Don't worry, if your dog is suffering from a lick granuloma, you're not alone. A lick granuloma is a skin disorder that affects dogs. It is caused by excessive licking of one or more areas on the body, which leads to the formation of a red, inflamed skin lesion. This condition is surprisingly common in dogs and can be caused by a variety of things. In this article, we'll go over the symptoms of a lick granuloma in dogs as well as some treatment options that are available to dog owners. So please keep reading!

What is a lick granuloma in dogs?

A lick granuloma, also known as acral lick dermatitis, is a skin disorder that affects dogs. It is characterized by the formation of a localized red, inflamed skin lesion on one or more areas of the body that results from excessive licking. Lick granulomas are most often found on the front legs, especially the carpus (wrist), but they can also occur on the hind legs, ankles (hocks), or feet.

While dogs of any age and breed can develop a lick granuloma, they are most common in younger (~4yrs) large breed dogs.

While dogs of any age and breed can develop a lick granuloma, they are most common in younger (~4yrs) large breed dogs.

lick granuloma in dogs
lick granuloma in dogs

What are the causes of a lick granuloma in dogs?

The two most common causes of lick granuloma in dogs are allergies and behavioral conditions. Dogs may lick excessively out of boredom or because they're anxious or stressed. The vast majority (97%) of lick granulomas in dogs are secondarily infected with bacteria. The lick granulomas are exacerbated by secondary infection and a foreign body reaction from the ruptured hair follicles (furunculosis).

If a dog has an eroded or ulcerative skin lesion, it may become itchy and keep the itch-lick cycle going. For some dogs, licking leads to endorphin release, which calms them down and blocks pain perception.

How is a lick granuloma diagnosed?

The purpose of the diagnostic work-up is to identify any underlying primary factors and rule out conditions that could cause symptoms similar to those seen in lick granulomas or acral lick dermatitis.

A lick granuloma in dogs can usually be diagnosed based on the clinical signs and history. A lick granuloma starts as an oval to round, red crust or plaque that gets harder and thicker over time, eventually becoming an ulcerative lesion with scarring.

Although allergies are not ruled out by non-seasonal licking (because both environmental and food allergens can cause itchiness all year round), dogs with atopy who lick excessively may only do so seasonally. Because behavioral issues are associated with lick granulomas, your veterinarian will consider these in the treatment plan. They will take a complete behavioral history of your dog's habits, interactions, and any changes in their environment.

Other helpful diagnostic aids that benefit include:

  • Skin culture and sensitivity: To identify the bacteria involved and test for antibiotic sensitivity.
  • Allergy testing: To rule out environmental or other allergies as a primary cause, especially if your dog has signs of severe allergies in addition.
  • Skin scrapings and hair plucks: Important to perform to rule our demodectic mange.
  • Fine needle aspirate: FNA and secondary cytology.
  • Skin biopsy: This will confirm the diagnosis and rule out other conditions that are clinically similar to that of a lick granuloma.

Treatment options for lick granuloma in dogs

The first goal of therapy is to break the itch-lick cycle. Apply an Elizabethan collar, or similar device, to prevent your dog from licking the affected area and breaking the itch-lick cycle. You may also need to put a wrap or sock on the affected limb.

In some dogs, the application of noxious topical medications may prevent licking. Diluted "bitter apple", applied every 8-12 hours has been effective in some dogs.

Additionally, topical steroids can also be very beneficial in reducing inflammation and the desire to lick. To allow the steroid to penetrate deeper within the tissue, ask your veterinarian to mix it with DMSO. This topical preparation can be applied twice daily.

As we've learned the vast majority of lick granulomas in dogs are secondarily infected, a long course (6-8 weeks) is often required and the antibiotic selection should be based on culture and sensitivity testing.

Some dogs may benefit from a combination of medication and behavioral modification to reduce boredom-related licking. Increasing activity and environmental enrichment can also help to reduce this behavior.

Supportive therapy options for a lick granuloma in dogs

To reduce the itching associated with lick granulomas, acupuncture has been administered near or surrounding the afflicted area (not into the lesion) with success.

Cold laser and surgical laser therapy have both been used with some success to help lick granulomas heal.

How can you prevent a lick granuloma in your dog?

If the cause of a lick granuloma is discovered to be behavioral, it may be prevented by training and environmental enrichment to modify the behavior. If the cause of a lick granuloma is discovered to be allergies, it may be prevented by minimizing causes of allergic flare-ups (e.g. avoiding food ingredients that your dog is allergic to).

In summary, lick granulomas or acral lick dermatitis is a condition in dogs that results from long-term, localized self-inflicted damage to the limbs. Allergies and behavioral conditions are common underlying causes of a lick granuloma in dogs. The treatment for lick granulomas involves treating both the skin condition and the underlying behavioral issue. The goal is to reduce or stop the itch-lick cycle while also identifying and treating any underlying conditions. If you think your dog may have a lick granuloma, please make an appointment with your veterinarian.