I get some great questions from clients. They inspire me with article ideas and keep me in tune with diabetic pet owners. I enjoy interacting with our readers, and sometimes the questions are worthy of a newsletter. I bet if one person has this question and takes the time to write me, there are likely lots of folks with a similar question. Let’s jump right in and talk about helping this itchy puppy!

Question: My dog, Katie, is going through that yearly scratching and licking phase. She is now taking Apoquel as she has had steroid shots already. My vet doesn’t want to keep giving her the steroid shots, so we have her back on Apoquel. It’s been a couple of weeks now and we haven’t seen an improvement. Now she is starting to howl because of the itchiness. How long should I keep her on the medication and what is the absolute amount she can take daily?

Answer: I’m assuming your pet is NOT a diabetic. It would be very unlikely that your veterinarian would give a steroid injection to a diabetic pet. I point this out as most of our newsletter readers have diabetic pets. Steroids are a known cause of insulin resistance, so we try especially hard to avoid steroids in diabetic pets.

Now, if Apoquel worked in the past and suddenly is not, there may be a secondary infection. You should take her to the vet to rule out infection. Typically vets will do a swab of the skin or tape prep cytology to look for yeast and bacteria under the microscope. Infections cause itch despite great drugs like Apoquel and Cytopoint. Sometimes simply taking care of an infection can alleviate the itch.

If it really is a seasonal allergy, there is a good chance it is atopic dermatitis (aka hay fever). I won’t give dosing advice as I’ve never examined your pet, but there is a brand new product out that works similarly to Apoquel and can be used with Apoquel for hay fever. Apoquel works within cells to prevent cytokines (messenger proteins in the body) from causing itch. Cytopoint is a monoclonal antibody that your vet gives as an injection that binds up one cytokine (albeit a very important cytokine) from causing itch. Cytopoint latches onto the cytokine extracellularly. And it is quite safe.

When she is itchy, do give her a bath. Bathing is very holistic and can really cut the itch. Use a non-drying shampoo like an oatmeal shampoo.

Also, let’s not forget the beauty of antihistamines. I’m a fan of Zyrtec which comes in an over the counter generic, cetirizine. It causes minimal drowsiness. If she is howling, get her back to your vet promptly to search for infection and to re-evaluate the game plan. At night time, consider the antihistamine, Benadryl (aka diphenhydramine), as it is known to cause drowsiness and can help her to sleep through the night.

Is she on omega 3 fatty acids? Fish oils have a subtle effect in the short term, but are definitely an aid for long term allergy management. And of course allergy testing is another option. Allergy testing has come a long ways in the last few years. Your veterinarian can pull her blood and send it to the lab which can test her for antibodies to various pollens and grasses and trees in your geographic region.

If the seasonal allergy occurs in warmer months, then we have to consider flea allergy. Parasites happen! Part of a good physical exam is to look for fleas or other parasites that are too small to be seen with the naked eye such as mites.

Have a chat with your vet and keep me posted!

Have a question or comment? Post below or email me at joi.suttondvm@adwdiabetes.com. I always enjoy hearing from my readers!


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

Dr . Joi Sutton

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 and is the President and Founder of 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.
Dr . Joi Sutton

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