Apoquel® was approved by the FDA and launched by Zoetis in January 2014 for the treatment of itch, most often caused by allergic dermatitis. Unfortunately, the demand quickly exceeded the manufacturing capacity and this led to limited availability and backorders. Remember this if you have asked your veterinarian about Apoquel® but were unable to try this medication for you're your own dog. In many cases, only veterinary dermatologists have increased access to this medication. Zoetis anticipates increased availability of the drug in the summer of 2015. The drug has a rapid onset of action with decreased itching often noted within a few days. This medication is typically given twice daily for 2 weeks, and then tapered to once daily. Because the drug has a short half-life, tapering to lower doses is typically not possible.
Most clinicians in private practice are regularly faced with challenging dermatologic cases, and a common question arises: How much prednisone is too much? No one can definitively answer this question, as different dogs respond in different ways. Some patients are unaffected by long-term prednisone administration, while others immediately demonstrate polyphagia, polydipsia and polyuria, or incontinence. Still others show signs of iatrogenic Cushing's disease—muscle wasting, a pot-bellied appearance, and muscle weakness—early on in therapy. The best approach is to try the safest treatment first, monitor the patient's response carefully, and adjust the therapeutic protocol if side effects become problematic or the condition does not respond.