Petwatch – acral lick granuloma

February 2010

Of the challenging conditions I see, some may require a long and drawn-out diagnostic work-up, or delicate surgical treatment, while others may not demand great technical ability at all, but rather be difficult by virtue of their resistance to treatment, or failure to respond to logical forms of therapy.

 

One such condition is the so-called lick granuloma. These are ugly swellings that arise typically in the skin overlying the carpus (wrist) or tarsus (ankle), often in Springer Spaniels and other larger breeds of dog. They start small and barely noticeable to most owners, but gradually increase in area and thickness, becoming hairless, cracked and infected. The other consistent feature of these lesions is that dogs just won’t leave them alone – there is a compulsive drive to lick at them.

 

Over the years that I’ve been in practice, I have seen these treated in all sorts of ways: sufferers have received all manner of creams and tablets, had them frozen or excised. Many a patient has been forced to wear an Elizabethan collar for weeks on end, to prevent the incessant licking, while others have been dressed and redressed to achieve the same end. The reality was that none of these approaches were terribly successful, and trying to treat the condition usually resulted in a good deal of frustration for both vet and owner.

 

I am happy to say, however, that our understanding of this condition has moved on, and it is now regarded not as a form of skin disease, but as a manifestation of an obsessive/compulsive disorder, i.e. a behavioural problem. Consequently we are using behaviour-modifying drugs now for this condition, and with much more success. In general dogs stop licking the lesions within a month, and this alone results in marked reduction in size and general unpleasantness of the lesion.

 

We also have a trained acupuncture therapist in the practice and I am informed that she has had success using acupuncture in treating this condition, thereby giving another option where drug therapy might not be appropriate.

 

The question remains as to why these lesions develop. What stimuli result in obsessive/compulsive behaviour developing in a particular dog? This may not always be apparent and may, in some cases, merit consultation with a canine behaviour therapist. But for most, their owners are just happy that we have been able to do something for their dog at last.

 

Martin Hall is a partner at Copthorne Veterinary Clinic in Shrewsbury.

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