Both Apoquel (made by Zoetis) and Cytopoint (made by Zoetis) have been in use for a while – they’ve been around for eight and five years, respectively. These drugs are the most recent and effective in the veterinary arsenal for dogs suffering from allergies. However, there is always the possibility of side effects or contraindications to their use. These drugs have greatly improved the lives of many dogs with severe allergies without any side effects.
Before I go into detail about why these drugs are so revolutionary, let me briefly explain why some dogs have severe allergies and what the veterinary medications that preceded these drugs were like.
TREATMENTS FOR DOG ALLERGY
Allergies in dogs are characterized by normal, healthy-looking skin with itching. Either the allergen is inhaled (atopy), or ingested. Itching from inhaled allergens can be seasonal (only in spring and only in fall). Itching from food allergies can occur all year.
Allergy therapy aims to relieve the itching. Your dog will scratch, chew and bite his way to secondary skin conditions if you don’t treat the underlying cause.
Between the allergen being first recognized by the body, and the end result, which is skin inflammation or itching, there is a biochemical cascade with many mediators. The treatment of allergic itch can either block or interrupt the cascade. The better allergy itch control is, the more complete the interruption or block.
Although it would be great if the dog could avoid contact with all substances that are allergic to them, this is not possible in the case atopy. You can do it with food allergies. This is possible if your dog is able to identify the foods or foods that he is allergic to. You must give your dog a diet that is very limited in ingredients and contains only novel ingredients (nothing else) for 8 to 12 weeks. Then, wait for the symptoms to subside. If it does not, then it is most likely that he has atopy.
Many medications that relieve itching from allergy can’t treat food allergies. You may be disappointed or frustrated if this step is skipped.
The only way to protect your dog from the allergens he is allergic to is through allergy testing or immunotherapy (allergy shots).
This therapy aims to stimulate the dog’s body in order to produce antibodies against his allergens. In this way, the therapy stops the inflammatory cascade from starting. This is not the best option for allergy management. It is labor-intensive, expensive, and not without risk.
We now turn our attention to medication. They are safe, affordable, and available over-the-counter. They don’t work well for dogs. They won’t work in the case of an allergy inflammatory flare-up. It is too late to block histamine in this stage.
Antihistamines are most effective when taken before your dog has an allergy season. You can help your dog’s allergy symptoms by giving him an antihistamine before he starts to have trouble. Sometimes, an antihistamine can be added to a prescription medication that is providing some relief but not 100%. Talk to your veterinarian about this.
Although steroids work well to relieve itching, their immediate effect can be quite severe. They also have a host of adverse effects that can cause immune suppression and allergic reactions. They can be prescribed for acute, severe cases. However, I will only recommend them in the beginning to control inflammation. We then look for a longer-lasting, safer solution.
In 2003, the Food & Drug Administration approved Atopica (cyclosporine). This is a good alternative to steroids for long-term allergy management. It can also cause immune suppression, just like steroids. It takes too long for it to kick in. It can take up to four to eight weeks for maximum response. This is too long for both the allergic dog as well as his owner.
NEW ALLERGY MEDICINE AVAILABLE FOR DOGS
Apoquel, Cytopoint and Cytopoint are the most recent allergy treatments. These medications stop the inflammatory cascade at various points. They have very few side effects and are quick-acting. Each has its pros and cons, which we’ll discuss.
Apoquel (oclacitinib manate) blocks the actions of cytokines. These are pro-inflammatory proteins that are heavily involved in the allergy cascade. The tablet is taken twice daily for 14 days and then again once daily. It works quickly and is very effective for many dogs. Although side effects are rare, vomiting, diarrhea and loss of appetite have all been reported.
Apoquel safety testing suggests that there may be some immune suppression. Apoquel could have some side effects. Apoquel can cause serious infections in dogs, such as pneumonia and demodectic menge. This is a common side effect of the drug. This was particularly true for puppies. The drug should only be used in dogs aged 12 months and older. It is not recommended for use in breeding or nursing dogs.
Apoquel has never caused immune suppression in my clinic. I have not had any issues with it and will continue to use it for appropriate patients. This makes it important to monitor these patients.
Apoquel is not recommended for dogs suffering from tumors. These dogs may prefer Cytopoint, which has no warnings and concerns about tumors.
Apoquel can sometimes work well when taken twice daily, but it doesn’t always work as well when taken only once daily. This is something I see a lot at the clinic and it’s very disappointing for pet owners. Many pet owners have asked me whether they can continue to do twice daily. Unfortunately, there have not been any long-term safety studies on this dose. Although Apoquel can still be taken off-label, there are no safety studies.
For these dogs, I prefer to give the Apoquel one time per day (as indicated) and then add Cytopoint. These two medications can be used together safely and often work well for dogs with severe allergies.
Subcutaneous injections of Cytopoint must be done by a veterinarian. It lasts four to eight weeks, and is less likely to cause side effects than Apoquel.
Cytopoint (lokivetmab), a monoclonal antibody that is directed against the cytokine interleukin 31(IL-31), is a major player in the allergic inflammatory cascade. It is an injectable drug that is administered under the skin. It works quickly and relieves itching within 24 hours. It can last anywhere from 4-8 weeks.
Although side effects are uncommon, there have been reports of nausea, vomiting, diarrhea and loss of appetite. Although discomfort or pain at the injection site can occasionally occur, it is usually mild and temporary. Cytopoint does not cause immune suppression and there are no concerns or warnings about tumors.
Cytopoint can cause antibodies in dogs. This could cause the medication to lose its effectiveness forever. This is possible, although I have not seen it yet. If your dog responds well to Cytopoint initially, but then becomes less responsive, it is likely that this is what is happening. It’s a shame I haven’t seen it.
Cytopoint is a great product for veterinary practice. Cytopoint would be my first choice if I had an allergic dog.
This information will help you navigate your journey if you have an allergic dog. Your veterinarian is the best resource for you and your dog.
The Cytopoint Whole Dog Journal and Apoquel are ground-breaking dog allergy medicine options.