? Budesonide & apoquel

I spoke to my vet today about switching Tinks from Pred (steroids) to budesonide for her skin issues as the pred increases BG so can be directly affecting the diabetes or even causing it. We weaned her off the pred 3 weeks ago and her skin allergies are terribly she's itching, licking and scratching constantly and making big wounds. I read of others on here that have used budesonide for skin and other issues so I requested that and my vet says he's never heard of it? He has recommended apoquel. It's only been in Canada 1 year and isn't approved yet for cats so it doesn't have a cat label as there's not been enough tests done yet but he says he recommends it over Atopoca as it has less side effects than Atopica. Has anyone heard of it or used it? I'm concerned about using a drug that's has little testing. He says it takes at least 3 weeks to work on cats so she's need to be on both the apaqil and the pred at the same time for 3 weeks then just the apaqil. I'm really not happy about that. I really wanted her to not be on pred as I know it'll affect her BG and also it really makes her skin worse after. Being on two auto immune suppressants could be really damaging especially one that's not well tested yet. Does anyone know if you can get budesonide in Canada? Does it have another name possibly?

Has anyone used antihistamines with any success for itching or skin allergies? We haven't tried any yet. Thank you!

 

I'm not sure about antihistamines but Smokys dermatologist just took the allergens he was allergic to and some saline and made up a formula for him.
I had a choice of allergy shots or giving drops under his tongue. I picked the drops but wish I had chosen the shots. The drops were every day twice a day for 6 months. The shots were twice a day for so long and then once a day and then once a week, then once every two weeks. Finally end up with one shot a month.
I think the whole schedule lasted three months.
Smoky had lost half of his hair from indoor and outdoor allergies. He was fine after the treatment but it did cost me about $800.

 

Hi Lisa, thanks for sharing your and Smoky's journey! I'm so glad to hear he is doing well now. It is a very costly process though. How did you know what Smoky's outdoor and indoor allergens were? Did you have a skin scraping test or blood serum test? How much did that cost out of interest and which company did you use? I've been quote around $580 and $650 for blood serum tests for food and environemental allergies and apparently with blood serum its often inaccurate for food allergies. This doesn't even include the prescription immunotherapy shots or drops for the mouth. Did the drops in the mouth not work then or was it just more inconvient than the shots? Sounds like you did the drops first and then went on to do the shots? Its great though that Smoky has improved so much thats encouraging to hear! I would really like to get Tinka tested, I had to do my own reseach as my vets don't know or recommend any tests or shot/drops etc they just keep giving steroids! Did Smoky have steroids or anything else for his skin or did you just go straight for the tests and treatment? I would love to work with a vet dermatologist but don't know of any here or near us. Its such a stressful process and poor Tinka is missing huge patches of hair too its awful. Thanks for your help!

 

I forgot to mention that smoky was itching so badly he tore open his skin and was pulling his hair out to try and stop the itching. The allergy drops worked wonders for him although my wallet sure did take a beating.

 

Yes this is exactly what Tinka is doing the itch is so bad she scratches or licks her hair off then tears open her skin its awful Each time she goes on steroids it clears but then is much worse after! What tests did you have done to determine the allergies? Did the drops alone work or did you have to switch to the shots or was that more for convience? $800 is pricey, did that include the tests? Thanks so much!

 

I was looking up smokys records for his dermatologist. He has indoor and outdoor allergens and food allergies. He had skin scrapings done and blood tests but not serum testing done. They checked him for ear mites which was negative. He does have bad allergies to chicken, grains, and soy. The total cost for tests plus consultation was a whopping $580!

 

I chose the drops for convenience since I was deathly afraid of needles. He was better on steroids but the meds might have contributed to him getting diabetes.
They do skin scrapings which is far cheaper than doing a full panel for allergies plus they hav to sedate the cat for that. I think that ran about $800 so I didn't get that done. They tested him for the most common allergens for cats in house lab and gave me the results in an hour.

 

Thank you for this info! It's really crazy how much the vets charge and the only ones who suffer are sick pets and their owners! Its more expensive then human tests!

Where about are you based? Do you know what company the tests were done through? I need to find one that does the skin scraping and blood tests like you had as those are more reliable I believe.

 

Sounds like Tinka has very similar issues to Smoky! I believe that the long term steroids caused or hugely contributed to the diabetes in Tinka too. Which is why I want her off them asap. They don't address the underlying issue either.

Is the skin scrapings painful for them? I guess no more painful then her pulling out her own hair and tearing open her skin. So the skin scraping tests for both the food and allergies? That was really fast in getting your results back! Sounds like a good vet dermatologist that you saw. Do you mind sharing the vets name and clinic? Thank you

 

The tests they ran are as follows: Ear cytology, Tricogram, HESKA lge ELISA; (blood test). I know that all sounds technical. Do you have a vet dermatologist specialist where you are?

 

The scrapings are not that bad for them really. They took Smoky into another room for that and brought him back about 10 minutes later. I live in north eastern Pennsylvania close to Philadelphia on the east coast. It was an additional cost to have the vaccine made up whether it is for shots or drops. I'm looking up his results so be right back

 

Thank you for this info There are no vet dermatologists in my area is have to travel to the nearest city but it'd be worth it to get good treatment. Just wish I could get a recommendation to a specific clinic or vet. We've been on this journey 6 years now so really hoping to get good treatment for Tinka.

 

Thank you so much really appreciate your help!!

 

First bill from specialist

 

This is vet dermatologist practice in my area plus written recommendation he gave me for Smoky. My camera on my phone is terrible, need a new one.

 

Intradermal allergy test results for Smoky

 

So Smoky is allergic to two types of dust mites, a storage mite, Alteria- a type of mold; Red Maple trees, Kentucky bluegrass and Meadow Gracie, both types of grasses. So total bill was just under $770. I'm still paying off my credit cards.

 

Thanks so much for all this info it's super helpful to know what tests you had done, results and treatment! I can read them all thanks it's just the first one is too blurry.

On the long letter I see he recommended citirizine for treatment t to help Smokey before he started on the immunotherapy drops. Did the help Snokey? I have never heard of citirizine is it a anti histamine or what type of drug is it? I see you had to stop it 14 days before allergy tests that must hv been s challenge him not bring on anything for 2 weeks?

At the moment as soon as we stop steroids her skin goes crazy! But im interested in knowing about the citirizine (generic Zyrtec) as maybe that's an alternative option till we can get her these proper allergy tests and treatment.

 

Citirizine is an antihistamine and it helped Smoky with sneezing, watery eyes, and itching. It has the same effect on animals as in people.

 

Its crazy how many allergies our pets have now a days, I wonder what it is that is causing their immune systems to not function well in the first place. For tinka i believe it was the vaccines, dewormers that she had an unnessary amount for esp considering she's an indoor cat and then eating kibble and other vet prescribed foods in the past and then steroids that further suppress immune system. Its amazing how the immunotherapy drops and shots work to stimulate the immune system to overcome the allergies. I can't seem to see anywhere on the tests about the food allergy tests? If we go this route and have to likely pay this amount too that'll be going on my credit card too, super expensive

 

Thats good to know thank you as our vet has not yet tried any anti histamines for tinka. Did it work as well as steroids? Did you notice any side effects?

 

They don't work as well as steroids but are much safer. They can make a kitty tired or jittery although sleepy is more common. Food allergies are treated by feeding a single protein by itself, for example; beef, pork, chicken,quail, duck, turkey,venison, etc. For a time period of at least 4 to 6 weeks with no other food or snacks outside of the novel protein you are using. Keep track of their reaction to food, if they seem OK with the food; no vomiting, diarrhea, or other adverse reactions. Remove food you are trying and give food you were feeding before. If symptoms come back when feeding, food allergy is probably suspect. You keep repeating this cycle with different types of a single protein to see what the cat is allergic to. It can be a very long process. See my signature page at bottom of posts.

 

I am going to tag @Carol & Murphy as she uses apoquel and I am pretty sure she has great results.

I use budesonide with my non diabetic and it has helped him with his runny poo--we tried pred and it was great with firming his poo but it weekend his heart

 

Thanks for the info I think we will try get this anti histamine tomorrow it looks like its available over the counter. Did you give it with the steroid as well or by itself? We may do steroids for a few days or a week till the itch is under control and the wound is healing then try switch to the anti histamine. The itch is just really bad right now. So you didn't actually have any food allergy tests done just the elimination diet to try to work out food allergies? We have been trying the elimination diet for over a year but it hasnt' worked as she won't eat one protein for long periods of times she becomes bored with the food and refuses to eat. Now that she's on raw she loves it but the problem is I can't source a single novel protein that has the meat, offal/organs and bone. Im happy to prepare myself I just can't source the meats. We live in a very small town! The best I can do is a pre-made raw mix of rabbit meat and bone with pork organs. But she tends to be a bit fussy so i usually use orijen freeze dried treats on top and as rewards after cleaning wounds or taking BG or her insulin shots but they don't do pork or rabbit so now I'm stuck with no treats which I'm not sure will work. Can't find any just rabbit or just pork or combo treats. I'm hoping when we have the allergy tests, skin scraping etc that they will test for food allergies as at this point I have no idea what she's allergic to except i know that chicken makes her work and I think sardines.

 

Thanks Jayla, thats good to hear. My vet says he's nevery heard of budesonide. Do you get it by that name or a generic? Where about do you live? Wondering if its available here in Canada or if my vet has just not heard of it. Thats awful to hear about the pred, I do worry about all the side effects with it. Thanks for the tag

 

Have you ever tried probiotics or slippery elm for his poop out of interest? I've had friends that have used with IBD cats with good results.

 

I just gave smoky the Zyrtec by itself, your vet should be able to tell you if steroids can be taken with antihistamine. If you look on Amazon Orijen makes a wild boar and lamb flavor freeze dried treat.

 

Yes we have tried both and many other things too-
SEB used to work for Dre to poo but nothing ever made a difference with Rico (non diabetic )with his runny poo.

Rico had water poo and Dre has constipation

Dre doesn't do well with mirialx (pukes it) we used microflora from Herbsmith-a product I love and made no difference. Aloe-nothing .....
So we stick with the budesonide for Rico and I give Dre a enema when it has been 3 days or if he is acting "clogged"
I am lucky he is such a sweet boy

 

I have given slippery elm to Smoky on occasion for both his pancreatitis and IBD and it works well.

 

I actually heard of it for the first time here on the board. My regular vet had never used it or heard of it but the cardiologist has another Dr in her office that uses it-I believe it is compounded. I think @Wendy&Neko is in Canada and she used it with her sweet Neko (GA) I am in Chicago.
Rico was getting fluids which I am sure played a part in the heart failing...he now gets lasix as well. He was only on the pred a few days before I saw him struggling for breath....the ICU drs were ready to euthanize
In the morning we went to his cardio Dr and she rocked!

 

We've had a few cats here switch to budesonide from pred when they became diabetic. I know budesonide works for gut issues, don't know if it works for allergies. It was the internal medicine vet that suggested using budesonide for Neko's IBD/lymphoma, again because pred was contraindicated due to her heart issues and diabeties. You can get it in pill form as the standard 1 mg format, but when we changed doses and for easier medicating, I got it compounded at the local compounding pharmacy - liquid fish flavour. And it's cheaper than pills. I'm in B.C. I still have some of the budesonide, I'd ship it to you, but the liquid needs to be kept cool.

I seem to remember @carfurby uses Zyrtec for one of her itchy civies.

 

Thanks so much Wendy for sharing Thats good to know that the budesonide is available in Canada. I will speak to the other vet when she's in next week and see if she knows about it and if its helpful for food/skin allergy issues. If not i'm hoping maybe the zyrtec could possible help till we get the to see a dematologist vet and have the tests done and treatment with immunotherapy. Really hope we can get her off the pred soon and some relief from all this itching. Thanks again!

 

I have not heard or read of using budesonide for for skin issues. It is for gut issues.

The following includes good information on the use of Apoquel in cats
http://www.cliniciansbrief.com/sites/default/files/attachments/MEDS_Oclacitinib.pdf

 

I've only used Zyrtec for sneezing and those kind of allergies. My vet said I can safely give 1/4 of a 10mg tablet twice a day. I hope you find something that helps. Poor kitty.

 

Thank you for this info. It says that there were only good results in 4 of 12 cats so that's only a 33% rate of success which is not very high. The study size was pretty small to0. It says that further studies on cats are needed. The cats they tested the drug on also had non food related skin dermatitis and at this point it's likely Tinka has food an environmental allergies causing skin dermatitis. Thanks for this info I think it shows that this drug is likely not suitable unfortunately. But not completely writing it off just yet. The pred is certainly effective but has a lot of side effects so really need to find something better. If anyone has used apoquel/Zyrtec on their cats with skin issues/dermatitis etc I'd love to hear if it was helpful or not? Thanks!

 

Thanks for sharing Did you find it helped your cat for sneezing out of interest? It it environmental allergies your cat has?

 

Thank you! I really want to get Tinks off the pred soon, scary the type of side effects it has. @Carol & Murphy would love to hear about your experience with apoquel with your cat please? Thanks so much!

 

Seasonal allergies. Yes it helps. Sometimes I have to give it a couple of days before it helps.

 

@Carol & Murphy on the Lantus forum uses Apoquel for her kitty. Oops! I see someone beat me to this.

 

Carol may not be getting her tags....might want to PM her

 

Sorry I have not been getting either tags or notifications unless I sign onto the forum - sorry about that
Regarding Apoquel- it was developed for dogs with cutaneous allergies and worked so well, they are looking for other uses for it. It has a completely different mechanism of action in the inflammation cascade from the traditional antihistamines we are familiar with. Murphy doesn't have cutaneous allergies, but rather intractable congestion thought to be seasonal allergies. My vet gave it to Murphy about a year ago, to give in addition to zyrtec. I have to say that it is almost a miracle drug for him - within two days, there was a HUGE improvement in his congestion. As far as I understand it, it has few side effects and is very safe. I would definitely go for it. The dose is 1/2 pill twice a day, but very quickly I was able to get him down to once a day, and my vet said that some people only use it once every other or every third day

 

Hi Carol, thanks so much for sharing! I haven't tried Tinka on any antihistamines yet but I was considering trying Zyrtec in place of steroids, I'm just not sure if it'll be as effective or strong enough. The pred works well for Tinka but she can't be on it permanently and it raises her BG and her skin has got worse with it in that each time we try come off the pred her skin gets worse and worse. What was your experience with zyrtec before starting the apoquel? Have you tried him without it and just on the apoquel?

That's so great to hear you had good success with the apoquel! Also that you have a proper diagnosis for Murphy. My vets don't seem to know much at all about skin allergies and different conditions they've never given me a diagnosis or run different tests they just give steroids. I'm looking into a vet dermatologist now for testing. What exactly is intertractable congestion? Wondering if it's similar to what Tinka has. That's good you found a dose that works well. Do you haven't noticed any side effects or new sickness mess or symptoms since he started it a year ago? And has it completely solved his skin issues? Sorry for all the questions we've just been on this journey nearly 6 years and with her skin and health getting worse based on drugs iv used in the past I'm just trying to make better informed decisions. Thanks so much

 

Hi Tanya - Murphy has no skin issues at all He was started on the apoquel because his congestion wasn't getting any better with antihistamines alone. I also thought he had "seasonal hay fever" but this year he has had congestion even with snow cover, so I am not sure about that.
Apoquel is supposed to be very safe - I would absolutely go for it - since it was originally developed for cutaneous canine issues. It doesn't raise blood sugar or act as an immunosuppressant or anything like that