For years veterinarians have used steroids to treat pet allergies. We put on our detective caps to try to figure out if the allergy is from fleas, from food, or due to atopy (aka hay fever). We eliminate any possible source of allergies. We treat the treatable. We use flea meds. We try antihistamines. We institute bathing regimes. We add in omega-3 fatty acids. And we might even try elimination diets or test the pet for specific allergic triggers like grasses and pollens and such. Nonetheless, when a flare up occurs we typically reached for steroids when we need a “rescue” medication.
A vet would really need to be in a tough spot to give steroids to a diabetic dog or cat. Steroids are notorious for causing insulin resistance. I’d rather walk through a snake pit than give steroids to a diabetic pet. Well, that’s a touch dramatic, but you get my point. Luckily there aren’t too many snake pits in my neighborhood!
Thankfully, we now have two rescue drugs for allergy flare ups! Zoetis initially launched Apoquel 2 years ago but then it went on back order. It was so eagerly anticipated that the company couldn’t keep up on production. Little vet clinics like mine didn’t actually get the drug until last year. Even now, I’m only allotted 2 bottles of 2 of the sizes each month. I still only have a handful of pets on the drug because it would be just plain mean to start a pet on the drug then run out! I initially told my clients who got it from not to tell my other clients that they got it from me since I had such a limited supply. I reserved it for only my itchiest patients!
Pets who respond usually respond quickly if it is going to work. It has peak plasma concentrations in an hour. Several of my clients with itchy pets have told me it is a “miracle” drug! And yet I have one patient that didn’t seem affected by it at all. If it doesn’t work, we should double check that there isn’t a complicating factor like an infection or parasites such as fleas or mites. Apoquel works for allergic dermatitis but it won’t fix an infection! It’s not a guaranteed fix either. You just don’t know unless you try. One of my clients who calls it a miracle drug has been battling her senior boxer’s allergies for most of the dog’s life.
What are the other potential side effects? Well, it’s immunosuppressive. Alas, the immunosuppression is what we are after for allergies. After all, an allergy is hypersensitivity to something. We don’t want the pet’s immune system to overreact and cause itchy skin or respiratory issues. And yet, we can’t just suppress the immune response to just that one trigger. Using an immunosuppressive drug is a double edged sword! So, if your pet has a serious infection we might not choose Apoquel. There is also fear that it could exacerbate some types of cancer. And, it can definitely cause tummy upset. The manufacturer of Apoquel warns higher risk of pneumonia and demodex for pets taking is med. If your pet has side effects, the good news is that the half-life is 4 hours and it will essentially be out of the body in 24 hours.
Let’s chat a bit more about its immunosuppressive qualities. You can expect a higher risk of urinary tract infections for a diabetic pet in general due to sugar in the urine. (Bacteria find sugary pee a cozy place grow.) Add in an immunosuppressive drug and the risk obviously increases.
Wash your hands after handling Apoquel. This just makes sense. Don’t be afraid of handling the pill, but wash your hands afterwards so you don’t potentially touch your mouth or face and possibly absorb some of it yourself.
There is still a lot to be learned about Apoquel. Have you ever been watching television and seen a commercial asking if you or a loved one suffered ill effects from a certain medication? Obviously some medications pass FDA approval and only later other side effects are revealed when the med is used on a larger population of patients. Nonetheless, I’d rather use Apoquel than a steroid to alleviate the itch of a diabetic pet.
What about cats? As a cat lady I’m often irked that drug companies don’t often get FDA approval for kitty cats. It’s about the buck. I get it. Nonetheless, I am thrilled when a drug company shells out the clams to get FDA approval for our feline friends. As a vet who has been around a long time, I’m usually happy to opt for a generic medication for my patients, but when a pharmaceutical company spends time and money to run studies on our feline friends, I do my best to support the product. Apoquel is not currently FDA approved for cats, and there is minimal data for its use in cats. I personally haven’t used it on a cat to date, but I don’t give up hope that the company invests in research so that it may be FDA approved in cats in the future.
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NOTE: Consult your veterinarian first to make sure my recommendations fit your pets special health needs.
My cat became diabetic from a cortisone (steroid) shot for allergies when he was only 5! Now he is 12 and has been successfully treated for both diabetes and his allergies using atopica, which s a pill.
Cyclosporine is a great choice for a diabetic cat with hay fever! Good job!
What about over the counter human meds? I occasionally give Annie (20 pound, 15 years old, 8 years diabetic, Lhasa Apso) a 25mg diphenhydramine (Benadryl) if she seems to be affected by allergies.
Benadryl is helpful for hay fever! It can cause drowsiness so I often instead choose (for antihistamine options) Zyrtec, but if Fluffy is keeping you up at night it sure helps for everyone to get some sleep!