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CADI - Zoetis' Canine Atopic Dermatitis

Immunotherapeutic - Dog Owner Comments

September 30, 2015

Apoquel moving to a monthly shot called Canine Atopic Dermatitis Immunotherapeutic vaccine because of the supply demand problem
of the Apoquel still going on. My dog is new to Apoquel for allergies he has been suffering from for years. He is on the Apoquel for another 30 days and we have been chosen to get the new monthly vaccine. I will try to update you on the shot when it releases. Our dermatologist just finished training for the new shot. No idea of cost
yet either.

Breed: Great Dane, DOB: Aug 10, 2008, Weight: 124 lbs. He has 18 Environmental allergies, zero food. Worse molds.
Apoquel here cost $2.50 per 16 Mg pill, and he takes 4 a day. $300 per month. They suggested that vaccine will be equivalent or slightly less. Although, he stated again it is just an estimate. They have not mentioned taking both. Switching from one to the other. I hope this regime is effective because I have been watching him suffer for too long. He is my best friend. :-)

S.B.
Virginia

[Although it is designed to do the same thing (stop itching) this is a completely different medication than Apoquel. It is a mAb. Apoquel is a JAK-inhibitor. It is not a "vaccine" RSH]

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December 30, 2015

Hi Dr. Hines,

I just wanted to share my experience with the new Canine Atopic Dermatitis Immunotherapeutic (CADI) injection. Our Derm vet has been using the CADI in 26 of her patients. My dog is a 7-year-old Standard Poodle. It started having issues with itching and skin lesions about one year ago, Issues that have become more frequent. He is also on thyroid supplement for sub-clinical hypothyroidism and has some signs of IBD. Our vet thinks the IBD and allergy are somewhat related. It has mostly environmental allergies and was started on allergy drops in late Sept. We are continuing with the drops twice a day. He was on Apoquel for about 2.5 months and it worked really well. On Dec 3, he received his first injection of CADI. I have to say it works just as well as Apoquel and I hope that since it is more targeted and will have less unwanted side effects compared with Apoquel. The hope is for the allergy drops to help and he won't need the CADI in the near future. But for now, I am very happy with CADI being available as I feel it is effective without any known side effects at this time. We are actually going back today for another injection, a bit early due to upcoming holiday. It is still working well since the first injection- almost 4 weeks. The dog weights 72 lbs and the cost for the injection was $172 (two 40mg vials). His pet insurance covers it.

A.W-M. St. Petersberg, FL

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March 21, 2016

Just wanted to give you an update. Our dog, W*****, received two more CADI injections since we last communicated. It worked well for him with no noted side effects. His last CADI injection was at end of January. He has not receive another one since then. He has been on allergy drops based on serum allergy testing for almost 6 months and it seems to be helping. We decided to not give another injection and see if the allergy drops are working to ease his symptoms and it seems to be the case. I know you are not a big supporter of allergy testing and allergy shots or drops, but I do think it is worth trying as there are no other ways to reduce the allergic reactions.

Thank you.
A. W-M.
Saint Petersburg, FL

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April 23, 2016

My 10 year old lab mix has been suffering [] from canine atopy [] for about half her life. Initially, it was periodically; but now, constant and quite severe. She had been treated with antibiotics and fungal medication when flare-ups occur, but she is steady-state itchy and licks and scratches constantly.

We have not felt comfortable with what the dermatology vet [] has been offering regarding immunosuppressive drugs – and have steadily refused them. We have always treated our dog holistically, with minimal vaccinations and meds, using a variety of supplements and homeopathics, and acupuncture. Nothing has helped [her] – even with 2-3 baths per week, washing her dog bed covers when she gets a bath, vacuuming every other day, putting on child tees t-shirts to keep her from licking the elephant skin on her armpits, short walks during pollen season, etc. [] We are at a crossroads because we cannot continue to let this dog suffer. At our visit to Dr. ***** in December, he recommended the CADI shots – he is part of the study – since the Apoquel was unavailable at that time. I did some research (there isn’t much out there) and decided the immunotherapy shots were too new – the study just started last quarter of 2015.

Apoquel was recommended at our last visit to Dr.***** (last week) – the supply is now available, but with a questionable long-term supply outlook. We have not given the dog the Apoquel yet and with the information at your site, are even more wary of the effects on her immune system. We planned to start M**** off on the maintenance dose (~10mg) after discussing the dosing recommended by the dermatologist with my regular vet (~10 mg 2 times per day for 2 weeks, then 10mg/day – M*** is about 50 lbs) and noting your comment that relief is often achieved at lower doses.

Since it seems that the Apoquel can have a broader negative effect on the immune system than the CADI shots (theoretically, I guess) my question is what is your advice about just starting out with the shots vs the Apoquel ?
Thanks.
J.S., Clarksville, MD

Unfortunately, pharmaceutical companies do not share the results of their internal studies with practicing veterinarians or the public. When they do release data, it is generally in relation to a marketing campaign and only the positive data is presented. I suppose that is just raw capitalism at its best. But my intuition tells me that Zoetis would not be developing a product like CADI - which will compete directly with their own Apoquel product - if they did not belieive that there were some drawbacks to Apoquel and if they did not have some data that indicated that their CADI medication was less likely to cause those unwanted effects. If you look over the feedback emails from pet owners on my site; you will see that Apoquel is generally quite effective in alleviating itch. To the best of my knowledge, monoclonal antibodies like CADI are considerable more complex and expensive to produce than JAK inhibitors like Apoquel. The only other reasons that comes to my mind why they might be developing CADI it is that it is "finer-tuned" to target the causes of itching (IL-31) and less likely to produce undesirable side effects. According to their website, unlike Apoquel, CADI appears safe for dogs under one year of age and can, according to the Zoetis , be used in addition to most other atopy medications and treatments. But I have absolutely no direct knowledge or information to base that statement on other than that. If you do decide to try the CADI, please keep me informed as to how it performs for you and your pet.
RSH

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April 20, 2014
 
We have a 6-year-old Doberman Pinscher who [was] itching and scratching to the point that her chin and feet [broke] out in puss-filled sores. We tried the different foods: duck, fat dog formula, etc. Nothing worked.  We went to a vet who started her on Apoquel and she [] cleared up.  We then went to a dermatologist who said that they are now using a shot called Canine MAB Immunotherapeutic [CADI] instead of the Apoquel. She had the shot on April 6, 2016.  She also had a shot called Bactrim [trimethoprim+sulfamethoxazole].  On April 7th she had two nosebleeds and we rushed her to the vet.  They cleaned her up, said they didn’t know what had caused it and sent her home.  That evening she had a huge nosebleed.  On April 14th this perfectly spry and alert dog sneezed and dropped spread-eagle on the floor all four legs paralyzed.  All the doctors say there is no connection between the drugs and what happened.  She went to an emergency vet who wanted almost $9,000 to do an MRI and we would have to agree to surgery before he would run the tests.  They did take x-rays and blood work – all was clear.  We transported her back to our local vet and she is on a steroid regime.  She is able to slightly move her legs but cannot stand.  This is April 19th so its been six days since her collapse.  She is very alert, eats and drinks well and recognizes us when we visit her.  We still have no answers.  If [you know of] anyone who has had these issues or knows anything about what has taken place please let us know.  We are desperate for some answers.
C. H. , Georgia

This email shows the potential danger of making two treatment changes at the same time (and the danger of making snap decisions when a problem occurs). First, the dog received CADI, a medication practicing veterinarians have little experience with. At the same time, it received Bactrim, an antibiotic medication that is know , in rare cases, to cause bleeding. (ref) Third, it was a Doberman pinscher, a breed know to occasionally suffer from a blood clotting disorder that can cause nose bleeds (epistaxis) called Von Willebrand disease. So there is no way for me to know which factor or combination of factors caused this dog's problem. RSH ... 4/25/16 update: The dog was subsequently tested for Von Willebrand disease and found not to have that disease.

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July 15, 2016

I wanted to share with you my experience with Apoquel and CADI for my very allergic dog [Wally he is 6 years old neutered Labrador retriever]. My vet [recently] referred him to a veterinary dermatologist; one of the few who had a regular supply [of Apoquel at the time]. Apoquel had an immediate effect and the poor guy was comfortable for the first time.  The few times we tried to back off Apoquel (25 mg 1 x/day) for a 100 lb dog, we instantly regretted it.  He started itching himself raw, shedding, and smelling.  After 2.5 years on Apoquel, Wally was diagnosed with stage-3 kidney disease. [] The skin vet recommended taking him off the Apoquel and trying monthly CADI shots from Zoetis. The CADI shot worked amazingly and completely eliminated his itch and lasted for 5-7 weeks at a time.  The first time we administered the shot, we noticed a small rash around his muzzle that eventually resolved.  The second shot we feel caused a severe breakout around his muzzle and ear infections in both ears. Once the infections cleared, he was very comfortable and began to grow in a beautiful coat – the likes of which we hadn’t seen before.  He was really comfortable and happy.  We tried a third shot and right away he developed a severe urinary tract infection.  I’m not certain if the [drugs] contributed to his kidney disease, but I do know that his quality of life without it would have been very poor.  I was optimistic for the CADI shot, which worked also very well, but seemed to come with nuisance infections – though I’m uncertain if it would have been the same in a healthier dog.  Between the two, the CADI gave the best relief, but was expensive and the nuisance infections involve the hassle and expense of vet visits and suffering for the pet.  It also seemed that each successive dose of CADI resulted in a longer period of being itch-free, so it could be that over time dogs on CADI will need fewer and few shots.  
I hope this is all useful information for you.  Wally had some complex problems and wasn’t the healthiest dog to start with, so who knows if other dogs would have the same experience on Apoquel or CADI. 
For all his health problems, he was a wonderful dog, who really loved his people and we enjoyed a really nice 3 years with him, only wishing it was a bit longer. 

D.H. Ventura, California

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September 16, 2016

Dear Ron,
You asked if CADI was on the market yet in Holland. Normally the first to have the product is the University Clinic in Utrecht. I checked with them [recently] and the answer was NO.

Regards
P.H. , Kaag, The Netherlands

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September 19, 2016

Hi Ron,
Moby's update.
[According to the University College, Dublin] CADI is not [yet] available In Ireland.
D.S., Dublin, Ireland

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October 12,2016

Several months ago we exchanged emails about Apoquel, and you mentioned a new injectable product [CADI]. Well after 30 years I changed vets, actually didn't change my original vet left and started his own practice [] now we are back together again and he has the injectable. The cost is $57.00 per month but he said it may last as long as three months, so it wouldn't necessary be needed monthly. I am now paying $30.00 per month for Apoquel. So as soon as my present prescription runs out, we're going to give it a try. The cost isn't important, his health and the safety of the new drug is paramount.
Thanks,

S.K.
Cleveland, OH Sent from my iPad