Lick Granuloma in Dogs

Back ground
A lick granuloma, also known as acral lick dermatitis
An urge to lick the lower portion of the leg or sometimes
another part of the body such as the base of the tail.
Psychogenic dermatoses self-induced by continuous licking
or chewing
They usually occur in older, male, large breed dogs,
especially Labrador retrievers, golden retrievers, German
shepherds
May occur anywhere, although the cranial and medial
aspects of the carpus-metacarpus and the cranial and
lateral aspects of the tarsus-metatarsus are most commonly
affected
often occur in the carpal-metacarpal or tarsal-metatarsal
area.
sparsely haired, thickened, firm, ulcerated,
erythematous, and surrounded by a hyper- pigmented
halo.
 Etiology
Although wounds, foreign bodies, infections,
and musculoskeletal pain may be initiating
factors
Most lick granulomas are believed to be
psychogenic (obsessive-compulsive disorder)
and associated with boredom, inactivity, or
environmental change
 Clinical signs
Cycle of obsessive licking
secondary pruritus
infection develops
Superficial tissue may erode and expose bone
Lameness sometimes results from the mechanical
presence of the mass or from underlying periostitis
 Treatment
Activity or environmental modification
Bandaging, collars, muzzles, topical anti-chew agents
Radiation therapy, cryosurgery, surgical excision
Behavior modifying drugs (phenobarbital, diazepam)
Long-term antibiotic therapy (45 to 90 days) based on
culture and susceptibility results
Use bandages and restraint devices
Antidepressants are most commonly used, including
fluoxetine, and clomipramine
 Endorphin blockers such as naltrexone can be used to reduce
addiction to licking
Anti-licking ointments e.g mupirocin (which are bad tasting)
and Anti-lick strips (which are either bad tasting or simply
provide a barrier).
Surgery may be performed to remove whole lesions, but there
is risk of continued self mutilation to the area afterwards