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Apoquel for acute and chronic pruritis #309154
02/23/14 12:40 PM
02/23/14 12:40 PM
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Tammi Offline OP
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Saw this new drug posted on the other forum yesterday so did some reading last night. Seems very promising for those of us that have been through the gauntlet of tests and drugs, with little help, on our chronically itchy dogs. Going to discuss with my vet this week. Is anyone here using it yet?

Tammi

Re: Apoquel for acute and chronic pruritis [Re: Tammi] #309161
02/23/14 03:20 PM
02/23/14 03:20 PM
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Val da Tiger

Fuzzybutt the cat.
Neilla the Big White puppy.

RIP Cheyenne - AKA: Digger, CheyChey Girl, Cheyenne Large and In charge. 2/16/02 - 2/27/16
RIP Raya - AKA: Raz-a, Ray a Sunshine, RayBestos, the little one, Silly Girl. 9/21/05 - 6/27/14
RIP Lakota - AKA: Bubba, Big Boy, BooBoo (the other part of the Binky and BooBoo team). 1/19/03-9/19/2011
RIP DeeDee - AKA: DD Poo, Little Bit, Binky (part of the Binky and Booboo team) 6/23/02-6/20/11
Re: Apoquel for acute and chronic pruritis [Re: Wisc.Tiger_Val] #309180
02/23/14 06:28 PM
02/23/14 06:28 PM
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MaxaLisa Offline

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This is the first I've heard of it.

Being a new drug, I would want frequent blood tests for monitoring. I would also first try the herbal American Scullcap to see if it could calm the itch.


MaxaL (aka LisaT)

Jazmine, mini-mix, 10/18/2011
Max-n-Indy
Max, 5/2001-2/2012, RIP my partner, my Regal Boy
Indy, 5/1997-10/2010, RIP my friend, my teacher

Health Index
K9 TBD info and Tick List Links
http://www.rabieschallengefund.org/
Re: Apoquel for acute and chronic pruritis [Re: MaxaLisa] #309263
02/24/14 11:34 PM
02/24/14 11:34 PM
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Tammi— I’m not using it but searched for some information on Apoquel and it seems some dogs in the study were euthanized, developed a variety of cancers and had other side effects like anorexia, pneumonia, vomiting and diarrhea. (off topic, have you tried dinovite?)

Adverse Reactions— http://www.drugs.com/vet/apoquel.html

“…Adverse reactions reported (and percent of dogs affected) during Days 0-16 included diarrhea (4.6% APOQUEL, 3.4% placebo), vomiting (3.9% APOQUEL, 4.1% placebo), anorexia (2.6% APOQUEL, 0% placebo), new cutaneous or subcutaneous lump (2.6% APOQUEL, 2.7% placebo), and lethargy (2.0% APOQUEL, 1.4% placebo)…”

“…on APOQUEL had decreased leukocytes (neutrophil, eosinophil, and monocyte counts) and serum globulin, and increased cholesterol and lipase…”

‘…one dog that had an intense flare-up of dermatitis and severe secondary pyoderma after 19 days of APOQUEL administration, and one dog that developed generalized demodicosis after 28 days of APOQUEL administration…”

“…Two other dogs on APOQUEL were withdrawn from study due to suspected or confirmed malignant neoplasia and subsequently euthanized, including one dog that developed signs associated with a heart base mass after 21 days of APOQUEL administration, and one dog that developed a Grade III mast cell tumor after 60 days of APOQUEL administration…”

“…Additional dogs receiving APOQUEL were hospitalized for diagnosis and treatment of pneumonia (one dog), transient bloody vomiting and stool (one dog), and cystitis with urolithiasis (one dog)…”

“…the following additional clinical signs were reported after beginning APOQUEL (percentage of dogs with ]at least one report of the clinical sign as a non-pre-existing finding): pyoderma (12.0%), non-specified dermal lumps (12.0%), otitis (9.9%), vomiting (9.2%), diarrhea (6.0%), histiocytoma (3.9%), cystitis (3.5%), anorexia (3.2%), lethargy (2.8%), yeast skin infections (2.5%), pododermatitis (2.5%), lipoma (2.1%), polydipsia (1.4%), lymphadenopathy (1.1%), nausea (1.1%), increased appetite (1.1%), aggression (1.1%), and weight loss (0.7)…”

“…Five APOQUEL group dogs were withdrawn from study because of: darkening areas of skin and fur (1 dog); diarrhea (1 dog); fever, lethargy and cystitis (1 dog); an inflamed footpad and vomiting (1 dog); and diarrhea, vomiting, and lethargy (1 dog). Dogs in the APOQUEL group had a slight decrease in mean white blood cell counts (neutrophil, eosinophil, and monocyte counts)…”

“…one dog developed demodicosis following 273 days of APOQUEL administration. One dog developed dermal pigmented viral plaques following 266 days of APOQUEL administration. One dog developed a moderately severe bronchopneumonia after 272 days of APOQUEL administration…”

“…dog was euthanized after developing abdominal ascites and pleural effusion of unknown etiology after 450 days of APOQUEL administration. Six dogs were euthanized because of suspected malignant neoplasms: including thoracic metastatic, abdominal metastatic, splenic, frontal sinus, and intracranial neoplasms, and transitional cell carcinoma after 17, 120, 175, 49, 141, and 286 days of APOQUEL administration, respectively…”

“…Two dogs each developed a Grade II mast cell tumor after 52 and 91 days of APOQUEL administration, respectively. One dog developed low grade B-cell lymphoma after 392 days of APOQUEL administration. Two dogs each developed an apocrine gland adenocarcinoma (one dermal, one anal sac) after approximately 210 and 320 days of APOQUEL administration, respectively. One dog developed a low grade oral spindle cell sarcoma after 320 days of APOQUEL administration…”

“To report suspected adverse events, for technical assistance or to obtain a copy of the MSDS, contact Zoetis Inc. at 1-888-963-8471 or www.zoetis.com...”

Re: Apoquel for acute and chronic pruritis [Re: MSD] #309269
02/25/14 12:02 AM
02/25/14 12:02 AM
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To put this in perspective, the ages of the dogs and their breeds would have to be taken into the equation. Older dogs and breeds like my golden are already predisposed to lumps, bumps and cancers.

Also, the fact that this study has been ongoing for more than 4 years and in most cases the side effects posted state "1" dog.

The study has to be done using many times the suggested dosage as well as for a very long time frame.

In the real world, a vet should be using this short term and offering allergy testing, counseling on better foods, etc.

Also, my understanding is that the vomiting and diarrhea resolved on their without need for medication and is due to the castor oil in the base.

As opposed to prednisone certainly, this looks promising to me and I will be interested in hearing how it does in the real world.

Unfortunately, it is in back order and won't be available from most vets for
weeks


Bonnie

With approval of my friends:

SamCat, 03/2011
Bennie the 12 1/2% GSD 02/2013

Seiko, Solo, Sophie, Skye and Buddy - bridge dogs who taught me so much
Re: Apoquel for acute and chronic pruritis [Re: PositiveDog] #309304
02/25/14 03:34 AM
02/25/14 03:34 AM
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Tammi Offline OP
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I read the study results and then did a lot of googling for results of folks already using on their dogs.

I haven't tried Dinovite. Almost did but then saw some less than favorable reviews and frankly have to wonder how it's any different than the many other non pharmaceuticals that I've tried. Supplements are good, but I'm pretty sure my boy's problem is much deeper than what they can fix. Skin testing is the last thing to try but he has to be off prednisone for that.

MSD is your boy doing well now?

Tammi

Re: Apoquel for acute and chronic pruritis [Re: Tammi] #309431
02/25/14 10:56 PM
02/25/14 10:56 PM
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Hi Tammi— I hope the Apoquel works for you if you decide to try. I am curious does your boy continue to scratch and have weight loss or is it just fur missing along with black skin? I have limited experience with steroids, how does the prednisone help, if at all? I have nothing meaningful to add and it seems that unfortunately our boys are in similar situations. I wish you the best of luck and if you learn something please let me know and I will do the same because I was wondering for some time now if you had found the cure and I’m sorry to read that you haven’t.
Best,

Re: Apoquel for acute and chronic pruritis [Re: MSD] #309455
02/26/14 02:12 AM
02/26/14 02:12 AM
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Tammi Offline OP
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MSD yes he continues to scratch, fluctuates on weight, black skin. Even during the best of healing his elbows never recover. I've resorted to a hydrolyzed kibble which doesn't even help 100% without drugs. He appears to be allergic to everything, food and environmental. We went several months without a hotspot but unfortunately he just got one 2 weeks ago. I'm using vetericyn on it, and spraying his belly with it as well. I'm trying to stay on a low dose of prednisone, it takes the edge off so he can at least sleep. He's still on soloxine. Baytril worked very well but once we stopped everything came back. I've tried lots of things to heal his gut to no avail. Currently trying bone broth - only started a couple of days ago. We're almost at the 3 year mark of this fight. We have a vet appointment Thursday evening. I'll definitely let you know how we make out.
Tammi

Re: Apoquel for acute and chronic pruritis [Re: Tammi] #309625
02/28/14 12:36 AM
02/28/14 12:36 AM
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Tammi Offline OP
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I had a conversation with my vet about Apoquel. As you know vets have more information about the drugs/clinical trials than we do. He's not ready to prescribe this drug yet, for anyone, for various reasons. I guess any immunosuppressant-like drug (or whatever category it falls into) can do that but I'll trust his instincts for now.

Re: Apoquel for acute and chronic pruritis [Re: Tammi] #309626
02/28/14 12:59 AM
02/28/14 12:59 AM
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Being more the cynic, I would say that the vets have more access to the drug reps, who most often are not very balanced in their presentations.

Here is a very pro-opinion piece: http://www.dermatologyforanimals.com/apoquel/

Here is the FOIA info (note, it's written by Zoetis): http://www.fda.gov/downloads/AnimalVeter...s/UCM363901.pdf

This has an easy to read chart, but it really makes me wonder what they were using as placebo in the study - placebo are not necessarily inert: http://www.noahcompendium.co.uk/Pfizer_Limited/Apoquel_film-coated_tablets_for_dogs/-62739.html


MaxaL (aka LisaT)

Jazmine, mini-mix, 10/18/2011
Max-n-Indy
Max, 5/2001-2/2012, RIP my partner, my Regal Boy
Indy, 5/1997-10/2010, RIP my friend, my teacher

Health Index
K9 TBD info and Tick List Links
http://www.rabieschallengefund.org/
Re: Apoquel for acute and chronic pruritis [Re: Tammi] #309627
02/28/14 01:02 AM
02/28/14 01:02 AM
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MaxaLisa Offline

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Originally Posted By: Tammi
.... black skin...

Oddly, when I've used Phosphatidylserine or acetyl-l-choline, Jazz's black skin on the inside of her armpits and legs lightened up quickly. But she doesn't itch. In fact, they list itching as a possible side effect.


MaxaL (aka LisaT)

Jazmine, mini-mix, 10/18/2011
Max-n-Indy
Max, 5/2001-2/2012, RIP my partner, my Regal Boy
Indy, 5/1997-10/2010, RIP my friend, my teacher

Health Index
K9 TBD info and Tick List Links
http://www.rabieschallengefund.org/
Re: Apoquel for acute and chronic pruritis [Re: Tammi] #309636
02/28/14 01:31 AM
02/28/14 01:31 AM
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I would much rather use this than steroids or other drugs for temporary relief, while figuring out the underlying cause of the skin problems.

It doesn't need loading doses, begins to work within 24 hours and can be started and stopped as needed.

It was a long study and seems to me to a safer alternative to what is used now.

shrug


Bonnie

With approval of my friends:

SamCat, 03/2011
Bennie the 12 1/2% GSD 02/2013

Seiko, Solo, Sophie, Skye and Buddy - bridge dogs who taught me so much
Re: Apoquel for acute and chronic pruritis [Re: PositiveDog] #309642
02/28/14 01:41 AM
02/28/14 01:41 AM
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Wisc.Tiger_Val Offline
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As a person who had a dog with severe allergy problems and skin problems I would have tried the Apoquel.


Val da Tiger

Fuzzybutt the cat.
Neilla the Big White puppy.

RIP Cheyenne - AKA: Digger, CheyChey Girl, Cheyenne Large and In charge. 2/16/02 - 2/27/16
RIP Raya - AKA: Raz-a, Ray a Sunshine, RayBestos, the little one, Silly Girl. 9/21/05 - 6/27/14
RIP Lakota - AKA: Bubba, Big Boy, BooBoo (the other part of the Binky and BooBoo team). 1/19/03-9/19/2011
RIP DeeDee - AKA: DD Poo, Little Bit, Binky (part of the Binky and Booboo team) 6/23/02-6/20/11
Re: Apoquel for acute and chronic pruritis [Re: Wisc.Tiger_Val] #309670
02/28/14 03:18 AM
02/28/14 03:18 AM
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Tammi Offline OP
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I went in wanting to try it. Maybe he just doesn't know enough about it yet. I don't know, feeling a bit overwhelmed presently and let him talk me out of it. I would imagine Ty's skin would clear up quicker while on abx if he had this too. I don't want long tem use, just looking to get his skin healthy again and go from there.

Re: Apoquel for acute and chronic pruritis [Re: Tammi] #309672
02/28/14 03:38 AM
02/28/14 03:38 AM
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It's REALLY hard when you work so hard and you don't find relief.

I would say that if I had exhausted everything, I would probably try it, but in a very conservative way, after it had been out awhile. I do have a "never use a new drug" philosophy. I tried cyclosporine when my boy had perianal fistulas. I tried pred for Jazz here when I had already tried all the other things I knew (though it took me a year to to that). LOL, of course those big drugs didn't help in either case, but they had to be tried.


MaxaL (aka LisaT)

Jazmine, mini-mix, 10/18/2011
Max-n-Indy
Max, 5/2001-2/2012, RIP my partner, my Regal Boy
Indy, 5/1997-10/2010, RIP my friend, my teacher

Health Index
K9 TBD info and Tick List Links
http://www.rabieschallengefund.org/
Re: Apoquel for acute and chronic pruritis [Re: MaxaLisa] #309733
02/28/14 04:10 PM
02/28/14 04:10 PM
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Tammi, I haven't used Apoquel but would consider it if I had to. I know Dr. Lewis, he took care of my Heidi for several years and I trust him.
http://www.dermatologyforanimals.com/blog/

I just switched Nikki over to the allergy drops three weeks ago, would that be something you would are willing to try?

Last edited by HeidiGSD; 02/28/14 04:11 PM.

Michaela

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Olivia von Jagenstadt "Nikki" - 11/21/2009
Heidi von Shiloh - 2/10/1995 - 2/21/2009
Re: Apoquel for acute and chronic pruritis [Re: HeidiGSD] #309767
02/28/14 10:06 PM
02/28/14 10:06 PM
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Tammi Offline OP
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Thank you. I'm going to let the abx run it's course and see how that goes. It's been awhile since he's been on them. I'll revisit the Apoquel after that as I'm sure his problem isn't just food but since we haven't gotten off prednisone (even .5mg doses on and off) for 30 days we haven't been able to do any skin tests besides the usual scrapes. I'm iffy on the allergy blood testing.....but don't even know if he has to be off pred for that as well. I would not be opposed to anything that would help at this point.

Re: Apoquel for acute and chronic pruritis [Re: HeidiGSD] #309773
02/28/14 10:46 PM
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Originally Posted By: HeidiGSD
Tammi, I haven't used Apoquel but would consider it if I had to. I know Dr. Lewis, he took care of my Heidi for several years and I trust him.
http://www.dermatologyforanimals.com/blog/

I just switched Nikki over to the allergy drops three weeks ago, would that be something you would are willing to try?


I would try the drops, but not the shots if I have another allergy problem dog.


Val da Tiger

Fuzzybutt the cat.
Neilla the Big White puppy.

RIP Cheyenne - AKA: Digger, CheyChey Girl, Cheyenne Large and In charge. 2/16/02 - 2/27/16
RIP Raya - AKA: Raz-a, Ray a Sunshine, RayBestos, the little one, Silly Girl. 9/21/05 - 6/27/14
RIP Lakota - AKA: Bubba, Big Boy, BooBoo (the other part of the Binky and BooBoo team). 1/19/03-9/19/2011
RIP DeeDee - AKA: DD Poo, Little Bit, Binky (part of the Binky and Booboo team) 6/23/02-6/20/11
Re: Apoquel for acute and chronic pruritis [Re: Tammi] #309786
03/01/14 01:00 AM
03/01/14 01:00 AM
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I did the skin testing with both of mine and Nikki's dermatologist does the blood test at the same time also. I hope you get it figure out, I know how frustrating allergies are.


Michaela

-----------

Olivia von Jagenstadt "Nikki" - 11/21/2009
Heidi von Shiloh - 2/10/1995 - 2/21/2009
Re: Apoquel for acute and chronic pruritis [Re: Wisc.Tiger_Val] #309793
03/01/14 02:27 AM
03/01/14 02:27 AM
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Tammi Offline OP
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Originally Posted By: Wisc.Tiger_Val
I would try the drops, but not the shots if I have another allergy problem dog.


Please share why? I'd like to know the pros and cons before I get to that point. He had to be on B12 for awhile and hated those monthly shots.

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