Saving Sam’s Foot

November 5, 2015Surgery
Author: David S. Thomson DVM

Sam is an exuberant, somewhat chubby, 11-year-old Labrador retriever who has nothing bad to say about anyone. Sam had been sore on his right front leg for six months. His regular veterinarian discovered a wound on the central pad of the right front foot, and figured Sam had stepped on something. He treated Sam with several courses of antibiotics, but the wound did not go away.
In fact it steadily got bigger. When I first saw Sam, he was quite lame. He still managed to thunder through the waiting room and jump onto the bench in the exam room, but he did this pretty much on three legs.

Dogs have five pads on the bottom of their feet…one pad for each toe and a central footpad at the ball of the foot just behind the toe pads. Dogs can lose two of their toe pads and do just fine. However, they do not walk without their central footpad.

underwood-sam-pic-2-10-01-2015

Upon examination, I found a raw, red, walnut-sized lump involving Sam’s central footpad. It was pretty clearly a tumor, although I did not know what type. Whatever it was, Sam would not walk on the foot as long as it remained there, so the tumor needed to be removed. Unfortunately, that would mean carving out two-thirds of his central footpad, and Sam would never walk on that foot again. Fortunately, there is an ingenious solution to this problem.

Since Sam does not need all his toe pads to walk, I could move one of his good toe pads into the defect left after the tumor was removed from the central pad. So I removed the tumor, removed the nail and distal two phalanges from toe number five, and then folded the associated toe pad into the hole I had made in the central pad. Voila, a new central footpad! The surgery went very well, and post-op the foot looked fabulous.

sam-u-healing-foot

We are now five bandage changes down the road, and Sam is doing great. His foot is healing steadily. Sam is now only mildly lame, and over the next week or so, this should resolve, too.
The tumor proved to be a malignant melanoma. The excision was complete (good news), but the tumor was a very aggressive one and it may still spread (the bad news).

But for now, our big galoot Sam is a star. He plows through the front door for each bandage change, with his tail wagging, his tongue flapping, and a huge smile on his face.

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