Dog Allergy Treatment Cost: A Year of Cytopoint vs Apoquel, Plus Ear Infections

Dog allergy treatment costs about $325 to $3,900 a year with Cytopoint injections, or about $1,091 to $2,306 a year with daily Apoquel tablets. The gap comes from your dog's size and how often the itch returns. Ear infections add a separate bill, usually $100 to $200 for a simple one and over $1,000 for a stubborn one.

This guide prices a full year of allergy care for one dog. It compares the two most common itch medicines by dog size, shows the exact injection price at which Cytopoint stops being the cheaper choice, and adds the ear infection and specialist fees that most price guides leave out. The arithmetic is ours, built from the published prices linked below.

Photo: Mikhail Nilov / Pexels

Dog allergy treatment cost at a glance

A year of dog allergy treatment runs from about $450 for a seasonal case to $2,905 for a year-round case in a medium dog. The three budgets below combine medication, exams and ear infections. Each assumes a medium dog, since size changes the Cytopoint price most.

Budget	What it includes	Yearly total
Seasonal flare	2 general-practice exams, 3 Cytopoint injections, 1 ear infection	$450-$820
Year-round medication	Cytopoint every 4-8 weeks, 2 specialty rechecks, 2 ear infections	$950-$2,905
Testing plus immunotherapy, first year	Exam, cytology, skin scrape, allergy test, allergy shots, 2 rechecks, 1 ear infection	$1,438-$1,538

The inputs come from four sources:

• Exams. A nonprofit clinic charges $40 for an exam, per Richmond SPCA's wellness price list, effective October 1, 2025. A university dermatology recheck costs $82.50, per LSU's dermatology service fees.
• Cytopoint. A medium dog pays $90 to $180 or more per injection, per ThePricer's Cytopoint cost guide, updated July 1, 2026.
• Ear infections. The average claim was $100 to $200, per Trupanion's Commonly Claimed Conditions sheet.
• Testing and shots. LSU lists allergy skin testing at $458 and allergen-specific immunotherapy at $450.

LSU says its prices are approximate and gives no effective date. A private clinic near you can land well above or below any of these figures.

What Cytopoint costs by dog size

Cytopoint costs about $325 to $3,900 a year, and the price rises with body weight. ThePricer puts a single injection at $50 to $100 or more for a small dog, $90 to $180 or more for a medium dog, $150 to $260 or more for a large dog, and $200 to $300 or more for a giant dog.

The injection repeats every 4 to 8 weeks as needed, per the same guide. That is about 13 injections a year at the 4-week end and 6.5 at the 8-week end. Multiplying gives the annual range for each size:

Dog size	Price per injection	Every 8 weeks (6.5 a year)	Every 4 weeks (13 a year)
Small	$50-$100	$325	$1,300
Medium	$90-$180	$585	$2,340
Large	$150-$260	$975	$3,380
Giant	$200-$300	$1,300	$3,900

The low column uses each size's lowest price at the 8-week interval. The high column uses the highest price at the 4-week interval. Many dogs fall in between.

Clinics also differ on fees around the shot. ThePricer notes that some practices add an exam, injection, or medical waste charge, while others bill only the drug. Ask which applies before you book a visit.

What Apoquel costs, and why size barely matters

Apoquel costs about $1,091 to $1,153 a year when one tablet a day fits your dog. Chewy lists the 3.6 mg chewable at $2.99 a tablet and the 16 mg chewable at the same $2.99 a tablet. A 16 mg non-chewable tablet lists at $3.16.

That flat per-tablet price is the useful fact. Cytopoint scales with weight. Apoquel scales with the number of tablets, not their strength. At $2.99 to $3.16, one tablet a day for 365 days is $1,091 to $1,153, or $91 to $96 a month.

The labeled dose is 0.4 to 0.6 mg per kilogram, given twice daily for up to 14 days and then once daily, per the Apoquel label on Drugs.com. The label covers dogs at least 12 months old. The first two weeks add 14 extra tablets, or about $42 to $44.

Whether one tablet is enough depends on weight. Our math from the label dose puts a single 16 mg tablet at roughly 27 to 40 kilograms (59 to 88 pounds). Smaller dogs use the smaller strengths, and in-between weights may need two tablets. Two tablets a day cost about $2,182 to $2,306 a year.

We found a price for the 3.6 mg and 16 mg strengths only. The 5.4 mg strength sits between them, and its price may differ. Ask your vet which combination your dog needs, then check the pharmacy price against the clinic price.

Cytopoint vs Apoquel cost: the break-even injection price

Cytopoint beats Apoquel on cost when your vet's price per injection is below $84 to $177, depending on how often your dog needs it. You can test this in a minute. Take the price on your estimate, find your dog's injection interval in the table, and compare.

The cutoff is a year of one Apoquel tablet a day, $1,091 to $1,153, divided by the injections per year.

Injection interval	Injections per year	Cytopoint is cheaper if one shot costs under
Every 4 weeks	13	$84-$89
Every 6 weeks	8.7	$126-$133
Every 8 weeks	6.5	$168-$177

Here is how that plays out. A small dog at $75 a shot every 6 weeks pays about $650 a year, far under Apoquel. A medium dog at $135 every 6 weeks pays about $1,170, close to even. A large dog at $200 a shot every 4 weeks pays about $2,600, more than double Apoquel.

Cost is not the only axis. A review in Veterinary Evidence rated the head-to-head evidence on the two drugs as weak and called canine atopic dermatitis a lifelong condition. The 2023 AAHA allergic skin disease guideline table lists oclacitinib as acting within hours and lokivetmab as usable in puppies. Your vet picks the drug on your dog's age and health. The price math tells you what to budget once that choice is made.

Dog ear infection cost: simple, severe and chronic

A simple dog ear infection costs about $100 to $200, and a severe one handled at a university hospital costs about $1,074 to $1,574. The gap is the difference between drops and a flush under anesthesia.

Trupanion's claims sheet lists the average cost of an otitis claim at $100 to $200 in most breed cards we reviewed, with allergy claims at $100 to $400. The sheet carries a June 2019 form code, so treat it as a floor for today's prices.

LSU's dermatology page shows what a harder case costs:

Line item	LSU fee
Initial dermatology exam	$205
Cytology	$30
Bacterial culture and susceptibility	$156.50
Video-otoscopy ear irrigation, with anesthesia	$600-$1,100
Recheck	$82.50
Total for a severe episode	$1,074-$1,574

That total is before take-home medication. A general practice will charge less for each line. The point is the order of magnitude: an ear that needs a deep flush costs roughly five to fifteen times a simple infection.

Ear infections usually follow allergies rather than stand alone. A Banfield Pet Hospital study of nearly 2.3 million dogs found otitis externa in 14.4% of them, according to Today's Veterinary Practice. The article also cites a dermatology study in which 22% of dogs seen for skin conditions had otitis externa. Its author, a board-certified veterinary dermatologist, recommends a workup for a primary cause when ear infections keep returning.

Bigger dogs get ear infections more often. Giant breeds were diagnosed at 19.5%, compared with 12% for toy and small dogs. A large allergic dog therefore carries both the higher Cytopoint price and the higher ear infection rate.

What a specialist workup adds

A first dermatology visit costs $205 at LSU, and finding the allergen adds $458 for skin testing. Together with cytology, a skin scrape and allergy shots, the first-year workup comes to about $1,173 before rechecks.

Workup item	LSU fee
Initial exam	$205
Skin cytology	$30
Skin scrape	$30
Intradermal allergy test	$458
Allergen-specific immunotherapy	$450
First-year workup	$1,173

The page does not say how long one $450 immunotherapy order lasts, so ask before you commit. The AAHA table lists allergen-specific immunotherapy as a long-term management option. It also notes that oclacitinib does not interfere with intradermal testing, so a dog does not have to stop Apoquel for the test.

Testing is not for every dog. It is worth pricing when medication costs are climbing, when the drug is not controlling the itch, or when you want a long-term plan with fewer injections. A specialist visit is also where a stubborn ear gets a proper cause analysis instead of repeated drops.

How to lower the bill without lowering the care

You can cut a dog's allergy bill by asking five specific questions before the visit. Most of these save money without changing the medicine.

1. Ask for a written estimate that names the injection fee. Some clinics bill the drug only, and others add an exam or waste fee. Our guide to asking for a lower-cost treatment plan has a script.
2. Ask whether the interval can stretch. The injection repeats every 4 to 8 weeks as needed, so a longer gap between shots cuts the annual total. Do not stretch it without your vet's agreement.
3. Compare the pharmacy price with the clinic price for Apoquel. A prescription lets you shop. Chewy lists the tablets at $2.99 to $3.16, and your clinic may charge more or less.
4. Get cytology before antibiotics. A $30 cytology at LSU can show whether yeast, bacteria or both are present. Guessing wrong can mean a second visit.
5. Treat the cause of repeat ear infections. The article's author recommends a primary-cause workup for recurrent cases. Four simple visits at Trupanion's $100 to $200 average cost $400 to $800, and a single deep flush at LSU costs $600 to $1,100.

If the bill still does not fit, our guide to vets that take payment plans lists the financing options.

Insurance, timing and the emergency fund

Insurance helps with allergies only if it starts before the signs do. In the North American Pet Health Insurance Association's 2025 data, covered in dvm360's report, ear infections were the second most common dog claim. Skin conditions ranked third and allergies fifth.

The same report says about 6% of dogs in the United States are insured. The other 94% pay these bills directly, which is why an allergic dog's first year can be a surprise.

An allergy first noticed after a policy starts is typically covered as an illness, subject to the waiting period. One noticed before is typically pre-existing and excluded. Our guides to pre-existing conditions and waiting periods and coverage for allergies and other chronic conditions explain the wording to check.

If your dog is uninsured, treat the year-round budget above as a recurring bill, not an emergency. Size a cushion for the ear infection that needs an anesthetized flush with our emergency vet cost guide.

What to do this week

Pick the budget that matches your dog, and compare it with your vet's estimate. Four steps get you there:

1. Write down the three numbers. Note your dog's weight, the vet's per-injection price, and the injection interval.
2. Divide. Multiply the price by 52 and divide by the interval in weeks. Compare the result with about $1,091 to $1,153 for one Apoquel tablet a day.
3. Ask about the ears. Request cytology at the next ear visit, and ask whether allergies are the cause.
4. Add it to the plan. Run your dog through the PetBudget calculator for a baseline annual cost, then add the allergy line that matches your budget.

A dog with allergies is a recurring cost, not a one-time bill. The number you plan for is a decision. The one that arrives unplanned is an emergency.