Lick Granuloma (Acral Lick Dermatitis)

Lick Granulomas are a fairly common skin problem of dogs. They appear as a thickened, hairless, eroded or ulcerated area of the skin, usually located on a lower limb within easy reach of the dog’s mouth. Any dog at any age can develop lick granulomas.

There is no single cause for granulomas. Possibilities include infection, previous injury, allergies, joint disease, tumors, back pain, neck pain and even just being bored. The “classic” dog that develops a lick granuloma is a large breed, middle-aged, male dog that doesn’t have enough to occupy his mind and time.
Possible scenarios which lead to lick granuloma formation are:

  • Wound on leg -> dog licks wound -> wound enlarges -> licks more -> wound enlarges -> licks more -> wound thickens -> licks -> enlarges . . . . .
  • Dog is bored, frustrated or stressed -> licks leg for something to do -> creates wound ->licks more -> wound enlarges -> licks more -> wound thickens -> licks -> enlarges . . . . .
  • Bony changes along the spine -> irritates nearby nerve -> referred pain to lower leg -> licks lower leg even though the problem is in the spine -> creates wound…

It is believed that the constant licking causes the release of chemicals called endorphins. These chemicals are the body’s natural “feel better” drugs. They decrease pain and increase their feelings of happiness. Over time the dog becomes addicted to these feelings and licking becomes an obsessive-compulsive behavior.

Treatment of the wound itself, the underlying cause, as well as the obsessive-compulsive disorder needs to be managed all at the same time. This may include antibiotics, pain medication, physical therapy, laser therapy, anti-inflammatories, spinal manipulative therapy (aka chiropractic), and mental stimulation.

While it can be very difficult to completely resolve lick granulomas, they usually do not lead to the premature death of the pet. Addressing any underlying medical problems will improve the comfort of the dog and aid in the management of the granuloma.