Apoquel has become the most widely prescribed drug for allergies in our dogs, but are we educated enough on this drug?  While it’s marketed as safe, fast acting and with minimal side effects, there are more and more people reporting nasty reactions to Apoquel. 

In this blog we are going to look at what exactly this drug is, the side effects of using it on our dogs and healthier alternatives we should be trying before opting for this as a solution.

Apoquel and Janus kinases

Apoquel is an anti-allergy drug.  The active ingredient in Apoquel is oclacitinib which is a Janus kinases inhibitor.  It works by blocking the effects of Janus kinases.  What are kinases?  Kinases are signaling compounds that cells use to communicate with each other.  What this means is Apoquel is stopping these ‘communicators’ from signaling the body that there is an infection by creating an ‘itch’.  The drug stops this communication thereby stopping the itch, AND stopping the immune system from functioning properly. 

The Janus kinases in particular play an important role in policing the formation of tumors in the body, forming white and red blood cells, regulating inflammation and ensuring the T-cells are functioning properly.  Having these ‘switched off’ is extremely bad for the immune system.

Side Effects of Apoquel

Before we get into the studies that have been conducted on this drug, here are some of the side effects listed on the information sheet inside the Apoquel box:

• Vomiting
• Diarrhea
• Anorexia
• Lethargy
• Decreased leukocytes and/or globulins (bone marrow suppression)
• SQ or dermal masses (unspecified)
• Increased cholesterol and lipase
• May exacerbate neoplastic conditions (conditions that may cause tumor growth)

Interesting that the side effects are mostly skin related when that is exactly the issue you are trying to heal! 

Studies Conducted

The Apoquel manufacturer, Zoetis, conducted a safety study in which they reported that there were no fatalities or abnormal health events resulting from the use of Apoquel.  However, it’s important to note that this study was only conducted over a period of 28 days, and did not continue on after that, while the dogs were still taking the drug.  And, here are some of the other findings from that period:

• 2 of the dogs developed a Grade II mast cell tumor (after 52 and 91 days)
• 2 of the dogs developed an apocrine gland adenocarcinoma, one of which was dermal and the other an anal sac. These issues arose after 210 and 320 days on Apoquel.
• 1 of the dogs developed a low-grade oral spindle cell sarcoma after using Apoquel for 320 days.
• 1 of the dogs was euthanized after 450 days of using Apoquel, after developing abdominal ascites and pleural effusion of unknown etiology.
• 6 of the dogs were euthanized because of a suspected malignant neoplasm.

What we need to be aware of here is that the study results are only from a 28 day period.  We need to consider the implications of using this drug over an extended period, beyond the time frame for which it has been tested.  Pet owners are not purchasing this drug for a 28 day period, but rather on a more long-term, on-going basis. 

Note: Apoquel comes with a clear warning not to be used on dogs under 12 months of age or those with serious infections as it may increase the chances of developing serious infections.  We believe this warning should be considered beyond these guidelines.

Natural Alternatives

We would like to see dog owners turning to natural alternatives when caring for their dogs.  For this to happen it is essential that we educate ourselves.  This means educating ourselves on the drugs available on the market as well as educating ourselves on the safer, healthier choices for our dogs.  With that said, here are some natural alternatives that could be used instead:

• Using MicroMed Topical Acute Care Probiotic sprayed directly onto the affected area. Our ‘commensal’ microbes are nature’s remedy for treating this minor skin irritations. Our Everyday Care Oral Probiotic works on re-establishing the mircrobes to assist the immune cells, secrete substances that act as anti-inflammatories and ensure improved internal health.
• One of the safer alternatives to using Apoquel is the bioflavonoid, Quercitin. Quecitin comes from apple peels, red onions etc and helps to reduce itching naturally.  Not all Quercitin formulations are equal, though.  The whole plant extract is the most effective, so look for a supplement that uses the whole plant.
• Acupressure: A great book for this is Animal Acupressure Illustrated, The Dog by Deanna S Smith
• Homeopathy: Homeopathic Care for Cats & Dogs by Don Hamilton

Please note that kibble is ‘inflammatory’ and NOT a species-appropriate food and for the chronic itch we do recommend novel proteins on the PMR diet.

While we all want the ‘result’, at the end of the day what we really want is a healthier and happier dog.  This means looking at the big picture and staying the course for the best result, and this isn’t always the ‘quick fix’.  Be sure to educate yourself before making choices that affect your dog’s health, because we don’t know what we don’t know heh.