Name
Acral Lick Granuloma, Canine
Short Description
Acral lick dermatitis, acral lick
furunculosis.
Affected Animals:
Acral lick granuloma may affect
dogs of both sexes and all breeds;
however, males or dogs that are older
than five years are more often affected.
Breeds disposed to this condition
include the Great Dane, Doberman
pinscher, Labrador retriever, golden
retriever, German shepherd, and Irish
setter.
Overview:
A commonly seen skin disorder
of dogs, acral lick granulomas are
skin wounds that are worsened by a
dog's constant licking of the affected
area. Because the repeated licking
hinders resolution of the lesion, dogs
must be prevented from licking the
acral granuloma until the wound has
healed completely. Acral lick
granulomas have a variety of possible
causes. The disease is often
bothersome to owners as well as their
dogs. A veterinarian can implement
appropriate medical therapies to treat
the lick granuloma and to prevent
recurrence.
Clinical Signs:
Lick granulomas are skin wounds
typically located on the distal area
of the front leg or hind leg of a dog.
Some dogs may have more than one lick
granuloma at a time. These lesions
usually appear as firm, raised,
hairless areas of skin that may be
hyperpigmented, or darkened with
pigment, due to the dog's chronic
licking of the area. The center of the
lesion is usually ulcerated, red, and
moist, or may be covered by a scab.
Description:
An acral lick granuloma is a
lesion, usually located on the distal
part of one of the limbs of dogs,
which is caused or worsened by the
animal's obsessive licking of it.
Damaged cells are believed to release
pain-relieving endorphins that addict
the dog to the licking and mutilation
of the lesion. The possible causes of
the itching and licking behavior
include boredom, trauma, arthritis or
other joint problems, allergies, and
skin infection. Often it is difficult
to ascertain whether the cause of the
lick granuloma is due to an underlying
condition or the dog's obsessive
licking. Treatment is usually lengthy
and often only minimally effective.
Early interventions have the best
chance of success. Some animals will
respond to medical therapy by
maintaining a milder form of the
lesion.
Diagnosis:
Diagnosis of acral lick
granuloma and its cause requires a
thorough history and physical exam.
The following tests may be performed
in order to determine the underlying
cause of skin lesions: cellular
evaluation using a slide impression of
the mass, biopsy, allergy testing, and
x-rays. Underlying conditions of the
lesions include joint disease, cancer,
bacterial or fungal infection, demodex
mite infection, previous trauma,
allergy, and psychogenic licking.
Prognosis:
Because acral lick granuloma is
difficult to cure, veterinarians
usually give it a guarded prognosis.
Dogs that receive early treatment have
a better prospect of recovery than
dogs with chronic conditions.
Transmission or Cause:
The causes of acral lick
granulomas include infections caused
by bacteria, fungi, or mites;
allergies, cancer, joint disease, or
previous trauma; and an
obsessive-compulsive disorder caused
in some dogs by boredom. Dogs are
incited by their condition to lick an
area until they cause hair loss and
erosion of the superficial skin
layers. The consequence is further
itching, which in turn results in more
licking. This itch-lick cycle is
exacerbated by the fact that damaged
cells release endorphins, or brain
chemicals, that are powerful
analgesics. The licking may with time
cause secondary infections, thickening
of the skin, and changes in
pigmentation.
Treatment:
Treatment of acral lick
granuloma requires addressing the
suspected cause of the lesions.
Bacterial infections, for example, are
treated with antibiotics. Arthritis is
treated with pain management and joint
therapy. The obsessive-compulsive
component of the disease is more
difficult to treat. The dog may be
prevented from licking the area by
using some type of mechanical blocking
device such as a collar, muzzle, or
bandage. A topical product may be used
for a period of weeks to decrease the
itchiness of the area and aid in the
healing process. Severe cases may call
for the injection of a corticosteroid
into the lesion. If the lesion is
small, it may be surgically removed.
Radiation therapy has been tried in
some cases, but its rate of success is
poor.
Prevention:
There are few recommended
measures for prevention. Dogs
suffering from boredom or from the
stress of being left alone for too
long should be given a more
stimulating and socially interactive
environment.
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