Dog paw lump

Hi everyone, My 3-year-old Pomsky has had a small bump between his toes (next to one of the small paw pads, not near the nail/claw) for about 1 month. I took him to the vet, and they examined it. They sent us home with antibiotics and then an anti-inflammatory (Rimadyl) and said if it doesn’t improve, they want me to come back next week to rule out something more serious, including possibly cancer. He has no limp, doesn’t seem to be in pain when I touch it, and still walks normally. The bump doesn’t seem to have changed much, although I’ve noticed some tiny red spots around it. The claw looks normal. He normally walks around 4 miles a day (split into multiple walks), but I’ve limited his walks over the last few days to see if reducing the friction helps. My follow-up appointment is in 1 week, and I’m honestly really worried. Based on the photos, what do you guys think? Does this look more like an interdigital cyst or inflammation, or does it look concerning for a tumor? Has anyone had something similar with their dog? Thank you—I really appreciate any opinions or experiences.

Hello and thankyou for this interesting question.  I am not currently a vet due to ill health, but do have a vet degree and a decades experience in small animal practise.  For me, lumps look alike; the devil is in the detail, in the content of the lump and the cell-types within it.  Most cancer is painless and most inflammatory lumps hurt to some extent; however, dogs are very good at hiding their pain; they can simply put the weight on another area of their pad (having four legs helps) and you can see from the overgrowth of keratin ( the pale, stiff fronds of dry skin growing on the sides of the pads) that weight-bearing on this foot is uneven.  For these reasons, I would take seriously your vets' offer to assess your dogs' pads in more detail.

Thank you so much for taking the time to reply. I really appreciate your help Today was his last anti-inflammatory pill, and I think the bump may have gone down by about 10%, although it’s hard to tell for sure. I’m also going to upload a photo from today of the same toe area on his other paw, because that side seems to have some uneven pressure and similar keratin buildup too. Thanks again and I hope you get well soon.

It looks and sounds to me as though the lump has reduced, but has not resolved by some margin; it sounds to be worth a follow up visit with your vet in order that they can fathom out what is causing it / what sort of cell the lump consists of.  Please will you let us know how you get on?

He has an appointment next Wednesday for a needle aspiration test, so hopefully that will give us a clearer answer. I’ll definitely keep you updated. I’m honestly just super worried and driving myself a little crazy thinking about all the possibilities. I really appreciate your help

I saw my vet. She said cancer is very unlikely and that there isn’t really a distinct lump to do a fine-needle aspiration because there’s “nothing to poke.” She prescribed Animax ointment. I’ve been using it for 4 days now and haven’t noticed any improvement yet. Do you think I should get a second opinion from another vet?

I don't usually recommend that.  It's pretty frustrating for vets when they are beginning to treat a case and work out over the first few visits what direction they think it's going in, then the client becomes frustrated and leaves.  More importantly your new vet might not have all this insight, so unless you took the history with you and had it in your hand in the consult  (which we'd always recommend by the way) the new vet wouldn't have the benefit of your old vets' working out.  So there is often a consultation or several wasted.  For me, the best second opinions come from an expert and your vet should suggest and organise that if it seems necessary- you could suggest it if you were concerned, particularly if things were no longer improving but things do appear to be improving right now. The frustrating thing is with paws is, that a lot of diseases can all look very similar to one another, and sampling (biopsy) in that area can be pretty messy so while we do it if there's an obvious need, the lump is much less obvious now and your vet sounds to be thinking 'inflammatory' and  treating the symptoms to see whether they can control them. Possible differentials may also include: (Cancer not ruled out - but 1 year old, responding to anti inflammatories, so perhaps looking much less likely at the moment?) Arthritis or joint pain - affects weight-bearing on feet, causes secondary damage.  Interesting treated by Rimadyl which is a pain killer as well as an antiinflammatory. Overgrown claws - doing the same Demodex mites - can cause stubborn lumps between the toes.  These can be scraped for if your vet is worried. Inflammation due to a skin problem / heat / yeast between the pads.  These tend to be chronic -  I e recurr throughout an animals life, so well with getting a handle on (Possibly some zinc related diseases, can be distinct to some particular breeds). If you ask your vet about differentials, they may have more. From the differentials list, vets try to rule the most serious ones out quickly, causing as little harm as they can. Plans change according to what your vet sees and what differentials (possibilities) are forefront in their mind. It may be worth sticking with them for now until things stop improving. Wishing you both all the best.