Dogs can form bad habits just as people do. When they engage in a bad habit, it is just as difficult for them to stop just as it is for people to stop bad habits, even when they are harmful. While dogs don’t smoke cigarettes, or are able to pull out their hair, some dogs do get into the habit of licking their paws, between their toes and other areas on their bodies, causing major problems, and developing into lick granulomas, also called “hot spots” or acral lick granulomas. Lick granulomas are similar to nail biting in people. They are caused by excessive licking which results in a thickened plaque on the skin that looks like a large sore.
Dogs initially lick their feet and skin for a variety of reasons. A major reason is due to allergies. Other reasons include bacterial or fungal infections, joint problems or disease, demodectic mange or nerve damage. Flea bites can cause itching, and even anxiety or boredom can result in lick granulomas. Dogs that are left alone for long periods of time are often prone to lick granulomas. Dogs that suffer from separation anxiety can also suffer from lick granulomas as they resort to
excessive licking to cope with the anxiety they face from being left alone. Some vets believe that dogs can also suffer from obsessive-compulsive disorder and the lick granulomas are a symptom of this. Changes in the home such as a new puppy, a loss of owner, moving to a new house, longer periods of confinement or being left alone can result in lick granulomas developing.
Lick granulomas are often seen in large breed dogs. According to Wikepedia, dogs that are prone to developing lick granulomas include Dobermans, Great Danes, Labrador Retrievers, Irish Setter, Golden Retriever and German Shepherds. According to Pawprints and Purrs Inc. states that male dogs are more prone to developing lick granulomas than female dogs
How Lick Granulomas Develop:
At first the licking starts as a way to stop itching, reduce pain or cope with anxiety, but once it becomes a habit, the dog will continue to lick and bite the area for so long that the hair begins to wear away and red sores develop, called lick granulomas. You may notice some weeping of the wound, or even bleeding in severe cases. Cats can also develop lick granulomas but rarely do. If you notice your dog licking their leg a lot, inspect it to see if the hair is beginning to wear down. Take immediate action if you notice excessive licking.
The dog’s licking soothes the itching, pain or anxiety initially but once the problem is removed, such as the fleas are gone or the allergies are under control, the licking continues as a habit has been formed. The licking causes endorphins to be released which then leads to more licking as the licking has not only relieved the initial problem, but it has also become pleasurable.
Prevention and Treatment for Lick Granulomas:
The best thing to do to prevent lick granulomas is to quickly resolve the problem causing the itching. If the dog has fleas, provide flea treatment in the form of shampoos, flea collars or a product such as Frontline which can be applied to the top of the neck and provides flea prevention for a month.
To keep allergies under control, there are a number of things you can do. You can get your dog allergy testing, but this will cost you between $100-200 at your vet’s office. If allergies are found to be the problem, your vet may suggest allergy shots. However, you should know that this is a long term treatment your dog will probably be on for the rest of her life. It is costly as well as time consuming and results are not quickly seen. One of my labs has suffered from lick granulomas repeatedly throughout her life. Our vet suggested allergy testing as an option but did warn us that results are not seen quickly and suggested trying other methods first.
During times of high pollen counts, you can try to keep your dog indoors as much as possible, wash their feet and skin when they come back inside with a warm, wet cloth, use anti-itching shampoos and shampoo their coat on a more regular basis and utilize products that reduce itching and provide relief such as lotions, moisturizers and anti-itching crèmes and solutions.
Allergies are also not just environmental, and your dog may be suffering from food allergies. The way this is determined is to have the dog on a special diet under veterinarian supervision and to add ingredients one by one, watching for any allergic reactions. For example, wheat may be added over the course of a week or two, the corn, etc. Many dogs are allergic to wheat. Switching to an all protein diet such as Innova, Evo or Wellness can provide great relief for your dog’s allergies, as well as increased health. I decided to switch from Purina to Wellness and Innova (switching between the two) about 6 months ago and have noticed major improvements in my lab’s health as well as a reduction in allergies, better skin health and decreased lick granulomas.
Fatty acids have been shown to help decrease underlying causes of lick granulomas as well as antihistamines. I have had my lab on a fatty acid as well as vitamins with Omega 3 and 6 which have been very effective in helping decrease the lick granulomas.Your vet may do a skin scraping or biopsy to determine if there are underlying causes such as fungus or a bacterial infection.
Once your dog has developed a lick granuloma, it is a major undertaking to get rid of it. Wikepedia states that control for lick granulomas does not occur in 65% of the cases.Trying to treat a lick granuloma is often a trial and error approach. The first thing to do is to be sure to keep the area clean. Use an antibiotic ointment such as Neosporin on the lick granulomas, and then cover the area with a self-sticking bandage. If your dog has a lick granuloma, chances are that she will continue to lick the area and may begin to bite through the bandage in order to get at the hot spot. Try to keep an eye on your dog when she has a bandage on. Consider putting the bandage on while you are home and off when away if your dog has a major problem with having a bandage on her foot or skin. It is also helpful to use a first aid anti-itching product daily or several times a day in order to reduce the itching and soreness associated with the problem. If your dog continues to lick the area or bite off the bandages, an Elizabethan collar may be used for a period of several weeks to allow the lick granuloma time to heal. This may not be a comfortable option for your dog. My lab became severely depressed when we had an Elizabethan collar on her, so we decided this was not a good option for her as it caused a secondary problem. Bitter tasting sprays such as Bitter Apple can be used over the bandage to discourage licking. I have not had good luck with this particular method as the Bitter Apple does not seem to last for a long period of time. Cortisone applied directly to the lick granuloma can help aid in the itching associated with the lick granuloma. We have had some luck with antihistamines and steroid treatment but not complete success.
Your vet can also prescribe medications such as Prozac which helps to make your dog more calm and secure. If your dog has a major problem with continuously developing lick granulomas, this can be an option to consider. This is a long term route to take and the chances are that your dog will be on a medication such as Prozac for the rest of their lives. Steroids are other medications your vet may prescribe. According to Wikepedia, before behavioral treatment has time to take effect, there are drugs on the market in addition to Prozac that can be helpful such asdoxepin, amitriptyline and clomipramine. They also suggest endorphin blockers such as naltrexone to reduce addiction to licking or endorphin substitutes such as hydrocodone which may help decrease the urge to lick.
According to Mar Vista Medical Center, Prozac is helpful in about 50% of lick granuloma cases. Medication is given for 4 weeks and doubled if no change is noticed, then discontinued after 4 weeks if still no change occurs. They state it will cost about $135 for one month’s treatment for a 75 pound dog. Mar Vista Medical Center reports that Naltrexone is helpful in about 50-60% of cases and is taken for about a month. If the licking stops, the medication is discontinued.
The other major reason why lick granulomas develop is behavioral. If you have ruled out allergies, fleas or other conditions such as a joint issue, then it is likely that there is a behavioral reason such as anxiety, or what I call, “being unemployed”. Larger dogs such as working dogs like Labrador retrievers are more prone to developing lick granulomas as a result of boredom and anxiety. Providing chews, rawhides and Kongs are a very helpful way to keep your dog occupied. Be sure your dog gets plenty of exercise and engage them in activities where they have to work at or seek food such as stuffed Kongs. This provides a similar experience for hunting for food. If your dog is left alone for long periods of time, consider avoiding confining them to small spaces, providing more exercise before the time they are left alone and increased interaction upon your return home. There are also products such as pills on the market that are designed to help increase calmness in dogs that suffer from separation anxiety or thunderstorms.
An extreme method of treatment is surgery. According to Wikepedia surgery can be performed to remove the lesions but there is a risk of self mutilaton afterwards. In addition, licking on another leg may also result causing another lick granuloma. Mar Vista Medical Center also suggest acupuncture as a possible treatment.
My Experience with Lick Granulomas:
My lab has suffered from lick granulomas for most of her life. She tends to develop lick granulomas on one leg and when that one begins to heal, she finds another spot usually on the same leg, so the sore becomes larger or there are then two sores. Finding a way to treat the lick granulomas has very much been trial and error with our dog and a constant source of annoyance for my poor dog. We have discovered that the lick granulomas are both due to allergies as well as anxiety and a lack of “work”. To control the allergies, I bathe her more in the spring and summer when the pollen count is high, and wipe off her paws and between her toes. For food allergies I switched my lab from Purina to Wellness or Innova and have found using a high protein diet has been very helpful for her. Her coat is healthier and she licks her paws less frequently. In addition, fatty acid supplements, Omega 3 and 6 help to reduce itching and is good for her overall health, especially now that she is older. Antihistamines and steroids have all been tried with some results but not completely helping. I also do not like to keep my dog on steroids for a long period of time as they do have side effects and with long term use can be harmful. Preferring not to use medications we have only kept our lab on them for short periods of time to help with severe allergies or when the lick granulomas become severe. This seems to occur during certain times of year such as the change of season. Using bandages has been frustrating for both me and my dog. She removes them almost as soon as I put them on. If I am really persistent and replace the bandage each time she bites it off, I can go through a few a day but it does help the lick granuloma heal but only a little. However, it is not always realistic to replace a bandage a couple of times a day as most of us work and have other obligations. I have found applying Neosporin daily to her lick granuloma helps in the healing and seems to keep her away from chewing it. In addition to the changes in food and providing supplements, the biggest treatment that has been the most effective is providing more work for her to do. Never being one for toys or much of a chewer, my lab has not chewed bones for many years until our puppy came along. She suddenly began to show an interest and providing her with rawhides, Kongs, Dental Bones, Nyla bones and other bones has helped incredibly to keep her occupied and licking/chewing other things besides her feet.
My best advice is to try a variety of methods to treat your dog’s lick granulomas. It is probable that one method won’t work initially and a combination of methods will be the most beneficial. It is probable that your dog has developed a lick granuloma for more than one reason and you will need to treat more than one cause. Be persistent even though it can be disheartening to know you care for your dog in many ways but yet they still have developed a lick granuloma. Know that it can take weeks and months to heal a lick granuloma and when one heals, another may develop. Do this in conjunction with a vet’s advice to be sure you are seeking the most appropriate treatment and that there are no serious underlying medical causes for your dog’s lick granulomas.
