I think it's the way it's sold, right? Aren't you required to buy a set of 10/20/30/40mg vials?
The only dermatologist I've heard talk about it liked it because it gets the owner away from pilling (so long as the owner was good about coming in regularly for the injection), but she felt like it wasn't really "more" or "less" effective than Apoquel. Her take was kinda "some dogs do well on one, some do well on the other, some do well on either, and some don't do well no matter what you do." Didn't seem to have any actual data comparing the two.
But I always like hearing what the GPs think..... I'm always a little suspicious of the info from the specialists because of their bias of seeing the more 'difficult' patients that the GP couldn't manage. I love the specialists, but I think it's inherently hard for them to see the big picture sometimes. (Not a slam on specialists at all - it's just the nature of the beast.)