It starts innocently enough--your dog gets a small scratch or break in the skin, but then he starts licking the area and will not stop. Eventually, there is a huge, oozing wound that will not go away. The constant licking causes the skin to become thick and ulcerated, while the injury keeps getting bigger. These are the classic beginnings to an acral lick granuloma.
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What is an Acral Lick Granuloma?
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An acral lick granuloma (often just called a lick granuloma) is a raised area on the skin of a dog's leg that is raw and irritated due to excessive licking. Usually a granuloma starts when a small injury causes the dog to start licking. Once he starts, it becomes a compulsive habit--like nailbiting in people.
Granulomas usually only occur on the front or back legs of a dog. The skin of the granuloma is thickened, with bacteria, oil glands and broken hair follicles deeply embedded in the tissue.
What Causes Them?
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Veterinary dermatologists think that the number one cause of a lick granuloma is boredom. The dog is bored, so he starts licking his leg to pass the time. The behavior then becomes a habit, comforting to him, so he begins to do it with increasing frequency. Some dermatologists think that an underlying allergy creates itchy skin, which the dog tries to relieve by licking. They can also begin as a result of psychological upset--such as the addition of a new family member, loss of a companion or separation anxiety.
How Can They Be Healed?
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Unfortunately, these self-inflicted granulomas can be extremely difficult to treat. The obsessive aspect makes it hard to keep the dog from licking the wound. Even if you are able to accomplish that, often the dog will start licking again when the chance arises.
Treatment often starts by putting a restrictive bandage on the wound so the dog cannot lick it. You can also use an Elizabethan collar (otherwise know as a "satellite dish") to keep the dog from licking long enough for the skin to heal. Antibiotics, often 6 to 8 weeks worth or longer, kill bacteria and infection. Cortisone creams applied topically reduce the inflammation and itching.
If your dog has allergies, putting him on an anti-histamine can also reduce the urge to lick because of itchiness.
Why Can't They Just Stop Licking?
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Just curing the skin is seldom a long-term solution, though, especially if there is an underlying psychological issue. Before trying medication, increase the dog's activity level, change his environment and give him more mental stimulation
If all these prove to be unsuccessful, however, there are some drugs that can help.Anti-anxiety medication, such as Valium or Xanax, or anti-depressants, such as Elavil or Prozac, have been used with varying degrees of success. In severe cases, consultation with a behavioral specialist is recommended.
What Next?
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Lick granulomas can be incredibly frustrating. Working closely with your veterinarian can help figure out the best solution. Generally it will take trying several different things to find what works best for your dog.
In severe cases, surgery might be required to remove the irritated tissue. If that is the case, you need to keep a close eye on the dog to make sure he does not create another granuloma on top of the incision. When one granuloma heals, another can begin with any scratch or cut, so be diligent and take him to the vet at the first signs of persistent licking.
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