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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 27942
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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Dr. Dave, Our 7-year old English Setter has lost all the hair on his belly and thinning in

Customer Question

Dr. Dave, Our 7-year old English Setter has lost all the hair on his belly and thinning in numerous other areas of his body. Our vet has put him thyroid care initially but all his blood tests have come back normal. Our vet now thinks it might be allergies, but steroid shots haven't helped. The only medicine our dog takes is Sentinel. The bare skin and other hair loss areas don't seem to bother him, no noticeable itchiness. Any idea on the hair loss and what we should do?
Submitted: 2 years ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 2 years ago.
Aloha! You're speaking to Dr. Michael Salkin
Can you please tell me if Chud is intact? A sex hormone dermatosis should be considered if he hasn't been neutered. There are also miscellaneous follicular dysplasias occasionally associated with the color of the hair, pattern baldness (unlikely in an English Setter), idiopathic (unknown cause) follicular dysplasias, and alopecia areata - an immune-mediated reaction to follicular wall antigens. When skin scrapings, cytologies (microscopic examinations of a small sample of the skin surface for abnormal numbers of bacteria or yeast), and fungal cultures find nothing untoward, punch biopsies of the skin should be considered. Biopsies are often the only manner in which to differentiate one type of alopecia from another.
Can you upload a photos of Chud's skin to our conversation? You can use the paperclip icon in the toolbar above your message box (not if you're using the chrome browser) or you can use an external app such as imgur.com or dropbox.com. I can be more accurate for you if I can see what you're seeing.
Customer: replied 2 years ago.
Thanks. He was neutered as a young puppy. I am attaching two photos of his belly and one of his thinning chest hair. Our vet has done skin scrapings, cytologies and fungal cultures with nothing found. The vet has not done biopsies. At this point our vet is focused on allergies and tells us to just wait and it should clear up and the hair re-grow.
Expert:  Dr. Michael Salkin replied 2 years ago.
Thank you! ***** can see the erythema (redness) that would be associated with an allergic dermatitis. When the ventrum (underneath) is affected, both atopy (allergies to environmental allergens such as pollens, molds, dust, and dust mites, etc.) and food intolerance should be considered. Atopy is usually nicely responsive to steroids. Food intolerance isn't and is best addressed with a hypoallergenic diet.
Atopy can now be addressed with the new cytokine antagonist oclacitinib (Apoquel) which should be considered if you didn't see a positive change when the season changes and an offended pollen disappears. I believe this is what his vet is waiting for to happen.
Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that Chud's immune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. The prescription foods are available from his vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra (my preference). A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can arise at any age and even after our patient has been eating the same food for quite some time.
Please continue our conversation if you wish.
Customer: replied 2 years ago.
Thank you! Do you see any need to be concerned with giving him Sentinel? As I mentioned, apparently English Setters are prone to hair loss related to thyroid issues, but his levels are normal. More of a cosmetic question, but how long does it take for the hair to re-grow once the issue is resolved?
Expert:  Dr. Michael Salkin replied 2 years ago.
Sentinel (milbemycin + lufenuron) isn't expected to be contributory. It's not the best flea preventative, however, so you might consider adding another product (Advantage, Frontline, or a newer prescription product from his vet) in case fleas are contributing to his allergic dermatitis.
The speed at which hair regrows would be predicated upon which stage those hair follicles are in. Anagen follicles - active growing follicles - can replace the hair within just a few weeks. Telogen follicles - quiescent follicles - might not kick in for a few months.