Crazy itch

Q: My three-year-old French Bulldog started licking her left leg after she was bitten by ticks. She has licked that particular spot so much that the fur around the area has dropped off, leaving a wet, oozing skin lesion, and she continues to lick. What should I do?

A: Due to the severity of the tick bites and the resultant licking, one of the following is likely to have occurred:

• A piece of the tick’s head—specifically the palps and hypostome—may be lodged in the skin, resulting in a local reaction.
• The tick has fallen out completely, but left a residual infection deep in the skin (deep pyoderma) that is causing irritation.
• Either of the above has happened and the skin and subcutaneous tissues have healed, but too much fibrous tissue has formed, making it difficult for the immune system to get rid of the infection.

If you prefer a thorough investigation, you can ask your vet to send the lesion for a biopsy. If you’d rather start a treatment based on a working diagnosis, then your vet will most likely make a presumptive diagnosis of a deep pyoderma secondary to a tick bite. 

The treatment for deep pyoderma is usually a long course of antibiotics for about two to six weeks. In some cases, your vet might prescribe corticosteroids in the initial stages because if used for short periods at moderate doses, it can reduce inflammation and allow better penetration of antibiotics into the inflamed tissue. We’d usually check progress in about 10 to 14 days, or two to six weeks if corticosteroids were given. 

Deep pyodermas are unlikely to respond well to topical creams and ointments, because the infection is deep in the skin. 

Some canines develop lick granulomas, lesions that form from excessive licking of one spot. Lick granulomas usually present as small hard lumps, and can be present for months or even years. They typically respond well to a small dose of long-acting corticosteroids injected beneath them; the patch often remains hairless and grey but no longer raised and the dog loses the urge to lick it. 

Some people put cones or Elizabethan collars on dogs, but I tend not to unless the lesion is very severe and/or the licking is excessive. It’s best to take your pooch to a vet for an opinion and/or biopsy. All she may need is a two-week course of antibiotics.