Acral Lick Granuloma: A Dermatology Nightmare
The use of laser surgical instrumentation is fast becoming a useful tool to assist in treatment of lick granulomas in dogs. The laser instrument ablates (removes) the tissue by vaporizing the surface layers. As the laser light energy passes over the diseased tissue it is essentially vaporized, nerve tissue is sealed so that little sensation is perceived by the patient, and bleeding from the surgical area is minimal.
Your veterinarian may have laser surgery or may refer you to a veterinarian who does so that a consultation specific for your dog's problem can be arranged.
There are also other numerous methods that have been tried in an effort to stimulate healing and resolution of acral lick granulomas in dogs. Some therapy is directed at attempts to keep the dog away from the skin lesion in order to allow it to heal. The truth is that no single method works very well.
Such things as bandaging the entire leg (the dog will lick just above any wrap or cast that is placed over the lesion) and applying nasty tasting materials such as bitter apple or hot sauce have been used to treat lick granulomas, usually to no avail.
Barbed wire wrapped in plaster casts doesn't work. Putting an Elizabethan collar on doesn't work well either because as soon as it is removed the licking starts again and the dog will activate the lesion all over again.
The bottom line is that these chronic, infected, ulcerated skin lesions are often the result of a psychological compulsion to lick and chew at this target area.
Obsessive and compulsive disorders do occur in dogs and these lick granulomas can therefore persist for years and years. Psychogenic and anti-anxiety drugs have been tried, too. And though they may make a slight difference, it dogs do not respond well enough to call psychoactive medications a cure.
Cortisone injections into and under the granuloma quiet them down, alleviate pruritus (itchiness) and shrink them --but only for a while. The dog will then start to lick at the area and the lesion becomes as big as ever. Deadening cutaneous nerves has been tried, even Cobra venom was professed to have a cure rate of 90 percent way back in the early 1970s, but these methods have proven to be unsatisfactory.
We've got a real dermatology nightmare here! Something makes the dog compulsively attracted to the granuloma and they often will start licking at a different place if the dog is prevented from licking at the original lesion!
So what is one to do about lick granulomas? Long-term antibiotics seem to be the best form of treatment -- as long as three to six months may be required for significant improvement. Cortisone topical creams rubbed into the lesion daily can help. Topical medications that have multiple antibiotic/cortisone ingredients can also help.
Acral lick granuloma is one disorder where the veterinarian preaches control or management of the skin problem since a cure is not now known. Any little thorn, splinter, tick bite, scratch or infection over the carpal areas in the front legs and over the area lower down from the tarsus in the rear legs can quickly lead to a granuloma. So keep a close eye on these problem spots and at the first sign of persistent licking at one particular site, get veterinary help as soon as possible.
Many types of dermatological problems are avoided if the dog or cat is consuming an optimum diet. If your dog or cat seems to lack good coat and skin health, consider upgrading the diet to a meat-based ingredient formula and adding a supplement, such as omega fatty acids, can make a very real difference.
Please remember not to be overcome with despair. You and your veterinarian will come to the best form of treatment for you furry friend.
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