Sloughing of the nail or claw (onychomadesis)
  • Infection
  • Immune-mediated disease—types include the following: pemphigus, bullous pemphigoid, systemic lupus erythematosus, drug eruption, symmetrical lupoid onychodystrophy
  • Decreased or inadequate blood flow (known as “vascular insufficiency”)—inflammation of the blood vessels (known as “vasculitis”); clumping together or agglutination of red-blood cells when the temperature of the cells drops below normal body temperature (known as “cold agglutinin disease”), such as exposure of the legs to cold weather
  • Tumor or cancer—types include the following: squamous cell carcinoma, melanoma, eccrine carcinoma, osteosarcoma, subungual keratoacanthoma, inverted squamous papilloma
  • Unknown cause (so-called “idiopathic disease”)
  • Deformity of the nail or claw caused by abnormal growth (nail dystrophy)
  • Condition caused by excessive levels of growth hormone, leading to enlargement of bone and soft-tissues in the body (known as “acromegaly”)
  • Increased levels of thyroid hormone in the cat (known as “feline hyperthyroidism”)
  • Zinc-responsive skin disorder (known as “zinc-responsive dermatosis”)
  • Congenital (present at birth) malformations of the nail or claw

Risk Factors

  • Inflammation of soft tissue around the nail or claw (paronychia) due to infectious causes—decreased ability to develop a normal immune response (known as “immunosuppression”), which may be related to immune-system problem of the body or to the use of medications to decrease the immune response; feline leukemia virus (FeLV) infection; trauma; and diabetes mellitus (sugar diabetes)
  • Sloughing of the nail or claw due to bacterial infection (bacterial onychomadesis)—excessively short nail trimming (into the quick) postulated to increase likelihood of bacterial infection and subsequent sloughing of the nail or claw

Treatment

Health Care

  • Inflammation of soft tissue around the nail or claw (paronychia)
  • Surgical removal of the hard part of the nail (known as the “nail plate” or “shell”)
  • Antimicrobial soaks
  • Identify underlying condition and treat specifically
  • Fungal infection of the nail or claw (onychomycosis)
  • Antifungal soaks—chlorhexidine, povidone iodine, lime sulfur
  • Surgical removal of the hard part of the nail (nail plate or shell)—may improve response to medication administered by mouth or injection (known as “systemic medication”)
  • Amputation of the third bone of the toe (known as the “third phalanx”), which is continued by the nail or claw
  • Brittle nails or claws that tend to split or break (onychorrhexis
  • Repair with fingernail glue (type used to attach false nails in humans), as performed or directed by your pet’s veterinarian
  • Remove splintered pieces
  • Amputation of the third bone of the toe (third phalanx), which is continued by the nail or claw
  • Treat underlying cause
  • Sloughing of the nail or claw (onychomadesis)
  • Antimicrobial soaks
  • Treat underlying cause
  • Deformity of the nail or claw caused by abnormal growth (nail dystrophy or onychodystrophy)
  • Treat underlying cause
  • Tumor or cancer
  • Determined by biologic behavior of specific tumor
  • Surgical removal of the tumor
  • Amputation of toe
  • Amputation of leg
  • Chemotherapy
  • Radiation therapy

Medications

Medications presented in this section are intended to provide general information about possible treatment. The treatment for a particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive

  • Bacterial infection/inflammation of soft tissue around the nail or claw (paronychia)—antibiotics based on bacterial culture and sensitivity, administered by mouth or injection (systemic antibiotics)
  • Yeast (Candida or Malassezia) infection/inflammation of soft tissue around the nail or claw (yeast paronychia)—ketoconazole administered by mouth (systemic treatment); nystatin or miconazole applied to the affected area directly (topical treatment)
  • Fungal infection of the nail or claw (onychomycosis)—griseofulvin or ketoconazole administered by mouth (systemic treatment) for 6–12 months until negative fungal cultures; itraconazole administered by mouth for 3 weeks and then as directed by your pet’s veterinarian
  • Sloughing of the nail or claw (onychomadesis)—depends on cause; medication to decrease the immune response (known as “immunosuppressive therapy”) for immune-mediated diseases
  • Other medications include cyclosporine, tetracycline with niacinamide, pentoxifylline, vitamin E, essential fatty acid supplementations, and chemotherapeutic agents (such as azathioprine, chlorambucil)

Follow-Up Care

Patient Monitoring

  • Determined by underlying cause

Preventions and Avoidance

  • Determined by underlying cause

Possible Complications

  • Determined by underlying cause

Expected Course and Prognosis

  • Bacterial infection/inflammation of soft tissue around the nail or claw (paronychia) or fungal and yeast infection of the nail or claw (onychomycosis)—treatment may be prolonged and response may be influenced by underlying factors Fungal infection of the nail or claw (onychomycosis) and brittle nails or claws that tend to split or break (onychorrhexis)—may require amputation of the third bone of the toe (third phalanx), which is continued by the nail or claw, in order to get resolution
  • Deformity of the nail or claw caused by abnormal growth (nail dystrophy or onychodystrophy)—prognosis is good when underlying cause can be effectively treated
  • Sloughing of the nail or claw (onychomadesis)—prognosis determined by underlying cause; immune-mediated diseases and blood vessel/blood flow (vascular) problems carry a more guarded prognosis than do trauma or infectious causes
  • Tumor or cancer—removed surgically by amputation of the toe; some are highly malignant and may have already spread (known as “metastasis”) by the time of diagnosis

Key Points

  • Nail and nailbed disorders are a group of abnormalities or diseases that affect the nail or claw and/or the tissues surrounding the nail or claw (that is, the nailbed)

Spay and Neuter

Spaying / Neutering Your Dog

There is no question about whether to spay or neuter your dog. Spaying (female) or neutering (male) your dog is good for your dog’s health, for you as a dog owner, and is good for our community.

Spay

Spaying (ovario-hysterectomy) is the surgical removal of the reproductive organs (ovaries, uterus, and fallopian tubes) of the female dog.

Neutering

Neutering (orchiectomy or castration) is the surgical removal of the reproductive glands (testes) of the male animal. The outer is left, and only the testes are removed.

In order to achieve the majority of the health benefits derived from spaying and neutering, female and male dogs should be spayed or neutered by 6 months of age.

Health Benefits of Spaying or Neutering Your Dog

Spaying/neutering offers a variety of medical benefits that helps your dog live longer and remain healthy:

  • In males, a dog neuter completely eliminates the risk of testicular cancer if the surgery is performed before the pet is 6 months of age.
  • In female Dogs, spaying your dog decreases the risk of breast cancer dramatically. The rate goes down to almost zero if the spay is done before the first heat cycle!
  • Spaying your dog also eliminates the chance of developing a serious and potentially fatal infection of the uterus that is very common in unspayed dogs called Pyometra.

Less Stress on the Owner

Spaying or neutering your dog also creates less stress in your life. After this procedure, you no longer need to worry about blood spotting in females that are going through their heat cycle nor male dogs in the neighborhood attempting to mate with your female during heat season. Neutering also removes the urge in males to roam in search of a mate, which ultimately lessens the chances of them being struck by a car.

Good for the Community

Pet owners who don’t plan on breeding their dogs should spay or neuter their dog. Dog owners who do not plan on breeding their dogs are responsible members of our community when they spay or neuter their dogs. This is because spaying and neutering prevents unexpected pregnancy from occurring. Unexpected pregnancy is often the cause of homeless dogs and the over-crowding of the pet shelters across New Jersey.

Puppy Training Assistance

Puppy Training Assistance

Training your puppy is not just about entertaining your friends with a dog that can roll over other “silly tricks”. The act of training helps to strengthen an important bond between dog and human, while positions you as the alpha dog. In addition, many of the training commands like “sit”, “stay”, and “come” could actually save your dog’s life one day.

At Tri-County Animal Hospital, we understand the importance of a well-balanced puppy and would like to assist you with any training questions that you may have. In addition to private dog training, we also suggest training your dog in a classroom setting amongst a group of other dogs and dog owners. We would be happy to direct you to upcoming classes in Wayne, New Jersey or the surrounding area.

Housebreaking and Training

Now is the time to start working with your puppy so that he or she can be a loving part of the family. Starting from day one – Crate training is the best way to housebreak your new puppy. Consistency and patience are important when working with new puppies. In addition to your puppy’s home schooling, our staff at Tri-County Animal hospital can recommend inexpensive group classes for basic training.

Puppy Care

Vaccinations Are Crucial for Your Puppy’s Good Health

You will need to vaccinate your puppy against harmful viruses that would otherwise pose a threat to them later in life. Puppies require 3 sets of vaccines – with each set administered approximately 3 to 4 weeks apart from each other. The very first set of vaccines is typically given to your puppy when they are between 6 to 8 weeks old.

DHPP Combo

This initial set will include what is called the DHPP Combo & vaccinates dogs against several harmful diseases. These diseases include:

  • Distemper
  • Hepatitis
  • Parainfluenza
  • Parvovirus

The DHPP Combo will be “boosted” in 3 – 4 weeks and then boosted once more in another 3-4 weeks to ensure that your puppy has built up the appropriate anti-bodies to fight against these viruses. In order for your puppy to be fully protect throughout their life, they will be required to return in one year for another booster vaccine and then ever two to three years depending upon your dog’s exposure risks. We will advise you on what is best for your puppy, based on his or her anticipated lifestyle, in an effort to avoid over-vaccination while still providing adequate protection for your pet.

Rabies Vaccine

In New Jersey, the rabies vaccine is required by law.

This vaccine is administered only once during puppy-hood, when the Puppy has reached 12 weeks of age (typically given on the third set of puppy vaccines).

In addition, the state of NJ also requires that a booster vaccine be given every three years and repeated ANY TIME that your Puppy comes in contact with wildlife or undomesticated animals.

Lyme Disease

While the vaccine is OPTIONAL, Lyme disease is a serious threat to pets in our area. We suggest that you vaccinate your pets against this harmful virus. Transmitted by ticks, lymes is a multi-system disorder that can slowly paralyze your Puppy. The Lyme vaccine is administered to dogs twice during their puppy vaccines — 3 weeks apart. It is suggested that an annual booster be given throughout the dog’s life for full protection.

It’s important to note that the Lyme vaccine is not 100% effective – and is not a substitute for tick control.

However, if your puppy will be exposed to ticks – we strongly advise this vaccine.

Leptospirosis

Leptospirosis is a bacterial disease found in many undomesticated animals and local wildlife in New Jersey. It is a difficult disease to treat and often causes complete kidney and liver failure. The vaccine for leptospirosis is administered to puppies twice – 3 weeks apart. Dogs are then given a booster vaccine annually throughout their life.

Bordetella (Kennel Cough)

If your Puppy will ever come in contact with other dogs at parks, kennels or grooming salons, the bordetella vaccine is recommended to prevent what is commonly referred to as “Kennel Cough” in dogs. This is an air-borne virus that spreads rapidly and is easily prevented with a yearly vaccine.

Aside from causing your Puppy great discomfort, advanced cases can result in pneumonia or other more serious conditions. For this reason, we recommend the bordetella vaccine.

Canine Influenza (Canine Flu)

Canine Influenza, or more commonly referred to as the Canine Flu is another highly contagious respiratory infection of dogs. Don’t worry, it’s not contagious to people but vaccination is recommended for any pets that may be exposed at Puppy parks, kennels, Puppy shows or grooming salons.

Puppies are vaccinated twice -2 weeks apart. Dogs are then given a booster vaccine each year thereafter.

Fecal Exam (Stool Exam)

Dr. Silberman strongly suggests having a stool sample checked on your new puppy to identify any microscopic parasites that he or she may have. The majority of intestinal worms are invisible to the naked eye, and require the assistance of a microscope to diagnose. Intestinal parasites are commonly found in puppies within Northern New Jersey – but can be treated quite easily.

These parasites can cause vomiting, diarrhea, distended abdomen, and variable appetites.

We strongly advise against purchasing over-the-counter type dewormers as many of them make use of old technology that are often harmful to your puppy or just simply don’t work. In addition, there are many different types of intestinal worms and not all types are treated with the same medication. Our staff will look at the fecal sample under a microscope and determine whether your pet has worms, and if so — The type of worm that they are infected with. Next, Dr. Silberman will administer a safe dewormer that is specific to your puppy’s condition.

Some common pet parasites, like “hookworms”, can affect children so we suggest that this inexpensive test be repeated alongside your dog’s annual vaccines each year.

Heartworm Disease Prevention

Heartworms are blood parasites that are transmitted to dogs through mosquitoes. The heart worms settle in the heart and lungs, causing serious problems for your Puppy. Treatment can be risky and very involved – but prevention is simple and inexpensive.

On your first visit to Tri-County Animal Hospital, we will advise you on the best heart worm prevention for your Puppy. This is to be given at home each month for the rest of your dog’s life.

Dental Care

Dental disease is one of the most common medical problems that we see at our animal hospital. Dr. Silberman recommends that you brush your dogs teeth regularly to reduce dental calculi and bacteria.

Dental disease is not just a cause of bad breath, but can lead to heart disease, kidney disease, liver disease and other problems.

We suggest that you start caring for your pets teeth while he or she is a puppy so that they become accustomed to the regular brushing.

Flea / Tick Control

Flea and tick control is now easier and safer than ever with some of the newer products available. There are many life threatening diseases in New Jersey that are spread by both of these pests, and prevention should be administered year round (Lyme Disease, Ehrlichia, Rocky Mountain Spotted Fever).

One of the veterinary technicians at Tri-County Animal hospital will be happy to assist you in choosing a flea and tick preventative that is suitable for your new pup. Most of the current products are approved for use on puppies over 8 weeks of age.

Spaying / Neutering Your Pup

We recommend spaying and neutering of puppies between the ages of 4 and 6 months for all puppies that will not be used for breeding. Surgical alteration provides your pet with numerous medical benefits, and helps to reduce the population of unwanted pets in the New Jersey area.

Housebreaking & Training

Now is the time to start working with your pup so that he or she can be a loving part of the family.

Starting from day one – Crate training is the best way to housebreak your new puppy.

Consistency and patience are important when working with new puppies. In addition to your puppy’s home schooling, our staff at Tri-County Animal hospital can recommend inexpensive group classes for basic training.

Remember –

Prevention Is Always Better Than Treatment

At Tri-County Animal Hospital, we have a strong belief in preventing harmful diseases and conditions before they can affect your pet. This philosophy results in a happier, healthier Puppy and is much more economical for the Puppy owner. Ask a staff member at Tri-County Animal Hospital how you can keep your pet safe and healthy through prevention.

Never Give Medication To A Puppy Unless It Was Prescribed By A Veterinarian

Most Importantly, NEVER GIVE medications without direct approval from your veterinarian. Many products that are deemed safe for humans are extremely toxic to pets and can prove to be fatal.

If in doubt — Call Our Office first and ask – 973-831-2426.