very raw sore on front paw

Totally indoor cat with no environmental or food change for 11 years. No fever or other symptoms of a problem. Good appetite, very affectionate. Purrs even when in pain.
Cut lip 2 months ago on a cat food can.  It was bleeding but seems to heal okay.
Injured paw about 2 months ago (cut or gouge) I think from scratching a wicker chair.
This bled then seemed to heal okay.  About a month ago paw started bleeding again and became swollen.
1st vet visit an antibiotic shot to re-evaluate in 2 weeks.
Seemed to clear up in a week, then the sore on the paw reopened.  Noticed nose was scabby.
2nd visit vet different antibiotic (Keflex tablets) which was hard to administer so he may not have got the full dose and at my suggestion of fungal as well as bacterial infection started intraconazole.  Started soaking paw in saline solution once/day and applying vaseline.
3rd visit vet a second injection of 2 week antibiotic and sample taken of skin on paw and nose. Paw still very raw, nose may be a little better.  Still soaking in saline and applyin vaseline to nose and paw. Some involvement of other front paw seems to have cleared up

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

From your description, it sounds like your cat has sores on the nose and several toes. Potential causes include fungal skin infection (cryptococcus, sporotrichosis, less likely ringworm if the lesions are ulcerated), an unusual bacterial infection such as Actinomycosis, nocardia, or mycobacterial infection, an autoimmune disease such as pemphigus, or multifocal squamous cell carcinoma (a type of skin cancer). The partial/temporary improvement with antibiotics suggests a secondary staph bacterial infection is present, but the underlying cause needs to be found.  If the skin culture is not elucidating, then I recommend evaluation by a veterinary dermatologist for biopsies; there are several not too far from you:

Kathy C. Tater   Phone: [phone]  
Angell Memorial Animal Hospital - Boston  
Angell Dermatology Service  
350 S. Huntington Ave.  
Boston MA, 02130  Hours:Tuesday-Friday 7:30 am-5:00 pm
www.mspca.org/dermatology
    
Gene H. Nesbitt DVM, DACVD   Phone: [phone]  
VCA Northboro Animal Hospital  
286 West Main St.  
Northboro MA, 01532  Hours:By appointment

    
Laurie J. Stewart   Phone: [phone]  
Veterinary Dermatology of New England, Inc.  
25 Carlisle Road  
Westford MA, 01886  

Good luck,
Kimberly Coyner, DVM DACVD
Dermatology Clinic for Animals of Las Vegas
www.dermvetvegas.com