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A complete natural treatment protocol for lick granuloma in dogs

A complete natural treatment protocol for lick granuloma in dogs

The surprising cause and a 7- step natural treatment plan
There are many misunderstood conditions in medicine, but lick granuloma is probably one of the most common ones. It could easily be the medical form of “a wolf in sheep’s clothing.”

By definition, lick granuloma stands for a hairless, thickened, inflamed, swollen patch of skin that dogs usually lick obsessively. If you are wondering how to differentiate other skin conditions from lick granulomas, they can be recognized or differentiated by your dog paying attention to one single, very specific patch of skin.

In the conventional medical circles, the most common explanation of the cause of lick granuloma is the incessant licking of a patch of skin attributed to anxiety, obsessive behaviour and some sort of emotional instability in the affected dog.

Here is a quotation from a medical article by Dr. Mark Grossman, DVM:

Acral lick dermatitis (aka acral lick granuloma or acral lick furunculosis) is a self-induced dermatologic condition in dogs. It develops secondary to excessive and chronic skin licking on one or more areas of the body. To quote the esteemed veterinary dermatologists Danny Scott and Bill Miller here, 'This is one of the most obstinate skin disorders to treat, but at least it is not life-threatening.' 

For several years after my graduation, I followed the conventional treatment protocol to stop licking by applying bitter apple spray on the affected area, recommending Elizabethan collars (“the cone”) on my patients and, in some cases, resorting to biopsies of the affected skin to find nothing more than chronic inflammation and possible secondary infections. As the number of unsuccessfully treated patients and frustrated owners/clients grew, I clearly saw that I was missing the real cause. I decided to ditch the textbooks and became a sort of medical detective determined to solve the lick granuloma mystery.

Most dogs are naturally happy, content, and intuitive creatures, and I was convinced that there was another reason behind their licking than obsessive behavior. If you are a person who glances at an article and moves on to the next one, and if you have a dog who suffers from a lick granuloma, I urge you to make an exception and finish this one. It will allow you to gain a completely different perspective, help your dog with his discomfort, and gain the ability to help others.
Beyond cookbook medicine 
There is a part of veterinary medicine beyond the “cookbook” approach to disease that is exciting, eye-opening, and full of simple solutions to many health issues. The following lines will take you through a series of clues that led me to help many dogs with lick granulomas without drugs and surgery and also at a very low cost.

I. What if?
It is common knowledge that with some exceptions, most lick granulomas are located in the forelegs and forepaws. Naturally, one must wonder why dogs choose the forelegs.

When we step back from the idea that dogs lick because of obsessive behavior, the natural question that comes up is: “WHAT IF dogs who lick excessively feel some sort of abnormal sensation such as numbing or a pin and needle sensation?”

Lick granuloma can be also present on the skin of hind legs and paws but this is not as common as on the forelegs. It is also very rare to see lick granuloma (LG) in other locations of the body.

II. What is responsible for a possible sensation in your dog's legs and feet?
The key to resolving the mystery of lick granuloma is to allow ourselves to think that LGs are not as they appear. If you allow yourself to trust that your dog licks, then the possibility of some sort of abnormal sensation (paresthesia) is highly likely.

Such sensation may come from either local sensation due to a thorn, a sliver, or some sort of foreign material embedded in the skin. However, to most people’s disappointment, local causes of lick granulomas are rare.

Accepting this, there are two other options:

A. Your dog’s abnormal sensation can come from a nerve injury or pressure along the nerves that supply the foot or the leg.
B. The abnormal sensation comes from a pinched nerve near your dog’s spine. The nerves for your dog’s foreleg originate at the lower cervical and cranial (closer to the head) portion of the thoracic spine. In the case of hind leg licking, the nerve supply comes from the lumbar spine.

III. Foreleg and forefoot lick granuloma
Because the nerves to the front leg originate in the neck and cranial thoracic spine, one must pay attention to collar injuries. Most dogs pull on their leash, which can lead to cervical injuries. However, even the dogs that do not pull their leash on a regular basis may suffer side-effects from retractable leashes that apply persistent pressure to the neck. Other causes of neck injuries may be collars that are too tight (less than 2 fingers fit between the skin and the collar), sudden jumps or jerks forward when on a leash, or falls and tumbles.

These injuries range from mild muscle tightness that causes nerve impingement of the nerves supplying the foreleg to cervical disc injuries, the most severe form.

Such injuries lead to abnormal nerve sensations such as pins and needles or numbing. The location of this sensation depends on which nerve gets injured. The nerve pathways are also parallel to the energy meridians and blood flow in the affected area, which affects the overall health and resilience of the particular segment. These factors combined lead to a lack of hair growth and an unhealthy thickening of the affected skin.

This thought process helped me create a simple treatment plan that has been surprisingly effective. It works like a miracle in the majority of dogs, and the purpose of this article is to share it with you.

Here is a 7-step plan to treat a lick granuloma in dogs
  1. Free your dog’s neck of collars and replace them with a well-fitting harness. If you need to keep your dog’s collar on for identification (or fashion), make sure that it is loose enough not to cause any pressure on the neck. I also suggest that you remove your dog’s collar at home, during car rides, and at night. In my experience, many dogs walk around with collars that are too tight, which can lead to problems such as lick granulomas.
  2. Take your dog to an experienced physiotherapist, chiropractor, acupuncturist, or massage therapist to work with the cervical spine.
  3. Ensure that there are no lumps along the front leg pathways that may push on the nerves. This is relatively rare but possible.
  4. Examine the area of lick granuloma for any evidence of injury, slivers, thorns, or grass seed.
  5. To speed up your dog’s healing, ensure that your dog is on the best diet possible and not missing any essential nutrients needed for skin repair. Here is a list of four essentials for dogs. This is not a condition for recovery; however, this step will speed up the hair growth and improve your dog’s overall health.
  6. It may take some time for the nerve irritation to settle, especially if your dog has licked for a while because the licking may have become habitual. I am not in favour of Elizabethan collars in cases of lick granuloma as they may be stressful. Instead, you can apply a light bandage on the affected area, and if the skin is irritated, you can use herbal Skin Spray directly on the skin or apply a piece of gauze saturated with Skin Spray. Change the bandage once or twice a day or when it is soiled.
  7. To reduce the inflammation of your dog’s skin, you may also consider a hemp-based CBD oil. The dose of CBD oil for dogs is .1 to .25 mg/lb of body weight. Start with a lower dose and increase gradually over a period of 1 week.
IV. Hind leg and foot granuloma
While the origin of hind leg granulomas is also neurological, the muscle, back and nerve injuries are usually located in the lumbar spine. Similar to people, dogs often suffer from lumbar pain and muscle tightness that leads to neurological symptoms and abnormal sensations.

Lumbar injuries may be caused by slipping or falling but also by excessive strain and surprisingly also by digestive issues or poor diet. Gut function and health are directly connected with the lumbar spine muscles, which have a tendency to tighten up if the gut is unhealthy or inflamed.


If you decide to apply the above steps to address and treat your dog’s lick granuloma, there is a high chance that your dog’s problems will be solved once and for all. However, it is important to be patient and apply all of the steps mentioned to maximize the likelihood of your dog’s recovery.

Thank you for caring and for sharing this article. The more you share, the more dogs get help.

© Dr. Peter Dobias, DVM
About the author

Dr. Peter Dobias, DVM is an Integrative veterinarian, nutritionist and creator of natural supplements for dogs and people. Helping you and your dog prevent disease, treat nutritional deficiencies, and enjoy happier, healthier, and longer lives together.

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