MakGSD,
Gosh, I knew this question would come up and I wish I had a clear cut answer but I don't.
The doggie dermatologist told me he had massive overgrowth of yeast due to environmental allergies.
I'll give you a quick snapshot of what I did but which, if any, worked is questionable. I'm saying that because he had other issues to (massive tick invasion then followed up with huge flea infestation) that may have been the root of it all.
I was feeding Orijen Regional Red. Went totally to raw. I made and fed daily homemade bone broth and homemade veggie stew. I bathed him once a week using a rotation of Fresh & Clean oatmeal shampoo, Bonner's coconut soap, & Douxo Chlorhexidine PS. Sometimes I'd rinse with vinegar/water or Providine Iodine/water.
I did the whole natural repellent stuff for the bugs but that just made the dog smell good. Totally useless in my opinion. I got rid of the brown dog ticks using the vacuum daily, watching where I walked him, flea comb twice daily, DE puffed all over my carpets, I bought many gallons of Wondercide cedar sprays and sprayed inside and out and the dog. Finally got rid of that nightmare but shortly after we had the flea infestation and I followed mostly the same outline. All this time I had Traveler on Apoquel at least 16 mgs daily or twice daily Finally my holistic vet told me to get
Nexguard. That worked for the flea problem. Traveler also got a fecal implant and IV fluids for home. At this point he had minimal fur, doggy sad eyes, flaking skin and had been diagnosed via ultrasound for hemangiosarcoma a few months prior. Poor little guy. He was not improving going to raw and some say it is detox but he was losing so much weight and I didn't feel I was knowledgeable enough or secure enough to continue 100% raw. (Now I do a mix- sometimes raw, sometimes Orijen, always bone broth always veggie stew) Slowly but surely after the bug fiasco, he started to grow all his fur back, was happy and eager to play, I cut back the Apoquel to once every few days and a couple months later I stopped it altogether.
Shoot! What worked? Don't know. What didn't work? Other than the EO flea and tick bug deterrent formulas, I don't know.
What I do know is that without the Apoquel, he wouldn't be here with us. I had a choice; watch him tear himself up and be miserable beyond believe but maybe die early or watch him be able to sleep in comfort, no ripped up skin, act like a dog, take walks without stopping to scratch every few feet, and eat with pleasure.
That's our whole story- Reader's Digest Condensed version