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Compulsive or Boredom Licking
Medical or Behavioral Issue?

Also known as Granuloma, Acral Lick Dermatitis or Psychogenic Alopecia (often over diagnosed as being the problem, especially with cats). Medical conditions that can be confused with psychogenic alopecia should be ruled out before beginning treatment.

Medical Conditions to Consider:

  • Skin parasites (mites, fleas) might cause excessive irritation and thus overgrooming. For those familiar with psychogenic alopecia, the appearance is fairly typical, and parasites are fairly easy to detect, but confusion is possible in some cases unless a careful inspection is made. Skin scrapings may be needed.

  • Fungal infections of the skin. Skin scrapings and fungal culture should be performed. A trichogram [microscopic inspection of shed and purposely depilated hairs] can be helpful. With psychogenic alopecia it is common to find broken, barbered hair shafts rather than intact hairs with the root attached.

  • Hormonal conditions can be ruled out by means of appropriate blood work.

  • Allergies (from environmental products such as harsh laundry detergent used to wash bedding, plug in air fresheners, cleaners to  improper diet for the breed) can produce a similar pattern of baldness and their possible contribution should be carefully considered. Sometimes the irritation caused by allergies can focus an anxious dog on self-grooming so that the two conditions become intertwined.

  • Yeast infection caused by the overuse of antibiotics which negatively alter the intestinal microflora balance.

A simple rule to remember to assist in diagnosis is that allergies respond to treatment with corticosteroids whereas OCD (obsessive-compulsive disorder) does not.

Last but not least, consider any new medications your dog may be taking, even if over a month or more. Your dog may be showing signs of an allergic reaction to the drug by licking his feet. 

Why Do Dogs Do That Constant Licking?

Numerous theories abound regarding this almost mesmerizing habit. Some possible causes include trauma, itching, peripheral nerve irritation, boredom, allergies, skin infection, arthritis or other joint problems. Boredom, confinement, loneliness and separation anxiety have also been implicated. It is often very difficult to determine if a physical or psychological problem is causing a dog’s obsessive licking and grooming of the area.

Unless a dog is exceptionally high strung and obsessive, this problem usually does not occur until a dog is five or six years old.

It is fairly common in older, more sedentary and overweight dogs. As dog age and arthritis and obesity make them less mobile, they spend more time grooming themselves – an activity that requires less energy.

Sometimes the lesion begins as a scrape or pustule; but often there is no apparent defect at the site where licking begins. It is very uncommon for a dog to have more than one or two of these areas on his or her body. As they continuously lick these areas, hair is lost, the area becomes firm and raised and superficial staphylococcal infections often set in.

With time, the skin of the area thickens and either gains or looses pigment. The resulting wound is called a granuloma. The center of these lesions is often ulcerated. These wounds are often unsightly but never life-threatening. Scabs rarely form because of incessant licking.

One theory may apply for one dog and an entirely different theory may be correct for another.  In Summer's case (the dog on our website), it was an insecurity issue coupled with boredom.

Before acquiring her, she had been crated most of her young life for long periods of time. Boredom easily set in and with no where to go and no distractions offered, she began licking the inside of her paws. Constant licking had totally remove all the hairs between her toes and the skin was raw.

It took us almost three months of constant care before Summer's wounds began to heal. We did not use an e-collar. Our opinion of those things is that they are a tortuous invention designed to drive a sane dog either mad or into depression.

What we used to help heal her lick granuloma:

  • Several pairs of white, cotton, infant socks.

  • One pair of nylon dog booties with velcro fasteners.

  • Antibacterial liquid soap

  • Gold Bond Medicated Powder

  • Buffered Baby Aspirin (81mg) if needed for pain. For a dog under 10 lbs, only use 1/4 of an 81mg aspirin. Our dog weighed over 80 lbs so and 81mg aspirin was adequate.

This is how we treated her wounds:

  • Using the antibacterial liquid soap, we cleansed her paws twice daily and thoroughly dried them even using a paper towel afterward to make certain there was no dampness at all.

  • Next, we generously applied Gold Bond Medicated Powder to the affected area. Gold Bond POWDER 

  • Then we slipped on the infant socks which would provide cushioning and comfort inside the nylon booties

  • Lastly, we fastened on the nylon booties over the infant socks.

  •  Buffered baby aspirin was only used during the initial cleansing but was not needed when her wounds began healing.

Remember that a lack of companionship is a major factor in many cases of prolonged paw licking called granuloma. Summer eventually ceased the continuous licking habit and only once in a great while would retreat back into that world of hers where she would close her eyes and begin licking her paws. When we would be aware of this behaviour, we would quietly say "Summer", and she would immediately stop. Her skin and and hair growth returned to normal and fortunately she never had that issue again. 

Here is another cost effective method for skin problems an individual submitted. Apple Cider Vinegar mixed with water. ACV

1 teaspoon of vinegar per cup of water. Vinegar is an antiseptic which prevents the proliferation of bacteria, viruses, or yeast that trigger infection. It can also dissolve excessive fatty deposits at the surface of the skin and reduce scaly or peeling conditions. Lastly, vinegar regulates the pH of the skin. Saturate the affected area with the vinegar solution. (Allow to dry thoroughly before covering with any type booties or socks.)

Do not use near eyes or sensitive areas like the anus. Use cotton balls to apply the vinegar as these retain the moisture quite well. Unless the dog’s skin is infected, try to treat with natural methods rather than using antibiotics or steroids. Adding teaspoon vinegar to your dogs drinking water will also help.

Licking (Boredom or compulsive)

Do not use any alcohol or peroxide to cleanse the wounds as these will cause major discomfort. Witch Hazel will accomplish the same thing without burning. In fact, it feels cool so your dog may not mind if you pour it on the affected area. Hint: Try putting a little on the area initially so as not to startle your dog needlessly. Witch Hazel can be found along the same isle as rubbing alcohol.

If this licking has recently occurred, you may want to investigate your dog's diet. Proper nutrition plays a major part in the overall health of a dog and all dogs do not benefit from the same foods. Dog food nutrition

Breeds most likely to have a Lick granuloma
Doberman Pinscher German Shepherd Golden Retriever
Labrador Retriever Irish Setter Weimaraner
Lick granulomas are almost always located on the front of the wrist area (carpal area)  or on the front or outside of the rear leg just above the paw (tarsal area).  They are thick, hairless, scarred sores that have ulcerated and oozing centers as a result of continuous, compulsive licking.

Many dermatologists think that boredom is a major underlying factor in some cases of Acral Lick Granuloma. The dog's licking activity helps pass the time. Some believe that allergic inhalant dermatitis creates stress in the skin resulting in inflammation and pruritus (itching) which triggers the dog's propensity to lick at any convenient area.

A foreign body such as a thistle spine, splinter or bee sting might start up a reaction in the skin which leads to drawing the dog's attention to the spot.

Bone or joint pain can draw the dog's attention to the wrist or ankle area and in an attempt to alleviate the discomfort the dog licks over the top of the joint.

Psychological stimuli such as separation anxiety, a new pet or child in the home, or neighbor dogs invading the dog's "territory" can create psychological stress.  Self stimulation such as picking out an area to concentrate on and licking for extended periods of time are a way for the dog to relieve the "stress". 

Hypothyroidism has played a role in some cases of Acral Lick Granuloma.   Especially in Black Labs with lick granulomas it would be a good idea to have the Thyroid Gland function checked.  Thyroid medication may just be what the dog needs to have those skin lesions resolve.

Vaccinations and boosters Over vaccination of pets is sometimes known to cause allergic reactions.

http://www.k911.biz/Petsafety/VaccineDangers.htm 

Anytime there is a "behavior" involved, it is most important to first rule out an underlying medical reason for the behavior. If all medical concerns are ruled out, then the problem can be approached as a behavioral one, and behavior modification techniques can be employed.

Some questions to consider: Is this a new behavior? Is it both front feet or all feet? Are there any other conditions present such as limping or swelling in the foot? A foot licking problem can start out as a medical one and later become a habit or compulsive behavior.

Your veterinarian will be the only one to fully determine what is going on with your dog's feet, but here are some things your veterinarian will want to know and will be looking for on examination:

  • Are the feet red, swollen, or crusty/flaky?
    This could be indicative of a local irritant (such as deicer) or inflammation/infection from bacterial, fungal and/or parasitic sources. Even if the inciting cause is no longer present, constant licking and chewing can become a self-propagating cycle of continued trauma to the skin and continued inflammation.
  • Is licking present in the absence of any noticeable pathology of the feet or toes? This could be from inhalant allergies causing general itchiness, arthritis or other painful "interior" conditions causing pain in the area without visible infection, etc. on the foot.
  • Are there any irregular lumps or bumps deep between the toes or foot pads?
    Cysts or other growths or small abscesses can occur, causing discomfort and licking.
  • My dog is just licking without any visible signs of something wrong on the foot!
    Foot licking can be simply a habit behavior as well; seen when the dog is relaxing, stressed, or bored. Some dogs even chew at their nails with this type of behavior.

Depending on what your veterinarian finds on examination, treatment to stop this behavior will be aimed at the underlying cause. For cases of allergy or infection, there are medications and/or dietary changes that can be made to assist with the problem. In situations where pain is the underlying cause, that should be dealt with directly to alleviate the licking. Growths or abscesses are usually treated surgically. Pet owners should always be vigilant about environmental hazards to feet; such as deicing compounds in the winter and very hot pavement in the summer.

Behavioral modification to stop paw licking and chewing, like any behavioral modification, takes time, patience and consistency.

Distraction is also a good technique: playing games, offering other toys and incentives to keep your dog occupied coupled with positive reinforcement will help break the cycle. Do not opt for an e-collar as your first choice of dealing with the problem. Most dogs do not like these and it will only add to their stress level.

See also:  http://www.k911.biz/Petsafety/HotSpots.htm

http://www.k911.biz/Petsafety/WormsandParasites.htm

Constant licking may occur if your dog has a heavy worm load.