Lick Granuloma in Dogs

By Ernest Ward, DVM

Medical Conditions, Surgical Conditions

December 11, 2008

What is a lick granuloma?

Also known as acral lick dermatitis, this problem begins as an area of hair loss and reddened skin most commonly on the top of the wrist or carpal joint on the front legs. It often looks like a "hot spot." These differ from "hot spots" in that they persist despite treatment. They are often associated with chronic, persistent licking, especially when the pet is alone or when the family is sleeping.

Is there any breed disposition?

lick_granuloma-1_2009The condition occurs mainly in medium to large breeds, particularly Dobermans, Great Danes, Labrador Retrievers, Golden Retrievers and Irish Setters. However, it is important to remember that any breed may develop acral lick dermatitis.

What is the cause?

The exact cause of acral lick dermatitis is unknown.

"In some cases, the licking may start because of a minor irritant such as an insect sting. Psychological factors such as stress or boredom may also initiate the condition."

In some cases, the licking may start because of a minor irritant such as an insect sting. Psychological factors such as stress or boredom may also initiate the condition. It should be noted that although it can occur on the hind limbs, the anterior and lateral aspects (top and outside surfaces) of the forelimbs are most commonly affected. These are areas that the dog can constantly lick while lying in a normal position. In chronic cases, bacteria will often invade the area, leading to a secondary deep pyoderma or infection. It is important to distinguish between psychological and physiological causes in order to provide the proper treatment. Most dogs require treatment aimed at the inflammation, infection and psychological components for resolution.

How is it diagnosed?

The location and appearance of the lesion is a major guide to diagnosis. Your veterinarian may recommend radiographs of the underlying joint to determine if arthritis is present. Skin biopsies may be necessary there is no response to treatment, or to rule out other causes such as mange or tumor.

What is the treatment?

The treatment will vary depending on your pet's condition. Long-term antibiotics, topical and oral anti-inflammatory medications, low-wattage laser therapy and psychoactive medications are some of the more common treatments for acral lick dermatitis. Omega-3 fatty acid supplements have also been recommended. Most pets will benefit from increased aerobic activity and decreased caloric intake. Since the root cause is often related to anxiety or boredom, increasing interaction and stimulation are often strongly recommended. While the condition can be frustrating to get under control, most cases of acral lick granuloma can be successfully treated if the owner is willing to pursue extended tests and treatments.

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