Acral Lick Granuloma in Dogs

Allergic Acral lick granuloma is a term used to describe a skin lesion created by stereotypic (repeated) licking and chewing behaviour. This occurs typically anywhere on the legs down to the paws. The licked area becomes hairless, thickened and can become ulcerated with deep infection possibly following. If this is not resolved early, chronic secondary changes to the skin will develop. The underlying trigger and cause for initially starting to lick may include one of a combination of the following:

• Allergies
• Joint pain
• Injury and neurological driven itch
• Behavioural disorders (especially anxiety)

Long term licking may result in certain chemicals (endorphins) being released in the brain leading to an addictive behavioural pattern.

There are a number of steps required for successful management of acral lick granuloma. A referral to a veterinary dermatologist is the first step in resolving the lesions but also often may involve a referral to the specialist in veterinary behaviour.

Initial treatment involves treating the deep infection part of these lesions. This can be quite complex and depending on the chronicity of the lesion (how long it has been going on for), it might mean other treatments are required to ultimately return the skin to normal and no longer provide the focus to return to that area to chew. Deep infection can be complicated and will often require 4-6 weeks of antibiotics, possibly even require a biopsy and deep tissue culture. It is then essential to address the underlying trigger to prevent relapses and this will require addressing the allergy (allergy vaccine), behaviour treatment or addressing other possible causes (as mentioned above).

Acral lick granulomas can be a frustrating and complicated problem to resolve but with referral to a specialist dermatologist the prognosis is good.

Related reading:

• AREN Dermatology Services
• AREN Behaviour Services

Information provided by Melbourne Veterinary Specialist Centre (MVSC), part of the AREN network.

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