Acral Lick Granuloma is a frustrating skin condition of dogs that is as much a behavioral problem as a physical ailment. It is most common in intelligent and sensitive breeds. Doberman Pinchers is number one but no breed is immune. Skin lesions tend to appear on the extremities especially where a dog can easily lick itself. The most common site is on the dorsal or top surface of the carpus (wrist) or forearm.
Lesions tend to be oval, alopecic (bald), raised with a rough surface, oozing, erythematous (red) and painful. But the number one clue is that the dog is constantly licking. This is considered a self-mutilation injury in the compulsive category of behavior problems. Because this is a behavior issue it can be very challenging to treat. The worst case I ever saw was a dog that self mutilated so bad it gave itself a bone infection that took months to resolve.
The first part of treatment consists of treating the infection. Dogs are put on antibiotics. The lesion is treated topically with cleansing agents and antibacterials. Treatment has to last at least three weeks but frequently much longer. I always warn clients they need to be dedicated and ready for the long haul. Medical treatment alone works about half the time.
The next part of treatment is preventing the dog from licking the area. Bandages usually do not work. First of all they feel weird to the dog and bring attention to the area. Bandaging also make topical treatments difficult to apply. Someone has to change the bandage each time. Also if the dog cannot lick that area because of the bandage, they will often start self-mutilating another spot – aversive displacement behavior. Elizabethan collars help but many dogs are awkward with these banging into everything and just not liking them.
We also use anticompulsive drugs. These usually help but require preliminary blood test and the dog needs to be on them for an extended period of time. And the treatment can be expensive. I will say that the earlier such problems are treated the better. It is best not to give the itch – lick – self mutilation cycle a chance to get started or to treat it before it gets out of control, especially in Dobermans.
Dr. David Roy Hensen, DVM, DABVP has been a Veterinarian since 1983. He opened Paumanok Veterinary Hospital in 1992 and is board certified in the American Board of Veterinary Specialists, canine and feline.