According to statistics, the top three reasons dogs visited veterinarians in 2012 were skin allergies, ear infections, and skin infections. Poor Maddy appears to have all three, which is not uncommon. The ears are just an extension of skin, and both are prone to infection secondary to allergies.
Pruritis (itchy skin) can have multiple causes and take months to sort out. My goal is to equip you to better communicate with your vet about Maddy’s condition.
We have two issues to address:
1. Maddy’s ear and skin infection.
2. The underlying cause, which is most likely allergies. We must manage her allergies to prevent recurring infections.
I do think Maddy has food allergies, which are typically incurable in dogs, and can develop at any age. However, she may also be affected by things in the environment. Dogs with allergies seem to have an “allergic threshold”, meaning they have multiple allergies, but there is a point where “the straw breaks the camel’s back” and symptoms manifest. The predominant sign of food allergy is that symptoms are year round, not seasonal. Further, recurrent external ear infections are present in more than half of dogs with food allergies.
The most common food allergens for dogs (in order) are: beef, dairy, wheat, chicken, egg, lamb, and soy. About half of all dogs are allergic to more than one ingredient. It’s important to understand that “grain free” is not synonymous with “hypoallergenic”. Consider the ingredients in diets on which she thrives, versus the ingredients found in foods or treats that cause her to flare up. I’m guessing there’s more to the story than just grains. How can we determine what Maddy is allergic to?
Blood tests for food allergies are not reliable and are a waste of your money. A “dietary trial” is the gold standard for diagnosing food allergies. Talk with your veterinarian about conducting a food trial. Maddy’s doctor may recommend a prescription diet, or even home cooking a balanced recipe. Over-the-counter diets should not be used for food trials, but can be fed once the offending ingredients have been identified.
As for her skin, the rash you describe sounds classic for a skin infection. While this is not the same thing as skin allergies, the two often go hand in hand. This type of infection is caused by bacteria and/or yeast, and each is treated differently.
Bacterial skin infection, called pyoderma, is best treated topically and with oral antibiotics. Through simple tests, your veterinarian can tell what types of organisms are causing her skin and ear infections and determine proper treatment. If she requires another course of antibiotics, I would recommend administering high quality human probiotics, or a doggie product like FortiFlora, during the course of her treatment.
Ultimately, I completely understand your concerns. Allergies are frustrating for clients and veterinarians alike, not to mention the dogs! While, Maddy will likely always be prone to skin flare ups, I feel confident that you and your veterinarian can transition her out of a skin “crisis” to long-term successful management of her skin and allergies.
Dr. Julie's opinion or advice does not replace an actual exam with a veterinarian.