Treating Interdigital Cysts at Home

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Image of a common interdigital cyst between the toes of a Bulldog. Image courtesy Bizkai Bulldogs

 

This has not been our week(s) when it comes to healthy Frenchies. First Journey ruptures an anal gland, then mystery chunks start falling out of Penelope, and now Elliott has an interdigital cyst.

For those who aren’t familiar with this particular bane of the French Bulldog and Bulldog owner, an interdigital cyst (their proper name is ‘Interdigital furuncle’) is an inflammation of the skin between the toes. The Merck Veterinary manual says -

The most common cause is a deep bacterial infection. Many dog breeds (eg, Shar-Pei, Labrador Retriever, English Bulldog) are predisposed to bacterial interdigital furunculosis because of the short bristly hairs located on the webbing between the toes, prominent interdigital webbing, or both. The short shafts of hairs are easily forced backward into the hair follicles during locomotion (traumatic implantation). Hair, ie, keratin, is very inflammatory in the skin, and secondary bacterial infections are common.

 

In Elliott, we first noticed he seemed a little bit lame, which I assumed was the result of a typical ‘rambunctious dog’ related injury. When he was limping worse the next day, I took a closer look. That’s when I saw the red swelling between his toes, with some crusted blood under the nail. The blood under his nail first led me to assume he’d damaged it somehow, perhaps by cracking it on the concrete patio after he’d jumped off the patio table. Elliott is our resident goat dog – if there’s a table, chair, or other high surface around, he’s sure to climb onto it, and jump back down. So much for the “Don’t let Frenchies jump off the couch” theory.

 

Closer inspection showed that the blood was likely from the swelling between his toes tearing the skin around the nail, which is when I realized it was a cyst, and not nail damage.

Although this is one the most common health problems in French and English Bulldogs, I’ve never personally had a dog with an interdigital cyst before.  I’m familiar with them from talking to other owners and breeders, and aware that they can be nasty little suckers.

Cysts are scary looking. They’re huge, swollen and obviously painful for the dog.

My first reaction was to take him in to the vet, but the complicated course of treatment Merck recommends seemed rather daunting:

Interdigital furuncles respond best to a combination of topical and systemic therapy. Cephalexin (20 mg/kg, PO, tid, or 30 mg/kg, PO, bid) is recommended for 4-6 wk of initial therapy. However, because the lesions are pyogranulomatous, it may be difficult for antibiotics to penetrate them; therefore, >8 wk of systemic antibiotic therapy may be required for lesions to completely resolve. These lesions are often complicated by concurrent Malassezia spp infections. Oral ketoconazole or itraconazole (5-10 mg/kg) for 30 days may be indicated. The presence of Malassezia can be documented by cytologic examination of nail bed debris and/or impression smears of the skin. Topical foot soaks in warm water with or without an antibiotic solution (eg, chlorhexidine) and the application of mupiricin ointment are recommended. Some dogs may benefit from antibiotic wraps and bandaging. Antihistamines given for the first several weeks of treatment may partially alleviate pruritus, if present.

This is in stark contrast to the relatively mild and non invasive treatments other Bulldoggers and Frenchie owners recommend for treating cysts. I’d decided I would try a lower impact home remedy, before loading Elliott up with 4-6 weeks of antibiotics.

The most common home remedy I read about was to soak or compress the affected foot several times per day, then apply antibiotic ointment. A few people recommended applying Preparation H or other hemmorhoid creams. We decided to do a bit of each.

Three to four times per day we’ve been soaking Elliott’s foot in Epsom salts. The easiest way we’ve found to do this is to fill the laundry tub up with 2 to 3 inches of fairly warm water, to which we’ve added a cup of Epsom Salts. We then stand Elliott in the tub, and sit beside him for ten minutes or so. Luckily for us, he’s a good boy, and just stands there patiently so long as we give him the occasional head scratch.

After ten minutes or so have elapsed, we put Elliott on a thick towel and gently pat his affected foot dry. I then fill a large, wide coffee cup with about an inch of hydrogen peroxide, and hold his foot in the cup for a few moments. The affected areas on Elliott’s foot, in particular the cyst itself and the surrounding hair follicles, respond to the hydrogen peroxide with bubbling, whereas the rest of his foot does not.  This shows that there is catalase enzyme present in these areas, which is one of the components released when blood or damaged cells are present.

After soaking in hydrogen peroxide, we again pat Elliott’s foot dry. I then apply either Panalog ointment, or Anusol hemorrhoid ointment.

We’ve been treating him using the above method since Saturday morning, and in that time period his swelling has reduced by approximately 40%, and the redness is almost completely gone. With any luck, it will be completely gone within another day or so, and with no antibiotics. Of course, if it doesn’t clear up, or returns, then we’ll try traditional Veterinary treatment and oral antibiotics.