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Do NOT Ignore Your Dog’s Obsessive Licking. It Could Be Acral Lick Dermatitis

What is acral lick dermatitis?

Acral lick dermatitis, or “lick granuloma” is a self-induced skin condition occasionally seen in dogs. The dog continually licks one area of leg producing a raised, red, hairless, oval sore. It is firm raised, ulcerative or thickened that is usually located on the dorsal aspect of the dog’s leg. The name for this condition stems from its location (acral meaning on the extremities or legs) and it’s caused by licking. Affected dogs usually lick at one chosen spot on one leg. They may spend hours engaged in this activity every day.

What causes lick granulomas?

pawsAcral lick dermatitis is considered a psychogenic disease that is caused by a behavioural disorder. There are many factors that may contribute to the development of a lick granuloma. Almost always, the condition is self-perpetuating. Once the dog creates the wound, it is a continual source of irritation and stimulates further licking. The licking can become enough of a habit that it continues even when the “underlying” cause is resolved. Some of the factors that may contribute to lick granulomas include:

  • Itching: An itchy skin condition such as allergy may initiate the lick granuloma
  • Pain: The dog may lick the skin over a painful joint or bone.
  • Boredom: Energetic dogs that are left alone for much of the day may focus their attention on excessively licking a limb.
  • Stress: The continual licking may help a nervous dog relieve their anxiety.
  • Obsessive-compulsive disorder: The behaviour that creates a lick granuloma shares some features with human obsessive compulsive disorders.

How are lick granulomas diagnosed?

Several other skin conditions may appear similar to acral lick dermatitis. We make the diagnosis by taking history from the pet’s owner, examining the skin, and by finding out how much licking behaviour is noted at home. We sometimes recommend a skin biopsy or other procedures to make sure that we are not dealing with a similar appearing skin condition that would be treated quite differently. A specimen may be sent to a laboratory so we can find out what kind of bacteria is present in the granuloma.

While making the diagnosis is rarely difficult, finding out what has caused the granuloma can be a challenge, especially when it has been going on for a long time. Our investigation includes an assessment of the dog’s temperament, personality, daily activities and concurrent skin conditions.

How are lick granulomas treated?

Acral lick dermatitis can be challenging to treat. Therefore, the first step is evaluating a dog to rule out other contributory medical and skin conditions. Often the visible skin lesion is the only surface of the problem and the root cause is psychological or behavioural. Many different treatments are used for lick granulomas. Unfortunately, any treatment that is extremely effective for one patient may fail for the next; there is no miracle cure available. Sometimes a dog may receive several different treatments before one to work very effectively. Some of the treatments that are used for lick granulomas include:

  • Antibiotics: Both antibiotic pills and ointments are used to treat lick granulomas based on bacterial culture and sensitivity. There is usually an infection within the granuloma that contributes to the continued irritation. Antibiotics do not address the underlying cause for the granuloma’s development, but in some cases no other therapy is needed.
  • Anti-inflammatory medications: We may use either oral, topical or injectable anti-inflammatory medications to reduce the irritation from the granuloma.
  • Other topical therapies: We may prescribe a bitter spray to deter licking or a cream to numb the skin.
  • Electronic bandages that produce a very tingling sensation when licked.
  • Physical barriers: Bandages and plastic Elizabethan collars may effectively prevent the dog’s access to the granuloma, but are not usually suitable for long-term use.
  • Behavioural modifications in dogs whose lick granulomas seem to result from the psychological factors listed above, we may recommend :
  • Spending more time actively and walking with your dog
  • Avoiding confinement in kennels or crates
  • Obtaining a companion for your dog
  • Behavioural training
  • Psychological drug therapy, either short-term or lifelong medications to reduce anxiety, stress and obsessive-compulsive tendencies.
  • Surgery: laser or radiosurgery to remove the infected tissue and seal off nerve endings may speed the resolution of the lick granuloma. Unfortunately, the facility is not available in our country.
    Because each dog is unique, different combinations of therapy may be recommended for your pet. With some time and effort, lick granulomas can be controlled in most dogs.

Routine Follow-up

  • Monitor level of licking and chewing closely.
  • Because determining the best treatment requires trial and error, several visits may be necessary to determine the optimal combination of treatments.

Dr Sharad Singh Yadav is the Chairman of Advanced Pet Hospital & Research Centre which is open 24 hours throughout the year and located in Bishal Nagar, Kathmandu. He may be contacted on tel: 4422855 or email: aphktm@gmail.com