These lick granulomas are sometimes due to itching from allergies.
If the current meds have not cleared this up you might ask your vet about checking for allergies. Dogs when itching from allergies can chew themselves raw and create these lick sore due to that. I'll give more info on allergies below.
Another possibility for licking like this, in a senior dog especially, could be pain due to arthritis in the joint near the area being licked. You might consider an x-ray of the leg to see if maybe he needs arthritis meds though if that was it I'd expect improvement when using rimadyl.
Allergy info -
Paw licking, itching and skin chewing are often signs of allergies. You may see red staining to the fur in the licked areas or raw spots where the dog chews itself.
The skin itches from allergies, the dog licks and chews trying to soothe the itch, making the skin raw and allowing other infections to set in which may itch even more.
You can read about allergies and dermatitis in dogs here
Dogs can develop allergies to foods, even ones they eat all the time, and to inhaled items, and contact allergens such as rug cleaners, cedar beds, or chemicals including lawn chemicals or even flea bites.
You might want to try a different dog food that has no ingredients the same as what you feed now. Diets of Fish and Potato, venison, or rabbit etc. where the protein source is new and there are no grains in the food can work for many dogs for example. Another option is the hypoallergenic diet from your vet Hills ZD. Changing food does no good if you feed the same ingredients. Remember food changes have to include all treats and supplements. It can take 8-12 weeks or more before you see results in skin and coat.
If this is an inhalant allergy, which often shows up only seasonally, you may find using a HEPA air filter in the room the dog uses most and wiping the dog down with a damp towel when it comes in helps reduce allergen exposure.
You might want to see if some plain Benadryl helps with the itching. A common low dose is 1mg per pound of dog every 12 hours. Do check with your vet about using a med but this one or another may help him a lot. If you choose to use that please read here about cautions
You may want to consult with your vet and consider doing allergy testing.
Or ask your vet about using Temaril-P to see if that works
You can try a Chlorhexiderm shampoo from the pet supply store in case the problem is a bacterial skin infection. Follow directions on the bottles if you try this.
Dogs can have low thyroid level issues and that can trigger skin allergies. The vet can check for that with a blood test.
If your dog is not on a flea prevention that might also help. Just one flea bite can make an allergic dog itch all over. If that is the problem then Frontline could resolve a lot of the reactions for you.
Some people find their dogs do better when they are given omega 3&6 fatty acid supplements such as Derm Caps or Linatone from the pet supply store.
If your regular vet is not able to help you then you may want to see a veterinary dermatologist and this page may help you locate one if your vet can't refer you to one
Hope this helps you!
He has had trouble with the same leg for the last five years, it was even operated on at one point but found nothing, the vet thinks it could be arthritis, i dont want to take him back to the vets as she was very rough last time, is ther nothing i could put on it that i dont have to get from the vet, and also could he be given asprin for the pain for his arthritis. He has always limped slightly on that leg sometimes more than others, so i know it is definetly not an allergy. and the first lot of medication he had 16 months ago worked very quickly , but this time it doesent seem to have .
I'd suggest trying another vet in your area if you are unhappy with your current vet. It may be worth some travel to resolve this.
Aspirin can be used in dogs but it can increase bleeding and cause gastric upset.
You can read about using it here
It could be allergies or pain causing him to lick.
It might be worth trying a food change as I listed above to see if that helps.
You could see if glucosamine chondroitin such as Cosequin will help with joint pain.