Golden Retriever with recurring skin inflammation/outbreak/infection?

Beginning last August, our 9-year-old Golden Retriever started having inflammatory outbreaks on her head. The vet refers to them as hot spots but has not been able to decide whether it is an irritation that becomes an infection or an infection per se. Our beautiful girl usually looks like this:



But we came home from a trip to find her looking like this:



She was on several rounds of antibiotics and a cortisone injection to calm the initial outbreak. It calmed down. Then it came back. I would say that it recurs roughly around every six weeks. I can almost tell when it is about to break out again because she becomes somewhat listless a day or two before.

The last couple of times we have had good luck with catching it early and treating it with hydrogen peroxide and Neopsorin, so we have been able to avoid the antibiotics. But it keeps coming back.

The vet suggested that it might be a food allergy. We've been feeding her the Purina OM (Overweight Management) kibble and Wellness canned food for a long, long time and I wonder if she may have developed a sensitivity to it over time. My dog groomer recently noted that our dog has developed "brown spots" on the skin of her back which the groomer thinks may be related to a food sensitivity. This is, of course, complicated by the fact that we often also give her cooked chicken as a supplement instead of the the Wellness and that she gets table scraps here and there.

My husband is loathe to change out the kibble/canned food because it has kept her weight down so well. She was once up to 113 lbs (she is an English Cream, so bigger frame...) but she has maintained 75-80 lbs for a long time since going on the OM regimen.

It's also, of course, possible that the outbreaks are related to environmental allergens of some kind. The fact that our vet is stumped by this has been frustrating to us. I am hoping that someone on BYC may have seen something like this and have some helpful advice. TIA!

I would suggest asking your vet to do allergen testing to identify the culprit(s) before starting to make changes - you can't eliminate the cause if you don't know what it is. While it may seem costly, think of what you have already spent and what you will continue to spend if the triggering item(s) are not removed. Either way, whether you do the testing or simply try to run it yourself by doing a "purge" of a hypoallergenic homemade feed for 2-3 months and then slowly introduce individual ingredients to test for reaction to food based triggers you WILL have to eliminate the treats/scraps until you have identified which ones are/aren't going to trigger as doing any treats outside of the current test item during the testing phase will nullify the entire effort as you won't know what she is reacting to - the treat or the test item of that period.

I would say to try a good grain free dog food, I had various trouble too until I put mine on Taste of the wild wetlands, no more greasy smelly dogs, digestive problems stopped and my dogs don't shed like they used to or have flaky skin, they are more healthy looking and tons of energy. Dogs are not designed to digest grains. Unfortunately it's become a cheap filler that will keep dogs alive but not nourished. Sorry about my tirade, I used to believe in Purina until they changed to poor ingredients. I don't know if it will help with the hot spots, but food allergies can be a big trigger. Just my experiences.

Poor baby! I think switching foods is good advice. Might also want to try a product called "Olewo dehydrated red beets" found on Amazon.com. Works for one of my dogs who has hot spots. I also switched to grain free food. Good luck

There are a lot of skin conditions that could cause lesions like that. Parasites, ringworm, and bacteria are all potential culprits in skin disease. I'll have to look through my notes to see what other things cause lesions like that but I will say that allergies can be really difficult to deal with. However, food allergies tend to be relatively rare. Unfortunately, the only way to know if it is a true food allergy is to do a novel protein food trial. I will say that if a shot of steroids helps, it is less likely to be a food allergy.

No one can truly diagnose her over the Internet, but I would recommend having the vet do a skin scraping to look for bacteria, fungus, or parasites if they haven't already. Sometimes one thing can cause issues and another thing (like bacteria) moves in and causes more issues.

Another thing I would consider is having full blood work run on your dog. It seems like she may be an older girl and often times skin problems manifest after other systemic issues start to occur (things that may be cause some sort of immune suppression). Older dogs generally don't just start developing severe allergies like that so I would want to rule out any other medical issues. You also might want to consider bringing her to a veterinary dermatologist, as they would be best able to get some good answers about what is truly going on.

My min pin had spots that looked similar to that. Putting her on 4Health brand dog food from TSC cleared her up in about two months.

Thanks all for these helpful replies!

@Ol Grey Mare the allergy testing is super expensive, from what I hear. That was my first instinct, too, but my husband is horrified by how much we've been spending at the vet of late so he's not willing to go that route. Hearing about the grain-free diet options really strikes a chord with me and after hearing your suggestions I think we might try that first.

I looked up the nutritional content of her current Purina OM kibble:

Whole grain corn, corn gluten meal, soybean hulls*, soybean germ meal, soybean meal, pea fiber, wheat gluten, poultry by-product meal, animal digest, powdered cellulose, tricalcium phosphate, animal fat preserved with mixed-tocopherols (form of Vitamin E), salt, choline chloride, zinc sulfate, ferrous sulfate, Vitamin E supplement, manganese sulfate, niacin, Vitamin A supplement, calcium carbonate, copper sulfate, brewers dried yeast, calcium pantothenate, garlic oil, pyridoxine hydrochloride, Vitamin B-12 supplement, thiamine mononitrate, Vitamin D-3 supplement, riboflavin supplement, calcium iodate, menadione sodium bisulfite complex (source of Vitamin K activity), folic acid, biotin, sodium selenite. Q-4560

That's a fair amount of grain content so I wonder if it could be the problem.

The Wellness canned food doesn't look like it has a lot of grain in it:
Chicken, Chicken Broth, Chicken Liver, Whitefish, Ground Barley, Sweet Potatoes, Carrots, Ground Flaxseed, Carrageenan, Canola Oil, Guar Gum, Potassium Chloride, Salt, Iron Proteinate, Zinc Proteinate, Choline Chloride, Vitamins E Supplement, Cobalt Proteinate, Copper Proteinate, Manganese Proteinate, Riboflavin Supplement, Sodium Selenite, Thiamine Mononitrate, Vitamin A Supplement, Vitamin B-12 Supplement, Potassium Iodide, Biotin, Vitamin D-3 Supplement.
but I also just saw that they make a "grain-free" version so I am also going to look for that.
@Chickerdoodle13 when it first happened I immediately thought about immune suppression. The vet ran a lot of tests with the first outbreaks because she was really acting sick along with the skin issues. Everything they did came back negative. It seems like she becomes a bit lethargic just prior to one of the outbreaks and I feel like I may be getting to where I can predict one based on that. But I can't quite figure out the relationship between her listlessness and a dermatologic issue. It really puzzles me.

Your girl is beautiful!
I have a similar story to yours. Our 9 year old yellow Lab developed a similar looking condition to your dog, except it was around her neck. We had extensive (and expensive) blood work done, after which the vet concluded that she was ridiculously healthy and he didn't know what caused it. All he could suggest was trying grain free food. He said that often dog food producers change their ingredients, and of course don't advertise that, so perhaps there was something in the food now that there never was before, and hence the reaction. We switched her to Nature's Domain from Costco (very economical as far as grain free foods go) and she's looked good ever since.

The canned food is fine, it's that dry food that's nothing but junk. Since you are feeding wellness canned, I would try their dry food, it's more expensive but in the end it isn't, you will get less vet bills, you dog will eat less, probably drop her extra weight. I find it funny that Purina uses grain, especially corn in a weight control food, it's the same as people eating cheetos to lose weight. I wish I had the smarts to attach dog food ingredients. Purina should be ashamed of their foods. Poultry by product meal and animal digest for protein, that's beaks and a predigested mess of junk. You dog needs meat and good carbs.

Your dog acts lethargic and ill before a big breakout because the allergies actually make her feel sick.