Often when underlying conditions are occurring Apoquel does not work so well to address itching often is seen.
In cases of an underlying low thyroid condition, this can be called hypothyroid. When the thyroid level gets low, the hair goes into the resting phase, when this happens it falls out very easily, then it does not grow back in as well. Our metabolism will slow down, this will cause weight gain. The skin becomes poorer quality, this then leads to the invasion of opportunistic yeast and bacteria deeper into the skin. This leads to intense itching and terrible yeast odor to the whole body. Worsening infections particular of the ears and paws occur. To assess for this, we can have the thyroid level tested on the blood, if it is low, then we start on a thyroid supplement. Typically after 4-8 weeks we can have the thyroid level tested, as long as the level is in the range we want it to be in. Then we continue at that dosage. As the level comes up, we become more active, the skin and hair coat become more healthy and we have less skin infections an less smell. In short, it is like we almost have new dog. However the key is we have to find out what the underlying condition is. Many times starting with a thyroid test at your veterinary clinic may be the next step to have this assessed.
Below is brief discussion also of Cushings (Hyperadrenocorticism)
Many of these conditions can be caused from underlying issues, like hypothyroidism. Many times if the hormone levels on a dog are off, that area of the tail can bald also. There is what is called the caudal tail gland there, when hormonal levels are off it can be common to have the balding area over this area of the tail. Low thyroid can cause nerve degeneration. Hypothyroid induced neuropathy, you can look it up on the internet. It can cause them to become less active, less energetic, weaker on the back end also. There can also be some laryngeal paralysis which can make to cough more after drinks. Another condition that can cause many of these signs is CUshings ( hyperadrenocorticism), This is where the body produces too much natural steroids. It can cause many of the same signs, as both can cause poorer skin and hair coat. Cushings also can make for more drinking, urinating, and panting too. This can also cause muscle loss which will also lead to potential weakness to the back end too. These can be looked at with bloodwork at your clinic if you decide to work these up more.
With low thyroid there can be nerve degeneration over time, one of the first nerves affected can be the ones that control the larynx, the opening to the airway. When this happens often it sounds like collapsing trachea too. However you notice more coughing as drinks as the larynx does not close as well and then water can get into the trachea. Then as the nerve degeneration continues there gets to be more weakness to the back end also. As the nerves have to travel farther to the back end than to the front end. This is why often they may try to put on anti-inflammatories or steroids to reduce inflammation in this area too. However over time the weakness to the back end worsens often to the point that the dog no longer can get up well, jump on the bed, even simply climb the stairs. The haircoat also goes in the resting phase and more hair starts to fall out and it grows back in more thinner. The good news is that if this is the case it is reversible. Testing the thyroid level to see where it is at, if it is low or low/normal then starting on thyroid supplement. Within a few months of being on the supplement nerve healing and degeneration can be reversed. My last German Shorthair Ruger had this same condition. He could not jump onto the couch even and then within a few months of being on the supplement. He was able to jump back into the trucks and couch again. I just mention this as I not only see this in cases but however see it in my own pets too.
Often the thyroid level may be in the low/normal range of under 2. Many clinics will call a dog normal at a thyroid level of 1-2. However studies show that these dogs do better when the thyroid level is up to 2.1-5,4. This is why I am interested in the thyroid level.