How are lick granulomas treated?
Lick granulomas are very difficult to treat. It can take multiple attempts to try to solve the problem.
The sooner treatment is started the less the risk of secondary infection and more major local treatment such as surgery.
A first step is to try to establish if there is a cause of irritation. Allergies are the most common cause of skin problems. Check out the list of allergy symptoms and see if your dog has any of the other symptoms such as rubbing their muzzle, licking paws etc.
In addition to allergies, your vet will check for mites and other potential triggers. If the original cause was an infection or a wound this will probably no longer be detectable.
If a cause is found, the underlying problem will be treated by your vet.
The aims of local treatment are to stop the dog licking the area, healing of the granuloma and treatment of any secondary infections.
To stop a dog licking the area, bad-tasting liquids can be applied to make the area unpalatable. This is often not effective, but worth a try. Bad-tasting liquids formulated for dogs can be purchased wherever you buy your pet supplies, or through your vet.
Steroids, both applied to the granuloma and injected in the area may be used. These will reduce the amount of inflammation and irritation in the area.
Usually a dog will be given antibiotics to cure any infection that has developed. It can be quite difficult to completely stop an infection, so multiple antibiotics or an extended treatment time may be required.
If the lick granuloma is well developed, a vet may decide to use surgical removal, cryotherapy (freezing) or radiation treatment.
An Elizabethan collar (lampshade) and/or bandaging are often used while the area is healing so that the dog cannot lick the area.
If stress, boredom or separation anxiety are playing a role in the licking behavior, then without dealing with these, there is probably no chance of permanently stopping the licking. Regular moderate exercise, more mental stimulation and attention are often very helpful.
To reduce the obsessive component of a dog’s behavior, a vet may temporarily prescribe a medication that is used for obsessive compulsive behavior such as Clomipramine (Clomicalm). This may help break the habit.
DAP, or dog appeasing pheromone, is a pheromone that a female dog will secrete for a few days after the birth of puppies to keep them calm and quiet. Dogs of all ages will respond to the pheromone.
Some dogs with obsessive behaviors will respond to DAP and either stop a behavior, or more frequently be less interested in doing it. It is certainly worth trying as part of the overall treatment strategy.
Besides DAP collars, sprays and diffusers are also available.
Lick granulomas are hard to treat.
Any source of irritation, which may have started the process, has to be eliminated. The granuloma has to heal and not leave anything that will attract the dog’s attention so that they will start licking again. Also a dog has to no longer want to obsessively lick the original area (or another area), so their needs to be a change in behavior.
Curing a granuloma and stopping the behavior can take multiple tries, until the best approach is found.