If your dog has allergic dermatitis or atopic dermatitis, your vet might prescribe Allergy-related itching in dogs is common, and something veterinarians deal with daily. Most allergies in dogs aren鈥檛 curable. However, with the right diagnosis, management, and treatment, controlling the uncomfortable symptoms is possible.聽Apoquel is especially useful in treating atopic dermatitis or environmental dermatitis, such as allergies to pollen or grasses, etc. which you can鈥檛 control the source of. Read on to learn more about how Apoquel for dogs works and its benefits and limitations.
What Is Apoquel, and How Does it Work?
FDA-approved Oclacitinib (sold under the brand name Apoquel) is an oral medication used to manage the inflammation and itchiness associated with allergies in adult dogs, says , assistant professor of practice in the College of Veterinary Medicine at the University of Arizona.
The fast-acting drug inhibits specific proteins (called Janus kinase enzymes), which trigger the itch response resulting from allergic skin diseases and atopic dermatitis in dogs. 鈥淲ith Apoquel, the immune system鈥檚 signaling cascade is halted before it can send the inflamed, itchy signals,鈥� Dr. Wesley says.
When Do Vets Prescribe Apoquel, and When Won鈥檛 They?
Apoquel is a well-tolerated and effective alternative to and steroids, the traditional options for allergy itch relief. 鈥淥nly about 30% of dogs with environmental allergies will respond to antihistamines,鈥� Dr. Wesley says. 鈥淢oreover, multiple antihistamines are available to try, and one cannot predict which, if any, will be of help to each individual.鈥�
Apoquel won鈥檛 provide relief for all dogs either, but it tends to be more effective for more patients than antihistamines.
Dr. Wesley says that steroids work hard and fast (within one to two days) to relieve itchiness, but some dogs experience less-than-desirable side effects from these drugs. 鈥淢oreover, steroids may not be safe for some dogs, such as those with heart disease, kidney disease, and/or certain liver problems,鈥� she says. Apoquel rarely has serious side effects and is safe to use alongside other medications such as , antiparasitics, , , , and .
While Dr. Wesley says that Apoquel is one of her favorite allergy treatments in her toolbox for itchy dogs, it isn鈥檛 right for every allergy-related diagnosis. 鈥淭his product is labeled for use in dogs one year of age or older; therefore, I may consider alternative treatments for puppies,鈥� Dr. Wesley says. 鈥淭he manufacturer also advises against its use in breeding dogs, pregnant dogs, or nursing mothers.鈥�
Dr. Wesley explains that studies show dogs using Apoquel haven鈥檛 shown any consistent increase in new cancer development when compared to control populations. 鈥淚 avoid this medication in dogs for whom cancer is a concern based on their history or my exam findings,鈥� says Dr. Wesley.
Dr. Diana M. Sim玫es is a Diplomate of the American College of Veterinary Dermatology and owner of . She says that caution and discretion are necessary in patients with severe secondary infections, untreated parasitic or fungal disease, and autoimmune disease.
鈥淏ecause Apoquel alters the way the immune system may respond in some scenarios, it may increase the risk for certain infections in some dogs,鈥� Dr. Wesley says. She says that, for this reason, your veterinarian may recommend lab work and an updated exam before starting treatment with Apoquel and periodically if your dog receives long-term medication rather than just to offer relief during an allergic flare-up.
The drug may also increase a dog鈥檚 susceptibility to the Demodex mite. Dr. Wesley says Apoquel isn鈥檛 a good option if your dog has an active Demodex infection.
Efficacy and Limitations of Apoquel
Dr. Sim玫es says many robust studies show Apoquel can be a safe and effective treatment option for many allergic patients. It doesn鈥檛 work for every dog, though. 鈥淓fficacy depends on the underlying cause of the allergy, proper diagnosis, patient response, degree of severity, and more. No allergic patient is ever 鈥榦ne size fits all,'鈥� she says.
According to Dr. Wesley, there is research to support that the large majority of dogs with environmental allergies (reports of about 70%) will experience a reduction in itchiness when using Apoquel. She says it works hard and fast when it鈥檚 effective, with some dogs seeing a significant decrease in itchiness within the first day. For others, it may take longer.
鈥淎poquel may control the itchiness elsewhere on the body better than it controls ear itchiness,鈥� Dr. Wesley says. If your dog has super itchy and inflamed ears, she says they may need additional care to keep them as comfortable as possible and the ears free of secondary infection.
For food-related allergies, Dr. Wesley says a specific diet prescribed by your veterinarian may be the best option to relieve itchiness. 鈥淚n some cases, Apoquel may help support the work of the food,鈥� she says, but it won鈥檛 be the primary treatment.
How to Administer Apoquel?
鈥淎poquel comes in oral tablet form, as well as a chewable treat-like form to make administration to pets even easier,鈥� Dr. Wesley says. You can give the tablets with or without food. If the medication is effective, you should see your dog鈥檚 itchiness diminish within 24 hours.
Your veterinarian may prescribe Apoquel twice daily for up to two weeks and then reduce the dose to once daily. In other cases, starting with one dose a day will be sufficient. Because the effects of Apoquel wear off within 12 to 24 hours, a daily dose is necessary to maintain your dog鈥檚 comfort levels. A twice-daily dose isn鈥檛 recommended for long periods as it can increase the chance of side effects.
Never give more Apoquel than your veterinarian recommends. Overdoses can lead to immune suppression and side effects, such as gastrointestinal upsets, skin inflammation or growths, and enlarged lymph nodes.
Apoquel Side Effects
鈥淎poquel is generally well tolerated in most dogs with few side effects when used appropriately,鈥� Dr. Sim玫es says. However, she explains that Apoquel can have bone marrow-suppressing side effects at high doses. This is another reason why it鈥檚 important to administer only the prescribed amount.
While side effects are rare, the most common of these include:
Sometimes, side effects will be mild and resolve over time, but always let your veterinarian know if you observe anything abnormal, including changes to your dog鈥檚 skin, energy levels, appetite, breathing, or urination. It鈥檚 normal for your veterinarian to conduct periodic blood work analyses to monitor for any atypical side effects while your dog takes Apoquel.
Other Allergy Treatment Options
Don鈥檛 worry if your dog doesn鈥檛 respond to Apoquel or your veterinarian determines it isn鈥檛 the best option. 鈥淎poquel is one of several treatment options available for allergic patients, and a good veterinary dermatologist is the best equipped to assess which are best suited for each individual allergic patient,鈥� Dr. Sim玫es says. She explains that prescription and over-the-counter options include allergen immunotherapy, other non-steroidal allergy medications, steroids, and topical therapies (such as or creams).
Depending on your dog鈥檚 type of allergy, their symptoms, and their severity, your veterinarian may use a combination of treatments. Dr. Wesley says that some 鈥渢rial and error鈥� can be involved to determine the best combination for your dog.
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