His 4 paws are puffy and spongy and the right front pad bleeds intermittently. The vet is leaning toward plasma cell pododermatitis and may want to do a biopsy. Can the diagnosis be made without a biopsy and start a treatment empirically? We installed new upgraded rugs in our home on Nov 30, 2015 and his first bleeding occurred on Dec 9. But my wife says she noted puffy paws (but no bleeding) at least a month before the new carpet went in. Incidentally we also found out in Dec he has creatinine of 3.3 and BUN of 52 so he has some kidney disease too. But he eats well and is very affectionate.