Many, many trick and treats have been tried in an attempt to keep the dog away from the skin lesion in order to allow it to heal. Ya know what? None of 'em work very well. Such things as bandaging the entire leg (the dog will lick just above any wrap or cast that is placed over the lesion) and applying nasty tasting stuff like Bitter Apple or Tabasco sauce doesn't work. Barbed wire wrapped in plaster casts don't work. Putting an Elizabethan collar on doesn't work well because as soon as it is removed the licking starts again and the dog will activate the lesion all over again.
Anti-anxiety drugs have been tried, too. Very occasionally such medications as Prozac or Xanax might make a slight difference...but not enough dogs respond well to these to be able to call psychoactive medications a cure. Cortisone injections into and under the granuloma quiet them down and shrink them...for a while; then the dog starts licking again and the lesion becomes as big as ever. Deadening cutaneous nerves has been tried, even Cobra venom was professed to have a cure rate of 90% way back in the early Seventies, and these methods have proven to be unsatisfactory.
We've got a real dermatology nightmare here! Something makes the dog compulsively attracted to the granuloma and will start licking at a different place if it cannot get at the original lesion.
Long term antbiotics seem to be the best helper...as long as three months may be required for significant improvement. Cortisone topical creams rubbed into the lesion daily can help. Topical medications that have multiple antibiotic/cortisone ingredients can help. This is one disorder where the veterinarian preaches control or management of the skin problem since a cure is not now known. Any little thorn, splinter, tick bite, scratch or infection over the wrist areas in the front legs and over the area lower down from the ankle in the rear legs can lead in a short time to an Acral Lick Granuloma. So keep a close eye on these problem spots and at the first sign of persistent licking at one particular site, get some veterinary help as soon as possible.
Many types of dermatological problems are avoided if the dog or cat is consuming an optimum diet. In some cases, adding a supplement such as DermCaps, a popular Omega Fatty Acid supplement with a number of beneficial ingredients, is the key factor in avoiding repeated episodes of Hot Spots and other skin afflictions. If your dog or cat seems to lack good coat and skin health, consider upgrading the diet to a meat-based ingredient formula and adding a supplement such as DermCaps.