A lick granuloma is an open sore, usually at the ankle or wrist, perpetuated by constant licking. It is seen most often in large, shorthaired dogs such as Doberman Pinschers, Great Danes, Labrador Retrievers, and bird dogs.
At one time, lick sores were thought to be psychogenic in origin and related to boredom and inactivity. It now appears that many cases are preceded by an itchy skin disease (such as canine atopy) that starts the lick cycle. Other possible initiating causes include demodectic mange, a bacterial or fungal infection, prior trauma, and underlying joint disease. The precipitating event focuses the dog’s attention on the area. The licking then becomes a habit that may be perpetuated by psychological events, so behavior may still be a factor.
As the dog licks at her wrist or ankle, the hair is rubbed off and the surface of the skin becomes red and shiny. Eventually, the skin becomes raised, thick, hard, and insensitive to pressure. However, it remains fresh-looking from the constant licking. Some dogs will lick long enough and hard enough to cause breaks in the skin and serious wounds.
Treatment: It is important to review the course of events in an attempt to identify the precipitating cause. If a disease such as canine atopy is diagnosed, medical treatment is directed toward that condition.
Local treatment may involve the use of topical and injectable steroids, radiation therapy, bandaging, surgical removal, cryotherapy, and acupuncture. Some dogs will require antibiotics due to secondary infections. Results are variable. The lick granuloma is one of the most difficult skin problems to treat successfully.
Because lick sores are perpetuated by psychogenic factors, a change in the dog’s routine or lifestyle should be part of the treatment program. For example, some arrangement may need to be made to provide company for the dog when the owner is away. A new puppy in the house may provide companionship and entertain an older dog. Behavior-modifying drugs may be beneficial in some cases.