Skin breakouts , small white pimples, black spots

We have a wonderful Retriever that has had the worst of skin since he was around 6 months old.  We have had him on antibiotics , sprays, shots, benadryl.    He is on a restricted diet of duck and potatoe and we are so sad for him.  He seems to have so many breakouts.  We bathe him once to twice a week and then blow dry him too.  Some vegatables, broccolli and asparagus, plus some times wild salmon dried.  

Otherwise,No treats, we are afraid of breakout.  
Any ideas of diets, programs, specific to this type of breed .  We live in Woodinville, WA.  Thank you all for your commments.

[Kimberly Coyner, D.V.M., DACVD]

Skin problems can be very frustrating, I know! But it certainly sounds like you are taking wonderful care of your dog and getting him treatment from your veterinarian. When you say "shots", do you mean steroid shots (cortisone), or allergy hyposensitization shots based on an allergy test?

Skin breakouts and pimples in dogs are usually signs of a bacterial skin infection. Chronic recurrent skin infections in dogs are usually secondary to an underlying allergic cause, either food allergy or pollen/dust allergies, both very common in golden retrievers. Hormonal disorders such as hypothyroidism can also cause recurrent infections, but hypothyroidism occurs usually in older dogs, not in 6 month old puppies, so this is less likely. If his symptoms continue to recur despite the strict hypoallergenic diet, then the diagnosis by exclusion is pollen/dust allergies, and the next step is allergy testing and desensitization injections to identify and treat the cause of the recurrent infections.

Allergy testing can be done with a blood test (which is more convenient and can be performed by most primary care veterinarians, but may be less accurate than skin testing), or by intradermal/skin testing (usually performed by veterinary dermatologists, it requires a light sedative and shaving, and is considered the “gold standard” of allergy testing). Allergy hyposensitization injections are given every 1-4 weeks (the dose and frequency of the vaccine are different for every pet), and are helpful in 70-75% of allergic pets to reduce symptoms and needs for medications. Allergy immunotherapy is usually a lifelong treatment and the degree of response to therapy varies with each individual animal; some pets only need the hyposensitization vaccine, some still need some symptomatic medications such as antihistamines, and some still need steroids, but at lower doses, less often or only during certain seasons. Allergy hyposensitization injections address the cause of a pet’s itchy skin by changing/calming down the hyperactive immune response to the environmental allergens, but require time (2-12 months) for effect, so symptomatic medications are continued while immunotherapy has time for effect. You can ask your veterinarian about allergy testing, and if needed they can find a veterinarry dermatologist in your area by going to www.acvd.org and clicking on the "find a dermatologist" tab. If your dog is already on allergy hyposensitization injections based on a blood test, I would consider re-allergy testing him with veterinary dermatologist and with a skin test to see if new or different allergies can be identified.

Finally, in a small percentage of dogs, recurrent skin infections are due to an unknown (idiopathic) cause, and in those cases trying to stimulate the immune system with a staph bacterial vaccine (Staphage lysate) can be helpful, and you can ask your veterinarian for further information on this as well.

Although allergies in pets are not “curable”, they are very treatable and controllable in most pets. Every animal is an individual and often different medications need to be tried or combinations of medications may need to be used for maximal comfort. When the motivated pet owner, family veterinarian, and, in difficult cases, a veterinary dermatologist work together, our allergic pets can live long, comfortable lives.

Good Luck,
Kimberly Coyner, DVM DACVD
www.dermvet.com