21. Little PR, King VL, Davis KR, et al. Rosenkrantz WS, Bourgeois AS. 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. 5. Uses for Apoquel Vet Dermatol 2019;30(1):17-e6. Allergies are generally managed based on the severity of clinical signs. How Organized Are Your Horses Health Records? If signs . Rosenkrantz WS, Bourgeois AS. Until recently, glucocorticoids (systemic and/or topical) and cyclosporine have been considered the most effective symptomatic treatment options to manage atopic dermatitis.5 Oclacitinib is now also an effective option (BOX 1). With an online account, access our extensive formulary or over 40,000 unique items - 24 hours a day, 7 days a week. J Vet Pharmacol Ther 2014;37(3):279-285. The Feed: One of the most common recommendations for managing Equine Asthma has always been to stop feeding hay. Apoquel Dosage in Dogs Apoquel tablets for dogs comes strengths of 3.6mg, 5.4 mg and 16mg of oclacitinib per tablet. We have been using an inflatable fleece e-collar on her . Gonzales AJ, Bowman JW, Fici GJ, et al. Use of oclacitinib (Apoquel; Zoetis) for treatment of cutaneous mastocytosis in a cat. Apoquel can only be obtained with a prescription; it is available as film-coated tablets and chewable tablets in different strengths to cover a range of dog weights. Download Apoquel Information Sheet. Yamaoka K, Saharinen P, Pesu M, et al. Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. Pros and cons of oclacitinib therapy. Helpful steps you can take include providing full-body fly apparel, applying fly spray liberally, avoiding turnout at dusk and dawn, and using fans in stalls to disrupt insect flying patterns. 4. Loft K, Simon B. 3. Simpson AC, Schissler JR, Rosychuk RAW, et al. 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. This site is intended for US animal healthcare professionals. She still has her mane this year- which is good! Vet Dermatol 2017;28(5):485-e113. 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. The dose range is very strict, I do not recommend going above the recommended dose due to immune suppression, below the range and it doesn't seem to work in most cases. Adding an update here in case its helpful for others. 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. Is it horrendously expensive? This is a new treatment option, and currently the tablets are not FDA approved for horses, only dogs. Vet Dermatol 2014;25:153 (abstract). But I had my mare tested last year, she also came up allergic to some foods (flax being one) for which I was told serum was not an option. Many medications are available to help manage your horses allergies, some of which are best used as preventives in sensitive horses. This content is intended for counseling purposes only. The frequency of urinary tract infection and subclinical bacteriuria in dogs with allergic dermatitis treated with oclacitinib: a prospective study. We can let your veterinarian know that you are interested in our compounded Dexamethasone. 8. A Magnawave-certified practitioner, Lucile also runs a small equine PEMF therapy business. 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. Her asthma had gotten so bad I thought I wouldnt be able to ride her again, but now we are back to w-t-c. She is down to every other day. I am not saying it is a cure all, but that and some generic Zyrtec make my mare a whole lot more comfortable. Olivry T, Banovic F. Treatment of canine atopic dermatitis: time to revise our strategy? Even though the drug is currently labeled for use in dogs (with allergic dermatitis), initial studies show that horses absorb it well, Fultz says. A horse can hypothetically be allergic to anything he touches, inhales, ingests, or has applied to or injected into his body. Oclacitinib, a Janus kinase inhibitor, has become an important drug in the management of allergic pruritus. 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. After that it would be about $250 every 6 weeks or so if I cant further reduce time between pills. 9. Saridomichelakis MN, Olivry T. An update on the treatment of canine atopic dermatitis. The frequency of urinary tract infection and subclinical bacteriuria in dogs with allergic dermatitis treated with oclacitinib: a prospective study. BMC Vet Res 2019;15(1):137. 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. The results are problematic. If your horses allergies are seasonal, talk to your veterinarian about steps you can take to stay ahead of them. 1,2 For over 30 years, Adequan i.m. At that point, the treatment can be changed to oclacitinib. 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. For the first two weeks, this is to be given twice per day, and then once per day after the first two weeks for maintenance. Option 1 is the cheap/easy route, but comes with risks. 14. Some allergic reactions are unexpected, as White has realized through his research. Cosgrove SB, Wren JA, Cleaver DM, et al. The efficacy of oclacitinib was also compared to that of other drugs such as prednisolone and cyclosporine. Treatment success in three Andean bears (Tremarctos ornatus) with alopecia syndrome using Oclacitinib maleate (Apoquel). In fact, in our recent study evaluating almost 400 potential allergens, latex proteins were the most significant allergens for diagnosing severe equine asthma.. Apoquel. Use of oclacitinib (Apoquel; Zoetis) for treatment of cutaneous mastocytosis in a cat. 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. Most commonly, immunotherapy involves injecting gradually increasing doses of a specific allergen subcutaneously (just under the skin), explains White. 15. Vet Dermatol 2015;26(4):235-e52. Option 4 is an oral tablet called Apoquel. Now divide the 10,000 mg by the 500 mg in the concentration. The dose of APOQUEL tablets is 0.4 mg/kg to 0.6 mg oclacitinib/kg body weight, administered orally, twice daily for up to 14 days, and then administered once daily for maintenance therapy. Since some horses have both "types" of asthma, you may need to try a stall without bedding, or experiment with different types of bedding. Insect and pollen season is here. Even though the drug is currently labeled for use in dogs (with allergic dermatitis), initial studies show that horses absorb it well, Fultz says. Loft K, Simon B. Many allergens can cause skin reactions. Since oclacitinib has been shown to be comparable to prednisolone, oclacitinib can be a good alternative to prednisolone when combined with cyclosporine for initial treatment. 1. Commonly prescribed for: Manage inflammation in diseases or conditions in which the immune system has a significant role, Therapeutic Class: Synthetic Corticosteroid Hormone. Dexamethasone commonly is used in horses to treat allergic reactions such as respiratory allergies, chronic obstructive pulmonary disease (heaves), hives, itching and inflammatory diseases including arthritis. Breeding and Reproduction Horse breeding from planning through foal care; Diseases and Conditions Horse-health-problem risk factors, prevention, diagnosis, and treatment; Farm and Barn . But you're making a deal with the devil when you use these . 13. These might include antihistamines such as cetirizine, which you can buy over the counter as Zyrtec from any drug store or pharmacy, or hydroxyzine, which requires a veterinary prescription. IgE binds to cells in the body and releases inflammatory molecules. Unlike steroids, the drug has minimal impact on the immune system. Dosing Chart Warnings Apoquel should not be used in breeding, pregnant, or lactating dogs. For years, glucocorticoids and cyclosporine have been used for the symptomatic management of atopic dermatitis, including the associated pruritus. 2019;30(3):201-e63. Oclacitinib is available in 3 different tablet sizes: 3.6, 5.4, and 16 mg. Pulsoni D, Freire A, Ferreira DR. Juvenile-onset ischemic dermatopathy in two dogs treated with oclacitinib. Atopic dermatitis is often a complex disease that requires a multifaceted approach. Her lifelong love of horses motivated her to adopt her college care horse, Claire, upon graduation. Thats def not nothing but its not insane. Allergen avoidance and allergen-specific immunotherapy are measures that address the allergy itself; various drugs are available for symptomatic management. Six adult horses with a mean weight of 528 kg were . The Vet had put her on Apoquel as an initial dose for 10 days tapering off. and unfortunately grass and dust are the main culprits. The dosage for dogs 15-19.9 lbs is one 3.6 mg tablet twice daily. @stb its definitely not cheap. Dexamethasone: EZ Dose Micro Transdermal Gel, Dexamethasone: Twist-a-Dose Transdermal Gel, Discussion Guide for Pet Owners and Veterinarians, Medication Information for Pet and Horse Owners. On the topic of simple and economical allergy management, a readily accessible ingredient that helps many horses is flaxseed. Schindler C, Levy DE, Decker T. JAK-STAT signaling: from interferons to cytokines. In cats, this medication can cause excitement rather than sedation. While oclacitinib is a very effective and fast-acting antipruritic drug, the decision of when to use it depends on various factors. Because insects are omnipresent in the horses environment at least some portion of the year, IBH is particularly labor-intensive to manage. It is an anti-inflammatory drug from the class of drugs known as Janus kinase (JAK) inhibitors. This content is intended for counseling purposes only. Vet J 2016;207:29-37. 20. Cochet Faivre N, Degorce-Rubiales F. Clinical eosinophilic popular dermatitis associated with histological eosinophilic granuloma rapidly responsive to oclacitinib in an adult Labrador retriever. Shes on 5 pills once a day for 7 days, after that we will drop to every other day, and then see how far we can space it out. Cats have been reported to drink more water while receiving this drug and also experience be- havior changes while receiving hydroxyzine. In the past 5 years, however, oclacitinib (Apoquel; zoetisus.com), a Janus kinase (JAK) inhibitor, has become another important drug in the management of allergic pruritus. Like most treatments, this medication will not be successful in every horse, but if it does work, it avoids the risks associated with steroids. Available As Tablets For use with Canine Strengths 3.6 mg 5.4 mg 16 mg Vercelli A, Cornegliani L. Use of oclacitinib for the treatment of acral lick dermatitis in a dog: a case report. Her allergies have reared their ugly heads again - no jowl pyoderma, but ears itching. 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(5):479-e114. Vet Dermatol 2018:29:371 (abstract). It's touted as being "a fast-acting and safe treatment for the control of acute and chronic canine pruritus." Pruritus means itching. Many of these cytokines bind to cytokine receptors that have JAK enzymes associated with their cytoplasmic portion. Stay current with the latest techniques and information sign up below to start your FREE Todays Veterinary Practice subscription today. Topical suspension administered in the ear. Vet Dermatol 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 second option is serum (blood) testing. The mare luckily didnt have a lot of food allergies and eliminating flax wasnt a big deal. Cosgrove SB, Cleaver DM, King VL, et al. 27. 26. 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. Use of them does not imply any affiliation with or endorsement by them. Fukuyama T, Ganchingco JR, Bumer W. Demonstration of rebound phenomenon following abrupt withdrawal of the JAK1 inhibitor oclacitinib. Pet owners should visit ZoetisPetcare.com for product info, rewards and support. Apoquel has not been tested in dogs receiving some medications including some commonly used to treat skin conditions such as corticosteroids and cyclosporines. 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. If the horse is allergic to any of them, his immune system elicits a response, and a hive forms at the injection site. I have noticed that in general she is more comfortable on cooler days. The Janus kinases (Jaks). One of the things the trials found on using apoquel with horses is that they need a relatively small dose. The dose of APOQUEL (oclacitinib maleate) tablets is 0.18 to 0.27 mg oclacitinib/lb (0.4 to 0.6 mg oclacitinib/kg) body weight, administered orally, twice daily for up to 14 days, and then administered once daily for maintenance therapy. Dosage and administration For oral use.