A New Non-Steroid Treatment for Diabetic Dogs with Allergies

By Dr . Joi Sutton|2017-04-19T15:02:18-04:00Updated: April 27th, 2017|Pet Care, Pet Diabetes, Pet Newsletter|8 Comments
  • Shiba Inu Scratching Face

You know I’m always on the lookout for treatments for allergy dogs, especially diabetic allergy dogs, that don’t involve steroids. Remember that steroids cause insulin resistance amongst other unpleasant side effects. Steroids can derail a diabetic’s blood glucose regulation in a New York minute. Until recently, we didn’t have a lot of effective treatments for severely itchy diabetic dogs. We would use antihistamines, food trials, omega 3 fatty acids, avoidance of the allergen, etc. In general, veterinarians use immunosuppressive drugs if needed to give allergic dogs relief from itching and scratching. Immunosuppressive drugs include steroids and cyclosporine and more recently Apoquel.

A new drug has just been released that may help dogs with atopic dermatitis – that’s the fancy name for hay fever. This new medication works in a similar fashion to Apoquel, but it has some neat twists. Both drugs are made by the same company and affect cytokine function. Cytokines are proteins that cells use to communicate with each other, particularly for inflammation and allergic itch. Apoquel stops numerous cytokines from causing itch by inhibiting an enzyme within cells after cytokines attach to a cell. Cytopoint binds up one particular (very important) cytokine from causing itch by binding the cytokine while in circulation, preventing it from attaching to cells. Cytopoint affects just one cytokine, but it is an important cytokine for atopic pets.

Let’s talk about both drugs and how they work and how they are administered.

Last year I wrote one of these newsletters when I was all excited about Apoquel, an oral drug that helps prevent cytokines from causing itch. Unlike steroids, it does NOT cause insulin resistance, so it is a good option for allergic diabetic dogs. However, it is still immunosuppressive like steroids. And it can’t be used in dogs less than a year old. Its use is extra-label in cats, meaning the FDA hasn’t approved it for cats. Apoquel works for any kind of allergy—food allergy, atopic dermatitis, contact allergy and parasitic allergy. It blocks an enzymatic pathway and prevents cytokines from successfully signaling itch within cells. For dogs it works fast, usually within a day. For the majority of dogs I’ve given Apoquel to, it has been a wonder drug. Still, I have had a couple allergic patients who did not respond to it.

Of course most drugs have fine print. I borrowed the following paragraph from the manufacturer: “Do not use APOQUEL in dogs less than 12 months of age or those with serious infections. APOQUEL may increase the chances of developing serious infections, and may cause existing parasitic skin infestations or pre-existing cancers to get worse. APOQUEL has not been tested in dogs receiving some medications including some commonly used to treat skin conditions such as corticosteroids and cyclosporines. Do not use in breeding, pregnant, or lactating dogs. Most common side effects are vomiting and diarrhea. APOQUEL has been used safely with many common medications including parasiticides, antibiotics and vaccines.”

Cytopoint is similar to Apoquel, but it binds up the most important cytokine that causes itch in atopic dermatitis. It is a monoclonal antibody to that one very important cytokine. The antibody is made in a lab and injected into the pet. Cytopoint won’t work for food allergies nor on flea allergies. Cytopoint only works on atopic dermatitis. I see lots of atopic dermatitis patients year-round here in south Florida with all the grasses and lush plants and trees we have. In many colder parts of the country, atopy is a springtime issue. Atopic dermatitis dogs often present with an itchy face and ears and itchy underside of the dog. Atopic dogs often lick or chew at their feet. Initially owners may see a seasonal component. As dogs age, or move to Florida, they may be itchy year-round.

So when would we choose Cytopoint over Apoquel? If we know it is atopic dermatitis and want to get a pet through a flare up it is a great choice. If the pet has a serious infection, we could still use Cytopoint as it is not immunosuppressive. It’s also a great choice for atopic diabetic dogs. If you have an atopic dog who is difficult to pill, it would be dandy as it is an injection given in the vet office and it lasts for 4 to 8 weeks. It can be used with other treatments, and it has no known side effects. What an amazing idea this is. What cool science this is!!! I’ve been in the veterinary field for 30 years, and sometimes I am awed at the novel treatments researchers invent.

Have a question or comment? Post below or email me at [email protected]. I always enjoy hearing from my readers!

NOTE: Consult your veterinarian first to make sure my recommendations fit your pets special health needs.

About the Author: Dr . Joi Sutton

Dr. Joi Sutton is a 1993 graduate from Oregon State University. She has practiced both in emergency medicine and general practice. Dr. Sutton has done extensive international volunteer work though Veterinary Ventures, a nonprofit organization that takes teams of veterinarians to undeveloped countries for humane medical care. She also runs a small animal practice in South Florida. Connect with Dr. Joi on LinkedIn


  1. Lillian December 13, 2022 at 11:32 am - Reply

    How much am I expected to pay for a shot of cytopoint. My dog is on two shots of insulin a day

    • Dr . Joi Sutton December 19, 2022 at 9:07 am - Reply

      The cost of Cytopoint is dependent upon your veterinarian. There is the drug cost plus the cost of staff to give the injection. This may vary from clinic to clinic. Cytopoint is not in inexpensive medication but monoclonal antibodies are in general extremely safe and an injection can last up to 2 months. It can be given every month or 2 depending on how the pet responds. Cytopoint would have no effect whatsoever to your dog’s diabetes regulation, so if your pet has atopic dermatitis it would be a very good choice.

  2. Lauren wright January 22, 2021 at 1:34 pm - Reply

    Hi, I was just wondering my dog has been on cytopoint for about 11 months now and for the past couple of months I have noticed she has been drinking and peeing more often. I now fear that she has developed onset diabetes and I am wondering whether there is a connection between the injection and the diabetes. She is a very small yorkie. Do you think the injection could be causing it?

    • Dr . Joi Sutton January 24, 2021 at 6:45 pm - Reply

      Cytopoint is very safe and highly unlikely to cause diabetes. I make the joke that the only side effect of cytopoint is to your pocketbook as it is a princely medication. It is a monoclonal antibody other no known side effects.
      Yorkies are Very prone to pancreatitis which could cause diabetes. You should take your weenie to your vet for a full blood profile and urinalysis.
      Best wishes.

  3. Toni day March 7, 2018 at 9:31 pm - Reply

    Our Puggle has been on the Cytopoint injection for about 8 months and it has been like a miracle drug! She was just diagnosed with diabetes in December so I’m thrilled to know this is a compatible medication to the insulin she now is getting twice a day. What I’m wondering is can she build up a tolerance to the Cytopoint? She can usually go 5-6 weeks between injections but this time, I’m noticing her biting at her feet and dragging her butt very soon after getting the shot. She has always dragged her butt since she was very young. We had anal glands removed , tried everything we could to stop her from doing it. Apoquel didn’t work at all, steroids only worked short term and are bad for her. The Cytopoint worked right away and she usually goes the 5-7 weeks without any signs of itching. I am just noticing some itching signs this time. Can they build up a tolerance to this medication?

    • Dr . Joi Sutton March 11, 2018 at 8:42 am - Reply

      As a vet in south Florida where there are tons and tons of hay fever dogs, I love cytopoint. It lasts for 4 to 8 weeks and usually kicks in within 3 days of the injection.
      An itchy bum is often a sign of allergies in dogs.
      Cytopoint is a monoclonal antibody to the cytokine most important in the hay fever itch. Unless a pet forms antibodies to cytopoint (which is theoretically possible) it is unlikely that she would become resistant to it.
      I’m so glad she is doing well. (I have a deep affection for puggles in general!)
      🙂 Joi

  4. Chelsea Harvey May 25, 2017 at 4:58 pm - Reply

    Awesome read! My vet mentioned this I think we will try it my 14 year old Shih-tzu was diagnosed 3 months ago with diabetes and to think he could go 4-8 weeks pill free is a dream! Thanks!

    • Dr Joi June 7, 2017 at 7:13 am - Reply

      You are very welcome. Nonetheless, the thanks would go to researchers and cool modern medicine! 🙂

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