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post #1 of 21 (permalink) Old 08-18-2014, 09:45 PM Thread Starter
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Severe allergies, Apoquel, Atopica and or alternatives

Please bear with me, as this is a long saga, but I wanted to cover all the bases of what we have already done up to this point.

Does anybody have any ideas what to do for severe food allergies and potential environmental allergies or how to get a hold of Apoquel?

I'm at a loss as to what to do with Khaos's allergies. He has always had very soft stool and would poop up to 8 times a day. He was originally on Purina Pro Plan which is Chicken based (per the breeder) and I kept him on that for about 2 months after I got him and then changed him to TotW Sierra Mountains (Lamb based). His poop improved but only marginally. We ruled out any parasite and even did a mal-absorption test without any results. Since I changed food, I didn't think it was a food allergy at that time. In July/August last year he started getting hives. Nothing my vet did made any impact and he referred me to a dermatologist. By the end of September, I finally got the appt with the specialist, but Khaos had progressed to this already.


The derm. suspected food allergies because of his chronic soft poop and how often he pooped. She dx him with a severe generalized staph infection secondary to allergies. We did a Culture and Sensitivity since she said it would require at least 3 month of antibiotics and I didn't want to put any meds in him, that wouldn't help, unnecessarily. Luckily I did, since his staph turned out to be MRSP and only responded to a few AB. The one with the least side effects was Doxycycline, but he needed 800mg of it for over 3 months. Coupled with Weekly Chlorhexamine Shampoos and Daily Chlorhexamine Sprays. He was also put on a strict food trial.

By the end of Jan he looked great. We then started to challenge his food allergies and quickly found out that he is allergic to Chicken, Turkey, Lamb and especially Beef. To the point that he can't have heartworm pills but has to get Revolution, can't get any gelatin caps like Fishoil (I used salmon oil in a pump bottle) and no flavored toothpaste or he will break out. I switched him from the rx food (duck and potato) to Orijen Six Fish and he has been hive free with a solid poop since we stopped trying to find new proteins that he can use outside of Duck and Fish around the beginning of April.

This is how he looked after the treatment and a successful switch to the Orijen Six Fish.

However a few weeks ago he started up with the hives again. The first time we though he might have maybe gotten a lick in on some food he wasn't supposed to have, even so we are ultra careful. The first two outbreaks were treated with Prednisone injection after the hives didn't clear up on their own. The dermatologist told me about a medication that Khaos would be perfect for, called Apoquel. However, nobody can get it and she put him on the waiting list in her office and pushed him to the top because he is such a severe case, but unless one of her existing patients goes off it, we can't get it and it probably won't be back on the open market until probably next May.

Well last Monday he did have yet another outbreak of hives. My vet and the dermatologist both decided to treat this initially with 75mg of benedryl in a last ditch effort to avoid yet another steroids injection. But the hives are spreading and he is even getting some of those giant hives he had last year and he is getting more and more itchy. I took him back in today and they gave him yet another shot, this time of the short acting steroid. I haven't seen an improvement yet from this morning.

At this point I'm wondering if he doesn't have environmental allergies after all, on top of the food allergies, since he got really bad last year around this time, despite the fact that the blood test we did last November was negative for everything environmental except cats. I don't have cats, but I can't guarantee that there aren't any ever walking through my yard. One of the other alternatives (but not a good one) would be Atopica. It doesn't address food allergies, takes 2 months to begin working, is very expensive and has side effect that are potentially bad. I'm waiting to hear back from my dermatologist to see if she thinks in light of the new outbreak that is getting worse, if Atopica would now be indicated and if it would even help at this point or if the potential side effects outweigh the benefit.

We can't repeat the test for environmental allergies at this point because of the prednisone and per my dermatologist, even if we can figure out what he is allergic too, he couldn't get allergy shots because he would react to even those. He will get an injection side reactions about 3-4 weeks after even an antibiotic/steroid injection and she feels he would break out from the allergy shots for sure.

So for those of you that made it through my novel, thank you for reading. Does anybody have any ideas of where to go or what to try next?

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post #2 of 21 (permalink) Old 08-18-2014, 10:02 PM
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Kip is on IAM's prescription KO--a kangaroo protein based food. I can't imagine your dog would have been exposed to kangaroo--maybe a food based on that protein would help. We never identified a food allergy with him, but he has bloated four times (one just last week) and biopsies have shown that he had intestinal inflammation based on allergic reactions.

He was lucky enough to be in a study of Apoquel, and as such, his dermatologist has been able to keep a prescription going for him. I think it has helped--we have not have to use any anti-histamines since he has been on it, though he keeps up his allergy shots just in case (environmental allergies). He's never been on Atopica, but does take a small dose of steroids every other day, which also seem to help.

He gets MRSA off and on (not recently) and we have gone through that same long term antibiotic treatment (can't remember the antibiotic), but that seems to have died down as we put him on the Apoquel.

There are, of course, other antihistamines you could use (some dogs respond to one but not to another) both alone or in some combinations.

I'm sorry your pup has had such an uncomfortable time, based on your pictures. Hope you find an answer soon.
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post #3 of 21 (permalink) Old 08-18-2014, 10:10 PM Thread Starter
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Khaos is on hydorxycine 100mg twice a day but I don't think that is helping at all. Maybe we need to try a different antihistamine. Are there any that work better than others?

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post #4 of 21 (permalink) Old 08-18-2014, 10:37 PM
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Apparently it depends on the dog--no way of knowing which will work better until you try it. Most of the antihistamines made for people are possibilities (claritin, zyrtec, benedyrl, chlortrimeton, allegra (if no liver issues) and so on) but in about double quantities as the boxes recommend for people. You can also combine some of them. Your dermatologist should be able to tell you more.

I'm not a vet, and I don't want to give specifics not knowing everything about your particular dog.
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post #5 of 21 (permalink) Old 08-18-2014, 11:35 PM Thread Starter
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Thank you Melbrod and I completely understand. My dermatologist should be back in the office tomorrow and I hope to talk to her then to discuss this. I just wanted to know if I could ask her for anything specifically. I will bring up the antihistamine you mentioned and see what her recommendation it.

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post #6 of 21 (permalink) Old 08-19-2014, 05:21 AM
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I've learned that for dogs with allergies it is important to change foods before the body has a reaction to it.

So you'd be working constantly with novel proteins, and rotating foods before you see issues.
Some rotate every 3-4 months, some rotate every second month. Always trying to rotate before there are any symptoms. Keeping a food journal helps.

Have you considered a raw diet? It can be easier to access novel proteins and rotate through them.
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post #7 of 21 (permalink) Old 08-19-2014, 12:11 PM
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Shanoa developed a pretty severe allergy this year for the first time, at age 5 1/2. With her severe anxiety, the itchiness was causing massive anxiety issues, serious licking problems (she already has OCD licking behavior), which led to sores...etc. Not only that, but she is limited in her drug options because of her anxiety drugs.

We were *extremely* lucky that our vet has a very good supply of Apoquel, and was able to start her on it. It has been a miracle drug for her. If there is a way for you to access it, I would absolutely try to get on it. It sounds like they anticipate production catching up to demand in the spring. I don't know if your vet can try to get any; it's a very serious shortage and I think I mostly got lucky...I have a long standing relationship with my vet and they had kind of a stockpile. We are hoping with the first hard freeze here in Minnesota that Shanoa will not need to stay on the Apoquel over the winter, and potentially whatever allergen she encountered this year will be gone next year (it's been a very high allergen this summer in MN), though I'm not optimistic about that.

***edited to add: Apoquel DOES NOT TREAT the allergy. What it does is block their sensation of the allergy. So, it's not going to prevent him from getting hives, is my understanding. It would prevent him from "feeling" the itchiness, and scratching, biting, licking, etc. You still have to try and keep them from high exposure to the allergen - you don't want them so exposed that they have hives, sores, etc.


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post #8 of 21 (permalink) Old 08-19-2014, 12:22 PM
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Definitely do the skin test when you are able, it's the only one I trust in determining environmental allergies.

I'll also second trying a new food/foods. Rotate the ok proteins (fish/kangaroo/etc..) going raw is a good option as well, much easier to be sure nothing ucky is in there.

In the meantime you can buy hypoallergenic baby wipes and give him a good wipe down, his whole body, between the toes, etc.. after he's been outside, that way if it is an environmental trigger you are helping wash it off and lessen the irritation.

Poor khaos Hope you can try the apoquel soon!

OH! also watch www.pollen.com and keep a journal of what pollens are high on days he seems a bit itchier as well as when he had what food/treats. Very helpful for pinpointing when itching started and possible allergies.

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post #9 of 21 (permalink) Old 08-19-2014, 04:01 PM
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I can tell you as a vet tech we have a waiting list 12 people deep that want to go on the drug. We BEG from the reps every single time they come to the office to spare us a bottle or two. Right now, we can get the 16mg size in, but not the medium size of 5.4mg. (We still have some of the smallest size.)

When this drug was presented to our office last year they gave us trials of it to use on our own affected pets. I didn't personally need it, but the techs who had pitbulls, shih tzus and bulldogs SWEAR by it.

MeadowCat is correct. It will not treat the allergy, it only makes it so the dog doesn't "suffer" from the side effects.

I wish there was a way I could get some to you.

Our office is using Atopica, cetirizine, Claritin or benedryl. Another one that is highly popular and effective, but comes with side effects is Temaril-P which is an antipruritic (anti-itch) with a small amount of prednisone.

My fingers are crossed for you!

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post #10 of 21 (permalink) Old 08-19-2014, 04:23 PM
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I have a related question for you guys: Lazlo just started taking Apoquel for his allergies on Friday. It has definitely helped, but of course it does nothing for his watery eyes, etc. Can I still give him benadryl along with the new medication?

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post #11 of 21 (permalink) Old 08-19-2014, 04:36 PM
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Quote:
Originally Posted by Desy View Post
I have a related question for you guys: Lazlo just started taking Apoquel for his allergies on Friday. It has definitely helped, but of course it does nothing for his watery eyes, etc. Can I still give him benadryl along with the new medication?
Yes, Shanoa is on both benedryl and Apoquel.


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post #12 of 21 (permalink) Old 08-19-2014, 07:07 PM Thread Starter
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I just got off the phone with the dermatologist. Because of how fast this last attack is spreading, she did some more digging. She is able to get the 5.4mg, but not the 16mg. (wouldn't it be nice Matteo if we could swap lol). So for the time being, she suggested giving him a triple dose of the 5.4mg. She has enough of those available. It will triple the cost of the Apoquel, but to be honest, if it works, I don't even care. Well I do care of course, but he is more important to me. It is great to hear how it has worked for other dogs and thank you all for your replies. She did suggest keeping him on the antihistamine for at least the first couple of weeks. I will start wiping him down every time he comes in from outside and see if that helps. She did tell me that for his food allergies especially it is still important not to feed him foods he is allergic too, so I am aware of that. I have to say that my spirits are lifting and I really hope this will work for him.

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post #13 of 21 (permalink) Old 08-19-2014, 10:42 PM
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My horse vet suggested the possibility of combining a class 1 histamine blocker with a class 2. Essentially mixing a Zantac with a Zyrtec. She wasn't sure if it would work in dogs, (it's worked in humans amazingly well during a full on hives attack). She's doing some research and she's suppose to get back to me. I'm in no way endorsing this but it might be worth asking your vet about.
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post #14 of 21 (permalink) Old 08-20-2014, 01:03 AM
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So sorry Khaos is going through this. I feel your pain and Soter says hi to Khaos. We're dealing Soter's allergies flaring up again too. I think we've got his food allergies under control but his grass allergies are out of control. His coat is looking pretty shabby these days, he's itching, has hives, weepy eyes and bald patches.

He was at his worst when both food and environmental allergies were acting up at the same time. He looked exactly like Khaos, he looked like someone had run him over with a lawn mower.

With the food allergies under control, we are able to at least keep him comfortable despite the grass allergies. What we do:

Obsessive, compulsive control over all his food. I bake all their treats using only organic, all natural products. There is only one brand of food on the market that he can eat but I give him beef, goat and halibut so he gets some different protein types. We are looking into a kangaroo based food as well. His current food is GO! All Natural Salmon formula.

Wipe him down completely after he's been outside even if he's only been out for two minutes.

We built a gravel dog run so he doesn't have to be on grass to go potty.

I'm not much help for medication. Soter was on a steroid (I can't remember the name right now) when he was at his worst but he was able to stop them once the food was under control. In winter he doesn't need medication at all. Right now he has two Benadryl a day as long as he is mostly ok. When he gets too bad, he goes back on the steroids again for about two weeks until the rash and the hives go away.

I'm actually considering trying him on raw to see if that helps any but I have to admit I'm totally freaked out that I might get it wrong and he won't get enough nutrients or he'll choke on a bone or something. I just don't know.

It's an ongoing, constant battle. Feel free to pm me if you want, we can compare notes or even just vent if you want
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post #15 of 21 (permalink) Old 08-20-2014, 06:37 AM
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Poor Khaos. It does have it bad.
My boy has environmental allergies, and it got similar to Khaos but thankfully not as bad, he had to take antibiotics cefuroxima and also started on anti-histamin atarax, which he has to have until winter time. He has been off the antibiotics for about 3 weeks, and I'm praying it won't come back.

Whenever he goes out I do whipe him all over with watered down vinegar. He was taking echinacea to boost his immune system but now he is on vetinmune which helps them fight allergies, infections and bacterias. I've also been using once a week a dermo microemulsion P2, which has clorhexidina and fitoesfingosina, supposedly will help to restore his skin abilities to protect himself against the allergies.

I keep my fingers crosses for Khaos, and hope that the new treatment will help him.
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post #16 of 21 (permalink) Old 08-21-2014, 03:33 PM
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I plan to follow this thread and hope you have a great response to the new stuff. My boy, my avitar photo, has allergies and a horrible lick granuloma. He suffers really bad every spring.

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post #17 of 21 (permalink) Old 08-28-2014, 03:09 PM
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My girl has allergies almost this bad, they started really badly when she was almost 1. We did skin testing, found she was allergic to grass, pine trees, and basically every type of tree, weed and plant in my yard. She only has it really bad during the very hot months, pretty much the end of May (I'm in FL) through late Sept/Oct. The allergist had some type of serum made for her in NY, and we gave her allergy shots, and they DID help her, for a few years. We only did them during the summer. Then 3 years ago....they jsut stopped working. We were giving them, doing everything right, and she was still getting hives and itching like crazy. In the meantime, we tried to identify food allergies, but nothing seems to make any difference, at all, even when we try a single protein for weeks. Now, I rotate feeding her Natural Balance (canned) duck and potato and venison and sweet potato, this seems to give her the least amount of problems.

Weekly baths help the most. 75 mg of benadryl 2x a day, that helps. Hydrocortisone cream on her belly seems to help the most, although I realize it jsut masks the problem, but it does help, quite a lot. She rubs her face on the carpet to the point that it bleeds and has scabs on it, as well as around her eyes. Just today, as a last ditch effort to provide her with some comfort, I bought some organic, unrefined coconut oil and rubbed it into her muzzle and around her eye brows, and she just closed her eyes as I was rubbing this into her face, and I jsut CRIED, LOL! I know, I'm a big sap, but she has been about as bad as your dog is in this picture, and I try everything. It has been about 2 1/2 hours since I rubbed the coconut oil on her face, and she has not itched it, so we'll see if it helps, but I'm hopeful.

I cannot get Apoquel, same story, it's on backorder for months. I do give her about 1/3 of a can of sardines a day, the kind with the olive oil. Poor girl wants to go roll around in the grass and I'm like NOOOOOOO, I feel so mean! But when you are allergic to grass, you just can't go rolling in it. I can't wait for it to cool off.

Your dog looks worse than my girl. She has the hives really, really bad, and bumps and all of that mess, but it is mostly contained to her belly and arm pits, and elbows, however, she has a big sore spot on one of her back leg (haunches?)...whatever you call that thing that looks like a big lamb shank, lol, she has a big, raw spot that once turned into a giant lump, and was deemed "abnormal" when they tried to aspirate it, but it turned out to be just this skin condition that she has. Well, it gets raw, and she chews it, so we have to keep bitter apple on her. I'm trying this coconut oil to see if it provides some relief. I know coconut oil is this thing right now, and I'm not sure if it is just a trend, or if it has any real healing value to it, but I'm desperate, and I'm trying it. LIke I said, she actually closed her eyes when I was rubbing it into her snout. I'm going to do this to her feet tonight, since they are all red and itchy too. I figure, at least it can't hurt her to lick this stuff.

I will let you know if it helps. We have had acupuncture, been to specialists, spent thousands at our regular vet, we just can't seem to get a handle on it. I have only recently given her the sardines, and I do think it is helping a bit, and the hydrocortisone cream that I put on her belly when it is really, really bad, and the benadryl.

I feel for anyone that has these problems with their dogs with skin allergies, it is such a nightmare to look at your sweet dog and see them in such agony and know there is not much you can do. I hope you are able to find some relief.
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post #18 of 21 (permalink) Old 09-22-2014, 01:03 PM
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Quote:
Originally Posted by Thor_Red View Post
Please bear with me, as this is a long saga, but I wanted to cover all the bases of what we have already done up to this point.

Does anybody have any ideas what to do for severe food allergies and potential environmental allergies or how to get a hold of Apoquel?

I'm at a loss as to what to do with Khaos's allergies. He has always had very soft stool and would poop up to 8 times a day. He was originally on Purina Pro Plan which is Chicken based (per the breeder) and I kept him on that for about 2 months after I got him and then changed him to TotW Sierra Mountains (Lamb based). His poop improved but only marginally. We ruled out any parasite and even did a mal-absorption test without any results. Since I changed food, I didn't think it was a food allergy at that time. In July/August last year he started getting hives. Nothing my vet did made any impact and he referred me to a dermatologist. By the end of September, I finally got the appt with the specialist, but Khaos had progressed to this already.


The derm. suspected food allergies because of his chronic soft poop and how often he pooped. She dx him with a severe generalized staph infection secondary to allergies. We did a Culture and Sensitivity since she said it would require at least 3 month of antibiotics and I didn't want to put any meds in him, that wouldn't help, unnecessarily. Luckily I did, since his staph turned out to be MRSP and only responded to a few AB. The one with the least side effects was Doxycycline, but he needed 800mg of it for over 3 months. Coupled with Weekly Chlorhexamine Shampoos and Daily Chlorhexamine Sprays. He was also put on a strict food trial.

By the end of Jan he looked great. We then started to challenge his food allergies and quickly found out that he is allergic to Chicken, Turkey, Lamb and especially Beef. To the point that he can't have heartworm pills but has to get Revolution, can't get any gelatin caps like Fishoil (I used salmon oil in a pump bottle) and no flavored toothpaste or he will break out. I switched him from the rx food (duck and potato) to Orijen Six Fish and he has been hive free with a solid poop since we stopped trying to find new proteins that he can use outside of Duck and Fish around the beginning of April.

This is how he looked after the treatment and a successful switch to the Orijen Six Fish.

However a few weeks ago he started up with the hives again. The first time we though he might have maybe gotten a lick in on some food he wasn't supposed to have, even so we are ultra careful. The first two outbreaks were treated with Prednisone injection after the hives didn't clear up on their own. The dermatologist told me about a medication that Khaos would be perfect for, called Apoquel. However, nobody can get it and she put him on the waiting list in her office and pushed him to the top because he is such a severe case, but unless one of her existing patients goes off it, we can't get it and it probably won't be back on the open market until probably next May.

Well last Monday he did have yet another outbreak of hives. My vet and the dermatologist both decided to treat this initially with 75mg of benedryl in a last ditch effort to avoid yet another steroids injection. But the hives are spreading and he is even getting some of those giant hives he had last year and he is getting more and more itchy. I took him back in today and they gave him yet another shot, this time of the short acting steroid. I haven't seen an improvement yet from this morning.

At this point I'm wondering if he doesn't have environmental allergies after all, on top of the food allergies, since he got really bad last year around this time, despite the fact that the blood test we did last November was negative for everything environmental except cats. I don't have cats, but I can't guarantee that there aren't any ever walking through my yard. One of the other alternatives (but not a good one) would be Atopica. It doesn't address food allergies, takes 2 months to begin working, is very expensive and has side effect that are potentially bad. I'm waiting to hear back from my dermatologist to see if she thinks in light of the new outbreak that is getting worse, if Atopica would now be indicated and if it would even help at this point or if the potential side effects outweigh the benefit.

We can't repeat the test for environmental allergies at this point because of the prednisone and per my dermatologist, even if we can figure out what he is allergic too, he couldn't get allergy shots because he would react to even those. He will get an injection side reactions about 3-4 weeks after even an antibiotic/steroid injection and she feels he would break out from the allergy shots for sure.

So for those of you that made it through my novel, thank you for reading. Does anybody have any ideas of where to go or what to try next?
I have you carefully read story, my English is not so good.
My name is Sandy from Holland and I have a Brown Doberman bitch with the same problems. We have a blood test, skin test and skin biopsies done. Her rash is atopy. An allergy to dust mites and other mites. dogs cats rabbits and corn plants. We have 8 months done the desensibiliestaie, this is your dog allergic to it with the substances which they inject Unfortunately, this did nothing helped, we also have the apoquel already tried but unfortunately without success. Now since 2 weeks on the atopica plus antibiotics and prednisone. Atopica should go it alone will do but so far we see not so much change. Would you like to keep me informed of your developments? then I'll occasionally post how it there for us to State. Atopy is quite tricky to get under control especially when there are more secondary skin infections. I have google translator use so hope it a bit clear. Greetings Sandy & Joy
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post #19 of 21 (permalink) Old 09-22-2014, 01:11 PM
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Smeugie--you might want to send a Private Message to Thor_Red also with your request for updates, just in case they don't see the post you made.

Your google translator did a good job--your post is quite clear.
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post #20 of 21 (permalink) Old 09-23-2014, 03:24 PM
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Those looking for Apoquel... I just got news today that a compounding pharmacy will make it!! We are planning on sending several clients there. For those that are desperate for it, call local compounding pharmacies and see if it's available!! Just thought I'd share that bit of information. Good luck!
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post #21 of 21 (permalink) Old 10-01-2017, 01:32 PM
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Biting, scratching and compulsive licking

Hi,
I have read the above posts and now have another 7 ideas to try for Tanga and Nyika, 2 year old neutered Doberman. We live in Tanzania, E Africa and they are on (hideously expensive) Apoquel. The people who manufacture and sell this stuff are not going to die in the Poor House! We can get Pedigree biscuits sometimes, but that's about it.
Anyway, They live outside, but are allowed in. The vet suggests no ugali (corn-based polenta) and so they get local rice, fried cabbage which they like, and usually raw meat that has been ion the freezer long enough to kill off the worms. Sometimes they get it right out of the freezer and gnaw on it like a bone. They love that! The small fish, dagaa, usually dried they eat but are not impressed. The Vet says no tomatoes!
I think their allergies are more to do with the environment. I got them from Dar, in the city and they were fine, but here in a smaller town, they are having trouble. I thought the baby wipes was a clever idea and the diluted vinegar (malt, spirit, wine or apple?) presumably to reduce fungal infections. Any ideas on how to handle environmental stressors?
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