Lick Granuloma in Dogs - Treatment and Causes

The ‘granuloma’ of a lick granuloma is a skin lesion which results from macrophages (types of white blood cell) collecting to help fight an inflammation. These are caused by the dog licking a certain area repetitively. It is also referred to as acral lick dermatitis. There are different types of dermatitis in dogs as it broadly refers to skin inflammation. It is ‘acral’ because it occurs on the limbs of the dog. Pododermatitis in dogs affects their paws, but it can eventually lead to a lick granuloma.

A granuloma lesion will develop because the dog licks so much it removes the hairs on their limbs, exposing the skin underneath. This can lead to furuncolosis, an inflammation of the hair follicle itself. It is similar, but distinct to a ‘hotspot’. The latter are skin infections which develop into wet dermatitis, something which is also caused by licking. It most commonly affects the distal parts of the limb, i.e. the top of their paws. It can also occur at the base of their tail.

The mechanical cause of a lick granuloma is the abrasive action of the dog licking the same spot repeatedly. However, there are various underlying causes which can lead to dogs keep licking their paws. These are both physical and psychological.

• Trauma: licking an area of the skin can have analgesic properties for the dog as it relieves pain and frustration, albeit temporarily. If the dog receives a wound from a cut, bite or similar trauma, they can lick it to feel better. Unfortunately, the abrasiveness of their licking can make the problem worse and result in a lick granuloma.
  
  
• Parasites: external parasites in dogs such as mites, fleas and ticks can irritate the dog's skin. Similar to trauma, the dog will lick the area of the bite to relieve irritation and acral skin dermatitis can result.
  
  
• Infection: skin infections can also lead to dermatitis. These can be localized bacterial or fungal infections, but systemic viral infections can also lead to the development of skin lesions. Although the symptoms of dermatitis may be minor at first, including redness and swelling, the licking can turn them into a granuloma over time.
  
  
• Allergy: allergies can also lead to dermatitis, as is seen with atopic dermatitis in dogs. When the dog tries to relieve the symptoms of the skin inflammation, it can lead to a lick granuloma.
  
  
• Stress and anxiety: it is not only physical pain which dogs try to alleviate with licking. If a dog is emotionally stressed or anxious, licking their paws can be a way to help them feel calm. Unfortunately, if a dog is chronically stressed, this licking can turn into a stereotypy, i.e. a repetitive action without obvious cause. When the dog is sufficiently stressed, they can lick their skin so much a lick granuloma forms. This is only one of the possible signs of stress in dogs.

Dogs prone to lick granuloma

Any dog can develop a lick granuloma, but some are more susceptible to others. Dogs which have received emotional trauma such as abuse or abandonment are more likely to develop stress and anxiety. Dogs in stressful situations such as those in kennels or animal shelters often develop lick granulomas. For not-well-understood reasons, certain dog breeds are more prone to acral lick dermatitis. They include:

• Neapolitan Mastiff
• Spanish Mastiff
• Great Dane
• German Shepherd
• Doberman Pinscher
• Labrador Retriever
• Golden Retriever

Learn about other veterinary health issues of two of these breeds with our articles on common health problems of German Shepherds and common health problems of Labrador Retrievers.

The beginnings of a lick granuloma can be difficult to detect. It is normal for a dog to lick their paws and other areas of their body, so we likely won't take much notice at first. Only when the licking becomes incessant will a problem arise.

For a lick granuloma to develop, the skin has to become abraded. The fur will start to fall off and a red swelling will be seen underneath. Over time, the area of the lick granuloma will become larger and a hard plaque on the skin forms. We will see ulceration of the skin where the lesion develops, hyperpigmentation and inflammation.

Image: seniors101.ca

There are many reasons why a dog may repetitively lick their paws and limbs. Many of these can be underlying causes of lick granuloma, but some may be unrelated. For example, interdigital cysts in between the toes of dogs can cause the dog to lick the area, but this is not the same as acral lick dermatitis. For this reason, an accurate diagnosis is essential.

Diagnosis of lick granuloma in dogs will be done with a physical examination. Specifically, a veterinarian will look for:

• Concomitant pyoderma (pus on the skin)
• Excessive licking
• Acral location

Since lick granulomas develop from other diseases and conditions, the veterinarian will have to determine the underlying cause. This diagnosis will be more difficult. They may take a blood sample if they think an infection is the root cause, but they will also check for parasites, wounds or other physical causes. Once a physical cause is ruled out, then a psychological evaluation of the dog's well-being should be carried out by a canine ethologist.

Treatment of lick granuloma in dogs will depend on its underlying cause. For example, a bacterial infection will likely require antibiotic treatment and fungal infections may be helped with topical or oral antifungal medicine. Viral infections cannot be treated, but systemic support can be provided to manage symptoms and help the dog fight the infection.

For parasitic infestations, the dog may need deworming agents, either topically or orally administered. For physical wounds, the dog will need time for the problem to heal. Topical antiseptics and creams may also be administered to speed recovery.

One of the difficulties in treating lick granuloma in dogs is that it is self-perpetuating. A dog may lick to ease their pain, but then cause more pain as the licking develops a granuloma. For this cycle to stop, we need to prevent the dog from licking the area, even if it is painful. This can be facilitated with the use of an e-collar around their neck or by bandaging the area. Bandages may not be appropriate, depending on how well it heals when covered.

When a dog with a lick granuloma has an e-collar, we need to provide additional support. They can become frustrated by the collar around their neck, so we need to provide more stimulation through play, activity, interaction and environmental enrichment.

Finally, if the dog's granuloma derives from stress and behavioral problems, we will need to find practical ways to help them. This can be more difficult. We need to assess the reason for their feelings of anxiety and provide support to overcome them. This is best achieved through the help of a canine ethologist, but you can also find some help with our tips for calming a nervous dog.

You must act primarily on the cause of the lick granuloma. Particularly if it is a behavioral problem, you must seek a substantial change in your dog's life. Providing enrichment, exercise, obedience, games and companionship are some starter ideas. Positive reinforcement is also important and we need to meet their emotional needs by providing affection and companionship.

If the lick granuloma was caused by the presence of parasites or bacteria, you must improve the hygiene of the dog and their living areas. We also need to ensure they have suitable vaccination and deworming schedules to avoid acral lick dermatitis as well as other health problems.

This article is purely informative. AnimalWised does not have the authority to prescribe any veterinary treatment or create a diagnosis. We invite you to take your pet to the veterinarian if they are suffering from any condition or pain.

If you want to read similar articles to Lick Granuloma in Dogs - Treatment and Causes, we recommend you visit our Mental problems category.