Cytopoint for Seasonal Environmental Allergies

[Laurie, Wally & Charlotte]

Our new vet has recommended using Cytopoint for itchiness caused by seasonal environmental allergies. I would love to hear your experiences with Cytopoint, including any side-effects or negative reactions. Thanks. 

[Karen, Jasper and Jackdoodle]

Unless you want to see a veterinary dermatologist and have intradermal testing done, your treatment options for seasonal environmental allergies (Atopic Dermatitis) are limited to immunosuppressant drugs: Prednisone, cyclosporine, (Atopica), Apoquel, and Cytopoint. Cytopoint is the newest of these. There is still a risk of cancer with it, but it's thought to be less than with Apoquel or cyclosporine, mainly because it's injected rather than ingested. Is your dog has symptoms less than 4 months of the year, steroids (prednisone) might be a better option, and it's sure a lot less expensive. 

[J and Riley (and Luna)]

Prednisone does have more side effects though (for Luna it did anyway).  Huge increase in appetite/thirst being the main one, she always seemed to be "starving" when on prednisone.  The increase in appetite made her very rude and removed any of her training when it came to stealing food/counter surfing/eating random garbage on walks.

Apoquel is the one I think she ended up on the last couple years.  Who knows if it contributed to her coming down with lymphoma, it certainly made her a lot more comfortable during ragweed season though.

[Karen, Jasper and Jackdoodle]

My feeling was that thirst and increased appetite were preferable to an increased risk of cancer. (along with digestive issues, which are also common with the immunosuppressant drugs.) And once the dog's body adjusts to the steroids, the side effects usually subside. JD was on low dose prednisone every other day for 6 years without any side effects.

[J and Riley (and Luna)]

I don't remember but I'm not even sure the vet mentioned the increased cancer risk.  We didn't look it up either but I'm pretty sure he didn't.

Anyway if we ever need to go down that road again we probably wouldn't do the same thing, especially with Riley since Bernese are so cancer prone to begin with.

[Karen, Jasper and Jackdoodle]

Both Apoquel and Cytopoint went on the market with very little research behind them. One study on a small group of Beagles, in each case. Jack's dermatologist was always hesitant to use drugs with a lack of a long-term track record.
I think these drugs are popular with some GP vets because they can do the treatments themselves instead of referring to a specialist.  

[Laurie, Wally & Charlotte]

Why is there a risk of cancer?

[Karen, Jasper and Jackdoodle]

There is with all of the immunosuppressant drugs. The human ones, too. Those TV commercials for what they call "biologics" for Psoriatic Arthritis, Crohn's Disease, etc. always mention lymphoma, and these are the same drugs. You're playing with the immune system & immune responses. Atopy is an immune-mediated disease. You suppress the immune system, the allergy symptoms subside. That's why the skin testing and the immunotherapy is the safest treatment when possible. 

[J and Riley (and Luna)]

It makes sense to me.  Immune cells are the ones that hunt naturally-occurring cancer cells in our bodies.  I always scare my students when I'm teaching about the immune system and tell them that everyone has cancer cells pop up in their bodies but our body defenses usually catch them before they can "take root" and multiply.

[Karen, Jasper and Jackdoodle]

As Jane mentioned in your last discussion about Cytopoint, her Murphy is being switched from Apoquel to Cytopoint for his seasonal allergies because he developed a pre-cancerous growth and her vet felt that Cytopoint was lower risk.
See her comment here: https://doodlekisses.com/forum/topics/cytopoint-for-atopic-dermatitis

[Laurie, Wally & Charlotte]

Thanks for the link to that previous discussion. I did search for that (unsuccessfully) before I began yesterday's new thread. Charlotte's allergies do seem to be seasonal, so my gut is to avoid anything that would halt her immune responses and stick with Claritin or Zyrtec. I have promised our vet that I would do my homework and research Cytopoint, so that is what I am doing. 

[Karen, Jasper and Jackdoodle]

Omega 3 fatty acids, specifically DHA & EPA which are found onloy in fish, and GLA, found in evening primrose oil, all help a lot with seasonal allergies, especially when used in conjunction with antihistamines. 
If I haven't posted this for you before, here are some tips from JD's allergist that really helped a lot:

For temporary relief of inhalant allergies, here are some things that you can do:

Give Omega 3 fatty acid supplements. You want the Omega 3 fatty acids DHA & EPA, which are only found in fish. You can also give GLA in the form of evening primrose oil supplements. In both cases, use human softgel supplements. 

If you feed dry dog food, check the Omega 6:3 ratio. You want a ratio of 5:1 or less, the lower the better, and the Omega 3 content should come from fish.

Give antihistamines. Different antihistamines are more effective for different dogs. Typically, you want second generation antihistamines that do not cause drowsiness, like Claritin, Zyrtec, Atarax, etc. rather than Benadryl.

Use OTC anti-itch sprays on the affected areas. These are available at most pet supply stores.

Wipe the dog down every time he comes in from outside, paying particular attention to the feet. Brush the dog daily.

Keep the indoor areas where the dog spends the most time as clean and dust free as possible. Wash bedding weekly, wash food & water bowls daily. Vacuum as often as possible.

Keep dry foods in air-tight storage containers and don't buy more than you can use in a month unless you can freeze it. Discard the bags the food came in and use ziplock freezer bags. 

If the feet are affected, you can soak them in tepid water with epsom salts. Be sure to dry thoroughly afterwards.

Bathe the dog often, weekly if possible, with a shampoo formulated for allergic dogs. (I like Douxo Calm). Do NOT use leave-in conditioners or other grooming products. Use a cool dryer setting or air-dry. 

As much as I hate doing it, keeping windows closed really helps with pollen allergies. Run the A/C in warm weather especially, the allergy symptoms are exacerbated by humidity. Use a furnace filter with a high allergen rating and change it monthly.

[Laurie, Wally & Charlotte]

Well, as it turns out, I can check off everything as ALREADY DOING, except perhaps for wiping her feet and brushing her daily, and I have never given her evening primrose oil. I do use betamethasone valerate on the base of her tail when that seems to be itching. And the vet suggested using natural aloe (which I already have for Wally's nose). Is there a particular dose for the evening primrose oil for a dog that's just under 25 pounds? Thanks.