To assess the dog for a possible skin condition your vet will need to examine the dog all over, as the primary affected area may not in fact be where the dog is licking. Then the vet will decide whether to go ahead and do skin scrapes, hair plucks and so on. It is also usually necessary to take a skin biopsy of the affected area for histopathological assessment and a swab for culture to determine whether antibiotics are indicated and which type will be effective. Other tests may include blood tests to check hormone levels.
Managing the condition
Management of a skin condition will depend on many factors, such as the underlying cause (external parasites such as fleas or environmental allergens, for example), the severity of the condition and financial constraints. Treatment consists of a multi-modal approach and may include products such as prescription shampoos, topical creams, skin supplements, prescription diets and prescription oral medication. Management is often ongoing and should be adjusted regularly according to how well the patient is responding.
Licking as a response to pain will require a thorough examination and possibly radiographs. Some conditions that cause pain could be a foreign body (such as a thorn) or arthritis. Effective pain management will depend on the origin of the pain and the severity of the pain but may include anti-inflammatories and a prescription diet.
An acral lick granuloma can be a primary behaviour problem, but it is often triggered by a medical condition. The dog starts licking in response to the underlying medical condition, but then the licking becomes compulsive. Compulsive behaviours are difficult to treat. Environmental enrichment and a behaviour modification programme must be implemented as part of behaviour therapy. Most cases require behaviour modifying medicines, which may need to be given life-long. The underlying medical condition must also then be treated at the same time.
Dr Patricia Mills