Atopica administration ideas help!

[Potager_girl]

Adopted the sweetest little 6-year old ex-farm cat a couple of years ago and she came with signs of allergies, with the shelter treating her with steroids. After several bouts of steroids with our current vets it became clear that she needed more specialised help.

We have been seeing a skin specialist for a while now and have completed 6-weeks of food control under Royal Canin anallergenic. She takes steroids so easily as long as it's in a bit of Easypill but during the 6-weeks we had to stick it down her throat, as well as using disinfectant mousse and sprays, and she became incredibly scared of us.

She completed her food trial with no obvious changes or improvements so is now being treated for atopy and is 3-weeks into Atopica. After the 6-weeks of steroids down her throat, doing that with Atopica isn't an option so we are trying every way we can to administer it as a 'treat'. She refused to take it mixed in any food, freshly cooked chicken or even her favourite treats. Searching the internet we discovered gelatin capsules and are able to divide her 0.29ml between 2 x size 4 capsules and - if smeared in a pate - she can be tricked in eating it as long as she doesn't bite down!! But she is starting to get savvy and we could do with some suggestions of really strong tasting foods/ ideas that we can try? Thank you

[susand]

Positive reinforcement is the answer here!

The active ingredient in Atopica is cyclosporine. Cyclosporine can also be given subcutaneously (an injection just under the skin), usually administered on the back, just to the left or right of the spine. Insulin for diabetes is given the same way and my parents found if they gave their diabetic cat a treat, such as a couple of Dreamies, immediately after his insulin injection he was very compliant because he came to associate the needle (which is very small by the way), with something nice to eat. It got so that if my dad was late with his injection, Genghis would come to remind him, jump up on the table and position himself ready to receive it, purring all the while!

It may be too late to try positive reinforcement by giving treats now that your cat associates the oral route with something negative, although it might be possible, but maybe ask your vet to prescribe subcutaneous cyclosporine instead of tablets and make sure she gets a fist full of Dreamies or whatever immediately after her injection, so she comes to associate injection time with something nice happening.

[susand]

PS; for positive reinforcement to work, the treat has to come immediately after the medication, not before. Also not too long after, because the cat won’t register the link between getting the injection and getting the treat if there is too big a gap between the two events.

[susand]

PPS; You can get the vet or veterinary nurse to give the first dose, so you can watch how it’s done and be taught how to do it yourself at home. Also, I think subcutaneous cyclosporine only has to be given every couple of days rather than daily, which will make things easier for both you and your puss as well.

[Potager_girl]

I had no idea that cyclosporine could be injected!! And the vet didn't mention it either... We did try approaching compounding pharmacies to see if we could get her dosage in tablet form but none in the UK will do it, apparently if we lived in USA it would be no problem

The specialist said we have to get her on just Atopica for a month then hopefully go to every other day

[susand]

Well to be fair, it’s not commonly given via injections and studies show that it’s not got great absorption via this route, although absorption via the oral route isn’t great either. Steroids, on the other hand are commonly given as depot injections every few weeks instead of orally, which is worth bearing in mind if she ever needs steroids again.

If you are after something that could be given as a small tablet, you could talk to your vet about Apoquel. It’s only licenced for dogs (because that’s what the clinical trials were done on when they first developed it) but is increasingly being used in cats. It has the added advantage that it targets a small specific part of the immune system, rather than shutting down great swathes of it, so your cat will be much less at risk of infection due to immunodeficiency.

I have a cat on Apoquel. I crush half a tablet a day, which is really tiny, into his food and he eats it just fine (although he’s not a fussy eater so I can’t be sure your cat will be the same). It has really helped his skin.

[Potager_girl]

Well to be fair, it’s not commonly given via injections and studies show that it’s not got great absorption via this route, although absorption via the oral route isn’t great either. Steroids, on the other hand are commonly given as depot injections every few weeks instead of orally, which is worth bearing in mind if she ever needs steroids again.

If you are after something that could be given as a small tablet, you could talk to your vet about Apoquel. It’s only licenced for dogs (because that’s what the clinical trials were done on when they first developed it) but is increasingly being used in cats. It has the added advantage that it targets a small specific part of the immune system, rather than shutting down great swathes of it, so your cat will be much less at risk of infection due to immunodeficiency.

I have a cat on Apoquel. I crush half a tablet a day, which is really tiny, into his food and he eats it just fine (although he’s not a fussy eater so I can’t be sure your cat will be the same). It has really helped his skin.

Thanks for that @susand. In which case subcutaneous wouldn't be an option, which is a shame as so far she's responded favourably to the Atopica as we wean her off the steroids. Really trying to get her off the steroids for good as they potentially will shorten her life in the long-term. We are already off licence for the Atopica as she is taking it with steroids and we also have to give her vaccine booster on it so being off licence for Apoquel wouldn't really be a big issue, the specialist has mentioned it before as an option if the Atopica wasn't successful and did advise it was only trialled in dogs but I wasn't aware it was a tablet.

Can I ask why your cat is taking it and have you tried Atopica first? Or did your vet suggest Apoquel first? Also, a 17ml bottle of Atopica lasts about 60 doses and is well-over £100, can I ask how much a months supply of Apoquel is? Tiny tablets have a massive appeal at the moment and is something she would happily eat in a bit of Easypill! Which also means going away wouldn't be such an issue as friends and family would be able to medicated her easily.

[susand]

Hi,

My cat has atopy too. I paid for immunology studies to see if any allergens could be identified so he could undergo immunotherapy but nothing was detected. However, there’s no test which will detect every allergen under the sun and it doesn’t test for food allergies so my vet thinks it is probably all down to some kind of allergy, probably in food but they can’t be sure. He is on a hypoallergenic diet (Purina) as well as the Apoquel and in case it’s down to a flea allergy he has prophylactic flea treatments once a month. I did find he had a reaction to the spot on treatments for fleas, with itching and redness at the site I put it on so he takes an oral flea treatment (Credelio) instead.

He was started on steroids but it was soon found that he was a cat flu carrier, because the immunosuppression caused it to reactivate and his eye swelled up horrendously. He therefore had to stop steroids immediately and anything else which causes significant immunosuppression is also a no, no and that includes Atopica, so he was never tried with that. The vet suggested Apoquel as the only option for Harvey because it doesn’t cause widespread immunosuppression and only blocks a specific molecule within the immune system which is involved in atopy but other parts of the immune system carry on functioning normally so it doesn’t leave him vulnerable to infection and means he can keep from going blind or dying of cat flu whilst being treated for his itchy skin!

I buy my cat meds online as it is by far the cheaper option. I usually use Petdrugs Online but there are others. You do have the legal right not to buy medications direct from the vet and can ask them to write a prescription so you can get the meds elsewhere. The vets I use are more than happy to do this and in fact it was them that suggested this option since they are not able to offer the drugs at a good price.

The vet will charge a fee for the prescription (about £9) but will issue it as a repeat prescription so I can use the same prescription 5 times. I then order the Apoquel, and upload the prescription, which goes on record at the online pharmacy so when you go to reorder, you don’t have to keep uploading the prescription.

Petdrugs Online charge £79.50 for 100 tablets. My cat has half a tablet twice a day if he goes through an itchy spell but only once a day at other times, so that’s 200 days worth for £79.50.

[susand]

PS. I see a 17ml bottle of Atopica is £63.24 from Petdrugs Online.

[Potager_girl]

It's good to chat with someone who has been through a similar process. As the food trial was inconclusive Tilly is now on Royal Canin vet Skin and coat biscuits which is boosting her fatty acids and acting as another barrier defence for her skin. We are still moussing her a couple of times a week with Clorexyderm which she tolerates.... we opted to not go along the immunotherapy route as potentially it was going to be a year of injecting her for very little results and she was quite stressed after the food trials/medicating her; besides she could be allergic to 1 thing or 100 but at least we knew it wasn't food. We've put her Credelio too.

That's interesting about the Petmeds online. Will definitely opt for submitting the prescription online for that price.

We seem to be winning at the moment with administering the Atopica, we went down the Dreamies route! Atopica in a capsule, covered in a thin layer of Easypill with a Dreamie stuck on top - she isn't even chewing them at the moment but swallowing whole!?

Can I ask if your boy is vaccinated? And if so do you get him boosted while he's taking Apoquel? We'll have to give Tilly her vaccines on Atopica but if we can get her down to every other day it would be preferable as the manufacturer said it may lower the potency of the vaccines. I do prefer the sound of Apoquel - not just because it is in tablet form (and cheaper!) - but like you said it isn't suppressing her whole immune system. If we can keep going with the Atopica until our next specialist appointment then I think we'll have the discussion with them about the possibility of Apoquel for her in the future.

[susand]

Hi,

You may need to be a bit pushy (in a nice way of course) with the vet about getting it as a repeat prescription rather than a one off. I’ve had an occasional time where one of my vets has just issued it as a single one off prescription. I then point out that it costs me nearly a tenner each time she puts pen to paper and she will then agree to tick the ‘repeat’ box. I don’t think they are greedy, I think it’s that they just don’t think!

I’m so glad the Dreamies are working. You can also try giving her another one right after swallowing her pill to teach her there is a reward for swallowing it like a good girl.

Yes, Harvey is vaccinated as normal whilst taking his Apoquel. Apoquel won’t reduce a vaccines efficacy and there is also no risk from the Apoquel of viral reactivation from a live vaccine.

The only side effect he had from it, which is common apparently, is diarrhoea when he first went on it but that settled after a week or two and his bowels are fine now.

I hope your vet is receptive to the idea of switching to Apoquel and that it works for your Tilly. Good luck!

[Potager_girl]

**important update on Apoquel**

Communicated with my specialist vet this morning re pos of transfering onto Apoquel. She contacted the manufacturer - Zoetis- for any updates on the product, only to be told that in the last month Zoetis are strongly discouraging the use of Apoquel in cats and have asked the British Small Animal Veterinary Association to remove the dosage reccommendations that prescribing vets use from it's formula page. At this stage they are saying they can't validate its effects after 28 days of use but giving no further information.

@susand it may be worth contacting your vets for an update.

Such a shame, l thought we may have found a solution to the meds situation - although dreamies and encouraging words are getting us through at the moment, yes, there's a good 5 immediately after to take the taste away!

Our vet said there's lots of companies out there trying for a breakthrough in feline atopy but it's just a waiting game at the moment

[susand]

Well that is worrying, especially since it works so well for Harvey and is really his only option since he can’t have anything that causes significant immunosuppression. I wonder why? They haven’t suggested any serious side effects in cats have been reported, either to your vet or on their online website. And the last official update on Apoquel on their website that I can find is back in 2015 and it doesn’t mention Apoquel being contraindicated in cats anywhere.

I wonder if it’s a legal thing, that they can’t advertise/recommend it’s use in cats because it’s off label?

There is also something I found just now on Google stating that the dose required in cats appears to be higher than that needed for dogs, so could that be why they are removing the current dosing instructions?

I’ll investigate further to find out as, obviously, if it’s been found to be dangerous in cats I need to know.

If I find out any more I’ll post to let you and everyone else reading this thread know.

[Potager_girl]

I did think of you and your Harvey, especially as you said it was the only thing he could have.

Can your vet contact the company rep to see if they get more info? My specialist said they wouldn't give much away.

[Mollycat]

My specialist said they wouldn't give much away.

If a product has been in use for a long time with little or no issue and suddenly they suspect there might be something they won't recall until they know more, but they might suggest vets stop prescribing to new patients as a precaution while they investigate further. It can end up being a small change on the label, more caution when prescribing to cats in a newly discovered risk group, a credible but unlikely claim by one owner, anything.

For years Metacam was given with caution or not at all to any cat with renal issues, and recently other studies suggest in certain situations it can be bad but in others it can actually help (don't ask me how) so Apoquel could have been found to be a problem in one study even though that has never been found in any other study.

Wait and see is a good plan.

[susand]

Yes, it seems to be something of this sort. I phoned the Zoetis technical helpline yesterday and got the lowdown. It seems that in the last 6 months Zoetis have done their own study on Apoquel in cats. This has shown that the way the drug is metabolised in the cat is very different to the way it is metabolised in the dog (for which the drug was originally designed), including the speed at which it is broken down. This is due to the differences is in physiology between the two animals.

Because of this, cats cannot be assumed to be small dogs when it comes to dosing so it is not possible to extrapolate data from studies in dogs, with respect to safe dose, and apply it to cats. This is why they have asked for dosage recommendations to be pulled.

Apart from that, little has changed. It was always the case that no one could vouch for the safety of Apoquel in cats, which is why it was only allowed to be prescribed off label and still is.

Drug companies have to be really careful about endorsing their products because if a drug is used and something goes wrong it can cost them millions, sometimes billions in lawsuits and reputational damage. With drugs where the scientific data is incomplete, they therefore shift the responsibility for the decision to prescribe onto the vet. My vet then shifted the responsibility onto me by getting me to sign a form stating that I understood that the drug was off label and therefore it’s safety could not be guaranteed. So if something goes wrong it is my fault!

The new data regarding pharmacokinetics is a little worrying. Is the therapeutic dose too close to the toxic or fatal dose for comfort? Is there a metabolic breakdown product of the drug that accumulates in cats and results in toxicity? Who knows.

I’ll continue with the Apoquel for the following reasons;
-Harvey has been on it for 9 months. It has worked well for him and there have been no adverse affects that I can detect, other than diarrhoea in his first week of taking it.
-The other drugs out there are contraindicated in Harvey because he is a cat flu carrier.
-The other drug’s out there can also have serious adverse affects, including death. It’s just that these are known about so the cat owner and the vet can factor risk/benefit ratio into the decision to prescribe which they can’t do with Apoquel because the risks aren’t really known.

[Mollycat]

Sounds very sensible. I can't remember exactly what now but we've had drugs recently that the vet warned us was off label, she never asked us to sign anything and added that she's been prescribing it for years, but we were made aware.

As for the differences between cats and dogs and how they metabolise drugs and nutrients, that's a really important point, because so many things that can be given to one can be fatal to the other just the same as some drugs and foods are safe for humans but not pets.

Well done for getting all this info, I'm really impressed!

[susand]

Thanks Mollycat. I have a background in life sciences so I understand a bit about pharmacology, knew where to go to get the information I wanted and was able to talk to the technical adviser in their own (scientific) language, which helps.

[Potager_girl]

Thank you Mollycat and Susand.

Good to hear that Zoetis have been running trials but a shame that it has drawn this conclusion, for now.

Susand, you have very little option but to continue, hopefully Harvey will continue to do well on it.

It's so frustrating that feline atopy treatment is so far behind that of dogs, fingers crossed we might get something decent on the market soon that will be better options than Atopica and Apoquel.

Curious re any others who may be following this thread but are people out there treating feline atopy with anything other than Atopica or Apoquel?

[Cat_warrior_84]

Hi there guys.

I have just read through this thread for the 1st time. I am currently fostering a cat who has problems with itchy skin.
He was given in to the rescue after his owner threatened to drown him due to the skin problems.
He has been in the rescue since September last year and has been with us for 6 weeks now. He is on the Hills prescription diet z/d for his wet food and the royal canin hypoallergenic for dry.
At the time we brought him home he was on prednisone but unfortunately this hasn't seemed to help, then he's had the long lasting steroid injection (again doesn't seem to havs helped).
He is only a young cat, about 18 months and is constantly in the 'cone of shame' to stop him injuring himself. Such a shame for him because he is so ready to be adopted but I think the rescue are waiting to get this resolved.

I didn't realise that there was such a lack of investment in feline atopy (we have a dog with very similar issues who is treayed with Cytopoint and a vaccine allergy). I'm hoping, as we are coming to the end of the 4wks after the long lasting injection, that we will be starting a different medication regime.

Do your allergic cats also have problems with runny eyes?

[susand]

Hello Catwarrior,

Harvey gets a runny eye when he is getting an attack of cat flu (he is a carrier and has flare ups now and then) but I don’t thinks it’s related to his itchy skin. Sometimes his skin can be bad and his eyes are fine and visa versa, so I think they are two separate diseases in his case.

[Cat_warrior_84]

Thanks for the reply.

I'm at a loss for poor Snowball (not my choice of name). He is so ready for his forever home and it is gutting to see him suffering.
Hopefully the rescues vet will have a plan C as nothing seems to be working so far. It would be such a shame if he was just stuck in the cone for his whole life.
I was hoping she might prescribe the apoquel as the atopic sounds like he would need at least another 12 weeks before rehoming. Here's hoping we can get him situated before that.

[Potager_girl]

Thanks for the reply.

I'm at a loss for poor Snowball (not my choice of name). He is so ready for his forever home and it is gutting to see him suffering.
Hopefully the rescues vet will have a plan C as nothing seems to be working so far. It would be such a shame if he was just stuck in the cone for his whole life.
I was hoping she might prescribe the apoquel as the atopic sounds like he would need at least another 12 weeks before rehoming. Here's hoping we can get him situated before that.

Hi cat_warrior_84 and welcome to itchy pet corner!

I feel your pain about Snowball as we've had all the same experiences with Tilly. She doesn't have runny eyes though and like susand said could possibly be related to a previous bout of cat flu?

I doubt your vet will prescribe Apoquel at this stage, not until the internal powers that be there decide it can or can't be used off licence again for cats Unfortunately, products safely licenced for cats are few and far between

Like Snowball, we adopted Tilly from a rescue a couple of years ago where she had been brought in from a farm. They thought she would be better off as a pet as she didn't hunt and wanted to be in the house all the time - that is exactly her personality! She came with the after mention that she had a flea allergy and was being treated for it.

Steroids seemed to work at the beginning but then confusingly sometimes didn't work at all. We were becoming concerned about the length of time she was spending on them as they can cause a number of long term health issues including diabetes and heart disease. As she came with the skin issue we aren't covered on her insurance for anything to do with it - something the shelter need to realise could affect his chances of being rehomed.

Never-the-less we opted to work with a private dermatologist to see if we could get some answers. On first diagnosis she had 3 skin infections of bacterial and yeast origin (something our regular vet didn't pick up). As her immune system goes into overdrive against allergies they can easily pick these up and you need barrier methods to prevent them. We have a mousse and spray to get rid of these which have permanently kept them at bay (names listed in the thread). Fatty acids are also a great barrier too but they won't cure - Royal canin veterinary skin and coat contains this but you can also get supplements too - salmon oil, omega 3 capsules, Vetpro also do a skin and glossy coat supplement.

We ran a food trial with her that meant being on nothing else but Royal Canin anallergenic food for 6-weeks (she was still able to have steroids but they went straight down her throat). She had previously been on the z/d diet but we were told there were some studies coming out that claimed animals could still react to some of the ingredients in this food. After the 6-weeks we were able to put her back onto normal food to see if it made any difference, in her case it didn't. So we went down the route of Atopica - which hasn't been easy!! She can be a nervous little cat and attempts to administer it straight down her throat have caused her great stress - another element that exacerbate skin conditions! We can get size 4 capsules from our vets and administer it into them with a bit of easypill or Pill Assist around it but she's getting too savvy about it, so sometimes it has to go down the throat. It is a foul tasting liquid so make sure there is a handful of tasty treats to give straight after. The Atopica took 3- 4 weeks to really kick in and is working a dream - apart from when she had a bad tooth and refused to eat anything. Her fur has grown back lovely and she is much happier in her skin and completely off steroids. BUT we are nearly 12-weeks and £1000 into her treatment with the specialist, so the shelter need to accept that Snowball's treatment is a long road either for them or some willing person to take him on.

We've now decided we would like to try immunotherapy for Tilly. This is a LONG treatment option and not guaranteed to work for cats, it is also expensive. But.....Atopica suppresses the cats immune system, which means that the pet is susceptible to infections and cancers, it also can interfere with the effectiveness of vaccines, especially those for cat flu and can be a big problem for cats who hunt (which she never does) as the raw meat can cause toxoplasmosis. If there is a chance we can get her body's natural immune system working at an acceptable rate to even reduce the amount of Atopica she's on then we feel it's worth a go.

Our current dermo specialist isn't at diploma level so we are being referred to someone local that is. It is another £150 for initial referral consult then she will have to come off all meds for 10-14 days before having the intradermal testing (injected with numerous allergens £300 - 400) She will have to be in a collar and/or rash vest prior to this to ensure her skin is in good condition for the testing. If any allergens show up then she will have an individual serum made (£250 - 300) with these in. She's then inject twice a week for a couple of months to start building up her bodies response to them, reduced to injections twice a month for anything between 4 to 12 months. Fingers crossed after 6-months we will see whether we can start reducing her Atopica. BUT, even if the immunotherapy is successful she will need to be injected twice a month for life. There are some studies that say you can try to take them off it after 3 - 5 years but it's not a guarantee.

Immunotherapy is a very big 'if', it may not work for her at all but at least we know where we stand. And hopefully in the next couple of years new products will come out that will be suitable for cats but it doesn't help our little critters for now.

I know this was a long post cat_warrior_84 but I think you really need to be upfront and realistic with your shelter about what the future means for Snowball. The road is long and expensive either for them or a prospective new owner. Could they possibly do a crowdfunder with his treatment to a specialist? Or if they advertised him and say they were willing to pay for his treatment? The fact you are fostering him is great for him as he probably wouldn't be doing half as well with all this in the shelter.

Good luck and let us know how you get on

[ukmisfit]

Hi, I may be a bit late but I give Atopica straight down the throat followed immediately by evening meal and it works wonders with no problems at all. Been doing it this way for three years now, on and off, due to worrying she'd miss some in her food x

[Potager_girl]

Hi, I may be a bit late but I give Atopica straight down the throat followed immediately by evening meal and it works wonders with no problems at all. Been doing it this way for three years now, on and off, due to worrying she'd miss some in her food x

Hi ukmisfit

We've had to resort to straight down the throat for the last few weeks and have one stressed out little cat, we can't go near her without her running away! It is a foul smelling liquid so I doubt it tastes much better either. As a rescue farm cat she spent most of her life not being handled so this just adds to her anxiety. We have our specialist appointment for immunotherapy in a week, got everything crossed that we get a positive result from it.

Did your vet advise to feed immediately after? I only ask as manufacturer advice is that it is given 2 hours before or after food to allow for absorption.

Really pleased it's working well for you and your kitty though xx

[ukmisfit]

Hi, I may be a bit late but I give Atopica straight down the throat followed immediately by evening meal and it works wonders with no problems at all. Been doing it this way for three years now, on and off, due to worrying she'd miss some in her food x

Hi ukmisfit

We've had to resort to straight down the throat for the last few weeks and have one stressed out little cat, we can't go near her without her running away! It is a foul smelling liquid so I doubt it tastes much better either. As a rescue farm cat she spent most of her life not being handled so this just adds to her anxiety. We have our specialist appointment for immunotherapy in a week, got everything crossed that we get a positive result from it.

Did your vet advise to feed immediately after? I only ask as manufacturer advice is that it is given 2 hours before or after food to allow for absorption.

Really pleased it's working well for you and your kitty though xx

Hoping for a positive resuklt. Yep the label says with food and every leaflet i find says so too, maybe it depends on the cat?

Should Atopica Be Given with Food?

While cyclosporine should be given on an empty stomach in dogs, there is reportedly no difference in absorption of the medication in cats whether it’s given with or without food. However, it is recommended that whatever way is chosen, that this method of administration is kept consistent.

When giving with food, it is recommended to administer directly onto a small amount of canned or soft food to ensure that the dose is consumed.

[Potager_girl]

Hi, I may be a bit late but I give Atopica straight down the throat followed immediately by evening meal and it works wonders with no problems at all. Been doing it this way for three years now, on and off, due to worrying she'd miss some in her food x

Hi ukmisfit

We've had to resort to straight down the throat for the last few weeks and have one stressed out little cat, we can't go near her without her running away! It is a foul smelling liquid so I doubt it tastes much better either. As a rescue farm cat she spent most of her life not being handled so this just adds to her anxiety. We have our specialist appointment for immunotherapy in a week, got everything crossed that we get a positive result from it.

Did your vet advise to feed immediately after? I only ask as manufacturer advice is that it is given 2 hours before or after food to allow for absorption.

Really pleased it's working well for you and your kitty though xx

Hoping for a positive resuklt. Yep the label says with food and every leaflet i find says so too, maybe it depends on the cat?

Should Atopica Be Given with Food?

While cyclosporine should be given on an empty stomach in dogs, there is reportedly no difference in absorption of the medication in cats whether it’s given with or without food. However, it is recommended that whatever way is chosen, that this method of administration is kept consistent.

When giving with food, it is recommended to administer directly onto a small amount of canned or soft food to ensure that the dose is consumed.

That's really interesting! Are you in the UK? From the specialist it didn't state 2 hours, on the label from our regular vet it states it's 2 hours and got from Animed which states 2 hours too (thank you for your email, got the 17ml for very similar price that you said) but have also read up on some studies that conclude as you said that in cats it made little difference with food, absorption rates aren't brilliant anyway!

[ukmisfit]

Hi ukmisfit

We've had to resort to straight down the throat for the last few weeks and have one stressed out little cat, we can't go near her without her running away! It is a foul smelling liquid so I doubt it tastes much better either. As a rescue farm cat she spent most of her life not being handled so this just adds to her anxiety. We have our specialist appointment for immunotherapy in a week, got everything crossed that we get a positive result from it.

Did your vet advise to feed immediately after? I only ask as manufacturer advice is that it is given 2 hours before or after food to allow for absorption.

Really pleased it's working well for you and your kitty though xx

Hoping for a positive resuklt. Yep the label says with food and every leaflet i find says so too, maybe it depends on the cat?

Should Atopica Be Given with Food?

While cyclosporine should be given on an empty stomach in dogs, there is reportedly no difference in absorption of the medication in cats whether it’s given with or without food. However, it is recommended that whatever way is chosen, that this method of administration is kept consistent.

When giving with food, it is recommended to administer directly onto a small amount of canned or soft food to ensure that the dose is consumed.

That's really interesting! Are you in the UK? From the specialist it didn't state 2 hours, on the label from our regular vet it states it's 2 hours and got from Animed which states 2 hours too (thank you for your email, got the 17ml for very similar price that you said) but have also read up on some studies that conclude as you said that in cats it made little difference with food, absorption rates aren't brilliant anyway!

I am in the uk yeah. I'd give it as your vet says because there could be a cat specific reason that may not apply to my cat if that makes sense. Weirdly, this box label doesn't say a thing about food or how to give it!