Acral Lick Dermatitis (Lick Granuloma)

Patty Khuly

Summary

Among the most downright frustrating dog diseases is acral lick dermatitis (perhaps more commonly referred to as “lick granuloma” but also known as “canine neurodermatitis”). This potentially hereditary expression of obsessive-compulsive behavior manifests as self-mutilation.

Dogs with this condition will repetitively lick, suck and sometimes even bite at their skin, most commonly over their lower limbs. Ultimately, this display of stereotypic behavior is likely to have have many environmental origins. Nonetheless, strong evidence for a hereditary component can be observed in lick granuloma’s obvious breed predilection.

Symptoms and Identification

Hairless lesions that vary in size and severity are the hallmark of this disease. In their more severe manifestation, these self-inflicted wounds will appear as raised plaques of tissue with deep ulcerations. They range in size from less than a centimeter in diameter to lesions that cover the entire limb.

Diagnosis is made based on history and clinical signs alone.

Affected Breeds

No specific mode of inheritance has been identified but the following breeds are predisposed.

Treatment

Addressing the stress, boredom and frustration in an affected dog’s environment is likely to improve the clinical signs associated with this disease. Exercise, obedience training and addressing any specific signs of separation anxiety are strongly recommended approaches to this.

Veterinary behaviorists, a specialty group severe cases are often referred to, will often help design behavior modification protocols tailored to help deal with the underlying stress. Prozac-like pharmaceuticals intended to decrease anxiety and obsessive-compulsive clinical signs are often prescribed as well.

Treating the self-traumatized areas themselves will usually require avoidance methods (Elizabethan collars, leg protection, etc.) and wound care approaches that may include antibiotics, bandaging, etc.

Veterinary Cost

The cost of behavior modification therapies can be minimal to extensive, depending on whether veterinary behaviorists and/or professional trainers are employed. Drug therapy alone can reach $150 every month for some severely affected pets.

Prevention

There is no perfect mode of prevention for acral lick dermatitis beyond the obvious, if unrealistic approach: 100% prevention of stress, boredom and frustration coupled with a complete inability to self-traumatize.



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References

Davis, Lloyd E., Handbook of Small Animal Therapeutics. Churchill Livingstone Inc., 1985.

Dodman, Nicholas E., Shuster, L.E., White, S.E., Court, M.E., Parker, D., Dixon, R. Use of narcotic antagonists to modify stereotypic self-licking, self-chewing, and scratching behavior in dogs. Journal of the American Veterinary Medical Association. 193:7 Oct 1/88 pp 815-819.

Goldberger, Erica G., Rapoport, J.L. Canine Acral Lick Dermatitis: Response to the Antiobsessional Drug Clomipramine. Journal of the American Animal Hospital Association. Mar/Apr 1991. Pp 179-182.

Rivers, Bill, Walter, P.A., McKeever, P.J. Treatment of Canine Acral Lick Dermatitis with Radiation Therapy: 17 cases. Journal of the American Animal Hospital Association. Nov/Dec 1993. Pp 541-544.

White, Stephen, J. Naltrexone for treatment of acral lick dermatitis in dogs. Journal of the American Veterinary Medical Association. April 1990. Pp 1073-1076.