My Bodie has severe environmental and food allergies also. He has sensitivities to: grass, dust mites, storage mites, pollen, molds, latex, fragranced candles and air fresheners, and a slight sensitivity to cotton. For foods: All Fish, Turkey, carrots, duck rye, gluten gum paste, grains, corn/maize, and cows milk. We tried the Atopica, it didn't work and it has a 98%success rate vs. the immunotherapy injections that has the 50% success rate. Out vet has told us that at this point she doesn't think the immunotherapy would help and even if it did help to build immunity towards the list of things he's already sensitive to, there's a big percentage that he'll then become allergic to something else. We've been on the Apoquel for about a year now, it has NOT been the "Miracle Drug" that I hear other people say it has been for their dogs, but it has cut down on his itchiness and his comfort level to where he's not miserable all the time. And that's why we continue to give it to him. We figured if it have him any relief at all then it's worth it, because without it, he's an unhappy, miserable, itchy baby. We have had the issues with it being on backorder over the last year, but I've been told that it's now becoming more available, slowly! As far as what [MENTION=14291]blazincfd[/MENTION] stated about Apoquel supressing the immune system, this is the 1st I've heard of that. It doesn't contain any type of steroid, it is the ONLY drug of it's kind, it is supposed to inhibit the "itch receptors" in the brain to fool the immune system to thinking there's no issue. (don't quote, my medical lingo is not 100%) and I've never been told of it causing cancerous tumors, that's something I'll have to research myself. But with Bodie, any side effects are GREATLY out weighed by the benefits. Its all in what your dogs needs are. Like I stated before, it hasn't been a miracle drug for us, it has helped, but it has been a miracle drug for many dogs, so it's definitely worth checking into!