If you have a pup with allergies, then you’ve probably heard of Apoquel for dogs. This fairly new medication for allergic skin conditions in dogs has become very popular.
If you’ve used Apoquel for your dog’s allergies, the relief for your dog – and you – was probably fast and effective.
But you may be wondering whether the medication is safe for your dog. Also about Apoquel side effects in dogs who use it for a long time, considering the effects on their immune system.
With so much information and debate out there, it can be difficult to decide if Apoquel is right for your pup. This guide will help you cut through the noise, by providing clear and concise information.
Why is Apoquel for dogs prescribed in the first place?
Skin allergies in dogs
Most of us have had the experience of a pup licking and scratching themselves endlessly to relieve an itch.
Their skin might become red and raw and possibly infected. Eventually their hair thins and falls out. Later scaly and hard patches can develop.
There’s nothing worse than seeing your canine companion in distress. You’ve probably tried every bit of advice to help your furry friend. In fact, most dog owners try at-home treatments – up to 15 different ones – before seeing the vet.
A condition known as atopic dermatitis (AD), or what we commonly know as eczema, is usually the reason for this agonizing itch. It’s caused by an overreaction of the immune system to something in the environment. Like food sensitivities, flea bites, plant material, dust mites, and more.
One study in the US reported that nearly 9% of all consultations in over 50 veterinary practices was for AD.
Dogs can also experience contact or allergic dermatitis with the usual symptoms of a localised rash with some itching and pain. This could be accompanied by hives or swelling in the area.
A reaction to a specific substance is the cause of these skin conditions. Things like poison ivy, latex or chemicals. They are easier to treat and to control by avoiding contact with the trigger.
Allergies are however not the only cause of itchiness in dogs. You vet needs to examine your dog and make a proper diagnosis before you treat your pup for an allergy.
Apoquel for dogs is a medicine recently developed by Zoetis Inc to treat allergic skin conditions in dogs.
What is Apoquel for dogs?
Apoquel (with oclacitinib as its active ingredient), stops dogs’ allergic itching within hours. It disrupts the pathway of the itching sensation and inflammation.
The drug inhibits the Janus kinase (JAK) 1 enzyme – a protein that sparks itching and inflammation. It doesn’t treat the cause of the allergy, but does block the symptoms very quickly.
This gives vets and owners some breathing room to discover and treat the dog’s underlying condition. In the meantime it provides your dog with relief and comfort.
Apoquel side effects in dogs seem to be fewer than those of the standard medicines, previously used for dog allergies.
The medication is safe while given with almost any other drugs, including anti-fungals and NSAIDs. However, always check with your vet before beginning your dog on a new medication.
But does that mean Apoquel for dogs is entirely safe?
Is Apoquel safe for dogs?
Apoquel is only safe for dogs over a year old. According to the manufacturers it can be administered both for short-term breakouts and for maintenance over the long-term.
The FDA granted approval of the drug based on clinical trials carried out in the US.
In the first trial 67% of dogs with allergic dermatitis were successfully treated with Apoquel, according to their owners.
In long-term trial with dogs suffering from atopic dermatitis around two-thirds of them had a more than 50% improvement of their itching and dermatitis after three months. The owners of over 90% of the dogs reported that their pup’s quality of life had improved.
However, according to the manufacturer, Apoquel for dogs may make your pet more susceptible to infections and mange.
Apoquel should not be given to dogs with any serious infections, cancer, or parasitic skin infections. It’s also unsuitable for pregnant, breeding or lactating dogs.
Apoquel – The Wonder Drug?
When Apoquel for dogs first hit the market in 2014, it was hailed as a wonder drug.
Having a medicine that provides relief to itchy dogs within four hours, and controls the itch completely within a day, was great news for desperate dog owners.
But given that the drug disrupts a dog’s immune system, some pet owners remain wary of the long-term consequences.
In so-called ‘margin of safety’ studies conducted by the manufacturer on 12 month old dogs, there were incidences of warts, cysts and abnormal or swollen lymph nodes.
It also lowered white and red blood cell counts, although not below the normal range.
Safety studies performed on dogs less than six months old were discontinued as some of them developed bacterial pneumonia and mange.
So are these potential issues something you should be worried about when using apoquel for dogs?
Apoquel side effects in dogs
In clinical studies, fewer than 5% of the dogs on Apoquel experienced side effects.
The most common side effects were vomiting and diarrhea. Some dogs also experienced lack of energy, decreased appetite, and skin lumps. Most of these side effects disappeared after a week or two on the treatment.
Like any other treatment for allergies, Apoquel does suppress the immune system. Quite a few dogs developed skin, ear and urinary tract infections. These infections can however be effectively treated and resolved.
One veterinary dermatologist, that has placed over 1000 dogs on Apoquel, reported another rare side effect. Owners explained that their dogs get a funny look on their faces and run around the house like crazy. The problem resolved once Apoquel was stopped.
For this vet the rare occurrence of bone marrow suppression from Apoquel is the most concerning side effect. That’s why, in the case of long-term treatment, blood tests should be done after the first three months, and then every year.
Does Apoquel cause cancer?
There has been a lot written recently about Apoquel causing cancer. A study that followed dogs who had been treated with the medication for up to three years reported that 12 out of 239 dogs developed some form of cancer.
One should, however, keep in mind that the dogs might have developed cancer anyway. The finding does not necessarily mean that it was a side effect of Apoquel.
Any medication that has effects will have side effects. And all the medicines used for allergies in dogs have similar side effects, as they all suppress some part the immune system.
If you’re worried about potential risks for your dog from Apoquel, talk to your vet about your concerns. While your pup is on the medication keep an eye out and let your vet know about about anything that worries you.
Furthermore, keep to the dosage and follow-up examinations prescribed by your vet.
Apoquel dosage in dogs
Apoquel tablets for dogs comes strengths of 3.6mg, 5.4 mg and 16mg of oclacitinib per tablet. The dosage will depends on your dog’s weight.
According to the manufacturer’s dosage chart, a large breed weighing between 130 and 175lbs should take two Apoquel 16mg daily.
If you’ve a medium or small-sized pup the Apoquel 5.4mg for dogs is probably more appropriate. For a dog weighing between 20 and 29.9lbs, one 5.4mg tablet daily is sufficient.
Very small breeds, weighing between 6.6 and 9.9lbs should take the lowest dosage. Half a tablet of the Apoquel 3.6mg for dogs is the recommended amount.
How to give Apoquel
Tablets are usually given twice a day for up to 14 days and then once daily for maintenance if needed. The tablets only work for about 24 hours and so there is no point in trying to reduce the dose to a tablet every second day.
You don’t have to wait for mealtimes – dogs can take Apoquel with or without food.
Unlike steriods, there is no complicated tapering off period. Dogs can simply stop taking the medication at any time.
What if your vet wants to change to Apoquel when your dog is already on a steroid? Your dog will probably start on the new medication while the steroids are tapered off.
It’s very important to follow your veterinarian’s instructions when it comes to Apoquel dosage in dogs. There may be reasons to adjust the recommended doses to suit your pet.
And don’t try and pop an Apoquel for your own allergic reaction – it’s been developed for dogs only.
Given that Apoquel for dogs has become so popular, you may be asking the cost is.
Apoquel for dogs price
Online retailers sell Apoquel for between $1-$2.50 per tablet. The different strengths used to be the same price, but most of the retailers now have a price range.
Don’t be fooled if you come across Apoquel generic for dogs online however. Zoetis still has the sole rights to produce oclacitinib tablets and so Apoquel is the only available brand.
Now that we’ve covered Apoquel you may be wondering about other options for treating your dog’s skin allergies.
Apoquel alternatives for dogs
Atopic dermatitis, in particular, can seldom be treated successfully without medical intervention. The condition is genetically linked, mostly chronic and rarely cured. However, in most cases it can be managed successfully.
Your vet will usually prescribe a medication to relieve the itching and to stop the skin condition from becoming worse. The next step will be to try and find the cause so that the condition can be avoided, rather than just treating the symptoms.
The older drugs that were most commonly used to treat allergy-related itching in dogs are glucocorticoids (a type of steroid) and cyclosporine.
Glucocorticoids, such as Prednisone, also give quick relief. They come in tablets and an ointment. They’re still the most effective for treating long-term skin changes from AD.
However, Glucocorticoids have more serious side effects than those reported for Apoquel, especially if used for a long time.
Cyclosporine (Atopica) has the advantage that it can be given to pups from as young as 6 months old. It is very effective in treating treating the inflammation which goes with AD.
A downside is that it takes quite a while to start working. Potential side effects are similar to those of Apoquel
Cytopoint – a new treatment
In 2016 Zoetis brought out another treatment for AD, Lokivetmab,with the brand name Cytopoint. It’s an injectable antibody, similar to a vaccine.
Cytopoint inhibits the activity of a natural immune messenger molecule in the body. It is given every 4 to 8 weeks. The treatment is suitable for dogs at any age and even those with current infections and cancers. At this stage it’s still very expensive.
The cause of the condition can be found and treated once your pup’s distressing itch and inflammation have been relieved.
Further treatments for dog skin allergies
Your vet can run blood tests to try and find out what your dog is allergic to.The cause can then either be avoided or your dog can be given a course of treatments known as allergen-specific immunotherapy.
This involves testing to find out what your dog is allergic to, followed by a series of shots. This is the only effective long-term treatment that doesn’t involve suppression of the immune system. And that will improve the quality of life for your pet with a condition that is likely to get worse over time.
Your vet might also recommend further steps tailored to your dog’s specific problem. These could include additional medications against inflammation and supplements. Also dietary changes, infection prevention, and avoidance of allergens.
If the allergen is something in the environment then common sense tells you that you should keep your pup’s bedding clean. And give them regular baths.
Between baths, it’s also good idea is also to wipe down your dog’s coat and paws after a long walk outside.
Furthermore, there are a variety of natural alternatives you can try with your vet’s approval.
When my dog has an allergy breakout, I find that an oatmeal bath soothes his red, itchy skin. Make a paste with oatmeal and warm water and rub it into his fur, leave for a few minutes and thoroughly wash.
Another option is a baking soda bath, using a ratio of one tbsp of baking soda to one cup of warm water.
Apoquel For Dogs – a summary
An itchy dog can drive itself and its owner mad – with it’s chewing, licking, biting and scratching,
Treating an itchy, allergic dog is often a difficult process of trial and error. As one veterinary dermatologist explained: “I expect to find a symptom-relieving combination that will work well for most dogs. But I do not expect to find it the first time, every time.”
Using Apoquel for dog allergies can give both you and your pet much-needed instant relief. It might also be the best long term option for constant and severe distress from atopic dermatitis.
But it’s important to be an informed customer. Talk to your vet, read the manufacturer’s information and do your research. This will help you to make the right decision to ensure the best possible quality of life for your pup.
And, of course, the ideal treatment is to get to the core of the problem, not just alleviating the symptoms. It may be worth having your dog tested if he is diagnosed with allergies.
Knowing whether he’s suffering from food or environmental allergies can help you pinpoint the problem and put an end to your dog’s misery – giving him a happy, healthy, itch-free future!
This article has been extensively revised and updated for 2019.
- American Animal Hospital Association. 2018. The itchy dog: short and long term approaches to allergy. AAHA Newstat.
- Cosgrove, S.B. et al. 2013. A blinded, randomized, placebo-controlled trial of the efficacy and safety of the Janus kinase inhibitor oclacitinib (Apoquel) in client-owned dogs with atopic dermatitis. Veterinary Dermatology.
- Cosgrove S.B. 2015. Long-term compassionate use of Oclacitinib in dogs with atopic and allergic skin disease. Veterinary Dermatology.
- Eisenschenk, M. 2018. Apoquel information: my clinical experience with Apoquel (olacitinib). Pet Dermatology Clinic.
- Gortel, K. 2018. An embarrassment of riches: an update on the symptomatic treatment of canine atopic dermatitis. The Canadian Veterinary Journal.
- Zoetis. 2018. Apoquel. Zoetisus.com.
- Zoetis. 2013. Prescribing information. Zoetisus.com.