Are Your Dog's Pressure Sores (Calluses & Hygromas) Dangerous?

Pressure sores in dogs (calluses and hygromas) are common over bony areas like elbows and hocks. Most are manageable with bedding and protection, but signs of infection or deep ulcers need prompt veterinary care.

What are pressure sores in dogs?

Pressure sores are areas of skin and soft-tissue damage that form where a dog repeatedly rests against a hard surface. Two common presentations are:

• Calluses (also called lichenification or pressure hyperkeratosis): thickened, hairless, sometimes scabby skin over bony prominences such as the elbow or hock.
• Hygromas (olecranon bursae or elbow hygromas): fluid-filled, fluctuant swellings over the elbow that develop from repeated trauma to a bursa or tissue space.

Common locations

• Elbows (olecranon) — the most frequent site for calluses and hygromas
• Hocks (tarsal area) — calluses can form where the dog rests on rear legs or sits on hard floors
• Other bony prominences — hips, sternum, and areas in contact with hard surfaces in recumbent or immobile dogs

When to See a Vet Immediately

Seek veterinary care right away if you notice any of the following:

• A sore with increasing redness, swelling, or warmth
• Purulent (pus-like) discharge, bleeding, or a foul odor
• Rapidly growing swelling or sudden pain on touch
• Your dog is feverish, lethargic, or stops eating
• The sore has exposed deeper tissue or bone, or your dog won’t put weight on a limb

Red Flags - Seek Emergency Care

If any of the following are present, treat this as an emergency:

• Heavy, bloody, or odorous discharge from a wound
• High fever or shivering
• Marked limp or inability to stand
• Soreness spreading to other areas quickly
• Sudden behavioral change (aggression, collapse)

How pressure sores and hygromas develop

• Chronic pressure and shear: Repeated rubbing or bearing weight on a bony prominence causes skin thickening (callus) or leads to a pocket of fluid forming under the skin (hygroma).
• Immobility: Dogs that lie in the same position for long periods (post-op, neurologic disease, obesity) have increased risk.
• Surface hardness: Sleeping on tile, concrete, or very thin bedding concentrates pressure.
• Conformation and activity: Large breeds with prominent bone structures, or dogs that frequently kneel on hard surfaces, are predisposed.

Differential diagnosis (common causes ranked by likelihood)

A veterinarian will use history, physical exam, and possibly diagnostic tests (needle aspirate, cytology, culture, X-rays) to distinguish these.

How vets diagnose pressure sores and hygromas

• Physical examination: location, size, fluctuation (fluid wave), skin integrity
• Fine-needle aspiration or bursal fluid sampling: differentiate sterile fluid from infected fluid
• Cytology and bacterial culture/sensitivity if infection is suspected
• Radiographs (X-rays): evaluate for bone involvement or osteomyelitis if deep infection is a concern
• Biopsy: rarely required unless a mass or neoplasm is suspected

When pressure sores become infected

Calluses or hygromas that crack, ulcerate, or are punctured can become colonized with bacteria. Signs of infection include:

• Purulent discharge (pus)
• Foul smell
• Increased pain and swelling
• Systemic signs: fever, inappetence, lethargy

Treatment options

Note: Never attempt surgical or deep draining procedures at home. The following are typical veterinary approaches.

Conservative (first-line for uncomplicated cases):

• Environment and bedding changes: thick, soft, supportive bedding (orthopedic dog beds, memory foam, folded blankets), foam elbow pads, egg-crate foam or anti-slip mats reduce pressure points.
• Protective coverings: elbow wraps, doughnut cushions, or commercial elbow protectors to cushion and redistribute pressure.
• Weight management: reducing excess weight decreases pressure on bony prominences.
• Positioning and activity: encourage different sleeping positions; physical therapy or gentle exercise to improve mobility if appropriate.
• Topical care for minor abrasions: veterinary-recommended antiseptic washes (e.g., dilute chlorhexidine or saline) and non-adherent dressings. Follow your vet on products and frequency.

• Aspiration and bursal drainage: may be performed by a vet to relieve a hygroma, but repeated aspiration can encourage infection and is not always recommended.
• Bandaging and protective splints: to keep pressure off the area while the tissue heals.
• Antibiotics: systemic antibiotics if infection is present; ideally chosen based on culture and sensitivity.
• Surgical treatment: indicated for persistent, recurrent, or infected hygromas or deep pressure ulcers. Surgery may excise the sac or perform skin reconstruction. In chronically infected hygromas, removing the bursal tissue and closing with adequate padding often prevents recurrence.
• Pain control and anti-inflammatories: as needed and prescribed by the veterinarian.

Home care steps you can safely take

• Provide soft, thick bedding and consider an orthopedic bed. Keep bedding clean and dry.
• Monitor the lesion daily for changes in size, odor, discharge, or pain.
• Keep your dog off hard floors if possible; place rugs or runners in favorite resting spots.
• Use a veterinarian‑approved antiseptic wash or plain saline for gentle cleaning of minor, unbroken scrapes. If you’re unsure, check with your vet first.
• Avoid home drainage, puncture, or squeezing of sacs or sores.
• If your vet prescribes topical medication or a bandage, follow instructions exactly and return for rechecks as advised.

Preventing pressure sores

• Invest in supportive bedding: memory foam or thick orthopedic beds reduce focal pressure.
• Use elbow/hock protectors or create padded sleeping areas with folded towels/foam pads.
• Keep your dog at a healthy weight.
• Encourage movement and repositioning for dogs that rest frequently in one position. For immobile dogs, change their position regularly to relieve pressure.
• Trim nearby hair if matting traps moisture, and keep the skin clean and dry.
• For dogs at special risk (large breeds, arthritis, post-op): discuss preventive measures with your vet, such as protective sleeves or physical therapy.

What to expect at the veterinary clinic

• Assessment of lesion severity and sampling (aspiration/cytology, culture) if infection is suspected
• Radiographs if deep tissue or bone involvement is possible
• Treatment plan: conservative management vs. aspiration vs. surgical repair
• Pain relief and antibiotics if needed
• Instructions for bandage changes, wound care, and rechecks

Prognosis

• Uncomplicated calluses: good prognosis with preventive measures and protective bedding; they may persist as thickened skin but often become less problematic.
• Hygromas: many resolve or shrink with reduced pressure and protective measures; recurrent or infected hygromas may require surgery.
• Infected or deep pressure ulcers: prognosis depends on depth, duration, and whether bone (osteomyelitis) is involved. Early treatment improves outcomes.

Key Takeaways

• Pressure sores in dogs include calluses (thickened skin) and hygromas (fluid-filled swellings), most commonly at elbows and hocks.
• Prevention is usually simple: soft supportive bedding, elbow/hock padding, weight management, and regular movement.
• Monitor for signs of infection: pus, increasing redness, swelling, pain, foul odor, fever — these require prompt veterinary care.
• Never lance or drain a hygroma or deep sore at home. Veterinary assessment is needed for aspiration, antibiotics, or surgery.
• With early care and environmental changes most pressure sores improve; chronic or infected lesions may need surgical treatment.

Further reading and references

Primary clinical reference: Merck Veterinary Manual (merckvetmanual.com). Additional information and veterinary dermatology guidance can be found in standard texts such as Miller & Griffin's Small Animal Dermatology and veterinary surgical references.

If you’re concerned about a pressure sore on your dog, call your veterinarian for an exam — early action can often prevent infection and more invasive treatment.

Frequently Asked Questions