Peripheral edema can be caused by allergies, immune, or heart issues.
Localized or single-limb edema may result from injury, such as from a car accident, burns, obstruction in an artery (due to a blood clot), contact with toxic agents, such as a snake bite or bee sting, abnormal tissue growth (known as neoplasia) in the lymphatic tissues of the body, or high pressure in the capillary fluids.
For a couple of days, when looking at Jasmine sleeping at night, I felt that her rear right leg didn’t look quite right. It seems somewhat chunkier than I believe it should. More staring didn’t bring more insight and I wasn’t sure whether I wasn’t just seeing ghosts. Until today.
Today she was lying in such a position that I could really compare the two legs well. The right one certainly did look thicker.
I decided I was not seeing ghosts and that there really appear to be some swelling. Nothing better to mess with my peace of mind.
Ok, so the leg seems kind of swollen. What is going on?
There didn’t seem to be any pain or associated lameness. Jasmine didn’t seem bothered by it, just me. There has been some licking of her rear right foot around the toes but I couldn’t see any discernible reason.
What I would have really liked to have done would be taking her to see her vet right that minute.
Unfortunately, that was not possible. Hubby teaching classes till late evening and no hubby means no transportation.
I needed to talk to somebody which expertise and somebody who was available right then.
I have to admit that the first place I turned to was justanswer.com. I’ve had a subscription there for quite a long time now and it works well for simple questions. So I posted my question there. The answer I got was fine but came nowhere close to easing my anguish. Sometimes you get the answer you need and sometimes you do not.
Turning to VetLive
I have used them in the past and the thoroughness of the answers and the investment in each of their cases is amazing.
The first thing to expect when you turn to VetLive is more questions. Questions are good. There are no answers without questions.
VetLive: What does the swelling feel like? Is it kind of squishy? When you press on it (holding pressure for about two seconds), does it immediately swell back out again? How long does it take to “fill out?”
- Is the swelling even up and down her leg, below the knee that is?
- Is her foot swollen?
- Is the color between her footpads normal? What color?
- Any lameness? Decreased energy? If so, estimate a percentage, please.
- When did you notice this? Has it gotten worse?
- Any other abnormalities–changes in urination, thirst, appetite, cough, etc.?
- What is Jasmine’s current drug regimen and has anything changed?
- I’ll probably think of other questions but this is a good starting point. Can you take pictures (several are better than one but one is better than none).
- Thanks in advance for your thought in answering these questions. Also, has her vet taken a look at the swelling yet?
Of course, that was when our camera refused to cooperate so I at least took a few shots with my phone. You know, those days when everything is bound to go wrong.
I answered the questions the best I could.
Jana: Actually, now, playing with it, it seems it is only from the hock down (hock area inclusive)
It doesn’t feel like much, doesn’t really feel like a swelling, not squishy. It doesn’t really feel differently from the other leg to me, just the leg looks thicker. It’s quite subtle, just the leg doesn’t look right and doesn’t look as “bony” as it typically would and as the other one does.
When I do push down on the area that seems the “thickest/flashiest” the indentation does come right back.
I thought it seemed pretty even overall, now, when staring at it, it seems a little more pronounced on the top of the metatarsus(?) and foot and underneath the hock.
The top of her foot, just before the toes is swollen.
The bottom of the foot appears normal.
There is no lameness observed on that leg (there has been some on the left rear leg due to the angry muscles/just did acupuncture for this Monday/the swelling was present prior the acupuncture treatment/I just wasn’t sure I wasn’t just making things up in my head)
Energy seems consistent with her normal level; just one thing I noticed she might not be as quick to come to greet hubby at the door as usually last couple days; otherwise ready to go on walks, ready to rumble … overall I’d say there is possibly a 5% decrease in energy but I wouldn’t bet my life on it
Appetite is also normal/very good.
I think I noticed this Sunday night but wasn’t sure what I was seeing. Definitely saw this on Monday. Doesn’t appear to have gotten worse, seems the same. The licking of the top of her foot had gone on for couple weeks but nothing we could find is a problem there so figured to wait for her next appointment with that. It is not severe licking, maybe 20 minutes a day total …?)
Urination and thirst are normal, appetite is normal, there was a temporary decline in stool quality for couple days, seems resolved and not unusual for her (not diarrhea, just not as well formed as it should and some traces of mucus, now also resolved)
No cough, had a lot of sneezing yesterday, none today and none to speak of before.
I can take pictures but have to wait for hubby to get them on the computer (complicated set up here); will be happy to send those once I have them available
- Gabapentin (for about a month her vet wanted that for those muscles; not doing anything, though)
A lot of supplements, do you want the full list of those? Nothing new was added in the past week.
I swear I checked that leg up and down, looked at the foot, toes, between them, didn’t see anything of note.
VetLive: My initial thoughts are that this is non-pitting edema based upon the information you provided but I do want to take a look at those pics as it may not be that severe.
I don’t want to provide inaccurate information so I will wait until we delve further. I take it you have given her leg and foot a very close examination to look for scabs, what could have been puncture wounds, bug bites, scratches, etc. If you haven’t look over the affected area as closely as possible.
I’ll be back with more thoughts (and maybe more questions too) after I can look at those pics.
Photographing the leg
After several failed attempts with the camera, I took a few photos with my phone at least.
VetLive: I got the pics and it does look mildly edematous, nothing too severe so that is good.
Do you have an appointment scheduled soon? I’ll wait until the clearer pics but if it does look edematous you will need to find the cause. I’ll help you out with possibilities and where I would start first.
Also, is the swollen area at the same temperature? I’m assuming it is or you would have noticed it but I don’t want to miss something. Just checking!
I suspect the bottom of her foot is normal because of the pressure that pushes the fluid up when she walks. The top part of the foot doesn’t really receive this effect so unless the edema is moderate or severe (and I would say her’s is indeed mild) the underside of the affected limb is usually unaffected.
One other question–can you say if the licking of the foot occurred before or after the puffiness? It is okay if you don’t know.
Unfortunately, I was still waiting for hubby to come home to see when we might be able to take Jasmine to see her vet.
Jana: Doesn’t feel warmer than the rest. I think the licking started before the puffiness, I’m fairly sure but not 100% whether the top of the foot might have had some swelling to it when it started; if so then the rest of the leg would have gotten puffy sometime later (that is what I can figure, of course, I could have missed it then as we were focused on foreign bodies, infections, wounds, etc …)
Not sure whether the swelling could have gone unnoticed by me, I would think not but, of course, it is possible.
How much do you think I should be freaking out?
I was freaking out plenty.
Still waiting for hubby to see when we can see the vet and get the stupid (it’s a great camera, really and I love it–but not today I did not) working.
VetLive: Not emergency situation so I don’t want you to be freaking out. I probably will recommend having her seen tomorrow or Friday if it’s possible. Edema can take a very long time to find the cause of. I really can’t think of a reason she should be seen immediately or be in danger by not being seen. Hang in there! Hopefully, I can be more confident in calling it edema or not after seeing the new pics.
It didn’t look like an emergency situation to me either but I was worried about something circulatory, lymphatic or neoplastic.
The good thing was that it didn’t seem to bother Jasmine, just me.
Jana: … this would be a good place to say this is not what cancer would look like
VetLive: It would be rare for it to have anything to do with neoplasia–very rare. There are some rare reports, but even then, they usually have a mass that you can see, feel, etc. With that said, it is still possible. Not trying to scare you, I just believe in full disclosure.
Circulatory, lymphatic, inflammation from an undetected scrape or bite is more likely. Most cases of edema resolve without us finding the cause–I don’t know if that makes you feel better or worse. It’s simply that most pet parents choose to “try the meds” first for financial reasons and then go through diagnostics if that doesn’t work.
There were several other things we discussed.
It kind of didn’t make sense to either of us that something systemic would affect a single leg. Also talked about the possibility of tick-borne disease, but Jasmine was tested not too long ago and everything was negative.
VetLive: I am glad she didn’t get lyme. One would think that systemic causes wouldn’t cause isolated edema but the body doesn’t always make sense to us.
Considering the whole picture, as in the whole realm of veterinary medicine, this is so mild right, it could even be possible that it would be very rare for most pet parents to detect it at this point. I would consider it possible that it the edema is showing up in this leg first, and I wouldn’t rule out that other body parts would follow. When symptoms or diseases are caught early, we know less about how they will progress. I certainly don’t mean to say that I think this is likely, I just think it is best to keep an open mind, especially in something as difficult to diagnose as edema.
Meanwhile, hubby came home. The first order of business was getting the camera to work and take some proper photos.
Taking more photos
The swelling looked more prominent when Jasmine was standing, which was previously unobserved, as there is normal movement involved also.
One of the photos revealed a red dot on the side of one of the toes.
Yet still couldn’t see anything with bare eyes.
VetLive: Well, the pics do justify a vet visit. After an exam, if your vet thinks an x-ray is warranted, I would do it–I would want to do it to rule out a bony infection that could be easily missed. Basic blood work may also be recommended and this is very reasonable.
I can’t see the bump you are talking about but our wireless Internet in our house went out due to storms tonight (Florida) so I am using 3G on my iPhone.
A red bump from a bug bite, puncture wound, etc. would be the most likely cause of edema. This would be awesome and I am encouraged. I would still definitely have her check out though.
Couldn’t help but keep trying to find the source of the little red dot on one of the photos. And that’s why we found it.
There is a bump on the inside of that toe; tucked away and very well hidden!
Is this thing behind the swelling? And what is it? A bite? Foreign body? How long has it really been there? Now, when looking at it, I cannot understand how we didn’t find it before!
Hubby can’t make it to the vet until Friday afternoon. Can this wait till then?
VetLive: That could certainly be the cause. I would have it aspirated at the vet to find out what it is. I wouldn’t skip that step. Based on the aspirate results, x-rays may/may not be warranted. Try and keep her from chewing it tonight.
If it does blow up, or scarier, loses sensation, changes in temperature, she can no longer walk on it, she really becomes painful…these are reasons not to wait until Friday.
So now we have a potential source but we still don’t have a cause.
I’ll be up all night watching whether the swelling or the bump gets worse. So far it seems the same.
We don’t really have any venomous spiders up here. There are some rattlers here but we have never seen one; they are extremely rare …
Thank you, VetLive, for always being there for me.
Waiting for veterinary appointment
Just when you think that you’re observant enough, that’s when you miss something …
The wait for Jasmine’s appointment felt endless. But the circumstances were such that it had to wait till Friday afternoon.
I did send the photos of Jasmine’s swelling and the lump found on the toe to her vet and we talked on Thursday morning. He reviewed it all and said that it looked like an interdigital cyst to him.
(Actually, an interdigital cyst is a common way to refer to this kind of bump, though technically incorrect. Generally, a cyst is a fluid/semi-fluid filled sac. An abscess, in comparison, is filled with pus. An abscess is formed when foreign organisms are attacking the tissues. What is referred to as interdigital cyst is really an interdigital furuncle, in other words, a boil.)
Either way, it was a relief to hear. This would not pose any immediate or future serious threat.
Interdigital cysts are quite common and we kept our fingers crossed that’s what it was. I did some research into the subject and there were a couple of things that worried me.
- I didn’t find any mention of associated swelling
- There seemed to be no evidence of pain or lameness (these are supposed to be painful and cause lameness)
Of course, this thing is pretty tiny compared with photos I found online, so perhaps that’s why the lack of evidence of pain. The swelling, though, kept worrying me.
No mention of a swelling resulting from interdigital cyst anywhere I could find, while mast cell tumors do have the ability to cause swelling. They don’t seem to look the same, but pretty darn close, particularly when you’re looking at something very tiny. All reference photos of either condition feature large lumps. And I still have to wait before we could find out.
VetLive: I have never seen edema caused by a cyst but if it is irritating her body enough then I can see the logic there.
I was a basket case.
I kept checking the lump, which seemed unchanging and staring at the swollen leg. The more I was staring at it, the more swollen it seemed …The lack of any other symptoms was somewhat comforting.
I did look up potential causes behind an interdigital cyst, several were possible. I was leaning toward either ingrown hairs or foreign body, or yeast infection. I did notice that Jasmine’s feet smelled kind of salty (for lack of better interpretation of what I was smelling)
I didn’t really feel that allergies would be behind this, I keep saying this all the time but it’s true–Jasmine is not an itchy dog.
I found that typical treatment would be Cephalexin (an antibiotic used to treat skin infections), along with topical treatments. That would be good, Jasmine was on Cephalexin in the past with no adverse effects.
I found out that the most useful diagnostic tests include skin scrapings (for mites), impression smears, or fine-needle aspirates to confirm the presence of an inflammatory infiltrate. Source: Merck Veterinary Manual I wanted to be sure we know exactly what we’re looking at.
I wasn’t certain whether we could do a needle aspirate on such a tiny thing, but I made a list of all the things I wanted to do to confirm anyway. I really do feel sorry for Jasmine’s vet.
Finally, we made it to the time of Jasmine’s vet appointment. The diagnosis is in: Jasmine indeed has an interdigital cyst, secondary to Malassezia infection (yeast).
So now I know what that salty smell means.
This was confirmed by physical examination and cytology results. We also sent some of it to the lab for further bacteriology.
All four feet are actually affected by the yeast infection, possibly some virulent strain than Jasmine had previously encountered. The vet was asking whether Jasmine met any new dogs; well, she didn’t meet them per se but there are a lot of new dogs in our complex now…The rest of Jasmine’s body is infection-free, the vet checks her inch by inch.
The treatment, as I suspected, is Cephalexin and antifungal shampoo.
So I guess I should be able to breathe again. Still obsessing about the swelling, though, so I hope it’ll go down sometime soon. Of course, it would go down faster with steroids but my gut tells me that is not a good idea. So unless things get worse, I’d rather stay away from that.
When I shared the results with VetLive, I realized that I really was not overly paranoid about the mast cell tumor at all.
VetLive: I am SO glad it’s not a mast cell tumor! She really has the worst luck so I was hoping it would not continue to this. Some of the sweetest patients have the worst health luck if there is such a thing.
I was paranoid alright. I even fasted Jasmine prior to the visit, just in case she needed any diagnostics or treatments that would need her fasted.I trust our vet 98%. But the remaining two are enough to drive me out of my mind in a case like this.
And the long wait only fed my worry. I figured that combining his expertise with the cytology results we can be reasonably sure that it indeed is the interdigital cyst. I was glad to get a confirmation.
VetLive: Mast cell tumors practically scream their names on a slide.So that ought to be enough even for my ever-worrying heart.
The swelling still bothers me, so hopefully, it’s not going to be there for much longer.
Jasmine’s birthday is coming up next Friday, I so hope she can enjoy it fully with nothing bothering her.
Jasmine’s interdigital cyst is just about healed. She always responded well to antibiotics, and it held true this time as well. So that’s the good news.
The bad news is that the swelling remains.
Apparently, the cyst was just a coincidence and the swelling is due to the yeast infection. We’re doing the medicated foot baths religiously, every two days. I also change all her sheets after every bath. Those have to be the cleanest sheets in the history of clean sheets.The salty smell is gone but the swelling is not.
It has temporarily improved after Jasmine’s underwater treadmill session on Saturday. She also got cold laser treatment on all her feet. But the next day it seemed to look about the same as at the beginning.
What would my life be if I didn’t have something to worry about?
Jasmine’s vet, though, isn’t surprised by this and says that he wouldn’t expect the swelling go down until Tuesday or Wednesday. We also made a follow-up appointment so he can check it out. With our planned trip to Jasmine’s ranch (we’re supposed to leave Thursday early morning), I would really like for this to be resolved before that.
So it all depends on whether the leg looks good by then and/or whether her vet clears her for the trip. I would hate to run into complications while virtually in the middle of nowhere and I’d prefer having a vet whom I trust on the case. So far we’re acting as if we’re going as planned.
Jasmine is already on a low-glycemic diet, just low starch veggies, and animal protein. I am wondering whether I should add some coconut oil or oregano. A bit of coconut oil shouldn’t hurt anything. I am somewhat worried about oregano because Jasmine doesn’t do all herbs equally well. One virtue that I am not very fond of – patience.
Oh Lord, give me patience, and give it to me now!
On second thought, never mind patience, give me healthy Jasmine. Thank you so much. Amen.
Swelling (Edema) in Dogs
Peripheral Swelling in Dogs