Millie is a lively, energetic dog. She is taken for a walk twice daily, and she loves to exercise. She rushes everywhere, never seeming to tire. When she comes in from a walk, she is still brimming over with nervous energy. When I saw her recently, Millie had developed a skin problem that was related to her excited, edgy temperament.
For no particular reason, a red, raised patch of skin had appeared on the front of her lower left leg. Millie had never suffered from skin problems before. She began to lick the sore area, and soon, a clearly demarcated swelling as big as a one euro coin could be seen. It almost looked like some type of skin tumour. Millie was soon licking and chewing it almost continually, and she was brought in to see me. What could be going on?
I checked Millie over carefully. She was a robustly healthy dog, in her prime. There were no skin parasites such as fleas, ticks or mites. She had not had any change of routine, such as new bedding which could have prompted an allergic reaction. The only problem I could find was that single raised red area. I clipped the fur away from the sore skin, so that it could be seen more clearly.
As I worked with her, Millie looked at me anxiously. Some Labradors are passive, calm individuals, who are completely relaxed and docile, unfazed by anything going on around them. Millie would not fall into that category. You can see from her facial expression that she has a tendency to be anxious about anything out of the ordinary. As I picked up her leg to examine her skin more closely, her brow furrowed and she glanced nervously around the room. When the electric clippers were switched on, she tried to leap off the table.
Millie’s sore area was a classical example of a skin condition known as a “lick granuloma”. This is a self-perpetuating area of sore skin. It is initiated by a one-off episode of irritation, such as a small cut, a graze or an insect bite, which nearly always goes unnoticed by an owner. In most dogs, such a mild irritation rapidly resolves by itself.
But dogs like Millie start to lick and nibble the irritated area, and this makes it even more swollen, red and itchy. A vicious circle then kicks in. The more Millie licks and chews the area, the more swollen and itchy it becomes. This makes her want to lick and chew it even more. The problem is then aggravated by bacteria moving into the damaged skin. As the bacteria multiply, they produce acids and toxins which cause further irritation. The problem goes on and on, and without help, a lick granuloma can persist for many months or even years.
The problem is especially common in intelligent but nervous dogs. It is a combination of a physical problem with a psychological urge to lick and chew. Treatment is not always easy, involving a combination of dealing with the physical problem as well as addressing the psychological issues.
In general, it is necessary to cover the area with a dressing, or to use an “Elizabethan collar” to stop the dog from licking the area. I suspected that Millie might not cope well with the stress of a large lampshade-like collar around her neck, so I started with a simple bandage over the affected area. I sprayed this with an anti-chew aerosol that gives the bandage a bitter taste. I also gave her a course of antibiotics to control the bacterial infection in the skin.
I also discussed what could be done about the psychological problem. Anna told me that Millie enjoys chewing a red rubber chew toy called a Kong, which contains a central cavity filled with food. Millie loves the challenge of working out how to get the food out of the Kong. We agreed that it would be a good idea to give her a newly filled Kong twice daily, to give her something to think about rather than her sore leg.
The self-chewing habit can be very, very difficult to resolve in some dogs. Sometimes a course of anti-anxiety medication (like a dog version of “Prozac”) is needed to help a dog get over a nervous habit like this. I remember one dog that had to stay on permanent medication. Even when the original problem had completely cured, she would start to lick and nibble her leg as soon as her owner stopped giving her tablets. The red sore area that had completely resolved would recur within a few days if the tablets were not restarted. In her case the problem had become a deeply engrained psychological urge that could only be modified by anti-anxiety drugs.
Luckily, most cases respond very well to simple treatment. As it happened, Millie needed to come back to have a lampshade-like collar after all. Bandaging alone was not effective enough. But when she came back three days later, she had grown used to the collar, and she was leaving her leg alone. The red area was much smaller in size, and I am confident that she will soon be fully cured.
Tips
- “Lick granuloma” is a common problem in intelligent dogs
- Keeping affected dogs busy with interesting chew toys is part of the treatment
- Some cases are very difficult to cure, and can continue for many months.
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