Max the itchy scratchy lab and Apoquel

Max came to see us when he was about 18 months old with persistent itching and scratching. Max would rub his body along the cement, lick, bite and chew his legs and feet, scratch his ears and have bald patches and sores on his body from incessant scratching. Max also had the misfortune of passing very sloppy poos.

Like so many skin presentations, this case was very frustrating – not only for Max’s owners but for staff at New Lambton Vets. When you book your pet in for a skin appointment, quite often reception staff will slot you in for a long consultation as skin issues are rarely quick fixes and the reason behind an itchy pet is usually multifactorial and complex. Skin cases are expensive and challenging to work up.

In brief; skin can be itchy due to such things as hypersensitivity to flea saliva, contact with certain grasses and weeds, to inhalation of airborne pollens, sometimes via ingestion of certain food proteins and also endocrine (hormonal) disease processes can affect skin. As the pet itches and traumatises their skin secondary bacterial and fungal organisms thrive and an infection ensues perpetuating the itch – scratch – cycle. In many cases your pet may be scratching due to a combination of the causes.

With Max because his condition was so chronic and he did not respond to traditional treatments such as antihistamines, medicated shampoos and antibiotics we ran a blood test. This was an allergy panel. Allergy testing ruled out that Max was allergic to flea saliva, grasses, weeds and pollens but he tested POSITIVE to mould. Max lives in New Lambton Heights and his garden is shaded and often damp so this allergy made sense.

Given Max had never really had “normal” poos he was also started on a strict hypoallergenic diet. Within 24 hours Max’s stools changed consistency and became solid. Advice was given on dehumidifiers, use of fans to aid air circulation and environmental management and housing of Max to lessen contact with mould and mould spores. Max is on vet recommended flea treatment all year round and bathed with Malaseb antifungal and antibacterial shampoo to minimise secondary infections. He also has daily essential fatty acid supplements to aid the skin’s normal defence mechanisms against allergens and inflammation.

Max’s skin is not perfect and he still has sporadic flare ups of skin irritation. With his most recent flare up he commenced a trial of a new treatment called Apoquel. This a medication effective at controlling itch in cases of flea allergies, contact allergies, food allergies and atopic dermatitis (inhalational/pollen allergies). It is a different class of medication than has been used before for allergic skin disease specifically targeting cytokines involved in itch and inflammation. It is fast acting and Max is now 2 weeks into his treatment with Apoquel and owner feedback is really positive. His skin settled within a few days and he has not scratched since!

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