Zoe's obsessive licking

[Sari Brafman]

Hi All-

I have a 4 year old F1 Goldendoodle named Zoe. Zoe has had extremely sensitive skin since she was a puppy. She has no allergies, but does best on Blue Buffalo limited ingredient turkey and sweet potato.
For Zoe's entire life she has been prone to hot spots. One little scratch from a brush or a park will cause a massive hot spot within an hour. We have always had luck with Neopredef powder and an E-Collar to keep her away from the area. In the past once the area was healed she left it alone.
About 6 months ago, Zoe developed a hot spot on her back right leg. We followed our usual protocol and it healed. We took the cone off, and she appeared fine UNTIL we left her alone. That is when she started to lick it again.
For the past 6 months Zoe has been in a hard E-Collar (she is able to move the comfy cone around enough to still get to the spot) when we are not home. The area has been completely cleared for a while but each time we left her alone, she was go at it again. Last weekend we tried to leave her for small amounts of time without the collar on and she was fine. On Tuesday I left her alone while I was gone for work (6:30-3:00), and she was fine again! Unfortunately, yesterday she licked her leg and irritated the spot again.
Has anyone had any similar issues with a dog?
She is perfectly fine when we are home. Even when she isn't being entertained she leaves her leg alone. It is only when we aren't home.
My vet recommended putting her on Xanax, but I am leaving that as an absolute last choice since she is only 4. Zoe doesn't have separation anxiety, thunderstorm anxiety or any other issues besides sensitive skin.
Any help would be greatly appreciated! I definitely don't want my sweet girl to be in an E-Collar for the rest of her life when we aren't home! Also, has anyone used anything other than the E-Collar and had any luck? We have tried vet wraps, bitter sprays, etc.
Thank you!

[F, Calla & Luca]

Xanax is short acting and will not build up a steady state. In general antidepressants are better for ongoing anxiety treatment in people and I think for dogs too.

[Mari Bezanson]

This must be so frustrating for you.  Our previous dog suffered terribly from hot spots but the trick that worked for us was to keep his hair short.  Any amount of moisture that sat on his skin would almost always result in a hot spot.  Don't give up hope, I am sure there must be a solution for Zoe...

[Sari Brafman]

Zoe goes back to the vet tomorrow for her yearly check up, so I am hopeful we can come up with another option to try. 

I am taking her on Tuesday to be groomed and I am going to have them trim her fairly short. I am always so nervous about her being groomed because one little cut or any razor burn will throw her into a terrible hot spot. Her skin is just so sensitive.

[Stella]

Are her hot spots always in the same place, or does she get them in a variety of places? If it is always the same place, it could be being caused by something else. This may sound a little out there (!!) but dogs with problems with their neck or back can give themselves hot spots in areas where they have pain or altered sensation. The area supplied by the affected nerve feels funny to them, and a dogs natural response to an area that feels strange is to lick at it.

[Sari Brafman]

We've thought about that because Zoe does have hip dysplasia, but the vet told us it probably wasn't the cause. Except for a funny wiggle when she walks, she shows no other symptoms. 

The hot spots are usually on her legs. In the past they have only been on the front, which were much easier to control. The back leg presents a whole new obstacle. 

Hopefully we'll find a solution soon!