Lick granuloma is a chronic skin condition of the dog which can be difficult to treat. It is also known by a number of other different names, these include acral lick dermatitis (ALD), Acral Lick Granuloma (ALG) or Acral Lick Furunculosis (ALF), but is in fact one and the same disease. My experience is that this disease is more often seen in larger breeds such as German Shepherds and Golden Retrievers and in addition some authorities think it is more common in male dogs.
.The photograph above is a very good illustration of what this disease looks like. It is most commonly found in the ” wrist ” area of the front legs, it may occur in this area because that is the nearest part the dog can easily get to when lying down. Once you have a chronic lick granuloma established then it becomes a self perpetuating situation as an itch scratch then cyle occurs. The more the animal licks the more itchy and inflamed the lesion becomes and of course this will just result in the dog licking and worrying the area more. In time these become hard fibrous lesions which will be slightly raised from the skin and they may become pigmented when compared to the surrounding skin.
.So what are the trigger factors which eventually lead to a chronic lick granuloma? There have been quite a few of these put forward : Consider boredom, a manifestation of compulsive behaviour disorder or anxiety due to stress of some kind. Other possible causes include allergies, fleas, demodex, fungal infections and bacterial infections or granulation tissue from wounds which have not healed properly. Very often though it is not possible to determine a precise causal factor and secondary infections can make matters worse.
.This is a complex disease with no one magic bullet cure for each case, successful treatment varies from case to case. Usually a course of antibiotics is called for to control any secondary bacterial disease and immunosuppressant drugs like steroids and cyclosporine have been used as a prime treatment. Sometimes steroids can be more effective when injected directly into the lesion. Socks, bandages and cone collars may help as well as bitter apple type sprays which may make the dog leave the lesion alone and so give it a chance to heal. Capsaicin (0.25 percent) applied topically for a short course is said to be effective in some cases and in dogs where psycological factors are involved consider the likes of clomicalm, prozac or amiltriptyline have been found to be useful. Finally as a last resort surgical excision, cryosurgery and even radiation therapy are possible.
.This is often a demanding disease for both the vet in charge of the case and the owner but with persistence and patience very often the problem can be resolved but it can take quite a time.
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