Toy Black Poodle skin Problem with Hair Loss

My poodle, Shadow, about 14.5 lbs has had a problem for over 6 months, maybe as long as a year.  I've gone to the Vet a number of times for this problem, and am usually told its probably a dietary problem or fleas.  Well, I don't think its either.  My dog's don't have fleas, and are on a flea treatment regimen.  My 4 dogs diet consists of cooked chicken (less skin) either boiled or roasted, Beef Shanks also either boiled or roasted, kibble always in their dish, canned dog food in between other foods, Dog snack bones (of the milkbone variety) and occasionally, not often, chicken fried rice, and Pet Tabs.  Here are Shadow's symptoms.  Loss of hair on the underside of the tail, all around the anus, and down the inner rear legs.  Skin that is very wrinkled, dry, rough.  Hair over the rest of the body is thin, with hair around the ears barely growing at all.  The hair around the face is also thin, and was absent around the eyes, but some has slightly returned.  For awhile, he looked like he was wearing glasses.  He seems to itch a lot, and thus scratches.  I have been using an itch spray with aloe in it, which seems to help a little.  He is groomed every 5 weeks and bathed with anti itch oatmeal shampoo.  I bathe him once or twice between groomings.  He has very dry crusty inner ear flaps.  He has developed a problem with his rear legs which seem to be deforming...he walks extremely bow legged and although will still jump up on the couch or climb 3 steps to get onto the bed, he does so reluctantly like maybe they cause pain.  Not sure that this is related to his skin/hair problem, but thought I'd mention it.  Not having gotten very satisfactory answers from my Vet, and we've been to him almost every month for the past 2-3 years, I'm thinking he might have some auto-immune disease and perhaps arthritis as well.  They've performed a number of tests, usually also involving ultrasound or XRay with no diagnosis.  I'm looking for suggestions as to what his problem could be, and what tests I should direct my Vet to make, since their decisions have been just costly and non-productive.  I'm thinking something like testing for Addison's, Cushing's, Parasitic Mites, Mange, and various blood test for Cortisol, Cortisone, Testosterone levels, Estrogen Levels, Glucose Levels, Insulin Levels, Liver Enzimes, Alkaline Phosphates.  Does anyone have any idea if I might be going in the right direction, or have any other suggestions for diagnostic tests that might help pinpoint my dog's problem.  He's 12 years old.  His brother, a litter mate, which received the same treatment at home, and same diet, but has none of the symptoms of Shadow.  In Fact, I have 4 dogs, the two poodles, a Pekinese, and a poodle terrier mix.  All are at or under 16 pounds.  Except for seasonal itching that all four display, usually around the Late Spring, Summer, and early Fall, the others have none of Shadow's problems.  Shadow has also lost a little weight over the past year having lost about 1 - 1 1/2 pounds.

[Jerry_NJ]

Please see my reply to "Black Skin Disease" in this Community.

It isn't the answer, but it may contain some helpful ideas... for one I think there are better dog shampoos than the oatmeal type when there is a skin/yeast problem...this may be part of the problem.

[Margot49]

Sounds like a good possibility it is autoimmune.  I am thinking if a couple and will try to check them later.

[Misfits4Me]

Hi Bill, Welcome to the forum.....I have some ideas, too....First, More questions:

Has he had a full blood panel? NOT specialty tests, but a regular blood panel? This would rule out a few internal diseases... Such as Liver & Kidney disease....Would also have clues to some of the other diseases you mention....

How are his potty habits? Any excessive drinking or peeing? What does his poop look like?

Is his belly swollen (To look at) at all? Any symmetrical  hair loss down both sides of his body?

What flea treatment are you using and how often?

What was the ultrasound and xrays of? What were they looking for?

Have you ever been offered or used an anti-inflammatory for his possible arthritis?

Name of food (Kibble & Canned) that you feed....

Has there ever been a skin scrape to rule out mange, yeast or fungus?

Does he have an odor?

Anything else would be helpful.......Thanks, Karla

[Bill94561]

OK, here are some the answers to the questions asked.  I've been relying on my Vet to recommend tests, interpret them and provide treatment for whatever they feel the test results indicate.  Up to now, they have not provided me with the actual test results, and I have been depending on them since they are supposed to be the doctors.  Having said that, Shadow has had several CBC blood tests.  According to the Vet, everything was normal except for Thyrod, which they gave him  levothyroxine 100 mcg ta Mylan.  He is prescribed 1 and 1/2 tablets twice daily.  The only thing the Vet has ever given me is a written itemization of the bill, for instance, the latest which was done yesterday 2/25/13 reads:

----------------------------------------------------------------------------------------------------
Service/item                                   Qty                     Price                  Amount
Treatment Progress Evaluation      1.00  D              35.00                   35.00
Skin Scraping                                  1.00 D               41.96                  41.96
Cytology-in house                            1.00 D               35.25                  35.25
Senior Profile w/Hwt                        1.00 D               169.90              169.90
Blood/Urine Sample Collect             1.00 D               16.30                 16.30
Urinalysis with Panel                        1.00
Cortisol                                             1.00 D                70.85                70.85
Convenia Antibiotic Tesatment         0.60
*                                                        0.60 D                122.58              73.55
Culture Aerobic                                 1.00 D                  52.22              52.22
Discount                                                                                              -49.52
                                                          Net Invoice                               445.51
--------------------------------------------------------------------------------------------------  

The Anti-itch spray was not recommended by the Vet, but I got that on my own.  I have a couple different kinds, one is Pet Relief Anti-Itch Spray Which I intended to use once the Hartz Health Measures Anti-itch Hydrocortisone Spray with Aloe is empty.  The shampoo I am using now, does not have Oatmeal.  Its called Sulfodene Medicated Shampoo for dogs and is supposed to help stop itching and flaking.  The wet food we are feeding the dogs is Ceasar Canine Cuisine.  The kibble we are giving is either Science Diet Small Bites, or Beneful original, and as previously mentioned, we give them boiled or broiled fresh chicken without skin, or boiled or broiled beef shanks.  We give them the marrow from the bone as well as the meat, but not the bone.  We also give them Kirkland Super Premium dog biscuits. We like to change their diet since giving them the same thing every day would probably get boring for them, so sometimes we give them one type of kibble, other times the other.  Same with the Chicken and Beef.  Currently they are on Frontline Flea treatment but the Vet suggested that we start on Revolution rather than Frontline since it also treats some skin bacteria.  She mentioned yesterday that they examined the scrapings and saw bacteria but not something else they expected (I forget what it was she said).  Since they do not provide me with written results of their tests and findings, I have a tendency to forget some of what they tell me.  Like I said, I have been depending on them to do what is right, but now that I think about it, I am going to start asking them for written results and recommendations if they will give them to me.  She told me that they couldn't test the thyroid because it has to be within a 4-6 hour window of giving the Levothyroxine, so we will do that in a couple of days, when the other test results come back.  The tests they did yesterday was because I told her what I wanted to do (since they keep repeating other tests with no results, and I don't want to keep throwing money at things we've already tested.)  Basically, I wanted her to test for Cushings and Addisons disease, hormonal imbalance, mange, mites including rabbit mites (since I also have rabbits) I hope this provides the additional information requested.  Regards,  Bill

[Jerry_NJ]

Sorry to read you are having such a tough and expensive time.

Your opening post mention 6 months, is that how long you have owned the dog, and what age is he?

I think Sulfodene is a brand name but has a 2-something active ingredient - it has been around a long time and well regarded, I believe.  However, if there are any signs of yeast/dermatitis I understand a shampoo containing Ketoconazole is best - that's what we use on our Westie, that has an ongoing battle with yeast.

I think limiting the food to try to reduce the possibility of food allergies is best, and for a dry kibble I like Nature Balance Grain Free.  Even the Science Diet that I've seen never tells the full story of what's in the kibble.

We are using a sweet potato and fish kibble as we thin our Westie may have allergic reactions to chicken.

[Misfits4Me]

Hi Bill....I will come back in awhile & go over everything on your receipt with you & what your Vet tested for...It appears that they DID cover ALL bases......This is a wonderful workup.....We just need the results of what they found, if anything....Do you have a follow up appointment or will they call you with the results? Let me know.....  Karla

[Bill94561]

Hi all, thanks for your interest, suggestions, and helpful advise.  I spoke with my vet yesterday, and she said that most of the tests she did have come back normal, so currently no indication of Cushings, but she said there is still a possibility it could be Cushings and will have to run another, more definite test.  The skin scrapings came back with bacteria, but the biopsy hasn't been completed yet.  I asked my Vet for the actual results of the tests and she said all I have to do is come in, and they will give me copies of all the tests We've run on Shadow over the years, up to now.  FYI, Shadow was born on 9-9-2000, so will be 13 years old later this year, but I still want to keep him around as long as possible, and with as good a comfort also.  I'll post additional, when I know more.

[Misfits4Me]

Hello Bill, Let's go over your bill from your vet:

Skin Scrape-- This is how they found the bacteria on the skin, which I assume they gave you the antibiotic for (listed on your bill)...Some bacteria IS NORMAL on the skin.....This test would have also checked for Mange, Mites, Fungus & yeast.....So, these can be ruled out!

Cytology--A cyst/growth must have been cultured/biopsy & either examined in the office or more than likely, sent out to a lab.....These results are not in as of yet.

Senior Profile w/Heartworm test--- This would be the complete blood test to check for internal function of organs.....Added was a heartworm test....Your Vet said these came back normal, so that's great!!! THIS blood profile test is what I always ask for a copy of, so I can come home & look at it again....

Urinalysis--Checks for bacteria/blood in the urine....Such as for a Urinary Tract Infection...I suppose this was clear, also?

Next: Cortisol Test--To measure levels in the blood....This is to rule out Cushings AND Addison's Disease.....You seem to be worried about Cushings.....Does your dog have any other systems other than hair loss? Such as a Pot Belly Appearance, Excessive drinking & urination? If not, then it's not Cushings.....

Culture Aerobic--Your Vet has sent a culture to a lab (Mainly looking for a specific bacteria).....This could be from the cyst, the skin scraping OR of from the urine...... There is no way to tell from the receipt.....You probably already know what was cultured from being at the appointment....

This is a truly thorough evaluation!!!! The other thing that I would have suggested is hypothyroidism which you have already ruled out and are treating for.....So, good for you....

However, Since your on top of the flea problem, that takes me back to your first post & I too, think it's the DIET......I'm not talking about table foods & your meats.....They are fine within moderation....Excessive meat WITHOUT proper Calcium can become a problem.....But again, a piece here or there is fine.....

Your dog's problem is the dogfood your feeding & it will eventually effect you others as well!!! Your dog needs some better nutrition!! The Beneful, Ceasars & Science Diet are some of the lowest qualities available....On a scale from 1 to 5, they are a 0!!! If you knew what was in them, you'd know why your dog was sick......Actually, I will show you one of them so you can get an idea....There are 19 questionable  & some very dangerous ingredients in the Beneful alone.....Nutritionally Great dogfoods will have NONE of these ingredients in them! Here is the link to explain:

http://www.dogfoodadvisor.com/dog-food-reviews/beneful-dog-food-dry/

The Science Diet & Ceasars are about as dangerous.......This link is from Dogfood Advisor, but all places to rate foods say the same thing about these three....If you need more resources, let me know.....You can also find the best of the best listed at this websight....Make SURE you feed at least one meal a day of High quality, Wet/canned food...Your dog will heal faster because of not only the much needed moisture, but canned food is higher in nutrient value because it is not baked to death like kibble is.....

You will pay higher prices for these good foods, but it boils down to "You get what you pay for!" You also feed LESS of top quality products because they are NOT full of cheap, by-products & unnecessary nutritionally worthless fillers, like saw-dust & peanut hulls & corn!!!! Yes, one of the company's foods your feeding includes all three in some of their formulas! ;(

You also need a GOOD Omega 3 supplement to add to their meals....There are thousands out there; my favorite is Andi Brown's "Holiday's Best in Coat" Supplement....You will not find it in stores, must be ordered online!!!  Good luck & I hope this all helps you.........Karla

[Jerry_NJ]

And for Bill too:

What is a good, even best, canned dog food that one might expect a dog to eat.  Our Westie is currently on no chicken or beef (or pork...) until we figure out what he can eat fish is what he gets for protein.  I just got some Plato Salmon treats from Amazon that he seems to like, as we have discussed elsewhere he rejects foods most dogs do "back flips" for.  Y

You again raise the too much baking for kibble, our dogs main (almost only) food until we find out what he is allergic to is Natural Balance Sweet Potato and fish Kibble

I wonder why so (many?) vets recommend Science Diet.  My vet sells the stuff, including a by prescription only make up, we have some Potato and Venison which she recommended for the first step in determining if elimination of chicken and beef helps.  We moved to Natural Balance on the recommendation of a Westie breeder (rescuer).  Our Westie was going on a food strike about the Science Diet anyway.  When I asked about "grain free" my vet looked at me like I couldn't read:  the bag says Potato and Venison what's my question about about grain?   I have a friend who has a daughter who completed Vet school and 4 years residence as a cardiologist and she recommends Science Diet.    

I think my question and comments fit in to the discussion with Bill, I do recognize it is his thread.

[Misfits4Me]

Bill: Your Vet recommends Science Diet because he/she is PAID to sell it.....He/she makes a profit by selling it to you! That, and they want to see you more often!!!

Also, Your Vet receives about a 6-8 hour course in nutrition in Vet school....Guess what company sponsors the course? HILLS, the makers of Science Diet....A Holistic Vet or Animal Nutritionalist would CRINGE at the mention of Science Diet!

There are too many science diet brands for me to view them all right now, but I don't see one that is Potato & Venison. Is that what you meant?

If you are talking about Natural Balance, although a much better food, I still think it's too carb heavy, mainly plant based and not enough meat! Their limited ingredient diets are of lower quality than their regular line....Also, it contains NO probiotics added, which is defeating the purpose for Yeast infected dogs.....All this can be found at Dogfood Advisor.com.....

P.S. I have one dog that starts itching the second she eats potatoes.....No Kidding!!!!     Karla

[Misfits4Me]

Opps!!....My last post was meant for Jerry.......Sorry bout that!    Karla

[Bill94561]

Ive been trying to post test results, but the web site fails to post it....I get the message failed to save post.

[Bill94561]

OK Folks, I just got back from the Vet and here are the Tests and results four showed high and 2 showed low.  According to the Vet, Addisons is not an issue, I am wondering if Cushings is though.  I also requested testing both Testosterone and Estrogen, but Vet says not necessary as Shadow (a Male) was neutered over 12 years ago, but neutering was necessary as one testicle did not fall and they had to go up and get it  Some other things I asked for were Pituitary, and adrenal glands, liver enzimes, alkaline phosphates, and any issues with hormones.  Since I'm not a vet I don't understand most of the tests/results, so don't know if any of these additional items were tested for or even necessary.  My whole goal is to check everyting that doesn't require invasive work or surgery that could possible be causing Shadow any problems.  My other 3 dogs do not have any of the symptoms that Shadow is showing and all are close in age and size to shadow, who has lost some weight in the past year, he's now down to 12+ pounds.

[Bill94561]

Cortisol

Test                              Result                      Reference Range

Cortisol                           8.2                               2.0 - 6.0 ug/d            H

Reticulocyte Panel

% Reticulocyte                0.5                               - %
Reticulocyte                     31                                10 - 110 K/ul

Senior Profile W/HW Chem 27

Alk. Phosphatase             29                                 10 - 150 U/L
ALT (SGPT)                      67                                 5 - 107 U/L
AST (SGOT)                     39                                  5 - 55 U/L
CK                                     380                               10 - 200 U/L           H
GGT                                   6                                   0 - 14 U/L
Specimen Required Ultracentrifugation Due to Gross Lipemia
Amylase                              540                               450 - 1240 U/L
Lipaise                                300                                100 - 750 U/L
Albumin                               3.4                                 2.5 - 4.0 g/dl
Total Protein                        6.9                                 5.1 - 7.8 g/dl
Globulin                               3.5                                 2.1 - 4.5 g/dl
Total Bilirubin                       0.0                                0.0 - 0.4 mg/dl
Direct Bilirubin                      0.0                                0.0 - 0.2 mg/dl
Bun                                       23                                 7 - 27 mg/dl
Creatinine                             0.7                                0.4 - 1.8 mg/dl
Cholesterol                           131                               112 - 328 mg/dl
Glucose                                96                                 60 - 125 mg/dl
Calcium                                10.1                              8.2 - 12.4 mg/dl
Phosphorus                           3.4                               2.1 - 6.3 mg/dl
TCO2 (Bicarbonate)              17                                17 - 24 mEq/l
Chloride                                 113                              105 - 115 mEq/l
Potassium                              4.4                               4.0 - 5.6 mEq/l
Sodium                                   149                              141 - 156 mEq/l
A/G Ratio                                1.0                               0.6 - 1.6
B/C Ratio                                32.9                             -                               H
Indirect Bilirubin                      0.0                               0 - 0.3 mg/dl
NA/K Ratio                              34                                27 - 40
Hemolysis Index                      +++
    Index of +++ may decrease ALP by 25-50%,
                           and increase AST by 25 -50 %
Lipemia Index                           N
  Index of N, +, ++ exhibits no siginificant effect on chemistry values
Anion Gap                                 23                               12 - 24 mEq/l

Senior Profile W/ HW  T4

T4                                               3.4                             1.0 - 4.0 ug/dl

   Interpretive ranges:

    4.0              High
        2.1-5.4       Therapeutic

    Dogs with no clinical signs of hypothyroidism and results within the
    normal reference range are likely euthyroid.  Dogs with low T4
    concentrations may be hypothyroid or "euthyroid sick".  Occasionally,
    hypothyroid dogs can have T4 concentrations that are low normal.  Dogs
    with clinical signs of hypothyroidism and low or low normal T4
    concentrations may be evaluated further by submission of free T4 and
    canine TSH.  A high T4 concentration in a clinically normal dog is
    likely variation of normal; however elevations may occur secondary to
    Thyroid autoantibodies or rarely thyroid neoplasia.  For dogs on
    thyroid supplement, acceptable 4-6 hour post pill total T4
    concentrations generally fall within the higher end or slightly above
    the reference range.  (NOTE HAND WRITTEN BY MY VET IN THIS SECTION (0.1 m) on 1.5 tab thyroid not 4-6  md post P.M.)  I believe she said that this test could not be properly performed because Shadow is on Thyroid medication and was not within the 4-6 hour window for testing.

Senior Profile W/ HW CBC Standard

WBC                                    10.6                            5.7 - 16.3 K/uL
RBC                                     6.13                            5.5 - 8.5 MuL
HGB                                    15.4                            12 - 18 g/dL
HCT                                     46.2                            37 - 55%
MCV                                     75                                60 - 77 fL
MCH                                     25.1                            19.5 - 26.0 pg
MCHC                                  33.3                             32 - 36 g/dL
% Reticulocyte                     0.5                                - %
Reticulocyte                         31                                 10 - 110 K/uL
Neutrophil Seg                     81.0                              60 - 77 %                H
Lymphocytes                       8.0                                 12 - 30 %                L
Monocytes                            6.0                                 3 - 10 %
Eosinophil                            5.0                                 2 - 10 %
Basophil                               0.0                                 0 - 1 %
Auto Platelet                        305                                164 - 510 K/uL
Remarks                               Slide reviewed microscopically
Absolute Neutrophil Seg      8586                               3000 - 11500 /uL
Absolute Lymphocyte           848                                 1000 - 4800 /uL      L
Absolute Monocyte               636                                 150 - 1350 /u/L
Absolute Eosinophil              530                                  100 - 1250 /uL
Absolute Basophil                 0                                      0 - 100 /uL

Senior Profile W/HW    Heartworm AG Elisa

Heartworm antigen - elisa      Negative

Senior Profile W/ HW  Urinalysis

Collection Method                  Cystocentesis
Color                                       Yellow
Clarity                                      Hazy
Specific Gravity                       1.040
Glucose                                   Negative
Bilirubin                                    Negative
Keytones                                  Negative
Blood                                       Negative
PH                                            6.0
Protein                                      Negative
WBC                                         0-2                             0-5 HPF
RBC                                          0-2                             0-5 HPF
Bacteria                                    None Seen                 hpf
Epi Cell                                     Rare (0-1)                  hpf
Mucus                                       None Seen
Casts                                         None Seen
Crystals                                     None Seen
Other                                         Amorphous Debris
Urobilinogen                              Normal
    

[Bill94561]

I have another update as to what I am doing...I have just changed my dog's diet to **** Van Patton's Natural Balance.  I am staying away from chicken, turkey, and beef.  I am also ceasing feeding of the chicken and beef shanks, and will be feeding them **** Van Patton's wet food as well.  I stopped by my Pharmacy today, and discussed my problem with Shadow.  The Pharmacist advised agains using Ketoconizole or dermisil.  Instead, he said if it turns out to be a yeast infection, use a mixture of 1:1 of white vinegar and water, and soak shadow for a few minutes, then rinse off.  Anyway, that's where I'm going with the Elephant Skin problem, however, I must now set up another appointment to determine if the test results indicate Cushing's, and if so, what treatment plan to follow.  My vet did not do a VARL test, so still unsure of allergies.

[Jerry_NJ]

Van Patton, I had to go back and check, yes that's what I feed my Westie. I feed him the sweet potato and Salmon kibble.  This was recommended to me (sorry if I repeat myself) by a Westie breeder and show person, the person who rescued my Westie - we adopted the dog from her.

Karla thinks Natural Balance is okay, but there is better stuff to be had.  She also recommends giving the dog some wet/canned food too. I still haven't selected a canned food but will stick to fish as I am trying to determine food allergy conditions - which I think he has.

The active ingredient Ketoconazole in shampoo is the standard recommendation from the world of Westies, and these dogs are notorious for yeast problems.  Ifr you have time you might want to browse Westiemed.org on how to treat skin problems in Westies.  Yes I recall your dog is a poodle.  Still, yeast is yeast, I think regardless of what breed it exists on.

Good luck

[Bill94561]

I just came from my vet again today, and obtained results of skin scraping.  The lab result was:

Bacillu Species - 2+  This isolate is an environmental organizsm with very low pathogenic potential.

Escherichia Coli - 3+

This bacteria is resistant to Amoxicillin, Amox/clav Acid, piperacillin, cephalexin, cefovecin, ceftiofur.

The Vet prescribed 1 Zeniquin 25mg tab daily.

I am wondering if my Vet is just leading me down a primrose path.  Do you know if this type of bacteria can cause elephant skin and loss of hair in poodles?  I posted the results of blood tests and urinalysis that were completed a few days ago.  I did a google search on these bacteria/bacillus and it didn't seem these could cause the skin problems I am seeing in my dog.  If you look over the blood test results I posted earlier, what would your opinion be?  I'm beginning to think that my dog has Cushing's and the Vet is just not competent!!  I made her do an acth response test with Cortrosyn injection to see if there are any problems with my dog's adrenal or Pituitary glands.  Do you think I am on the right track?  He has really lost a lot of weight (for his size), and you can feel his bones and spine and his entire fur coat (where not absent on the rear end and back legs and belly area), is very thin.  His fur does not seem to be growing on his ears (Poodles have naturally long ear fur), and he has a well defined bow to his rear legs.  He has a tendence to sling one of his hind legs when walking.  This vet is costing me an arm and a leg to get to the bottom of my Shadow's problems and I'm beginning to think she is just prescribing unnecessary stuff out of ignorance or to make more money.  What do you think of my opinion to force the persuit of Cushings.  She also suggested a VARL test for Allergies, but at this point, I don't think the problem is allergies.  Your comment please, if you care to.

[Bill94561]

Well, now I'm at a loss.  Just got the results back of an ACTH Response Test that is supposed to further define whether Shadow has Cushings, and discriminate between Pituitary or Adrenal caused Cushings.  Well, the ACTH test came back and the results are normal, further, the resting Cortisol test is also normal.  What the heck is going on.  Shadow is certainly not well, has lost 2 pounds over the past 6 months, has thinning fur, elephant skin between his rear legs and abdomen.  We've changed his diet, eliminating all beef, chicken, and turkey.  He is having trouble with his rear legs (walking bowlegged and his left rear leg is twisted at the knee).  I think we've done just about every test there is, and cannot define any problem.  Certainly need help on this one...as nothing we've tried has had an effect and every test has proved to be either unconclusive or negative.  What do I do now?????

[Misfits4Me]

"What do I do now?????"  

"GET THIS GUY SOME REAL FOOD" and NO DRY KIBBLE, would be my suggestion!!!!!  

The leg is more than likely a "Luxating Patella"....Very common in the breed!!!! A Great Joint supplement will help!!!!

Please read this thread that I'm adding to:
http://www.medhelp.org/posts/Dogs/Homemade-dog-food/show/1906865

Karla

[Jerry_NJ]

I realize you do not have a Westie, but I offer the following information on how some real messed up skin/coats were cured for Westies. The link I provide below if for malassezia  If you go back one step in the link there is a selection of health issues.  

http://www.westiemed.org/health/malassezia/

[Bill94561]

Hi everyone, and thankyou for all your knowledgeable suggestions and recommendations.  Be assured that I will certainly, persue them.  Although I haven't gotten down to the bottom of Shadow's problems, I think I have an excellent start because of you all.  I am and shall continue to monitor their diet closely, and have noticed some improvement in the overall health of my other dogs.  Luxating Patella seems to be a right suggestion, according to my vet though, Shadow's health is probably not well enough to persure a surgical remedy, so the only thing I can do right now, is make sure he doesn't have trouble getting up on the couch or bed, or getting down.  He has his own steps, so he doesn't have to jump.  My greatest concern is his weight, he has gone from 15 lbs last year to under 12.5 lbs now.  We are persuing everything we can to put weight on him, improve his quality of life, and treat any bacterial infections he may have as well as any internal issued.  Again, Thanks for you suggestions and support.