Heavy Breathing with Deep Skin Infection

[Gladallover]

My Dog (pyrenean moutain dog) is being treated with antibiotics for a deep skin infection under her front leg. The infection is very slowly starting to look a nicer colour but it is still very sore and is weeping and bleeding after 2 weeks of treatment. This evening she has started breathing very heavily and panting. We phoned our vet who asked us to check the colour of her gums, feel if her paws were warm and count her heartbeat - all of which she said was ok. She thought it the panting was due to stress and pain but 3 hours later it is still very bad.
The dog has gone to sit in the garden in the cold and is panting and dribbling. I am worried that the infection could be effecting her lungs. Is that possible? Can pain cause such heavy breathing and is there anything we can do to help her tonight?  
We are going to ring the vet first thing in the morning but I am so worried about her sat out in the cold, i just don't know what to do.
Thank you

[Kimberly Coyner, D.V.M., DACVD]

Stress or pain can certainly cause panting, but I would not expect a skin infection to cause these symptoms unless the infection has spread internally, which would be unusual. If there is any swelling of her belly, if she seems weak, if her gums become pale, or if her heartrate consistently increases over 120 beats/min, then I would recommend calling an emergency veterinary clinic and getting her seen tonight, if that is possible. Unfortunately, there is nothing that we can recommend doing at home other than trying to keep her calm, make sure she stays hydrated and getting her seen ASAP.
Good luck,
Kimberly Coyner, DVM DACVD

[Gladallover]

Thank you both for your replies.
Today there is some good news. She seems much better, the panting has calmed down a lot and she is much more alert. She is drinking but still not eating much.
The lump on the infection has shrunk overnight but it is still very bloody. The vet was concerned that the skin may split but we can't see any sign of that when we wash it off.
We picked up some more pain killers and antibiotics today and the vet told us to take it one day at a time and see how it goes.
She is quite wobbly on her legs and has been lied down all day, i'm hoping this is because of the sedatives but we will have to wait and see.
Thanks again for your help :)

[Justine Lee, D.V.M., DACVECC]

Were chest x-rays done? This is really important, especially in a more geriatric dog! The antibiotics shouldn't cause panting at all, and again, the wound should respond really well to antibiotics. If it doesn't start responding, I'd recommend potentially getting the wound re-cultured or even biopsied!

Good luck!

[Kimberly Coyner, D.V.M., DACVD]

After 2 weeks of antibiotics, there should be some sign of improvement, and if her condition is not getting better then further diagnostics such as biopsies of the affected area for pathology and tissue cultures (aerobic and anaerobic) would be recommended. She may have a resistant or unusual bacterial infection, or the dermatitis may be due to other causes such as deep fungal infection or less likely a tumor such as inflammatory mammary carcinoma.
Good luck,
Kimberly Coyner, DVM DACVD

[Gladallover]

Thank you for your reply.
The emergency vet came out and saw her this morning and gave her some sedatives which has calmed her down a lot but she is still breathing heavily.
The vet listened to her heart and lungs and said they sound fine so she thinks the panting is a symptom of the pain of her skin infection.
She has prescribed some calming medication to give her this evening and told us to carry on her antibiotics.
She also suggested we admit her into the clinic so the nurses can dress her wound and give her injections as she needs them, but we are undecided on that because we don't want her to be over-stressed and she has never been away from home.
Our original vet did tell us that it will take weeks for the antibiotics to work but it's been 2 weeks with no definate signs of improvement. Do you know if that is typical of a deep skin infection?