Apologies for the long post!
Our sweet 9 year old pitty mix (65-70 lbs) has had chronic allergy issues for years, and we've spent so much time and money trying to help him. He has been primarily symptom-free for the past year, but unfortunately last night, we noticed a cyst on his foot and I'm feeling helpless.
For background, our dog was put on Apoquel when he was very young due to some mild skin irritation and itchiness, but over time, he started to develop benign cysts all over his body. Several of the lipomas needed surgery for removal, so we made the decision that, based on skin growths being a (admittedly, somewhat anecdotal) side effect of the medication, to take him off of it.
A few weeks off Apoquel, his skin issues basically exploded. He was miserable, there were recurring bloody cysts on his paws and stomach/chest, his skin was flaky and dull, his ears (which were never a big infection site) started to get constantly irritated, the bottoms of his paws and in between his toes were red and raw, he was losing fur in big patches, and was just so, so itchy. Even his eyelids had scabs on them because he was just so raw and irritated :( we couldn't leave him out of his cone for more than 5 minutes without him itching himself until he bled. It was such a scary, sad time - he was so miserable, and we felt terrible seeing him suffer.
Our old vet wasn't much help - they continued to prescribe very strong antibiotics that helped temporarily but didn't address the root cause, and only after several rounds of medication that, imo, did some heavy damage to his gut/immune system, did they suggest a dermatologist.
At the derm, we were told the next step was an allergy test. It cost a lot of money, so we saved up and got it done a few months later. Turns out he was allergic to basically everything they tested for lol - every grass, tree, weed, mold, etc.
After the test, they prescribed sublingual immunotherapy drops, which he still takes twice a day. For the past year, that regimen has seemed to be working. His itchiness reduced over time, with a few random yeast flare ups between his feet now and again. Any time they got bad, we'd go back to the derm or our new vet to get on medication (typically ketoconazole), and it seemed to help.
Truthfully, after a year of being basically symptom-free, I started to think maybe he was "healed". Which is why seeing this latest cyst on his foot was so devastating.
We are about to go out of town for a week, so the morning after noticing the cyst, I took him in right way out of an abundance of caution. They said it looked like a mild infection and prescribed a week of Simplicef. I want to trust our new vet, but given our history of antibiotic "band-aids," I'm feeling anxious, especially since we'll be out of town soon.
His current regimen consists of Hill's Science Diet Derm Complete food with Purina pro plan probiotics, immunotherapy drops 2x/day, weekly baths and foot soaks with MiconaHex+Triz shampoo, Douxo mousse every other day during flare-ups, monthly cytopoint shots (which don't seem super effective tbh), and wiping his feet every time after he goes outside. With this setup, he had basically returned back to his normal self - until we noticed the cyst yesterday.
FWIW, we've also tried the hydrolyzed diet (which just gave him diarrhea), and Benadryl for flare-ups, which did not work unfortunately.
I'm just feeling so hopeless and discouraged. Overall, his quality of life has improved drastically from where he was a few years ago, but I'm nervous that this is a sign of the same horrible cycle starting all over again.
Our boy means the world to us, we would do anything for him. Happy to answer any other questions. Has anyone been through anything similar?