#cytopoint

So I listened to a talk from a drug rep the other day who came into the clinic to promote Cytopoint, the anti-allergy injection for dogs.

It’s a great drug, overall. Super useful for many, literally life changing for a few, and now a mainstay of the allergy treatments we offer. But I had to laugh at something the rep said:

“It’s not really a drug. It’s a bio-mimicry molecule! It’s replicating normal molecules that would be found in the body and just providing more of them!”

And I’m sitting here thinking: that is still totally a drug. A drug is any substance which when given to a living organism produces a physiological effect. 10mg of lokivetmab is most definitely a drug.

But if you are going to argue that Cytopoint is not a drug because it mimics a natural molecule found in the body, then by that logic neither are insulin, thyroxine, cortisone or just about every single hormone.

For goodness sake. I have to wonder what planet marketers live on some days.

We also had a bit of a debate because we’re widely told that Cytopoint shouldn’t have any side effects. Partly this is because monoclonal antibodies aren’t well known in veterinary medicine and they haven’t been around that long.

They’re certainly much safer than the equivalent drugs in other classes, but they’re not ‘side effect free’. They’re a protein, so it’s theoretically possible to be allergic to it. Like the Kesimpta I take it seems likely that some dogs will be ‘off colour’ for a day or so. The most common side effect is being quiet the next say, so it is pretty mild for a typical dog and still worth it. But it’s not zero.

Having a headache for a day is much milder than having acute kidney failure, but I wonder if we’ll get more reports in the future of extremely sporadic weird side effects as we gain more experience with this class of medication.

Medical advancements are wonderful and exciting. But don’t let marketers do all the talking!

Tristan is too good to be real. Unbelievable boy.

[Video Description: Tristan, a black and white cocker spaniel, sits eagerly on a grooming table. A person's hands show him a syringe and needle. Tristan licks toward the syringe, then ducks his head to make it easier to reach his neck, and holds himself still. The hands administrator the injection in the syringe, as Tristan holds himself steady. Tristan is told "all done!" and he wiggles happily as he is shown the empty syringe. (Not shown: many treats!) Sound is muted.]

Cytopoint has worked well with Alyssum but it doesn't with all dogs.

Regarding the side effects, frankly I more than considered those worth it with my dog. I was going to euthanise her at *3*, so I didn't care if it meant she might have issues later, because no matter what that would have been time with a good quality of life than she otherwise would have had. Being constantly itchy is maddening and significantly decreases quality of life. The reason I got Alyssum off the apoquel was because, after 5 years, she was showing some bone marrow suppression. However, she was also on 8mg a day which is twice the normal dose for a dog her size, and she was still somewhat itchy even on that. It was just no longer constant and driving her to self mutilate.

If cytopoint had not existed or had not worked, Alyssum would still be on apoquel. Because quality of life is more important than quantity with animals.

This week I got out a shot I needed to give Tristan and showed it to him (so he would know what to expect), and he got really upset. Ducked under the couch like he does when he thinks something is going to be awful. I put Gwyn in her room and just waited for him (only a few minutes, he wasn't trying to evade, just register a protest, which is totally acceptable)

When he did come up to me, I showed him the syringe again, tapped his back, lifted a tent of skin, gave him the subQ injection... he didn't have a problem with any of that. He was still bracing for the awful thing that he was afraid would happen. I told him he was done and he did the Tristan Happy Dance (bouncing straight up to tap my hands with his nose).

So if it wasn't the shot, what made him so upset? Tristan really, really dislikes being bodily restrained; I think that's probably what he was expecting. Something about the feeling is really upsetting to him, I have always thought it's probably related to the way his skin has just always been extremely sensitive. I had not realized *how* much of his dislike of vet visits is related to being held at all, rather than being manhandled by a relative stranger. I will have to work on that, see if we can desensitize the lil guy some.

Every year as the days get hotter, Tristan spends less time outside and is a little lethargic inside. Very reasonable, right? Every other creature in Florida does the same.

We've been trying to figure out why he produces such an enormous amunt of (not infected) goop from his eyes, and dealing with severe skin reactions to some biting insect. We tried Cytopoint a month ago.

It's getting hotter out, still, but every day now Tristan is having a *better* day. More playful outside and inside, spending more time outside, more into mischief every day. In this video, he's been patiently trying to teach Gwyn how to play "keep-away" properly (pick up the toy, mouth the toy, pretend to drop it, pick it up, push it away from you; Gwyn is having a little trouble with pushing it far enough away when she volleys it back).

Cytopoint offers long-lasting relief for dogs suffering from atopic dermatitis. Learn how it works and if it's right for your pet.