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Apoquel: Vet Says Beware the Side Effects


Does your dog have allergies? Has your conventional veterinarian offered you a popular allergy drug called Apoquel?

It’s touted as being “a fast-acting and safe treatment for the control of acute and chronic canine pruritus.” Pruritus means itching. When your dog is itchy, you get desperate to make him feel more comfortable. Nobody wants to be itchy and constantly scratching.

A dose of Apoquel can ease your dog’s itching in as little as 4 to 24 hours. And dog owners do say Apoquel works to relieve their dogs’ itching.

Sounds like something you might want to try, right?

Well, not so fast …

Before you expose your dog to the risks of this drug … you need to read on. If your dog is currently on Apoquel … you will probably rethink your options by the end of this post.

Why? Well, let me share why I would never give my dog this allergy drug.

Apoquel demolishes essential parts of your dog’s internal disease-fighting systems.

Let me tell you more … so you can keep your dog itch-free and safe.

Allergies and The Immune System

An allergy is an exaggerated and inappropriate immune system response. Conventional medicine loves to suppress symptoms.

Suppressing symptoms means getting rid of them without addressing the illness or disease. Allergies are an improper immune system response.

So, let’s look at the drugs veterinarians often use to suppress allergy symptoms.

The History of Allergy Drugs for Dogs

Prednisone was the first conventional medication vets used for allergies. Prednisone and other steroids work by suppressing the immune system.

Then, when allergic dogs stopped responding to steroids, veterinarians started using Atopica (cyclosporine). Cyclosporine was initially developed to prevent organ transplant rejections in humans. It suppresses the immune system to prevent the body from rejecting the transplant.

Atopica has a devastating and destructive effect on the immune system. You can read more about the Atopica and my concerns here.

Unfortunately, Atopica is still used today for some dogs. This is alarming … the FDA has 17 pages of adverse events for Atopica in dogs! Here are just some of these adverse reactions from the first page, along with number of cases reported:

  1. Vomiting – 3,108

  2. Diarrhea – 1,369

  3. Depression or lethargy – 1,142

  4. Anorexia (loss of appetite) – 834

  5. Pruritus (itchy skin) – 790

  6. Elevated liver enzymes – 429 (ALKP) & 311 (ALT)

  7. Drug interactions – 316

  8. Rapid panting – 287

  9. Trembling – 277

  10. Gingival hyperplasia (overgrowth of gums around the teeth) – 260

  11. Convulsions – 259

The number of cases reported is shocking. What is ironic is the fifth side effect on the list is pruritus – the very thing you want to stop!

So, what’s next?

Enter the latest scary allergy drug, Apoquel. It also suppresses your dog’s immune system … but in a different way.

What is Apoquel And How Does It Work?

Apoquel affects the body’s kinases. Kinases are signaling compounds that cells use to communicate with each other.

In the 1980s, an Australian chemist discovered some new ones. They are known as JAK1, JAK2, JAK3 and TKY2. With the growing epidemic of dog allergies, pharmaceutical companies saw an opportunity. They developed a drug that would stop these JAKs in their tracks.

And they sure succeeded.

Oclacitinib maleate, under the brand name Apoquel®, is a JAK inhibitor. That means it stops JAKs from doing their job.

JAKs are key elements in controlling both growth and development. These particular JAKs do the work of:

  1. Policing the body against tumor formation

  2. Controlling body growth and development

  3. Forming white and red blood cells

  4. Ensuring antibody-producing B cells, and “policing” T-cells are functioning well.

  5. Regulating inflammatory response

Apoquel And Life-Sustaining JAKs

Apoquel’s mechanism is to interrupt JAKs … and prevent them from working. But without JAKs your dog’s immune system cannot function correctly.

JAK1 is vital for the constant surveillance within your dog’s body. Its job is to find and destroy abnormal cells that have become cancerous … before they form tumors. And it’s needed to destroy invading parasites, fungi, bacteria and viruses.

JAK2 is central to the production of bone marrow stem cells. These cells then become red and white blood cells and platelets.

Your dog’s antibody system (B cells) and its killer-cell system (T cells) need JAK3 to work properly.

These JAKs all talk to each other and share information to keep your dog’s body healthy. So, you can see that by preventing JAKs from working … Apoquel undermines your dog’s immune system.

What the Research Says About Apoquel

Of course, there’s research showing how dogs react to these drugs. Here’s how its done …

The pharmaceutical company does a very quiet study and notes when problems occur.

For example:

  • Liver problems pop up 12 weeks into the trial.

  • Tumors start to form 16 weeks into the trial.

They carefully record these findings in the study notes. Once they’ve gathered all the data, they prepare their formal public study.

Often, they end the public study review before the problems show up. So, if the problems appeared at 12 weeks … they publish a 10-week study!

Apoquel research is no different.

The Truth Behind the Safety and Efficacy Studies

A study conducted by the manufacturer to test the drug’s safety and efficacy stated:

“There were no fatalities and no abnormal health events that necessitated hospitalization in either the study phase [day 0–7 (+3 days)] or the continuation phase [day 8–28 (±20 days)] of the study. Given that the majority of dogs in the placebo group withdrew after the completion of the study phase, the incidence of abnormal clinical signs was similar in both groups.”

So, it seems from these comments that the drug is fairly safe …

… but the duration of the study was only 7 days!

What About the Long-Term Studies?

There was a “continuation phase” after the 7-day study period, from 8 to 30 days. The researchers report:

“Six dogs (four oclacitinib and two placebo group) were withdrawn from the study during the continuation phase for abnormal health events. Abnormal health events were reported in 11 of 179 oclacitinib-treated dogs’ post-study. These were as follows: diarrhea (four dogs; severe enough to warrant cessation of treatment in one dog); vomiting (four dogs); fever, lethargy and cystitis (one dog); an inflamed footpad and vomiting (one dog); and diarrhea, vomiting and lethargy (one dog).”

So about 6% of dogs tested had abnormal health events. That doesn’t seem very high.

But that was only for 30 days!

If your dog takes this drug, he could be on it for years! Years … while this drug compromises his immune system. That’s a very heavy price to pay.

The manufacturer quotes a study that says it is safe for long term use … but the study results say something different. Here are some of the serious side effects noted:

  • 1 dog got euthanized after 450 days of Apoquel. The dog had developed abdominal ascites and pleural effusion of unknown etiology. This means that he had a fluid-filled abdomen and chest.

  • They euthanized another 6 dogs because of suspected malignant neoplasms. Those are cancers that spread easily … but aren’t detected because of immune suppression.

  • Two dogs each developed a Grade II mast cell tumor after 52 and 91 days.

  • One dog developed low-grade B-cell lymphoma after 392 days.

  • Two dogs each developed an apocrine gland adenocarcinoma. On was dermal, the other an anal sac. These problems happened after only 210 and 320 days on Apoquel.

  • One dog developed a low-grade oral spindle cell sarcoma after 320 days. It’s a very painful oral cancer for dogs.

Is it worth the risk? I certainly don’t think so.

In the 12-month-old dogs the symptoms likely related to Apoquel included:

  • Papillomas (warts)

  • Interdigital furunculosis (cysts) with related dermatitis symptoms

  • Edema of feet

  • Pneumonia

  • Lymphadenopathy (abnormal or swollen lymph nodes) in peripheral nodes

Yes, you read right. The side effects include various types of skin diseases.

The drug was also found to lower white and red blood cell count. And it impacted certain types of lymphatic tissue… lymph nodes as well as bone marrow.

Real-Life Experience Speaks Volumes

When cancer cases come to me, the dogs on Atopica or Apoquel have the same oncologist records. They always note that the oncologist recommends stopping Apoquel or Atopica treatment.

Of course, it’s too late for that to make any difference at all. But it is a good sign that the problems with these drugs are well known.

Here’s a letter from April, whose dog died of cancer:

Dr Khalsa,

In 2013 I took my dog to a veterinarian in PA that does clinical trials for all kinds of diseases in dogs. I trusted this vet to guide me in the right direction for my dog. I work in the medical field as a trauma nurse so I’m not new to health care. When this vet recommended Apoquel, I was excited to hear that there may be hope for my dog.

I specifically asked the vet multiple times before giving my dog this medication how the clinical trials turned out: side-effects, long term use, adverse effects, etc? He assured over and over again that this drug was safe and wasn’t known to have any harmful effects in dogs.

I started giving my dog this medication and before you knew it I found a mass on my dog’s abdomen. Immediately I took my dog to the vet as soon as I noticed the mass and she was sent in for surgery the next day to have the mass removed and biopsied. I found out she had adenocarcinoma of the mammary glands. Long story short, I went through surgery and chemo with my dog and in the end the cancer spread to her lungs and I had to euthanize my dog. I was devastated!

After a few weeks I contacted the vet who ran the clinical trial only to be told that this medication was known to cause abdominal tumors. ANGER is the only word to describe how I feel. I strongly believe this drug should be taken off the market.

I don’t know how this pharmaceutical company is getting away with essentially killing dogs.

– April

This is heartbreaking and sad. April and her dog are not alone.

Apoquel Alternatives

There is good news! You can heal your dog naturally.

Getting the Itch Under Control

Before you jump ahead into my top alternatives there are a few things you should do first.

1 – Feed a rotating diet

Ideally, feed novel proteins. A novel protein is a protein that your dog has never had before. One great novel protein to try is rabbit.

2 – Get an air purifier for your home

Removing allergens from the air will reduce the number of allergen stressors.

3. Contact me and I will give you all the guidance you will need on how to naturally get your dog’s immunity strong again and to put an end to their needless discomfort and no more itchy skin.