Expert: Dr. Louis N. Gotthelf - 2/12/2007

Question
I own a five year old German shepherd who has dealt with bouts of lick granuloma for the last three years or so.  On two separate occasions it has gotten so bad that I have had to take him to the vet and he has was prescribed antibiotics.  At this point it has become a fairly consistent problem but I have been able to recognize when it is getting bad and take preventative measures (gauze, triple antibiotic ointment and duct tape) to head it off.  I really want to solve this problem with something other than an Elizabethan collar.  Please offer some suggestions.  I really want to solve this issue.
Thank you for your time.
Sincerely
Samuel Hoover

Answer
Lick granuloma in dogs is an Obsessive Compulsive Disorder (OCD) which originates in the brain, not on the legs.  What happens is that the dog licks the paw(s) and it feels so good that they continue it.  It is like scratching a mosquito bite and it feels so good.  OCD dogs benefit from Prozac or Hydrocodone.  To treat the local problem on the paws, I have been using a CO2 laser to debride the mass and to seal off the nerve endings so the dog can't feel the lesion.  Depending on how large the mass is, small ones heal in 3-4 weeks while the larger ones heal in several months.  The problem is that because it is an OCD, the dog will start one on another leg or foot.