Lick Granulomas in Dogs



   A lick granuloma is an open sore on the skin caused by and perpetuated by constant licking. It is generally located on one of the legs, especially near the carpus (wrist) joint. Typically, the hair will be licked off and the area will be either raw and weeping or thickened and scar-like.

   Lick granulomas usually begin with an itching or tingling sensation on the leg. The dogs respond to that by licking; this may serve to further increase the itching or tingling. Very shortly, a viscous cycle develops, creating a habit much like a child sucking its thumb. Even if the problem that initiated the itching or tingling sensation is gone, the habit of licking continues.

Breed Susceptibility
   Certain breeds are more likely to get lick granulomas. They occur most commonly in German Shepherds, Doberman Pinschers, Great Danes, Labrador Retrievers, and Irish Setters, but it is possible in any breed. In addition, male dogs are twice as likely to do this when compared to female dogs.

Cause
   There is no agreement on the reason that some dogs develop this compulsion to lick. There are three basic views on the subject. Some see it as a primary skin disorder. Some see it as a behavioral problem, and some see it as a neurologic disease involving the nerves in the area. It is likely that most lick granulomas have more than one cause or a single cause with one or more contributing problems.

Diagnosis
   In most cases, the diagnosis is made based on the appearance and location of the lesion and the fact that the dog has a compulsion to lick the area. However, certain skin tumors, parasites, embedded foreign bodies, and allergies can create lesions that look very similar. In addition, trauma that causes bone fractures or nerve injury can also lead to constant licking, creating a similar lesion. Therefore, if the diagnosis is in doubt or if the dog does not respond well to initial treatment, fungal cultures, radiographs (x-rays), and biopsies may be recommended.

Treatment
   The approach to treatment generally begins by trying to eliminate potential psychological factors. Boredom and stress are important issues that should be addressed. Physical factors are also important to consider, like skin allergies and infections.

   Various strong prescription anti-inflammatory drugs can help to reduce the swelling in the granuloma and help the skin return to normal. During this time of treatment it is important to keep the patient from continuing to lick at the area by means of different collars available at your veterinary office. During this time it is also important to try and eliminate the factor that caused the granuloma in the first place.
   Sometimes in severe cases of lick granuloma, surgical exicision is the most curative treatment.

Prognosis
   This can be a very difficult medical problem for dogs. Because the initiating factor can be so many things, because there is such a strong habit that forms, and because there are multiple ways of treating lick granulomas; working closely with a licensed veterinarian helps to insure success. Regardless of the initial treatment plan, it is sometimes necessary to change the plan as the granuloma heals. It is important that you communicate progress and concerns with your veterinarian when dealing with this problem. For more information, please call The Animal Center at the below number.

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