Re: Lick Granuloma management

[Guest guest]

do "ring the dragon" inject homeopathic traumeel in a "round the clock" pattern sub Q under the lick granuloma. BHI inflamation remedy also good.

dr newkirkSee what's free at AOL.com.

[Guest guest]

Hi!

Try methylene blue ( or HELBO BLUE) on the lacerated skin or on the

wound just before lasering. I had the best success with behavioural

modulation training combined with anti-anxiety " Clomipramid " to stop the

dogs from licking. Drugs won't work without training (especially in a

Heeler) and a lot of exercise ( especially in a Heeler)

if the healing tendency is poor there is an acupuncture technique called

" circling the dragon " which I use quite often

regards, Sabine

Dr. Sabine Mai

MAS, Msc in Trad. Chinesischer Medizin

Fachtierärztin für Physiotherapie und Rehabilitationsmedizin

Garserstraße 45

Austria -3542 Gföhl

e-mail: physiovet@...

www.physiovet-team.com

-----Ursprüngliche Nachricht-----

Von: " rehabdvm "

An: <VetRehab >

Gesendet: Dienstag, 01. Mai 2007 16:27

Betreff: Lick Granuloma management

I need help with a case. The case is a 9 yr old Blue Heeler who

developed a lick granuloma at the distal end of the plate that was

used in a carpal arthrodesis surgery 5 months ago. There is no

clinical nor radiographic evidence of infection or screw instability.

The dog has been on antibiotics and has had a round of laser therapy

with no change in the propensity to lick. I'd love to know what

others have done with laser treatments, anti-anxiety medications,

anti-histamines, etc. We really don't want to remove the plate at

this time.

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02:10

[Guest guest]

I am using amitryptalline in a few cases

of lick granuloma (as per a lecture at AAHA).  Don’t know yet if it is

working though!  Good luck!

Pam

From:

VetRehab [mailto:VetRehab ] On Behalf Of Dr. Sabine Mai

Sent: Tuesday, May 01, 2007 8:54

AM

To: VetRehab

Subject: Re: Lick

Granuloma management

Hi!

Try methylene blue ( or HELBO BLUE) on the lacerated skin or on the

wound just before lasering. I had the best success with behavioural

modulation training combined with anti-anxiety " Clomipramid " to stop

the

dogs from licking. Drugs won't work without training (especially in a

Heeler) and a lot of exercise ( especially in a Heeler)

if the healing tendency is poor there is an acupuncture technique called

" circling the dragon " which I use quite often

regards, Sabine

Dr. Sabine Mai

MAS, Msc in Trad. Chinesischer Medizin

Fachtierärztin für Physiotherapie und Rehabilitationsmedizin

Garserstraße 45

Austria

-3542 Gföhl

e-mail: physiovetgmx (DOT) at

www.physiovet-team.com

-----Ursprüngliche Nachricht-----

Von: " rehabdvm " <rehabdvm>

An: <VetRehab >

Gesendet: Dienstag, 01. Mai 2007 16:27

Betreff: Lick Granuloma management

I need help with a case. The case is a 9 yr old Blue Heeler who

developed a lick granuloma at the distal end of the plate that was

used in a carpal arthrodesis surgery 5 months ago. There is no

clinical nor radiographic evidence of infection or screw instability.

The dog has been on antibiotics and has had a round of laser therapy

with no change in the propensity to lick. I'd love to know what

others have done with laser treatments, anti-anxiety medications,

anti-histamines, etc. We really don't want to remove the plate at

this time.

----------------------------------------------------------

--------

No virus found in this incoming message.

Checked by AVG Free Edition.

Version: 7.5.467 / Virus Database: 269.6.2/782 - Release Date: 1.5.2007

02:10

I am using the free version of SPAMfighter for private users.It has removed 871 spam emails to date.Paying users do not have this message in their emails.Try SPAMfighter for free now!

[Guest guest]

Hi,

I usually see these cases after they have

had a pretty extensive medical workup including rads, bx, C and S, skin

scraping and cytology. Most appear to have an underlying painful cause as well

as some propensity to lick whether that propensity can be due to anxiety or a

loss of ability to be active d/t sx. If the dog did not lick excessively

anywhere prior to the plate, I would be suspicious of underlying discomfort and

would search to find that first. Rads can tell you whether there is an

infection, etc, but they cannot assess pain. Even if the dog is not painful to

the touch on an orthopedic exam, he may have neuropathic pain. I have only seen

2 cases of ALD which were purely behavioral. The rest had some type of medical

issue. One was a dog who had an acute life change where another dog who

randomly beat the living daylights out of her was brought into the house. The

second was a police dog who could no longer work because his handler was

injured. The first one responded very well to medical tx of the ALD, plus extensive

beh mod/environmental mod + clomipramine and a benzo. The police dog didn’t

respond to anything that I did, but when he went back to work, the problem

resolved.

Some behavior mod options are – get the

dog back into work if that was what he did before and he can do so without jeopardizing

his recovery , keep him orally fixated on food toys or other things that can

occupy his mouth so that he doesn’t lick, teach the owners to redirect

him and not correct him when he licks, and teach the owners not to

inadvertently reward him when he licks.

Meds options-Gabapentin or NSAIDS x 14

days if you haven’t already. If those options don’t work, you

can try fluoxetine. I would probably use this before clomipramine even though

the latter was FDA approved for compulsive behavior in humans because of the

age of the dog.

Good luck,

Radosta DVM, Diplomate ACVB

Florida Veterinary Behavior Service

PO Box 210636

Royal Palm Beach, FL 33421-0636

info@...

www.flvetbehavior.com

Lick Granuloma

management

I need help with a case.

The case is a 9 yr old Blue Heeler who

developed a lick granuloma at the distal end of the plate that was

used in a carpal arthrodesis surgery 5 months ago. There is no

clinical nor radiographic evidence of infection or screw instability.

The dog has been on antibiotics and has had a round of laser therapy

with no change in the propensity to lick. I'd love to know what

others have done with laser treatments, anti-anxiety medications,

anti-histamines, etc. We really don't want to remove the plate at

this time.

[Guest guest]

I have treated very large 1 1/2 year old lick granuloma (and many smaller) with Cranial Electrotherapy Stimulation (centrally using ear clips accessing via the VIII cranial nerve) and Microcurrent electrotherapy stimulation ( www.alpha-stim.com ) around the wound twice a day for 2 weeks.

Plus Standard Process Canine Dermal Support. Also check for cervical subluxations as could have a radiculopathy feeding the problem.

I have not failed on any with this approach. The Golden Ret. with the severe wound once totally healed (which was from a wound encompassing an area of 6 cm X 4cm X 2 cm), she never licked it again for 4 years when she died of other causes.

Ava

Ava Frick, DVMHartz 2006 Veterinarian of the Year Runner UpVeterinary Medical Director, EPI, Inc. Animal Fitness Centerwww.petbodybuilders.comphone: fax:

Lick Granuloma management

I need help with a case. The case is a 9 yr old Blue Heeler whodeveloped a lick granuloma at the distal end of the plate that wasused in a carpal arthrodesis surgery 5 months ago. There is noclinical nor radiographic evidence of infection or screw instability.The dog has been on antibiotics and has had a round of laser therapywith no change in the propensity to lick. I'd love to know whatothers have done with laser treatments, anti-anxiety medications,anti-histamines, etc. We really don't want to remove the plate atthis time.

[Guest guest]

I have treated multiple lick granuloma lesions. Most have some source of pain associated with them. I have treated 17 cases of lick granuloma- only one did not resolve and it had multiple lick granulomas over its body. - Check the spine and motion of the vertebrae if you are trained to pick up subtle problems or ask some one trained in spinal maniupulation for help- (all of the cases I treated had restrictions in the motion around the nerve root of the nerve serving the dermatome). I also used manual fascial release techniques around the lesion.

Check carpal bone motion ( flexion and extension) of all joints and feel for thickened fibrous tissue/ pain/ heat. Most of the cases I have treated whether carpal or tarsal showed immediate decrease in licking post adjusting the spine. For the cases where there was local pathoolgy ie fibrosis/decrease motion of joints etc- I also treated these issues manually.

I have also treated a couple of cases passed on because acupuncture was having no great influence and these resolved with addressing the decrease motion of the vertebrae AND fascial release work. I would always send the owners home if significant superficial fibrosis was present with an exercise of using a finger to draw a straight line away from the lesion on the skin- like a picture of a sun- all around the lesion to help loosen the fibrous tissue and help circulation for healing. This manual technique is only light stoking and brought very good results.

I have written a paper on the treatment of lick granulomas with chiro therapy as a case study that was published in the AVP ( an Australian peer reviewed journal) and found through my investigations of other articles and my own experience in treatment of them - pain locally or neurogenic feedback where sensory neurons are sensitized ( they release inflammatory substances locally around the nerve endings) should be considered as a cause in the treatment

Obviously if there is superficial infection, this needs to be addressed.

Hope you have some luck with isolating a source of pain as it sounds that this will be the likely cause.

Lick Granuloma management

I need help with a case. The case is a 9 yr old Blue Heeler whodeveloped a lick granuloma at the distal end of the plate that wasused in a carpal arthrodesis surgery 5 months ago. There is noclinical nor radiographic evidence of infection or screw instability.The dog has been on antibiotics and has had a round of laser therapywith no change in the propensity to lick. I'd love to know whatothers have done with laser treatments, anti-anxiety medications,anti-histamines, etc. We really don't want to remove the plate atthis time.

[Guest guest]

Hi Toni.I'm impressed by your findings and strategy.  Would you mind posting your article on the list website for those of us who do not subscribe to the "AVP"?  If no, could you post the citation for the article?Thanks.Amie Amie Lamoreaux Hesbach, MSPT, CCRPPresident, Animal Physical Therapy Special Interest Group, Orthopaedic Section, American Physical Therapy Associationwww.orthopt.orgInstructor, The Canine Rehabilitation InstituteWellington, Florida USAwww.caninerehabinstitute.comCEO, For Paws Rehabilitation, LLCPort Republic, land USAwww.forpawsrehabilitation.comManager, Physical Rehabilitation, The Mid-Atlantic Animal Specialty Hospital, LLCHuntingtown, land USAwww.vetmash.com I have treated multiple lick granuloma lesions. Most have some source of pain associated with them.   I have treated  17 cases of lick granuloma- only one did not resolve and it had multiple lick granulomas over its body. - Check the spine and motion of the vertebrae if you are trained to pick up subtle problems or ask some one trained in spinal maniupulation for help- (all of the  cases I treated had restrictions in the motion around the nerve root of the nerve serving the dermatome). I also used manual fascial release techniques around the lesion.Check carpal bone motion ( flexion and extension) of all joints and feel for thickened fibrous tissue/ pain/ heat. Most of the cases I have treated whether  carpal or tarsal  showed immediate decrease in licking post adjusting the spine. For the cases where there was local pathoolgy ie fibrosis/decrease motion of joints etc- I also treated these issues manually.I have also treated a couple of cases passed on because acupuncture was having no great influence and these resolved with addressing the decrease motion of the vertebrae AND fascial release work. I would always send the owners home if significant superficial fibrosis was present with an exercise of using a finger to draw a straight line away from the lesion on the skin- like a picture of a sun- all around the lesion to help loosen the fibrous tissue and help circulation for healing. This manual technique is only light stoking and brought very good results.I have written a paper on the treatment of  lick granulomas with chiro therapy as a case study that was published in the AVP ( an Australian peer reviewed journal) and found through my investigations of other articles and my own experience in treatment of them - pain locally or neurogenic feedback where sensory neurons are sensitized ( they release inflammatory substances locally around the nerve endings) should be considered as a cause in the treatmentObviously if there is superficial infection, this needs to be addressed.Hope you have some luck with isolating a source of pain as it sounds that this will be the likely cause. Lick Granuloma managementI need help with a case. The case is a 9 yr old Blue Heeler whodeveloped a lick granuloma at the distal end of the plate that wasused in a carpal arthrodesis surgery 5 months ago. There is noclinical nor radiographic evidence of infection or screw instability.The dog has been on antibiotics and has had a round of laser therapywith no change in the propensity to lick. I'd love to know whatothers have done with laser treatments, anti-anxiety medications,anti-histamines, etc. We really don't want to remove the plate atthis time.

[Guest guest]

Dear Amie,

At the time of writing the article, I was advised not to write up about animals that had recevied more than 1 intervention. As most dogs coming to me have had other forms of intervention previous to seeing me ( antibiotics, behaviour modification drugs etc), I chose one dog that had no other form of treatment prior to seeing me , I only performed adjustment as the form of intervention and did not use any other form of treatment. This case was seen as passing the cause and effect test. As you can appreciate, it was very difficult to have this article published. However in practice, I have used fascial manipulation as well with quite a few as I discussed. I am waiting to gather more cases to do a case series report. I do not know how to post an article on the board, however the article appears in full on the Australian Veterinary Chiropractic website- www.chirovet.com.au. I would be happy to post it if someone could help me get it there,

Thanks for asking! Toni

Lick Granuloma management

I need help with a case. The case is a 9 yr old Blue Heeler whodeveloped a lick granuloma at the distal end of the plate that wasused in a carpal arthrodesis surgery 5 months ago. There is noclinical nor radiographic evidence of infection or screw instability.The dog has been on antibiotics and has had a round of laser therapywith no change in the propensity to lick. I'd love to know whatothers have done with laser treatments, anti-anxiety medications,anti-histamines, etc. We really don't want to remove the plate atthis time.