Life-threatening Infection Resolves; All Is Good? Billy's Story (Part II)

by Dr. Jonathan Mitelman, DVM and Barbara Kelly  

Continued from Part 1

Story to this point: Billy, a large standard dachshund, had been left in the hands of Dr. Mitelman. The dog had a life threatening infection in his front right paw that required immediate intervention.

"I just don't believe it," Barbara said, shaking her head in disbelief, acknowledging the gravity of the situation.

The infection, or deep pyoderma, as Dr. Mitelman described it, was so severe that Billy required hospitalization on intravenous antibiotics. 

All of the hair had to go since layers of desiccated skin and dried pus needed to be cleared off.

Blood tests were taken to look for the spread of infection into the bloodstream. Radiographs of his leg were taken to look for penetration into deeper tissues.

Billy handled this process well. He seemed to enjoy the attention while the techs took care of the sore paw. He trotted around proudly sporting an intravenous line in one forelimb, the other forelimb shaved and his now ever-present Elizabethan collar.

Billy's leg improved. 


After two days in hospital, the inflammation settled, and what remained were patches of fur sprouts amidst a bed of dry and healing flesh. It was uncertain how much skin would be regenerated, and how much would remain scar tissue.

Billy could not hold back the intense drive to lick his still painful wound. 

Strong painkillers were prescribed to dull the pain from the irritated and upset nerve endings in his skin.

Billy was ready to go home.

Barbara: It was a rough two days while Billy was hospitalized, but the staff gave us constant updates and took our frequent phone calls. They welcomed his dad Malcolm's unannounced midnight visit.

Our trust in Billy's caregivers grew.

When Dr. Mitelman explained the daily cleaning regime and aggressive antibiotic treatment plan, we realized the level of commitment that was required. Billy needed daily rechecks at the clinic. We were up to the challenge.

We, in turn, presented Dr. Mitelman with a challenge. We were due to leave for a vacation at a cottage in less than two weeks. We wanted to take Billy with us. He assured us he would prepare Billy, and us, for our much needed holiday.

Dr. Mitelman: There was no shortage of commitment and dedicated care for Billy's convalescence by the family. Armed with medications and topical disinfectants and cleaners, the Kellys continued the uphill battle at home. Some of the shampoos were such effective antiseptics that human hands required latex glove protection to prevent the handler's skin from drying out.

Wet, lather, rinse, pat dry. Wait, Billy's trying to lick again, put the ecollar back on. 

Like a broken record, this protocol repeated two, even three times daily. And they always came for the daily at first, then every other day, rechecks.

Barbara: Days turned into weeks. We had a successful trip to the cottage. The staff fashioned a protective covering so Billy could walk on the beach.

Dr. Mitelman was always available for our never-ending questions and concerns. And we discovered a common coping mechanism for the stress of the situation: humour. Dr. Mitelman and our family had a similar, quirky, at times even dark, sense of humour.

Dr. Mitelman:  Through all of this the family proved their stamina. So much so, they succeeded in washing Billy's paws without soaking the kitchen floor. Sort of. Restraining a wiggly dachshund while wearing rubber latex gloves is quite similar to wrestling with a greased pig. Except without the squealing. But cue in the splashing and water saturated clothing.

Wise to this, in one iteration, Malcolm stripped down to his undergarments and held fast to Billy on the floor while Barbara leaned over, latex gloves and all, to scrub Billy's leg. It wasn't a scene Patrick, their teenaged son, wanted to stumble upon. He stood on the threshold to the kitchen and stammered with incredulity, "What are YOU doing"?

Malcolm tilted his head and smiled, "We are washing Billy, wanna help"?

Patrick, grumbling under his breath, retreated to the safety of his bedroom.

Barbara: Thankfully, by mid-September, Billy's paw was much better. Still some small draining pockets but, to our delight, some hair was growing back.

Then one day I noticed blood all over the kitchen floor. 

My heart sank. What had happened? To my surprise and relief, the blood was not coming from the injured paw.

Rather it was the left front paw that was bleeding. 

The relief part was short-lived.

An immediate call to Dr. Mitelman's cell phone. Arrangements were made to meet at the clinic. Again after hours.

Upon examination Dr. Mitelman found a large inter digital cyst on Billy's left front paw. 

We looked at each other in disbelief.

At that moment Dr. Mitelman and I both realized that Billy's skin problems were not limited to his sore right paw. 

Our journey had just begun ...

To be continued ...

Related articles:
When A Small Sore Turns Into A Catastrophe: Billy's Story (Part I)
Life-threatening Infection Resolves; All Is Good? Billy's Story (Part II)
What Is Going On With Billy's Skin? Billy's Story (Part III)
The Plot Thickens: Billy's Story (Part IV)
I've Never Seen That Before: Billy's Story (Part V)
Billy's Diagnosis Still Unknown: Billy's Story (Part VI)
Neuronal Ceroid Lipofuscinosis (NCL)? Billy's Story (Part VII)
Time To Make A New Plan: Billy's Story (Part VIII)
Atopic Dermatitis? Billy's Story (Part IX)
It Is Not Neuronal Ceroid Lipofuscinosis But What Is It Then? Billy's Story (Part X)
My Dog Has A Gut Of Steel, Doesn't He? Billy's Story (Part XI)
Feeling As Though Running Out Of Options: Billy's Story (Part XII) 
Fighting Fire With Fire Backfires: Billy's Story (Part XIII) 
A Second Endoscopy: Billy's Story (Part (XIV)
Staying The Course: Billy's Story (Part XV) 
Fewer And Fewer Solutions Left: Billy's Story (Part XVI)