Acral lick dermatitis is a common skin condition in dogs that affects the paw pads and legs. It's caused by excessive licking, chewing, and scratching, which can be triggered by various factors.
Dogs with acral lick dermatitis often exhibit specific behaviors, such as intense licking, chewing, or pawing at the affected area. This behavior can be a sign of anxiety, stress, or boredom.
Some dogs may develop acral lick dermatitis due to allergies or skin infections, which can exacerbate the condition. In one study, 75% of dogs with acral lick dermatitis had underlying allergies or skin infections.
Additional reading: Doberman Pinscher Skin Bumps
What is Acral Lick Dermatitis?
Acral lick dermatitis is a skin condition that affects dogs, causing them to excessively lick a specific area of their body. This condition is characterized by obsessive licking.
The lick granulomas often occur in the front of the legs and feet. This is a common area for the condition to manifest.
Related reading: My Dog Keeps Licking Her Private Area after Grooming
Other symptoms of acral lick dermatitis include alopecia, which is the loss of hair in the affected area. This is a result of the constant licking and chewing.
Thickened skin is another symptom, as the skin becomes irritated and inflamed from the licking. This can lead to a range of other issues, including secondary bacterial or fungal infections.
Ruptured hair follicles are also a possible symptom, as the constant pressure and irritation from the licking can cause the hair follicles to become damaged.
Discover more: Dog Diseases That Cause Hair Loss
Diagnosis and Treatment
Diagnosis of acral lick dermatitis typically involves a physical examination by a veterinarian, who will check for signs of pain, swelling, and decreased range of movement in the affected joints. The veterinarian may also take radiographs to rule out underlying conditions such as arthritis.
To diagnose acral lick dermatitis, your veterinarian will consider your pet's history, including any previous allergic disease symptoms, trauma, or stress. They may also perform skin scrapings to investigate for mites, a full blood chemistry panel, and other diagnostic procedures.
On a similar theme: Dermatitis En Perros Schnauzer
The underlying cause of acral lick dermatitis can be difficult to identify, but it's essential to rule out underlying conditions such as allergies, arthritis, and stress. Your veterinarian may recommend an elimination diet, medication, or other treatments to address the underlying cause.
Here are some common underlying causes of acral lick dermatitis:
- Food allergies
- Atopic dermatitis
- Arthritis
- Stress and anxiety
Treatment for acral lick dermatitis typically involves a combination of physical barriers, topical medications, and antibiotics to address the infection and reduce inflammation. Your veterinarian may also recommend lifestyle changes, such as increasing exercise and playtime, to help manage stress and anxiety.
Diagnostic Approach
A thorough diagnosis is key to understanding and treating acral lick dermatitis. Your veterinarian will start by performing a physical examination on your pet to assess the affected skin and look for any underlying conditions such as arthritis.
Your veterinarian will also take a detailed history of your pet's symptoms, including when the licking started, how often it occurs, and any changes in your pet's environment or routine that may be contributing to the behavior.
Radiographs may be taken to rule out underlying conditions such as trauma or degenerative joint disease. Your pet may need to be sedated for this procedure.
A combination of the following steps can help diagnose acral lick granulomas:
- Patient history: when did licking start, how often does it occur, and have there been any changes in your pet's environment or routine?
- Clinical signs: such as the appearance of the lesion, whether it's hard, alopecic, raised, and erosive or ulcerated.
- Impression smear: to release exudate from the lesion.
- Skin scrapings or trichograms: to rule out demodicosis.
- Dermato-histopathology and skin culture: to confirm a diagnosis and rule out underlying causes.
A full range of laboratory tests, including haematology, blood chemistry, and urinalysis, can help exclude any endocrine diseases.
Treatment
Treatment for acral lick dermatitis and lick granulomas involves addressing the underlying causes and managing symptoms.
Preventing your dog from licking the affected area is crucial, and this can be achieved with physical barriers like Elizabethan collars, cervical collars, or wearing socks or boots.
Topical substances with an unpleasant taste, such as Yuk Anti-lick Gel or Grannick's Bitter Apple, can also be used to deter your dog from licking the area.
Antibiotics are often prescribed to treat the concurrent infection, and the course of antibiotics should be continued for at least two months.
In some cases, antibiotics may need to be continued for 6-8 weeks or even longer, especially in chronic cases where the bacterial infection is buried with fibrosis.
To identify the possible underlying disease, your veterinarian will want to spend time with you and discuss any possible factors that might have triggered the condition, including changes in your dog's environment or lifestyle.
Correcting any possible stressful factors and changing your dog's lifestyle to include more exercise and playtime can also be beneficial.
Immunotherapy to address allergies may be recommended, and drug therapy using cyclosporine (Atopic) has been beneficial in some dogs.
Here are some treatment options for acral lick dermatitis:
- Physical barriers (Elizabethan collars, cervical collars, socks or boots)
- Topical substances with an unpleasant taste (Yuk Anti-lick Gel, Grannick's Bitter Apple)
- Antibiotics (continued for at least 2 months)
- Immunotherapy to address allergies
- Drug therapy using cyclosporine (Atopic)
- Laser ablation (if the underlying cause has been controlled and the infection has resolved)
- Cryosurgery, radiation therapy, acupuncture, low-level laser therapy, and behavior modification techniques (increasing levels of activity and play)
Granuloma Treatment and Prevention
Treating acral lick dermatitis requires a multi-faceted approach that addresses both the primary cause and perpetuating factors. A course of antibiotics is always prescribed to treat the concurrent infection, which should be continued for at least two months.
To prevent the animal from licking the affected area, physical barriers such as Elizabethan collars, cervical collars, or wearing socks or boots can be used. Topical substances with an unpleasant taste or topical corticosteroid ointments or sprays with or without antibiotics can also be applied.
Immunotherapy to address allergies may be recommended, and drug therapy using cyclosporine (Atopic) has been beneficial in some dogs. Identifying and correcting any underlying allergies or hormonal diseases is essential for complete resolution of an existing granuloma and to prevent relapse.
Here are some common treatment options for acral lick dermatitis:
In some cases, addressing underlying psychological factors such as boredom or stress can also be beneficial. Providing company for the dog, increasing exercise or training, or using mood-altering drugs like Prozac or amitriptyline may be necessary to prevent relapse.
Treating Granulomas
Treating granulomas can be a complex process, and there is no one-size-fits-all solution. A course of antibiotics should always be prescribed to treat the concurrent infection.
Marked decrease of pruritus is seen in most cases after antibiotic therapy, and antibiotics should be continued for at least two months. Some cases have a mixed bacterial infection, so therapy should be based on culture and sensitivity.
For another approach, see: English Bulldog Wrinkle Infection
Good empirical choices include cephalosporin (cephalexin) and fluoroquinolone (enrofloxacin). Antibiotic therapy should be continued for a month past resolution of clinical signs, and it's not uncommon for a course to be at least 4 months.
Veterinarians reserve symptomatic treatment for only truly idiopathic cases, and it's essential to identify any possible underlying disease that might have triggered the condition.
Topical therapy may help in some cases, and mechanical barriers such as socks, bandages, or Elizabethan collars can be useful to minimize exposure to the area.
Some dogs may benefit from immunotherapy to address allergies, and drug therapy using cyclosporine (Atopic) has been beneficial in some cases.
Here are some treatment options for granulomas:
• Antibiotics (cephalexin, enrofloxacin) for at least 2 months
• Topical therapy (Yuk Anti-lick Gel, Bitter Yuk!, Grannick's Bitter Apple)
• Immunotherapy (cyclosporine)
• Capsaicin (0.25 percent) to trigger the release of Substance P
• Fluorinated steroids (Synotic) and flunixin meglumine (Banamine)
• Intralesional injections of glucocorticoids (Vetalog) (Depo-Medrol)
• Laser ablation, cryosurgery, radiation therapy, acupuncture, low-level laser therapy, and behavior modification techniques
It's essential to work with your veterinarian to determine the best course of treatment for your dog's specific case.
Consider reading: Cat Licks Flea Treatment
Prevention of Granulomas
Addressing underlying allergies or hormonal diseases is key to complete resolution of an existing granuloma and preventing relapse.
Lots of dogs have allergies or hormonal diseases that need to be addressed for complete resolution of an existing granuloma, as well as to prevent the relapse.
Reducing stress is essential in preventing granulomas, and simple changes in the environment, such as providing company for the dog, increasing exercise, or training, may suffice.
In some cases, mood-altering, antidepressant drugs like Prozac or amitriptyline have been advocated, and some reports of success with acupuncture have also been reported.
Acral lick granulomas are very frustrating to treat, and no simple cure exists, except by dedication and consistency in the approach of both the owner and the doctor.
Providing company for the dog, increasing exercise, or training can help reduce boredom and prevent granulomas.
Tackling the potential psychological factors is essential in preventing granulomas, and in some cases, simple changes in the environment may be enough.
Recommended read: Dogs Skin Allergies Pictures
Recovery and Follow-Up
Recovery from acral lick dermatitis requires patience and a multi-faceted approach. A guarded prognosis for full recovery is usually given, but with proper management, your dog can live comfortably.
Reducing exposure to allergens or switching to a hypoallergenic diet can help alleviate symptoms. This is especially true if your veterinarian suspects allergies are the root cause.
If stress is the underlying issue, assessing your dog's environment and removing stressors can be crucial. This might involve long-term medication, such as clomipramine hydrochloride, with regular blood chemistry tests to monitor your pet's health.
To prevent boredom, which can exacerbate lick granuloma, ensure your dog gets plenty of exercise, especially if they're a large breed.
Recovery
Recovery from Acral Lick Dermatitis requires a careful approach to manage the condition effectively. A guarded prognosis for full recovery is usually given, but with proper management, your pet can heal well.
Reducing exposure to allergens or switching to a diet free of causative allergens can significantly assist in the healing process. In cases of allergies, this can make a big difference in your pet's recovery.
If your veterinarian suspects stress is causing the behavior, assessing your dog's environment and removing stressors is crucial. This might involve changing your pet's living situation or making adjustments to their daily routine.
Regular blood chemistry tests will be necessary if your pet needs to stay on clomipramine hydrochloride long-term, so be prepared for ongoing monitoring. This will help ensure your pet's health is stable and the medication is working effectively.
Treating Acral Lick Dermatitis can be expensive, so it's essential to secure pet health insurance to avoid high vet care expenses. The sooner you insure your pet, the more protection you'll have from unexpected vet costs.
Follow-Up
Preventing boredom is key to avoiding lick granulomas in dogs, especially in large breeds that need plenty of exercise.
Allowing your dog to get enough physical activity can go a long way in preventing this condition.
Exercise is a simple yet effective way to keep your dog happy and healthy, and it's especially important for large breeds.
Flea allergy can also contribute to lick granulomas, so keeping your dog's flea control up to date is crucial.
Aggressive antibiotic therapy is often recommended once lick granuloma has started, so it's essential to catch it early.
Frequently Asked Questions
How do you treat acral lick dermatitis in cats?
Treatment for acral lick dermatitis in cats typically involves antibiotics for bacterial infections and topical antifungal creams for fungal infections. Early treatment can help manage symptoms and prevent further skin damage.
What does lick granuloma look like?
A lick granuloma typically appears as a bare, hairless patch on the leg, often red, inflamed, swollen, shiny, or bloody. It usually develops on the left leg, near the foot.
What are the clinical signs of acral lick dermatitis?
Clinical signs of acral lick dermatitis may include recurrent skin and ear infections, hot spots, and pruritus in areas like the feet, face, and trunk. Pruritus can be caused by infection, among other factors, making diagnosis and treatment crucial.
Should you cover a lick granuloma?
Covering a lick granuloma with a physical barrier like a bandage or E-collar can help prevent further licking and allow other treatments to take effect. This temporary solution can give the dog time to heal and forget about the lesion.
How to treat acral lick dermatitis in cats?
To treat acral lick dermatitis in cats, a topical antifungal cream is applied to the affected area, and a restrictive collar or bandage is placed to prevent further damage. However, treatment can be challenging if the condition is caused by a neurologic issue.
Sources
- Acral Lick Dermatitis in Dogs - Symptoms, Causes, ... (wagwalking.com)
- Lick Granuloma (Acral Lick Dermatitis or ALD) in Dogs (petplace.com)
- Acral Lick Dermatitis (cessnalifeline.com)
- Acral lick dermatitis: diagnosis and treatment (vetsandclinics.com)
- What Is An Acral Lick Granuloma/Dermatitis? (andysvetclinic.net)
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