Focal metatarsal sinus tracts in a Weimaraner successfully managed with ciclosporin

Abstract

Focal metatarsal sinus tracts ('fistulation') are, to the authors knowledge, reported for the first time in a Weimaraner. The six-year-old, entire male had a five-month history of two symmetrical, well-demarcated sinuses on the plantar aspect of each metatarsus. The area surrounding each pair of sinuses was slightly fluctuant and a serosanguineous discharge could be expressed. Cytological examination of the discharge was characteristic of pyogranulomatous inflammation. Bacterial culture showed the material to be sterile. Examination of a skin biopsy revealed a severe inflammatory reaction involving the dermal collagen, with an infiltrate of neutrophils, macrophages, lymphocytes, plasma cells and multi-nucleated giant cells, with some micro-pustule formation. Treatment with ciclosporin induced total remission. Reduction of the dose of ciclosporin resulted in recurrence of the physical signs with further remission on re-introduction of the original dosage. This is the first report of the use of ciclosporin to control this condition.

Focal metatarsal fistulae syndrome affecting a greyhound dog successfully treated with topical 0.1% tacrolimus ointment

“…Our case was in complete remission after 6 weeks of treatment with topical tacrolimus applied twice daily for only 3 weeks, followed by once daily for 3 weeks. Topical 0.1% tacrolimus has also been used successfully in a German shepherd dog in which prior treatment modalities had resulted in relapse . Oral therapies reported for the treatment of metatarsal fistulae have included prednisolone at a dosage of 1 mg/kg/day and ciclosporin at a dosage of 5 mg/kg/day .…”

“…Topical 0.1% tacrolimus has also been used successfully in a German shepherd dog in which prior treatment modalities had resulted in relapse . Oral therapies reported for the treatment of metatarsal fistulae have included prednisolone at a dosage of 1 mg/kg/day and ciclosporin at a dosage of 5 mg/kg/day . Neither drug was effective for maintenance therapy at less frequent intervals of administration …”

“…Systemic treatment options for this syndrome may include the administration of ciclosporin orally at 5 mg/kg once daily and prednisolone orally at 1.1–2.2 mg/kg once daily . Topical application of 0.1% tacrolimus twice daily has been used to successfully manage recurrent cases .…”

Treatment of immune-mediated skin disease in the dog and cat

“…(Griffies et al, 2004). Ciclosporin has been used successfully for focal metatarsal tracts by one author (Oliveira et al, 2007).…”

First known case of canine focal metatarsal fistulation in a Shikoku dog

“…Subsequently, the surface necroses and fluid (consisting of blood or serous fluid) are excreted from the fistula. The cause of this disease is unknown, but the exudate obtained from the lesion is sterile 1–3 …”