Clinical Management of Acral Lick Dermatitis in Dogs with Comparison of Fluoxetine and Clomipramine Treatment

Background: Acral lick dermatitis is defined as self inflicted skin disorder in dogs which induces localized alopecia and fibrotic lesion due to repetitive licking or chewing at the same ‘site most commonly near carpus or hock areas.
Methods: The present study was carried out to investigate the approach to the management of various etiologies associated with ALD in dogs. A total of 30 dogs that were diagnosed with acral lick dermatitis (ALD) were rated on the day 0 of theirvisit to the hospital on the basis of three clinical scalesie; ALD severity scale, clinical global impression (CGI) and likert scale. Assessment and weekly rating of the ALD lesion was done during the entire treatment trial.
Result: Dogs positive for psychogenic primary triggers were randomly divided in Group 1 (n=9; 47.36%) and Group 2 (n=10; 52.63%). Dogs in group 1 were treated with fluoxetine and dogs in group 2 were treated with clomipramine. Whereas dogs diagnosed with organic triggers were treated empirically. Dogs treated under group 1 exhibited significant difference (p less than 0.05) in the licking and ALD score values at the end of the trial, however, CGI score values were found to be non significant (p greater than 0.05) with mean recovery in 24±2 days and recurrence rate of 44.44% after mean 105±47 days of their treatment completion. 33.33% dogs were also reported with adverse effects of drug as drowsiness in group 1. Dogs treated under group 2 exhibited significant difference (p less than 0.05) in pre and post treatment values of all 3 scores (licking score, ALD score and CGI score) at the end of the trial with mean recovery in 41±5 days and 55.55% cases were reported with signs of reoccurrence after mean 37±21 days of their treatment completion. Total 2(20%) dogs out of ten were presented with adverse effects; 1(10%) with loss of appetite and 1(10%) was reported with vomiting. Both clomipramine and fluoxetine are effective in treating psychogenic triggers of ALD. However, fluoxetine helps in early recovery with lesser recurrence rates whereas clomipramine having better recovery rate with fewer side effects.
