Hi Dawn
I'll try to elaborate without being too confusing or writing a book
A lot of it was ruling other things out. I had a total blood panel done
before the derm appt, mainly because I was thinking she may have a thyroid problem, and my vet wanted to rule out things like cushings. She'd also been on a elimination diet (not vet likely food, but we tried it, and it did nothing for her). She'd been on several different antibiotics and anti-fungal meds, but it kept coming back because it was secondary infection to the primary cause, we just hadn't figured out what that was yet.
Maddie was also on benedryl - the vet told me I could give it up to 4x a day
(I typically stayed at 2x a day) but it didn't really do anything for her but make her dowsy and
maybe a little bit less itchy.
I'll quote:
"The diagnosis of vitamin A-responsive dermatosis is made by first ruling out other more common causes of crusty, scaly skin lesions such as bacterial, fungal, or parasitic infections. Depending on symptoms, evaluation for environmental or food allergies may be necessary. Biopsies of affected skin show marked excessive scaling of skin and hair follicles (orthokeratotic hyperkeratosis)."A skin biopsy would answer it for you, for sure. But a good dermatologist should be able to tell by looking, and when the treatment works you know its a done deal. Dr. Jeromin told me that we
could do a biopsy if I wanted to, but she KNEW that this is what it is, so it would be unnessisary in her opinion to put Maddie under and put her through that, plus she felt it would be a waste of money (something that I can not afford to be wasting
)
"Skin lesions include plugged, dilated pores/follicles, crusts,and crusty plaques especially on the ventral and lateral chest and abdomen. The crusty area may have protruding fronds of keratin, and hairs in affected areas are encircled by clumps of skin cells (follicular casts). The haircoat may be dull, dry, scaly, and secondary bacterial yeast infection are common, causing odor and itching. The ears may be affected by excess wax accumulated and inflammation."Now, Maddie's ears are clear (she even commented on how pleased she was they were so clean - and I was not able to bath or clean out her ears 2weeks prior to the appt
). She also did a skin scraping to elminitate walking dandruff, mites, and all that.
But there's these waxy plaque things at the root of the hair, on the skin (follicle) -- they look kind of like waxy soap flakes -- that is the main symptom I guess. Dr. Jeromin parted the ear hair at the tip of Maddie's ear, and showed me that they were there, too. And when you pick at it, the hairs attatch to that follicle fall out too easily (if its progressed as far as Maddie's, anyway)
which explains why I felt Maddie's hair was "falling out in clumps" because of plugged pores & waxy plaque.
She explained that the growth & repair of the skin is in a cycle of 28 days (or something like that, don't quote me LOL it was a lot of information in one day haha) but in cases like Maddie's, with Vit A Responsive Dermatosis, the cycle rushes to something like 8 days and and so the skin isn't... healthy... I guess you could say because its not using Vit A appropriately.
"Vitamin A-responsive dermatosis is an incompletely understood disorder of skin proliferation and maturation (keratinization)"Vit A problems also can effect vision, and appitite ~ which Maddie has been acting like she is starving (even more so than usual) which I was relieved Dr. Jeromin listened to me when I said this, and also asked questions about that... The 2nd OP vet I went to was more or less "its a cocker thing" when it comes to food
Which I know is true, but I KNEW something was "off" with my baby, and I'm soo glad to have some answers
But, it is an American Cocker Spaniel thing, with only a few cases reported with Labs... From what I'm reading (online) its pretty rare I guess.
learn something new everyday
Anyway, Dawn, if you have a dermatologist in your area (mine was a 45min drive, approx, but SO WORTH it) I would highly recommend a visit
... even if its not Vit A Responsive Dermatosis
Awesome! 
I know how frustrating skin issues can be. I've been following your posts about Moonbeam's IMHA, too(I lurk a lot more than I post...) and I'm soo grateful for this forum; so we can all learn from each other (& the support from the cocker community is awesome too 
)
The Douxo shampoo smells sooo much better than that other stuff 
