Lately I have been receiving a rash of enquiries from owners of dogs with toenail problems. It makes sense — spring is arriving in the Northern Hemisphere, and days that are warmer and longer mean dogs are getting more activity. Nail injuries, it turns out, are among the most common injuries that occur in otherwise healthy, active dogs.
The most common type of nail injury occurs when a dog’s nail catches on something. That something may be carpet, vegetation, a small crevice in a rocky surface, or a feature of an uneven surface. If the nail gets caught and the dog’s momentum keeps the foot moving, the nail may be pulled entirely or partially from the foot. A dog is most likely to have sufficient momentum for such an injury when he is running. Therefore, most nail injuries occur outside during vigorous activity.
Dogs’ nails, roughly speaking, consist of a core and a shell. The core, also known as the quick, is alive and contains nerves, blood supply, and so-called germ cells that produce the shell. The shell, also known as the cornified portion of the nail, is not alive — it consists of a hard protein called keratin. Most canine nail injuries involve the shell being torn partially or completely from the quick.
As I mentioned, the quick contains nerves. Significant discomfort generally occurs when it is exposed. Dogs with nail injuries frequently limp. They may lick the affected area, and they generally guard the injured digit carefully and resent any attempts to touch or handle it. Injured nails often bleed. The affected nail often will point at an abnormal angle.
Because of the pain caused by nail injuries as well as the potential for complications such as infection if the injury isn’t treated, I recommend that dogs with injured nails be seen by a vet.
The treatment for an injured nail depends upon the nature and extent of the injury. Some injuries result in complete removal of the hard portion of the nail from the quick. Such injuries, in my experience, are painful but have a relatively low risk of leading to infection. I generally treat them by cleaning the affected area gently and then placing a bandage to control bleeding and pain for a day or two. A prescription for pain killers is a must, but in my experience antibiotics are not necessary in most cases.
Often, the shell of the nail does not come completely off during the initial injury. Such injuries are the most common in my experience, and they result in a nail that appears to be distorted or pointing in the wrong direction. These nail injuries are quite painful — any contact with the hard portion of the nail results in stimulation of the nerves in the quick. I generally treat these injuries by infusing the affected digit with local anesthesia. Once the toe is numb, I remove the hard portion of the nail. The area subsequently is cleaned gently and bandaged in the same manner that would be appropriate for an injury in which the nail had been completely removed at the start.
Sometimes the hard portion of the nail comes partially off the quick, but remains too firmly attached for removal with local anesthesia. Treatment of such injuries is more complicated and controversial. Some vets I know recommend general anesthesia so that the hard portion of the nail can be filleted off the quick. I generally do not recommend moving immediately to such significant measures. Instead, I generally recommend antibiotics (in my experience this type of injury is the most likely to lead to infection), pain killers, and bandaging. Many times the nail reattaches. If it does not, it often becomes loose enough for easy removal after several days.
People often ask me how to prevent nail injuries in their dogs. Short of forcing your dog to live in a spherical room made out of something smooth, nothing is guaranteed to prevent nail injuries 100 percent of the time. It is important to understand that nail injuries may occur as a result of a dog leading a fun, active life.
In my experience, overgrown nails are a major risk factor for nail injuries. Therefore, regular nail trims are an effective and recommended means of prevention. It also helps to avoid heavy activity on high risk surfaces such as long carpet or uneven rocky ground.
Doggie shoes are available. These shoes, which cover the feet, are purported to protect the feet from cuts, scrapes, and injured nails. In my experience, these devices may interfere with a dog’s ability to sense and grip the ground as he walks. I therefore worry that they may predispose dogs to other injuries such as strains, torn ligaments, and broken bones. I do not recommend them for routine use for nail injury prevention.
Some unfortunate dogs suffer nail injuries as a result of underlying illnesses that weaken the nail or compromise the quick. Autoimmune issues, chronic infections, congenital problems, and certain nutritional deficiencies may contribute to frequent broken nails in these individuals. The key to helping these dogs is treating the underlying condition, if possible.
Finally, dog owners should be aware that tumors that sometimes develop on digits may compromise individual nails. Dogs with such tumors often require amputation of the affected digit.
The last two paragraphs present another reason why dogs with nail injuries should see the vet. A good vet should be able to determine whether the nail simply got snagged on something or whether a more serious issue might be involved.
Got a question for Dr. Barchas? Ask our vet in the comments below and you might be featured in an upcoming column. (Note that if you have an emergency situation, please see your own vet immediately!)