The Itchy Dog, Part 3: Taking the Stress Out of Fall Allergies

By Dana Liska, DVM, DACVD

Reading Time: 6 minutes

The joy of fall! he sun rises a little later and sets a little earlier, temperatures start to drop, and the ragweed pollen counts skyrocket. As people and pets spend time outdoors together, dogs are exposed to environmental allergens. Fall allergies to environmental allergens lead to itchy skin, a condition called atopic dermatitis. The uncomfortable skin sensation leads to licking, rolling, rubbing, and chewing, which may contribute to stress¹ as well as physical discomfort.

Do you live with an itchy dog?  Here are tips for dogs with allergic dermatitis:

1. Make an appointment with your dog’s veterinarian to stop the itch.

Have you received advice from family, friends or neighbors about how to help your itchy dog? Have you searched the internet for remedies for itchy dog therapy? Have you spent time searching the shelves of your local pet store for over-the-counter therapy for your itchy dog? You are not alone! We know from market research that 88% of pet owners have tried up to 15 at-home itch treatments before bringing their dog to the veterinary clinic.³ Just like you, those pet owners hope their veterinarian will have something better to offer than what they have tried before. What pet owners like you really want are therapies that are truly effective and work fast.

2. Antihistamines aren’t for itchy dogs.

Numerous medical papers have proven antihistamines are not effective for treating moderate to severe itch in most dogs.^4-13 A recent study followed dogs with atopic dermatitis where one group was administered Zyrtec and the other group received placebo (the equivalent of sugar pills) for two weeks; there was no difference in outcome between the two groups. In other words, the antihistamine had no effect on atopic dermatitis.⁴ Another recent publication supports oral steroids as likely to improve clinical signs of dogs with severe or extensive atopic dermatitis.¹⁴ We know that over 55 percent of dogs experience unpleasant side effects while taking a steroid.¹⁵ The most common side effects include increased hunger and thirst and excessive urination.

The key is getting your dog on a path that provides effective and sustainable therapy for allergies to decrease the stress that may be linked to your dog’s allergic skin disease¹. Two options to help manage allergic skin disease are APOQUEL® (oclacitinib tablets) and CYTOPOINT®. APOQUEL® and CYTOPOINT® target specific cytokines important in the allergic disease process. Targeting allows for optimal efficacy.

• APOQUEL® is a medication your dog takes by mouth which controls itch and inflammation associated with allergic and atopic dermatitis.  APOQUEL® has a rapid onset of efficacy starting within 4 hours¹⁸ and is out of the system in 24 hours or less.²⁴ This makes it ideal for stop and start itch control to see how your dog is doing throughout the fall. The most common side effects of APOQUEL in short term clinical studies were vomiting and diarrhea.²⁰
• CYTOPOINT®, by contrast, is an in-office injection, which has been shown to be effective for the treatment of dogs against allergic dermatitis and atopic dermatitis.^{21, 23, 25}  CYTOPOINT® begins to relieve itch within 24 hours and lasts for 4 to 8 weeks, giving the skin time to heal.²⁵  The most common side effects include lethargy and vomiting.²³ Your veterinarian can help you decide which therapy is best for your pet’s needs.

3. Put the treat into treatment.

Consider the behavior of your dog when discussing therapy options with your veterinarian.  Does your dog express anxiety when taking oral medications?  Condition him or her to take a small treat first, then a second treat hiding the APOQUEL®, finally receiving a reward with a third treat to celebrate.  Your veterinarian may be able to further reduce your dog’s anxiety and stress of taking oral medications by giving a CYTOPOINT® injection for the itchy skin in office to avoid problems surrounding medication time all together.  CYTOPOINT® is an excellent choice of therapy to reduce the burden of owner compliance for dogs already receiving other medications. Use a distraction technique like a special yummy treat when you pet receives the CYTOPOINT® injection.  For those patients who fear injections, travel or visits to the veterinary clinic, and are still learning how to overcome those fears, APOQUEL® given at home may be the best option.  Remember you are not alone!  Your veterinarian can provide real relief for your dog’s itchy skin. Your dog deserves comfort. You deserve peace of mind.

4. Learn more about canine itch at www.itchingforhelp.com and see your veterinarian for a skin health exam!

APOQUEL Indications: Control of pruritus associated with allergic dermatitis and control of atopic dermatitis in dogs at least 12 months of age.

Important Safety Information for APOQUEL:  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.

See full Prescribing Information at https://www.APOQUELdogs.com/APOQUEL_pi.pdf

CYTOPOINT Indications: CYTOPOINT has been shown to be effective for the treatment of dogs against allergic dermatitis and atopic dermatitis.

References:

1. Park SH, Kim SA, Shin NS, Hwang CY. Elevated cortisol content in dog hair with atopic dermatitis. Jpn J Vet Res. 2016 May;64(2):123-9
2. Zoetis data on file, 2018. Secret Shopper Study, C-Space 2018
3. Hsiao YH, Chen C, Willemse T. Effects of cetirizine in dogs with chronic atopic dermatitis: a randomized, double blind, placebo-controlled trial. J Vet Sci. 2016 Dec 30;17(4):549-553.
4. Eichenseer M1, Johansen C, Mueller RS. Efficacy of dimetinden and hydroxyzine/chlorpheniramine in atopic dogs: a randomised, controlled, double-blinded trial. Vet Rec. 2013 Nov 2;173(17):423.
5. Wildermuth K1, Zabel S, Rosychuk RA. The efficacy of cetirizine hydrochloride on the pruritus of cats with atopic dermatitis: a randomized, double-blind, placebo-controlled, crossover study. Vet Dermatol. 2013 Dec;24(6):576-81
6. Scott DW, Miller WH Jr, Cayatte SM, Decker GA. Failure of terfenadine as an antipruritic agent in atopic dogs: results of a double-blinded, placebo-controlled study. Can Vet J. 1994 May;35(5):286-8.
7. Hansson H, Bergvall K, Bondesson U, Hedeland M, Törneke K. Clinical pharmacology of clemastine in healthy dogs. Vet Dermatol. 2004 Jun;15(3):152-8.
8. Zur G1, Ihrke PJ, White SD, Kass PH. Antihistamines in the management of canine atopic dermatitis: a retrospective study of 171 dogs (1992-1998).  Vet Ther. 2002 Spring;3(1):88-96.
9. Scott DW1, Miller WH Jr. Nonsteroidal management of canine pruritus: chlorpheniramine and a fatty acid supplement (DVM Derm Caps) in combination, and the fatty acid supplement at twice the manufacturer’s recommended dosage.  Cornell Vet. 1990 Oct;80(4):381-7.
10. Cook CP, Scott DW, Miller WH Jr, Kirker JE, Cobb SM. Treatment of canine atopic dermatitis with cetirizine, a second-generation antihistamine: a single-blinded, placebo-controlled study.  Can Vet J. 2004 May;45(5):414-7.
11. Scott DW1, Miller WH Jr. Antihistamines in the management of allergic pruritus in dogs and cats. J Small Anim Pract. 1999 Aug;40(8):359-64.
12. DeBoer DJ, Griffin CE. The ACVD task force on canine atopic dermatitis (XXI): antihistamine pharmacotherapy.  Vet Immunol Immunopathol. 2001 Sep 20;81(3-4):323-9.
13. Olivry T, DeBoer DJ, Favrot C, Jackson HA, Mueller RS, Nuttall T, Prélaud P; International Committee on Allergic Diseases of Animals BMC Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA). Vet Res. 2015 Aug 16;11:210.
14. Data on file: Pet Owner Quantitative Market Research, 2016, Zoetis LLC
15. Cosgrove SB, Cleaver DM, King VL, Gilmer AR, Daniels AE, Wren JA, Stegemann MR. Long-term compassionate use of oclacitinib in dogs with atopic and allergic skin disease: safety, efficacy and quality of life. Vet Dermatol. 2015 Jun;26(3):171-9.
16. Little PR, King VL, Davis KR, Cosgrove SB, Stegemann MR. A blinded, randomized clinical trial comparing the efficacy and safety of oclacitinib and ciclosporin for the control of atopic dermatitis in client-owned dogs. Vet Dermatol. 2015 Feb;26(1):23-30
17. Gadeyne C, Little P, King VL, Edwards N, Davis K, Stegemann MR. Efficacy of oclacitinib (APOQUEL®) compared with prednisolone for the control of pruritus and clinical signs associated with allergic dermatitis in client-owned dogs in Australia. Vet Dermatol. 2014 Dec;25(6):512-8.
18. Cosgrove SB, Wren JA, Cleaver DM, Walsh KF, Follis SI, King VI, Tena JK, Stegemann MR. 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. Vet Dermatol. 2013 Dec;24(6):587-9
19. Cosgrove SB, Wren JA, Cleaver DM, Martin DD, Walsh KF, Harfst JA, Follis SL, King VL, Boucher JF, Stegemann MR. Efficacy and safety of oclacitinib for the control of pruritus and associated skin lesions in dogs with canine allergic dermatitis. Vet Dermatol. 2013 Oct;24(5):479-e114.
20. Michels GM, Walsh KF, Kryda KA, Mahabir SP, Walters RR, Hoevers JD, Martinon OM. A blinded, randomized, placebo-controlled trial of the safety of lokivetmab (ZTS-00103289), a caninized anti-canine IL-31 monoclonal antibody in client-owned dogs with atopic dermatitis. Vet Dermatol. 2016 Dec;27(6):505-e13
21. Moyaert H, Van Brussel L, Borowski S, Escalada M, Mahabir SP, Walters RR, Stegemann MR.A blinded, randomized clinical trial evaluating the efficacy and safety of lokivetmab compared to ciclosporin in client-owned dogs with atopic dermatitis. Vet Dermatol. 2017 Dec;28(6):593-e145
22. Souza CP, Rosychuk RAW, Contreras ET, Schissler JR, Simpson AC. A retrospective analysis of the use of lokivetmab in the management of allergic pruritus in a referral population of 135 dogs in the western USA. Vet Dermatol. 2018;29:489-e164.
23. Collard WT, Hummel BD, Fielder AF, King VL, Boucher JF, Mullins MA, Malpas PB, Stegemann
24. The pharmacokinetics of oclacitinib maleate, a Janus kinase inhibitor, in the dog. J Vet Pharmacol Ther. 2014 Jun;37(3):279-85.
25. Michels GM, Ramsey DS, Walsh KF et al. A blinded, randomized, placebo-controlled, dose determination trial of lokivetmab (ZTS-00103289), a caninized, anti-canine IL-31 monoclonal antibody in client owned dogs with atopic dermatitis. Vet Dermatol. 2016;27:478-e129.
26. Data on file, Study Report No. C863R-US-12-018, Zoetis Inc.

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

This article is brought to you in collaboration with our friends at Zoetis Petcare.ZPC-00377