His owner said: "I have been to your Surgery before but that was a long time ago. Vet 1 gave me a tub of cream to apply but the lump will not go away. What do you advise?"
I checked my records. I had vaccinated the Golden Retriever as a puppy and that was 5 years ago. Now this gentle dog has a big lump on the lower side of his right elbow.
"This is a case of a lick granuloma," I said. "It is hard to cure. I will manage your case with Dr Vanessa," I got the dog into the consultation room and informed Dr Vanessa that the owner wanted me specifically to handle the case. I would do the case with her since the owner did not object but I would be in charge.
"The elbow is a famous for hygromas," I said. "But this is not a hygroma. It is a lick granuloma. It can't disappear with the application of creams as it is quite large."
In the consultation room, I gave the owner 2 treatment options. One was steroid injection and the other was surgical excision. "I have not seen an elbow lick granuloma before," I said to the owner. "Lick granulomas are not common in dogs in my many years of practice. This elbow lick granuloma is a rare case for me. But I have seen other lick granulomas and have successfully treated two with steroid injections."
Singapore has nearly 90% of small breeds and lick granulomas are said to be more common in big breeds such as the Golden Retriever. I must organise my clinical research cases to show the conditions before and after treatment but time is so short.
P.S. Successful treatment of lick granuloma with chiropractic therapy, see: