Hi all,
We, like Tracy, started Kasey on the new drug called Apoquel. It is for dogs with allergic dermatitis and atopic dermatitis. It controls the itching that is produced by a specific enzyme in dogs when they have allergies - not food allergies, but environmental.

Within 2 days Kasey's itching went from 7/8 to a 1 or less! This drug is very new and the dog must get a baseline blood test before starting, another one 6 weeks later, and then every 6 months after that due to a possible side effect of an increase in liver enzymes. Most dogs do well on it and it has been studied in clinical trials for 3 years before FDA approval (whether we trust them or not!).

I would highly recommend an eval with a derma vet to talk about this drug if you have an allergy dog! It is not a cheap drug, but is a lot less than Atopica and comes with few side effects - Kasey and Tracy's dog aren't having any side effects. To give you an idea of cost here in So Ca, Kasey's dose (he weighs 87 lbs) is going to run us between $65 and $90 a month depending on which strength pill he ends up needing. But we get to stop the allergy serum, antihistamines, steroids, and mostly likely the Fluconazole (anti-yeast Rx), so we won't be paying much more than we are now.

Kasey is a new man! He has suffered with itching and rashes since he was 1 year old, he is now 7. For the first time in 6 years he is almost itch-free. He's running around acting like he's 3 again! Just wanted to spread the news in case anyone else wanted to look into it!

Lori, may I ask how long Kasey has been on the drug? I seem to remember in Tracy's thread that it worked miraculously for a couple weeks, but when they tried to reduce the dose, the symptoms came back, so his dog will always have to be on the higher dose. Is the plan to cut back Kasey's dose after a while and see how he does?

My sister has allergy/itching problems with one of her Bassett Hounds, none of the traditional treatments are helping much, and I've been telling her she needs to look into this new drug. I want to forward her all the information I can get.

Cheri, Kasey has been on it for 5 days, so yes, we're in the first 2 weeks dose. BUT, in our case Kasey is on the borderline for dosage - he could take either the one pill, or 1 1/2. We have him on the one pill, and for the 2 weeks it's one twice a day. But after he's done with the initial 2 weeks, we can try the one pill a day and if it's not enough, then he can take the 1 1/2 pill dose and still be in the completely safe margin since right now we're on the low end of dosing. That's why I mentioned it will cost between $65 and $90 a month - $90 if we have to give him 1 1/2. The vet feels pretty good about the chances that the 1 1/2 once a day will be enough since the 1 pill twice a day is working so well.

She said they will not let a dog be on double dose past that first 2 weeks due to possible liver side effects. But they do try taking that once a day dose and splitting it in half - so 1/2 pill twice a day. And that is effective in many of the dogs. This drug does not stay in the system long so if you give it twice a day they are covered longer and sometimes that's more important for some dogs than the actual amount of drug given. She said it seems to be very individual.

In their practice they have over 200 dogs on the drug at this time (since the end of December) - they were also one of the clinics who did the trial studies. Of these dogs, she said about 50-60% show 'miraculous' improvement. Of the other 40% or so, it varies in levels from quite a bit to not much. So about 75% are helped to a pretty good degree.

Lori--I am so thrilled that Kasey is having such good results! And I'm glad to know another person that can understand just what a miraculous change this drug can have in the quality of life of a dog. For us, it seemed as much like magic as medicine.

Cinco has now been on the drug for 9 weeks. I'll recap here for those that are interested, and update on our latest news.

The drug is labeled for a 2-week period of twice-a-day (BID) dosing. After that, the label dosage is reduced to once-a-day (SID). I'll use that vet Rx shorthand to save keystrokes.

After the initial BID period (which was an unqualified success--zero itching after the first dose), we reduced Cinco to the SID dosing.

At SID dosing, he had a half day of zero itching, followed by a half day of itching. The med seems to act so quickly, and the half-life is so short that it was almost like flipping a switch.

After monitoring this for 2 weeks (SID dosing), I contacted the derm vet for a report. He said we could go back to BID dosing. So we did. Again, miracle result. Zero itching. Cinco has had thin and balding patches in his hair coat his entire life--and all that hair has regrown thick and healthy. He is a different dog.

After 5 weeks being on the BID dose (at Cinco's weight the dose is 9.8 mg. of Apoquel BID)--and still no side effects, I decided it would be prudent to have some blood work done to make sure everything was still good. We had that blood work done yesterday, and I just got the results this morning.

He was tested for full blood panel, plus liver and kidney function. All came back within normal ranges. Cinco had done a similar blood panel a few months before starting Apoquel, so we had a good healthy baseline to compare to. All factors were unchanged--with the exception of a slight drop in nutrophils (white blood cells), but were still within "low normal" range, and nothing that made my regular family vet concerned. But something to watch. We're re-scheduling a follow up test in 3 months, and at that time will also check cholesterol and lipids.

We've also decided to do a titration test--to gradually reduce the dose to determine Cinco's individual "minimum effective dose." No use giving him more of the drug than is required to achieve the result. So that's where we are. We are now on day 2 of a slightly reduced dose (now 8 mg. BID instead of 9.8 mg BID). So far, so good. I've not noticed any increase in itching. So we will continue with this dose for a while, then attempt a further reduction. (This change from 9.8 mg. to 8 mg. has just cut the cost of the med in half for us, as a bonus.)

The take away here, I think, is this: this is a new drug. It has undergone the usual FDA tests (I've read all the results of them), including some testing of long-term BID dosing (up to 300-something days). Some lab dogs were even given 5x label dosing. So it seems safe. But, like Lori, I'm being pro-active about blood testing for a while, just to be sure. Most regular vets are just now hearing about this drug and know nothing about it. For now, it's really only available in the Derm Vet world.

I think with more dogs using it, and with longer term real-world data over the next few years, it will become clearer what leeway there is in dosing, and what potential effects there might be from long-term (life-long?) dosing.

Every medicine comes with a risk/benefit analysis. For now, what I have read--and now experienced--with Apoquel, it seems very positive and promising. The joy of seeing an allergy dog for the first time be completely comfortable in his skin is a miracle.

Lori, I wish you and Kasey continued success and good health!

"Every medicine comes with a risk/benefit analysis. For now, what I have read--and now experienced--with Apoquel, it seems very positive and promising. The joy of seeing an allergy dog for the first time be completely comfortable in his skin is a miracle.

Lori, I wish you and Kasey continued success and good health!"


Me too. This is one of the most exciting developments I've seen in many years.

Atopy is misery, and usually leads to bigger and badder misery.

I'm glad to hear that folks are liking the results with Apoquel. There were 2 days of talks about this medication at the meeting that I just attended--- I didn't go, but there was a huge buzz about it, with 10-15 veterinarians around the vendor at every lunch break.
It works differently than all the cortizone products, stopping "itch mediators" earlier in the cascade. Beyond that I don't know much about it, though I did overhear some bitching from one of the vets that the sizing of the tablets made accurate dosing tough (you have to break odd sized tablets in half).
Reports were miraculous results. Some vomiting initially.

Let's hope that it is as good as it looks initially. There IS miracle medicine out there--let's hope this is one!

 Quote: Betty Landercasp

I did overhear some bitching from one of the vets that the sizing of the tablets made accurate dosing tough (you have to break odd sized tablets in half).

This is a curious/annoying thing with this drug. It's available in 3 pill sizes: 16 mg, 5.5 mg, and 3.6 mg--all scored for breaking in half if needed. They break cleanly. Curious part: all the pills cost the same regardless of their size/strength. The price is set by the drug co.

So for an in-between-size dog it means buying pills of two different sizes. And tweaking the dose up or down even a little can either double the cost, or cut it in half.

But I'm not complaining. To me, it's worth whatever it costs.

There was bitching about that too -- that the pill cost was all the same, regardless of dosage.

I had my sister read this thread and had previously forwarded her some other information on Apoquel. She had Tess, her Basset Hound to the vet yesterday. Her vet is a GP, but she had definitely heard of the drug and was more than willing to prescribe it. Interestingly, the vet said one of her neighbors was a person who had been involved in the development of the drug.

My sister wasn't able to get the pills right away; the vet had to order the correct dosage. I'll post with an update when we know how it's working for her dog.

Good, I definitely want to hear!