Lick Granulomas

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.

The above is general veterinary information. Do not begin
any course of treatment without consulting your regular
veterinarian. All animals should be examined at least once every
12 months.