Neurodermatitis in Dogs

Neurodermatitis is a skin condition of canines which is caused by the dog excessively and obsessively licking spots on their own body. Although allergies, insect bites, and arthritis may initiate the obsessive licking that is characteristic of this disorder, it is at its core a behavioral issue. The obsessive licking first leads to hair loss, then to calluses on the areas that are being licked, and eventually to open wounds with masses of granular tissue which are best known as granulomas. Treatment usually includes both behavioral and medical therapies.

Neurodermatitis, also known as acral lick dermatitis and lick granuloma, is a skin condition caused by the dog excessively and obsessively licking one or more areas of the body.

The symptoms of neurodermatitis most often occur during adulthood, with most manifestations happening after the canine’s fifth year. Lick granuloma symptoms are similar to many other skin granulomas, and may include:

• Crusting
• Excessive licking or chewing of skin
• Hair loss
• Itching
• Rash
• Redness
• Scaling
• Sensitivity to touch
• Swelling
• Ulcerated skin
• Yellow papules

Types

There are two general types of medications that may help to reduce the behaviors that cause neurodermatitis. Both types of medication work by blocking the reabsorption of serotonin into a nerve cell, and are known to interact with several other prescription medications. These medications can include:

• Selective serotonin reuptake inhibitors (SSRIs) - Medications in this category include Prozac and Reconcile, and they are more commonly used than the tricyclic antidepressants as they have fewer side-effects 
• Tricyclic antidepressants - This group of canine medications includes Elavil and Clomicalm, among others; this is one of the older categories of antidepressant and tends to produce more side effects than newer drugs, but can be helpful for animals who are resistant to other forms of antidepressant

This disease is sometimes initially triggered by the itching of allergies or arthritis, but in many cases it is idiopathic, meaning that it doesn’t have an underlying medical condition. Also known as acral lick dermatitis or lick granuloma, this disorder is essentially a behavior disorder, and the licking that causes the damage frequently continues long after any instigating disorders have been successfully treated, and stressors such as separation anxiety, boredom, and unexpected change, can also lead to the development of this behavior.

The visit to your veterinarian will generally start with a physical examination, and if the damage is in the area of the joints, the evaluator will most likely concentrate on the joints, checking for swelling or stiffness. The veterinarian will also typically request standard blood tests like a biochemistry profile and a complete blood count to check for any other disorders such as systemic infections or even hormonal imbalances. If the patient is also suffering from allergies, then the blood tests may expose an overabundance of a type of white blood cells known as eosinophils.

Skin scrapings will typically be collected from any areas that are affected by either scaling or by granulomas and will be utilized in the microscopic examination of the skin cells known as a cutaneous cytology. This is done to evaluate if it is possible that other disorders, such as infections or infestations, may be the cause of the symptoms. If allergies are suspected either as a cause or as a concurrent condition, intradermal testing may be recommended in an attempt to determine if an allergy exists and what the allergen is.

The areas around the granulomas may be shaved in order to get a better idea of the damage that has been done as well as to facilitate the administration of any topical medications, which may include anti-inflammatory medications, antibiotic ointments, or corticosteroids. Once the wounds themselves are treated, the veterinarian will address any underlying causes to the obsessive behavior. Additional medications will be administered as needed and may include antihistamines for allergies, anti-inflammatories for pain and swelling, and antibiotics for any secondary infections. The behavioral issue, usually considered to be a form of canine compulsive disorder, may be harder to eradicate. It is essential to get the dog to stop mutilating itself, and several methods may be attempted to in order to discourage or prevent this behavior.

Making sure that your dog gets the appropriate amount of exercise for their breed and condition can help to reduce the nervous tension that may be triggering the bouts of obsessive behavior, as can giving your dog appropriate mental stimulation using puzzle toys designed for dogs, long lasting treats, or by creating games at home by hiding treats or toys and having your dog find them. Another good way to encourage your pet to use their minds is to work on training exercises with them, this not only stimulates their minds, but it also gives them a job to do, something that many dogs crave. In severe cases, anti-anxiety medications may be recommended as well to help the dog control its urge to lick.

Neurodermatitis in dogs can become a serious behavior problem that can have unpleasant consequences if not addressed. The licking and sucking behaviors that cause the damage to the skin carry with them a higher risk of bacterial infection, and antibiotics may be prescribed to combat this tendency. When antibiotics are prescribed it is important to follow your veterinarian’s instructions and give them the entire course of the medicine to prevent any infections from reoccurring. It is also crucial to inform your doctor of any medications that your canine is already taking, particularly if anti-anxiety drugs are part of the treatment plan as anti-anxiety medications often react negatively when combined with other medications.