Working as a veterinarian for small animals for the past 20 years, I have gained much experience in several areas of my field, not the least of which is toenails. To my knowledge, there is not yet a board-certification for specialty in this area, but as new specialties are emerging on what seems like a daily basis in both the human and veterinary medical fields, I may be wrong.
Toenails fall under the jurisdiction of "dermatology" since they are essentially modifications of the skin, but they are much more than that, as far as I am concerned.
Sure, they are susceptible to infections, viral, bacterial or fungal. Poor nutrition can make them bizarrely deformed. They can become cancerous at the growth center or "nail bed." There can be more of them than are normal or necessary, like on our crazy multi-toed cats. But most annoyingly, they are commonly traumatized and bleed (a frequent subject of emergency calls) many of said traumas having been inflicted by the owner.
"Hello, Mrs. Jones, it's Dr. Daverio, how may I help you?"
"Oh, thank goodness - Buster's bleeding from his toenail and it just won't stop. I feel awful. I was just trying to trim them up a little ... is he going to be OK?"
"When did this happen?"
"I don't know, like 20 minutes ago. He's not going to bleed to death, is he?"
"Does he have a bleeding problem that you know of?"
"No, he was neutered last year - that went fine."
"Good, then he should be fine, but you still need to calm him down and try to stop the bleeding."
Typically, perfectly calm, logical thinking goes flying out the window when an animal is in distress - especially when there is blood involved. Those folks who normally would look at their kids' skinned knees, split chins or busted lips and calmly whip out the soap and water, ice, Neosporin and Band-Aids completely lose it when their animals are injured. Once we get through the initial panicking stage at the sight of blood, we can usually make progress on the treatment. So, how do you deal with such an emergency?
Basic human first aid also applies to most pet emergencies. Direct pressure to stop bleeding is the first thing to remember. A clot has a pretty tough time sticking around when your crazy Labrador is running around like a maniac. If you force him to sit still (I know, I know, he's a Labrador, but try) for two to five minutes while holding a paper towel firmly to the bleeding toenail, you'd be amazed at the results.
If you think the nail has gotten dirty and may be in danger of becoming infected, it's best to wash the foot with some soap and water and even try some hydrogen peroxide on the nail before even attempting to stop the bleeding. Those of us who have lived through Mercurochrome applications would attest that a little soap and water and hydrogen peroxide are for sissies; this shouldn't cause the dog any more distress. Unless it's a husky you're treating, then good luck (huskies typically being screamers, your neighbors may call the police, thinking you are torturing someone).
If direct pressure alone doesn't work, try pushing a pinch of flour into the part that's bleeding (after you've blotted the blood away). This can often help the blood clot faster. Don't keep wiping it to make sure! You might dislodge the clot that is trying to form.
Also, sometimes ice can help to constrict the blood flow to that area (not to mention elevating the limb and calming the dog down - blood pressure plays a big role here). If none of this works, you can fashion a bandage for the foot with something clean and dry (gauze from a first aid kit is best, but a paper towel will work) and some gauze tape or masking tape. Duct tape works great, but is very sticky. You will have a rough time removing it later. Translation: Please don't use duct tape to make a bandage! Make sure any bandage you apply is not too tight - if it causes swelling of the leg, it must be removed right away.
And, of course, if you can't accomplish any of this, or the bleeding just won't stop, you may need professional help. Don't be afraid to call your veterinarian. For those who do like to live dangerously and trim their dogs' toenails at home, but always seem to make them bleed, there are products available through pet supply stores and catalogs that work by cauterizing the small vessels in the nails and will stop bleeding from most toenails very quickly.
"How's it going? Did you get the bleeding stopped, Mrs. Jones?"
"Hold on ... Buster, come here - BUSTER! He won't let me look at it. I think he hates me now."
Yes, he probably does, but he'll get over it. His hatred will usually only transfer to the object of his pain: the dreaded nail trimmers. That is, unless the nail was cut too close by the unlucky groomer, technician or veterinarian. In that case, one of us will be the object of his loathing ... until the end of time.
No matter what a dog has been through in his life: a painful incident with a porcupine, a really poor decision to eat garbage, an unlucky encounter with the neighbor's cat - all pain, nausea, even fear is easily forgotten. In fact, many dogs are repeat offenders, sometimes being hospitalized multiple times for the same self-inflicted maladies. But a nail trim mishap will be engrained in the memory centers forever. And ever.
Yes, it is my theory that toenails are not just a dermatologic extension; they are linked directly to the longterm memory center of the dog. Now, how can I utilize this information to teach my dogs to do my bidding? A work in progress.
Daverio is a veterinarian at Williamsport West Veterinary Hospital.
Her column prints every other Sunday in the Lifestyle section. She can be reached at firstname.lastname@example.org.