please help my poor old pup with these odd issues???

[1nanaof7]

what can i do to help my dog with this inflammation, weight loss, and seeming sick issue???  he looks so sick and is getting skinner as we speak.

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

Royal Canine rabbit/potato comes in both canned and dry forms. The key to a hypoallergenic diet is feeding only the prescription food with no other treats, table scraps, rawhides, milkbones, chewable supplements, etc. since it only takes one bite of a non-hypoallergenic food to trigger a reaction. But if the skin infection is recurring, he needs to be rechecked and probably restarted on antibiotics, as well as screened for demodex mites, and yeast skin infection, and trial treated for scabies. A diet change will not eliminate skin infection, only prevent it from recurring if food allergy is underlying the cause. It will not harm your other dog to eat the prescription food.
Kimberly Coyner, DVM DACVD

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

I am sorry to hear about your dog's troubles, and it certainly sounds like you have taken wonderful care of him.  There are 2 issues that may or may not be related:
1. the weight loss and decreased activity are a big concern in an older dog, as they can indicate severe internal disease or cancer. One of his kidney enzymes is elevated, and this may indicate early kidney disease or kidney infection--a urinalysis and urine culture are needed to investigate this, since a chronic kidney infection could cause weight loss. His low Na/K ratio can be an indication of Addison's disease, which is when the adrenal glands do not make enough cortisone, and this can be evaluated with an ACTH stimulation blood test to test the adrenal function. Addison's disease can also cause weight loss and decreased activity, as well as increased kidney enzymes and dehydration. Lastly, if all lab tests are inconclusive, abdominal ultrasound may be needed to visualize his internal organs.
2. The itchy red skin is due to skin infection (bacterial or yeast, or microscopic parasites such as demodex or scabies), and possible underlying food allergy or hypothyroidism. He needs skin scrapings to identify what types of infection are present, +/- skin culture if antibiotics are not helpful. His low normal thyroid level can be rechecked with a free T4 by equilibrium dialysis blood test. Since scabies mites are difficult to find on skin scrapings, I often will trial treat for parasites with Revolution spot on applied every 2 weeks for 3 treatments. And since there is no accurate blood or skin test for food allergy, a hypoallergenic diet trial would be needed for diagnosis and treatment (my preferred diet is prescription Royal Canin rabbit/potato, and nothing else but water for 6-8 weeks).
There are alot of things going on with your little guy, and it may be helpful to get the input from specialists in veterinary internal medicine and veterinary dermatology: http://www.carolinavet.com/

Good luck,
Kimberly Coyner, DVM DACVD
Dermatology Clinic for Animals of Las Vegas
www.dermvetvegas.com

[1nanaof7]

thank you!  we have an appt fri to have him checked for addison disease as well as the other.  thank you so much.  we will get this food and try it also.  non of our animals get tables scraps. etc.  only during the summer they love watermelon and we will give them a small bite or two once in a while of it.  but that is all they ever get other than their food.  thank you so much for your help.  i sure hope he gets better.  he is such a sweetie and its hard to watch him become so different.

[1nanaof7]

thank you so much.  i looked on the full lab panel i had run and do not see an ACTH result on here.  he was treated recently for skin infection etc and it was bacterial so it was a long run of antibitotics.  but it is rebounding terribly.  i hadnt thought about the food allergy.  he is on  a soft dog food because he has lost teeth due to his age and has been on the same food for prob 2 yrs.  however, i do sometimes buy a different brand of it.  he doesnt get anything but dry food and this is a softer kind.  any suggestions on maybe a better softer food???  his dad is also on of our pup and he is a little older so they both need the softer food.  the dad is not experiencing any of these issues.  thanks again!!