Acral lick granulomas

ACRAL LICK GANULOMAS

BACKGROUND

Acral lick granulomas are a common problem in dogs, especially Doberman Pinschers, Great Danes and Labrador Retrievers. Lick granulomas can develop secondary to allergies, trauma, bacterial/fungal infection or underlying joint disease. They most commonly appear on the wrist or ankle. Acral lick granuloma may cause a dog to lick the affected area, which may become habitualized so that the sore does not have a chance to heal.

CLINICAL SIGNS

Acral Lick Granulomas appear as an area of hairlessness and redness, predominantly on one of the limbs. Over time, the skin becomes red, irritated and hard, maintaining the appearance of an open wound.

DIAGNOSIS

Veterinarians can usually diagnose acral lick granulomas based on behavioral history and an examination of the sore. However, identification of the underlying cause can be more difficult, requiring a series of diagnostic tests. A history of trauma may suggest joint damage. Physical examination may reveal other signs of allergy. Depending on the physical findings, it may or may not be possible to identify what initiated the behavior.

TREATMENT

Treatment is directed at alleviating the underlying cause, such as an allergy, infection, or joint disease. If a bacterial infection is suspected, antibiotics may be prescribed. Allergies may be treated with immunosuppressive therapies. In most cases, your veterinarian will suggest you employ an Elizabethan (funnel-like) collar with your dog to curb the behavior.

If an underlying cause cannot be found, then the lick granuloma itself should be treated. There are a number of ways of doing this. Topical treatment with a combination of Synotic and Banamine has been used, as have anesthestic preparations like DermaCool or Relief. Other strategies include use of bitter apple or chloramphenicol ophthalmic ointment, as well as bandaging or using a sock to cover the lesion. Hydrocodone may be prescribed to cut down on the irritation and/or fill the need for endorphins that the dog may be experiencing.

In cases where the behavior is linked to psychological stress, simple changes in the environment may help significantly. In more persistent behavioral cases, amitriptyline (Elavil), naltrexone (Trexane), clomipramine (Anafranil)and fluoxetine (Prozac) are often prescribed. Other solutions include: radiation therapy, casts over the area, cryosurgery and surgical excision. Ultimately, finding a cure may take several approaches to find the one that will work.

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