Your pet is showing signs of allergic skin disease. This condition most commonly occurs as a result of environmental allergies or, less commonly, food allergies. Allergic dermatitis is a common condition in this area and can be managed in a variety of ways.

Management includes decreasing exposure to allergens, modulating the immune systems response to allergens and improving the overall health of the skin so that it less susceptible to secondary infections. 

Since there is no cure for allergies, we must try and minimize exposure by:
ensuring your pet is on regular effective flea and tick prevention. Unfortunately generic brands do not seem to be very effective with this type of medication. The most common allergy in cats and dogs is to flea saliva, A single bite can cause itching for up to 2 weeks. 
Regular bathing to mechanically remove allergens on the skin (like pollen or other contact allergens)
if your pet has a diet allergy (uncommon) feeding a hypoallergenic food eliminates exposure to the allergen. Hypo-allergic foods are: Hills z/d, Royal Canin Ultamino or Hydrolyzed protein, or Purina HP. 
General Recommendations for allergy treatment are:
Bathing- If multiple areas of the body are affected bathing (2 - 3 times a week) is very beneficial especially with a prescription soothing shampoo. With chronic infections, we recommended a medicated shampoo with antibiotic and antifungal medication. 
Mousse- For localized treatments (or for dogs who hates baths), topical leave-ons, like mousses can be an alternative to bathing
Supplements to improve skin health. 
fish oil can improve skin health and decrease the immune systems response to allergenic stimulation. Fish oil can also help support, kidney, nerves, brain, heart, and joints. kin health as well.
There is some recent literature suggesting that probiotics can be of benefit to skin health and allergies
Allergy medications or Cytopoint injections can be of benefit in controlling symptoms of allergies. We consider these medications successful if you see >50% improvement in symptoms. These medications are helpful when we can not eliminate exposure to an allergen (like with an environmental allergy).

My recommendations for Your pet at home are as follows:
Bathing- _ Shampoo- bathe 2-3 times weekly. This shampoo works by contact time. Wet coat, lathis/her with shampoo and massage into skin. Let shampoo sit on the skin for 10 minutes prior to rinsing thoroughly. For dogs with a thick coat, blowing dry is also a good idea
Mousse- Apply to affected area 2-3 times weekly for _ weeks, then as needed to control reoccurrence.
Apoquel- oral allergy medication- Give _ tablet(s) by mouth every 12 hours for _ days, then give _ tablet(s) by mouth every 24 hours as needed to control symptoms. If this medication works well, we can discuss using this medication for chronic allergies. 
Simplicef/Clavamox- antibiotic to treat secondary bacterial infection- Give _ tablet(s) by mouth every _ hours until finished. Give this medication with food to decrease risk of vomiting/diarrhea. We may increase the duration of this medication depending on response. 
Recheck- Please schedule a recheck in _ days. This appointment is important to ensure resolution of this incident and to assess response to therapies so that we will know how to treat flare ups if they occur in the future
If these treatments are not improving the clinical signs, allergy testing and immunotherapy may be recommended. Referral to a dermatologist is always an option. Dermatology services are available at NCSU veterinary School or at Triangle Veterinary Referral Hospital in Holly Springs. Neither of these services require a referral, but I am happy to submit one if you would like. 
Allergies are among the most frustrating conditions to treat and there is no one therapy that works for every pet. It is important to remember that allergic skin disease cannot be cured. It can only be managed. Flare ups are common.

How do I get my pet scheduled?
If your pet is an existing patient of Local Mobile Vet, simply fill out the appointment request form, and we will reach out to get an appointment scheduled.

If we have never seen your pet before, fill out the New Client Form and we will reach out to help you determine if we are the right fit for you and your pet.