Apoquel Alert: Serious Side Effects of New Dog Allergy Medication
There is a NEW drug on the market to control itching in dogs from allergies, called Apoquel.
It has been launched with much fanfare…from Zoetis..
FDA Approves APOQUEL® (oclacitinib tablet) to Control Itch and Inflammation in Allergic Dogs
Zoetis Offers a Targeted New Approach to Rapidly and Safely Stop the Cycle of Itch and Inflammation Associated with Allergic Skin Disease in Dogs
Atopic dermatitis is one of the most common allergies in dogs, affecting approximately
10 percent of the dog population. Itching caused by an allergic skin disease can be an
acute, short-term condition or can be recurrent or chronic—all which can impact the
quality of life for both the dog and its owner unless they are controlled with effective
FDA approval of APOQUEL is based on results of two clinical trials conducted in the
United States which showed that APOQUEL was effective in the treatment of pruritus
associated with allergic dermatitis and for the control of atopic dermatitis.
Sounds great, right?
Having treated hundreds of dogs for allergies, it is MORE than welcoming to have a drug that works to STOP the itching without all the side effects of predisone.
But be CAUTIOUS
A small study of 299 dogs- 50% of the dogs took the placebo medication, and most dropped out of the study.
66% of dogs improved on the medication, but keep in mind that means 33% (1/3) didn’t at all.
Health events associated with the drug were difficult to compare between groups given the low number of dogs in the placebo group at the end of the study.
The rate of adverse events overall was low (<5%) and included
diarrhea, vomiting, and lethargy that resolved spontaneously in 90% of cases and did not
require discontinuation of therapy. Anorexia was the only adverse event noted more often
among the oclacitinib group compared with placebo (2.6% vs. 0%, respectively).
While still within reference ranges, mean serum globulin and mean white blood cell,
neutrophil, eosinophil, and monocyte counts decreased among dogs in the oclacitinib group
by day 14. Among dogs in the oclacitinib group, one dog withdrew from the study because
of the development of severe pyoderma (after day 19) and one dog withdrew because of the
development of generalized demodicosis (after day 28). Another dog required
hospitalization for the diagnosis and treatment of pneumonia (after 91 days), and one dog
was hospitalized for cystitis secondary to urolithiasis (after day 80 of therapy).
(Source: Cosgrove SB, Wren JA, Cleaver DM, et al. 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. Vet Dermatol 2013;24:587-597.)
Translating the above means that for the first 2 weeks of medication the most common side effects are gastro-intestinal ( vomiting/diarrhea), BUT after 2 weeks, there are measurable blood value changes.
Apoquel is suppressing the immune system, and this caused pneumonia, mange, skin infection, bladder infection.
Because most of the placebo dogs dropped out, they really couldn’t compare the groups.
My cautious warning.
If you have a severely allergic dog, you need to be treating them.
BUT don’t consider this pill the ‘answer’
The potential for serious side effects is substantial, and that 1/3 of dogs did not respond in the study.
Here are my 7 most important natural remedies you should be considering:
1.Less Allergenic Food. Feed your dog a simple food that he is less likely to react to. I have found that a commercial diet of fish and sweet potato work very well, and with this there is less itching, and licking. Every dog is different, so you have to try different foods; there is not just ONE right food. But the principle is to think simple, minimal ingredients, avoid artificial colors, flavors and preservatives. Try the new diet for 4 weeks.
2.Adequate flea control- ensure that you are not dealing with fleas as a problem. You can use a Natural flea spray that has cedarwood oil, and a safe holistic powder for putting in the cracks and crevices of your house called Borax.
3.Regular bathing- of your dog’s feet as he comes in from outside, and of your entire dog. I am giving my own allergic dog an oatmeal shampoo weekly. In the summer when his allergic signs are more common, I am bathing him twice a week. I have also found that by wiping his feet with a damp towel after he comes in from outside, there is far less itching and scratching.
4.Antihistamines- both natural and conventional. I have used Benadryl for big flare ups of his skin, dosing him at .5mg per lb ( I give 50lb Jessie 25mg of Benadryl at night), and I’ll do it twice a day if needed. Lately I have been trying Vitamin C which has some antihistamine qualities, and his itching is decreasing. The Vitamin C dose is 100mg per 10lbs twice daily.
5.Essential Fatty Acid supplements. IF your dog has allergies, he needs to be on these. I am using my supplement, Ultimate Canine Health Formula, which contains EFA’s in the form of flax oil. The omega 3 dose I suggest is 1000 mg per 10lbs daily- this works out to giving 1 tablespoon of flax per 50lbs daily to your dog.
6.Probiotics are increasingly being used for dogs with allergies. These beneficial bacteria play a role in normalizing the overactive immune system. You won’t see an instant response, but you may see some marked decrease in allergic signs after using probiotics for 4 weeks. I am using my supplements with lactobacillus and bifidobacterium, but you can dose lactobacillus at 1/4 capsule per 10 lbs of body weight twice daily.
7.The last increasingly used ingredient for allergies is colostrum. Research has found an ingredient known as praline-rich polypeptide (PRP) in bovine colostrum; it appears to be what is helping decrease the allergy symptoms. The colostrum dose for dogs with allergies varies based on the company; I advise giving ¼ of the human dose per 20lbs daily. My supplement, Ultimate Canine Health Formula contains bovine colostrum in adequate levels for your dog.
Dr Andrew Jones, DVM
P.S. If you are looking for a quick and easy way to help your dog’s allergies, I suggest you try my supplement, Dr Jones’ Ultimate Canine Health Formula. It contains essential fatty acids, probiotics, and colostrum, but more importantly it has helped thousands of dogs. See what it can do for your dog here: http://www.thedogsupplement.com