What is a lick granuloma?
A lick granuloma, also known as acral lick dermatitis, occurs when a dog obsessively licks at an area, often on a lower limb, most commonly the wrist or carpal joint of the front limb. These dogs find a spot to lick and start a cycle of self-trauma, inflammation, and infection. This condition is thought to be both physical and psychological in nature.
"This condition is thought to be both physical and psychological in nature."
Is there any breed disposition?
The condition occurs mainly in medium to large breeds, particularly Doberman Pinschers, Great Danes, Labrador Retrievers, Weimaraners, Golden Retrievers, and Boxers. However, any breed may develop acral lick dermatitis.
What is the cause?
The exact cause of acral lick dermatitis is unknown. However, it is believed to be caused by multiple factors that are both physical (e.g., allergies, infection, joint pain) and psychological (e.g., fear, anxiety, compulsive disorder). In some cases, the licking may start because of a minor irritant such as an insect sting. Although it can occur on the hind limbs, the top and outside surfaces of the forelimbs (front legs) are most commonly affected. These are areas that the dog can constantly lick while lying in a normal position.
How is it diagnosed?
The location and appearance of the lesion are a major guide to diagnosis. Your veterinarian may recommend radiographs (X-rays) of the underlying joint to determine if arthritis is present. Your veterinarian may recommend skin tests to look for bacteria, yeast, or other fungal diseases. Skin biopsies may be necessary if there is no response to treatment or to rule out other causes such as mange or a tumor.
It is important to consider both psychological and physical causes in order to provide the best treatment.
What is the treatment?
The treatment will vary depending on your pet's condition. Identifying the underlying cause is important in determining the best course of treatment. Most dogs require treatment aimed at the inflammation, infection, and psychological components for resolution.
Topical and oral anti-inflammatory medications, such as corticosteroids, are helpful in reducing inflammation. Antibiotics are often required to treat secondary skin infections. Therapeutic laser and acupuncture have also been used successfully for this condition. Protective devices used to prevent self-trauma, such as e-collars, bandages, or shirts may be recommended in the initial stages of the disease while the medication is starting to relieve the itch.
Behavior modification and psychopharmacologic medications may be needed to manage anxiety and compulsive behavior disorders. Addressing any underlying anxiety by providing the dog with more pleasant interaction and stimulation as well as eliminating anxiety triggers is often strongly recommended.
These lesions can often be chronic, relapsing problems that require long-term therapy. While the condition can be frustrating to get under control, most cases of an acral lick granuloma can be successfully treated if the owner is willing to pursue extended tests and treatments.
"...most cases of an acral lick granuloma can be successfully treated if the owner is willing to pursue extended tests and treatments."