Apoquel® Helps Stop the Itch!

logo-apoquelOne of the most common reasons we see dogs is for itching and allergies. A recent study stated that there are approximately 8.2 Million itchy dogs in the U.S.. Dogs who chronically chew, lick, scratch or constantly rub against household items are often suffering from allergies. Constant scratching can cause hair loss, discolored skin, body odor, and sores.

The underlying cause of allergies can be food, parasites, outdoor plants, as well as contact allergens such as cotton, wool or dust. In the past, often the “go to” medication was a steroid called prednisone. Most pets’ allergy symptoms significantly decrease when taking steroids, but there are many side effects to these steroids. Short term side effects include increased panting, urination and weight gain. Long-term steroid use has similar side effects as well as an increased risk of diabetes, heart disease and ligament injuries.

We usually try to treat allergies in a multimodal approach. This means that we will use more than one approach to get the greatest benefit while lowering the dose of the various medications we are using. There are medicated shampoos, lotions, topical sprays, hypoallergenic foods, antihistamines, immunotherapy (specially made injectable allergens for your specific dog), and the list goes on. All of these can be important tools in controlling your dog’s allergies but some treatments are more effective than others.

We now have a new drug in our arsenal called Apoquel®. It is not an antihistamine or a steroid, but rather an entirely new type of drug that works by blocking the inflammatory pathway associated with allergies. It has been shown to be effective in dogs with food allergies, outdoor allergies and contact allergies as well as flea allergies. More specifically, it blocks what is called the JAK-1 or “janis kinase” receptors on a cell. When triggered by allergens, these receptors are signaled to release proteins which tell the brain that the skin is itchy.

Apoquel® is a small tablet which helps stop the itch in about 85% of dogs, over the age of 12 months. It is not available for dogs less than a year of age, due to the fact that their immune systems are still developing. The manufacturer, Zoetis states that it starts to work within 4 hours and has very few side effects. The most common side effect, although rare, is vomiting and diarrhea, which resolves with continued use. In a clinical trial, Apoquel® was found to have no long-term side effects in healthy dogs. Additionally, it can be safely used with most medications.

Recently we have been prescribing Apoquel for our puritic (itchy) patients with great success. I (Dr. Beger) recently started my own dog, a Schnoodle, on Apoquel® and have seen amazing results. He has suffered from year-round and seasonal allergies for the past 10 years. Steroids were the only drug which seemed to make a considerable difference in his comfort. Since the first day on Apoquel®, he is no longer chewing at his feet or licking and scratching at himself. As a veterinarian and having had tried my own dog on all of the allergy treatments available, I can state with conviction that Apoquel® has made a huge difference in my dogs life. With Apoquel®, he is finally comfortable. This in turn makes me a happier mom and strengthens my bond with him. He still gets a weekly bath and is on hypoallergenic food, but overall I would say Apoquel® has made a huge improvement with his allergies. If you would like to learn more about this new option for your dog’s itchy skin, please contact us.

Aimee C Beger, DVM

Comments

  1. R* says

    Excellent review!

  2. Linda says

    I am in Marietta, GA and my vet said they might not be able to get Apolquel until this summer. I am afraid to put my 45lb female 4-5 year old lab mix on a new medication just released on the market. But, she is taking 15mg of Prednisone QOD. Do you have the product and could I get it from you? How much would it cost? Thank you, Linda

    • superDoc says

      Sorry, there is a shortage of the product. I realize there are serious allergies in GA, but we have serious allergies in Arizona as well. If you can just move out here :). As for the safety of the new drug, you will make the final decision. If you were my client, I would hope that you would use the medication we prescribe after having a frank discussion. I am confident that there is now comparison of the safety of prednisone to Apoquel.
      Dr. Tenney

      • charlotte says

        I just got some Apoquel today from the vet. Gonna try it, to see if it works. Today, she starts 1/2 tablet twice a day for 2 weeks, then 1/2 tablet daily thereafter. My question is, is this something we stay on all time or just 2 weeks? My vet didn’t say.

        • superDoc says

          Many dogs will likely be on Apoquel extended periods of time.

          From the website http://www.drugs.com/vet/apoquel.html,
          the dosing information is as follows:
          Dosage and Administration
          The dose of APOQUEL (oclacitinib maleate) tablets is 0.18 to 0.27 mg oclacitinib/lb (0.4 to 0.6 mg oclacitinib/kg) body weight, administered orally, twice daily for up to 14 days, and then administered once daily for maintenance therapy. APOQUEL may be administered with or without food.

  3. Linda says

    I’m Linda from Marietta, GA. I forgot to tell you that she is taking fish oil, olive oil and Loratadine 10mg BID. I don’t know how much they help her. None of them stop the itching except the prednisone. Thank you. Linda

  4. Marilyn Borns says

    My German Shepherd has been on apoquel for a month. She is loosing her coat more than ever before. She is 8 years old and has a lot of allergies. I have never seen such a hair loss.Any help?

    • superDoc says

      Good morning Marilyn,
      The question you pose is a good one. Hair loss can be the result of so many things. Allergies are only one.
      I am sure your vet will work your Shepherd up for thyroid disease, Cushing’s disease and maybe even recommend a biopsy. Apoquel is only effective in treating allergies, a common but not unique cause of hair loss. I am curious if you saw a decrease in itching after starting Apoquel. Consider yourself lucky though, Apoquel in already on backorder.

  5. Mike says

    My Shepherd is also on Apoquel. Worked great at the start but has diminished considerably in the past two months. She was treated for yeast infection which has cleared but still have increased itching. Her coat also thinned out a lot. Btw- she is also taking the sublingual serum and hydroxyzine, and her thyroid was tested. Nothing seems to work as well as the prednisone but that is a last resort for us now.

    • superDoc says

      Some cases are harder than others. I am surprised your pet has been on Apoquel for 2 months. It has barely been on the market that long.
      It sounds like you have a very thorough vet. I am sorry you are getting poor results in spite of all that you are doing.

  6. Meghan says

    My Cammy has been on Apoquel for a month and it is working wonders. As a Mom of a very itchy dog, I was willing to try anything to help my little man. I have noticed he has gained a pound in a month so I am concerned about that. It is winter, and we haven’t been out much, so that could be it. Anyone have any feedback on that? Thanks!

    • superDoc says

      Thanks for the feedback. Now if we could just get it in in adequate supplies…

  7. rebecca says

    My jack russell has major flare ups in the spring and unfortunately this spring it started very early. He has now been on the Apoquel for 3 weeks. The first 2 weeks I wanted to jump for joy. Unfortunately, I was told at his 2nd week check up that the effect diminishes after 2 weeks but to hang in there because supposedly the study shows that it kicks back in after the 4th week on it. The vet was right because on the 14th day, the scratching and licking started up again. Have you heard also that after the initial 2 weeks they will start itching and do you believe/and witnessed that this is the case? I so do not want to go back on prednisone so I am holding on to the fact that the vet is correct on this.

    Thank you!

  8. Pattty says

    Hi,
    My bichon has been on Apoquel since the end of January. He is 5 and was on steroids and Atopica for server allergies. It was so wonderful the first few weeks on the Apoquel ! We had a bright eyed baby back, but then the Apoquel seemed to wearing off and he started the scratching and biting again. He had gone form 2 pill a day to one and is now back on 2 pills again and he h has good days and bad. we live in the Boston area and I notice on cold days he is good but on warmer days he will scratch and bite, still not as much as he use to. We will not put him back on steroids. He got a severe infection that he could not fight off as his immune system was so suppressed from being on steroid for 4 years. We will see how he does this summer. In the meantime, I have the donut that I put around his neck to proctect his eyes and face when he is scratching. He does have a lot more energy now and acts like a puppy again! The Atopica use to made him feel all drugged up

  9. Marty says

    We have a Papillon, nine pounds, spayed,that is allergic to just about everything: flea saliva, dust mites, most foods so she is on Science Diet Z/D, still itches. Gets a Heska shot every three weeks, still itches. Apoquel has been a God send,started this past February, but its’ effectiveness seems to diminish over time. Started with a half pill each AM and PM, then half pill morning only . Full Pill size is 3.6 mg. Poor dog is back to itching all night. Itching had gone away in the early going. I am going to try going back to a half pill before bedtime for relief in addition to the AM dosage. Is this too much? Long term effects? Halp! and thanks!

    • superDoc says

      It is fun for me (Dr. Tenney) to read about your experiences. Obviously, they are mixed. But the relief many pets are getting is remarkable.

  10. Diane S. says

    I started my Golden Retriever on this in the last week and I’m already seeing quite an improvement. No more scratching and bottom scooting. He even scooted after having his anal glands expressed. He’s also on allergy shots after getting skin tested. He’s been on those for about eight months, but our spring and fall (South Carolina) are both rough on those who suffer with seasonal allergies — people and dogs. I was never comfortable giving him prednisone and even 1.5 Temaril-P tablets made him incontinent. No thanks! I felt so badly for him and just decided against prednisone.

    I’m a little worried about the newness of this product but given his issues and my options, I decided to go ahead and give it a try.

    • superDoc says

      It sounds like a good choice. From our experience and based on the extensive testing, I feel that this is a safe product.

  11. Pam says

    I have a 10 year old Golden; he has had problems with itchy skin for the last few years. He can’t take most meds to help this, no prednisone!!! We have tried shampoos, sprays, creams, gels, Atopica; you name it we have tried. He lives in a e-collar when we aren’t home because he kept rubbing his chin, chewing hotspots. I started him on Apoquel not to long ago and it’s is wonderful. He is a happy dog again, and doesn’t need to be in his e-collar all the time like before. I am very pleased with this product. I work for an animal hospital so believe me I have tried everything for my pet. This product works.

  12. Diane S. says

    I meant to ask a question. Silly me. Have you noticed an increased appetite in your pet taking it? My Golden Retriever, Luke, is not usually very food motivated. Lately, he’s ravenous.

    Thanks!

    • superDoc says

      I am not aware of this side effect.

    • Rob says

      My dog was the same he became very hungry and was never very food motivated either and my vet said that it shouldn’t make him more hungry so she’s not sure why.

      • superDoc says

        I will put a link here to a website that has the product listing as filed with the FDA. http://www.drugs.com/vet/apoquel.html
        The most common side effects or adverse effects noted are as follows:

        Adverse reactions reported (and percent of dogs affected) during Days 0-16 included diarrhea (4.6% APOQUEL, 3.4% placebo), vomiting (3.9% APOQUEL, 4.1% placebo), anorexia (2.6% APOQUEL, 0% placebo), new cutaneous or subcutaneous lump (2.6% APOQUEL, 2.7% placebo), and lethargy (2.0% APOQUEL, 1.4% placebo). In most cases, diarrhea, vomiting, anorexia, and lethargy spontaneously resolved with continued dosing.

    • Sharon says

      This is how I came to this website. My Jack Russell is the same. He’s been on it for month now and we’ve noticed this week an increase in his appetite, as well as shedding. It could be coincidence regarding the shedding as we are in spring here in the UK.

      • superDoc says

        I still an not aware of any reported effects of Apoquel resulting in increased drinking.
        If this continues, I would see your veterinarian and see if lab work for diabetes, kidney disease or one of many other underlying diseases may be the cause. Good luck.

  13. Michelle says

    I am so happy & disappointed at the same time. I have a two year old German Shepherd that is allergic to everything, including himself, I think! He was placed on Apoquel 16mg for 10 days as a trial with our vet, and he did absolutely wonderful. Itching was completely gone and he even stopped gnawing this paws. I called my vet to get another supply and was told they were out and had to place him back on prednisone again. Since that time, I have been unable to get the Apoquel 16 mg anywhere and keep being told, that they do not know when it will become available again! I am so saddened by this, as it truly was the only thing that worked for our baby and he is now back to being itchy and irritable again! Any suggestions?

    • superDoc says

      Believe me Michelle, we feel your pain. It is sad that Zoetis so underestimated the demand for this product when it came to market. They can be credited with bringing to market in the first place, but we are actually getting less of an already tiny supply as time goes on. We too, will have to move some of the few patients on Apoquel back to the inferior alternatives.
      Dr. Tenney

  14. Brad says

    My dog started Apoquel in Jan. He was on prednosone for over 1 year as Atopica did nothing for him. It worked great on the initial dosing. Tried to reduce the dosing (as prescribed) but it wasn’t effective enough. Increased the dosage slightly and it was working for about another month.

    It does seem that certain days he does begin to scratch but nowhere as bad as it used to be before Apoquel. So not quite as effective as the first 2 weeks, but still better then the alternatives.

    • superDoc says

      Thanks for the feedback. Good luck.

  15. superDoc says

    Goes to show that this is not a “magic pill”. I am sure that we will see some failure to respond among our patients as well. So far so good.
    Dr. Tenney

  16. Kathy Holladay says

    Since my 10 year old dog has been taking Apoquel he has been urinating alot, loosing weight, no appetite, no energy. Can you explain why my dog has never urinating on my bed before until he took this Apoquel

    • superDoc says

      I have no idea. If you were my client, I would advise working your pet for diabetes and then looking for other causes of these important signs. I seriously doubt that there is any connection to Apoquel except coincidence and timing.

  17. Marissa says

    I am waiting for Apoquel to be re-supplied to my vet here in Tucson. But in the meantime my pup is suffering. And I can’t help but wonder why it is so many pets are in need of meds these days. I’m probably going to, once again, start making her food since I have learned her sensitive food’s formula was recently changed. Just a shame.

    • superDoc says

      If your pet has food allergy as a component of the allergic picture, choosing the appropriate food is a good idea.
      Good Luck! Ron Tenney, DVM

  18. Elizabeth Frazer says

    My Golden Retriever was on Apoquel. He is losing his hair and his skin has turned very dark. Took him off the drug 2 days ago. Seeing that 2 other dogs are having the same problem…..plus their was a dog who was removed from the study due to his skin turning dark. Seems to me this is a side effect of the drug. My poor dog looks awful……hope this is not permanent!

    • Debbie says

      My 8 year old has been on Prednisone since she was a year old – I’ve tried every drug out there and now just found out about this new drug. I was told by my vet that it is on back order until 2015 but was able to call a different one who prescribed it. My question is – being on Prednisone for so long – she takes 5 mg every day & I just started trying to wean her off to 5 mg qod (every other day) how soon should I start Apoquel? My vet didn’t seem to know. Thanks

      • superDoc says

        I am sorry that your pet is so allergic that he or she requires daily prednisone. In my experience, that is a rare exception. We generally start with daily (or even twice daily) dosing and then quickly taper off to every other or even every third day as soon as possible. That mitigates some of the harm potentially done to the adrenal system and the liver.
        My approach would be to start Apoquel first and then begin tapering off over a 2 week period of time. Otherwise, how will you know if the response you are seeing in your pet is from the Apoquel or from the ongoing prednisone therapy.
        As always, ask your veterinarian. He or she is in the best position to know what is best for your pet. Our practice is in Arizona where dogs and cats are rarely infested by fleas. You may be in an area of the country where this is an ongoing concern and it would be inappropriate for me to comment on what is best in your specific situation.
        Good luck
        Dr. Tenney

  19. Ericka says

    My little Olivia, 5 year old English bulldog has had food and environmental allergies since she was a puppy. We cook her food ground rabbit, green beans, carrots, apples and bananas but she still itches and scratches her body until we used Apoquel. I’m heartbroken to find out that is now in backorder until 2015. I’m trying to find a place that might still have it but not one soul has any left. The only pharmacy that has it available is in the UK and they won’t ship to US. Olivia has had bad allergies for almost 6 years and we were so relief with the new medicine and we don’t want to go back to the old days. Hope anyone can help.

    • superDoc says

      I don’t know about the backorder going all the way to 2015. I hope that they can get it in sooner. Good luck.
      ~ Dr. Tenney

  20. Liz Taft says

    We tried everything for my Westie who bit all of the fur off of her paws because she is allergic to so many things. Apoquel has been a miracle drug. Lily has had zero side effects and she is like a new dog. Her paws are now snow white and full of fur. She is happy and healthy and is not itchy anymore!! She got her puppy spirit back because of Apoquel! Lily has been on Appquel for 6 weeks now. She stopped the biting after the 2nd pill amd hasn’t bitten herself since.

  21. Debbie says

    My three year old standard poodle has been on Apoquel since it came out. He has stopped chewing and licking his feet but now the vet is out of the big pills so I have to pay $72.00 for a two week supply of the little pills. Also my dog has gained five pounds since starting the medicine.

    • superDoc says

      That’s weird. Either your vet has the medication or he doesn’t. I can’t see how the price would go up if we can’t even get it. Anyway, I am glad you are getting medication.
      ~ Dr. Tenney

  22. Dawn says

    My 7 year old Frenchie has also experienced a relief in her itching from apoquel! But since she has started using it she had been urinating in my house, which had never been an issue for us with her! She had hr first urinary track infection within a week of taking the medication and even though her urine shows no bacteria anymore has continued to pee all over our home…
    I plan on stopping the medication to see if she goes back to being the good girl she always has been!

  23. Liz Taft says

    I just bought a 6 month supply of Apoquel on Viovet.com. You will need your vet to sign the prescription form that is online. Print it and take it into your vet. Email it to viovet with your order number. I just took a picture of it with my iPhone and sent it.

    • Jay Ellis says

      Has anybody received apoquel from vio
      vet. My vet is considered it may be counterfeit.

  24. Marie Lumbard says

    Can you start Apoquil before stopping Prednisone (1 mg daily)?

    • superDoc says

      There can be a time when the medications are blended. Remember to follow your vet’s advise on stopping any steroid medication. There will be a tapering off period.

  25. Stacy Josefowicz says

    Dr. Tenney- I just had my dog at my vet in Gilbert yesterday and she said that Apoquel looks to be on backorder possibly until Fall at the earliest… are you aware of anyone in Az that still has a supply of the drug available, or are all veternarians already on backorder?

    • superDoc says

      In a conversation with some of the personnel from Zoetis, we are being told that the back-order could last into the spring of 2015. We are not prescribing it to any new patients now. The frustration is too great to see improvement only to be unable to refill the prescription.

  26. Linda Hemphill says

    “Loki” has the WORST allergies my Vet has ever seen.
    Loki will not walk on grass if he can help it. In the yard he walks on the curbing just to avoid stepping on grass.
    My Vet told me about Apoquel as Loki was on everything “under the sun” to try and help. He was also on Atopica 40 mg. every other day. Well…within a day being on Apoquel Loki STOPPED biting his feet. They were raw…His eyes cleared. His breathing was not as intense. Loki has been on it for 2 weeks and what an AWESOME change! Loki’s feet are healing as he has not tried to chew them once ! So since they are healing, no odor either. He happily comes to take this pill. Truly is a miracle! I took him back to my Vet and the Vet was oh so happy to see the change in Loki.
    Hard to get, but my Vet said he has an order in for more. Loki is a 9 year old black and tan Miniature Pinscher. And…the best! Loki now walks PROUDLY on the grass! And I caught him rolling around on the grass as if to say…”THANKS” !!! Apoquel is truly the BEST out there for allergies. If only Loki could talk I know he would also say that Apoquel gave him a “new lease on life”….

    • superDoc says

      I am happy to hear you are having such an amazing turn around. I hope your veterinarian can continue to supply you with the medication.

  27. Ilona Grubb says

    I have a Doctors Prescription for my dog Katie for
    Apoquel 5.4 for 100 Pills could you please let me know if you are able to fill it and the cost
    Thank you
    Ilona Grubb

    • superDoc says

      As far as I know, all veterinarians are equally affected by this shortage. So if your veterinarian can supply you with 100 tablets, you are lucky. We are only allowed to fill prescriptions for our own patients that we have a valid relationship with. Good luck.
      Dr Tenney

  28. Ilona Grubb says

    Thank you so very much
    Ilona Grubb

  29. Kim Kinney says

    Can regular pharmacies get supplied with Apoquel?
    I wonder if it would be cheaper there.

    • superDoc says

      I doubt if human pharmacies can get Apoquel. It is on backorder.