Apoquel for Dogs: A Long Term Solution?

Atopic Dermatitis in Dogs

The active ingredient Oclacitinib, brand name Apoquel (distributed by Zoetis), is a medication commonly used to better manage atopic dermatitis - symptoms due to an allergic reaction. 

It’s strange how we can turn on the television and not go one episode without seeing a commercial for allergy medication.

Yet, we seemingly forget about the fact that many dogs struggle with atopic dermatitis from allergies, and the associated scratching and itching can leave them in a lot of pain and suffering. 10% of dogs suffer from atopic dermatitis - a chronic and incurable type of allergy due to an overactive immune system.

Even scarier, this statistic does not even include skin reactions caused by food, medications, or the environment.

Atopic dermatitis can take away your dog’s quality of life and their time with us is already short enough as is. The uncontrollable urge to itch and scratch, known as pruritus, can tear through a dog's skin and make them miserable.

So now we know why it’s so important that we are always on the lookout for allergic dermatitis, let’s look for solutions available that can stop symptoms like pruritus and associated skin lesions with Canine skin allergies in dogs.

Apoquel is a vet-trusted solution to atopic dermatitis. Throughout allergy testing trials, the drug Apoquel has been proven to make a real difference in atopic dermatitis pain caused by a constant itch.

Apoquel oclacitinib is one of the most commonly prescribed medications to help treat inflammation and itching skin associated with allergic dermatitis in dogs. A tablet of Apoquel will take effect to stop an itch within 4 hours and Apoquel can provide overall relief from this allergic skin disease anywhere from 12 to 24 hours.

The issue with this, however, is an Apoquel tablet will need to be re-administered on a constant basis to prevent allergic dermatitis. The price of Apoquel is side effects developing, and even first-time users can report alarming side effects within 24 hours.

What Are The Benefits of Using Apoquel For Dogs

An Apoquel tablet is convenient, and with effects lasting up to 12-24 hours, they can experience a full day free of atopic dermatitis and pruritus with just twice-daily administration.

Apoquel can be used to control itching skin pain from atopic dermatitis. The itch and inflammation are relieved within 4 hours of the initial Apoquel dose.

Apoquel vs Benadryl: What to Use

Many pet owners use Benadryl to treat their dogs’ atopic dermatitis instead of Apoquel. Benadryl (generic name Diphenhydramine) is a staple in most home medicine cabinets and first-aid kits. Due to this, it is sometimes more convenient to stop an itch than other medications. However, it is not always the best choice when you have the option to use Apoquel.

Apoquel is marketed for dogs older than 12 months and weighing over 6.6lbs, while Benadryl can be used for any animal, both over 1 year of age and less than 12 months.

Dogs treated with Apoquel works within four hours, controls allergy itching within 24 hours, and is safe for short-term and long-term usage. It is used to control dog's itching with some effect on immune function.

While a Benadryl tablet does relieve allergy symptoms, it is more of a blanket solution in case of emergency. Say it’s 11 PM and your dog gets bitten by insects while running around in the backyard. They won’t stop itching, but there’s no emergency vet open near you. If you have Benadryl in your medicine cabinet, it will control symptoms like pruritus until you can get to the vet.

To recap: Apoquel may work better for long-term solutions to pruritus, but Benadryl will be fine in a pinch until you can get something better.

How Does Apoquel Work?

The drug Apoquel from Zoetis is a selective Janus Kinase inhibitor (JAK inhibitor) that acts on the immune system and inhibits its response to signals that trigger itchy allergic sensations. In allergy testing, the JAK inhibitor was shown to chemically alter the brain in order to control the itch.

By eliminating itchiness, Apoquel taken twice daily can be used to treat all forms of allergic reactions: allergic dermatitis, atopic dermatitis, skin infection, irritant contact dermatitis, food allergies, control of pruritus, and external parasite-related reactions.

Does Your Dog Have Allergies?

Remember dogs experience allergic reactions to all of the same things we do: pollen, dust mites, mold, animal dander, etc...

As well, you can expect to see the same symptoms:

• Scratching due to a constant itch
• Bald spots in the fur
• Hotspots
• Lesions or scarves
• A runny nose
• Sneezing
• Discharge from the eyes
• Chewing or biting at paws, legs, etc. 
• Red skin, body odor, head shaking

Other Common Reasons Your Dog Is Scratching

While dogs with atopic dermatitis commonly scratch and itch, there are other completely separate reasons as to why they can’t control their pruritus. Fleas and other parasites like dog ticks and mosquitoes can cause your dog to itch like hell.

As well, they could have an underlying medical issue that could be either physical or mental. Anxiety is often seen as a culprit in the development of hot spots forming around an itch.

Hot spots are lesions and tears in the skin that are infected or severally prone to serious infections. They are caused by constant scratching regardless of the source.

Temporary Allergies: Irritant Contact Dermatitis

Last, we have irritant contact dermatitis, and while it’s a type of allergy, it won’t need the exact same treatment that atopic dermatitis requires. As you’ve probably guessed by the name, Irritant Contact Dermatitis happens when a strong chemical touches the skin and causes a reaction like itching.

It may burn the skin causing blisters - in the case of acids - or it may cause them to break out in a rash - in the case of poison ivy which leads to itching, or pruritus.

In the large majority of cases, this type of allergy will pass after the substance is no longer in contact with the skin. Wash the area thoroughly, then contact your vet for advice on how to proceed.

If your vet advises you to bring your dog in, they will at most prescribe them a steroid, an anti-itch corticosteroid, or tablet of antihistamine.

Apoquel Dosage

The typical dosage for Apoquel is 0.4-0.6mg per kilo of body weight, or 0.18-0.27mg per pound of body weight every 12 hours, or twice a day - administered in tablet form. This dosage of Apoquel should be given for dogs at least 12 months of age for 14 days, after which your vet will likely reduce the dosage to once a day.

The 14-day marker is an important time to pay attention to as the FDA does not approve more than two applications of a drug per day after 14 days, so when the time comes, use Apoquel only once a day.

This is due to the way Apoquel suppresses your dog’s immune system, which we don’t want to keep in lowered condition for too long. By suppressing the immune system, we can open our dogs up to diseases like ear infections and parasites.

Dogs receiving Apoquel can end up getting sick and spend their life constantly in discomfort and misery. Even worse, Apoquel treatment just doesn’t work for some dogs. This puts your dog at risk for no reason at all.

A dose of Apoquel is administered in tablet form - available in three sizes: 3.6mg, 5.4mg, and 16mg. It can be administered with or without food.

What Are The Common Side Effects of Apoquel  

All things come with a risk for your dog, but some more than others. While many conventional medications like Apoquel have mild side effects that are worth the risk, others don’t.

With short-term twice-daily use, avoiding the side effects that come with conventional drugs like Apoquel isn't difficult. However, that changes if Apoquel is used for extended periods of time.

Immune System

Clinical trials have shown Apoquel suppresses the immune system and Janus Kinase enzymes, the FDA only recommends it's used for up to 14 days. While helping dogs in the short term, extended suppression of the immune system can lead to devastating effects. Our poor dogs become victims to exacerbate neoplastic or infections like demodicosis.

As well, Janus kinase isn't just responsible for inducing itching, it also protects against tumor formations, and helps grow white and red blood cells.

Reasons why we don’t want to use Apoquel for extended periods:

• Appetite loss
• Cutaneous lumps
• Decreased globulins
• Development of polydipsia
• Diarrhea
• Ear infections
• Histiocytomas
• Increased lipase and cholesterol
• Increased aggression
• Lethargy
• Pneumonia
• Reduced leukocytes
• Subcutaneous lumps
• UTIs
• Vomiting and diarrhea
• Weight gain

As well, in some cases, dogs have overdosed on Apoquel, causing permanent damage and some cases have even died from taking it. Apoquel can cause existing parasitic skin infestations to worsen that will require antibiotic or antifungal treatment. Be sure to closely monitor your dog when administering Apoquel and if you notice any concerning signs, immediately call your animal healthcare professional.

Apoquel Alternatives: What Are Your Options?

Apoquel is not recommended for many dogs due to the sensitive nature of immunosuppressive medications. Apoquel can quickly open your dog up to a host of diseases, serious infections, etc. because their immune system is too weak to fight them.

Apoquel is not recommended for the following dogs: 

• Pregnant or lactating
• Dogs nursing pups 
• Dogs under 12 months of age

It is also not recommended for use in breeding dogs.

Apoquel can put these dogs at greater risk by increasing the chances of infections developing, promoting the growth of pre-existing cancers, and worsening already existing parasitic skin infestations.

As well, there are no clinical trials detailing the risk of using Apoquel in conjunction with other allergy medications that treat skin conditions like corticosteroids and cyclosporine. However, Apoquel can be safely used with some common medications such as antibiotics, vaccines, and parasiticides.

Common antihistamines like Benadryl and Apoquel are safe to be used together.

But if your dog is not able to take Apoquel but has a persistent itch, or suffers from pruritus caused by atopic dermatitis, other solutions can help.

Conventional Alternatives To Apoquel

Before we move past Zoetis Apoquel and look into all-natural alternatives that can provide fantastic relief from atopic dermatitis with low side effects, let's talk about common allergy medications.

Zoetis Apoquel isn’t the only allergy medication out there of course. And since Apoquel may come with serious side effects that can cause devastating and lasting results, we wanted to share with you the concerns associated with other common allergy medications.

Zyrtec For Dogs

Zyrtec is a popular second-generation antihistamine first prescribed to people. However, more and more veterinarians have started prescribing it to dogs in pain with pruritus caused by allergic dermatitis.

The reason for this is Zyrtec is rather low-risk, however, it’s not as effective as the drug Apoquel. Zyrtec’s main issue is that it’s an antihistamine which studies have found to only help about 30% of dogs with 25% of them having adverse reactions.

As well, Zyrtec like Apoquel will not cure atopic dermatitis in dogs - only manage it while they are on the medication. This goes for all allergy medications, which means they will likely have to be on some form of medication for their entire life.

Because of this, we want to make sure long-term use is as low-risk as possible. We don’t want anything to come back and harm them when we were just trying to help.

Vets report long-term use of Zyrtec can lead to serious infections and may cause kidney and liver problems. As well, Zyretc treatment can increase symptoms of allergic dermatitis-like pruritus — completely defeating our goal of helping.

Zyrtec has not been approved for use in dogs by the FDA.

Hydroxyzine For Dogs

Hydroxyzine is another antihistamine. Hydroxyzine is commonly prescribed to people to help treat nervousness and tension related to mood disorders. It does this by acting on natural substances in the body like serotonin and acetylcholine.

The relaxed mood will lessen the symptoms of allergic dermatitis and lower the amount of itching.

As well, it blocks histamine, but this isn't something we want to block for extended periods of time. While histamine causes itchiness, it’s a natural compound vital to health.

Why Antihistamines Should Not Be Used Long-Term

Antihistamines are commonly prescribed to dogs to help manage allergic reactions by blocking histamine. However, allergic reactions are not currently curable and may require extended periods where medication is needed to control them.

We do not want an antihistamine, in this case, as histamine plays a vital and beneficial role in the body.

Histamine makes you itchy for the same reason running increases blood flow. Histamine will contract smooth muscles, dilate capillaries, and allow an increase of blood flow into the area to fight the infections. However, this isn’t all histamine does:

Histamine’s role in the body:

• Cools the body down
• Increases alertness and wakefulness
• Increases motivation
• Increases water intake
• Improves cognitive function
• Reduces appetite
• Reduces stress
• Protects against seizures 

Benadryl vs. Apoquel

Unlike the other antihistamines we discussed above, Benadryl - a generic name for diphenhydramine - is an over-the-counter that provides quick relief with lower side effects. Relatively safe to give to dogs for immediate help, but watch extended use and high doses can produce dangerous hallucinations.

Alternatives To Apoquel

Before we proceed with even more alternatives to Zoetis Apoquel, we want to address the elephant in the room. We 100% support and recommend that you always talk to your vet first before treating dog allergic reactions yourself.

If you suspect that your dog has allergies, and are seeing signs of pruritus, talk to your vet first about their recommendation. Never discontinue the use of Apoquel as prescribed by a vet without getting their approval.

The goal of this article is to bring attention to the advantages and disadvantages of conventional treatments like taking Apoquel. We found concerns with the long-term use of many conventional allergy medications and wanted to let our readers know.

This especially goes for Zoetis Apoquel for dogs whose makers have been called out by the FDA for misleading claims. This should only strengthen the discussion between you and your vet.

We want to show you alternatives that are safe for long-term use. As well, these alternative methods can be used alongside conventional treatments. This is great as it can keep conventional medication dosages low and used sparingly.

ChefPaw Alternative

For many dogs suffering from allergies and associated itchiness, Apoquel has been the go-to medication. However, a more natural and holistic approach is gaining traction among pet owners and veterinarians: the food elimination diet. By systematically removing potential allergens from a dog's diet and observing for improvements in allergic symptoms, the root cause of the discomfort can often be identified and eliminated.

ChefPaw The Dog Food Maker has played a pivotal role in this approach, offering tailor-made, high-quality, limited-ingredient meals for dogs. With ChefPaw's bespoke recipes, several dog owners have managed to alleviate their pets' allergic reactions, allowing some dogs to completely transition off Apoquel. This shift emphasizes the power of nutrition and the potential for dietary solutions in addressing health concerns.

 

CBD For Dogs

If you haven’t heard about CBD before now, then you’re in for a CBD treat — which you can give to your dogs to support a pain-free life. CBD studies have shown that it works naturally with the body, boosting lipid-based neurotransmitters that activate receptors that specialize in promoting homeostasis. Homeostasis is the equilibrium of the body and all the internal functions working together in harmony. It optimizes and repairs an organism on a cellular level giving them the best at survival in their environment.

For example, the immune system is constantly fighting off pathogens, bacteria, and other nasties and this puts it under a lot of stress. Eventually, all this stress causes it to become unbalanced and damaged.

But the body uses homeostasis to re-balance and repair internal functions like the immune system when this happens. Studies have shown that CBD treatment acts and strengthens a major repair and regulation system that is found throughout the entire body called the endocannabinoid system.

Instead of suppressing the immune system, a dose of CBD can act on mechanisms that regulate, re-balance, and repair the immune system. By keeping the immune system as calm and functioning as it should, your dog’s immune system is less likely to overreact to harmless molecules.

CBD has been used for its inflammation and immune system protection properties which are well-known and loved by the many who have tried it. But because of the way CBD works, it can have the ability to help with virtually every condition in some way. The anti-inflammatory properties are useful in reducing itching caused by pruritus — when the skin is not inflamed, the desire to scratch is lessened.

Pet owners report CBD treatment is as just as effective as drug treatment without a high price or negative side effects.

In fact, CBD oil first rose to fame because studies had shown to improve many rare forms of epilepsy that conventional medications failed to control. As well, it’s a fantastic medication for anxiety and perhaps the first true over-the-counter supplement for it. This is just the beginning.

Check out awesome ways CBD treatment can help benefit your dog:

• Anxiety
• Arthritis/anti-inflammatory
• Behavioral issues
• Cancer treatment
• Epilepsy/seizures
• Immune system regulation and protection

Our Favorite CBD Products

There is no better way to give your dog better health than rewarding them with a lip-smacking, mouth-watering, and delicious treat. And with CBD treats that’s now a complete possibility. With flavors like Steak & Cheese or Maple Bacon & Berries, your dog will come running, eager to take their daily treat for better health without the risk of spitting out a drug like Apoquel.

For smaller dogs or dogs less than 12 months of age, there are CBD soft chews that provide a more appropriate dose. As well, Chews like Turkey & Apple are perfect for older dogs that need to watch their teeth or are reluctant to take harder treats.

If treats aren’t an option for you, CBD comes in a dose of oil/tincture. This is great for giving your dog a precise dose - you can also make your own customized CBD dog treats with the tincture. The oil can be given directly under your dog's lips for immediate results or mixed into their water bowl for a slower effect.

CBD oil has all the same great benefits that come along with the treats and can improve your pet’s health in a multitude of ways.

• CBD oil and CBD treats are rich in healthy fats like omega 3s and 6s.
• Promotes a shiny and soft coat, healthy appetite, and lowers inflammation.  
• Increases overall quality of life.
• CBD can give older dogs a youthful boost.
• Promotes appetite, supports a pain-free life, improves recovery, and relieves arthritis.
• Appropriate for all ages and pregnant & lactating dogs.
• Can be given to breeding dogs with no side effects.
• Great for working dogs after a long day.
• Not a drug like Apoquel or other conventional medications that control allergic reactions in dogs.

Other Ways To Ease Allergies

The best way to avoid the side effects of taking Apoquel and other conventional medications is to use them as sparingly as possible. As well, we want to keep the dosage as low as possible.

We learned how CBD can help reduce atopic dermatitis and treat skin conditions - thus reducing the need for other drugs. But let’s learn about even more ways for maximum health and protection for dogs with allergies.

Regular Baths

Remember, like us, dogs get allergies for the same reasons, and for many of us that suffer from allergies, we dread certain times of the year. Pollen, ragweed, etc. are the banes of many, dogs hate them just as much as we do, if not more so.

Why? Because it gets trapped in their fur, so even when they remove themselves from the environment it travels with them. The best way to avoid this happening is with regular baths.

You’ll want to be careful that you don’t dry out their skin with regular bathing as this can engender itchiness and scratching — once a month or so in the winter and maybe twice a month in the spring and summer is ideal. If your dog is outside a lot or you live in a high pollen area, you may have to increase the rate.

Flea Protection

Baths will help with fleas as well. These parasites are notorious for biting and causing our pups to break out with an allergic reaction. You can talk to your vet about an appropriate formula or check out an all-natural flea and tick solution.

Diet

One of the first things you’ll want to check when you see your dog having an allergic reaction is their food. Dogs are just like us and can have reactions to the same foods we do.

Try to stay away from lots of grains and make sure the food is rich in meat protein. Raw food diets are a great option for healthy adult dogs - especially if grains are causing issues.

Dogs can also have allergic reactions to beef, poultry, and other meats. Your vet will have the ability to test them and nail down the specific cause. 

Gut Health: Microbes, Probiotics, and More 

Paying attention to gut health is all the rage today, and there is a big reason why - an unhealthy gut can spell inflammatory bowel disease, weight issues, poor mental health, and trigger allergies. A healthy gut means a digestive tract full of 100+ different single-celled microorganisms which are all there to aid in digestion.

So what’s the best way to create a booming micro-colony in your dog’s gut? Well, there are lots of ways, and this is great because most methods by themselves don’t deliver a full spectrum of microbes.

Nature

That’s right a good walk can do a lot to improve your pup’s gut health. Healthy microbes are found in the dirt, on plants, and even in the air. So take them outside and let them smell away.

So much of health comes from a holistic life that blends with nature and takes advantage of all-natural and easy solutions.

Probiotics and fermented foods

Probiotics are showing promise, but they are running into some serious roadblocks. In most cases, they offer only one type of bacteria or they aren’t delivered in an ideal state/environment.

One study compared a probiotic to fermented foods - both in a petri dish - and saw a healthy and rich microcolony develop in the fermented food but not the probiotic. This shows the importance of a multifaceted solution to improving gut health.

Raw foods

A raw food diet can deliver a lot of healthy bacteria, but care needs to be taken to ensure bad bacteria does not form. Make sure the raw food is dog safe as you do not want to accidentally cause stomach pains while trying to help.

Stress

Mental health and gut bacteria share a circular relationship. A bad gut can cause stress and anxiety, while stress and anxiety can cause an unhealthy gut. We’ve talked about CBD above, and its ability to improve anxiety and reduce stress is loved by many. Another reason to check out this awesome oil!

Final Thoughts On Treating Dog Allergies

We hope you have found this article to be of great help when it comes to providing your dog with the best health possible. At the end of the day, it is your decision how you want to treat your dog’s atopic dermatitis.

We recommend a multifaceted approach - with CBD treatment, regular baths, a flea and tick solution, improvements in gut health - along with all of your vet’s recommendations.  The animal health information contained in this article is offered for educational use only and should not be considered a substitute for advice from an animal healthcare professional.

These are all fantastic ways to reduce and prevent the use of medications that can come with very serious side effects - some of which can injure your dog forever. Our goal is to bring attention to pet health - both in the natural health world and in modern medicine. For more information, our blog contains a wealth of knowledge all with easily explained science.

Approved by:

Dr. Ivana Vukasinovic

Doctor of Veterinary Medicine, University of Belgrade

Ivana Vukasinovic grew up in Serbia and attended the University of Belgrade where she received a degree in Veterinary medicine in 2012 and later completed surgical residency working mostly with livestock. Her first year of practice was split between busy small animal practice and emergency clinic, and after two more years of treating many different species of animals, she opened her own veterinary pharmacy where an interest in canine and feline nutrition emerged with an accent on fighting animal obesity. In her free time, she acts as a foster parent for stray animals before their adoption, likes to read SF books and making salted caramel cookies.

 

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Sincerely,
The Innovet Team

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