Dog behaving very old before her time - usual vet checks OK - suggestions?

I'd ask for recommendations. I go to a particular very good but very expensive vet in a different area for skin things and he is fabulous. This was after multiple trips to a local vet which was not very good at all TBH.
My dog usually clears up after a shot and course of Apoquel (he's due another course soon) but I think the root cause for him is stress and then it just becomes a vicious cycle.
Because it is very localised I'd go leftfield and explore a spine X-ray or MRI. A lot of time itching is because they can't 'reach' something happening internally.
 
I would follow Ester's and CC's advice and ask for referral.

Something that crossed my mind was psoriasis with possibly psoriatic arthritis, which would make her reluctant to move around.

https://wagwalking.com/wellness/can-dogs-get-psoriasis

Thanks - that's really interesting - she can be really really stiff and sore to move some times (pottery and yelping if you accidentally move her) so this is definitely something to get them to consider.
 
Thanks - that's really interesting - she can be really really stiff and sore to move some times (pottery and yelping if you accidentally move her) so this is definitely something to get them to consider.

In that case I think referral, definitely, and I'd second esters recommendation of a general medicine specialist first. Not sure where you are, but I'd recommend Langford in North Somerset if it's close enough. We've been referred there for general medicine, dermatology, neurology and the pain clinic over the years, and always had good service
 
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I am another for seeing a different vet and specialist referral. The idea of an autoimmune disease is a good idea. People with this are in pain, itching, organs working at suboptimal levels etc.
My old JRT had a autoimmune problem (can't remember the name). She did well with steroids occasionally if it was a huge flare and occasional antibiotics if skin was broken, but aproquel worked really well for her. It does have side effects but any dog who is tearing itself apart cannot be sleeping well, relaxed or happy. It must be horrible for her. Whatever the cause there will be a reason to find if the vet tries hard enough.
 
Although obviously don't ‘like’ Blodwyn ?

I've said before we need a unlike button.

I've been assured twice that her organ functions are fine. I was on a yard that had a horse start itching it's skin off - that had liver failure and was dead within 4 months despite the absolute best vet care money could buy.

She's been like this to different degrees for 18 months so I'm hoping noting nasty. It was the best over lockdown when routine was 100% the same every day - so I do wonder about stress - but she was never stressy before the old dog died and doesn't have other stressy features - it's v odd but I really appreciate all the suggestions.

Back to vets about referrals (to talk to them on the phone while she's tied up outside obviously!!)

I'm in West Yorkshire if anyone knows of a good local specialist.
 
Agree with referral, derm/medicine, but if you can't get in for a bityour local vets could check thyroid- this is not normally included in routine in house bloods and can be difficult to diagnose. Need min T4 and TSH to lab if not full panel. Sometimes I will do treatment trial if suspicious andbloods equivocal.
I love cytopoint injections for skin- once /month and very targeted. Won't work if not caused by allergies though so good to r/o endocrine (thyroid and cushings).
 
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