Longterm side effects of Atopica

lizmagic

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Hi all,

I am relatively new to this site, and wanted to inquire about Atopica, a drug I give my cat for his allergies. I will first say that he has been on Atopica for almost a year after a 2 year struggle of trying every other treatment on earth (except steroids). We tried allergy shots for almost 1.5 years, and unfortunately, we saw little improvement in his symptoms. 

A little on my snuggle muffin (very dignified nickname) and his battle with his immune system:

Magic is a 8-10 year old (he was a hoarder rescue, so I don't know his age) black shelter special that I adopted in Milwaukee. I moved down to South Carolina in mid 2013 for a job, and all hell broke lose as soon as we entered the south. He had zero symptoms in Wisconsin.

He started ripping apart his face and got infections from the open wounds. All of his itching was centered on his face, so my first vet and I did a food trial initially (he is always treated for fleas and I had my apartment sprayed repeatedly just in case). I always rotated his diet and he was grain free, so the only protein he could get was venison (Ziwipeak). He had been fed all the major proteins previously and had peas, so I had to eliminate all these ingredients. Unfortunately, I couldn't get novel proteins that I could make myself (my only options were bison or venison). His symptoms did not improve (he was in a cone the whole time and had to be replaced twice due to the constant scratching at the cone), so we moved on to environmental allergies. I have major mold allergies, so I clean a lot and have HEPA filters. He was tested and was allergic to longleaf pine, ragweed, and a weak response from mold. I live in South Carolina, so those pollens are around year round in high quantities. Then, I tried allergy shots, and was really hopeful. Unfortunately, the veterinary dermatologist and I finally decided to discontinue them because we had no improvement after 1.5 years. 

So, I finally with a heavy heart decided to try Atopica. I hate drugs, but I had done everything else. He is still on a raw diet (Rad cat, Ziwipeak, and some homemade stuff). He gets bored easily, so I try to keep him interested. He also is on omega 3/6 supplements to help with his skin. They have definitely helped with severity, but he still needs the Atopica most of the year so far. I did recently get a job in Ontario, so I am hoping moving to a colder climate will help with the pollen. 

Anyway, he actually doesn't mind Atopica too much as long as he eats, and he knows he gets Ziwipeak afterward (it's his favorite, he loves deer). He hates the dry food however... I am wondering if anyone has been on Atopica longterm and seen any side effects. I have had bloodwork done after 6 months, and everything looked great. He acts completely normal otherwise, no strange side effects so far. Is there anything that I should look out for? The vet admitted (both the derm and normal vet) that they are reluctant to put cats on Atopica, and haven't had many cats on them longterm. Both said that the cats that were on Atopica, tolerated it very well for 2+ years.

I am sincerely hoping the allergies will greatly improve when I move up north again, but I have learned to not assume anything with his allergies. His symptoms are largely controlled with Atopica, but rarely can I go more than 1 or 2 days without a dose (right now he is full dose due to the high amount of ragweed). The really hot, lengthy summer caused a huge allergy season this year.

Thanks in advance!

Liz and Magic

 

Geoffrey

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I am a human doctor, not a veterinarian and any medical advice that I give you should be checked by a vet. 

Atopica is Cyclosporin, a fancy, commercial, name for a powerful immune suppressant.  Long term use may well indeed be associated with a host of side effects including malignancies and  an increased susceptibility to infections. I believe that diabetes has also been reported. 

There are so many side effects and complications with this drug that I really must advise you to discuss the long term treatment with  Atopica with your treating veterinarian. This is the best person to advise you about Magic's particular illness and susceptibilities and what medications would be best for him. 

With kindest regards,

Geoffrey

 
 
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lizmagic

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Thanks for the quick reply. I should have clarified a couple of things. The reason I posted on here about Atopica was sort of to get another side to Atopica. I have discussed the side effects thoroughly with both his derm and regular vet, it actually took me two months to agree to try Atopica at all due to the many side effects of immunosuppressants.  I also researched the scientific literature about cyclosporine itself (I'm a postdoctoral researcher in animal genetics, so I have access to journals through our library). The subject was certainly outside my realm of expertise, but as a whole, there does not seem to be much motivation to study cyclosporine outside those funded by the makers itself. Unfortunately, (and the vets agreed on this as well) very little research has been done outside of humans long-term (generally long-term is 90 days), and the side effects felt in humans may not translate well to pets. I found the dosages of cyclosporine are much higher in humans (rough math scaling down, obviously not scientific at all). 

The most concerning side effect is the higher incidence of cancer, but no study in cats was carried out beyond 3 months (blarg..). Humans also had an increased incidence of cancer, but many of them already had cancer (or had it previously) or had a high family history of cancer (i.e., it would be hard to disentangle those effects). 

With all that, I just wanted to know how others experienced Atopica besides the horror stories of getting them to take Atopica (it is bitter..). That was really all I could find, so I thought I would ask more directly. Thank you again for the advice, I really appreciate it. My vets unfortunately didn't have a lot of stories to share about their previous patients because they haven't prescribed Atopica a lot (most pets they said generally respond to one of the measures I had already tried). They said of the hand full that they have prescribed Atopica to (maybe 10 cats total since 2014), none had developed cancer to their knowledge, but around 10-15% had minor side effects such as GI upset and weight loss.

Thanks! 
 

katma

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I've had Fiona on Atopica for about 1.5 years. We started at 1 every 2 days, and can now do 1 every 4 days, which is a blessing. Fortunately the capsule is smooth and shaped just right, and slides easily down her little tongue. I need to get her in for bloodwork to make sure things are going okay. Previously she needed steroid shots once a month bc she was biting and scratching herself bloody, even after I eliminated chicken and grains from her diet. I live in N. Flori-duh so have many of the allergens/and molds [more mold probably] you do [or did, if you're now in Canada, lucky you].

She now eats a grain-free diet, but there aren't many cat foods out there that don't have at least some chicken in them! Fish is great, except, mercury ... a heavy metal toxin that accumulates can't be great.

Love my Fi, she's my Big Personality cat. I would rather she live without the misery of heavy-duty dermatitis, so realize we may have to look at a shorter life, though, Bast willing, she'll be with me for at least a few more years [currently 11 y/o]. With two other cats, I find it hard to believe I could feed a homemade diet for le$$ than I pay for good-quality canned.
 

Spencer's Mom

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My little buddy Spencer came to me from a shelter at 7 months old and showed no signs of allergies at that time. At around 1.5 years old he had started chewing on himself to the point of bleeding and causing infection. Now he has been on Atopica for over 1.5 years and it is the ONLY thing that I've tried that gives him relief. We have tried several diet changes and he is currently on HP food (thankfully he's not picky about what he eats). Just recently his Atopica was backordered for 1.5 months and it was hell. He was on steroids that just barely kept him from chewing holes in himself, but he was still itchy. His personality never changed, he's always been happy and playful, but he would stop, mid-play, to gnaw away at an itch. He had to resort to a cone when he wasn't being supervised. One week on Atopica and he was back to himself. The one negative for sure that I have seen is that it causes tooth reabsorption of incisors. I would rather that then a bloody, uncomfortable cat.
 

silkenpaw

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My Ford has been on Atopica for lymphoplasmacytic gingivostomatitis. He started 18 months ago and now gets it every third day. He hasn’t had any problems, but sadly, his mouth looks inflamed again and the vet thinks we need to try something else :(
 
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