Lokivetmab

So we think about steroids and JAK inhibitors, inflammation plus itch, which is really nice.

Your third option for fast-acting, effective itch control would be a monoclonal antibody, right? So we know of Cytopoint, and now we have Bifrena as well.

So we have these two monoclonal antibodies that could be very effective to help alleviate itch quite quickly.

So stop that lick behaviors.

Yeah.

So as a pet store owner, you need to stay up to date on all the drugs, the Cytopoint, the Baranza-

Yeah

...

It's like, like I had one client who came to me.

She'd been going to the dermatologist for three years.

The dog had been on Apoquel and Cytopoint, so it's going, getting Cytopoint injection every month.

It's on Apoquel.

When we look at healing these problems, this is where there is not a magic pill to fix it overnight.

I know sometimes like steroids and Apoquil and Cytopoint, like they can seem like that.

But they're treating a symptom.

And that's why we don't get lasting results or effect from those medications, because we actually have to look deeper and ask, why is it actually there? And then resolve and fix the systems, which takes time.

Which is a great segue into the next one about symptom suppression because that got people heated.

People did not like Dr. Dell saying that Cytopoint, Could be used long term and likely is not going to cause cancer that he doesn't have concern around that.

And over and over again, maybe I posted the wrong clip and it wasn't clear.

I don't know.

Let's talk about cyclosporine, which I have to use in some of my really itchy patients.

And we do think that there's an increased, it's small, increased risk of lymphoma with that.

And so I guess when people are really upset that they think we're lying about the fact that Cytopoint is not going to increase your dog's risk of cancer, that's real.

It's not.

So my questions are...

What do we do as far as starting? How long does it take to see improvement? If he will take it, if he refuses it, what other options do I have? Could I use something like Cytopoint, which is a monoclonal antibody? So this is always difficult, right? Those pets that do not want to take medications.

And certainly we see this a lot in cats, but we could certainly see it in dogs as we are with this German Shepherd.

One thing I'd like to, I guess, remember if you're able to use this is how palatable, chewable Apoquil is.

And we're rechecking them, right? We're rechecking them to see how well they're responding and then making decisions once they are doing well of how we can try to take a step back from those medications.

So ending the last part of that question, monoclonal antibodies.

So using something like Cytopoint or when it's more widely available, something like Bafrena, which are both interleukin-31 monoclonal antibodies.

It's probably not going to do much, honestly, because the reason we're seeing some of these JAK inhibitors be helpful, right? And think about all the other medications we use for autoimmune disease, steroids, cyclosporine, and then other ones even like azathioprine and DODS, mycophenolate, we are really decreasing inflammatory mediators in a lot of these cases.

If you develop allergies and you start this allergic march where you're getting worse and worse every season, and you're spreading from dermatitis to asthma to rhinitis, you can also kind of intervene to try to stop that as well.

And then if we know the immune mechanism and we know that interleukin-4, IgE, other chemicals that are involved are interleukin-31, which we'll talk about a miracle, magical allergy treatment in dogs called Cytopoint blocks interleukin-31.

then we can really kind of target molecularly really specific proteins and this is kind of where we get into peptides which is all trendy on the human side right now.

So we could use peptides, monoclonal antibodies and target these and have very specific effects.

So then the question is what kind of side effects does it have? So all of these are going to have good things and bad things about them.

In dogs we're actually a little bit ahead.

We have a drug called Cytopoint which is one of these monoclonal antibodies and it blocks interleukin-31.

And it turns out that of all of these 30 chemicals that the mast cell releases and that's involved in this immunomechanism, the interleukin-31 is the elephant in the room and this injection you can give it within 24 to 48 hours, it can shut down 90-95% of the allergy symptoms, especially in dogs with environmental allergies.

If you develop allergies and you start this allergic march where you're getting worse and worse every season, and you're spreading from dermatitis to asthma to rhinitis, you can also kind of intervene to try to stop that as well.

And then if we know the immune mechanism interleukin-4, IgE, other chemicals that are involved are interleukin-31 which we'll talk about a miracle, magical allergy treatment in dogs called Cytopoint blocks interleukin-31.

Then we can really kind of target molecularly really specific proteins and this is kind of where we get into peptides which is all trendy on the human side right now.

So, we could use peptides, monoclonal antibodies and target these and have very specific effects.

So then the question is what kind of side effects does it have? So all of these are going to have good things and bad things about them.

In dogs we're actually a little bit ahead.

We have a drug called Cytopoint which is one of these monoclonal antibodies and it blocks interleukin-31.

and it turns out that of all of these 30 chemicals that the mast cell releases and that's involved in this immunomechanism, the interleukin-31 is the elephant in the room and this injection you can give it within 24 to 48 hours, it can shut down 90-95% of the allergy symptoms, especially in dogs with environmental allergies.

Yeah.

It's, it's really, and going back to the whole Applequell thing, like, Oh, well my pet and Cytopoint or catty injection.

Oh yeah.

Well we come in every four to six weeks for the, their, their catty, their Cytopoint injection.

And I'm like, that's not normal.

This shouldn't be a normal part of your pet's like maintenance.