Mystery illness with hair loss

Our beagle is about 12 years old. 8 months ago she had a circular bald spot appear on her nose. We got it checked out and hair lightly grew back. But over the course of about 3 months the same spots started to appear on her legs and in another 3 months they were all over her body. Now about 60-70% of her hair is gone. We brought her into the vet when they spots started to spread and the rules out mange, mites, and parasites. Her liver enzymes were through the roof thought. We got antibiotics and anti fungal medication for her but it did not help and we could not pin down the cause. Doctors did say she had a bacterial skin infection but has been treated and condition still exists. She did have an infected sebaceous cyst removed that was bleeding about the same time these showed up, but the vet said it was unrelated. Over the last 2 months her skin has gotten extremely red/irritated along with lots of lethargy. Today she didn’t get out of her bed until 1pm. Her days also seem to get worse on days we do not give her special allergy free food, but still has some flare up days regardless. When he flare ups occur because of food she will shake and skin will turn fire engine red. Additionally sometimes she has mucus and blood in her stool but it’s not significant. By working with our local vet network we have the following additional info: - not Mites and parasites (tested) - Not Cushing disease (tested) - X-rays are normal and no tumors - blood work is now clear. - bacteria present but seem to exist because of another condition making her vulnerable. -yeast present from antibiotics (per vets) Happy to provide pictures if people need. Hoping to get a lead on a condition from this so we can test for it. Thanks in advance, Bill

Some additional info I forgot: -her liver enzymes are currently normal (although six months ago they were at very high levels)

This looks like an immune system overreaction. Is it possible you use cleaning supplies, air fresheners, or something else that might trigger a severe allergic reaction in your Beagle? I'd recommend changing everything and seeing if that makes a difference. It's possible the dog has lupus, but that can be hard to accurately diagnose.

Thanks EmMarley! Allergic reaction is our best guess as of now too. We have switched out all of her food (she’s on special allergy free food), and changed things like the rug in the room she sleeps in (was fairly new), medication, collars, some cleaning items(we use all organic cleaning items now). Haven’t seen anything make a difference yet but we will keep switching things out. thanks for the help!

Yes, I'd definitely be talking to your vets about an allergy workup. Unfortunately, there's no simple test for allergies ("allergy tests" are generally to work out what the allergy is, rather than whether one exists). And certainly allergic dermatitis could cause the signs you've described. Good luck with her! Fortunately, while most allergic skin disease in dogs can't be cured, it's very unusual for it not to be manageable with the right medications and management.

You might also want to think about the history and any seasonality - when it started, has there been a history of other skin or ear problems, if it's worse at certain times of year, etc - that could be really useful to your vet! Good luck!

Thanks David! We are definitely working with the vet on testing for allergies. In terms of history, she's been a very healthy dog. No history of allergies, ear infections, or any other issues. This is the only issue that has come up, along with the cyst that was removed around the same time the symptoms started. Attaching some pictures to show you the progression of when this began to today. First sign of hair loss (approx 8 months ago) Removal of cyst (Approx 7 months ago) Starting to show more hair loss on legs (approx 6 months ago)    

More photos Approx 1 month ago   Two pictures taken in the past week   Thanks again for all the help!

Hello! I'll start with my twopennorth about allergies, but feel free to skip this paragraph as para. 2 may be more helpful.  Allergy free foods work by not exposing an animal to an allergen (eg by using a different protein source).  It is worth noting that if the pet is still exposed to the allergen (ie a different food containing the allergen is given on intermittent days), they will not have any effect.  A diet will only work on an allergic dog if the correct allergen is completely omitted from the diet for long enough.  Many skin allergies are to things not found in food.  In summary, to try to pinpoint an allergy is actually quite complicated - it is best done under the supervision of your vet or, even better, a dermatologist.   However, allergy might not be at the top of a dermatologists differentials list for this case.   I think you said that the lesions weren't particularly itchy.  If this is the case, then autoimmune diseases might be a differential (alternative) to think about as these can cause a good deal of damage, tend to present as hair loss and aren't particularly itchy.  I think I'm right in saying that your vet may need biopsies to diagnose them, if they are suspicious.   Ringworm can also cause non itchy areas of hair-loss.  You don't mention which antifungal you tried or the specifics, but such diseases can be tested for. This is a complex and challenging case and I wonder, if your vet agrees, whether a skin specialist has seen this case, as this may be a good way forward?

Oh dear my paragraphs all ran together in the end!  The interesting part that isn't about allergies starts at line 19! Your little one looks extremely sore and I hope that you get to the bottom of this in the end!  Please will you let us know how you get on?

Ps Having given this more thought, it occurs to me that there are yet more differentials!   1)  Demodex deserve a mention - these are mites, but need a deep skin scrape to diagnose them and do not respond to a lot of anti-mite treatments.  I have never seen demodex-infected skin look so inflamed however, unless also badly infected.   2) Cutaneous lymphoma (which is a cancer) may be a possibility.  3) There is an unusual syndrome hepatocutaneous syndrome, which can occasionally present with a very high liver enzymes and skin changes.  Again the cases I have seen didn't look so dramatic, but it may be a possibility. Therefore, more tests may be needed - possibly by an expert skin vet - to get to the bottom of this case.

Hi Liz, thanks so much for all the leads! Our vet did mention autoimmune and cutaneous lymphoma as possibilities. We definitely need to get a skin biopsy to help us to narrow down on those. Thanks for the leads on the other items as well! We will discuss with our vet and see what he thinks! Hopefully one can will be it. If anything else comes to mind please let us know!

I look forward to hearing how you get on.  Please note that your vet is much better placed to know what should be on your dogs' differentials list than I am - being fully qualified, having examined your dog and knowing much more about the history!   There is no situation in which we should be giving your vet advice.

Definite understand. We are treating these as ideas for our vet to evaluate as options. We really appreciate the thoughts and feedback!

Hi there. My dog is experiencing the same symptoms in terms of hair loss (started with a circular spot on the bridge of his nose, then bald spots on lower legs). I'm wondering if the cause/condition has been determined for your pup and how she is getting along?