It’s allergy time of year again, and our pets are feeling it just like we are.
Seasonal allergies can lead to itchy, inflamed skin and are the most common underlying cause of chronic skin and ear infections in dogs. Do you have a dog that constantly has black debris coming out of his ears, is always licking her feet or gets hot spots regularly? Then you likely have a dog with allergies.
Dogs can be allergic to everything we are, like pollen, grasses and trees. An allergy is when the body mounts an immune attack against one of these substances that it considers a foreign invader. The skin and ears get inflamed, and then the yeast and bacteria that are on the skin normally take advantage of this inflamed skin and overgrow to cause an infection.
Because of this underlying allergy, just treating the infection will not solve the problem. For example, you may clear up an ear infection temporarily by treating it with an antibiotic or topical cream, but in pets with allergies, if you don’t make a plan for managing the allergic problem long-term, the ear infection will quickly reoccur.
Allergies are very frustrating for pet owners and veterinarians alike, but there are some new allergy therapies available now that are very effective and have fewer side effects than traditional therapies.
The traditional way we have managed allergies is with antihistamines, steroids or topical treatments.
Antihistamines like Benadryl still have their place for dogs with mild allergies. Benadryl is inexpensive and safe and is available over the counter. In dogs with mild allergies, Benadryl is a great place to start with treatment.
The dose of Benadryl for dogs is one milligram per pound. For example, a 25-pound dog will take 25 milligrams of Benadryl and a 100-pound dog will take 100 milligrams of Benadryl every eight to 12 hours. The downside of Benadryl (or other antihistamines) is that, for dogs with moderate to severe allergies, Benadryl isn’t strong enough to stop the allergic reaction.
Topical medications, like shampoos, sprays and creams with steroids, antifungals or antibiotics in them, are also used to help manage allergy symptoms.
For dogs that have very localized problems — foot itchiness, for example — we can sometimes get away with a local treatment. Topical medications can be effective if the client is able to administer them properly and regularly and the dog doesn’t immediately lick the medication off.
You and your veterinarian can decide if topical management of allergies and secondary infections is a good fit for you and your dog. The biggest problem I see with topical medications is compliance. It is not always easy to rub a cream on the skin, especially if the dog is very furry.
Steroids, like prednisone, have also been used for many decades to manage allergies. Prednisone is very powerful and effective, but it has a lot of side effects that make it undesirable for long-term use.
Taking steroids long-term prematurely ages the patient. Steroids will thin out the skin, weaken tendons and muscles and put undue stress on internal organs. Plus, they make your dog drink a lot and urinate a lot, so you need to be able to take your dog outside frequently to avoid accidents in the house.
Prednisone is cheap, and for short-term use is fine. I typically tell clients that if we have to use steroids for more than six weeks out of the year, we should discuss some of the new allergy management options that are available.
As a veterinarian, I love two new allergy medications that have become available over the past several years. Apoquel and Cytopoint are powerful medications against allergies but without the side effects that we see with steroids.
Apoquel came out several years ago. Unlike prednisone, which suppresses the whole immune system, Apoquel is not as broad a spectrum of an immunosuppressive drug. It targets primarily cytokines, substances released by immune cells that are involved with coordinating an allergy response. It works quickly and with very few side effects. It is not sided effect-free, however, and it is important that your dog undergo blood monitoring if he takes Apoquel long-term.
Apoquel has been known to reduce white blood cells and elevate liver enzymes. At our clinic, we recommend a blood check one month after starting Apoquel and then every six months after that to screen for any side effects from the medication.
Cytopoint is an injectable medication that your veterinarian administers at the clinic. It is an even more targeted approach to stopping the itch cycle then Apoquel.
Cytopoint binds to one specific cytokine called Interleukin-31 (IL-31). IL-31 has been shown to be responsible for most of the itchiness that is seen with allergies. By binding and inactivating IL-31, some patients are completely itch free until the shot wears off. The Cytopoint shot will last for four to six weeks in most patients.
Cytopoint is very new for general practitioners. We have only had it available since the beginning of this year. So far, no real side effects have been reported. However, it is an immune-modulating drug, and for that reason, we are exercising caution and recommending blood monitoring with this medication as well.
Apoquel and Cytopoint are terrific, and I am so happy that I have these new allergy medications to offer my clients. The big drawback to these medications is the cost.
Depending on the size of the dog, it can cost $70–$150 per month to treat an allergic dog, and that doesn’t include the cost of blood monitoring. They are new medications, so hopefully, the cost will come down over time. Also, because they are so effective at controlling allergies, there is a cost-saving in that you won’t have to see the veterinarian so often to treat those secondary infections that arise.
Your dog doesn’t have to suffer through another allergy season. Talk to your veterinarian about the new allergy medications that are available. You and your dog will be happy that you did.
Cytopoint and Benadryl
Cytopoint and Benadryl are two different medications used to treat allergies in dogs, primarily to provide relief from itching and skin irritations. They have different mechanisms of action and can be used individually or together, depending on the severity of the allergy and the recommendation of the veterinarian.
Cytopoint (lokivetmab) is a monoclonal antibody that specifically targets and neutralizes interleukin-31 (IL-31), a protein involved in triggering itchiness in dogs. It is administered by injection and typically provides relief for 4 to 8 weeks. Cytopoint is a relatively new medication and is specifically designed for use in dogs with atopic dermatitis (allergic skin disease) and other chronic skin conditions. It has a low risk of side effects, as it does not suppress the immune system or impact other organs.
Benadryl (diphenhydramine) is an antihistamine used to treat allergies in both humans and animals. It works by blocking the effects of histamine, a substance released during an allergic reaction that causes itching, redness, and inflammation. Benadryl is available in oral tablet, liquid, or injectable forms and can provide short-term relief from itching and other allergy symptoms. It is important to use the correct dosage for dogs, which is typically 1 mg per pound of body weight, given every 8 to 12 hours. Side effects may include drowsiness, dry mouth, and urinary retention.
If you are considering using either of these medications for your dog’s allergies, it is important to consult with a veterinarian first. They will be able to determine the best course of action and recommend the appropriate treatment based on your dog’s specific needs and medical history.
Apoquel vs Prednisone
Apoquel and prednisone are both medications used to treat allergies and inflammation in dogs, but they have different mechanisms of action and potential side effects. A comparison of these two drugs can help you understand their uses, benefits, and drawbacks.
Apoquel (oclacitinib):
- Mechanism of action: Apoquel is a Janus kinase (JAK) inhibitor that works by blocking the action of certain enzymes involved in the inflammatory and itch pathways, providing relief from itching and inflammation associated with allergic skin conditions.
- Benefits: Apoquel starts working quickly, often providing relief within 4 hours, and has a full effect within 24 hours. It can be used long-term to manage chronic skin conditions and has fewer side effects compared to corticosteroids like prednisone.
- Side effects: The most common side effects include vomiting, diarrhea, and lethargy. However, these side effects are generally mild and may resolve on their own or with adjustments to the medication dosage. Apoquel can also increase the risk of infections and should be used cautiously in dogs with pre-existing conditions.
Prednisone:
- Mechanism of action: Prednisone is a corticosteroid that works by suppressing the immune system and reducing inflammation. It is commonly prescribed to treat a wide range of conditions, including allergies, asthma, and autoimmune disorders.
- Benefits: Prednisone is a powerful anti-inflammatory medication that can provide rapid relief from itching, inflammation, and other allergy symptoms. It is usually prescribed for short-term use or in tapering doses to minimize side effects.
- Side effects: The side effects of prednisone can be more significant than those of Apoquel, especially with long-term use. These may include increased thirst and urination, weight gain, panting, and behavioral changes. Long-term use can also lead to Cushing’s disease, diabetes, and other serious health issues.
Apoquel vs Cytopoint
| Apoquel (oclacitinib) | Cytopoint (lokivetmab) | |
|---|---|---|
| Mechanism of action | Janus kinase (JAK) inhibitor | Monoclonal antibody against IL-31 |
| Form | Oral tablet | Injectable |
| Administration | Once or twice daily (depending on dog’s weight and veterinarian’s recommendation) | Every 4 to 8 weeks (given by a veterinarian) |
| Onset of action | Relief within 4 hours, full effect within 24 hours | May take a few days to provide relief |
| Duration of effect | Daily administration required | 4 to 8 weeks |
| Benefits | Fast-acting, can be used for short-term and long-term management | Targeted action, low risk of side effects, longer-lasting relief |
| Side effects | Vomiting, diarrhea, lethargy, increased risk of infections | Minimal side effects, temporary pain or irritation at injection site |
Both Apoquel and Cytopoint can be effective in treating itchiness and allergies in dogs. Apoquel is generally faster-acting but requires daily administration, while Cytopoint provides longer-lasting relief with less frequent injections. It is important to consult with a veterinarian to determine the most appropriate treatment option for your dog based on their specific needs and medical history.
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