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Won't Grow Hair Back
08-22-2017, 10:04 AM,
#1
Won't Grow Hair Back
Almost 2 years ago I worked at the vet clinic that Delilah was brought into. She was a stray and the only hair she had was on her face, head, and ears. Her skin was bright red, cracked, and horribly infected. The doctor I worked for said she had demodectic mange that had gotten completely out of control. She was treated with NexGard (one tablet every other week) and Pyoben shampoo (bath every other day) for 2 or 3 months for the mange and she was put on antibiotics for the secondary skin infection. After she had her negative skin scrapping I adopted her and continued the NexGard regiment and did the Pyoben twice a week for 6 more months. We are now giving the NexGard once a month, a bath with Trizchlor once a week. At both her one year and two year check ups, we got skin scrappings done that were negative. Her problem now is that she is not growing most of her hair back. She has hair on her legs, feet, and only guard hairs on her lower back. No hair on her upper back, chest, most of her tail, or belly. She has absolutely no under coat. We had her thyroid checked and the tests came back normal. Her yearly blood work all came back normal except for a slightly elevated creatinine. One vet told us to try melatonin (2mg a day). We did that for 6 months. At first we thought it was working, but we started it at the end of October when her "winter coat" was starting to come in. By April, she had lost all of the hair she had grown. We don't know what breed she is, but I assume some kind of pit mix. Our vet is at a loss, so we are just treating the skin so she won't get infections (baths, lotion, and Benadryl). She says the next step is a biopsy, but that is going to be expensive.


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08-22-2017, 12:29 PM,
#2
RE: Won't Grow Hair Back
(08-22-2017, 10:04 AM)DelilahDog Wrote: Almost 2 years ago I worked at the vet clinic that Delilah was brought into. She was a stray and the only hair she had was on her face, head, and ears. Her skin was bright red, cracked, and horribly infected. The doctor I worked for said she had demodectic mange that had gotten completely out of control. She was treated with NexGard (one tablet every other week) and Pyoben shampoo (bath every other day) for 2 or 3 months for the mange and she was put on antibiotics for the secondary skin infection. After she had her negative skin scrapping I adopted her and continued the NexGard regiment and did the Pyoben twice a week for 6 more months. We are now giving the NexGard once a month, a bath with Trizchlor once a week. At both her one year and two year check ups, we got skin scrappings done that were negative. Her problem now is that she is not growing most of her hair back. She has hair on her legs, feet, and only guard hairs on her lower back. No hair on her upper back, chest, most of her tail, or belly. She has absolutely no under coat. We had her thyroid checked and the tests came back normal. Her yearly blood work all came back normal except for a slightly elevated creatinine. One vet told us to try melatonin (2mg a day). We did that for 6 months. At first we thought it was working, but we started it at the end of October when her "winter coat" was starting to come in. By April, she had lost all of the hair she had grown. We don't know what breed she is, but I assume some kind of pit mix. Our vet is at a loss, so we are just treating the skin so she won't get infections (baths, lotion, and Benadryl). She says the next step is a biopsy, but that is going to be expensive.

Your vet suggesting Melatonin might suspicion a skin disease referred to as Alopecia X.  Where Melatonin has a 50% response rate,  after 6-8 weeks of use.  Melatonin is a pituitary hormone that has the function of flipping the sleep switch to On.  As an animal ages, the pituitary produces less.  It also has some interesting interactions with other hormones, and even the immune system.  Ask your Vet if 5 mg could be given.  A human body will just throw any excess Melatonin hormone taken.  I gave my one cancer puppy (75 lbs) 5 mg of Melatonin the last 6 months of her life to help her sleep at night.  With any immune-modulating properties welcomed.

Alopecia X is thought to be an imbalance of sex hormones - even in spayed/neutered dogs.  If the dog has not been spayed/neutered, the condition usually improves afterwards.  The most frequent hair loss pattern is on the body, except for the head, and front legs. where the hair growth is close to normal.  The treatments range from Testosterone down to ketoconazole, cimetidine.  Cimetidine is a first generation acid blocker, and is sold at drug stores.  Ask your Vet for the dosage.  Typically 100-200 mg.  As long as the hair loss doesn't cause other skin problems, most Vets will usually be very conservative in its treatment. Adrenorcortical hormone elevation is present without an elevation of cortisol.

Since you already eliminated the most common cause hypothyroidism,  the other potential cause is atypical Cushings.  Diagnostics include an extended panel showing precursors to Cortisol elevated, without Cortisol itself being elevated as is typical for regular Cushings.  Also seen elevated are the sex hormones.  Naturally the tests for Cushings are expensive.  Your Vet will also be looking for the other usual signs of Cushings disease present, such as increased thirst, appetite, and weight gain. 

Here's a link that discusses all the sordid details of the biochemistry pathways, and the subtle distinctions between the two diseases.

http://veterinarycalendar.dvm360.com/fun...roceedings

Note the drug Trilostane is mentioned as a potential treatment for either disease.  Although it's not conclusive for being beneficial against Alopecia X.  Usual dose is 1-2 mg/kg bid.  With regular electrolyte screening after starting.  That might be worth discussing with your Vet.  

Aside, my 14 yr old puppy had a mild episode of demodex mite infection at 8 weeks.  He has consistently had dandruff throughout his life.  Sometimes the mites can cause permanent damage to the ecosystem of the skin/hair.  It has never caused him any problems such as itching or irritation.  I gave him 2000 mg of Fish oil bid, until he came down with Leukemia in 2015.  Now he gets 4000 mg bid.  His weight is around 70 lbs.  While discussing with your Vet a next step for your problem, adding in Fish oil to the diet won't hurt.  Make sure you get the regular fish oil, and not the "Burpless" type with a hard, and bitter outside.  Ask your Vet about an appropriate dose of Vitamin E to give, which may or may not help.
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08-22-2017, 02:32 PM,
#3
RE: Won't Grow Hair Back
I am thinking that if your vet prescribed Melatonin he/she perhaps suspects something called "seasonal alopecia" where dogs develop bald spots in the briefly lighted months (eg. winter). Dogs with this condition generally should have their hair grow back in by the time summer is around the corner (or at least see an improvement). Since summer is coming to an end and the hair loss is not improving, I am guessing that it's time for further investigation. Perhaps a consult with a veterinary dermatologist may help.
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