Best Care Animal Hospital
a1, Matthews, NC 28105
Traditional treatment for pets that are itchy:
Anti-histamines are not effective in treatment of pet pruritus. Some studies showed that anti-histamines like Diphenhydramine are only effective in less than 15% of the pets. Traditionally the only treatments that worked on itchy pets are either corticosteroids or cyclosporine (Atopica). However these medicines have extreme side effects from reduced immunity to weight gain and infections. The reason for their side effects is that they not only targeted the inflammation pathway they also targeted the other useful pathways of cells.
When Veterinarians and pet owners were worried with a difficult choice of treating the itchy pets to make them comfortable or not to treat them because of the side effects of steroids and immune suppressants, Apoquel came into market as a life saver.
Apoquel is a brand name for Oclacitinib. It is one of the most promising medicine for atopic dermatitis in dogs. It is a selective inhibitor of Janus Kinase 1 (JAK1). JAK1 when stimulated causes expression of inflammatory cytokines like Interleukins (IL) 2, 4, 6, 13 and 31. By being selective Apoquel reduces the side effects of non-selective medicines like steroids.
Apoquel being a new medicine, its full safety profile is not known, however it is implicated in reduced blood cell count, non-specific tumors and other minor side effects. The reduced blood cell count was never significant enough to drop below the range of the lab normal. But care should be taken to monitor the pets for any tumors either on the skin or internally.
Off label use of medicines is permissible by the veterinarians and some vets use Apoquel for cat or feline asthma.
Suppression of IL-4 and IL-13 causes a decrease of Th2-cell differentiation, which plays a role in atopic dermatitis. Suppression of IL-31 decreases pruritus (Itching). Oclacitinib inhibits JAK1 and not the pruritogenic cytokines like IL-31. There is evidence that suddenly stopping the medication caused an increase in rebound itchiness, where in more cytokines were produced to overcome lack of response by JAK1.
Metabolism and clearance:
Response to Apoquel will start in 4 hrs after taking the medication and itchiness will be completely gone in 24 hours. Apoquel reaches maximum plasma concentration of 89% within one hour and is mostly metabolized by liver.
We recommend doing annual or bi annual liver function tests on dogs that are on long term Apoquel.
Possible side Effects:
Reduced immunity, infections, liver damage, reduced blood cell count, volition.