Veterinary Referrals UK | Rutland House Referrrals St Helens Merseyside Rutland House Referrals, Abbotsfield Road, St Helens, Merseyside, WA9 4HU

Acral lick granuloma associated with spinal canal stenosis


Bruce was referred to Rutland House Dermatology Department with mild but chronic  skin disease which had been present since he was a much younger dog. More recently he had developed signs of a lick granuloma on his right hind leg.  He had also developed signs of other lick lesions on his tail, over his hocks and on his other hind leg.  These had shown only a limited response to topical therapy.

At the time of clinical presentation, Bruce showed some evidence of mild hindlimb paraparesis, he was dragging his hind feet. A physical examination revealed some evidence of pain when his lower spine and hind legs were manipulated.  Extension of his right hind leg triggered quite a marked pain response.  Bruce had had atopic dermatitis diagnosed 4 years previously which had been well controlled with allergen specific immunotherapy. As there was no obvious reason why his skin disease had become unstable it was hypothesised that the self traumatisation may be due to hyperaesthesia due to neurological disease rather than pruritus due to atopy. We have seen dogs at the referral centre with signs of cauda equina or other spinal disease that can develop hyperaesthesia in their hind legs which can lead to self inflicted trauma.
Skin lesions on his legs and tail were assesed.  Cytology revealed an inflammatory infiltrate which was predominantly neutrophilic with cocci.  There was no evidence suggesting anything neoplastic. A culture from the lesion revealed a profuse growths of coagulase positive staphylococcus identified as Staphylococcus pseudintermedius with a good sensitivity to Cephalexin which was started at a dose of 25mg/kd po bid.   
Bruce underwent CT scan, which revealed remarkable disc protrusions at two of the intervertebral spaces (L6-7 and L7-S1) resulting in spinal canal stenosis and nerve root entrapment. CT scan findings were considered be be an appropraite explanation of his clinical signs and dorsal laminectomy and possible complications associated with this surgical procedure were discussed with the owner.

Dorsal laminectomy of two adjacent intervertebral spaces was performed under general anaesthesia. Surgical exposure was limited to minimize postoperative morbidity and to decrease a risk of articular facets fracture. The spinal canal was open and the nerve roots retracted to visualize slipped disc. The disc was consequently removed started between L7/S1 and finishing between L6/L7. The recovery from general anaesthetics was uneventful and Bruce was ambulatory next day after surgery. He was able to urinate voluntarily. He was given pain relief and antibiotics to continue the treatment of secondary pyoderma. His lick granuloma lesion healed without recurrence.

Dorsal Laminectomy and Distectomy

Acral lick granuloma


Acral lick granuloma




Rutland House Referrals

Rutalnd House Referrals | Veterinary Referrals UK
Rutland House Referrals
Abbotsfield Road
St Helens
WA9 4HU
Tel: 01744 853510
Fax: 01744 853511. 


Latest News
Dobby's Story

Testimonials
Rutland House Customer Satisfaction

- 5 star Absolutely fantastic vets, all the staff are so friendly and helpful. Both my pugs have needed surgery within days and I can not praise them enough. Especially Harry who has stayed in contact all weekend with me, after my little girl pug became unwell. Thank you all so much
Helen Smart

Pro Bono Testimonials
Rutland House Customer Satisfaction
Mishka had been referred for bilateral cruciate surgery. Mishka wasn't insured & owners could not get assistance from anywhere.