About 20% of dog owners will recognize these symptoms: head shaking, ear scratching, face rubbing, itchy skin, chewing at paws, and licking, licking, licking – all of it accompanied by the irritating jangle of metal dog tags, day and night. Those 20% have pets with allergies, otherwise known as atopy, or atopic dermatitis.
Allergies are triggered by environmental irritants such as pollen, mold, or dust mites. Pollen allergies occur seasonally. Although a dog’s symptoms can be severe, they’re usually pretty well controlled with a combination of cortisone (steroids), topical medications, essential fatty acids, and antihistamines.
Pooches who are sensitive to molds and dust mites aren’t so lucky. Their symptoms can last for months, or even year-round, because molds and mites are in your home all the time, even if you are a fabulous housekeeper. Giving steroids year-round can have profound negative health effects and isn’t recommended.
Up until about 10 years ago, immunotherapy (allergy shots) was the most effective long-term treatment for the year-round itcher. Then a drug call Atopica (generic name cyclosporine) was approved by the FDA and provided another good treatment option.
Cyclosporine is an immunosuppressive drug. The dose we give to dogs has been proven to be generally safe, especially because we try to adjust the dose to the lowest effective level. Although Atopica is said to relieve itching in 74% of patients, there are some side effects, such as vomiting and loss of appetite. My personal experience has been that it seems to stop working in some dogs. I’ve heard dermatologists at national meetings praise Atopica but also admit that it isn’t the panacea for allergic dogs that they had hoped for.
But now there’s a new player on the market: Apoquel. When allergens such as pollen and mold enter the body, they cause immune cells to release chemicals called cytokines. These cytokines cause inflammation and itching. Apoquel specifically inhibits cytokines to help stop itching, with minimal negative impact on immune function. Our clients notice a beneficial effect within a week of starting Apoquel, but it takes about four weeks to get the best effect.
As with any drug (especially new ones) there are some restrictions mandated by the FDA: Apoquel can’t be used in dogs younger than 12 months old, or in dogs that have cancer, serious infections, or other severe conditions. So far, it hasn’t been approved for use with steroids, and it shouldn’t be given to pregnant or dogs used for breeding. So far the most common side effects we’ve seen are vomiting and diarrhea, but those seem to be infrequent.
Now for the frustrating bit: The popularity of Apoquel wasn’t anticipated by its maker, Zoetis, and the supply is running low. The veterinary community is irked by this; it’s reminiscent of the late, great Steve Jobs creating fervor over the newest Apple innovation and then making consumers wait months to buy it!
After all the exaggerated promises made about Atopica when it first came on the market, most veterinarians have approached Apoquel with cautious optimism. We’re finding that Apoquel isn’t a quick fix for the chronic allergic dog, but it’s a very good tool to add to our allergy arsenal.