Eur J Pharmacol 2017;794:20-26. It is no surprise we see this omega-3-rich plant with anti-inflammatory and antioxidative properties in many skin and allergy supplements. The frequency of urinary tract infection and subclinical bacteriuria in dogs with allergic dermatitis treated with oclacitinib: a prospective study. 2: The Barn and Pasture: Horses with Summer-Pasture-Associated disease usually have less symptoms when kept in the barn during the warmer months. Each dosage is sold per tablet, in 20 count, or 100 count bottles. Gonzales AJ, Humphrey WR, Messamore JE, et al. Dosing Chart Contraindications Little PR, King VL, Davis KR, et al. All dogs itch sometimes, but when you notice it happening more and more, it could be a sign of a medical condition. In the past 5 years, however, oclacitinib (Apoquel; zoetisus.com), a Janus kinase (JAK) inhibitor, has become another important drug in the management of allergic pruritus. Many allergic reactions are evident as a mild case of transient hives. The drug is primarily used as a tranquilizer to calm anxious pets, especially dogs and horses, according to DailyMed. Before your vet administers immunotherapy, though, you must identify your horses respiratory and skin allergies. Drake GJ, Nuttall T, Lpez J, et al. The frequency of urinary tract infection and subclinical bacteriuria in dogs with allergic dermatitis treated with oclacitinib: a prospective study. Look for a supplement with at least 1,500mg of DHA per serving. Such an immune response is essential for survival; it protects against all sorts of pathogens, from bacteria and viruses to fungi and parasites. Cosgrove SB, Wren JA, Cleaver DM, et al. Banovic F, Tarigo J, Gordon H, et al. Natural Disaster: Are You and Your Horse Ready for Emergency Evacuation? Ortalda C, Noli C, Colombo S, et al. If you must give corticosteroids to an asthmatic horse, your veterinarian might prescribe them to be administered via an aerosol route through the nostril (rather than orally or via injection), which minimizes the amount that gets into the general circulation. Vercelli A, Cornegliani L. Use of oclacitinib for the treatment of acral lick dermatitis in a dog: a case report. Ive used it on a couple of mine, and I also have some friends who have done it. If she stays the way she is now, I will play with spacing it out furtherfirst with every 2 days. APOQUEL FOR DOGS DOSE. You may give this medicine with or without food. By blocking cytokines, Apoquel blocks your dog's skin from itching and inflammation. 22. In the first pilot study, oclacitinib (0.4 to 0.6 mg/kg, q12h for 14 days, then q24h for 14 days) was used to treat pruritus in cats with non-flea, nonfood-induced hypersensitivity dermatitis. Freedom of Information Summary NADA 141-345 Do not use in breeding, pregnant, or lactating dogs. Interestingly, the results suggest that oclacitinib has immunosuppressive properties, but only at a higher dosage than that approved on the label.30. Binding of these cytokines to their receptors activates the JAK-STAT (signal transducers and activators of transcription) pathway, which leads to further cytokine production. Apoquel is sold per tablet in strengths of 3.6 mg, 5.4 mg, or 16 mg. Schindler C, Levy DE, Decker T. JAK-STAT signaling: from interferons to cytokines. Lucile Vigouroux holds a masters degree in Equine Performance, Health, and Welfare from Nottingham Trent University (UK) and an equine veterinary assistant certification from AAEVT. So new drugs such Atopica and Apoquel are prescribed routinely, to help dog owners find a quick fix for dog allergies. This links to a pdf file Storage and Handling : Store at controlled room temperature 20 to 25C (68 . The Vet had put her on Apoquel as an initial dose for 10 days tapering off. Efficacy of oclacitinib (Apoquel) compared with prednisolone for the control of pruritus and clinical signs associated with allergic dermatitis in client-owned dogs in Australia. Apoquel is an anti-itch tablet given twice daily for the first . If the diagnosis is wrong or the medication affects the horse adversely, you could endanger your horse's life. You are encouraged to speak with your prescriber as to the appropriate use of any medication. A blinded, randomized, placebo-controlled trial of the efficacy and safety of the Janus kinase inhibitor oclacitinib (Apoquel) in client-owned dogs with atopic dermatitis. 1,2 For over 30 years, Adequan i.m. Vet Dermatol 2019;30(1):17-e6. Apoquel is not FDA approved to use twice daily longer than 14 days. Hay replacement consists of any of the following: a complete pelleted diet, soaked alfalfa cubes, hay pellets, or possibly a bagged forage product like Chaffhaye. There are a few medication protocols for horses with Equine Asthma. The dosage for dogs 15-19.9 lbs is one 3.6 mg tablet twice daily. Oclacitinib is available in 3 different tablet sizes: 3.6, 5.4, and 16 mg. actually treats degenerative joint disease (DJD), not just its clinical signs. But I had my mare tested last year, she also came up allergic to some foods (flax being one) for which I was told serum was not an option. Thereafter the dose should be reduced to once daily for maintenance. This might, down the road, be an easier and less expensive alternative for horse owners. Apoquel Dosage for Dogs. J Zoo Wildl Med 2017;48(3):818-828. Interleukin-31: its role in canine pruritus and naturally occurring canine atopic dermatitis. Oclacitinib in feline nonflea-, nonfood-induced hypersensitivity dermatitis: results of a small prospective pilot study of client-owned cats. Breeding and Reproduction Horse breeding from planning through foal care; Diseases and Conditions Horse-health-problem risk factors, prevention, diagnosis, and treatment; Farm and Barn . But you're making a deal with the devil when you use these . Cost is about $10 per day for the first few weeks of treatment, and may decrease to around $5 per day depending on the horses response. Repeated oral dose tolerance in dogs treated concomitantly with ciclosporin and oclacitinib for three weeks. Initially, the recommended dose of 0.4 to 0.6 mg/kg should be given twice daily for up to 14 days. found a significant improvement in 76% of horses with skin allergies within one year of using allergen-desensitization serums. For years, glucocorticoids and cyclosporine have been used for the symptomatic management of atopic dermatitis, including the associated pruritus. While oclacitinib is a very effective and fast-acting antipruritic drug, the decision of when to use it depends on various factors. Dexamethasone: EZ Dose Micro Transdermal Gel, Dexamethasone: Twist-a-Dose Transdermal Gel, Discussion Guide for Pet Owners and Veterinarians, Medication Information for Pet and Horse Owners. Maximizing ventilation when horses are stalled and bedding with low-dust options such as wood byproducts; Purchasing dust- or mold-free hay and wetting, soaking, or steaming it prior to feeding to reduce inhaled particles; and Offering an alternative feed than hay for low-dust options. Apoquel (oclacitinib tablet) Dosing & Administration How to dose Apoquel 0.4-0.6 mg/kg (0.18-0.27 mg/lb) Twice daily (BID) for up to 14 days Continue therapy once daily (SID) thereafter for maintenance May be given with or without food May discontinue without tapering Apoquel Dosing Guide Weight Range (lb) Number of Tablets to be Administered Noli C, Matricoti I, Schievano C. A double-blinded, randomized, methylprednisolone-controlled study on the efficacy of oclacitinib in the management of pruritus in cats with nonflea nonfood-induced hypersensitivity dermatitis. What company did you use? Therefore, in many of these cases, veterinarians use steroids sparingly, says Fultz, at lower doses than recommended, or they turn to non-steroidal medications. When your dog is itchy, you get desperate to make him feel more comfortable. I often recommend switching your Asthma horse off of regular hay and trying a period of hay-replacement to see if it helps. Fultz adds that over time this process teaches the immune system to tolerate exposure to substances it previously considered irritating. Read on below! She reports choosing Apoquel over corticosteroids in several of her allergic patients that are also at risk for developing laminitis. This content is intended for counseling purposes only. Less common side effects include diarrhea, vomiting, lack of appetite, dry mouth and mild straining to urinate. A native of Japan, Dr. Hensel subsequently moved to Basel, Switzerland, where she opened a veterinary dermatology practice in 2014. Veterinarians are especially wary of administering corticosteroids to allergic horses that suffer from pituitary pars intermedia dysfunction, insulin dysregulation, and/or equine metabolic syndrome, because these conditions are also risk factors for laminitis. For atopic and allergic dermatitis, Apoquel may be given to dogs at a dosage of 0.18 - 0.27 mg/lb. According to the manufacturer's dosage chart, a large breed weighing between 130 and 175lbs should take two Apoquel 16mg daily. Researchers have proven flaxseed reduces skin lesions in IBH horses (ONeill et al., 2002). Orthobiologic Options for Treating Horses. These animals require the opposite regimen. Apoquel is an anti-allergy drug that's often prescribed by vets. Long-term compassionate use of oclacitinib in dogs with atopic and allergic skin disease: safety, efficacy and quality of life. My dog has been on apoquel for about 2 years. 23. We have had variable results with this treatmet. For years, glucocorticoids and cyclosporine have been used for the symptomatic management of atopic dermatitis, including the associated pruritus. Control of pruritus associated with allergic dermatitis and control of atopic dermatitis in dogs at least 12 months of age. Adverse events were reported in less than 5% of dogs, including urinary tract infection, vomiting, otitis, pyoderma, and diarrhea.9 A subsequent study concluded that there is no increased risk for urinary tract infections.10, The efficacy of oclacitinib was also compared to that of other drugs such as prednisolone and cyclosporine. The pharmacokinetics of oclacitinib maleate, a Janus kinase inhibitor, in the dog. Trials showed that spreading out dosing was more successful than lowering. Acupuncture: It appears that some horses with Equine Asthma can benefit from acupuncture to help with breathing function. Oclacitinib is available in 3 different tablet sizes: 3.6, 5.4, and 16 mg. Clenbuterol should only be used short-term, since it will stop working with long-term administration. Webcast | To ensure that it's easy to administer the proper dosage to your dog, this treatment comes in three different dosages. 6. Pollen and other plant-based aeroallergens are the source of their distress, and they fare much better inside a well-ventilated barn. Lopes NL, Campos DR, Machado MA, et al. Assuming you cannot contact your vet: For hives or possible allergic airway disease (heaves), for a 1000 lb horse, give 5-10 tabs of 25mg diphenydramine crushed up and mixed in water and dosed in a syringe orally (by mouth). A follow-up study assessed the long-term safety, efficacy, and quality of life of oclacitinib-treated dogs. This would be treatment with a systemic steroid (usually dexamethasone or prednisolone). To overcome its delayed effect, cyclosporine is often initially combined with other drugs such as prednisolone to accelerate the anti-inflammatory and antipruritic effects. Insect and pollen season is here. Adv Vet Dermatol 2017;8:192-198. Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. This study showed that pruritus was improved in only 42% of the study population; thus, use of oclacitinib in cats did not seem to be as effective as in dogs.17 A follow-up study was conducted with a higher dose (0.7 to 1.2 mg/kg) and a longer induction period (28 days). Vet Dermatol 2015;26(1):23-30, e7-8. Apoquel is typically administered in tablet form at 0.4-0.6mg per kilo of body weight, or 0.18-0.27mg per pound of body weight, every 12 hours or twice a day. In a 2019 study Radwanski et al. Transdermal applicator that gives easy & accurate dosing every time. Im hopeful, however, that I will be able to stretch out more so that Im looking at $250 across 8-10 weeks instead. Gadeyne et al compared prednisolone and oclacitinib at recommended doses and found that both drugs resulted in similar rapid effects with regard to pruritus and dermatitis reduction.11 Little et al compared oclacitinib to cyclosporine. If your horse worsens when hay is re-introduced, you'll need to consider a permanent change to one of the other options! After completing a doctorate thesis and a rotating internship at the University of Zurich, Switzerland, he moved to the United States, where he completed a 3-year veterinary dermatology residency at the University of Georgia in 2004. Oclacitinib should not be given in dogs younger than 12 months of age due to an increased risk for activating demodicosis, bacterial pneumonia, and other serious infections. 4. Immunomodulatory in vitro effects of oclacitinib on canine T-cell proliferation and cytokine production. 11. Cochet Faivre N, Degorce-Rubiales F. Clinical eosinophilic popular dermatitis associated with histological eosinophilic granuloma rapidly responsive to oclacitinib in an adult Labrador retriever. Unlike some other allergy. 8. Many of these cytokines bind to cytokine receptors that have JAK enzymes associated with their cytoplasmic portion. 23. llergies can develop at any time, in any horse, and for virtually any reason. The dose range is very strict, I do not recommend going above the recommended dose due to immune suppression, below the range and it doesn't seem to work in most cases. One of my horses was tested at New Bolton (he has since passed away) and I was told that a serum wasnt possible or effective for most of his food-bourne allergies. This is a new treatment option, and currently the tablets are not FDA approved for horses, only dogs. Comparing Apoquel and Cytopoint. Several reports of successful use of oclacitinib to treat other diseases have been published. I spend $150 a month on my horse on apoquel. Licorice Roo t (Glycyrrhiza glabra) This sweet and soothing herb has been used medicinally for over 3,000 years. Thank you! Really? She would be a scratching mess without it. Join us as we interview leading equine researchers from the University of Kentucky, Problem Solver Series: How to Control Nuisance Birds on Horse Properties. These and other kinase-inhibiting drugs sometimes work very well to stop the itching. If your horses allergies are seasonal, talk to your veterinarian about steps you can take to stay ahead of them. The second option is serum (blood) testing. In the first 2 randomized, double-blinded, placebo-controlled clinical trials, it was shown that oclacitinib, given at a dose of 0.4 to 0.6 mg/kg q12h, induced a rapid reduction in pruritus and treatment success in 62.3% to 67% of treated cases within 7 to 14 days. Right now he is on an Aservo Inhaler but I dont see any improvement and he is getting real tired of the application process. Haugh IM, Watson IT, Menter MA. Vet Dermatol 2018:29:371 (abstract). Pulsoni D, Freire A, Ferreira DR. Juvenile-onset ischemic dermatopathy. 20. APOQUEL may be administered with or without food. If you mix it in their food, ensure that your pet chews the treatment rather than swallowing it without chewing for effective results. Rosenkrantz WS, Bourgeois AS. Helpful steps you can take include providing full-body fly apparel, applying fly spray liberally, avoiding turnout at dusk and dawn, and using fans in stalls to disrupt insect flying patterns. Fukuyama T, Ganchingco JR, Bumer W. Demonstration of rebound phenomenon following abrupt withdrawal of the JAK1 inhibitor oclacitinib. In cats, this medication can cause excitement rather than sedation. "Even though the drug is currently labeled for use in dogs (with. Initially, the recommended dose of 0.4 to 0.6 mg/kg should be given twice daily for up to 14 days. 1,2 The #1 prescribed medicine for allergic itch in dogs. You can give your dog Apoquel with or without food. The mare luckily didnt have a lot of food allergies and eliminating flax wasnt a big deal. FALL 2019. m. Editor: Norma White-Weithers, MS, DVM, DACVD Veterinary Allergy & Dematology Consultant, Baldwin, NY 11510 Work: 646-329-4719 . Sometimes it goes overboard and reacts in the face of a generally harmless substancewhich the body begins to recognize as an allergenand an allergic reaction occurs. The most common side effects associated with Apoquel are vomiting, diarrhea, and lethargy. Equine Nutrition FAQ Series, sponsored by Purina Animal Nutrition. This is interesting. Cosgrove SB, Cleaver DM, King VL, et al. Vet Dermatol 2016;27(Suppl 1):84 (abstract). Milder cases of asthma are still associated with coughing, airway inflammation, mucous production, and poor performance.. Its an easy and cost-free strategy you can do yourself. Powered by Discourse, best viewed with JavaScript enabled. In fact, in our recent study evaluating almost 400 potential allergens, latex proteins were the most significant allergens for diagnosing severe equine asthma.. 29. Apoquel has not been tested in dogs receiving some medications including some commonly used to treat skin conditions such as corticosteroids and cyclosporines. Feline idiopathic ulcerative dermatosis treated successfully with oclacitinib. Pre-slaughter withdrawal time is 14 days following the last dose. Then reintroduce each, one by one, while monitoring for hives or other signs of allergies. Apoquel is a prescription medication used to treat itching and inflammation in dogs. 26. It's typically prescribed twice daily for up to 14 days and then once daily after that. Allergies primarily affect the immune, respiratory, and integumentary (skin) systems and, if unmanaged, can seriously impact an animals performance and well-being. Until recently, glucocorticoids (systemic and/or topical) and cyclosporine have been considered the most effective symptomatic treatment options to manage atopic dermatitis.5 Oclacitinib is now also an effective option (BOX 1). It is important to address that the use of oclacitinib in cats is off-label, and owners should be informed before using oclacitinib in this species. The most common side effect is lethargy, dry mouth, and urinary retention. The recommended Apoquel (main ingredient, oclacitinib) dosage for dog use is as follows: The recommended dosage is 0.18 to 0.27 mg of oclacitinib per pound of body weight, for the first 14 days. The concentration of the drug is 500 mg/ml. Soaking hay can be time-consuming but is vital to helping horses that are showing signs of respiratory allergy., Feeding hay at ground level offers an added benefit: To maximize respiratory health, horses should spend portions of the day with their heads down, the way nature intended, she adds. Vercelli A, Cornegliani L. Use of oclacitinib in treatment of canine idiopathic ear tip vasculitis. Stay current with the latest techniques and information sign up below to start your FREE Todays Veterinary Practice subscription today. Simple strategies for dust reduction include removing the horses from the stalls when mucking out and blowing the aisle or ditching the leaf blower altogether, Fultz says. Vet Dermatol 2014;25(6):512-518. Since the vast majority of Equine Asthma patients do not have a histamine-associated problem, this isn't likely to work for most. Log in to fill, refill or renew the medication prescribed by your veterinarian. Option 1 is the cheap/easy route, but comes with risks. We have been using an inflatable fleece e-collar on her . These reports suggest the potential use of oclacitinib in, While oclacitinib is a very effective and fast-acting. Its anti-inflammatory and expectorant properties can soothe irritated lung tissues and help to expel mucus.Licorice root should not be fed to pregnant mares. Vet Dermatol 2019;30(2):110-e30. Apoquel sorted the problem in a day but after doing some research after noticing her doing some chewing again Apoquel has some disturbing side effects as it suppresses the immune system. This drug has been used in dogs with some pretty fabulous results. Your veterinarian might also prescribe corticosteroids such as dexamethasone or prednisolone, which provide fast and effective relief from immune-mediated conditions such as allergies because of their immunosuppressive properties. So I think cost becomes dependent on that. Why Do Some Horses Develop Respiratory EHV-1 and Others EHM? Option 4 is an oral tablet called Apoquel. 7. Simpson AC, Schissler JR, Rosychuk RAW, et al. 7. Apoquel has been used safely with many common medications including parasiticides, antibiotics and vaccines. Many medications are available to help manage your horses allergies, some of which are best used as preventives in sensitive horses. Many of these cytokines bind to cytokine receptors that have JAK enzymes associated with their cytoplasmic portion. I havent noticed any abnormal side effects. These animals require the opposite regimen. This product came to the market in the US in Fall 2020. Saridomichelakis MN, Olivry T. An update on the treatment of canine atopic dermatitis. Apoquel is the #1 prescribed medicine for fast, effective relief of allergic itch and inflammation due to atopic and allergic dermatitis 1 Indications Control of pruritus associated with allergic dermatitis and control of atopic dermatitis in dogs at least 12 months of age. Cosgrove SB, Wren JA, Cleaver DM, et al. 14. She reports choosing Apoquel over corticosteroids in several of her allergic patients that are also at risk for developing laminitis. Since it became available in 2014, several clinical studies have confirmed its antipruritic effect not only in dogs but also in cats, as well as in other immune-mediated diseases. We do a loading dose for 7 days, then every other day for 7 doses (so 14 days) then work to figure out how far apart we can go with our daily dose. Dosage and treatment schedule The recommended initial dose is 0.4 to 0.6 mg oclacitinib/kg bodyweight, administered orally, twice daily for up to 14 days. Dawn M. Cleaver, DVM Associate Director, Regulatory Affairs Dexamethasone commonly is used in horses to treat allergic reactions such as respiratory allergies, chronic obstructive pulmonary disease (heaves), hives, itching and inflammatory diseases including arthritis. Apoquel may increase the chances of developing serious infections, and may cause existing parasitic skin infestations or pre-existing cancers to get worse. Oclacitinib (APOQUEL) is a novel Janus kinase inhibitor with activity against cytokines involved in allergy. She then completed a 1-year rotating small animal internship in Massachusetts followed by a 3-year veterinary dermatology residency in Georgia. Topical suspension administered in the ear. Uses for Apoquel A Magnawave-certified practitioner, Lucile also runs a small equine PEMF therapy business. Treatment success in three Andean bears (Tremarctos ornatus) with alopecia syndrome using Oclacitinib maleate (Apoquel). Before your vet administers immunotherapy, though, you must identify your horses respiratory and skin allergies. The dose of APOQUEL (oclacitinib maleate) tablets is 0.18 to 0.27 mg oclacitinib/lb (0.4 to 0.6 mg oclacitinib/kg) body weight, administered orally, twice daily for up to 14 days, and then administered once daily for maintenance therapy. Merck & Co., Inc., Rahway, NJ, USA (known as MSD outside of the US and Canada) is dedicated to using the power of leading-edge science to save and improve lives around the world. If you struggle to get your dog to take tablets, you can try hiding it in their food, or wrapping it in a tasty piece of meat. This content is intended for counseling purposes only. The only FDA-approved equine PSGAG. In many cases, symptomatic therapy alone with drugs such as oclacitinib is insufficient to control allergies long-term. Adverse events were reported in less than 5% of dogs, including urinary tract infection, vomiting, otitis, pyoderma, and diarrhea. This content is informational/educational and is not intended to treat or diagnose any disease or patient. Since oclacitinib is a rather weak anti-inflammatory drug, it was suggested that remission of active moderate to severe atopic dermatitis be induced with a course of a broad inflammation-targeting drug, such as a short-acting glucocorticoid, until clinical signs become mild. Unfortunately since her allergies have jumped from skin to also being respiratory, zyrtec even 15 pills 2x a day does not do anything and even dex only worked at high doses. These are known as allergy shots. Dr. Nao Hensel obtained her doctor of veterinary medicine degree from Colorado State University in 2010. Pollen and other plant-based aeroallergens are the source of their distress, and they fare much better inside, Many allergens can cause skin reactions. Pruritus is a common clinical sign in allergic skin diseases. Luckily most of her allergies appear to be insect-based and she responds very well to the serum for that. 11. Most common side effects are vomiting and diarrhea. The most common practical starting dosage for many cats is of the 5.4mg tablet, or 2.7mg. I was one of the veterinarians involved in early field trials for Apoquel in horses. A blinded, randomized, placebo-controlled trial of the safety of oclacitinib in cats. Because its essentially impossible to predict these events, its important to keep records of your horses previous reactions and communicate them to your veterinarian. 18. Until recently, glucocorticoids (systemic and/or topical) and cyclosporine have been considered the most effective symptomatic treatment options to manage atopic dermatitis. Search term . Side effects have been rarely seen and documented, but the most common occurrences have been mild vomiting and diarrhea. Horse dosing is 5 pills. How Should It Be Given? A newer prescription drug, Apoquel (oclacitinib) has recently hit the market and might prove useful for allergic horses. Apoquel doses are usually between .04-.06 milligrams per kilogram of body weight (mg/kg) . You can use a nebulizer, an inhaler, or a single-nostril aerosol chamber. View more. 5. She has been allergy tested! 12. Hydroxyzine is usually given orally twice to three times daily in dogs, cats, horses and birds. Transdermal applicator designed for easy handling and accurate dosing. Zyrtec: The human antihistamine may be beneficial in a small proportion of horses with Equine Asthma. The drug targets pro-inflammatory proteins, called cytokines, responsible for itching and inflammation, relieving signs of skin allergies. Like most treatments, this medication will not be successful in every horse, but if it does work, it avoids the risks associated with steroids. Thats def not nothing but its not insane. Avoid storing hay in the same barn as sensitive horses, since hay particles and spores can be irritating, even from a distance and even if they are not visible in the air. There is a new drug available to help allergic horses: Apoquel. not random, very relevant and helpful! . We can let your veterinarian know that you are interested in our compounded Dexamethasone. Simpson AC, Schissler JR, Rosychuk RAW, et al. Speak to yourveterinarian in an emergency. An antibody called immunoglobulin E (IgE) is produced when the body detects an allergen, says Samuel White, PhD, a professor of equine science at Nottingham Trent University, in England, known for his research on allergen identification and diagnostic development in the horse. 30. Olivry T, Banovic F. Treatment of canine atopic dermatitis: time to revise our strategy? The Feed: One of the most common recommendations for managing Equine Asthma has always been to stop feeding hay. Most recently, it was suggested that the treatment strategy for canine atopic dermatitis might need to be adjusted. Stay up-to-date on the latest news about your horse's health with FREE newsletters from TheHorse.com. Vet Dermatol 2017;28(5):512-e123. 1. Vet Dermatol She has a master's degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in 1982. Like other medications in its class, it may also be used off . Dosage and administration For oral use. Vet Dermatol 2014;25:153 (abstract). Loft K, Simon B. May be used with other common medications.