Why Cytopoint or Apoquel may not be working

There are two great treatments for atopic dermatitis out on the market that when used appropriately have great benefits.  Once you have ruled out external parasites, contact allergy, skin infections and performed a 8-12 weeks strict prescription diet trial, then you can classify the patient having atopic dermatitis. One product that may be beneficial for usage is called APOQUEL ( Oclacitinib) made by Zoetis. This medication is an oral tablet that blocks the function of itch signals so they do not transmit them to the brain. When these signals would reach the brain it would typically stimulate your pet to scratch. This signal is blocked when using apoquel. This will not remove the itch totally if the nidus is related to things outside of environmental allergies. Cytopoint (Lokivetmab), made by Zoetis, is a dog monoclonal antibody designed to block the itch response that is injected under the skin every 4-8 weeks.  It is important to have the above issues ruled out before utilizing these as treatments. For instance, if their is a bacterial infection on the skin, these treatments may diminish the itch response initially but will not have a lasting effect. The reason being is due to the itch being from bacteria. It may be recommended by your veterinarian to allow them to perform diagnostic testing such as skin scrape, acetate tape prep, ear cytology, impression smear of the skin and skin culture/biopsy to help determine the underlying cause. A hydrolyzed or novel protein food trial should always be performed when there is no response to treatment or the pet is still really itchy despite treatment. Also, if this has been going on since the pet was a puppy or kitten, a diet trial should be initiated. These are great treatment options if used correctly. A lot of times we feel medications are not making improvement but WE have not addressed the actual reason for the itch.