I'm sorry to hear of this with Pepper. Excessive thirst (polydipsia) and hunger (polyphagia) are danger signs for three main disorders - diabetes mellitus
, Cushing's disease, and hyperthyroidism and all of these disorders can affect Pepper's skin. Until the etiology of her polydipsia and polyphagia is clarified and treated appropriately, adminstering antibiotics and prednisone are not only likely to be unhelpful but may well be contraindicated. Pepper's odor is called a seborrheic one often akin to that of diry gym socks. Seborrhea
- a skin disorder of keratinization and maturation - can be primary (often showing up early in life) or, more commonly, secondary to any chronic skin disorder. There are quite a few conservative approaches to seborrhea which I'll post below but the first order of business should be diagnostics in the form of blood and urine tests in order to see what's underlying all of Pepper's symptoms. Clinical signs of seborrhea may include a dull, dry, lusterless hair coat, excessive scaling (dandruff), follicular casts, scaly and crusty seborrheic patches and plaques
, and greasy, malodorous skin. Most of the body is involved to some degree, with interdigital areas, perineum, face, axillae, ventral neck, abdomen, and skin folds usually most severely affected. Pruritis (itchiness) is mild to intense, and ceruminous otitis externa (oily external ear
canal inflammation) is common. Secondary skin and ear infections with bacteria and Malassezia (yeast) are often present. I can appreciate how frustrating Pepper's care must be for you. I don't know everything you've tried so I'll list a primer for treatment and prognosis for you to peruse. 1) Ensure good nutrition. A commercially balanced dog food that meets AAFCO requirements should be fed. You should find the AAFCO statement on the food label.2) Any secondary bacterial and Malassezia skin and ear infection should be treated with appropriate topical and systemic therapies. Periodic treatments or long-term, low-dose maintenance therapy may be needed because these dogs are susceptible to recurring infection.3) For symptomatic control of ceruminous otitis, long-term maintenance ear care is necessary. Ear treatments with a multimodal therapy (consult with Pepper's vet) or ear cleaner should be administered to both ears every 1-7 days to control cerumen (wax) accumulation.4) For symptomatic control of seborrhea, antiseborrheic shampoos and emollients may be used every 2-7 days until the skin condition is improved (~2-3 weeks), then, bathing frequency should be decreased to every 1-2 weeks or as needed for maintenance. Antiseborrheic shampoos contain some combination of sulfur, salicyclic acid, tar, benzoyl peroxide, and phytosphingosine.5) Daily oral fatty acid supplementation may be helpful as an adjunct therapy (180mg EPA/10lbs). EPA is thought to be the most antiinflammatory of the essential omega-3 fatty acids. It's plentiful in fish oil supplements.6) Vitamin A 8000-10,000 IU per 20lbs orally administered with a fatty meal every 24 hours. Improvement should be seen within 4-6 weeks.7) For dogs with severe, greasy, malodorous, pruritic seborrhea, treatment with systemic corticosteroids may be helpful. Acitretin (a retinoid) may be helpful in some dogs. Calcitriol (vitamin D) may be helpful in some cases. The prognosis is variable, depending on the severity of the seborrhea. This is an incurable condition that requires lifelong therapy for control. Please respond with further questions or concerns if you wish.