2018 Update

So much to cover!

We recently moved from Georgia to Oregon, and Gidget’s CD (chronic dermatitis) reduced exponentially. We have started her on CBD oil, and the goal (working with the Vet) is to wean her off Apoquel completely by the end of the year.

As of July 2018, Gidget has shown no side effects from Apoquel and continues to have perfect full blood panels 🙂

 

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One Year Review.

Welcome to some of the new readers. Thank you to persons who have offered recommendations on other things to try; however, if you notice one of our very first posts, you will see everything we tried, most of which is continuing to be recommended as “alternate treatments” in order to earn money for link clicks. Please don’t do that.

It has been almost a year since we updated the blog. We’ve had some good and bad times. I will go over Apoquel and its effects on Gidget in a year.

Apoquel still works…sort of. For us, it has its downfalls such as the continued limited supply as well as causes ear irritation. We work on this by attempting to keep Gidget’s ears as clean as possible using Veterycin Ear Rinse and Zymox Ear Rinse, interchangeably. However, this does not always work 100% of the time. It seems as though Apoquel may promote excessive ear wax production and irritation even when a dog is on quality, grain-free, low starch kibble (or raw.)

I have not seen the allergy reports for our area in north metro Atlanta this year, but allergies this Spring have been particularly difficult for Gidget. She goes outside and comes back in, and her eyes have gunk pouring out of them, she itches her muzzle and sneezes, and she becomes generally itchy all over. I use a damp soft cloth and wipe her eyes clean as well as around her muzzle and body. When I took her to the vet for her monthly pedicure, they pointed out that she had been licking (when we’re not home) her paws that could lead to an infection around the nail bed. They said…..”caused by allergies.” We started soaking her paws in a betadine/epsom salt soak prior to her baths every night.

While Apoquel helped her in the beginning, it seems as though it’s not working 100% as it had a year ago. Because of this, we’ve decided to try to wean her off of Apoquel (after discussing with the vet) so that her one month supply lasts two months. We can give her a daily dose when allergies are at its peak.

Something we have done that HAS worked for her:

Zymox. We purchased Zymox anti-itch shampoo (just the conditioning shampoo) and Zymox conditioning rinse. Prior to Zymox, we had purchased a $30 bottle of shampoo at the vet’s that contained chlorhexidine. It requires bathing and then bathing again and waiting 10-15 minutes before rinsing. It worked the first time; however, the next few times after her bath, she would scratch briefly after her bath, and be okay for a day. By the next day, she needed another bath as you could feel the sticky (and stinky) yeast grime rising from her skin. Her skin would be pink by the next day.

With Zymox, we bathed her the first time. Then I used the conditioning rinse on her. I didn’t realize what the consistency was so I put it on, and it was like hair conditioner. I rinsed it off even though the instructions say you can put it on straight or cut it with water and use it as a leave-in. You can also use the conditioner to “spot treat” areas. Her skin remained white/pale/tan whatever you want to call it; it wasn’t red. We now bathe her every other day or every two days (even every three days.) I dry her off after rinsing her shampoo. Then I use the conditioning rinse and rub her down with it before letting it dry. It does not feel greasy, and it leaves no residue. In between baths, she gets wipe downs and conditioning rinse. Some people have noted that the conditioning rinse’s fragrance is “too strong.” However, we do not find it unpleasant. When she is out of the bath, she is not itchy. She has gone back to hopping in the tub on her own, and when I turn on the light in the guest bathroom (where she is bathed,) she comes walking into the bathroom to wait for me to get ready.

Because we’ve made a full circle with Apoquel (from wonder drug back to square one,) that is why we will be reducing her to every other day and up’ing baths/conditioner with Zymox. Hopefully this will limit the amount of ear irritation she has as well.

APOQUEL: Gidget’s Case Study – Just shy of three months

This is our three month update on Gidget’s APOQUEL usage.

Remember in the beginning when I said her ears were still bothering her, and the Vet said her ears were clear? Both dogs had their annual check up at the beginning of June, and Gidget’s ears were still bothering her to the extent of scratching at them, causing alopecia on the tips of her ear flaps. After doing more investigation into ALL side effects seen during the trial phase of the APOQUEL testing, “ear irritation and infection” was listed as one of the side effects shown. Unfortunately, that means that while Gidget’s overall coat and skin have cleared up with Apoquel, she will continue to have ear irritation issues until a remedy can be found for that. Right now, we are using a topical Gen-spray for her ear flaps, and we are ensuring her ears remain clean and relieved with the Vetericyn Ear Rinse.

Also during her annual check up, she had a full blood panel drawn up to check liver and kidney function after being on Apoquel for eight weeks. We are happy to say that the Vet called back and said that Gidget had some of the best and cleanest blood panel results they had ever seen, and she (Vet) wished HER blood panels looked as good as Gidget’s. We will continue to monitor her liver/kidney function with another blood panel at the six months and twelve months usage mark.

Other than that, she is doing great on Apoquel at a 10.8 mg dosage/daily. We give her 10.8 mg in the evening, and I can say it is right on spot for the correct dosage. By hour 23 and 45 minutes, I can tell that the Apoquel is wearing off as she gets itchy. However, being a smart girl, she no longer makes contact with her body when she is itchy around that mark (she can tell time, too.) She will lift her leg to itch her side but come about 4 inches shy of making contact.  She just “crawls” her skin. We have learned that Zoetis, again, is having a supply issue with Apoquel, but the supply issue is for new patients/clinics, and [supposedly] not for existing patients already using Apoquel.

Something I should mention, again, is that Apoquel is seemingly a miracle drug for people who know what their dogs’ triggers are or for pets currently undergoing allergy testing to determine the triggers. Apoquel does not attack the allergen. It acts as a form of immunosupressant so as not to cause the body to react so violently to the allergens. We know Gidget’s triggers, but unfortunately, unless we want to keep her in a bubble when she goes outside, we are limited to what we can do to help prevent a reaction. Apoquel complements what we currently do to control the allergens from really wreaking havoc.

APOQUEL: Gidget’s Case Study – First Month summary

I’ve been behind in posting Gidget updates.

We completed the first two weeks of Apoquel with Gidget. At that time, she was taking Apoquel twice a day. After two weeks, she got moved to once a day Apoquel. For the first day or two, she was “okay” with itching. By the third and fourth days, she was okay with itching during the day, but by around 5pm, she was itching. Granted, she wasn’t itching as much as she had without Apoquel, but her skin was crawly in the evenings.

Her skin is healthy and healing in parts that were damaged from her scratching, and hair has grown back over alopecia spots.

I will post a photo this evening of her as a one month update.

We have a call into her Vet to see what dosage she wants to do for Gidget since the once-a-day will not work for her. I will update this post when I hear back from the Vet.

All in all, still very impressed with Apoquel.

APOQUEL : Gidget’s Case Study – Day 9, 10, 11

We haven’t had a whole lot to report.  Gidget is still doing well.  Recently, she’s had two reddish spots form under her neck under her fur.  They look more like bug bites or a rash, not itch-related as she hasn’t been itching.

Here is a photo of her today.  Notice the redness missing around her eyes, and her hair still growing in around them.

Have a Happy Easter! Tomorrow the K-9 Kiddos get an Easter Egg Hunt in the backyard (plastic eggs filled with grain-free, yummy dog treats.)

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APOQUEL: Gidget’s Case Study – Day 8

Today marks day 8 of Gidget being on Apoquel.  Still doing great.  I don’t really have any sort of observational updates, but here are some updated photos to compare to earlier photos.

Top to bottom: 1. As you can see, this is Gidget’s side that, earlier, had thinning hair.  Her coat is already growing back, and her skin is great. 2. The hair around her eyes is growing back, and the redness is no longer present. 3. The thinned area on her shoulder is growing back.
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APOQUEL: Gidget’s Case Study – Day 6 and 7

Gidget is still doing well on Apoquel.  She has settled down and sleeps normally.  We have noticed that her recovery time/healing process has been a lot faster than just her prednisone/antibiotic treatments in the past. 

Already on Day 7 her coat and skin are softer and healthier, the dry skin behind her ears and around her eyes has healed, and hair has already started growing back on thinning spots that were originally caused by her scratching. 

She has not shown any signs of itching or discomfort since starting Apoquel.  She is still on her initial dose for another week (2x day) before she drops down to her next dose (1x day.) She is A LOT more active and playful and seemingly happy – probably because she isn’t miserable. 

Her bowel movements are the same: softer, but she has another week of antibiotics to go as well.  

Her appetite and water intake have been normal.  

Her ears are still causing her to shake her head in the morning, but after a rinse with Vetericyn, she seems to be okay. I believe her ear issues are not correlated to the allergies that are being tackled by Apoquel.  We here in Georgia have off the charts pollen counts, and I think the pollen is entering her ear canal when she is outside, causing a slight build up.  Her ears are not stinky or gunky as would be conducive to yeast issues, and her Vet said they were clean in her inner ear with no signs of infection present. We will continue to clean with Vetericyn Ear Rinse and will take a soft cloth with Vetericyn to do a more thorough cleaning tonight. 

I will post clear and updated photos this evening of her progress. 

APOQUEL: Gidget’s Journey – Day 4 and 5

I don’t know if restless sleep is considered a side effect or whether Gidget’s irregular sleep pattern was based on the fact that she hadn’t gotten a full night’s sleep with her allergies.  I do believe it’s the latter as for the past two night she has slept to or close to my alarm so we will rule that out as a potential side effect.

Still no itching caused by allergies.  She did shake her head yesterday morning, and we did a Vetericyn ear rinse, as usual, and last night I heard her itching her ears.  The Vet said they are clear so it must be the horrendous pollen we are having here in metro Atlanta, Georgia.

Eating, drinking, and pottying normally.  Her stool is still soft, but, again, she is on antibiotics for at least another week.  They still aren’t in an area to be concerned about them.

Her skin is healing, and her fur is already starting to grow back (merely because she hasn’t been itching them.)

She is acting like a different dog…in a good way.  She is more energetic and playful with our other pooch due to not being miserable from her allergies.

Day 4 existing hair loss image:

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APOQUEL: Gidget’s Case Study – Day 3

It hadn’t even occurred to me that the softness of Gidget’s stool last night could be caused from her antibiotics. Had I put two-and-two together from her previous antibiotics experience, it would have “clicked” a lot faster than this morning.  Luckily, she is on her probiotics/prebiotics/enzymes so I don’t foresee the softer stool being a continued issue for her. If it continues long after she has completed the antibiotics, then I will discuss with the Vet about it since gastrointestinal discomfort is a very small chance side effect of Apoquel.

3:34 a.m. (again, like clockwork) Gidget woke up and came into the bedroom.  I don’t know if it’s because she HAS to potty, or if she’s still not used to sleeping the whole night without itching and is used to a handful of hours worth of sleep. Just to be safe, I took she and our other dog out to potty.

5:45 a.m. Woke up to find a very energetic and happy Gidget.  She was shaking her head a bit more (3x in the matter of 20 minutes.) I did not do her ear rinse last night but will do it tonight as it relieves her issues.  When the Vet checked her ears at her appointment the other day and said her inner ear was clear with no infection, no gunk, etc. and thought the head shaking and scratching was just due to minor irritants, like pollen, in her ear.
Fed her breakfast along with her antibiotic, Apoquel, and Microflora Plus.  She went out to potty one more time, and then she jumped up in her bed on the couch. I am still able to pet her and scratch her all over without any issues. I ran my fingers along her back and sides which normally would have triggered crawling skin and itching, but I got nothing but a tail wag.

 

APOQUEL: Gidget’s Case Study – Day 1 and 2

Here is the real meat of this blog: APOQUEL and skin allergy issues.

I will create a post describing Gidget’s skin issues, tried and failed treatment methods, etc., but for now, I’d like to introduce you to the Gidget Case Study on Apoquel.

This Winter, Gidget’s skin issues were not terrible. They were not good, but they were not terrible either. In the month of March here in Georgia, the tree pollen starts kicking things up a notch.  Everything is coated in yellow pollen powder.  It was as if a light switch had been flipped and BOOM! One day, Gidget’s itching became intense.  I called the Vet at Animal Medical and Surgical Center in Canton, Georgia, and I made an appointment for Gidget to see her.  At this time, I had already been reading about Apoquel. Within a matter of a week and a half from her appointment (my husband and I both work full time so we were controlling her itching the best we could until we got her to the Vet on my husband’s next day off,) behind her ears were raw, and she had scratched two thinned hair patches on either shoulder and her side. She was also shaking her head though we rinsed them with Vetericyn Ear Rinse.

I gathered my information together, and my husband took Gidget into the Vet’s office. I told him that I REALLY wanted to try Gidget on Apoquel based on what I had read about the drug (FDA approves new drug ; Apoquel .) A few things stood out to me about Apoquel over other therapies:

1. The propensity for dogs to have gastrointestinal issues was not as high as Atopica (cyclosporine.)
2. Apoquel had results seen within four hours of the first dose.
3. A dog’s itching was reduced to “normal” itching after 24 hours (i.e. a dog that has a random itch behind its ear.)
4. It does not have the same side effects as prednisone as it is not a steroid and does not work the same way (i.e. panting, excessive thirst, excessive urination and, in Gidget’s case, unable to control her bladder even with taking her out on the hour.)
5. 1/2 to 1/3 less the monthly cost of Atopica (even the generic cyclosporine)
6. Can be given with/without a meal.

But with any drug also comes downsides:

1. There was a shortage that was later determined to be a packaging shortage shortly after this miracle drug’s release. Some Vet’s offices still have a limited supply.
2. There haven’t been any case studies weaning dogs off of Apoquel to an every-other-day type of administering of the drug.
3. POSSIBLE gastrointestinal issues.  Continuing to give Apoquel saw a reduction and end of this distress in those affected. (Gidget is on Herbsmith Microflora Plus Prebiotics, Probiotics, Enzymes so we didn’t foresee this being an issue.)

The Vet proceeded to give Gidget an exam. I was not there so I am relying on my husband’s info and the results.  No ear infections – just itchy from skin issues. The Vet was 100% on board with starting Gidget on Apoquel; so she did.  The Vet would like for us to do our own case study (see this blog?) with photos to document progress.  She said she has a few dogs in her practice on Apoquel now including a dog with allergies worse than Gidget to the extent that the poor pooch had “elephant skin.”  Fortunately, this drug worked for the dog, and her skin and coat started to grow back. We agreed.

Day 1:
Gidget has been started on the “high dose” of Apoquel twice a day for fourteen (14) days.
After fourteen (14) days, Gidget will have Apoquel once a day, and we will go from there.
For her first month of Apoquel (in this case, measured at 28 days,) it cost around $94. That is half of generic cyclosporine (quoted by current Vet) and 1/3 of Atopica from what we were quoted by a former Vet.
We gave Gidget her first dose of Apoquel with her meal at 4:45 pm.
By 7:17 pm, we had a dog whose itching had STOPPED, but she still continued to lick her paws and chew on her legs a bit due to itchiness. We could rub and pet her like a normal dog.  No crawly skin.  No itching.

Morning of Day 2: Gidget slept the entire night through without itching.

Day 2:
I had a very happy dog this morning.
I took her out to potty: normal bowel movement and urination.
I gave her her food with Apoquel in it along with her antibiotic and Microflora Plus.
I was still able to pet, scratch, and rub her. This is a HUGE step for us since we couldn’t touch her anywhere but the top of her head without her skin crawling.

When I came home in the later afternoon, I was greeted by a very happy Gidget.
No accidents in the house of either urine or feces.  With prednisone, I would always expect a urination accident even with my husband scooting home to take her out to potty on his lunchbreak.
I took her outside: normal urination, slightly softer defecation but not loose by any means.
Normal water intake.
Still…no itching.  I am able to pet her like a normal dog.
No more head shaking.
Her skin behind her ears and in other raw spots are starting to heal already.  They are not bright red. They are a very light pink.

Tonight I will give her a bath because her skin is dry from her itching earlier this week, and I will do a Vetericyn Ear Rinse on her as well since the pollen is ROUGH.

I hope to continue these positive updates.

Day 2 photo:
Hair loss around eyes, ears, shoulders.
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** There are active links in this blog post for items we use or feed as well as Apoquel information.  They will open in the same window.