Answer to Chronic Foot Pad Disease?

Fusion podoplasty is a reconstructive salvage procedure in which diseased interdigital skin tissues are removed and the phalanges and digital metacarpal/metatarsal pads are sutured in apposition to close the resultant skin wound defects. Total fusion podoplasty (TFP) is performed in cases of end-stage fibrosing interdigital pyoderma or to resolve chronic digital flexor tendon severance. Partial fusion podoplasty (PFP) is used when the pathology is confined to 2 adjacent digits, for paw reconstruction following digit amputation, or for congenital paw deformities.

This study examined the results of fusion podoplasty in 7 dogs and 1 cat (TFP, n = 6; PFP, n = 2). The patients suffered from various problems, including chronic interdigital furunculosis (n = 3), ectrodactyly (n = 1), digit abnormalities associated with tendonectomy (n = 1), redundant interdigital skinfolds (n = 1), conformational deformity (n = 1), and necrotizing fasciitis (n = 1). In 6 of the 8 patients, resolution of clinical signs was achieved. Two of the 8 patients had mild weight-bearing lameness. Minor dehiscense in 4 of the 7 dogs was noted during a median postoperative period of 11 days. The procedure is regarded as major surgery, and postoperative care is labor-intensive.

CommentarySurgery is not often considered for a patient with chronic end-stage disease between foot pads or on the paws. Private practitioners would do well to consider this technique, as many patients with chronic ailments of the paws remain with their primary clinicians for long-term medical management.—Heather Troyer, DVM, DABVP, CVA

SourceFusion podoplasty for the management of chronic pedal conditions in seven dogs and one cat. Papazoglou LG, Ellison GW, Farese JP, et al. JAAHA 47:e199-e205, 2011.