Dog Chewing Paw Pads

A dog persistently chewing or licking its paw pads is one of the most common presentations in small animal practice. While occasional grooming is normal, focused, repetitive chewing of the paw pads often signals an underlying medical or behavioural disorder. This pillar article provides a comprehensive, evidence-based review of the aetiology, diagnosis, and management of paw pad chewing in dogs, integrating guidelines from leading veterinary organisations.

Quick Q&A

Question: Why is my dog chewing its paw pads, and how can I stop it?

Answer: Paw pad chewing can stem from allergies, infections, pain, or behavioural issues like anxiety. A thorough veterinary examination is essential to identify the root cause; treatment may involve addressing the underlying allergy, managing infections, or implementing behaviour modification alongside environmental enrichment. Do not attempt home remedies without a professional diagnosis, as this can delay effective treatment.

Clinical Significance of Paw Pad Chewing

The paw pads (pulvini) are specialised structures composed of fibrofatty tissue covered by thick, keratinised epidermis. They provide shock absorption, traction, and insulation. Chronic chewing disrupts this protective barrier, leading to secondary bacterial or fungal infections, moisture-associated dermatitis (interdigital pododermatitis), and pain. In severe cases, the behaviour can progress to self-mutilation, requiring aggressive medical and behavioural intervention.

Differential Diagnoses: Medical Causes

1. Allergic Skin Disease

Allergies represent the most common medical cause of paw pad chewing. Canine atopic dermatitis (CAD), food allergy, and contact allergy all frequently manifest with pedal pruritus.

• Canine Atopic Dermatitis: Affects approximately 10-15% of the canine population. Pruritus localised to the paws, face, and ventrum is classic. According to the AAHA Dermatology Guidelines, diagnosis involves ruling out other causes and may include intradermal or serologic allergy testing.
• Food Allergy: Cutaneous adverse food reactions account for 10-20% of allergic skin disease. Paw chewing may be the sole sign. A strict 8-week elimination diet with a novel or hydrolysed protein source is the gold standard for diagnosis.
• Contact Allergy: Less common, but exposure to lawn chemicals, de-icing salts, or certain flooring materials can cause localised irritation and chewing.

2. Infectious Pododermatitis

• Bacterial: Staphylococcus pseudintermedius is the most common isolate. Moisture and maceration from constant licking create an ideal environment for bacterial overgrowth. Deep pyoderma may involve the interdigital spaces.
• Malassezia Dermatitis: Yeast overgrowth, often secondary to allergies, produces a characteristic rancid odour and greasy exudate. Cytology reveals budding yeasts.
• Parasitic: Demodicosis (Demodex canis or Demodex injai) can localise to the paws, causing alopecia, erythema, and chewing. Skin scrapings are diagnostic.

3. Pain and Orthopaedic Conditions

Dogs may chew a specific paw pad if they experience localised pain. Causes include:

• Foreign bodies: Grass awns, thorns, or splinters lodged between pads.
• Interdigital cysts: Sterile or infected furuncles.
• Arthritis or joint pain: Dogs with hip or stifle osteoarthritis may chew a front paw as a compensatory behaviour.
• Nail bed infections (paronychia) or broken claws.

4. Metabolic and Endocrine Disorders

• Hypothyroidism: Can cause secondary seborrhoea and recurrent pyoderma, leading to paw chewing.
• Hyperadrenocorticism (Cushing's disease): Immunosuppression predisposes to skin infections.

5. Environmental and Traumatic Causes

• Burns: Contact with hot pavement (common in Australian summers), chemical burns, or frostbite (in colder North American or European climates).
• Interdigital foreign bodies: Grass seeds (e.g., Hordeum species) are a particular problem in the UK, Europe, and Australia. They migrate into the interdigital space and cause intense irritation.

Behavioural Causes (Primary or Secondary)

When medical causes are ruled out or inadequately treated, behavioural factors may be primary or contributory.

Compulsive Disorder

Canine compulsive disorder (CCD) involves repetitive, ritualistic behaviours that interfere with normal function. Paw pad chewing can be a manifestation. Breeds predisposed to CCD include Doberman Pinschers (flank sucking) and Bull Terriers (tail chasing), but any breed can develop compulsive licking.

Anxiety and Stress

• Separation anxiety: Dogs may engage in excessive grooming or chewing when left alone.
• Generalised anxiety: Chronic stress from environmental changes, noise phobias, or social conflict.
• Boredom or under-stimulation: Insufficient physical or mental enrichment can lead to self-directed oral behaviours.

Attention-Seeking Behaviour

If a dog learns that chewing its paws elicits owner attention (even negative attention like scolding), the behaviour may be reinforced.

Diagnostic Approach

A systematic workup is essential. The AVMA recommends a stepwise approach.

History and Signalment

• Age of onset (young dogs: atopy, food allergy; older dogs: endocrinopathies, neoplasia).
• Breed predispositions (e.g., West Highland White Terriers for atopy, Labrador Retrievers for food allergy).
• Seasonal vs. non-seasonal pattern.
• Response to previous treatments (e.g., steroids, antibiotics, diet trials).
• Environmental exposures (new carpet, lawn treatments, recent walks on salted roads).

Physical and Orthopaedic Examination

• Palpate each paw for swelling, heat, pain, or foreign bodies.
• Examine interdigital spaces, nail beds, and pads.
• Assess gait and joint range of motion.

Dermatologic Diagnostics

• Cytology: Tape strip or impression smear from the affected area. Look for bacteria, yeast, and inflammatory cells.
• Skin scrapings: For Demodex mites.
• Fungal culture: If dermatophytosis is suspected (less common on pads).
• Allergy testing: Intradermal or serologic (IgE) testing after ruling out other causes.

Advanced Diagnostics

• Biopsy: For chronic, non-healing lesions or suspected neoplasia (e.g., digital squamous cell carcinoma).
• Radiography or CT: If foreign body or osteomyelitis is suspected.
• Endocrine testing: Thyroid panel (T4, TSH) or ACTH stimulation test.

Treatment and Management

Treatment must target the specific aetiology. A multimodal approach is often required.

Medical Management

Allergies

• Atopic dermatitis: Allergen-specific immunotherapy (ASIT) is the preferred long-term treatment. Antihistamines and essential fatty acids provide adjunctive relief. The EMA and EFSA have published guidelines on veterinary medicinal products for allergic disease.
• Food allergy: Strict dietary elimination and provocation.
• Contact allergy: Avoidance of the offending agent. Barrier protection (dog boots) can be helpful.

Infections

• Bacterial: Systemic antibiotics based on culture and sensitivity (e.g., cephalexin, clindamycin). Topical chlorhexidine or miconazole washes.
• Malassezia: Systemic antifungals (ketoconazole, fluconazole, or itraconazole) combined with topical therapy.
• Demodicosis: Isoxazoline class drugs (afoxolaner, fluralaner, sarolaner) are highly effective.

Pain Management

• NSAIDs (carprofen, meloxicam) for inflammatory pain.
• Analgesics (gabapentin, amantadine) for neuropathic pain.
• Surgical removal of foreign bodies or interdigital cysts.

Behavioural Management

Environmental Enrichment

• Increase physical exercise and mental stimulation (puzzle toys, nose work, training sessions).
• Provide appropriate chew toys to redirect oral behaviour.

Behaviour Modification

• Desensitisation and counterconditioning: For anxiety triggers.
• Differential reinforcement of alternative behaviour (DRA): Reward the dog for not chewing.
• Management: Use of an Elizabethan collar (e-collar) or soft cone to prevent chewing during the initial treatment phase.

Pharmacotherapy

• For compulsive disorders: Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine or sertraline.
• For anxiety: Clomipramine (a tricyclic antidepressant) is licensed for separation anxiety in dogs in many regions.
• Always combine pharmacotherapy with behaviour modification. The AVA recommends a referral to a veterinary behaviourist for complex cases.

Physical Barriers and Wound Care

• E-collars: Prevent self-trauma but should not be used as a sole treatment.
• Dog boots: Protect pads from environmental irritants and prevent direct access.
• Topical therapy: Silver sulfadiazine cream or medical-grade honey for superficial lesions. Avoid human topical corticosteroids without veterinary guidance.

Regional Considerations

North America (US and Canada)

• Lyme disease (caused by Borrelia burgdorferi) can cause polyarthritis and lameness, leading to paw chewing. Tick prevention is critical.
• De-icing salts are a common contact irritant in winter. Rinse paws after walks.
• The CVMA and CFIA provide guidelines on zoonotic skin diseases and antibiotic stewardship.

Europe

• Leishmaniasis (endemic in Mediterranean regions) can cause exfoliative dermatitis and pododermatitis.
• Grass seeds (e.g., Hordeum murinum) are a major cause of interdigital foreign bodies in the UK and continental Europe.
• The FVE and EMA emphasise prudent use of antimicrobials to combat resistance.

Australia

• Paralysis ticks (Ixodes holocyclus) can cause ascending paralysis and secondary paw chewing due to discomfort.
• Burns from hot surfaces are common in summer. The AVA advises walking dogs during cooler hours.
• Brown snake venom can cause localised swelling and pain, leading to paw chewing.

Prognosis and Prevention

The prognosis depends on the underlying cause. Allergic dogs often require lifelong management but can achieve good quality of life. Behavioural cases with early intervention have a favourable prognosis. Chronic, untreated cases may develop permanent fibrotic changes in the paw pads.

Preventive measures include:

• Regular paw inspection after walks.
• Routine parasite control (fleas, ticks, mites).
• Balanced diet and appropriate supplementation (omega-3 fatty acids).
• Adequate mental and physical stimulation.
• Prompt veterinary attention for any sign of lameness or excessive licking.

When to Refer

Referral to a veterinary dermatologist or behaviourist is indicated when:

• The condition does not respond to standard therapy after 4-6 weeks.
• Deep pyoderma or osteomyelitis is suspected.
• The dog requires advanced allergy testing or immunotherapy.
• The behaviour is severe, refractory, or associated with self-mutilation.

Summary

Dog chewing paw pads is a multifactorial problem that sits at the intersection of dermatology, orthopaedics, and behaviour. A thorough diagnostic workup is essential to differentiate between medical and behavioural causes. Treatment should be multimodal, targeting the specific aetiology while addressing secondary infections and providing environmental enrichment. Collaboration between the general practitioner, veterinary dermatologist, and behaviourist offers the best outcome for the patient. Owners should be educated about the importance of early intervention and the potential for chronicity.

References

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