Zoetis has manufactured Apoquel and Cytopoint for some time now – eight years and five years, respectively. Their use is not without risk of side effects and contraindications, however. The drugs are among the newest and most effective in the veterinary arsenal to treat dogs with allergies. However, these drugs have significantly improved the lives of many severely allergic dogs without causing any ill effects whatsoever.
I’d like to briefly explain why these drugs are so revolutionary, and how they differ from the veterinary medications they replaced.
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Does Apoquel make my dog sick?
Apoquel appears to have fewer side effects than steroids, cyclosporine, and other immunosuppressive drugs used in veterinary medicine. Dog owners, however, need to be aware of a few issues before administering this drug to their pets.
Among the problems associated with Apoquel are Toxicity, Side effects, Contraindications, and Allergic reactions.
APOQUEL is commonly associated with vomiting as an adverse reaction. There have been less frequent reports of diarrhea, lethargy/depression, anorexia, and liver or kidney problems.
You should contact your veterinarian as soon as possible if you observe any of these symptoms in your dog when taking APOQUEL. Symptoms may resolve on their own in some cases without a change in treatment.
However, if your dog is experiencing serious side effects (e.g., repeated vomiting or diarrhea), your veterinarian may prescribe an alternative treatment option in addition to APOQUEL.
If your dog develops hives, swelling, or difficulty breathing after being given Apoquel or any other medication, you should contact your veterinarian right away. An allergic reaction to Apoquel can be extremely dangerous.
Apoquel interacts negatively with other medications or has contraindications. You might have to stop giving your dog other medications prescribed by your veterinarian if you give it to them. If your dog also has a condition such as parasitic skin infections or cancer, this can be problematic.
The Adverse Effects Of Apoquel And Other Shortcomings
Apoquel’s not meant for short-term use or acute dermatitis. A vet turns to it when other treatments have failed to relieve their patient’s itching or when it can’t be easily determined what’s causing it. Once a dog starts taking Apoquel, he usually cannot stop.
You should look at the risks associated with this drug before making such a big decision about your pup’s health.
Potential Side Effects. Medications such as Apoquel are known to cause vomiting and diarrhea, but this drug also has its own list of worrisome side effects.
Apoquel works by disrupting your dog’s immune system’s kinase pathways. As a result, skin irritation and itching are reduced, but the immune system is also impaired in its ability to perform other important tasks.
A dog’s immunity is suppressed by a drug like Apoquel, which is linked to an increased rate of infection just like immunosuppressive drugs used in humans. Demodex mange, ear infections, and pneumonia are the most common infections.
The drug should not be administered to dogs under the age of a year due to the potential for serious infection. They naturally have weaker immune systems.
There is also a possibility of bone marrow suppression and a reduction in white blood cell count in all dogs.
However, kinase pathways aren’t just found within the immune system. All over the body, they play a crucial role. It may be that this is why more surprising side effects such as anorexia, lethargy, and elevated cholesterol and blood lipase are often observed in dogs taking Apoquel.
The Cancer Link. As we know, our immune system is responsible for fighting invaders from the outside world. However, it also plays a key role in fighting cancer within our bodies. This is also true for your dog.
Apoquel has been linked to an increased risk of cancer, which is by far its most alarming side effect.
In laboratory tests, Apoquel was found to worsen preexisting cancers, according to the third side effect on the box. Considering how this drug works, this shouldn’t be a huge surprise. Apoquel interferes with the normal activity of the immune system, so your dog is less likely to be able to fight cancer.
Even though Apoquel itself does not cause cancer cells to grow, it is possible that your dog is more likely to develop cancer if they are taking the drug than if they are not. 5% of dogs taking Apoquel were diagnosed with some form of cancer within 392 days of starting the drug, according to one long-term study.
The number of dogs experiencing vomiting while taking Apoquel is almost the same as the percent of dogs in most studies who did so.
A drug that prevents organ rejection may be associated with an increased rate of cancer, but it is up to you to decide whether this risk is worth it to help your dog find relief from chronic itching.
Becoming Dependent. Apoquel’s side effects seem to be disturbing, but the real danger to your dog’s system is how addictive it is.
In contrast to other medications, Apoquel is meant for dogs who have long-term skin problems. Therefore, most dogs have been prescribed this drug with no expectation that they will ever be removed from it.
My former client’s brindle boxer is an excellent example of why this makes sense. It had been years since this poor pooch had suffered from chronically itchy skin. When his owners finally found a treatment that worked, why would they stop using it?
They were forced to stop using the drug, at least briefly, because of its usefulness. In the months following Apoquel’s release, Zoetis’ ability to manufacture the drug was overwhelmed by the demand for the drug.
The drug was taken off the market for thousands of dogs. I remember how ferociously that poor boxer’s irritated, inflamed, and itchy skin returned. He seemed to be in worse shape than he was before he took the medication.
Apparently, this wasn’t just a matter of perception. Atopic or allergic dermatitis isn’t cured by Apoquel. In reality, it is more like a bandaid that forces your dog’s immune system to work overtime to compensate. As the kinase pathways attempt to reconcile with the restructured system once the bandaid is removed, your dog’s immune system can also fall into chaos.
Consider that your dog’s dermatitis will likely be even worse after a few months or years on Apoquel if you don’t try another form of treatment.
Prices for Apoquel are high. Apoquel’s price often leads owners to search for an alternative, despite its potential for cancer growth and dependence.
Since this drug was introduced six years ago, little has changed. It is still a revolutionary and unsurpassed treatment for severe itchiness that can only be obtained with a prescription from your veterinarian. Apoquel’s dominance over the market is reflected in the price.
For allergic dermatitis, prednisone used to be the drug of choice, which cost 800% less than Apoquel. The effectiveness of each treatment is generally equal, however.
Owners often wonder if there is a generic version of Apoquel, since they may have to pay this high price for the rest of their dogs’ lives. Unfortunately, there is not. Patents on this drug won’t expire until 2026 in the US, making it unlikely that anything will compete with it anytime soon.
Therefore, your options for Apoquel alternatives are limited to the old standbys for allergy-induced itchiness.
Before Apoquel, Atopica was the drug of choice for atopic dermatitis. Sadly, it was replaced with the new drug due to its own set of unpleasant side effects, most of which were worse than what Apoquel currently has. Additionally, the price is comparable to Apoquel’s, making this drug a poor alternative.
In the treatment of itchy and inflamed skin, prednisone and other steroids have long been used. It is not recommended to use these drugs long term because they have less of the desired effect than Apoquel.
Apoquel has no competition with Benadryl, chlorpheniramine, and other antihistamines for dermatitis. Antihistamines are rarely recommended to treat allergic dermatitis in dogs because they have little effect on itching.
In spite of this, they are generally safer to use than other drugs, so they might be worth investigating for a desperate owner looking for a short-term fix while pursuing one of the alternatives listed below.
Is there an alternative to Apoquel?
Diet changes for your dog. Can dogs who have allergic dermatitis that does not respond to environmental allergens suffer from allergies as well? It is very likely that these dogs have an allergy to their diet.
Food sensitivities and intolerances, which can also cause rashes and itchy skin in dogs, are far more common than food allergies. The best way to find relief from your dog’s dermatitis is to eliminate any food that may be contributing to it.
An elimination diet involves removing all potential allergens from your dog’s diet and then gradually reintroducing foods one at a time once symptoms have subsided. How do you determine what may be an allergen or intolerance? Any food ingredient that your dog has been exposed to in the last two years is likely to be an allergen.
Beef, dairy, chicken, wheat, soy, lamb, corn, and eggs are the most common dog allergies. You can, however, become allergic to any food your dog has previously consumed.
Check the ingredients label on your dog’s food bag. Take note of all the ingredients. Synthetic vitamins, preservatives, and other minor ingredients might cause dog allergies, but it is less likely. Add to that list any treats your dog has received, foods he licked up off the floor, and foods he ate while taking medications or supplements.
For the next few months, these are the foods your dogs cannot eat. It is now your responsibility to find a dog food that contains none of these ingredients. I recommend that you look for a limited ingredient diet that contains only one protein and one starch.
You might have to hunt for something with less common ingredients like venison and sweet potato or rabbit and oatmeal if your list includes several common proteins and veggies.
Over the course of a few days, slowly transition your dog to the new food. You should restrict your dog’s diet (including treats) once they have been completely switched to the new food to only items that are not on the potential allergens list you created.
In order to get your dog’s symptoms under control, you will need to continue this restricted diet. This may require waiting up to three months for skin allergies. Try changing your pup’s diet to one with different ingredients if his symptoms do not improve. There is no reason to suspect that you have a food allergy or sensitivity if there is still no improvement.
If you can tolerate one restricted food from the list once your symptoms have cleared, then you can add another. Continue this modified diet for at least two months. Symptoms are likely to return if the reintroduced food causes an allergic reaction in your dog.
Try removing the food completely from their diet, waiting for symptoms to resolve, and then trying another food from the list. Your dog must be able to eat a balanced diet with multiple proteins and carbohydrates without developing symptoms of allergic dermatitis after multiple trials.
Food may even be the cause of your dog’s allergies or intolerances, even if it doesn’t. A poor-quality diet can result in a dry, brittle coat and itchy skin. When your dog isn’t eating optimally, switch to a food that contains many quality animal ingredients at the beginning of the list, without fillers like corn or soy, and without synthetic dyes or preservatives. A healthy fat should also be present in foods with at least 25% protein.
Simply making this change can make a huge difference in your dog’s skin and coat health.
Addressing Environmental Allergens. In summary, dermatitis is never a diagnosis in and of itself, but rather a symptom of an underlying problem. Finding the root cause of your dog’s itching and treating that rather than treating just the symptom will lead to a cure much more quickly.
Additionally, 70 percent of canine skin conditions are caused by allergies, so tackling environmental allergens is a good first step. The majority of dogs who suffer from allergic dermatitis react to an allergen in the air or on surfaces. Pollen, dust mite saliva, and flea saliva are the most common allergens.
Your dog’s itchy skin is likely caused by pollen allergies during the spring and fall. If you have this diagnosis, you should use drug therapy sparingly. You should be aware that drugs like Apoquel can cause dependence and are difficult to discontinue.
If you don’t want to use drugs to treat your dog’s allergies, there are some other options that can help.
Use powerful air purifiers indoors, replace HVAC filters frequently, and limit grass exposure for your dog. A dog with highly sensitive skin, multiple allergies, or severe allergies may not be able to cope with this.
In this case, immunotherapy can cure your dog’s allergies. Immunotherapy works equally well on people and dogs. A series of tests are conducted to determine which allergies your dog has.
A series of injections or drops are administered over a period of days or weeks in order to gradually introduce the offending allergen to your dog’s system. As the number of doses decreases over time, there is an increase in allergens per dose.
The incidence of dermatitis decreases or disappears completely in approximately 70% of dogs whose immune system becomes accustomed to the allergen and stops reacting to it.
Supplements. Just as switching your dog to a higher-quality diet can relieve itchy skin, supplements can do the same.
When it comes to itchiness, fish oil is one of the first supplements to come to mind. Omega-3 fatty acids are present in this oil. Your dog’s skin, overall health, and ability to relieve itch are all dependent on Omegas. With the use of an omega supplement alone, 20% of dogs with dermatitis experience significantly reduced the itching. There is no downside to giving your dog these fatty acids since they are a healthy addition to their routine.
A digestive enzyme and probiotic blend made specifically for dogs can also relieve itching, especially if your dog suffers from unknown food intolerance or sensitivity.
Your dog’s stomach contains enzymes that break down certain foods. Your dog will experience itchy skin if they lack a certain enzyme or do not produce enough on their own. Undigested food can cause unnecessary immune responses or nutritional deficits that cause the skin to itch.
Additionally, probiotic organisms help break down particles in your dog’s gut that he cannot digest himself. Your dog’s intestinal flora plays a key role in helping him to absorb nutrients, including those that are crucial for his skin and coat.
Natural alternatives to Apoquel include yucca and quercetin. The effects of yucca are similar to those of steroid drugs without the side effects. Benadryl reduces itching in dogs whose itching is reduced by quercetin, which acts as a natural antihistamine.
Excluding infections and parasites. It’s likely that the first step in treating your dog’s itchy skin involved testing for parasites such as fleas, mites, and other skin infections. However, these tests often miss common causes of dermatitis. (If it didn’t, then you should definitely do it now.)
The most common flea allergies affect dogs that have few fleas, and one bite can cause a week’s worth of itching misery. Veterinary offices can easily miss this intermittent or minor degree of the infestation, so it’s important not to rule it out just because flea dirt isn’t visible.
It is possible to misdiagnose or even manage. Mites that live so deep within the dermal layer cannot easily be detected by normal skin scrapings and may require repeat testing. If your dog also exhibits other signs of mange, but your initial test was negative, you may want to talk to your veterinarian about additional tests.
The staph bacteria can even cause allergies in some dogs, especially those with thyroid problems and other environmental allergies. Most surfaces, including the skin of healthy animals, contain this microbial.
Antibodies can only be detected in blood tests that detect this infection and many others that cause allergic reactions. If you suspect that your dog’s allergic dermatitis is caused by an environmental or contact allergen or infection, this might be a worthwhile step to take.
Veterinarians sometimes give dogs antibiotics to rule out bacterial-induced dermatitis. Although this can be useful as a diagnostic tool, keep in mind that some infections take multiple rounds of antibiotics to eradicate and that yeast infection, often made worse by antibiotics, can also cause itchy skin.
You should always work with your vet and exhaust all possibilities before assuming that your dog has an infection or parasite causing his itchy skin. Even a veterinary dermatologist may be able to help your dog.
Topical Remedies. The market offers several topical balms and ointments for dogs with itchy skin. These products are greatly beneficial to many owners, especially for hot spots and flare-ups.
If your pup’s skin is itchy, you don’t have to spend a fortune buying premade remedies. To soothe your dog’s itchy skin, you can use many common items in your pantry right now.
Coconut oil has antibacterial and healing properties, making it an excellent skin soother. Apply it directly to the skin as is or mix it with essential oils of lavender or peppermint for truly soothing skin treatment.
These natural anti-inflammatory products can be mixed with water for a soothing soak: green tea, chamomile tea, baking soda, oatmeal, and apple cider vinegar. Getting your dog to remain still long enough to reap the benefits may be challenging, but once they feel the relief, they’ll likely thank you.
What happens if you give your dog too much Apoquel?
Apoquel overdose can result in the following symptoms: alopecia (local), dermatitis, papilloma, erythema, edema of the feet, abrasions, and crusting/scabbing, interdigital “cysts.”.
Apoquel is generally safe for dogs, but it can suppress their immune systems or have other adverse effects in some cases.
This makes Apoquel only suitable for use by veterinarians. Whenever you have concerns or questions about your dog’s health while taking Apoquel, always follow your vet’s instructions carefully and contact the office immediately.
Treatments for dog allergies
Allergies in dogs are characterized by healthy-looking, itch-prone skin. An allergen is either inhaled (atopy) or consumed (food allergy). Frequently, seasonal itching is caused by allergic reactions to inhaled allergens (only in spring or only in fall). Food allergies can cause itching throughout the year.
Allergy treatment aims to eliminate itching. In order to stop the underlying itch, you must stop your dog from scratching, chewing, biting, and rubbing himself into secondary infections, which add a second layer of itching and discomfort.
Several different mediators are involved in the complex biochemical process between the time an allergen is first recognized by the body and the resulting itch and inflammation of the skin. There are various ways to treat allergic itch by interrupting or blocking this cascade. Allergy itch is better controlled when there is more complete blocking or interruption.
The ideal situation would be for the dog to be completely protected from any substances he’s allergic to, but with atopy, this is impossible. When your dog is allergic to food, you can identify the food or foods he is allergic to by doing a diet trial.
For proper diagnosis of food allergies, it is necessary to feed either an extremely limited-ingredient diet containing only ingredients that are novel for the dog (that he’s never eaten before) or a hydrolyzed protein diet and nothing else for eight to 12 weeks and observe whether the itch subsides. (If it doesn’t, atopy, not food, is likely the problem.)
If you skip this step, you may end up disappointed and frustrated. Most of the medications used to relieve allergy itching don’t work well on food allergy itching.
As opposed to complete protection from contact between a dog and the substances he’s allergic to, allergy testing and immunotherapy (allergy shots) continue to be the gold standard for managing allergies in dogs.
During this therapy, the dog’s body is stimulated to produce antibodies against his allergens, blocking the cycle of inflammation right at the start. Due to its high cost, labor intensity, risks, and lack of guarantee, this is not the preferred method of allergy management.
Instead, medications are used. Over-the-counter antihistamines are safe, inexpensive, and available over the counter. Unfortunately, they are not effective for dogs. In the case of a full-blown, inflammatory allergy breakout, they won’t help. It is too late at that point to block histamine.
Antihistamines are probably best used in the weeks leading up to allergy season in your dog. You might consider taking an antihistamine ahead of time if you know he has trouble with allergies in the fall. Adding an antihistamine may also help if a prescription medication is working but not providing 100% relief. You should discuss this with your veterinarian.
Steroids stop allergic itching immediately and have a long-lasting effect, but they have a number of side effects on the body, including suppressing the immune system. They will still be prescribed for severe, acute cases, but only in the beginning, to get the inflammation under control. Thereafter, we will look for a safer, long-term solution.
In 2003, the Food and Drug Administration approved Atopica (cyclosporine). Compared to steroids, it is a reasonable alternative for long-term allergy control. It can, however, suppress the immune system like steroids. Additionally, it doesn’t kick in right away. The dog’s owner and the allergic dog may have to wait for as long as four to eight weeks before they see a maximal response.
Apoquel is it bad for dogs?
Since immunosuppressive medications have a sensitive nature, many dogs are not recommended to take Apoquel. Because their immune system is too weak to fight them, Apoquel can expose your dog to a wide variety of diseases and infections.
Can Apoquel shorten the life of a dog?
In a 28 day safety study conducted by Apoquel manufacturer Zoetis, there were no deaths or abnormal health events reported. 11 of 179 dogs experienced abnormal health events after the study.
Does Apoquel cause problems in dogs?
Other potentially serious adverse effects include susceptibility to infection (e.g., pneumonia, demodicosis), neoplasia, and skin disorders. The most common symptoms are gastrointestinal (vomiting, diarrhea, anorexia), polydipsia (increased thirst), and lethargy.
Should Apoquel be suddenly stopped?
Contrary to steroids (which must be gradually weaned off over a period of weeks), Apoquel can be abruptly stopped and then resumed at a lower dose.
How long does it take Apoquel to leave a dog’s system?
Most people need to take Apoquel daily because its antipruritic effects wear off after 12-24 hours.
Is Apoquel better than Cytopoint?
In general, Cytopoint® is less likely to cause side effects than Apoquel®, which is why people often choose it as their first choice therapy. Apoquel® and CytoPoint®, however, do not work for every dog. In some dogs, either the therapy does not work, or the therapy works initially, but then stops working.
Also Read: Vetmedin killed my dog – How To Handle It?
Reviews of Apoquel
Apoquel reviews indicate that it relieves itchiness in dogs who suffer from allergies. 94% of Apoquel users saw improvement in itching within two weeks of using the drug, according to Zoetis.
1. An allergic 7-year-old Shih Tzu lives in my house. I have noticed a marked improvement in his skin and itching since beginning Apoquel two weeks ago. Since I have tried almost every allergy medication, both oral & topical, this is the one that has worked the best for me.
Having no pet insurance makes it more expensive because it doesn’t have side effects. Anyone suffering from skin allergies and itching with their pet would benefit greatly from using this medicine.
2. Our dog scratched herself continuously to the point that she was bleeding. We used Apoquel for her. Within minutes of using it, she stopped scratching and returned to her normal self.
Apoquel has been administered to her for almost two months now and she has not experienced any side effects. I greatly appreciate that this medication is available. If we didn’t have access to it, we would have spent thousands of dollars on vet bills.
3. I am so glad my veterinarian recommended this drug. Even though I was a little concerned about the side effects, I gave it a try after waiting 2 weeks to see if any problems arose. I’m not sure if the restlessness was a reaction or if he was just adjusting to being itchy, but he calmed down on day 3 and has not had an itch since then.
His skin is now better than ever after having been treated for more than six months. His overall health has also improved.
4. I recommend this product to anyone who has a pet that scratches constantly because of allergies. While it isn’t cheap, it is worth the cost to ease his discomfort. Also, it takes effect quickly; he stopped scratching within several hours!