Help for seborrhea?

My 7 year old Shih tzu has seborrhea on her tail and back, it is seeming to spread. My vet gave me special shampoo (Pyoben) to use to help with it, but the problem is I am not good about giving her baths multiple times a week. Are there any other things that can help with seborrhea? She is already on hypoallergenic food (Hills z/d); we never confirmed food allergies, but she has environmental allergies which we used allergy shots for for a while, but haven't used those in years and her allergies have been stable. The seborrhea does not appear to be itchy.

She's kind of a "train wreck," she has multiple eye issues and incontinence in addition to her allergies/skin problems. Her eyes are stable and her incontinence is being treated with meds. She is currently taking Proin 12.5mg BID, Cyclosporin eye drops QD and Pred eye drops QOD. I used to have her on benadryl 12.5mg BID, but I think it's been at least a year since we've used that.

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

Seborrhea is not a diagnosis, it is a symptom of an underlying disease, such as skin infection (bacterial, yeast), hormonal disease (hypothyroidism, Cushing's disease), parasites (cheyletiella, demodex), nutritional or fatty acid imbalance, allergies, liver disease, etc. In an older dog, the first step is to perform full labwork and thyroid panel to identify any internal diseases, and to perform skin scrapings and skin cytology to look for skin  parasites and infection. If bloodwork abnormalties are found, then further diagnostics/treatment are prescribed based on the lab results. If skin infection is found, then antibiotics for 3-4 weeks would be needed. Because cheyletiella mites can be difficult to find on scrapings, I usually trial treat scaly dogs for these mites by applying Revolution spot on every 2 weeks for 3 treatments. Additionally, Demodex injai is a fairly newly described microscopic skin mite that causes oily scale preferentially on the back of terriers, and can be harder to find than the typical demodex mite.
Topical therapy with antiseborrheic shampoos can help reduce scaling; Pyoben is good for oily scaling, but is too drying if the scaly skin is dry to begin with; a better choice, if that is the case, would be Sebolux or Douxo shampoo, followed by a conditioner. However again, these products are not addressing the cause of the scaling, and I recommend talking to your veterinarian about going further diagnostically, or referring you to a veterinary dermatologist (www.acvd.org).
Good luck,
Kimberly Coyner, DVM DACVD
Dermatology Clinic for Animals of Las Vegas
www.dermvetvegas.com

[ng15]

Thank you for the information. If it's mites or mange, wouldn't my other dog have contracted it by now? This dog has had this problem with increasing severity for a couple of year now and my other dog does not show any signs. My vet told me it was related to her allergies, but I will discuss further testing with them.

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

Cheyletiella mites are transmissible to other animals, however Demodex mites are not. Good luck, let us know what you find out.