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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 24385
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My five year old great Pyrenees has lost hair on both sides

Customer Question

My five year old great Pyrenees has lost hair on both sides of her body?
Submitted: 1 year ago.
Category: Dog Veterinary
Customer: replied 1 year ago.
The bare spot are pink with little hair on them and no score or blood spots
Customer: replied 1 year ago.
Does she need vet attention?
Customer: replied 1 year ago.
How much longer can I expect to wait?
Customer: replied 1 year ago.
Why is it taking so long?
Expert:  Dr. Michael Salkin replied 1 year ago.
Aloha! You're speaking to Dr. Michael Salkin
I'm sorry that your question wasn't answered in a timely manner. Can you tell me, please, if you've noticed her excoriating (licking, scratching) at those areas?
Customer: replied 1 year ago.
Yes and biting the hair out..
Expert:  Dr. Michael Salkin replied 1 year ago.
Thank you! That rules out quite a few etiologies of such hair loss. I'd like to see a photo(s) of her if you can upload some 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.
I'm going to post my synopsis of the pruritic (itchy) dog for you so you have a good overview of the problem. A picture is worth a thousand words, however...
Pruritic (itchy) dogs are suffering from an allergic dermatitis in the great majority of cases. Allergies to flea saliva, environmental allergens (atopic dermatitis) such as pollens, molds, dust and dust mites, and foods should be considered. (Paw and extremity licking indicates both atopy and a food intolerance and so it behooves vets to distinguish one from another.) In many instances, a concomitant pyoderma (bacterial skin infection), yeast infection (Malassezia), or mange mite (Demodex or Sarcoptes) might be contributory.
YOur vet can check a sample of your dog's skin surface microscopically (a “cytology”) for abnormal numbers of bacteria and yeast and skin scrapings can be taken in an attempt to find mites. Pyoderma is treated with a minimum of 3-4 weeks of an antibiotic in the cephalosporin class such as cephalexin (Keflex) and yeast is addressed with ketoconazole for at least a month.
Our dermatologists tell us to apply an effective over the counter flea spot-on such as Advantage, a fipronil-containing product such as Frontline or one of the newer prescription products available from her vet even if fleas aren’t seen. I've found Revolution to be unreliably effective. Dogs can be such effective groomers so as to eliminate all evidence of flea infestation. Dogs who remain primarily indoors can contract fleas because we walk them in on us and flea eggs and larva can remain viable in your home for months. As the weather warms at this time of year, egg hatches are common. In severe cases, an anti-allergenic prescription glucocorticoid such as prednisone will work wonders for dogs allergic to the saliva of the flea. If you have other pets they may have fleas too but may not be allergic to the flea’s saliva.
Environmental allergies are usually initially addressed with prednisone as well. In some dogs an over the counter antihistamine such as clemastine (Tavist) at a dose of 0.025 - 0.75mg/lb twice daily or diphenhydramine (Benadryl) dosed at 1-2mg/lb twice daily may be effective. Antihistamines, however, aren’t reliable. Adding fish oil to the diet at a dose of 20mg/lb daily of the EPA in the fish oil might synergize with antihistamines to provide better anti-pruritic action. The omega-3 fatty acids in fish oil are antiinflammatory but may take 8-12 weeks to kick in. The new cytokine antagonist oclacitinib (Apoquel) is likely to revolutionize how we address atopic dogs and should be discussed with her vet.
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 her 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 her vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra. (I prefer the hydrolyzed protein diets.) 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 respond with additional information (photos) and further questions or concerns if you wish.
Expert:  Dr. Michael Salkin replied 1 year ago.
Hi,

I'm just following up on our conversation about your pet. How is everything going?

Dr. Michael Salkin