A lick granuloma is one of the most common, stubborn skin diseases you’ll encounter in dogs. It is also known as lick granuloma, acral lick dermatitis, acral pruritic nodule, and ALD, and is caused by a dog repeatedly licking one area of the body (usually the lower leg). In time, this localized self-trauma causes irritation and open sores. As far as pets go, lick granulomas only affect dogs, though they can also occur in cattle, and humans.


While the cause of the lick granuloma is the repeated licking action, what is causing your dog to do this, in the first place? Well, a number of things, like:

  • Boredom;
  • Atopy;
  • Food allergies;
  • Cancer;
  • Hypersensitivity;
  • Flea bite sensitivity;
  • Emotional problems;
  • Wounds;
  • Joint pain;
  • Behavioral problems;
  • Staphylococcal furunculosis;

According to studies, the most common causes of ALD are behavioral conditions and various allergies. In most cases of behavioral or allergic ALD, it’s also quite likely for your dog to develop a secondary bacterial infection, and a foreign body reaction from ruptured hair follicles, which keep the ALD going. The ALD is also kept going when the affected skin develops an ulcerative skin lesion (from the excessive licking), which becomes itchy, which then causes the dog to lick, and thus continue the cycle.

Aside from the relief provided by the licking, the action itself may release endorphins in some dogs, which can in turn help with anxiety, and help cope with stress. This may be another reason why dogs engage in obsessive licking behavior.

Lick granulomas are a very non-discriminating affliction – they can affect dogs of any age, and breed, both male and female. While any breed can be affected, lick granulomas are more common among German shepherds, Doberman pinschers, German short-haired pointers, Golden retrievers, Irish setters, Labrador retrievers, Pointers, and Great Danes.

Signs of ALD

As a dog owner, it’s also important to understand the common signs of lick granuloma to look out for in your pet. While the symptoms of this disease will vary from pet to pet, common signs include:

  • Hair discoloration;
  • Skin sores;
  • Hair loss;
  • Hyperplasia – is an abnormal increase in the number of normal cells. Obviously, you won’t be able to look for this yourself, but it may be spotted during a routine vet visit;
  • Fibrosis – this is a formation of fibrous, gristly skin and tissue;
  • Lameness – this difficulty is caused by the mass and growth of the underlying, affected bone.

While signs of a lick granuloma can be spotted anywhere, it’s more common for them to appear on the front or side of the lower legs. Although rare, you may discover such ulcers on the flank and base of the tail, as well. Keep in mind, as you examine your pet, that lick granulomas can occur in multiple areas of the body at once and are not limited to a single limb.

Diagnosing lick granuloma

Depending on the general condition of your dog, your vet may require one or more of the following, for an accurate lick granuloma diagnosis – physical examination, biopsy or histopathology, skin culture, or skin cell examination. All of these can help the vet determine the cause of your dog’s lick granuloma and the severity of the affliction.

Treatment of lick granuloma

Once an accurate diagnosis has been made, the doctor will proceed to determine an appropriate treatment. As with the diagnosis, the specifics of your dog’s treatment will vary from case to case. The first step in a thorough treatment plan will be identifying the cause of your dog’s lick granuloma. As we’ve seen, ALD can stem from a bunch of different issues, from the emotional or behavioral to more serious underlying conditions. The treatment prescribed by your vet will depend heavily on the root cause.

For instance, if it’s determined that your dog’s ALD comes from mental or emotional causes, then the vet may prescribe more human contact, providing other animal companions, changing kenneling habits, or distracting the animal with chew toys and playing. While tricky, in time, emotional and mental causes of a lick granuloma can be corrected.

The doctor may also opt for medical treatment options for your dog, including sedatives or tranquilizers, corticosteroids, antidepressants, antibiotics, pentoxifylline, or endorphin blockers.

If the lesion is severe, surgical removal may be necessary, as might radiation therapy, or laser therapy. Your doctor will also want to focus on preventive measures, to stop the dog from licking the lesion in the future. Common options include bandages, e-collars, or applying bad-tasting substances and creams to the granuloma.

While the treatment can take months and is tricky to get right from the start, doctors are hopeful. ALD can be controlled with patience and cooperation on the client’s part, even if finding the right treatment for your dog may take a while, at first. So have faith.