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Eric Barchas, DVM is a veterinarian who lives and works in the San Francisco Bay Area. His emphasis is on small animal medicine, emergency medicine, hospice and wellness. An avid traveler, he has studied lions in Botswana and salmon in southern Chile.

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Acral Lick Dermatitis and Lick Granulomas in Dogs

Animals Affected

Dogs

Overview

Acral lick is a syndrome in which dogs excessively groom the skin at the junction of the leg and the foot. This can result in trauma and irritation to the skin, known as dermatitis. As the process continues, a fleshy pink mass known as a granuloma may develop at the site.

Acral lick appears to have a psychogenic, or psychological basis. It can be exacerbated by boredom or stress. Once a granuloma develops, continued grooming of the area causes the release of endorphins in the brain. This results in a form of euphoria and promotes continued over-grooming.

Like other psychogenic problems in dogs, acral lick is difficult to treat and is rarely cured. However, most cases can be controlled with a combination of exercise, mental stimulation, and, in severe cases, medication.

Symptoms

  • Mild acral lick lesions occur as round, hairless areas at the junction of the leg and foot (the wrist on the forelimbs; the ankle on the hind limbs). The underlying skin may be moist, red, or irritated.
  • In more advanced cases, granulomas develop. Granulomas are hairless, pink, fleshy masses that are often moist.
  • In some cases, people living with the dog may notice excessive licking of the affected area. However, many dogs engage in over-grooming only when the owner is absent.

Risk Factors and Prevention

  • Individual temperament plays a role in the development of the syndrome. Nervous, high-strung, or high-energy dogs appear to be at increased risk.
  • Dogs that do not benefit from adequate exercise or enrichment (mental stimulation) are prone to acral lick.
  • Dogs that spend prolonged periods of time alone may over-groom due to boredom.
  • Some experts have suggested that flea bites may exacerbate the syndrome.

Complications

  • In general, acral lick is a nuisance but does not pose a serious risk to health or well-being. However, acral lick tends to be a chronic, long-term problem. Owners of dogs with the syndrome often become frustrated.
  • Rarely, dogs with severe acral lick lesions suffer from sever skin infections, pain, and discomfort.

Diagnosis

Most cases of acral lick are diagnosed by visual inspection of the affected area. Veterinarians may run tests to ensure that ringworm, demodectic mange, and other skin diseases are not participating in the problem. Skin biopsies are sometimes used to confirm the diagnosis.

Treatment

Non-medical therapy controls acral lick in some cases.

  • Increased exercise may prevent high-energy or nervous dogs from over-grooming.
  • Enrichment activities may provide mental stimulation and reduce boredom. Teaching tricks to a dog is an example of an enrichment activity.
  • Dogs that spend long periods of time alone may engage in less over-grooming if owners arrange to spend more time with them.
  • Meals can be provided in a toy that slowly releases food as the dog plays with it. This extends the duration of meals, and may alleviate boredom and over-grooming.

Topical treatments often aid in the treatment of acral lick.

  • Proper flea control should be implemented to ensure that flea bites do not exacerbate the problem.
  • Unpalatable substances, such as bitter apple, can be applied to affected areas as long as the skin in the area is not damaged. The flavor of the product may discourage licking.  Potentially irritating substances should not be applied to damaged skin.

Medications, including antibiotics, prednisone and related drugs, and antidepressants, are sometimes prescribed. Medications are more effective if they are implemented in conjunction with the non-medical and topical therapies above.

For some dogs with severe, intractable acral lick, an elizabethan collar (cone collar) is the only way to prevent over-grooming.  Surgical removal of the affected area of skin may help some dogs with acral lick granulomas.

Follow-up

Because acral lick is generally not curable, dogs may develop lesions recurrently.

Miscellaneous

The risk factors and treatments for acral lick dermatitis are similar to another common psychogenic disorder in dogs: separation anxiety.

Psychogenic alopecia in cats has causes and treatments that are similar to those of acral lick.

Copyright © Eric Barchas, DVM All rights reserved.
The contents of this page are provided for general informational purposes only. Under no circumstances should this page be substituted for professional consultation with a veterinarian.