Dog has chronic skin sores, vet can't find cause. What should I do?

There are a lot of things that could be causing this appearance to the skin, and it may not be easy or cheap to figure it out. I would recommend that you keep working with the vet. Baseline blood work, thyroid hormone, testing for Cushing's disease, skin biopsies, food trials, flea preventatives, etc may be needed.

There are four main causes of persistent skin issues and you must figure out the underlying cause to address the problem. The causes are: flea allergy, food allergy (this needs to be ruled out with a hydrolyzed diet), environmental allergy or hypothyroidism. With out any further information, it’s hard to know how to advise next steps. If your veterinarian is not comfortable with treating chronic skin conditions, find one who is. I recommend to rule out fleas with a product like Simparica. I rule out food allergy with a diet called Ultamino. Hypothyroidism is a blood test. Environmental allergies are unfortunately very common and also more complicated but they can be determined with a blood test as well. I hope this is helpful and please feel free to post any additional questions.

A food elimination trial should last a minimum of 6-8 weeks feeding one food exclusively, no other treats or foods. Afterwards, the condition should be reassessed. If this is the case with two different diets containing a novel protein/carb combo and still no improvement, then a consultation and exam with a veterinary dermatologist may be your next step. If Samson is licking or chewing excessively, an e-collar (cone) should be used. Consider an essential fatty acid supplement, such as DermCaps or EicosaCaps, to promote healthy skin and coat. If allergies are the underlying cause, they can be frustrating to diagnose, but once you determine specific allergens then management may be easier.

I would try a prescription hypoallergenic diet. Your vet will be able to recommend the one they think will work best for her like science diet Z/D or purina HA. This will be your best shot to rule out any food allergies. I recommend to do a minimum of a 12 week food trial with NOTHING else except for the Z/D. Even her heartworm prevention, if you give it, needs to be hypoallergenic. Unfortunately, most of the oral ones have chicken or beef flavoring in them. For treats, you can take the canned version of whatever food you choose and put a small amount into an ice cube tray and freeze them. Then popped them out and put them in a bag in the freezer for treats. I would also consider putting her on both apoquel and cytopoint at the same time to help control itching. I would also talk to your vet about whether or not they think there is any yeast on her. Yeast can be very itching. There is a anti-fungal that can be given long term and be safe. It is called terbinafine. I had a dermatologist to give it once a day for 4 weeks then every Monday and Tuesday long term to keep the yeast under control in my really allergic patients. Your vet will be able to determine the best dose and whether or not she even needs this. Finally, if this doesn't help, I would strongly recommend to find a veterinary dermatologist in your area to see if they can do different types of treatment. Most dermatologists can do skin allergy testing and get her started on allergy injections if needed. I hope this helps!

Thank you for submitting your question regarding Clyde. He skin looks very sore. Poor guy! When I see a patient with ongoing skin disease, I work hard to determine the underlying cause so effective treatment can be determined. I would recommend he has skin scrapes to look for mites and a fungal culture to rule out ringworm. Then I would start him on flea and tick prevention to rule out a flea allergy. Next, I would do bloodwork on him to ensure he does not have evidence of an underlying hormonal disorder contributing to his skin disease. Short of doing a skin biospy, the last thing is to treat for allergies. Food allergies are assessed by a diet trial with a prescription diet. The dog can eat absolutely nothing else during the trial. It is hard to do, but the only way to assess food allergies. Very few dogs are allergic to grains and the ones that are tend to be Irish Setters. So he could still have a food allergy despite your diet change. There are new medications to manage environmental allergies that are very effective with less side effects than steroids. So these could be an option as well. Consider bathing him with a medicated shampoo and a moisturizing conditioner twice per week. I hope this information helps!

Poor Scrappy Brown! It's definitely a constant battle when dealing with an allergy in a dog. Unfortunately there is no cure for these allergies and they require constant management. It would be worth talking with your veterinarian about a new medication called Cytopoint. Cytopoint is an injection that has very good success in treating skin allergies in dogs. This injection lasts for about 4 weeks and could be likely be used for long term treatment of Scrappy's allergies. Medicated bathing would be another option to treat Scrappy. This bathing is done two to three times weekly to help manage skin infections and yeast overgrowths. It would also be worth calling your veterinarian to see if they can prescribe a medicated shampoo like Douxo for Scrappy's skin. You can also consider a specialized diet for Scrappy as food allergies often cause skin itching. A prescription diet like Royal Canin Ultamino may be a good option for him. Thanks for using Petco Pet Education Center, formerly Petcoach and I hope the above options work to make Scrappy more comfortable!

You are correct that long term steroid use is not generally good for the body. The four main reasons for continued itching are allergies to fleas, allergies to something in the environment, food allergy or endocrine disease. Each one of these problems is detected and addressed differently and I recommend to discuss with your veterinarian which one to start hunting down first. Parasites are often ruled out with an oral medication like Simparica. Food allergy is best ruled out with a diet trial using a hydrolyzed protein. Endocrine diseases are detected with blood work. Environmental allergies are a little more difficult to detect but a response to therapy or a blood test can give an indication. Once you figure out and address the underlying cause, the itching should not come back. There are a couple things you can do at home and they can help but they may not address the underlying cause. You can try adding in an omega 3 fatty acid supplement for dogs, this can help improve the skin health. You may also try changing his diet to something like Royal Canin or Nutro as they are aimed at skin health. Also protect the area from trauma by having Nunu wear an elizabethan collar at all times. Regarding the diet, a hydrolyzed protein diet is best and I recommend Royal Canin Ultamino. You also need to be sure to conduct a proper food trial to see if it helps. He can only eat this diet and not treats or ANYTHING else for 12 weeks to see if it help. I hope this helps and please feel free to post any additional questions.