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If medication and baths don't help, look into his food. My mother's maltese, who is also hypothyroid, had really bad skin issues a few years ago. Crusty and flaky skin, swollen and irritated lips. We brought her to our regular vet & a dermatologist where she was treated with an injections, medicated shampoo & wipes. The medication would work temporally, but the skin issues would always return. At no point did either vet mention her food. One vet asked what kind of food she ate, which was wellness, but that was it.
After over a year of her suffering, I suggested to my mom that she try a limited-ingredient food and pick one that has a different protein. The Wellness food she was eating was chicken based. We switched her to California Natural Lamb & Rice and within a month, her skin issue cleared up. It's been 3 years now and it has not returned. She is currently eating Wellness' Limited Ingredient Lamb and is a happy camper.
So, if the medication works temporary, he may have an intolerance to an ingredient in his food.
No chicken protein in his diet. He eats Now! Proteins are turkey, duck and salmon. But he's been eating this for 3 years with no skin funk. I did consider switching him to Natural Balance LID, but the protein levels were too high. (I have to keep them low because of his liver). Though we just got new forumulas in the store that I need to check out.
I just heard about a grain-free lamb diet today though with a protein of 28%. I need to look into it further.
Frankly, I think his skin funk is just the latest progression in his disease.
@dawn2shelties. She did not do a skin scraping. Jut put him on antibiotics and a medicated shampoo.
I bathed him last night and I've not seen him scratching today, along with 2 doses of the antibiotics.
He really needs a brush out to remove the flaky skin, but I thought I would give him a day or two before I aggravate the poor pup further.
My mom's dog ate the same food and protein for years with no issue and then all of a sudden she developed a skin allergy to chicken. Actually, research shows that dogs who eat the same food or protein for consecutive years are more likely to develop an allergy or intolerance to an ingredient than dogs who rotate food.