Itchy & Twitchy Pets Part 2: What’s New in Dermatology Medications?

To bring some humor to part two of this blog discussion of skin products, I thought I would start with my December 1965 Christmas photo pfeaturing my “fake hair pony tail”. I look at it now and think it looks like one of those before pictures of extreme makeovers. What was I thinking? 

I mention this because pets hide a lot of things internally. However, when there is itching and the hair looks bad, there is no doubt things are awry. So I will "fly in" to some of the new medications. (Yes, that is me with a Piper Cherokee airplane  I flew during veterinary school in the late 1970’s.)

Is there a once a day oral antibiotic for superficial skin infections?

Yes!Cefpodoxine (Simplicef) is a 3rd generation cephalosporin administered orally once a day. The concern with this drug longterm is that overuse of antibiotics sometimes leads to things such as Methicillin-resistant Staphylococcal pseudointermedius. This  antibiotic should be saved for more advance infections, not the first line treatment. 

As mentioned last week, when possible, skin infections should be first treated with topical antiseptics. This lowers the risk associated with long term,repetitive use of antibiotics and possible drug resistance. There are other oral  antibiotic medications, such as potentiated sulfa drugs and higher doses of oral clindamycin that should be tried initially if once once a day treatments are suggested.

My pet is difficult to give oral medications to and often becomes nauseated after administration. Is there an antibiotic injection that lasts 7 to 14 days?

The injectable cefovecin (Convenia) is also a 3rd generation cephalosporin that has broad spectrum activity compared to traditional cephalexin for skin infections. Concerns with use of this product include that once the effective blood level is gone; there is a sub-therapeutic level that may persist in the tissue for up to 2 months. The potential is multi-level drug resistance with future use. Therefore, use should be limited to pets who are difficult to medicate orally, exhibiting nausea , or when first or second level tier antibiotics were tried and found ineffective. 

What's new in topical ear medications? 

Most medications are dispensed in drops, and that can be difficult to accurately administer due to inadequate volume or improper administration/application. EasOtic (Virbac) is approved for treatment of ear infections with a once-a-day treatment for five days using a pre-measured 1ml pump system. It goes deep into the ear canal. In my experience, this is easier for owners; however, many pets may need two to four weeks (or more) of topical medication. This is due to the chronicity of the infection that is secondary to the primary issue of flea, food, or environmental allergies. 

My dog is on oral prednisone to cut scratching. It leads to increased thirst and urination. Are there any alternatives to suppress the itch reflex?

Oclacitinib (Apoquel, Zoetis) is a JAX (Janus kinase) inhibitor and was recently approved to treat severe, chronic itching attributed to allergies when other treatments have failed.  It was introduced in the spring of 2014, and has none of the common side effects attributed to steroids such as prednisone. Unfortunately, it was wildly successful in its first two weeks on the market, so much so that the entire year’s drug supply was used up!  Dosing is twice-a-day for 14 days in dogs. After 14 days dosing is once-a-day. Note: This medication can mask mange, flea, bacterial, and yeast infections. It is best used as a temporary medication to alleviate incessant scratching until the primary disease is identified, such as adverse food reaction or environmental allergies.  

I conclude to pay tribute to Misty Beasley, a fabulous therapy dog that recently passed away. She was loved and will be deeply missed by all of us at Creature Comforts.

Betsy Sigmon DVM, Diplomate American Board of Veterinary Practitioners, Canine and Feline

Creature Comforts Animal Hospital

Cary, NC 27518