Hair loss, inflammation and ear issues

Hi, I have a 3 year old lab.  She has had ear issues with black stuff in her ears that we clean out regularly for years, she is always itchy and her ears bother her so much that she plows her face into things.  Her hair has started to just fall out in certain random areas, or if she scratches, etc. I have been to multiple local vets and no one has been able to help.  I have cut outmost allergic foods and she has been restricted by vets on some proteins and for grains, but nothing takes care of any of this. I am looking for what else I can try, or even vet recommendations near me.  I have even tried an online vet that was not able to help except say to restrict her more, that it’s probably allergies.  She is already very very restricted and extremely picky.  She likes kibble mostly, hates a large amount textures, etc. and I’m not sure what else to do.  Any recommendations would be greatly appreciated.

Hello!  This is an extremely common experience.  First and foremost, it is important for owners to recognise that skin disease is, in most cases, chronic.  Chronic as in, the opposite of acute, which means that most skin disease is not a disease that you 'get,' and that can be 'made better' or cured, but a long-running disease that you can expect to live with for the long term - similar to arthritis, asthma, or diabetes.  It is extremely common to hear of cases where owners go to their vet and get treatment - but of course the treatment might not clear the skin up entirely, or perhaps it does but the condition recurs after a while because it is after all a chronic (long-term) condition.  Typically owners then present to another vet, are prescribed some similar treatment which also doesn't 'cure' the problem and then they may even try a third vet, or a fourth. It is far more cost-efficient and helpful to view skin disease as the chronic condition that it is, a condition that flares up periodically and often needs to be managed rather than cured.  In order to get treatment working, it is useful not only to go to the vet once, but to book the revisit check-ups and ask them what might be causing the disease, what long-term management is likely to look like and at what point it might become appropriate. For example, has anyone spoken to you about the use of hypoallergenic foods and what they are expected to do?  They are not much use against grass allergy for example, because the patient still meets grass every time they go out for a walk.  Or a flea allergy, if the patient is indirectly being exposed to another dogs' fleas. Its sounds to me as though you need to find out which vet in the area 'likes' seeing skin cases and to ask them to review your dogs' care.   You might want to get a diagnosis, or you might just want to keep them comfortable as best you can.  This depends on a lot of details about the case.  There are a number of short articles on the blog which might help. Of course, there are some acute skin diseases - and cancers, even - but most cases are thought to be allergy mediated. Good communication with, to and by your vet is essential. Best of luck

Ps It's worth mentioning here that ears are simply very thin, sensitive skin down a hole, with a special adaptation to pour ear-wax on the site when it is inflamed.  Ear disease is also often be chronic.  However we have never known so much about the skin and most patients with skin disease can be kept tolerably comfortable throughout their lives, for example by actively treating against fleas and parasites and be using effective drug combinations.

I hope that some of this helps.