17. Cosgrove SB, Cleaver DM, King VL, et al. Vet Dermatol 2016;27(Suppl 1):100 (abstract). This content is intended for counseling purposes only. The American company "Zoetis Inc" created the drug Apoquel, which deservedly occupies a leading position among drugs for eliminating itching in dogs, regardless of its etiology. She adds, however, that some horses allergy signs are so dramatic that corticosteroids are the most logical choice, at least initially. Use of oclacitinib (Apoquel; Zoetis) for treatment of cutaneous mastocytosis in a cat. These reports suggest the potential use of oclacitinib in, While oclacitinib is a very effective and fast-acting. 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. Even though the drug is currently labeled for use in dogs (with allergic dermatitis), initial studies show that horses absorb it well, Fultz says. Orthobiologic Options for Treating Horses. Im glad that youve found a solution- but, after the allergy testing you can start them on a regimen designed exactly for what they are allergic to, which will help to desensitize them to those allergens. So lets review why allergies happen, how they affect your horses body, and how to treat themor, better yet, how to avoid them altogether. 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. While oclacitinib is a very effective and fast-acting antipruritic drug, the decision of when to use it depends on various factors. It is absolutely miraculous for these itchy miserable horses. Veterinarians dose Apoquel at 0.18-0.27mg per pound of bodyweight. 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. Rosenkrantz WS, Bourgeois AS. Powered by Discourse, best viewed with JavaScript enabled. This gives you the total number of milligrams for the dose for your horse. APOQUEL may be administered with or without food. Each dosage is sold per tablet, in 20 count, or 100 count bottles. Many allergens can cause skin reactions. 23. This content is informational/educational and is not intended to treat or diagnose any disease or patient. 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. 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. Weve also been able to start rehabbing back into work. Oclacitinib, a Janus kinase inhibitor, has become an important drug in the management of allergic pruritus. Vet Dermatol 2018:29:371 (abstract). Oclacitinib (APOQUEL) is a novel Janus kinase inhibitor with activity against cytokines involved in allergy. Nevertheless, these data should be taken with caution, and only as an approximation, because there is no basic information on the . These animals require the opposite regimen. Im not dealing with food allergies but both the company and the vet did not recommend allergy shots for my mare. We do a loading dose for 7 days, then every other day for 7 doses (so 14 days) then work to figure out how far apart we can go with our daily dose. Because one of mine had similar food allergies and I was told the serum would not address that. 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. 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. Vet Dermatol Learn how allergies happen, how they affect your horses body, and how to avoid or treat them. Alternatively, your veterinarian may be able to show you some techniques. Immunotherapy, also called hyposensitization therapy, is a strategy used to gain allergen-specific immune tolerance, says Fultz. See full Excede for Swine Prescribing Information. Have you considered trying allergy testing? Noli C, Matricoti I, Schievano C. A double-blinded, randomized, methylprednisolone-controlled study on the efficacy of oclacitinib in the management of pruritus in cats with nonflea nonfood-induced hypersensitivity dermatitis. If the patient remains stable and other controlling measures-such as allergen avoidance, allergen immunotherapy, and preventive topical therapyhave been implemented, the use of oclacitinib can be limited to flare control. A Magnawave-certified practitioner, Lucile also runs a small equine PEMF therapy business. Milder cases of asthma are still associated with coughing, airway inflammation, mucous production, and poor performance.. Therefore, the recommended initial dosage for dogs 6.6-9.9 lbs is of a 3.6 mg tablet twice daily. After that it would be about $250 every 6 weeks or so if I cant further reduce time between pills. This site is intended for US animal healthcare professionals. 9. Vet Dermatol 2017;28(5):485-e113. Drake GJ, Nuttall T, Lpez J, et al. Treatment may then be continued at the same dose given once a day. Gadeyne C, Little P, King VL, et al. If you mix it in their food, ensure that your pet chews the treatment rather than swallowing it without chewing for effective results. Avoid giving the medicine twice daily long-term. We recommend Platinum Skin and Allergy or Aleira. In severely affected horses, we would expect to see lower airway inflammation and airway obstruction, manifesting as increased respiratory effort, frequent coughing, mucous buildup, and exercise intolerance, White says. 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. Is it possible to cure an allergy? Summer-pasture-associated horses tend to be triggered by spring/summer allergens like grasses and trees, and classic horses tend to be triggered by barn dust and mold spores. Adding an update here in case its helpful for others. 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. New neoplastic conditions (benign and malignant) were observed in clinical studies and post-approval. How Organized Are Your Horses Health Records? 18. Apoquel is sold per tablet in strengths of 3.6 mg, 5.4 mg, or 16 mg. Oclacitinib is well tolerated and, compared with classic allergy medications such as glucocorticoids and cyclosporine, equally effective in controlling pruritus. When working with a liquid: Multiply your horse's weight in pounds times the dose rate in milligrams per pound. 28. 30. @vxf111 we were told the same thing for food allergiesthat they did not make serums fot them because they were not very effecttive and the the expectation was that the allergen be removed from the diet. On the topic of simple and economical allergy management, a readily accessible ingredient that helps many horses is flaxseed. 20. Rabies in Animals. Vet Dermatol 2015;26(3):171-179, e35. Commonly prescribed for: Manage inflammation in diseases or conditions in which the immune system has a significant role, Therapeutic Class: Synthetic Corticosteroid Hormone. Vomiting, diarrhea, and lack of appetite are also possible. This site is for US animal healthcare professionals. The bodys largest organ, the skin serves as the immune systems first protective barrier. Every cough means something is a common saying among equine veterinarians. I hear the result have been spectacular. Repeated oral dose tolerance in dogs treated concomitantly with ciclosporin and oclacitinib for three weeks. She still has her mane this year- which is good! There are a few medication protocols for horses with Equine Asthma. The anti-inflammatory/immunosuppressive response is confined almost exclusively to the lungs, avoiding a bodywide effect, says Fultz. Lopes NL, Campos DR, Machado MA, et al. Although no studies of pharmacokinetics in cats have been published, oclacitinib is well tolerated and seems to be safe when used in cats at 1 or 2 mg/kg q12h for 28 days.21 Further studies are needed to investigate adverse effects associated with long-term use in cats. Blood was collected prior to drug administration and at 15 min, 30 min, 45 min, 1, 2, 4, 6, 8 . I actually have 2 horses now on serum and one I eliminated the food specific allergens from his diet. Its an annoying pill schedule to keep track of, but my boarding barn has been great about it. I havent noticed any abnormal side effects. 1. Recently, researchers have delved into the causes and consequences of what now falls under the umbrella term equine asthma. He stayed on as a faculty member until 2013, when he decided to move back to Switzerland to open his own dermatology clinic in his hometown of Basel in 2014. There are 4 JAK families in mammals: JAK1, JAK2, JAK3, and TYK2. Oclacitinib preferably inhibits JAK1 and, to a lesser degree, JAK3, resulting in decreased activity of JAK1-dependent cytokines involved in allergy and inflammation (IL-2, IL-4, IL-6, and IL-13) as well as pruritus (IL-31). The most common practical starting dosage for many cats is of the 5.4mg tablet, or 2.7mg. Works on all common sources of allergens. Panteri A, Strehlau G, Helbig R, et al. actually treats degenerative joint disease (DJD), not just its clinical signs. Horse dosing is 5 pills. 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. The results are problematic. 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. 7. 22. 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. I know there are some cases where the horse only needs 5 pills 1x a weekothers where its every 4 days.My vet did say she has one client whos horse has gone down to 2 pills every 3 days. Recently, one group has looked into immunomodulatory properties of oclacitinib by observing canine T-cell proliferation and cytokine productions in vitro. Oclacitinib (APOQUEL) is a novel Janus kinase inhibitor with activity against cytokines involved in allergy. Then reintroduce each, one by one, while monitoring for hives or other signs of allergies. She reports choosing Apoquel over corticosteroids in several of her allergic patients that are also at risk for developing laminitis. Since oclacitinib is a rather weak anti-inflammatory drug, it was suggested that remission of active moderate to severe atopic dermatitis be induced with a course of a broad inflammation-targeting drug, such as a short-acting glucocorticoid, until clinical signs become mild. Her allergies have reared their ugly heads again - no jowl pyoderma, but ears itching. Long term itch reduction. Apoquel has been a game changer, however. The steroids are usually given orally, but we may want to start with injections for a week or so in severely affected horses. Before your vet administers immunotherapy, though, you must identify your horses respiratory and skin allergies. Saridomichelakis MN, Olivry T. An update on the treatment of canine atopic dermatitis. (https://www.zoetispetcare.com) I get $9 back for every 30 pills I order, it goes onto a Mastercard debit card that can only be used at a vets office but I spend plenty of money there. Previcox is an FDA-approved non-steroidal anti-inflammatory (NSAID) prescription medication used in dogs to treat pain and inflammation associated with osteoarthritis and for the control of postoperative pain and inflammation associated with soft-tissue and orthopedic surgery. 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. More severe ones, however, can truly take a toll on your horses health and make him miserable. Apoquel can be administered with or without food. Panteri A, Strehlau G, Helbig R, et al. Apoquel can be administered to dogs over the age of 12 months for 14 days, during which the veterinarian would most likely decrease the dose to once a day. Noli C, Matricoti I, Schievano C. A double-blinded, randomized, methylprednisolone-controlled study on the efficacy of oclacitinib in the management of pruritus in cats with nonflea nonfood-induced hypersensitivity dermatitis. Efficacy of oclacitinib (Apoquel) compared with prednisolone for the control of pruritus and clinical signs associated with allergic dermatitis in client-owned dogs in Australia. Meaning, if a 100lbs dog gets 16mg (1 pill), a horse does not need 160mg (10 pills). Proc (Bayl Univ Med Cent) 2018;31(4):524-525. 16. The recommended Apoquel (main ingredient, oclacitinib) dosage for dog use is as follows: The recommended dosage is 0.18 to 0.27 mg of oclacitinib per pound of body weight, for the first 14 days. My mare started on 5 pills every day and then we were able to move her down to 5 pills every other day. Avoid storing hay in the same barn as sensitive horses, since hay particles and spores can be irritating, even from a distance and even if they are not visible in the air. Since the vast majority of Equine Asthma patients do not have a histamine-associated problem, this isn't likely to work for most. Vet Dermatol 2013;24:48-e12. $ 78.30 - $ 245.00. Collard WT, Hummel BD, Fielder AF, et al. We cannot be sure of accurate dosing when tablets are quartered, and thus this practice is not recommended. Its important to know, however, that some horses can have BOTH types, and will need to managed year-round!What are your treatment and management options? Most common side effects are vomiting and diarrhea. Clenbuterol dilates the airways, and may improve air flow, but it doesn't treat the inflammation associated with the disease. All trademarks are the property of Zoetis Services LLC or a related company or a licensor unless otherwise noted. Gonzales AJ, Bowman JW, Fici GJ, et al. Urticaria (hives) is the most widely reported presentation of a skin allergy. Vet Dermatol 2016;27(Suppl 1):84 (abstract). This regimen may work better because oclacitinib has a short half-life of 4 hours. Oclacitinib can be given without food and may be discontinued without tapering. Long-term compassionate use of oclacitinib in dogs with atopic and allergic skin disease: safety, efficacy and quality of life. to 14 days, and then administered once daily for maintenance therapy. The Janus kinases (Jaks). 405 HERON DRIVE SUITE 200 SWEDESBORO, NJ 08085-1749 | 2004-2023 WEDGEWOOD PHARMACY, ALL RIGHTS RESERVED. This product is a hand-held device that administers an anti-inflammatory mist into the horses nostril. More severe ones, however, can truly take a toll on your horses health and make him miserable. Thats def not nothing but its not insane. Join us as we interview leading equine researchers from the University of Kentucky, Problem Solver Series: How to Control Nuisance Birds on Horse Properties. Read on below! Allergies primarily affect the immune, respiratory, and integumentary (skin) systems and, if unmanaged, can seriously impact an animals performance and well-being. I often recommend switching your Asthma horse off of regular hay and trying a period of hay-replacement to see if it helps. The most common side effects associated with Apoquel are vomiting, diarrhea, and lethargy. Renal Anemia, or . She has a master's degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in 1982. In some dogs, this can be overcome by splitting the total daily dose in half and give twice daily. KER offers EO3, which contains the omega-3 fatty acids DHA and EPA. Clenbuterol should only be used short-term, since it will stop working with long-term administration. Many of these cytokines bind to cytokine receptors that have JAK enzymes associated with their cytoplasmic portion. APOQUEL may be administered with or without food. and unfortunately grass and dust are the main culprits. Diphenhydramine can alter the results of skin allergy testing; discontinue this medication at least 2 weeks before testing. Fukuyama T, Ganchingco JR, Bumer W. Demonstration of rebound phenomenon following abrupt withdrawal of the JAK1 inhibitor oclacitinib. Rarely, dogs on Apoquel develop new skin masses; however, a long-term study found no association between Apoquel and the development of malignant cancer. I had my dog on it and the price was pretty steep. Aymeric E, Bensignor E. A case of presumed autoimmune subepidermal blistering dermatosis treated with oclacitinib. And some can got a lower dose or a further spread out dose. Efficacy of oclacitinib (Apoquel) compared with prednisolone for the control of pruritus and clinical signs associated with allergic dermatitis in client-owned dogs in Australia. There is a new drug available to help allergic horses: Apoquel. Vet Dermatol 2015;26:297 (abstract). ACVIM, a Florida-based large animal internal medicine specialist with an interest in respiratory disease. This links to a pdf file Storage and Handling : Store at controlled room temperature 20 to 25C (68 . Log in to browse, order and prescribe from our compounded drugs formulary. On the label for dogs, Apoquel is used every 12 hours for the first 14 days of use, then backed down to dosing every 24 hours once a day. With an online account, access our extensive formulary or over 40,000 unique items - 24 hours a day, 7 days a week. EHV Quarantine Released at Turf Paradise Racetrack, Six Simple Spring Safeguards for Senior Horses, Evaluating the Suspensory Ligament in Cutting Horses, Regular Dental Care Important in Horses Worldwide, Investigating Equine Cases of Toxicant Exposure, Podotrochlosis: Navicular is No Longer the End of the Road for Horses. This product is top-dressed onto the feed and helps horses with equine asthma, including heaves in older horses and inflammatory airway disease in young, athletic horses.". Trials showed that spreading out dosing was more successful than lowering. Dosing Chart Warnings Pulsoni D, Freire A, Ferreira DR. Juvenile-onset ischemic dermatopathy in two dogs treated with oclacitinib. 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). In a 2019 study Radwanski et al. Speak to yourveterinarian in an emergency. Submit Office Orders & Patient Prescriptions. Oclacitinib should not be given in dogs younger than 12 months of age due to an increased risk for activating demodicosis, bacterial pneumonia, and other serious infections. I had a cat on it years ago and it was $$$$ but it was the only thing that worked for her. Pros and cons of oclacitinib therapy. Thank you! This might, down the road, be an easier and less expensive alternative for horse owners. A horse can hypothetically be allergic to anything he touches, inhales, ingests, or has applied to or injected into his body. Both can be very serious. Apoquel is the brand name of oclacitinib, a dog medication designed to relieve itching associated with allergies in dogs, particularly canine atopic dermatitis. Pasture-associated equine asthma is most prevalent during the summer in the southeastern U.S. but has been reported worldwide. Equine Asthma- yep, that's the new name for "heaves," "RAO," "COPD" or whatever else we've called it over the years! Yes, we looked into this approach, but unfortunately it was not a viable option for my horse for a variety of reasons including other health factors and severity of allergies. 15. The efficacy of oclacitinib was also compared to that of other drugs such as prednisolone and cyclosporine. Some dogs exhibit increased pruritus when the dosage is reduced to once daily. The Janus kinases (Jaks). Vet Dermatol 2014;25(6):512-518. Is it horrendously expensive? The Vet had put her on Apoquel as an initial dose for 10 days tapering off. Several reports of successful use of oclacitinib to treat other diseases have been published. 21. Apoquel Dosage. 12. Frank RK, Galvan BA, Schoell AR, et al. not random, very relevant and helpful! The innovative formula of the drug allows you . Skin allergies can also cause pruritus (itching) and associated hair loss. In a 3-week trial, the combination of oclacitinib and cyclosporine did not show an increased risk for adverse effects. 18. Maximizing ventilation when horses are stalled and bedding with low-dust options such as wood byproducts; Purchasing dust- or mold-free hay and wetting, soaking, or steaming it prior to feeding to reduce inhaled particles; and Offering an alternative feed than hay for low-dust options. 11. Zyrtec: The human antihistamine may be beneficial in a small proportion of horses with Equine Asthma. Apoquel Dosing Chart For Dogs Minimum order 6 tablets per dosage. This is a new treatment option, and currently the tablets are not FDA approved for horses, only dogs. Apoquel is an anti-itch tablet given twice daily for the first . Yamaoka K, Saharinen P, Pesu M, et al. BMC Vet Res 2019;15(1):137. If you struggle to get your dog to take tablets, you can try hiding it in their food, or wrapping it in a tasty piece of meat. The dosages of oclacitinib of 1 mg/kg and 2 mg/kg were chosen because the dosages used for dogs (0.4-0.6 mg/kg) were not shown to be very effective in cats [ 18 ], and the higher dosage range of 0.8-1.3 appeared to be more effective in allergic cats [ 22 ]. Equine Nutrition FAQ Series, sponsored by Purina Animal Nutrition. The dosage for dogs 15-19.9 lbs is one 3.6 mg tablet twice daily. Simple strategies for dust reduction include removing the horses from the stalls when mucking out and blowing the aisle or ditching the leaf blower altogether, Fultz says. A newer prescription drug, Apoquel (oclacitinib) has recently hit the market and might prove useful for allergic horses. Licorice Roo t (Glycyrrhiza glabra) This sweet and soothing herb has been used medicinally for over 3,000 years. 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. No claims are made as to the safety or efficacy of mentioned preparations. Dosage options starting at $0.25 per dose. Pruritus is a common clinical sign in allergic skin diseases. 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). 13. Levy BJ, Linder KE, Olivry T. The role of oclacitinib in the management of ischaemic dermatopathy in four dogs. The pharmacokinetics of oclacitinib maleate, a Janus kinase inhibitor, in the dog. Apoquel is an anti-allergy drug that's often prescribed by vets. That something could very well be allergy-induced asthma. Atopic dermatitis is often a complex disease that requires a multifaceted approach. All rights reserved. Dosing Chart Contraindications found a significant improvement in 76% of horses with skin allergies within one year of using allergen-desensitization serums. Vet Dermatol 2013;24(6):587-597, e141-142. 3. Your veterinarian also may use dexamethasone in high doses in emergencies for anaphylactic reactions, spinal cord trauma or shock. In this study, 70% of the study population receiving oclacitinib showed improvement in pruritus compared with 75% in a group receiving methylprednisolone.18 Based on this study, a higher dose with a longer induction period seems to be the key to successfully treating feline pruritus with oclacitinib. 4. Rest assured, your horses are receiving the best possible disease protection. I was one of the veterinarians involved in early field trials for Apoquel in horses. Her lifelong love of horses motivated her to adopt her college care horse, Claire, upon graduation. Oral . Its an easy and cost-free strategy you can do yourself. Apoquel should be shipped with extreme caution when temperature is below 35 degrees Fahrenheit. Apoquel may increase the chances of developing serious infections, and may cause existing parasitic skin infestations or pre-existing cancers to get worse. Discount Prices on Pet Supplies, Nexgard, Bravecto, Trifexis, Simparica TRIO, Apoquel, and more. Apoquel starts working within 4 hours of administering the first dose and controls itching within 24 hours. Vet Dermatol 2015;26(4):235-e52. Equine Regenerative Therapies for Managing Arthritis in Horses, Infographic | 12 Smart At-Home Biosecurity Practices for Horse Owners, Infographic | How To Keep Your Horses Joints Healthy. Interestingly, the results suggest that oclacitinib has immunosuppressive properties, but only at a higher dosage than that approved on the label.30. Researchers have proven flaxseed reduces skin lesions in IBH horses (ONeill et al., 2002). Innovation is constantly occurring in the field of immunotherapy. Avoiding Allergies If the horse is allergic to any of them, his immune system elicits a response, and a hive forms at the injection site. Like most treatments, this medication will not be successful in every horse, but if it does work, it avoids the risks associated with steroids. K. Route of Administration . 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. This option has somewhat fewer risks than option 1, has a higher initial cost ($1,000 for the nebulizer mask), but a lower monthly cost- $20-$40/month. APQ-01043R3, halved to ensure that the ingredients are equally distributed. Treatment should be started at a dose of 0.4 - 0.6 mg per kilogram bodyweight twice a day for up to two weeks. Though rare, allergic reactions to medications and vaccines also occur. Banovic F, Tarigo J, Gordon H, et al. I have noticed that in general she is more comfortable on cooler days.