Lick Granuloma
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Drawing of a paw with

The so-called "Lick granuloma" is a raised, usually ulcerated area on a dog's wrist or ankle area caused by the dog's own incessant licking.

WHY DO DOGS LICK THEMSELVES RAW?

This type of foot-chewing may be compared to nail-biting in people.  We chew our nails when we are bored or worried, out of habit, or even as an obsessive/compulsive behavior.  Often, we find similar motivations in these foot-chewing dogs.  Frequently, there has been a change at home such as:

  • lengthy confinement
  • addition of a new pet or human house-guest to the family
  • death or loss of a companion pet
  • loss of owner or absence of a family member
  • moving to a new home
  • boredom

For many dogs, treating the skin lesion is not enough; the dog must be palliated psychologically as well. Extra attention to the pet on a reliable basis may be all that is needed; however, some dogs actually require psychoactive drugs.

TREATMENT FOR THE SKIN

There is a lot of disagreement as to the best treatment to attempt first in a case of lick granuloma. Here is a summary of what we have found effective for most cases:

  • A long-acting corticosteroid injection helps reduce the itchy sensation associated with healing.
     
  • Special wraps covering the wound allow healing to take place (though, at first, often an Elizabethan collar is important to keep the pet from bothering the wrap.)
     
  • Some veterinarians prefer specially mixed topicals to reduce inflammation in these areas.
     
  • Many lick granulomas may require a minimum of three weeks on antibiotics to clear the skin infection.

TREATMENT FOR THE MIND

For dogs who resume chewing as soon as treatment is discontinued or who simply change to a new foot, more than just extra attention may be necessary. The following medications are commonly used for people in reducing stress or depression as well as for treating obsessive/compulsive disorders.

AMITRIPTYLINE - helpful in only 30% of dogs but considerably cheaper than the others.  It takes 4 weeks on medication to determine if there will be an effect. If the medication is found helpful, the pet continues on it.

Approx. cost for 1 month of treatment for a 75 lb dog = $15.00

PROZAC - helpful for 50% of dogs that lick.  The medication is given for 4 weeks.  If no response is seen, the dose is doubled for another 4 weeks. Medication is discontinued if a good response is seen.

Approx. cost for 1 month of treatment for a 75 lb dog = $135.00

NALTREXONE - helpful in 50-60% of cases. The pet takes the medication for only one month. If licking stops, it usually is stopped for weeks to months. Should licking resume, another course of medication may be instituted.

Approx. cost for 1 month of treatment for a 50 lb dog = $210.00

ACUPUNCTURE - has recently gained favor as a possible treatment and may be worth looking into.

Some consultation with a behavioral specialist may be in order for more resistant cases.