Adrienne is a certified dog trainer and former veterinarian assistant who partners with some of the best veterinarians worldwide.
What are Acral Lick Granulomas in Dogs?
If your dog has an acral lick granuloma, most likely you'll be aware of it. The lesions derived from the constant licking may look quite graphic, and the first impression to those not familiar with this type of lesion may be of a severe wound. Those familiar with this type of lesion instead know for a fact what a dermatological nightmare this condition can be. Many have been dealing with these lesions for months, some even for years. But what is exactly an acral lick granuloma, and what causes it?
An acral lick granuloma is a skin disorder in dogs. The term acral, simply means affecting a limb or other extremity, a perfect term as the dog's lower portions of legs and tail area are the most affected. In particular the carpal area (the wrist) is the most common area targeted.
The term lick derives from the fact that the dog has a tendency to want to lick the area over and over. You can't blame him though; when dogs lick, endorphins are released and this makes the dog feel good; therefore, the licking behavior soon becomes addictive, making the dog want to lick the area over and over, with the end result of never giving the wound a chance to heal.
The term granuloma is used to depict an inflammatory state that causes an unsightly fleshy pink mass. The area may appear swollen, raw, red, irritated and oozy similar to a dog's hot spot. The skin may also thicken. Additionally, the dog's saliva may cause unsightly staining on the fur.
What Causes Acral Lick Granuloma in Dogs?
So what causes an acral lick granuloma? There may be several causes. Mature, older dogs seem more commonly affected. A while back it was thought to be mainly stemming from a behavioral issue, possibly triggered by boredom, a compulsive disorder, anxiety and stress. However, more possible causes have been identified as contributing factors such as underlying medical disorders. Skin allergies, a bacterial or fungal infection, joint problems or a foreign body embedded in the skin may be underlying causes. In some cases. hypothyroidism was a factor as well.
Here is where things get challenging, as often treatment is not easy. Indeed, dermatologists recognize that this is one of the most arduous skin problems to treat successfully in dogs. Identifying the culprit is often a good starting point. Vets often though need to run a vast battery of tests and this can turn out being financially challenging.
Management goes a long way in preventing the dog from aggravating the wound. Thismeans reducing the chances for licking. A no-bite collar such as an Elizabethan collar is often helpful for when the dog cannot be supervised during the day. Other options are no-bite collars if you are looking for a more comfy option.
To deter the dog from licking, Bitter Apple Spray or Bitter Yuck, may be helpful in some cases. However, some dogs will care less about these bitter flavors and will continue to lick.
Going to the Root of the Problem
If an underlying cause is found, it must be taken care of in order to resolve the issue. If there is a thorn or a grass awn embedded it should be removed. Joint problems, arthritic conditions allergies and thyroid problems should be addressed accordingly. Removing stress from the dog's life, providing interactive toys and preventing boredom go a long way in helping the dog recover when the licking is triggered by stress, anxiety or boredom in highly active breeds in need of exercise ad mental stimulation. Severe cases may require anti-obsessessional drugs such as clomipramine and fluoxetine given for several weeks.
Treating the Wound
Often, lick granulomas are infected and require sometimes weeks or months of antibiotics. The reason for this is that often the skin gets so thick topical products don't penetrate much and help "from the inside out" is needed. It is crucial to use the most appropriate antibiotics (often cephalosporins are used) as some types may not be effective. A culture may be needed.
Other topical treatments may appear to be ineffective or may work only temporarily. Some vets may try steroid injections under the granuloma or topical cortisone-based creams. Others may suggest acupuncture or other forms of chiropractic care.
In severe cases, the granuloma is surgically removed. While this may seem like an optimal treatment plan, consider that many dogs will feel compelled to lick at the surgery area, which of course, proves problematic for recovery. Some vets offer laser surgery to minimize bleeding and seal nerve tissue.
In general, the lick granuloma doesn't pose any major risk to a dog's health, but in some cases, when left untreated, an acral lick granuloma may develop into a bacterial infection, ruptured hair follicles and ruptured sweat glands. The area can be painful and cause the dog discomfort in walking, lying down and general movement.
Disclaimer: this article is not to be used as a substitute for professional veterinary advice. If you suspect lick granuloma in your dog, please see your vet and have any possible underlying causes ruled out.
A case of lick granuloma being treated with laser
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This article is accurate and true to the best of the author’s knowledge. It is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from a veterinary medical professional. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.
© 2013 Adrienne Farricelli
Adrienne Farricelli (author) on October 14, 2013:
Thanks Eiddwen, I am glad to hear you found my article on dog lick granuloma interesting, a happy day to you too!
Eiddwen from Wales on October 14, 2013:
Another very interesting hub for all the dog owners out there alexadry.
Enjoy your day.
Adrienne Farricelli (author) on October 11, 2013:
Epbooks, my dog did too, but it was a hot spot, but he soon took a liking to licking it over and over, it took about 4 months to heal. I remember sleeping with a flashlight under my pillow to check on him frequently, very exhausting!
Adrienne Farricelli (author) on October 11, 2013:
Peg, indeed many dogs get these as they age, it's listed as a contributing factor.
Peg Cole from North Dallas, Texas on October 11, 2013:
Thanks for this detailed explanation and tips for treatment. My 14 yo Dolly Joe had one of these on her wrist and just couldn't leave it alone. The vet diagnosed it exactly as you've described here and said it was due to her advanced age, probably triggered by joint discomfort. Now my Cookie has developed one on her paw. She is 13. It does seem as if the more mature dogs develop this condition.
Diana L Pierce from Potter County, Pa. on October 11, 2013:
Great information here. I have a dog with constant skin problems and have tried many remedies. Voted up.
Elizabeth Parker from Las Vegas, NV on October 11, 2013:
My dog has something like that on his tail, for which we are currently treating. For the most part, he's good... we put the eCollar on when he is not supervised though. We have YUCK too, but haven't needed to use that yet! Great hub!