Dog - Lick Granuloma

What is a lick granuloma?

Also known as acral lick dermatitis, it usually starts with an area of hair loss and reddened skin due to licking usually in the region of the carpus (wrist) on the front legs or the hock (ankle) on the hind legs. Initially it looks like a reddened spot so-called ‘hot-spot’ eczema. Due to chewing and licking erosion occurs with a sharp demarcation between normal and affected skin. Once the area is ulcerated the condition becomes self-perpetuating and chronic. With healing the dog appears more attracted to the site and so more self trauma occurs.

Are any breeds more prone?

The condition occurs mainly in medium to large breeds, particularly Dobermanns, Great Danes, Labradors, Retrievers and Irish Setters. Any breed can be susceptible including mongrels.

What is the cause?

The cause is presently not fully understood. Psychological factors, e.g. stress or boredom may initiate the condition. Although it can occur on the hind limbs, the anterior (front) and lateral (side) aspects of the fore limbs are the most common sites. These are considered to be areas that the dog can constantly lick while lying in a normal position. The chronic nature of the condition is often associated with extensive bacterial infection. Aching joints due to arthritis is also considered to be a contributory cause.

How is it diagnosed?

The site and appearance of the lesion is a major guide to diagnosis. Skin biopsies are often taken if (a) there is no response to treatment and (b) to rule out other causes such as mange. If there is the possibility of arthritis in the underlying joint radiographs (x-rays) may be taken.

What is the treatment?

• Treatment is usually symptomatic. High doses of antibiotics for long periods, often months, is routine.
• Prevention of licking by the use of Elizabethan type collars or bandaging is also commonly employed.
• Steroids injected directly into the lesion sometimes bring about a good response.
• Behaviour therapy and ‘mood modifying’ medication can also be used. These drugs include sedatives and antidepressants. They are used off licence in stubborn cases of acral dermatitis, often with spectacular results.