This maybe a tricky one….

I’m going to have to start with some long back story. I apologize in advance if this gets long. I have an a lay 3 year old AKC German Shepard. We got him as a pup from a breeder in 2020. he was seemingly always an itchy boy even as a puppy, but we didn’t think much of it. All of his vet appointments were good, we kept up on flea treatment and he never had any issues with those at all. around 2021 our boy started losing more hair. We didn’t question it to much and assumed maybe now that his coat was fully grown in, maybe it was a shedding process. fast forward to mid 2021 and into the fall of 2021 and he started having issues with rashes and sores that resulted in scabs. The vets diagnosed him with a skin infection, they put him on antibiotics and steroids. They said it maybe from an allergy and instructed us to start a food elimination diet. we noticed he did seem to react to eggs, chicken and turkey. So we put him on a different food but the change didn’t really help. This went on for awhile. Many rounds of steroids (the last being in late nov of 2022) and many rounds of antibiotics. At his last appointment in Nov 2022, they said he had yeast on him but said it didn’t need treatment, to continue to use the mal-a-keet shampoo they prescribed. No improvement. If anything he has declined rapidly. He’s lost all the hair on his belly, he smells awful. He is leaving massive amounts of hair everywhere. he looks miserable, the vets is booked out. He definitely looks to have an ear infection, I did phone 2 other vets, one isn’t accepting new patients and the other is booking out further. I’m not sure if this is really a food allergy, and now it’s gone into a full blown yeast infection? or does he have something underlying like autoimmune, which we have brought up the possibility of autoimmune or something of the disease area. They said “no way, it’s just allergy and he has anxiety” (because he has weird shaking fits too) His current status is, he hardly gets off his bed. Last week he was following everyone around the house. He’s barely moving. I’m expecting to find him deceased some morning at this point, and my anger for the lack of care from his vet is building. What can I do? :-( I also want to add that his nose is dry, and has been for several days  

Your poor boy.   It seems as though he has a a skin problem, but also as though he may be systemically ill (lethargy, not getting off bed).  The latter might be an emergency, so it sounds as though he needs to be triaged.  'He has an ongong skin problem with massive hair loss but has been very lethargic for X time and doesn't want to get up - please could I get him triaged as an emergency?' might be a good way to start this conversation.  I could give you lots of advice about hair loss, but if there is something serious underlying it, then that takes priority.  Dogs with Demodex (usually non itchy) or other (usually itchy) mites do tend to get dramatically worse when there is an underlying problem, or sometimes even after steroids.  Another group of diseases that you might want to look into are - I agreee - the autoimmune diseases, which can cause combined skin and systemic illnesses.   I hear that you do not like the vet, but this patient does need veterinary attention from somewhere and I cannot tell you how to treat it on an online chat forum; I cannot check for demodex or examine for systemic diseases or biopsy for autoimmune problems.  Please do seek some help out immediately, give treatment as offered and attend the follow ups - this won't be solved in a ten minute consult.  Do let us know how you get on.

Thank you for you response. He has been checked for mites and fleas. Both were non existent. I will call the vet first thing tomorrow and tell them how he’s now lethargic and mention that he had the dry nose as well. I know in my gut something more is wrong with him, and I’ve been telling them for many months, but no one listened. I think we will probably end up bringing him to the emergency vet at this point, it’s a hail but he cannot wait until his appointment. the hair loss has always been a problem, but it’s gotten very bad about a month ago. But I assumed it was something he at, since we have been told time and time again it was an allergy. but this is different, he has darkening of the skin and it’s very wrinkled. It’s never been like this. I do thank you for you time, I will update.

Following up, I did get in touch with his current vet. They said they couldn’t get him in soon, even though I told him he was lethargic and had a dry nose. I even put him on the cancellation list. I told them I am very concerned and they asked me to send in images, which I did. they called back and said he needed to go back on his apoquil, and mal-a-let shampoo. They also wanted to put him on another antibiotic, I told them I was not comfortable with that at the moment, especially since he smells so yeasty. I asked about an anti fungal, but they refused. He’s been on the apoquil and has had to shampoos since Friday. His skin is flacking off horribly. When I sweep it’s like ashes though out my house. I called in regards to that, and they said to schedule a follow up, but I already have an appointment? So I’m very confused. I do have an appointment with another vet but it isn’t until May. He is a little more perky, but it still laying around a lot. we have switched his food, hoping that helps some. But I doubt it. a friend of mine thinks he maybe has democratic mange. I googled it and it does look similar. And this has been going on since he was about 12 months old and has continued to get progressively worse. I feel like this vet is just not taking this serious. The poor dog smells terrible, and is covered is white skin flakes since starting treatment.