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The advent of monoclonal antibody therapy in treating osteoarthritis in dogs and cats

April 2nd, 2023

If I look back on a professional career that will extend to forty years next year, I can count on my fingers and thumbs the number of new medications that have changed the way we work as vets. Dramatic advances in treatment are rare. 

Advances in the treatment of allergies in veterinary practice(as detailed in a previous post) were the last I would put in this category. Before that pimobendan was a game-changer for the treatment of heart failure (and my own dog was one of many to benefit), reversible sedation changed veterinary practice forever, and among vaccines feline leukaemia and feline AIDS vaccines would save even more lives if we could persuade more cat owners to use them. The original Parvo epidemic swept through the UK in the mid70s so when I started seeing practice late in that decade a vaccine was available already, thank goodness. I heard the stories of litters of pups dying only at second-hand.

I think we are standing on the brink of another such advance. The use of monoclonal antibodies in the treatment of osteoarthritis in both dogs and cats will mean, I believe, that we will treat this common, painful and debilitating disease differently in the future.

There will be a change, I think, from daily or twice daily oral anti-inflammatories and pain-killers to a simple monthly injection. These treatments have been in use in the UK and Europe for two years now so they are not new, though they are new to Australia. A response to treatment should be seen within seven days. The minimum commitment required from an owner to assess the benefit is two injections a month apart, though the intention is to inject the patient each month thereafter as the level of pain relief increases over time. 

Does it cost more than traditional medication? Yes, a little, though the price difference is minimal for larger dogs on multiple medications at the moment. Given the enthusiasm with which regular anti-allergy injections have been accepted by my clients, I am confident that there will be a demand for these new treatments. Discuss them with me on your next visit to the clinic.

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Christmas and 2023

December 19th, 2022

Like many families,my family will be together at Christmas for the first time in three years.

To give us a little extra time together the practice will be closed on Christmas Eve (Saturday 24th December) and reopen on Wednesday 28th December. We will be open as normal on New Year’s Eve (Saturday 31st December) then closed till Tuesday January 3rd.

As with all businesses, the practice is facing inflationary pressure. Unfortunately our fees and charges will increase by an average of 7% from January, in line with CPI. I have held back prices from some suppliers so there may be a small number of items where the price increases exceed CPI. 

I’d like to thank you for your support over the year and wish you, your families and pets a Merry Christmas and Happy New Year! 

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Notice of 2 Saturday closures

March 13th, 2022

I have to give notice of two Saturdays on which the practice will be closed. On Saturday 19th March I will be attending the first day of a two day ultrasound course allowing me to get the best out of our new ultrasound machine.

On Saturday 16th April (Easter Saturday) I hope, COVID allowing, to be in Melbourne visiting one of my sons, and my sister and her family.

I apologise for any inconvenience but, as you will appreciate, for different reasons these are appointments I must keep.

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Because everybody loves free stuff

September 12th, 2021

The vast majority of clients that visit the practice value and appreciate us. In Andrew’s case probably more than he deserves. But there is a tiny minority of the pet owning public that consider all vets to be the enemy.

Please don’t tell them about this post:

Dear Reader,

If you have a puppy please allow me to remind you that, for some time now, we have offered a first heartworm prevention injection to puppies at no charge.

That’s three months heartworm prevention for free. At three months of age.

Thank you. No, really Thank YOU.

PS Should we tell them pups that come to Puppy Preschool get free intestinal wormers too? No, I agree, let’s keep it between ourselves.

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Allergies 2.0

September 12th, 2021

Eight years after my last blog post about allergies, I think it’s time we revisited this important subject. Especially because, in the intervening years, the treatment options we can offer have improved dramatically.

Two products for allergy treatment released on to the veterinary market in the last few years are the mainstays of our allergy management now. They are Cytopoint and Apoquel. Cytopoint is an injection and Apoquel comes in tablet form. Both are registered for dogs only. Apoquel can be used in cats as an off-label medication (which means as an owner you assume the risk for side-effects rather than the manufacturer or, well, me) but Cytopoint cannot.

I would struggle to say which is superior, even after several years of using them. It is true that one of the two may be more appropriate for a particular patient, and for a particular owner so let me expand on that.

Efficacy is the first consideration – does the product work? If Cytopoint works, I think it abolishes the itching and scratching associated with allergies more completely. Since Cytopoint will work for at least 2 weeks in about 99% of dogs, the question then becomes how long does it last? It’s too expensive a product to inject every fortnight. The manufacturer advises the duration of action is likely to be a month, but  a considerable proportion of owners report seven to eight weeks of relief, and they’re very happy with that. If the allergy is seasonal, even better as one or two injections a year may be all that is required.

On the other hand, the effect of Apoquel will last as long as you keep giving the tablets. This means you have to be ABLE to give the tablets. If you can’t you will appreciate the convenience of an injection of Cytopoint. Apoquel is, usually, very effective in suppressing itching. Because of the manufacturer’s pricing policy Apoquel can be much cheaper than Cytopoint for dogs of a particular weight and if your dog is that weight then this may override all other considerations. If you own a cat, Apoquel is the only one of the two you can use.

Side-effects are an important concern too, Cytopoint is a monoclonal antibody. Side effects of any kind are extremely rare. Apoquel has a lower risk of side-effects on the gut (depressed appetite, vomiting or diarrhoea) than the drug it superseded (cyclosporin) and the vast majority of patients tolerate it well, but if it does upset your dog’s tummy you will migrate to Cytopoint.

Whichever you choose, you can be confident that your choice will be much more effective than anti-histamines, and have none of the long term side-effects of prednisolone or other corticosteroids.

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