My dog is losing hair even with Apoquel. What are the possible causes?

The cause of the allergy must be understood to be able to reduce and eventually stop Apoquel. Three main type of allergies are usually affecting pets: food allergies, flea and parasite related ones and environmental type (allergens coming from trees, pollens, dust etc etc). Exclusion commercial diets are the best to rule out specific allergens. A blood test is available to determine the allergy panel (which substances he is allergic to). Please do not hesitate to contact us again on the forum or by requesting a consultation if you have any more questions or to discuss it any further.

Hi there! There are a number of different things that can cause hair loss and a skin rash in dogs, so it's hard to say what might be wrong without being able to examine her and run some tests. If the hair loss is mainly around her lower back and tail, the most likely culprit is flea allergies - so if she isn't already on a good flea preventative like Nexgard or Bravecto, this is the first thing I would suggest. If you're positive that she doesn't have fleas, other possible causes of these symptoms would include other types of allergies (food allergies, or an allergy to something in the environment), a bacterial or fungal skin infection, or skin mites (mange). Wheat allergies are one type of food allergy, but it's actually far more common for dogs to be allergic to proteins like chicken or beef rather than grains or wheat - so this is possible, but not nearly as likely as some of the other possible causes. Treatment will depend on what the underlying problem is, so it's important to get a diagnosis first in order to know how to treat her. I would recommend taking Bear to the vet for an exam when you are able to. He/she can do some simple skin tests if needed to help diagnose the problem and get her started on appropriate treatment.

Itchy skin and hair loss is often due to the following things: 1) Allergies - this can happen suddenly and is usually due to an environmental (i.e pollen) cause. 2) External parasites - fleas, lice and mites can all cause intense itching. It's good to check him for fleas and get treatment if needed. The permethrin shampoo is only temporary, so it's possible that he is getting re- infested. He may have mites, which are microscopic and require a vet to find. 3) Over-bathing, or using the wrong product for bathing - Bathing too often can cause the skin to get dry and irritated. Dogs should normally be bathed no more than once a month with a shampoo that is labeled for dogs. If you bathe more than that, or use a shampoo or soap that is meant for people, then you could be damaging the normal protective barrier of the skin. One thing you can do for itchy skin, is give a bath with cool water using an oatmeal or aloe shampoo. You can get these shampoos at the pet store. I hope this helps you to identify the problem. If not, then it would be worth taking him to the vet. We can usually discover the cause quickly and provide the most effective treatment. Below are some links to articles that should be helpful for you: https://www.petcoach.co/article/how-to-tell-if-your-pet-has-allergies/ https://www.petcoach.co/article/4-great-strategies-for-relieving-your-dog-s-allergies/ https://www.petcoach.co/article/skin-allergies-vs-food-allergies/

Cushing Disease, food allergies (it's too early to see results yet), skin mites, flea allergies and environmental allergies can all cause these symptoms. Make sure you are conducting a proper food trial. If Maddox does not respond to the food trial, discuss with your veterinarian next steps. Here are some links with good information" https://vcahospitals.com/know-your-pet/cushings-disease-in-dogs https://www.petcoach.co/article/allergy-testing-immunotherapy-in-dogs/ https://www.petcoach.co/article/food-allergies-and-food-intolerance/ I agree with your vet that a hydrolyzed diet is the best option. I hope this helps.

It looks as if your dog has a skin infection, most commonly caused by an allergy, a skin mite (Demodex) or fleas. 

The allergy could be a due to a protein in your dog’s food or an environmental allergy like to dust, pollens, grasses, etc. 

The allergy causes your dog to itch and chew at the skin which breaks down the skin barrier. This then leads to infection. Skin infections are typically characterized by large areas of hair loss, redness, crusting, flaking, and pustules. A thorough skin examination by your veterinarian should be able to determine the cause of the itch so it can be treated appropriately. A skin scraping and skin cytology should be performed to rule out mites and to determine the type of infection present (bacterial vs fungal). Your dog will most likely need antibiotics/antifungals longterm to help clear up the infection and possibly an allergy/anti-itch medication like Apoquel, Atopica, or Cytopoint to give some relief while the infection clears up. A medicated shampoo will be beneficial as well. I would also recommend he be on a good flea control routinely too. Once the infection has resolved a long term allergy medication (like Apoquel or Cytopoint) can be given on a regular basis to prevent any future problems. I hope this helps. Thanks for using Petco Pet Education Center, formerly Petcoach. Best of luck.


I would recommend getting some blood work on Precious and see if there is something system causing this like hypothyroidism or cushings disease. If everything is normal then I would recommend try Apoquel, which is a daily medication for allergies or Cytopoint which is a monthly injection for allergies. I would call your veterinarian to discuss these options with them. Thank you for using Petco Pet Education Center, formerly Petcoach.

Hello. While Apoquel has been an absolutely wonderful addition to our ability to help allergic dogs, it is not 100% effective all the time & in every pet. I have had to add medications to the really tough cases, including using the injectable Cytopoint, adding antihistamines, or even very low doses of glucocorticoids. Talk to your vet to see what might be the next step for helping Zelda. You might also consider seeing a veterinary dermatologist to see what exactly she might be allergic to & if a desensitization protocol would be helpful. Good luck & thanks for using Petco Pet Education Center, formerly Petcoach.