Apoquel

[Nancy and Georgia Brown]

Has anyone tried this for allergies?

My dermatology vet is excited about this drug but it is in such short supply they aren't giving it to new patients just yet.

[F, Calla & Luca]

I try to avoid medications new to the market until the safety and efficacy is clearly documented among a large population. In the meantime here is something I saw about safety. I would hesitate to use this until I had exhausted older, safer options.

"Important Safety Information

APOQUEL® should not be used in dogs less than 12 months of age or in dogs with serious infections. APOQUEL may increase the susceptibility to infection and demodicosis and may exacerbate neoplastic conditions. APOQUEL has not been evaluated in combination with systemic immunosuppressive agents such as glucocorticoids or cyclosporine. APOQUEL should not be used in breeding dogs, or pregnant or lactating dogs. The most common side effects seen in dogs administered APOQUEL were vomiting and diarrhea. APOQUEL has been safely used in conjunction with other common medications including antibiotics and parasiticides and with vaccinations.

- See more at: http://news.zoetis.com/press-release/companion-animals/fda-approves...."

[Karen, Jasper and Jackdoodle]

Apoquel is a powerful immune-suppressant, in the same drug class as the human "biologic" medication Zeljans, (used to treat immune-mediated inflammatory diseases like Rheumatoid arthritis and Psoriasis) and as such, has significant side-effects, not the least of which are increased vulnerability to infections and an increased risk of cancer. It doesn't cure anything, it just suppresses the immune response to the allergens, just like Atopica and cheap old prednisone.  

JD's dermatologist was not yet excited about Apoquel when I spoke to her last year, for the very reasons that F mentioned. It has not yet been used in enough dogs for a long enough period to know what kinds of side effects there may be down the road. She did feel it's likely that the side effects for dogs would be similar to those for Atopica. 

Skin scratch testing followed by immunotherapy (or desensitization) shots are still your safest option, IMO. 

[Nancy and Georgia Brown]

I do want to go that route.

I was surprised to find out that my dermatology vet doesn't offer that anymore. He's not convinced the results are that much better than the blood tests.

He did give me the number of a dermatology vet that will do it. She's still too young for it though.

[Karen, Jasper and Jackdoodle]

I'd still switch to the other derm vet. I don't like the advice the current one is giving you at all. 

The new vet may have more and better suggestions for managing her symptoms until she is old enough for testing. 

[Nancy and Georgia Brown]

Sigh.
She's already been to 4 vets already. This guy was recommended to me by 2 other regular vets.

[Karen, Jasper and Jackdoodle]

I understand how you feel. JD may soon be seeing his third internal medicine specialist, lol. But sometimes it takes a few tries until you find someone who will be the right advocate for you and your dog. When you do find that person, it's worth the search. :)

[Nancy and Georgia Brown]

Thanks F.
What would be older safer options? The other options the vet suggested don't seem that much better to me for long term use.

The other options he mentioned: Prednisone, Cyclosporin, Antibiotics.

She's too young for allergy testing just yet and the vet seems hesitant to go the route. His words: "You do the testing, and on younger dogs (older than a year though) things change a lot so you can't even count on the results. Also, if you find out she's allergic to grass or trees you are in the exact same spot. Unless you go the shot route and in his experience it's only about 60% effective and it's a long time before you even know if it will work."

My next step is to check out the holistic options. Again.

[Karen, Jasper and Jackdoodle]

This is actually a veterinary dermatology specialist telling you this? I'm honestly quite shocked. 

My regular vet had a similar opinion, but then he's not a specialist, and he also wanted to sell me Atopica at $180/month.

JD's derm vet told me that the immunotherapy is 70% effective in dogs, and the veterinary literature I've seen bears that out. A lot depends on the allergens themselves. Molds are the toughest to treat with immunotherapy. Fortunately, there was only one mold among the 15 things JD tested positive for. Lots of grasses & weeds, and he has done beautifully with the immunotherapy. 

[Nancy and Georgia Brown]

Yes.I could sent you a private link to info about him if you want but I don't really want to publish his name online.

I will add that he was nice and he's been doing it for a very long time. He didn't even charge me for my last visit yesterday.

[Karen, Jasper and Jackdoodle]

Please do send me his name. 

[F, Calla & Luca]

If some times are worse than others I would try an antihistamine during those times. I have not had Calla tested but as soon as the heat goes on in the fall she often starts scratching. I give her a couple of weeks of Allegra and all settles down. No side effects to date. I would avoid immunosuppressants if you can. Short term Prednisone is a better, cheaper option in my opinion, too.

[Karen, Jasper and Jackdoodle]

I agree. If the flares are limited to once or twice a year, you can use the antihistamines, fatty acids, and topical sprays to keep the symptoms at bay. Weekly bathing and washing of bedding helps too. 

JD once had a flare that mainly involved his feet, and his derm prescribed a topical steroid lotion that was mixed with another topical medication and applied twice a day. When the flare is more systemic, short term oral prednisone can be used, as long as it isn't for more than 4 months of the year.