. At that point, the treatment can be changed to oclacitinib. Hay naturally contains microscopic fungal spores, plus bacterial and dust components that horses inhale as they eat, explains Lisa Fultz, DVM, MS, Dipl. It is important to address that the use of oclacitinib in cats is off-label, and owners should be informed before using oclacitinib in this species. Not really cheap any way you shake it, but considering that she was on zyretc, dex, smarthbreathe ultra, respi-free previously. Log in to browse, order and prescribe from our compounded drugs formulary. Consider the risks and benefits of treatment in dogs with a history of recurrence of these conditions. Rosenkrantz WS, Bourgeois AS. The compounded medications featured in this content have been prescribed and/or administered by prescribers who work with Wedgewood Pharmacy. Oclacitinib in feline nonflea-, nonfood-induced hypersensitivity dermatitis: results of a small prospective pilot study of client-owned cats. Speak to yourveterinarian in an emergency. Apoquel should be administered orally, twice daily for up to 14 days, and then once daily for maintenance therapy. See how Apoquel works differently from steroids and cyclosporines, Discover how Apoquel can relieve allergic itch through an 8-week food trial, Hear from your peers about why Apoquel is their first choice for allergic itch relief, Explore the United States of Apoquel to see how Apoquel has benefited veterinarians in your region, Hear real stories of allergic itch relief from pet owners, See how Zoetis Petcare Rewards can benefit your practice, Informational resources for you to download and utilize within your practice, Provide additional information about Apoquel to pet owners with these resources, Continue therapy once daily (SID) thereafter for maintenance. Food allergies in particular you cant always do the serum for. Allergies are generally managed based on the severity of clinical signs. Anecdotal reports indicate that oclacitinib is not very effective in managing recurrent and/or chronic otitis and interdigital furunculosis associated with allergies, and a sudden loss of efficacy is often associated with bacterial or. Some dogs exhibit increased pruritus when the dosage is reduced to once daily. Thereafter the dose should be reduced to once daily for maintenance. The pharmacokinetics of oclacitinib maleate, a Janus kinase inhibitor, in the dog. Panteri A, Strehlau G, Helbig R, et al. A blinded, randomized, placebo-controlled trial of the efficacy and safety of the Janus kinase inhibitor oclacitinib (Apoquel) in client-owned dogs with atopic dermatitis. Levy BJ, Linder KE, Olivry T. The role of oclacitinib in the management of ischaemic dermatopathy in four dogs. 4. Apoquel is typically administered in tablet form at 0.4-0.6mg per kilo of body weight, or 0.18-0.27mg per pound of body weight, every 12 hours or twice a day. Oclacitinib maleate is used twice daily for two weeks and then dropped to a maintenance dose of once daily. Vet Dermatol 2015;26:297 (abstract). The efficacy and safety of oclacitinib have been assessed in various studies. Because many respiratory allergies come from the dust in hay and bedding, veterinarians generally recommend maximizing fresh-air time through turnout. The Janus kinases (Jaks). Treatment should be started at a dose of 0.4 - 0.6 mg per kilogram bodyweight twice a day for up to two weeks. Weve also been able to start rehabbing back into work. New neoplastic conditions (benign and malignant) were observed in clinical studies and post-approval. 17. APOQUEL tablets may be administered with or without food. Transdermal applicator that gives easy & accurate dosing every time. 22. This links to a pdf file Storage and Handling : Store at controlled room temperature 20 to 25C (68 . Many of these cytokines bind to cytokine receptors that have JAK enzymes associated with their cytoplasmic portion. Cost for the initial course of treatment (about 12 days) will be around $300-400. Adding an update here in case its helpful for others. This is interesting. 10. Proc (Bayl Univ Med Cent) 2018;31(4):524-525. For atopic and allergic dermatitis, Apoquel may be given to dogs at a dosage of 0.18 - 0.27 mg/lb. Many medications are available to help manage your horses allergies, some of which are best used as preventives in sensitive horses. Most common side effects are vomiting and diarrhea. Apoquel is sold per tablet in strengths of 3.6 mg, 5.4 mg, or 16 mg. Left untreated, these conditions can not only cause discomfort but also lead to raw, broken skin that allows bacteria to invade and infect. The only FDA-approved equine PSGAG. not random, very relevant and helpful! Apoquel is an anti-itch tablet given twice daily for the first . The results are problematic. Have you considered trying allergy testing? Because many respiratory allergies come from the dust in hay and bedding, veterinarians generally recommend maximizing fresh-air time through turnout. Since it became available in 2014, several clinical studies have confirmed its antipruritic effect not only in dogs but also in cats, as well as in other immune-mediated diseases. A follow-up study assessed the long-term safety, efficacy, and quality of life of oclacitinib-treated dogs. Designed by Elegant Themes | Powered by WordPress, You need to be logged in to fill out this form. This is a new treatment option, and currently the tablets are not FDA approved for horses, only dogs. But the immune system is not a perfect one. Barns can also have noxious gases from the ammonia in urine. I hear the result have been spectacular. Feline idiopathic ulcerative dermatosis treated successfully with oclacitinib. Frank RK, Galvan BA, Schoell AR, et al. Treatment success in three Andean bears (Tremarctos ornatus) with alopecia syndrome using Oclacitinib maleate (Apoquel). 5. Do not use Apoquel in dogs less than 12 months of age or those with serious infections. Apoquel is a prescription medication used to treat itching and inflammation in dogs. Hydroxyzine is usually given orally twice to three times daily in dogs, cats, horses and birds. This is totally random but figured Id mention it since I had no idea till I saw someone mention itZoetis has a rewards program and Apoquel is one of the drugs on it. Skin allergies can also cause pruritus (itching) and associated hair loss. My understanding from my vet and from what Ive read is that in horses theres been a lot of success in spacing out the dosing, but not as much success in lowering the dose amount. Apoquel (oclacitinib tablet) Dosing & Administration How to dose Apoquel 0.4-0.6 mg/kg (0.18-0.27 mg/lb) Twice daily (BID) for up to 14 days Continue therapy once daily (SID) thereafter for maintenance May be given with or without food May discontinue without tapering Apoquel Dosing Guide Weight Range (lb) Number of Tablets to be Administered Nevertheless, these data should be taken with caution, and only as an approximation, because there is no basic information on the . Cochet Faivre N, Degorce-Rubiales F. Clinical eosinophilic popular dermatitis associated with histological eosinophilic granuloma rapidly responsive to oclacitinib in an adult Labrador retriever. However, the study showed that cyclosporine caused a 3-fold higher risk for developing gastrointestinal side effects (vomiting and diarrhea) compared with oclacitinib.12, Despite its delayed effects, cyclosporine is still a popular drug to treat canine atopic dermatitis because in some cases it can be dosed every other day or even every third day after initial daily treatment. . This site is for US animal healthcare professionals. The downside is that it can cause laminitis and can suppress their immune system. She reports choosing Apoquel over corticosteroids in several of her allergic patients that are also at risk for developing laminitis. Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. In the first pilot study, oclacitinib (0.4 to 0.6 mg/kg, q12h for 14 days, then q24h for 14 days) was used to treat pruritus in cats with non-flea, nonfood-induced hypersensitivity dermatitis. Maintaining Your Horses Weight During the Winter, Special Report: Preventing 3 Common Equine Joint Issues, JACKSON- Gelding/Bay/Mustang (Nevada) - Project/Ready for Training, JENNINGS Gelding/Cremello/Mustang (BLM) Ridable (Green), recent study evaluating almost 400 potential allergens, BONNIE: Sorrel Mustang Mare Non-Riding Companion Only. Before your vet administers immunotherapy, though, you must identify your horses respiratory and skin allergies. Avoiding Allergies Several of their drugs are eligible. 15. Luckily most of her allergies appear to be insect-based and she responds very well to the serum for that. Pasture-associated equine asthma is most prevalent during the summer in the southeastern U.S. but has been reported worldwide. Vet Dermatol 2013;24:48-e12. 2. Hay replacement consists of any of the following: a complete pelleted diet, soaked alfalfa cubes, hay pellets, or possibly a bagged forage product like Chaffhaye. Apoquel is a non-hormonal drug for dogs, used for dermatitis of various etiologies, which are accompanied by itching. Immunomodulatory in vitro effects of oclacitinib on canine T-cell proliferation and cytokine production. Bursatti, Leeches) in Dogs, Cats and Horses. 9. Apoquel Overdose Information Dogs that received overdoses in safety studies had side effects that included one or more of the following: vomiting, diarrhea, cysts between the toes, skin inflammation, papilloma's (warts), pneumonia, enlarged lymph nodes, and decreased blood cell production. Successful treatment of atopic dermatitis with the JAK1 inhibitor oclacitinib. Though rare, allergic reactions to medications and vaccines also occur. The Feed: One of the most common recommendations for managing Equine Asthma has always been to stop feeding hay. Pre-slaughter withdrawal time is 14 days following the last dose. Interleukin-31: its role in canine pruritus and naturally occurring canine atopic dermatitis. In the past 5 years, however, oclacitinib (Apoquel; zoetisus.com), a Janus kinase (JAK) inhibitor, has become another important drug in the management of allergic pruritus. My Docs are among the first in the country to use this drug on itchy and wheezy horses. Depending on the size of a cat and the condition being treated, a veterinarian may elect to alter the dosage. With an online account, access our extensive formulary or over 40,000 unique items - 24 hours a day, 7 days a week. Since the vast majority of Equine Asthma patients do not have a histamine-associated problem, this isn't likely to work for most. Even though the drug is currently labeled for use in dogs (with allergic dermatitis), initial studies show that horses absorb it well, Fultz says. Apoquel starts working within 4 hours of administering the first dose and controls itching within 24 hours. I often recommend switching your Asthma horse off of regular hay and trying a period of hay-replacement to see if it helps. For more information, please see the full Prescribing Information. Interestingly, the results suggest that oclacitinib has immunosuppressive properties, but only at a higher dosage than that approved on the label. More severe ones, however, can truly take a toll on your horses health and make him miserable. Her asthma had gotten so bad I thought I wouldnt be able to ride her again, but now we are back to w-t-c. She is down to every other day. 20. Generally self-limiting and harmless, hives are nonetheless uncomfortable and can occasionally lead to angioedema (swelling under the skin) or purpura (blood vessels rupturing and leaking blood internally). Currently, White is part of a team evaluating the possibility of delivering allergy shots in the form of a juice squirted under the horses tongue. 23. . A blinded, randomized, placebo-controlled trial of the efficacy and safety of the Janus kinase inhibitor oclacitinib (Apoquel) in client-owned dogs with atopic dermatitis. Your veterinarian also may use dexamethasone in high doses in emergencies for anaphylactic reactions, spinal cord trauma or shock. These inhaled substances can trigger an allergic response that causes narrowing of the airways, mucous secretion, and cough., Luckily, minimizing common allergens in your horses environment could suffice to restore his comfort and breathing. Vercelli A, Cornegliani L. Use of oclacitinib for the treatment of acral lick dermatitis in a dog: a case report. White believes that while further research in horses is warranted, veterinarians should consider latex exposure a potential risk to equine respiratory health. Most recently, it was suggested that the treatment strategy for canine atopic dermatitis might need to be adjusted. has been administered by veterinarians to help horses of . If the diagnosis is wrong or the medication affects the horse adversely, you could endanger your horse's life. The frequency of urinary tract infection and subclinical bacteriuria in dogs with allergic dermatitis treated with oclacitinib: a prospective study. 26. After that it would be about $250 every 6 weeks or so if I cant further reduce time between pills. These reports suggest the potential use of oclacitinib in other diseases; however, it cannot be stressed enough that the use of oclacitinib in these diseases is an off-label use. Apoquel sorted the problem in a day but after doing some research after noticing her doing some chewing again Apoquel has some disturbing side effects as it suppresses the immune system. Most commonly, immunotherapy involves injecting gradually increasing doses of a specific allergen subcutaneously (just under the skin), explains White. Loft K, Simon B. No claims are made as to the safety or efficacy of mentioned preparations. She has been allergy tested! The most common side effects associated with Apoquel are vomiting, diarrhea, and lethargy. All dogs itch sometimes, but when you notice it happening more and more, it could be a sign of a medical condition. While oclacitinib is a very effective and fast-acting antipruritic drug, the decision of when to use it depends on various factors. 8. To overcome its delayed effect, cyclosporine is often initially combined with other drugs such as prednisolone to accelerate the anti-inflammatory and antipruritic effects. Search term . 2. Although oclacitinib is licensed for use in dogs, it has been reported to be effective to treat pruritus in allergic diseases in other species, including cats. Genome Biol 2004;5(12):253. Pollen and other plant-based aeroallergens are the source of their distress, and they fare much better inside a well-ventilated barn. 1,2 For over 30 years, Adequan i.m. 1. Vet Dermatol 2014;25:153 (abstract). 16. Gadeyne C, Little P, King VL, et al. She gets it all year long since she has a full list of allergies including dust, feathers, and cat dander along with grasses. Vercelli A, Cornegliani L. Use of oclacitinib in treatment of canine idiopathic ear tip vasculitis. The dose of Apoquel tablets is 0.18-0.27 mg/lb (0.4-0.6 mg/kg). More studies are necessary to confirm oclacitinibs effects in non-allergic diseases and what other immune-mediated mechanisms may be involved. Intradermal allergy testing is the gold standard for this and involves a veterinary dermatologist subcutaneously injecting very small quantities of potential allergens into a clipped patch of the horses neck. So lets review why allergies happen, how they affect your horses body, and how to treat themor, better yet, how to avoid them altogether. That's why dosage is usually tapered down to the lowest effective dose. Blood was collected prior to drug administration and at 15 min, 30 min, 45 min, 1, 2, 4, 6, 8 . U.S. Food and Drug Administration Center for Veterinary Medicine 7500 Standish Place Rockville, MD 20855 www.fda.gov . These might include antihistamines such as cetirizine, which you can buy over the counter as Zyrtec from any drug store or pharmacy, or hydroxyzine, which requires a veterinary prescription. If your horse worsens when hay is re-introduced, you'll need to consider a permanent change to one of the other options! The recommended dose of Apoquel for dogs is 0.18 to 0.27 mg per pound of body weight. Vet Dermatol 2015;26:134 (abstract). It is an anti-inflammatory drug from the class of drugs known as Janus kinase (JAK) inhibitors. 13. The pharmacokinetics of oclacitinib maleate, a Janus kinase inhibitor, in the dog. Cyclosporine, which is approved for the treatment of canine atopic dermatitis, has an onset of efficacy of up to 4 weeks. 15. Specifically, studies in cats have used the following dosage: Initially, doses ranging from 0.4 to 1.2 mg/kg body weight, twice daily, for 24-28 days. ACVIM, a Florida-based large animal internal medicine specialist with an interest in respiratory disease. Long-term compassionate use of oclacitinib in dogs with atopic and allergic skin disease: safety, efficacy and quality of life. Therefore, the recommended initial dosage for dogs 6.6-9.9 lbs is of a 3.6 mg tablet twice daily. Interestingly, the results suggest that oclacitinib has immunosuppressive properties, but only at a higher dosage than that approved on the label.30. In atopic dermatitis, it is mainly mediated by a large group of proinflammatory and proallergic Th2 cytokines (e.g., interleukin [IL]-4, IL-5, IL-10, IL-13, IL-31). 12. 24. She would be a scratching mess without it. Owners using a nebulizer will also have to replace the medication cups on the nebulizer every few months, at a cost of about $80 per cup. 1,2 The #1 prescribed medicine for allergic itch in dogs. Vet Dermatol 2015;26(1):23-30, e7-8. According to the manufacturer's dosage chart, a large breed weighing between 130 and 175lbs should take two Apoquel 16mg daily. The concentration of the drug is 500 mg/ml. This treatment option is FDA approved for equine asthma, and is very safe with no known side effects. Treatment may then be continued at the same dose given once a day. Available As Tablets For use with Canine Strengths 3.6 mg 5.4 mg 16 mg Preventing bites is key, because itching-inflicted injury to hair follicles and skin can take months to heal. As a result, muscles relax and cause heavy sedation, notes DailyMed. In the first 2 randomized, double-blinded, placebo-controlled clinical trials, it was shown that oclacitinib, given at a dose of 0.4 to 0.6 mg/kg q12h, induced a rapid reduction in pruritus and treatment success in 62.3% to 67% of treated cases within 7 to 14 days. 405 HERON DRIVE SUITE 200 SWEDESBORO, NJ 08085-1749 | 2004-2023 WEDGEWOOD PHARMACY, ALL RIGHTS RESERVED. Apoquel is an anti-allergy drug that's often prescribed by vets. Since oclacitinib has been shown to be comparable to prednisolone, oclacitinib can be a good alternative to prednisolone when combined with cyclosporine for initial treatment. More severe ones, however, can truly take a toll on your horses health and make him miserable. Like other medications in its class, it may also be used off . Initially, the recommended dose of 0.4 to 0.6 mg/kg should be given twice daily for up to 14 days. Saridomichelakis MN, Olivry T. An update on the treatment of canine atopic dermatitis. Treatment will probably need to repeated somewhere between 1 and 6 weeks after the initial treatment course. Vet Dermatol This is a new treatment option, and currently the tablets are not FDA approved for horses, only dogs. Zyrtec: The human antihistamine may be beneficial in a small proportion of horses with Equine Asthma. APQ-01043R3, halved to ensure that the ingredients are equally distributed. In the first 2 randomized, double-blinded, placebo-controlled clinical trials, it was shown that oclacitinib, given at a dose of 0.4 to 0.6 mg/kg q12h, induced a rapid reduction in pruritus and treatment success in 62.3% to 67% of treated cases within 7 to 14 days.7,8 Treatment success was based on reductions from baseline of at least 2 cm on the owner-assessed visual analog scale and at least 50% on the clinicians Canine Atopic Dermatitis Extent and Severity Index (CADESI-02). Rabies in Animals. Little PR, King VL, Davis KR, et al. Cochet Faivre N, Degorce-Rubiales F. Clinical eosinophilic popular dermatitis associated with histological eosinophilic granuloma rapidly responsive to oclacitinib in an adult Labrador retriever. How Organized Are Your Horses Health Records? But you're making a deal with the devil when you use these . This study showed that pruritus was improved in only 42% of the study population; thus, use of oclacitinib in cats did not seem to be as effective as in dogs.17 A follow-up study was conducted with a higher dose (0.7 to 1.2 mg/kg) and a longer induction period (28 days). Adv Vet Dermatol 2017;8:192-198. All rights reserved. Cosgrove SB, Cleaver DM, King VL, et al. Veterinarians dose Apoquel at 0.18-0.27mg per pound of bodyweight. Weve been doing really well with every other day dosing. Allergen avoidance and allergen-specific immunotherapy are measures that address the allergy itself; various drugs are available for symptomatic management. So I want to make sure she has the support she needs to acclimate to hot humid summer weather. Gadeyne et al compared prednisolone and oclacitinib at recommended doses and found that both drugs resulted in similar rapid effects with regard to pruritus and dermatitis reduction.11 Little et al compared oclacitinib to cyclosporine. Option 3 is using a nebulizer with dexamethasone and/or other drugs. This would be treatment with a systemic steroid (usually dexamethasone or prednisolone). Gonzales AJ, Humphrey WR, Messamore JE, et al. 6. Dosage options starting at $0.25 per dose. The frequency of urinary tract infection and subclinical bacteriuria in dogs with allergic dermatitis treated with oclacitinib: a prospective study. 7. 25. It is no surprise we see this omega-3-rich plant with anti-inflammatory and antioxidative properties in many skin and allergy supplements. On the topic of simple and economical allergy management, a readily accessible ingredient that helps many horses is flaxseed. Ordering your pet's prescription drugs from Wedgewood Pharmacy is safe, and convenient. Really? Meaning, if a 100lbs dog gets 16mg (1 pill), a horse does not need 160mg (10 pills). Oclacitinib was well tolerated in both studies. Vet Dermatol 2013;24(5):479-e114. You may give this medicine with or without food. The onset of efficacy for oclacitinib is up to 1 week, but Little et al found that after 4 weeks of treatment, both drugs demonstrated comparable control of clinical signs. holy crapola batman- just had to put my dog back on it (Hes usually on it April through Nov but with the weird weather we got away with waiting until July thankfully) and saw the price increase- yikes! The bodys largest organ, the skin serves as the immune systems first protective barrier. Unless my vet (and an unaffiliated nutritionist) I consulted are wrong-- I was told that allergy serum is only possible/effective for some allergies and a lot of food-based ones are not on the list. Apoquel doses are usually between .04-.06 milligrams per kilogram of body weight (mg/kg) . IgE binds to cells in the body and releases inflammatory molecules. Simpson AC, Schissler JR, Rosychuk RAW, et al. Topics. Efficacy and safety of oclacitinib for the control of pruritus and associated skin lesions in dogs with canine allergic dermatitis. Apoquel should not be used in breeding, pregnant, or lactating dogs. Let's look at the differences between these two medications, as well as some other treatment options for your dog's allergies. Oclacitinib (APOQUEL) is a novel Janus kinase inhibitor with activity against cytokines involved in allergy. Apoquel is the #1 prescribed medicine for fast, effective relief of allergic itch and inflammation due to atopic and allergic dermatitis 1 Indications Control of pruritus associated with allergic dermatitis and control of atopic dermatitis in dogs at least 12 months of age. Diphenhydramine can alter the results of skin allergy testing; discontinue this medication at least 2 weeks before testing. Pulsoni D, Freire A, Ferreira DR. Juvenile-onset ischemic dermatopathy. Im hopeful, however, that I will be able to stretch out more so that Im looking at $250 across 8-10 weeks instead. Apoquel is a dog allergy medicine used to treat and control chronic manifestations of allergic and atopic dermatitis in dogs. Some allergic reactions are unexpected, as White has realized through his research. Dr. Patrick Hensel is a 1996 graduate of the University of Bern, Switzerland. She is a New-York-based freelance author with a passion for equine health and veterinary care. It generally reduces itching very quickly within 24 hours and is felt to be as effective as corticosteroids. In the past 5 years, however, oclacitinib (Apoquel; ), a Janus kinase (JAK) inhibitor, has become another important drug in the management of allergic pruritus. Why Do Some Horses Develop Respiratory EHV-1 and Others EHM? This product is a hand-held device that administers an anti-inflammatory mist into the horses nostril.