Dog on immunotherapy - transition to atopica/apoquel?

RE: Dog on immunotherapy - transition to atopica/apoquel?

Martin Atkinson — Mon, 11 Apr 2016 12:18:40 GMT

[quote user="Anthony Todd"]I don't think I have ever seen an atopic,allergic or any dog "rubbing it's bottom" which didn't have abnormal anal gland content[/quote]I have seen quite a few, mostly Staffies which seem to rub their bottoms just for the sake of it. Indeed I had a controlled pool as one of my nurses bred them so we were were able to work up the cases reliably. Staffies just seem to have a fetish about their arses!

RE: Dog on immunotherapy - transition to atopica/apoquel?

Anthony Todd — Sun, 10 Apr 2016 11:06:39 GMT

I don't think I have ever seen an atopic,allergic or any dog "rubbing it's bottom" which didn't have abnormal anal gland content, [or impaction]

I think this animal has two separate conditions, the A/Gs and some sort of generalised allergic response. Fortunately it is easy to eliminate the A/Gs from the diagnostic process, which would be my first step, and for which the animal would be grateful.

RE: Dog on immunotherapy - transition to atopica/apoquel?

Iva Mayer — Sat, 09 Apr 2016 23:32:07 GMT

Based on my experience and official guidelines for CAD I would said that it might be possible that immunotherapy is not efficient any more. If she is "real atopic" she might be sensitised for more allergens during the time so basically 2012 serology results are just "old results." Moreover due to the fact that lots of atopic patients are sensitive to food as well it doesn't make much sense to provide immunotherapy without a proper food trail. the order of investigation in allergic patients is pretty clear: Fleas, (infection), food, other allergens.

Perineal pruritus is more (but not exclusively) connected to food sensitivity so I would try to exclude a food.If you think that she is in atopic flare you can switch to Apoquel immediately (make sure that she doesn't have infection of anal glands since inflammatory factors can be trigger for pruritus, and any infection will get worse due to Apoquel)....I wouldn't go with Atopica since you need weeks of "loading" meaning yo will have to introduce some corticosteroids as well. Hope this will help at least a bit.

RE: Dog on immunotherapy - transition to atopica/apoquel?

Kate Richardson — Sat, 09 Apr 2016 19:47:26 GMT

[quote user="villagevet"]

I would be suspicious perineal pruritis may be related to food reaction and no medication fully resolves same.

[/quote]

is this based on personal experience or from cpd/others experience?

RE: Dog on immunotherapy - transition to atopica/apoquel?

Anthony Todd — Sat, 09 Apr 2016 13:36:39 GMT

I'm sure you've checked the anal glands?

RE: Dog on immunotherapy - transition to atopica/apoquel?

Stephen Courtney — Sat, 09 Apr 2016 12:59:50 GMT

I have had several dogs with a minimal or questionable response to immunotherapy that have done very well on apoquel - all I did was start the apoquel , usually around the time their immunotherapy course was about to finish ( ie nothing left in the bottle). It usually works within a few days

Apoquel doesn't work in every case - but it does in most. sods law though, the worst cases seem less likely to respond.

In addition there is no reason not to use apoquel at the same time as immunotherapy. there is an argument for overlapping, so that any improvement in pruritus ( or not) could more clearly be attributed to the new drug, especially if pruritus improves on the pill, and doesn't recur when the immunotherapy ends

RE: Dog on immunotherapy - transition to atopica/apoquel?

Lindsey Edwards — Wed, 06 Apr 2016 22:09:05 GMT

I would be suspicious perineal pruritis may be related to food reaction and no medication fully resolves same. I would start strict hypo food trial alongside current immunotherapy before starting long term maintenance meds

RE: Dog on immunotherapy - transition to atopica/apoquel?

Nicola Cole — Wed, 06 Apr 2016 21:15:35 GMT

I'm led to believe that if you start extending the dose interval for immunotherapy you increase the risk of adverse reactions so personally wouldn't think a weaning off approach is a good idea....(don't know at what interval the increased risk kicks in though!)

RE: Dog on immunotherapy - transition to atopica/apoquel?

Jenny Boyd — Wed, 06 Apr 2016 21:15:17 GMT

Personally I have found apoquel more effective

RE: Dog on immunotherapy - transition to atopica/apoquel?

Rebecca MacMillan — Wed, 06 Apr 2016 14:21:58 GMT

Yeah sorry, it probably seemed like a basic question! The trouble is the dog has been on it for so long now the owners are unsure/unclear as to whether the immunotherapy is having an effect or not, so it seemed a bit rash to just stop the jabs dead if they were helping. But I guess if we implement drugs now whilst finishing the last of the immunotherapy, we would be unlikely to see marked pruritus.

Most people seem to be favouring apoquel now, and I must say I haven't used atopica myself for a while, but is this based more on cost and reduced side effects than it is effectiveness? i.e do people find one product better than the other at controlling prurituis? Just raising the question.

RE: Dog on immunotherapy - transition to atopica/apoquel?

Martin Atkinson — Wed, 06 Apr 2016 09:50:14 GMT

This is a no-brainer. Simples, start it on Apoquell and remove the immunotherapy as soon as the symptoms resolve which will be 3-4 days. It is magic.