Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you with your wee one today.
Seasonal allergies can be a nightmare for sensitive dogs (just as it can be for people). I am sorry to hear that the Piriton hasn't been enough to settle her allergic skin irritation. In mildly affected dogs it can work great; but may not be enough for those dogs with too much of an allergy challenge or that have too sensitive an immune system.
In this case if Bella's allergies are just too severe, then it would be worth considering alternative means of blocking that allergic reaction. Now I will just first note that if she also has spots/pustules/pimples on the skin, then the antibiotics are indicated for secondary bacterial infection. But it is unlikely that these can address the allergic situation on their own if the Piriton isn't helping.
Instead, you may want to consider alternative antihistamine treatments, if Piriton wasn't strong enough for her, since some work better for some dogs (just as with people). In regards XXXXX XXXXX you could consider a trial on Zyrtec (cetirizine). This is available over the counter and dogs can be treated with a small dose (for dogs under 30kg = 5mg tablet once a day). So, this would be another consideration on the antihistamine front.
Furthermore, I do want to note that we can help Bella with her issues of skin and coat quality lapse. Specifically, we find that treatment with essential fatty acids (EFAs) can help resolve dry, flaky skin and help restore coat health. In regards XXXXX XXXXX products there are many OTC options (ie Yumega, Viacutin, etc). But if Bella like fish, you can treat her with Omega 3 + 6 (EPA/DHA) fish oil to support her skin and coat health. To do so, we tend to give a dose equal to 20mg per pound of their body weight. For example, for every 10lb of dog body weight, we would want to give 200mg EPA + DHA). So, this too is worth trying with her to address this side of her skin condition.
Otherwise, in regards XXXXX XXXXX drug options for dogs in this position, there are a few. First, there is the oldest form of immune system dampening, steroids. These are likely something you have had experience with if Bella's skin has been frequent trouble. Steroids are very effective when it comes to dampening the immune system to block allergy flare ups but it is a drug that we use with a cost (since long term use can cause negative side effects and eventually lead to the dog developing Cushing's disease). That said, we do have other drug options that have less negative long term effects. Specifically, you may want to speak to your vet about Atopica (Cyclosporine). This drug is an immunmodulator that blocks inflammation and thus itching. Alternatively, there is a brand new drug on the market this year for itchy dogs that is showing a lot of promise and Bella could be a good candidate for this. It is called Apoquel (Info Sheet) and controls itchiness via preventing the skin itch receptors from being triggered. It tends to be as quick acting as steroids but doesn't have any of the negative side effects. So, if you haven't spoken to your vet about these two options, I would advise doing so. Because at the end of the day, we want to settle this seasonal irritation that is causing Bella to itch so that she can get on with enjoying the good weather.
I hope this information is helpful.
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All the best,
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