Bone infection or cancer?

OK the pictures in this post are not for the faint of heart.  This is a case of a very sweet dog that had something go horribly wrong with one of her toes.  Her owner contacted us shortly before Christmas because her toenail looked infected.  In the two weeks from when her owner called and we saw her the toe had swollen to double it's normal size.  We started treating her for a bad infection and the toe continued to get worse. 

Our next step was to get some radiographs of her toe and chest (to check for metastasis of possible cancer) to see what was going on under the skin.  The radiograph pictured is of her affected foot looking down on it.  You can see the circular swelling of the affected toe.  Look closely at the other toes.  You can see what a normal toe looks like with three phalanyx and the nail visible.  Compare that with the affected toe and you can see the nail and part of that phalanx no longer exists.  You can also see a periosteal reaction (inflammation of the periosteum, the outer lining of the bone) seen as a white fuzzy outline around the bone of that toe.  On first glance this appears to be a cancer of the bone, but there is a good chance that this may just be a serious infection of the bone.  She could have stepped on something or chewed on her toe creating an open sore that was then susceptible to bacteria.    Since conservative treatment with antibiotics did not help we are now at a point where the toe needs to come off. 

We scheduled surgery and in the few days between the x-rays and the surgery she managed to chew a large hole in the side of her toe.  There was also evidence of gangrene starting to set in. 
In the picture you can see where her toenail would have been and now there is just a large hole.  The hole on the side of her toe is from her chewing on her foot.  Amazingly with a toe like this she remained very sweet and loving and allowed us to do whatever was necessary to help her.

Surgery was performed and the toe was sent out for a culture and for histopath.  We will see her for a bandage change on Monday and are still waiting on results of her tests.  She is on some heavy duty antibiotics and pain meds for now and is actually starting to put weight back on her foot (which is bandaged) again.  I'll let you know what we find.  Keep your fingers crossed and say some prayers for her that she is now on the road to recovery!