Apoquel

Oclacitinib

Immune modulator
(Apoquel)
By Dr. Karen Burgess

Apoquel

Tablets

What is Apoquel used for?

Apoquel is labeled for the treatment of itch associated with allergies.  It is in general a very effective tool in the management of allergies for pets.  There are many other immune modulatory uses for Apoquel that are being discovered daily.  Apoquel begins controlling itch within four hours of administration and can be used short or long term safely.

What is Apoquel?

Apoquel is an inhibitor of a specific mediators of inflammation, JAK1 and JAK3(Janus Kinase).  JAK1 is one necessary component in the cascade of events that lead to an allergic response, typically “itchiness” and inflammation in dogs.  By using Apoquel this process can be safely interrupted.

How is Apoquel given and what if a dose is missed?

Apoquel is typically prescribed for once daily dosing after an initial two week course of twice daily administration.  If a dose is missed and it is less than 12 hours late, go ahead and give the missed dose.  If it is within 12 hours of the next dose, skip a dose and resume regular schedule with the next dose.

Are there any side effects associated with Apoquel use?

In rare instances pets may experience vomiting, diarrhea, loss of appetite, or lethargy.

Who should not take Apoquel?

Apoquel should not be taken by pets being given immunosuppressive or immunomodulatory drugs.  Examples of this include prednisone and cyclosporine.  Apoquel is not approved for animals less than one year of age, pets with cancer, or generalized demodex infections.

What follow up is necessary with Apoquel use?

Laboratory work should ideally be done prior to use and then annually thereafter.

Anal Sac Disease, Canine

Anal Sac Disease

By Dr. Karen Burgess

Why do pets develop anal sac disease?
It is unknown why our domesticated pets have anal sac issues.  It may be related to breed, weight, or underlying skin disease (the anal sacs are lined with cells similar to the skin).  Diarrhea or low fiber diets may also contribute to disease.

What are symptoms of anal sac disease?
Pets with anal sac disease often will scoot their bottoms or lick excessively at their anus.  In some pets the material in the anal sacs will become impacted or “plugged”.  The fluid in these cases is often thicker than usual contributing to swelling, blockage, and eventual infection.  With complete blockage, the anal sac can rupture through the skin near the anus leaving a large open wound or matted fur near the anus.  Pets with severe infection may show signs of general illness including lethargy, painful defecation, and anorexia.  If you suspect your pet has an anal sac abscess do not attempt to handle their back end as they may unintentionally bite due to pain.

How is anal sac disease treated?
An isolated episode may only require manual expression of the fluid in the anal sac.  This can be done externally but is more effectively accomplished by a trained professional rectally.  In cases of impaction or abscess, wound care (cleaning, flushing) with sedation is often necessary along with oral antibiotics, anti-inflammatories, and pain medication.  An Elizabethean collar will also be necessary to prevent further self-trauma.  Reevaluation by rectal palpation after infection resolution is necessary to ensure no residual disease or masses are present.

How is anal sac disease prevented?
There is no definitive way to prevent anal sac disease.  Some pets have their anal sacs expressed on a regular basis to prevent issues, but this may also contribute to their inflammation.  Weight control and exercise along with increased fiber intake (idea being that a bulkier stool increases stimulation and thus expression of anal sac material) may help prevent episodes.  In cases of recurrent anal sac disease, diagnostics for food or inhalational allergies (atopy) is recommended.  Surgical removal is an option, but should be avoided at all costs due to likelihood of complications.

Acne, Feline

Feline Chin Acne

By Dr. Karen Burgess

Why do cats get chin acne?
There is no one cause for chin acne. Contributing factors may include poor grooming habits of the cat, genetic tendency to produce too much sebum (a naturally produced oil produced by the skin glands), improper shedding of the hair thus leading to clogged follicles, or abnormal keratin production.

How do I tell if my cat has chin acne?
When looking at your cat’s chin it should be smooth and clean in appearance under the fur. If bumps, scabs, or a dirt-like substance are noticed then your cat may have chin acne. The chin may be painful and in severe cases fairly swollen. Chin acne may also affect the upper lip.

How does my veterinarian diagnose chin acne?
Often the clinical appearance is enough to diagnose chin acne. Additional testing of the skin for specific bacteria, parasites, or cancer may also be necessary.

How is chin acne commonly treated?
Better hygiene is typically the basis of treatment. Cleaning the debris off the chin allows for better penetration of medication which is often benzoyl peroxide based. In some cases clipping of the fur is also necessary. Medicated shampoos, pledgets, or ointments are often prescribed for use at home.  It often helps to first hold a warm moistened wash cloth against the area for a couple minutes to help open affected pores. In severe cases oral medications may also be necessary.  Removal of any plastic bowls is also recommended as there is some association between plastic exposure and chin acne. Prognosis for control or recover is good overall.