I was scrolling through my Facebook the other day, and I came across something that made me very sad. It was a picture of a friends dog with a pile of medications behind him about these skin issues that “just won’t quit”. It was light hearted, but unfortunate because think of how uncomfortable that is!
In the comments, several people commented their experiences with pesky skin complications. After all the allergy shots, tests, supplements, and “fancy raw food”, they all went to the traditional last resort, immunosuppressants. Apoquel, prednisone, cyclosporine, and associated glucocorticoids are amazing medical science feats. They are truly life-saving with immune-mediated disease and truly benefit a lot of animals since their conception. That being said, this worried me a lot:
“Our 2 vets can’t figure out his skin issues so they keep him on antifungals, antibiotics all the time and he has to take 3 Apoquel a day forever.”
3 Apoquel a day….. Forever.
Now, I do not know the full medical history of this dog and yes, there could most definitely be outstanding circumstances. I am not here to attack those who use these drugs, but I think there are some things to keep in mind when using an immunosuppressant drug.
How do immunosuppressants work?
Ok, so you go into the vet because you’ve tried EVERYTHING. I mean Iams, Royal Canin, AND Blue Buffalo (!!). It can’t POSSIBLY be the food.
Your vet gives you a couple of rounds of antibiotics, no change just some runny poops. You get a shampoo, a couple of lotions, and some sprays - just some flaky skin but still no change. Your poor baby is uncomfortable and suffering and no one wants to have that! At long last, the vet pitches Apoquel to you…
Apoquel is a “fast-acting and safe treatment for the control of acute and chronic canine pruritus.” - pruritus meaning itching.
As a pet owner, the concept of reduced itching and complete comfort within 24 hours sounds SO refreshing. A pill (or 3?) a day keeps the discomfort away!
Apoquel is a Janus kinase inhibitor (JAKs). Kinases are used to transmit signals and control complex processes in cells. Up to 518 different kinases have been found in humans. Apoquel targets the signaling pathway that results in itching and inflammation. JAKs control the immune systems response to itchy sensations giving almost immediate relief from atopic dermatitis, contact dermatitis, allergic dermatitis, fleas, and food allergies.
Here are a couple of areas where JAKs do their magic:
Guarding against tumor formation
Forming white and red blood cells (bone marrow stem cells)
Producing antibody-producing B cells and immune system “guard” cells, T-cells.
Regulating the body’s inflammatory response
A messenger for destroying parasites, bacteria, viruses, and other foreign invaders
Seeing as almost 10% of all dogs will have some sort of an allergic reaction in their lifetimes, its not shocking to see pharmaceutical companies taking this by storm.
Apoquel stops JAK’s from performing those functions listed above. Without those functions, your animal’s immune system cannot function normally. As this drug undermines your animals immune system, the body literally cannot raise a response when something bad really DOES happen. Say, a bacterial infection, a virus, or a proliferation of rapidly dividing cells (cancer).
The thing about conventional drugs, although extremely helpful, is that they are *so* good at covering up the problem. So yeah, the itching might go away, but at what cost? An immunocompromised animal? An allergy is an exaggerated and inappropriate response of the immune system. Commonly brought on by poor diet, but can be from other sources as well like dust mites, the environment, hormones and antibiotics in poorly sourced food, and synthetic fragrances and cleaning supplies.
Found by a great article in Dogs Naturally Magazine, the pharmaceutical study for Apoquel did a great “copy/paste” job for the safety of the drug. A study published by the manufacturer to test Apoquel’s safety stated that no fatalities or abnormal health events occurred in the study phase or the continuation phase. In total, 6% of the dogs had abnormal health effects which doesn’t seem too bad.. But that was only 30 days.
That girl that took her dog to the vet was told “for life”. Years of a compromised immune system…
Not to mention some of the recorded side effects:
-Abdominal ascites and pleural effusion of unknown etiology - required euthanasia
-Malignant neoplasms - required euthanasia
-Grade 2 mast cell tumors
-Low grade B-cell lymphoma
-Apocrine gland adenocarcinoma
-Oral spindle cell sarcoma
Stopping your dog or cats itching quickly and cheaply is wonderful, but is it worth the risk of your pet’s opportunity for a long, healthy life?
If your pet does suffer from allergies, uncovering them can be tedious, frustrating, and time-consuming. But honestly, it is the only way to get to the root problem instead of covering it up with a band-aid and letting it fester. Think about where your pet goes, what she eats, what she licks, smells, rolls in. All of these factors can contribute and many of them are under your control as a pet parent.
Some solutions to try if you think your dog or cat is suffering from allergies:
Allergy elimination therapy. This should not be confused with “hypoallergenic diet” which can be touted by many vets. I am talking about transitioning your pet to a different food they aren’t familiar with. Both the protein AND the carb should be switched (or better yet for cats, NO CARB). Dr. Karen Becker suggests a single or novel protein source for at minimum 2 months to notice a change. Recommendations would be cooling or neutral proteins like duck, rabbit, quail, or properly-sourced fish.
Keep grains and fillers to a minimum. The less grains and fillers you feed, the less opportunity for allergic reactions and inflammatory conditions. A species-appropriate balanced raw diet is the best way to prevent inflammation and dysbiosis in the future.
Address the dysbiosis. 70% of the immune system is in the gut. Working with your integrative vet will help you create a plan to restore gut health can help prevent issues in the future. I recommend 30 billion CFUs or higher with MULTIPLE strains of bacteria and no fillers (only prebiotics). Better yet, a natural source like raw goat’s milk, kefir, or fermented vegetables!
ROTATION: This is important for any animal regardless of allergies. A pet that has had an allergic response to one protein is more likely to develop sensitivities to the replacement over time. I recommend having a couple of ones you know are good on hand and rotate between those.
Supplement with Omega-3 fatty acids. For dogs, whole sardines are a great option, and for cats, a phytoplankton or krill oil works great!
Be aware of hydrolyzed proteins. Most vets will recommend a “hypoallergenic” diet to your pet which seems like a great idea but has drastic consequences. Hydrolysis breaks down a single protein (usually chicken or soy - allergenic to begin with) into particles so small that the protein is no longer recognized by the immune system as an allergen. Once again, the body is not being restored to health, it is being tricked into responding a certain way AND the methods used in the hydrolysis process do not convert protein into amino acids the same way your pet does. They are also ridiculously expensive with little to no benefit.
Conventional medicine is not the enemy. Trust me, it prolonged my dad’s fight with cancer. But using it to ignore a more threatening problem is not okay. As stated, I am not a veterinarian, just a concerned pet parent. However, I do believe that we should not ignore the body when it is so blatantly trying to tell us something. Masking that cry for help could be a drastic mistake.
Disclaimer: This page is not intended as a substitute for professional veterinary advice. I am not a trained veterinarian, just a pet parent with a passion for science, informational justice, and nutrition. Posts may contain affiliate links but I am not supported financially. All opinions are my own.