Apoquel Side Effects and Alternatives￼
Your dog is itching, and your veterinarian prescribed Apoquel. It sounds great, but Apoquel side effects can kill your dog. Apoquel is designed to treat itching in dogs, but there are a lot of problems associated with this medication. I would never give my dog Apoquel, and I will explain why.
When Apoquel first hit the market, pet parents flocked to give it to their itchy dogs. A miracle cure was touted by many mainstream veterinarians.
Apoquel stops something called JAKs from working in your dog. Your dog should not be without JAKs for long. JAKs, “just another kinase,” are messengers in the body that help growth and development.
Imagine what might happen if the immune system is suppressed and your dog’s body cannot grow and develop properly.
In the package insert that comes with Apoquel, the manufacturer, Zoetis, indicates six percent of dogs taking Apoquel develop cancers.
There are safer alternatives to Apoquel. This isn’t just my opinion or belief. I am the catalyst to share the information I gather, learn, and research over the years, coupled with current studies.
If you give your dog Apoquel and feel comfortable doing so in conjunction with your veterinarian, that is your personal decision. Each dog is different. The purpose of this article is to offer facts, options, and alternatives about Apoquel and its potential to do harm.
What Is Apoquel Used For In Dogs?
According to the manufacturer, Zoetis, website, “Apoquel (oclacitinib) is prescribed for fast, effective relief of allergic itch and inflammation due to atopic and allergic dermatitis.”
It is neither an antihistamine nor a steroid and is to be given with or without food. It is an oral medication for dogs only at this time.
Some dogs are reported to see results in as little as 24 hours. If you have an extremely itchy dog, this seems like a miracle.
It is intended for dogs one year or older. It should not be given to dogs with a history of cancer. Re-read that last sentence.
Cocker Spaniels are particularly prone to autoimmune diseases and diseases of the blood that happen when the immune system goes awry. One of those diseases, IMT (immune-mediated thrombocytopenia) nearly killed my Cocker Spaniel.
What Are The Apoquel Side Effects?
Here’s an image of the insert from a package of Apoquel:
Other side effects of Apoquel include:
- Increased shirts
- Skin and ear infections
- Bacterial and fungal infections, including pneumonia
- Urinary tract infections
- Decrease in the body’s ability to clot
- Decrease in liver function
- Decrease of the body’s ability to fight infection due to reduction in white blood cells
What Do Holistic Veterinarians Say About Apoquel?
Dr. Judy Morgan is a renowned author and veterinarian certified in food therapy, chiropractic care, and acupuncture. She has close to 40 years of experience and recently released her list of spooky drugs. One of them is Apoquel.
She writes, “Apoquel does not “cure” anything; it is an immune suppressant. It is only labeled for use in dogs and is unsafe for puppies under 12 months or senior dogs due to their weakened immune system.”
Unfortunately, Apoquel has become the top-selling product in the United States for animal health, according to a recent article in the AVMA Journal.
Here’s her outline of Apoquel side effects:
Dr. Morgan isn’t alone. Dr. Ron Hines, a Texas veterinarian, began cataloging feedback from pet parents whose dogs took Apoquel.
Dr. Deva Khalsa, a renowned holistic vet, says she would never give her dog Apoquel because of the frightening side effects.
Dr. Laurie Coger shared the new warning on the Apoquel label that the FDA required in early 2022. The update is startling:
Why Can’t Dogs Under One Year Old Take Apoquel?
According to the company’s website, “Do not use Apoquel in dogs less than 12 months of age or those with serious infections. Apoquel may increase the chances of developing serious infections and may cause existing parasitic skin infections or pre-existing cancers to get worse.”
Apoquel has not been tested in dogs receiving some medications, including some commonly used to treat skin conditions, such as corticosteroids or cyclosporines.
So if your dog ever took a steroid or cyclosporine or has undetected cancer, this isn’t good.
Dr. Deva Khalsa is a revered holistic veterinarian, professor at the British Institute of Homeopathy, and author of many animal health and wellness books. In her article about the safety of Apoquel, she admits she would never give it to her dog.
She explains that in a margin of a safety study performed on 12-month-old dogs, some of the symptoms believed related to Apoquel included:
- Papillomas (warts)
- Cysts with related symptoms (local alopecia, erythema, abrasions, scabbing, crusts)
- Edema of feet
Dr. Khalsa indicates Apoquel was found to lower white and red blood cell counts and could affect the bone marrow, lymph nodes, and lymphatic tissue.
What Are Pet Parents Saying About Apoquel?
I am the administrator of a very active Cocker Spaniel group on Facebook called Club Cocker. The topic of Apoquel comes up quite often. Cocker Spaniels are known for food and environmental sensitives and allergies.
Here are a few of the many comments from pet parents whose dogs were placed on Apoquel:
Our Sugar was on it and never, never again. She became aggressive. Aggression is a known side effect. We were lucky that was her only reaction. My sweet little girl became a nightmare. Both my vet and dermatologist have her folder marked NO APOQUEL, NO CYTOPOINT.Nancy K. Carter
Can be a dangerous medicine. Read up on it and talk to your vet. Mine was on it for recurrent ear infections due to allergies. She is only 4. It works by suppressing the immune system. I don’t think that is a good idea. But also don’t know the extent of your dog’s problem. With the help of a pet nutritionist and probiotics I got my girl off of Apoquel.Nancy W. Longiro
Apoquel suppresses the immune system. It gave one of our dogs a tumor on his lip. When he got off the Apoquel, the tumor shrank.Melissa Webb
It works well but research it first – it’s an immunosuppressant- I believe my cocker got cancer from being on it for several years.Kimberly J. Quintilla
Wow. don’t want to scare you because I don’t know, But I do know that Apoquel works on the immune system, and after using it on my dog for a while, she ended up with a possible autoimmune disorder that attacked her gut, PLE .. I joined a Facebook group of owners with dogs that had the same disorder, And not me, but somebody else asked the question if anybody else had used Apoquel, and shockingly just about everyone started responding saying yes, my dog has taken it or is taking it. It was a huge common thread. Nothing has been said scientifically or medically on this; just almost everybody in the group’s dog took this medication.Jana Boyling
Safer Alternatives To Apoquel For Dogs
First things first: Find out exactly what your dog is allergic to or sensitive to. What is causing his itchiness?
Dr. Morgan offers this advice:
“Allergies, skin infections, and ear infections are related to immune system dysfunction, which commonly occurs secondary to gut dysbiosis (imbalance of good and bad bacteria within the bowel resulting in swelling of the cells lining the bowel and secondary leaky gut).
The basis of allergy treatment requires:
- Removing or reducing allergen exposure, whether that is food or environmental
- Fixing the gut!
- Modulating the immune system
Here are steps you can take and other things you can do in place of Apoquel:
- Order a Nutriscan allergy test developed by Dr. Jean Dodds. The test kit is sent to you, you send a sample of your dog’s saliva back, and the results are emailed within two to three weeks’ time. NutriScan tests for the 24 most commonly ingested foods.
- Work with a veterinary dermatologist who can perform environmental allergy testing on your dog.
- If food is a factor, consider switching to a whole food diet, such as Dr. Harvey’s who makes Allergy for Dogs pure whole food you simply add water to.
- Join the Facebook group called Apoquel and Cytopoint: The good, the bad, and the ugly.
- Have your dog’s thyroid levels checked Cockers are overrepresented in terms of thyroid issues, which can affect their skin, and coat, cause itching, etc.
- Blood testing to assess environmental allergies. Talk to the veterinary dermatologist about allergen-specific immunotherapy (ASIT) shots. They are designed to give your dog itch relief and improve their quality of life. They make some time to start working. Like people, what a dog is allergic to may change over time.
- Get rid of allergens in your home with a high-quality air purifier. My favorite is the Rabbit Air A3 Air Purifier, which I use in different rooms. They continually get 5-star ratings, and mine is incredibly effective. Read my thorough review of the Rabbit Air A3 Air Purifier.
- Add high-quality supplements to your dog’s diet. The right Omega-3 fish oil can help with skin, dandruff, itchiness, and overall wellness. We add Dr. Harvey fish oils and rotate between Health and Shine and Salmon and Krill.
- Consider adding CBD Hemp Oil to your dog’s diet. Many pet parents associate CBD to calm an anxious dog, but it does so much more. We recommended and use the Pet Releaf brand of hemp oil called Daily Releaf. CBD has many beneficial properties, and helping control canine allergies is one of them.
- Use products to prevent and control the itch as you narrow down the culprit of your dog’s problem. We use and recommend products from Zymox, including Enzymatic Shampoo, Enzymatic Leave-In Conditioner, Topical Spray with 0.5% hydrocortisone, and Zymox topical cream with 0.5% hydrocortisone.
Bonus: We also use Dr. Harvey’s Herbal Healing Cream and the Skin and Paw Releaf balm from Pet Releaf as needed.
- Minimize the number of vaccines your dog receives. Read more about that in my titer or vaccination article.
- Read our article related to Helping a Dog With Allergies for bonus tips.
What About Other Medications Instead of Apoquel?
You likely know about the other medications designed to control itchiness or allergies in dogs. Unfortunately, many of them have scary side effects as well. I implore you to do your own research. I’ll outline a few of the “others” and potential issues.
Also called cyclosporine, this is prescribed to dogs for skin allergies (atopic dermatitis.) It is non-steroidal and FDA-approved.
Atopica side effects include headaches, vomiting, nausea, shaking, vision changes, loss of consciousness, swollen glands, gingival hyperplasia, nausea, immune system suppression, vision changes, and more. According to Dogs Naturally, these aren’t side effects but symptoms of poisoning by this mycotoxin poison.
This is an injectable medication made by Zoetis. The manufacturer claims there will be relief from itching within 24 hours, lasting four to eight weeks. Shots require a veterinary visit.
In his own words, veterinarian Dr. Edward Bassingthwaighte is a holistic veterinarian who maintains the Healing Vet Facebook page. Regarding Cytopoint, he says:
“Cytopoint is not safe for dogs. As a veterinarian, I wouldn’t prescribe it to dogs in my care. I think it’s likely to cause significant harm or even kill your dog. Cytopoint causes harm because it blocks a messaging process in the body that’s important in regulating many different processes. This can have multiple, severe unintended consequences … none of which are good for your dog.”
You can read more in the Facebook group called Apoquel and Cytopoint.
Steroids are a double-edged sword. Steroids save lives but have dangerous side effects if used long-term. Some of these side effects of prednisone include becoming aggressive, Cushing’s Disease, pot belly appearance, and more.
Hydroxyzine, also called Atarax or Vistaril, is an antihistamine used to treat itchiness and allergic issues and even as a sedative in dogs. Two of my Cocker Spaniels took Atarax for seasonal allergies with mixed results. It usually took two doses for an effect. Neither dog became sedated.
This combination of an antihistamine and a corticosteroid is designed to relieve itching. It is often prescribed for kennel cough. Side effects are similar to the long-term use of steroids. The trimeprazine in Temaril-P can cause sedation, tremors, and drowsiness.
Over the Counter Antihistamines
This includes medications like Benadryl and Zyrtec, which can be helpful in the short term under your veterinarian’s guidance.
Why Is Apoquel So Frequently Prescribed?
Apoquel has been on the market for at least 9 or 10 years. Touted as one of the most effective veterinary drugs to stop itching in canines, veterinarians want to help their clients.
Some veterinarians take extra precautions (and rightfully so) to monitor dogs on Apoquel. This includes careful monitoring with blood tests and office visits and checking in with their clients. Vets don’t want their clients’ dogs to be uncomfortable or itchy.
It is fast and incredibly effective for most dogs, and veterinarians are able to help their clients as a result.
However, there are very, very scary downsides to Apoquel. Each pet parent must choose to do what is in their dog’s best interests.
My goal in writing and sharing this information is to have a collective article with the latest data, reactions, veterinary feedback, warnings, FDA label requirements, and more.
Some dogs do well on Apoquel, and I wish that were the case for all dogs who take Apoquel. But it’s not.
Here’s what DVM360 has to say about the use of Apoquel and Cytopoint. This will give you a good idea of how veterinarians looked at Apoquel and Cytopoint when they first gained popularity.
What If My Dog Is On Apoquel?
If you give your dog Apoquel and feel comfortable doing so in conjunction with your veterinarian, that is your personal decision. You must do what you feel is best for your dog.
You can get a second opinion from a holistic veterinarian. If you do not have access to one near you, visit the American Holistic Veterinary Medical Association to search.
Many holistic veterinarians offer telehealth services, so you won’t need to drive to gain access to them.
Talk to your veterinarian if you plan to stop giving your dog Apoquel. There will be a period of withdrawal, and pre-Apoquel symptoms are likely to return (possibly even worse.) You will need a plan of action.
Apoquel never attacks the problem, nor do you ever know why your dog is itching and suffering. It merely changes the way JAKs work in the immune system. Those JAKs cannot function as they once did. Apoquel takes over in the driver’s seat.
FAQs About Apoquel for Dogs
According to Zoetis, relief of itch starts within four hours, and it “effectively controls the itch within 24 hours.” Unfortunately, their fact sheet states Apoquel is “without many of the side effects associated with some other treatments.”
No, there is no generic form of Apoquel available as of this writing.
There are serious side effects that pet parents should know about Apoquel. Apoquel targets your dog’s immune system. Your dog becomes more susceptible to certain conditions, including an increased risk of cancer.
According to Dr. Nicole A. Heinrich of McKeever Dermatology Clinics, “20 percent of dogs with atopic dermatitis do not respond to Apoquel.” She goes on to say, “Apoquel has potential for side effects.”
Apoquel has the potential for side effects. It can cause hepatotoxicity and bone marrow suppression in a small percentage of dogs. Some dogs tolerate Apoquel well, but some dogs simply do not.
No. “The long-term use of Apoquel combined with any other immunosuppressive drug has not been studied. Apoquel should be combined with other immunosuppressive drugs for only a very short duration (i.e., 2 weeks). Only in cases of last resort should Apoquel be combined long-term with other immunosuppressive drugs.”
This was an excellent article. Thank you very much.
We have a very, very, very itchy dog. Tried Apoquel and it worked extremely well right away. And then came the side effects. None of us could live with the dangerous aggression. Took her off Apoquel and the itching returned right away. We are using baths, fish oil and Benadryl with decent results. As many have said, Never Again!
I am so sorry your dog went through side effects and that all is okay now, Mary.