Back to Apoquel Article

All effective medications have risks and benefits and none are right for everybody or every pet. If you are quite happy with Apoquel, that needs to be on this page too.

Since I created this page, I have had many dog owners write to me describing mysterious health issues, difficult for their veterinarians to diagnose, that their pets developed while taking Apoquel. I did not post them because the health problems were so varied and there was never enough data to show that Apoquel contributed to those health issues. With time, I hope that things will become clearer in each of those pets. I am particularly interested in pets whose health issues change when they take Apoquel and change again once they no longer take it or when their dose changes; but I welcome any information your might provide.

You can see that since I created this webpage, many dog owners have written to me. To keep the page a readable length, I may not post your emails if they repeat similar short-term success with Apoquel. I think we already know that this drug works and that the benefits can be immediate and dramatic. What I want to concentrate on are what occurs after dogs have been on the medication for longer periods. Do the benefits continue? Do side effects begin to occur and, if so, what are they ? When you discontinue Apoquel or lower the dose, do the side effects go away?

Apoquel Dog Owner's Comments:

September 5, 2014

Apoquel works like nothing else we've tried. It is like magic - but
what it will do to him if he's on it long term I may never truly know. 

M.W.
Charleston, SC

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October 8, 2014

For the past eight months my bishon has been taking 8mg daily of Apoquel. The drug has given my dog (four years old) a quality of life I never thought was possible. He also receives an allergy serum injection every ten days. However, for the past several weeks his nose has been running constantly and as of late he has been gurgling rather than breathing. Two days ago, his nose was bleeding. I stopped the Apoquel immediately and will see the allergist this week. Most importantly, two days after I stopped the Apoquel, his nose dried up, no more running and no more blood. I cannot help but assume that the Apoquel
was the cause of his misery. After I see the allergist I will send another post of his findings. I know the angst of an allergic pet and was so thankful for the relief Apoquel gave my dog - but now, who knows.
B.
Charlotte, NC

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November 24, 2014

I came across your article on Apoquel while looking for information on the drug. There is very little out there, so I appreciate all of the info in your article. [abbreviated] We adopted our 6 year old Shiba Inu last February. We were told he was surrendered due to his previous owner's inability to care for him due to her own medical problems, that he had food allergies, but that he was on a restricted diet and things were under control. [abbreviated] It is clear from his records that they could not get his allergies under control even with steroids, and every year things just got worse and he got harder to treat. He was on various antibiotics for skin infections due to licking/chewing, as well as drops for an eye infection.
He was doing great until the beginning of August, when we noticed him start to scratch more and rub his face on the carpet. I bought a comfy cone in case it got worse, and it got much worse. We tried baths and home remedies and OTC antihistamines without success. We put the cone on when he started damaging his feet and took him to the vet. She told us about Apoquel, and at that point it was already back ordered and scarce.But they had a stash of pills for larger breeds, so all we had to do was cut the pills into thirds and we would have enough to get us through allergy season. We were so lucky that our clinic had some of this drug, because it worked. Our vet called it a miracle drug, and it sure seems that way to us. She said we should start to see improvement within 4 hours, and her other patients had improved significantly in 24 hours. It was true. It was amazing how quickly it worked. We did the loading dose of two pills per day for 14 days, then once per day after that. We were told some dogs got itchier when going to once per day, but that didn't happen with our dog. We stopped the Apoquel after we had days of freezing temperatures and snow with no significant warm-up in sight, so he was on it for just under 3 months. He was our vet's first patient to go off the drug, and he was perfectly fine. He had no side effects while on it.

Next year we can start the Apoquel as soon as his allergies start.It will be his first summer in years that won't end with a comfy cone and chewed up feet and sad, itchy dog. Are there potentially bad long-term side effects? Sure, but there are known bad long-term side effects for steroids and other options, steroids didn't seem to be working for him anyway, and we were able to avoid the antibiotics he had needed in previous years. He was completely miserable. Who wants to live like that for 3 months each year? I would much rather he be happy and have a great quality of life now, and then we'll deal with whatever problems may come if/when they come. [abbreviated] Please let me know if you have any questions. I have never seen a drug work so well with no apparent side effects. I don't know how many dogs at our clinic are on Apoquel, but our vet said only one owner stopped it because it didn't seem to be working, not because of any side effects.

S. H.
Madison, WI

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December 1, 2014

I have a mini long haired Dachshund who has been on Apoquel since june of 2014. I have been unable to sustain her on 1 dose a day. She has gained almost 3 pounds, and has become very yeasty and smelly. She also has pain going down stairs and playing. In reading about Xeljanz in an advertisement in a magazine, I noted that this drug is an immunosuppressant. Yes it works for the itching, but I am concerned about the changes in her health since taking this drug. I now question the efficacy of taking this drug and what to do to help her get back to good health again. HELP!

L.W.
Vermont

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January 16, 2015
Hi Doc,

I just read your excellent article on Apoquel and wanted to give you our experience. We have a black lab / mastiff mix dog that my wife and I rescued 5 1/2 years ago when he was about 3 1/2 (best guess). When we got him the only hair on his body was on his head and he had a smell you wouldn't believe. We spent literally thousands of dollars to get him well, and, although his hair grew back, he itched constantly. By constantly I mean sometimes he would scratch 30 or 40 times per hour. The hair and skin in our house was unbelievable. No matter what we did the vets could not stop the itching (he was lastly on a combination of Wellactin and a steroid that I don't remember the name of). We moved here (Wichita Falls, TX) from Hawaii and found a young vet at xxxxx xx xx (Doc xxxx) and she recommended Apoquel (started July, 2014). I must say, it has been a life changer for our dog Kodi. The very first day he literally stopped itching and has rarely (as in once a week maybe?) itched since. We did notice a few things that you brought up in your article: He developed a small "bubble" on his left hind leg (about the size of a quail egg) and Doc Lucy said she thought it might be cancerous tumor but we would need surgery and a biopsy to find out (more than we can spend at the moment, we're honestly more than $6,000 into this dog as it is) and it didn't seem to bother him much. He also had a sore (big, red and bled a bit; about the size of a large pea) on the bottom of his left rear foot, but that healed with a topical medicine and I'm not sure it was related (we were walking him on some concrete at the time). Lastly, he seems to have gained 5 lbs or so but, as he weighs 95 lbs when he looks perfect, at 100 lbs that's not alarming - again, he's half black lab and half mastiff so I think the mastiff side is manifested by his size. We can live with that. In any case, the Apoquel has certainly improved his quality of life. We're worried that it may have shortened it some, but he's happy now and he was miserable before. He's coming up on 9 yrs old, getting a little white under the chin but still runs when he wants and has no limp. Our one year old loves to play with him and Kodi doesn't seem to mind. We have hardwood floors and occasionally he slips a bit getting up or down, but I think that would happen anyway since there isn't much to grip. Oh, and he doesn't much like the UPS man...or anyone who rings the doorbell! In any case, I wanted to give you some feedback from our experience. Thanks again for writing the article and if you have any questions, please let us know. Thanks!

Lt Col xxx "xxxxxx" xxxxxx
Sheppard AFB, TX

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January 21, 2015

My Maltese has been taking Apoquel since the end of summer 2014.

This medicine has been wonderful for her. She has not had an allergy break out since she has been taking the medicine. She has been a happier dog, not irritable, does not itch (the itching gave her knots in her fur), she seems to feel good. Before the Apoquel she had horrible break outs of sores. The sores would even be between her toes and made it painful to walk. The breakout would come on fairly quickly, mainly on her tummy, rear and feet. I am concerned about the long term effects, side effects and availability. If I change the veterinary she is currently going to will I be able to continue getting the medicine?

K.B.L.
Littleton, Colorado

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January 27, 2015

I just read your article on Apoquel. My golden retriever mix, Lilly, has been on Apoquel for a year now. After suffering both food and seasonal allergies, this has been the only medication that has worked. Her energy is way up and she has hair on her feet now! I now don’t have to freak out if she does eat a piece of chicken or a grain on accident. She does not flare up within the hour with a rash and hives anymore. There is no reaction what so ever. We have had a very positive experience with Apoquel. It has improved the quality of life for my dog greatly. She has no health problems or symptoms caused by taking Apoquel. We went down the route after consultation with our vet of 4 years (was with us through the whole allergy process) and after our vet discussing this drug with specialists at Texas A&M University College of Veterinary Medicine and Biomedical Sciences.
She just turned 6 years old. She began having allergy issues around 1.5 and worsened as she got older.

E.E. Meadows Greater Chicago, Illinois

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January 27, 2015

I want to first thank you for Apoquel. I went through allergy shots, antibiotics, prednisone, bacteria baths, etc. Roscoe was a rescue that was abused and abandoned. He has been on the 5.4 mg pill - weighs 19 pounds. If I lower it he starts eating his feet. He has a few skin tags since he started taking it and he smells of medicine. I am trying to slowly lower the meds just to see if he stops smelling, it might be to much for his system. His lower part of his body hurts when I wash him but I think that might be from the prednisone because it started before the Apoquel. Again thank you and I will get back to you if any change.

Thank you

J. R., Cleveland, Ohio

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February 4, 2015

Dear Doctor,

Our mini-Schnauzer Curly has just been discharged after 4 days in the hospital. He was hospitalized due to a mysterious 105F fever, lack of appetite, huge papilloma lesions in his mouth, vomit,and abdominal pain. He has been on Apoquel for almost a year. It worked only in the beginning, and now it barely provides some mild relief to his itch; he chews his paws raw and no his face and legs and tummy itch a lot, too. Despite the potential side effects of Apoquel, we had to try it because the steroids, special diets and allergy shots have not worked. Curly is allergic to dust mites and all types of mites; the itch was becoming increasingly more severe, to the point that we started considering euthanasia. That's when Apoquel came to the rescue, but at a price. For the first couple of months, Apoquel worked like a dream; he only needed one pill pill once a a week. Over time, Apoquel became less and less effective, requiring daily doses for the last 5 or six months; nowadays, such doses only provide a 40% relief -if any- so we have to supplement with Benadryl; all along, he has continued his Heska allergy shots once a week.

So here is our challenge: It seems that Apoquel has greatly contributed to weaken Curly's immune system to the point that his platelets and also his red blood cell count is considerably low. At the same time, he is experiencing very little relief by taking it. The internist believes that continuing the Apoquel any further wreak havoc in his immune system, that we can only expect more papilloma lesions, further inflammation of his lymph nodes, lower platelet cell cell count and so on.

So, I thought you would like to know about our experience with sweet Curly, who is turning 3 years old this month .Apoquel provided him with awesome 100% itch relief for a few months, which resulted in a great quality of life, while it lasted. And now... I am beginning to plan Curly's memorial, as things are not looking good for this little boy.

Thank you Apoquel for buying my dogs at least a few months of relief, so that he could enjoy his beloved park and his loving home.

G.M.
Bothell, WA

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February 6, 2015

Hi Dr. Hines -

I've been researching Apoquel and came across your very informative site, thank you! My elderly Scottie, Molly, developed itching that couldn't be traced to anything, and eventually we tried Apoquel. Within 24 hours she was a different dog. After two weeks of 2 doses daily, we went to 1 dose daily. After the second month, the itching returned. i upped the dose to 2 x daily with no improvement, and now the itching is getting worse again. Since Apoquel is still in short supply, our vet has run out so Molly will be off it when this bottle runs out. I was wondering if anyone has reported any behavioral changes when their dog is on Apoquel? At first we just put her increasing mischievousness down to feeling better that she wasn't itching, but she's been off the charts goofy. She used to just sleep all day and be pretty laid-back barring the odd squirrel to chase, she's almost 13 and not terribly active. But in the past couple months she's been acting almost puppy like - she ate a whole stick of butter, got into a Christmas stocking and ate a giant block of cheese and a pound of chocolate (milk, fortunately, but still), she dug a hole and buried candy inside a houseplant. She got into the fireplace and hid something.I know these are all relatively normal dog behaviors, but she has NEVER done this kind of stuff. And she doesn't do it when we're
home, she definitely waits for the opportunity, it's just weird, and the only thing that's changed is the Apoquel. I'd love to hear if you've heard any similar stories.

All best,
K.M. Chicago, IL

[as of 4/6/15, there are no reports in the literature of any of this class of compounds affecting mood in humans. See comment below]

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February 16, 2015

My 9 yr old bull terrier who weighs 46 lbs was prescribed Apoquel (16 mg) which she has been taking for a year. I get the Apoquel from Germany at a considerable cost because my vet gets it sporadically. I just learned through reading that the
recommended dose for Abigail is 8 mg and not 16. Her allergies are under control now and she no longer is miserable. She could not tolerate Atopica. We notice that her behavior is changing in the last 2 months. She no longer wants to eat at her usual place and appears fearful if we put her metal bowl in the stand where she ate for 9 years, so we moved her bowl into another room and stand next to her while she finishes. She will not finish her food if we just put the bowl down. She wanders around the house more ( she has always been a lap dog who sits close to us). She has been non aggressive her whole life but she now growls and barks more and is less tolerant of our other rescue, a 3 yr old female bull terrier and of other dogs in the park and visitors. She only gets Apoquel -- I reduced the dose to 8 mg -- so I believe that these must be side effects; is this something other owners have experienced? Abigail gets regular check-ups at Vet. Her temperature was elevated for a day or so but went down to normal. There is also a change in bowl movements. She no longer regularly defecates but needs to be coached. She grinds her anus into the ground before and after pooping but Vet cannot find reason. He prescribed a pill to increase bowl motility but I have not given it.

J.S., Central Florida

Sent from my iPad so never mind typos !

[Dear J.S., I can not tell you if these changes relate to Apoquel.The only way to determine that would be to discontinue the product for a period of time to see if these mood changes resolve.]

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March 2, 2015

Our 4 year old [] female spayed Llewellin Setter has been on Apoquel, prescribed by a canine dermatologist, since February 2014. We adopted the female setter in October 2013, when she was a little over 3 years old. [] She was in bad shape when we took her from an Iowa kill shelter. We thought it was fleas and immediately took her to our vet who found no parasites, did the normal topical sprays, multiple prednisone treatments and antibiotics for secondary infections. The dog was tearing herself apart. After two months we sought out a canine dermatologist who immediately told us the dog was in bad condition. [] The dog was so bad that she was put on Apoquel in Feb 2014 [] done to essentially save her. Apoquel had only been available a few months at that time. As other have said, it has been a miracle drug. Within an hour or so all itching, scratching and digging stopped. Antibiotics cleared her secondary skin infections. [] The dog went thru allergy testing and the results indicated numerous normal environmental suspects and several specific grass and tree allergies. She was on allergy shots for about 10 months with no real improvement seen when temporarily taken off the Apoquel. The dermatologist recently stopped her desensitization shots. Today she is on Apoquel and Revolution. So what we have to present covers a canine that has had 12 months of constant Apoquel, probably longer than most canines given the newness and availability of the drug.The dog has shown no side effects of the Apoquel. Her blood test have been normal, her weight, appetite, and digestion are fine. All her hair grew back and is in good condition. We are now entering that stage of concern over the long term effect of Apoquel, if any. [] There is no question that Apoquel is providing her with a high quality of life although after a year she still will start to itch after about 20-22 hours after she has had her daily dose. There are certain times during the past 12 months she shows itchiness more than others even being on the Apoquel. [] As you can tell, we are searching for improved solutions. She has regular care to watch for long term Apoquel issues, but the drug has probably saved her life. []=abreviated

E. and S.
Lakeville, MN

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March 17, 2015

My dog has had problems with itching, razoring off the hair on legs and feet and chewing until sores appear. He can do this in less than 10 minutes. He is an eight yr old Bearded Collie. It started with itching and diarrhea as a young dog less than 1 yr old. He came from Canada to the US, Florida. It has been seasonal and I had him tested and treated by holistic vet for years until now when they no longer make the homeopathic combos to treat his itching. He is now undergoing the allergy shots and taking Apoquel for a month. This is the time of year in Central Florida where our cars and anything outdoors is yellowish green with heavy pollen. We live in an area loaded with Oaks and that is something he particularly seems to react to. I've booted him on walks and wiped him down with wet cloth after being outside which helps some. He was living in a Cone of Shame for awhile in February as he razored all the hair off a back foot and the foot was very swollen from chewing on it. So far the Apoquel has made a new dog of him. Not restless at night as he used to be. Finally getting a good night sleep. I thought he was fatigued but actually he was more relaxed for the first time. He played and was excited when called for. It was amazing to see the results.
After reading your articles, I wouldn't leave him on it , but give during peak pollen times if needed. Right now if I skip a night giving him the pill he starts scratching the next day, but not chewing. I think it's quite remarkable and like you said he has more quality of life.

J.A., Winter Park Florida
Sent from my iPad

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March 22, 2015

Hello Dr Hines,

My name is Lana and have a 9 years Maltese, Lexie. We have been fighting allergies and skin infections for about 8 years. Lexie has been on all kinds of treatments for the problem, cortisone shots, steroid shots and pills, shampoos, lotions, antibiotics, etc. Lexie is also one of the dogs who participated in the blind study of Apoquel in 2012. And she was the first dog that our vet prescribed it to once it became available in the fall of 2013. So, a year later, I think we have a big problem. She has been monitored all the time she has been on it, and every 6 mo’s they did blood work, and her liver enzymes gradually increased. Back in August of 2014, the levels were slightly elevated, in March of this year they are doubled. The vet suspected Cushing disease at this time and we have done all the tests and now it is confirmed that she has a tumor on her left adrenal gland (ultrasound showed that the left gland is twice bigger in size than the right one). And now we have no choice other than to go for a surgery to remove the gland. I am very unhappy and I am very concerned if this is will go ok for her, and if she can survive it, as I have read a lot about this procedure and know that this is a very delicate surgery to have… And I am not sure if this is what we should do at all. She does have some of the other symptoms of Cushing's disease, such as in increase appetite and thin skin. She has repeated ear infections and stiffness in her body. She had an infection in her toe in January, something she never had before. I am so worried about my dog… [edited from non-native English]

Thanks,
L.S., Noblesville, Indiana

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April 5, 2014

Dr. Hines,

Our 6 yr old Shih Tzu, Figgy used Apoquel for about a year.We tried to take him off once, and he got a bad ear infection. The 2nd and last time we pulled him off of this drug was after we found a mass on him - which is cancerous (salivary gland)
We had the mass removed and now are starting radiation and hopefully we can stop it from spreading. I read similar findings about other young healthy dogs on other websites about this drug with similar result. After reading your site and others, how can this drug still be prescribed?

Also how come you only have positive posts on your feedback site. I find this unusual. Please post my experience with this drug on your website.

Sincerely,
S. R. Figgy's Mom

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April 8, 2015

My chihuahua Peanut is 14 years old, and has always had skin allergies. We called her insistent foot licking "foot maintenance", since she always licked her feet after a walk. Recently, it's became really bad. She had some "hot spots" on her front legs that I just could not get her to stop licking and nibbling, even with baths, benedryl, hydrocortisone, bitter sprays, bitter wraps. Nothing worked except the cone of shame and even then she would find something to scratch or lick. In the past, she would have a flare-up, and we would go to the vet for creams, lotions, and antibiotics to treat the resulting yeast and other skin infections.
I also have environmental allergies, and am old enough to remember life before claritin, and it SUCKED. Well, imagine my great delight when our yearly trip to the vet ended up with a bottle of Apoquel. She takes 1.8mg daily. It worked almost immediately. Suddenly she can rest comfortably without jumping up to scratch, nibble, lick, etc. She is even playing a little! She's resting on my lap as I type, a favored activity that she hasn't been able to do for years. I'm so pleased, and happy for her. I hope we don't see any of the possible immune issues. Hopefully she'll be with me for several more itch-free years. Thank you for your very informative, evidence-based website. I so appreciate your references. I wouldn't have known anything about this drug's history or side effects without your website.

Best wishes,
Laurie and Peanut, Bellevue, WA

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April 18, 2015

My French Bulldog suffers from allergies and was scratching himself raw behind his front legs and chewing up his paws. We too tried many things including Atopica but they were either too strong to use for any length of time or caused a bad reaction... mostly throwing up, listlessness, and diarrhea. We switched his food to Kangaroo and oats which helped. Then we tried Apoquel. He has been on it for just about a year. He only needed 1/2 of the 5.6 (28 lbs). It was a miracle. No more scratching or biting and no side effects....until about a month ago. He started throwing up just about 10 hours after his pill. After 4 nights in a row we stopped giving him the medication (went back to Benedryl as needed). No more vomiting. So after a week we tried the Apoquel again and the vomiting came back. We are very sad that we have to discontinue the Apoquel after working so well for almost a year, especially at the beginning of his worst allergy season. The vet gave us a spray called Atop7 (basically all natural) and Muciprocin cream for bad breakouts (a mild antibiotic). These do help. Good luck to everyone else using Apoquel.
Ari is six and a male. We have had blood work done twice since he started and everything was fine. We will be trying a smaller dose and every other day. No diarrhea or change in weight. His appetite has always been good. I will write again in a few weeks after trying a different dose and at varied intervals.

C.B., Rhode Island
Sent from my iPad

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April 27, 2015

Dr. Hines

Thank you for the extensive information regarding Apoquel.
My 11.5 year old Bichon Frise started on Apoquel a year ago. She has had severe itching since she was about a year old that began as seasonal but after only a couple years, progressed to year-round. She has tried everything except allergy testing. Some of the things we tried were food restrictions, Atopica, steroids – injections and pills, behavior modification, over-the-counter medications, topical medications, special shampoos and such, oil and nutritional supplements, etc.Steroids helped but the side effects were bad and we experienced horrible long-term side effects (Cushings disease) from steroids with our previous Bichon. I wanted to avoid that with this Bichon although she had already been on steroids for several years.In light of nothing else working, the severity of my dog’s allergies making her miserable, and the need to get her off steroids, Apoquel has been an answer to prayer. Her dosage begins to wear off before 24 hours, but I supplement with Benadryl or an OTC medicine to get her through the last few hours until it is time for her daily dose of Apoquel. So although she is on Apoquel long-term, I try to keep the dosage as low as possible. She takes half of a 5.4 mg tablet per day. For the first time in her life other than her first few months of puppyhood, my dog is not constantly scratching, nibbling and driving herself crazy with the itching. Nor is she drinking excessive amounts of water and constantly begging for more food as she did with the steroids. Her quality of life is worth the risks of Apoquel and I hope she continues to benefit from this medication without having side effects.

K.C.
Claremore, Oklahoma

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May 5, 2015

I have a 5yr old black lab who has been on [Apoquel] for exactly one 1year. About 3 months into the medicine, we noticed a lump on [his] neck. It appeared to [] get smaller- [at first, so] we thought it was just an irritated hair follicle. I am terrified to think the medicine we thought was a miracle drug- may have caused my dog / family member- to now suffer from cancer. My Vet is [] reaching out the distributor []. I guess I am just looking at your articles and hoping for some insight on the long term effects of Apoquel. I realize there have not been to many findings as the drug is new. However if there is any insight- or advice you can give. [] Even if it's merely a little direction as to how I can approach the developers of Apoquel to get some real answers. I am not giving up on my dog - and I am determined to have him around for many many many more happy years.
Thank you for your time,
A. & W. Boston Massachusetts

Dear A.,
You have one of the most knowledgeable veterinarians in the World regarding Apoquel at Tufts Univeristy in Grafton. Her name is A. L. We have exchanged emails on the subject of tumors that have occurred subsequent to Apoquel. You can tell her I suggested her. She said that most resolve on their own when the drug is no longer given. But we don’t really know what that lump on W. is. It might just be an infection or some other process that may or may not be related to Apoquel. There is really not much more I can tell you without examining the dog. But lumps and lesions of many kinds often look the same superficially. What needs to be done is to have that lump biopsied. The biggest veterinary diagnostic laboratory in the USA is Antech Diagnostics.They charge me $95.45 (includes postage) for one of their pathologists to tell me what a lesion is. Let me know how things develop. RSH

4/24/16 update.....
Hi Ron,
W. went through the surgery like a true champion! I think I was more stressed than he was! The vet noted [], that this was one of the more difficult surgeries he had ever done - due to size, location-and because the mass had formed its own blood supply. He noted a large white "growth" that basically rooted itself inside his body. Although the vet urged me to do so - I opted not to have diagnostics done on the mass. As previously mentioned-I would not want to place W. on treatments that would effect the quality of his remaining life. His allergies are a battle alone. As curious as I am - I also do not want to know. As of today - its like I have my puppy back!

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May 6, 2015

Hi,

We began giving [Apoquel] to our mini dachshund a year ago. He is 12 years old, and had been itching so badly and biting his skin raw for the past 5 years that we felt we might need to put him down. The skin on his legs was puffy and baggy and encased in a thick layer of crust—or the parts of it that weren’t bleeding from his having bitten them raw. He would be constantly hot to the touch, and he would smell terribly within 12 hours after a bath. Needless to say, we tried everything, natural and unnatural. Any remedy we could find, we tried, with no luck. Prednisone would help for a bit, but only for a bit and it wouldn’t help that much. Atopica was a big waste of time. And good luck with all of the different shampoos with all of their amazing claims. We’ve tried them all. Apoquel has been a Godsend. The dog had no quality of life, and now he does. We hope it will keep working and we hope we don’t see any of the unfortunate side effects that would require to take him off of it. But so far, so good. The only issue we have is the $400 the dermatologist charges us every 3 months on top of the cost of the Apoquel. I wish I were kidding. None of our local vets can get it, in spite of the so-called freeing up of supply in April.
Paul,
Corvallis, Oregon

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May 7, 2015

Hello Ron,

The pattern we are seeing here at Tufts is that the incidence of cutaneous tumours seems to be higher than average in dogs that have been on Apoquel. There is no hard evidence to back this up, but this is our clinical suspicion and we are currently gathering data for analysis. In cases of histiocytomas, yes, they have regressed on their own once the Apoquel was discontinued.

Best,
Cummings School of Veterinary Medicine
North Grafton, Massachusetts

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May 13, 2015

Dear Doctor Hines

[abbreviated]

Our Cockapoo, Mollie is twenty months [old]. When Mollie was about six months [old], she began itching her paws. We thought it could be mites and used an alternative produce called Canker. However, this didn't work so we went back to the vets. [ ] The vets did a swab test of her paws and found her to be very yeasty. The prescribed Malaseb shampoo and to try to avoid 'polleny' areas. [ ] We returned to the vets because her paws were really sore and she was getting pretty distressed about it. I think at this point they gave her a steroid shot to see if the skin would calm and we would continue with Malaseb and trying to manage it topically as we were reluctant to use long term steroids. We began to explore many other kinds of alternative medicine, such as coconut oil, grain free food, turmeric, and some others I can't remember. [] The results did not show [improvement] in anything[]. She then went on a short course of oral steroids and we were recommended a homeopathic tablet as well continued use of Malaseb and now also Sebocalm, to build up a barrier on the skin. This didn't work either and we were back at the vets. She went on steroids for the rest of the season. Whilst we were able to lower the dose, she wasn't able to be sustained on half a tablet a day, she had to have at least one. [ ] We had also heard about Apoquel but this wasn't available at that time. So we phased out the steroids in October, but Mollie's itching returned with a vengeance and she even got an infection with her anal glands. The vets suggested Atopica and she also had another steroid shot to calm the skin. We were then sent to a specialist. [ ] She found that Mollie was quite yeasty. This has to be managed topically and it is often ineffective. [desensitization] serums, whilst they can be given were said to be ineffective. Allergy testing could reveal further allergies but the specialist said again, the effectiveness is low. She recommended changing her diet to Royal Canine even though she was sure the itching was not food related and gave up some hibiscrub infused wipes. [ ] But come January, after only a few months of improvement, it got much worse. It was at this time she was able to go on Apoquel. The results were immediate on two tablets a day for two weeks. But when we lowered the dose to the maintenance dose, the itching returned. Our vets suggested we build the dose up by a quarter of a tablet at a time. We tried to maintain her on one and a half but after about 8 hours on the half dose, the itching starts. [ ] As of the last three days, she is taking one tablet and three quarters. It's the first time she has slept through the night since we've been back.

Lisa
Greater London, UK.

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May 14, 2015

[Abbreviated]
In May 2014 my 7 yo lab developed itching that was not normal for her. We had just came up from Florida for the winter and we spend our summers in Missouri. My vet said it was the allergies in MO and offered us Apoquel which was wonderful, I could touch her back within a few hours. Unfortunately after the 2 weeks of 2 pills per day I was told that’s all we could get. I was on the fence about switching vets and eventually went to another recommended [vet] after a couple months of the scratching, biting, sores and bleeding. To my surprise this vet had Apoquel and was willing to give me enough to get me to Florida in October 2014 [ ]. 2 days after arriving in Fl and no more Apoquel she started right up again! She did receive 3 steroid shots over the winter which helped less each time [ ]. To make a long story short after spending $1,000s at our vets and hours on line researching food, allergies, yeast infections (which she had a bad one) and holistics I have to come to the conclusion that she is sensitive to Lamb, Chicken, all grains, all potatoes and krill oil. [ ] I was at my wits end and tried to figure it out, even sent in a sensitivity test with her saliva and hair! I called my Vet in MO and now that he had Apoquel again he gladly sent me a bottle, my Vet in Fl still can not get it. Within 6 hours I could touch her again without her going into spasms and scratching. We are only a week into the first 2 weeks and just got back to MO. Immediately she’s got one spot behind her front shoulder she’s scratching, but in all she’s a different dog meaning happy and energetic like she used to be. I hope this works and maybe after a couple months I’ll take her off [ ]. I will be aware of the long term use after reading your article but am hoping this can get us into a better situation!

K.S., Key West & Missouri .................Sent from Windows Mail

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May 16, 2015

Our 5 year old female bichon frise has had allergies for couple of years. The vet put here on steroids that worked until she developed diabetes 3 months ago. We have been struggling with trying every know allergy medicine to no avail. We were waiting for the release of Apoquel to our vet and now, after considering putting her down many times, after 3 days using Apoquel we are seeing a great change back to nearly normal. So far we are very happy with the results. We would have never imagined to see a change so [quickly].

20841XXXXX@messaging.sprintpcs.com

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June 6, 2015

We have a six year old German Shepherd who started itching / chewing at about age 2+. Feet and skin gradually became worse and worse. We tried all the usual treatments up to and including daily shots etc. Very early in 2014, our vet told us about Apoquel and we started with it then. The change has been something remarkable. His feet are completely healed up, and this coat which was always thin and washed out is remarkable. He now has a full coat with brilliant color. We are carefully monitoring him for side effects and have found none to date. He is active and happy. During a shortage of the drug in late 2014 we missed about 10 days. He started slowly with a little itching, a little chewing on his feet. As soon as we started his dosage again all of that stopped. This may not be the results everyone gets, but for D this has been a life saver, he is one happy, active and good looking dog.

N.F., Sylmar , CA

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June 17, 2015

[excerpted for brevity]

Dr. Hines -

I have been working with many rescue dogs over the years with many forms of skin and allergy issues. We current have a surrendered 7.5yr old [ ] Cocker [ ]. They had seen the McVet (they were banfielded) who had prescribed a bunch of expensive and useless medications. After a few years they could not go on with the costs and gave him up to our Cocker Rescue. [ ] We turned to a pet dermatologist in our area that works with our rescues to address his allergies. [ ] We started Apoquel in March and the change was DRAMATIC! His itching stopped in days. Now after a few months, he is a comfortable dog. He sleeps through the night. And other than pulsing ketoconazole to control the yeast, he is on only a 1/2 tablet of Apoquel daily [wt=35.2lbs]. His coat has cleared up and all the staining is gone. And a dry eye issues I had not mentioned that was treated with Optimmune is now discontinued as his tears production is normal in both eyes. And no more ear infections either. I am convinced all those pluses (good eyes, ears, fur) is due to resolving all the skin issues. I only wish Apoquel would have been in veterinary medicine chest YEARS ago.

C. Greater Minnesota Dog Rescuer

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June 20, 2015

Hi!
My 6 year old Boston Terrier was prescribed Apoquel and has been on it for exactly one week. I am definitely not an advocate of using drugs to treat side effects of a problem, but rather finding the root of the problem and fixing the cause. Allergies and skin issues have been a chronic problem his entire adult life. He has always been on high quality food and had consistent flea prevention. In an effort to eliminate his problems we went from Fromm Duck and Sweet potato (with some rice), to grain free Taste of the Wild (tried various protein sources), to grain free starch free Nutrisca, and now am feeding raw diet. Each was tried for several months. I have switched to dye free, fragrance free laundry detergent and have used various natural treatments (Apple cider vinegar, coconut oil with lavender oil, skin rescue lotion; and have also tried Benadryl and cortisone creams. He has definitely required his fair share of steroid treatments and antibiotics due to severity. We are at the end of week 1 and have seen vast improvements. He is no longer red, he no longer itches constantly (or really at all), and does not lick himself. While I am not a proponent of drug therapy, I feel such a since of relief for my baby. I always felt so bad for him. I am interested in any of your thoughts, opinions, and suggestions in use of Apoquel as some of the risks are serious and quite concerning.
Thank you,
B. L. Sent from my iPad

Dear Ms L.,
I think you are doing the right thing. You already know that the things veterinarians offered before for allergic, itchy dogs rarely if ever solved the problem. These hypoallergenic diets only improve a tiny tiny percentage of itchy dogs and blood-based allergy tests are, in my opinion, close to worthless. Vets dispense them and companies profit from them because owners and their veterinarians are desperate to do something – anything! Please do not feel guilty about using this new medication. None of the alternatives have worked for your dog. Sure, there are probably risks in the long-term use of Apoquel. But there were health risks - probably just as severe - in you dog remaining ill with the skin damage, infection and chronic immune system stimulation that itching causes. And the other drugs that could stop the itching, corticosteroids and cyclosporine, have as many or more potential side effects as Apoquel. With those drugs, the long-term side effects are already known because vets and human physicians have used them for years. With Apoquel, a new class of medication, we have not used it long enough to know. If your dog is happy now, that is the number one thing to concentrate on. The only medications that have no side effects are the worthless ones that have no benefits either.

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June 25, 2015

Dear Dr. Hines,

This is my experience with Apoquel. I adopted my French Bulldog when he was a year and 7 months old. When I got him he was in a very poor state. Some of his symptoms appeared to be from allergies such as scratching resulting in hotspots, watery eyes, ear infections and chronic diarrhoea etc. When we moved onto a fish based diet the worst of the diarrhea stopped and he began putting on weight. The dog however was uncomfortable and we kept having incidences of him licking his feet to the point of them swelling up like balloons and scratching his face to the point of his jowls swelling up massivle y with nasty infections. We went through food trials and ended up on an an-allergenic [hypoallergenic] diet on which the symptoms continued eg. sporadic diarrhoea, scratching and skin infections. We then saw a dermatologist who conducted blood tests which revealed allergy to dust mites, storage mites and various trees. This explained the constant nature of his symptoms. We started him on 5.4mg per day of Apoquel (double in the first week) and the scratching was greatly reduced. Everything seemed to go well for 2 months until the dog once again had to be admitted to the vets with a skin infection to the folds of his face. Since then the vet took him off Apoquel and onto steroids every other day. Today we decided that we would try him again on Apoquel in the hope that it would be controlled enough to start immunotherapy to try to bring some relief. The long term effects I have read on this website are horrifying but we cant keep sprinting to the emergency vet every time he scratches himself and ends up with a massively swollen face from a horrible infection ):

E.H.
Lecturer FMPE Department
Northbrook college, Worthington, UK

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September 1, 2015

Our dog, an American Hairless Terrier, had severe food allergies and skin allergies. We did all the testing for allergies and the [desensitization] shots - nothing worked. Our Vet recommended using Apoquel, we did and followed the suggestions for doubling up on the pill dose, twice a day for two weeks; then went down to once a day. It seemed to [be] working until we went to once a day and [then] the itching started back. We then took our dog to a veterinary dermatologist for testing. We were told to keep the dog on Apoquel, but because he was in the upper thirty percentile [most difficult to treat successfully], he required the pill twice a day and [because of that we should] then do blood tests every six months.

We were about into the third month and our dog died today, we were told he had aspiration pneumonia and that his white blood count was severely low. I have no doubt that the Apoquel helped with the itching but am also convinced ........... .
E.B.
Sent from my iPad

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October 2, 2015

Hi- thanks for the very valuable information about the drug Apoquel. My vet prescribed it for my shihtzu, who had been unresponsive to other medications for his incessant itching. At the point of prescribing, the poor dog had itched out swaths of fur and actually all fur on his neck and tail.
The vet put him on Apoquel 5.4mg daily (halved for a.m. And p.m. Dosing). While he was on it, it was a miracle drug. My very itchy dog (all seasons, all day, and we had tried everything from foods, antihistamines, and steroids and topical creams and shampoos) completely stopped itching and licking his paws, and his fur started to grow back. It was a blissful 2 weeks for everyone.
Now she has pared him back to 1/2 dose daily, but he has started itching, licking, and chewing. I'm taking him in for a vet check and hope he can go back to a full dose daily. For a 10 year old dog who has suffered for so many years, the medication is a godsend. He has a quality of life now he hasn't had in years.

Thanks for posting what you learn. I'll post a result later as well if he is able to stay on it.
Amy
Sent from mobile

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October 14, 2015

Insights of a Physician and his Dog [edited for non-medical readers]

My dog: A Miniature Schnauzer
Its age:10 years
Positive benefit of Apoquel: Excellent for a few months, then diminishing observed benefit. Has used the medication for more than 1 year.
Potential adverse effects:
1. rapid growth of a nodule on his left shoulder, excised [removed].
Pathology report: Hemangiopericytoma tumor
2. Six months later: Progressive growth of a previously noted soft, cyst-like 1.5cm mass on left lower chest wall, into a firm, inflamed mass 3.5 x 2 cm mass. Surgically excised.
Pathology Report: Grade 3 Mast cell tumor with positive margins, not fully resectable without rib resection.
Comment:
We stopped the Apoquel when we began prednisone [to treat] the mastocytoma.
His itching is more or less under control. We can't be certain if that is because of the prednisone [he is on now], which did not work before, if is working now because of his prior Apoquel use or if it is because of a possible reduction in histamine, or other other inflammatory mediators with significant debulking [removing most of] of the mast cell tumor. Prior cetirizine and diphenhydramine [antihistamines] were also of little benefit for his itching, but did allow him to sleep.
Granted, mast cell tumors are common, so its occurrence may be just be a coincidence, though the growth rate of the mast cell tumor seemed very rapid, after being a soft cystic structure for years.

We are just waiting for the symptoms of metastatic or invasive disease, then we will do the appropriate next step quickly, as we do not want to see any creature, anywhere, at any time in distress. Yes, the decision to use Apoquel was for that same purpose…to relieve discomfort.
Though our single experience does not establish a causal link, we hope it at least gives one more weak nudge to researchers to further question side effect profiles of all meds, especially immune modulators, before coming to market.

If I had to do it over, based on this one experience, I would exhaust all other measures before I gave Apoquel, and use that as a last resort only. I would also give it as a pulsed treatment.....maximum 1 month (nothing scientific to base that on), and do a thorough exam, possibly labs (as suggested in another user's comments), and wait several months before another brief course - if needed. For now, that is the current practice used for treating humans with a variety of immune modulating drugs.

M.V. MD, Birmingham AL

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December 12, 2015

We have a five-year-old boxer bitch (weight about 30 kg) that developed severe atopic dermatitis when only a few months old. She was treated with all the usual meds (steroids, Atopica, desensitization plus numerous topical lotions and creams). She scratched badly all year round, developing a scarred face, swollen and raw paws and clearly was not enjoying life. Then Apoquel appeared, which gave welcome relief, when available, but we went through lengthy periods of rationing and consequent relapses in her symptoms. For the past three months supply has been plentiful and she has been on 32 mg per day. It has completely transformed her life. Her scarring has healed, her paws are normal, but most of all she is now a lively playful dog again. Her quality of life is so much improved that even if the treatment shortens her life, we could live with that. She is regularly monitored for suspect lumps, of course.

J.G., Nottinghamshire UK

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December 18, 2015

I have a 5 year old chocolate lab. She has had extreme itching and feet chewing for 4 years. Nothing helped her until Apoquel. She did have serum allergy testing and has been on allergy shots/serum for 3 years for many environmental allergies. She also has many food allergies with frequent ear infections. She had immediate itch relief with the first dose of Apoquel. I find that 1/2 tab only lasts about 8-10 hours and so most days I have to give her 1/2 tab every 8-10 hours. My concern is that extra dose she is getting and if I am hurting her in anyway. Her blood tests have been normal to date. She has been on Apoquel for 2 years and so far I have seen no side effects. I care more about the quality of her life than the quantity at this point as she is absolutely miserable without Apoquel.

K.S.@hotmail.com

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December 31, 2015

My 5 year old Havanese suffers from what began as a seasonal allergy in the fall and seems to now have become an all year problem. She weighs 14 pounds and was prescribed 5.4 mg pills. The first 2 weeks she got half a pill twice a day. But when I switched to the maintenance dosage, the itching returned. I find that giving her one whole 5.4 pill every day is effective, but I am worried about over dosing. She has now been taking it for more than a year. By the way, I notice that her tear stains returned when I decreased her apoquel dosage. Thought you might like to know.
Sent from my iPad
Joan
NYC

With any medicine, the standard suggested dose is what the Company believes is an average effective dose. There will be dogs that require less than that, those that require more and some may require the medication more frequently than others. Zoetis, the FDA and the EMA suggest a long-term dose of 0.18 to 0.27 mg/lb body weight per day (0.4 to 0.6 mg/kg body weight). The first thing to do when a drug does not live up to expectations is to be sure the dog is not receiving less than that. Apoquel was tested using a relatively small number of healthy beagles. There are purely physical reasons why one dog may absorb more of a drug than another. Apoquel was designed to be absorbed through the small intestine where acidity is normally lower. Perhaps some dogs have higher intestinal acidity than others. The medication has an enteric coating – perhaps some dogs dissolve that better than others. Apoquel is only at high levels in your pet’s blood stream for 4.1 hours. Although the Company does not recommend it, perhaps some dogs would do better if the total daily dose was divided into a morning and evening portion. Apoquel is eliminated from the pet’s body through its urine (kidneys) feces and bile (in that order). Perhaps some dogs are more efficient at that than others.
When any medication must be used at a higher-than-average dose to control a disease, increased monitoring and watchfulness is always a good idea. That can be hard with medications that influence complex processes like Apoquel. But any increase in skin tags/warts (dermal papillomas), respiratory infections, skin infections or other infections, or changes in your pets white blood cell count and differential count might be early warning that the dose is too high. So would the development of infections between the toes (interedigital cysts), diarrhea and soft stools or increased susceptibility to giardia or coccidia infections. A decrease in the pet’s blood albumin and/or globulin levels might also be a warning that the dose is excessive. Read the studies that indicate that here and here.

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January 27, 2016

Hi I am getting back with you, as promised. Took my 7 y/o female cockapoo off of Apoquel about 3 wks ago. She had been taking it daily for several months for chronic dermatitis, and ear infection. The medication did not help her skin alkergies, but did well to keep her ears clear. Off of the meds for 3 wks, I have noticed signs of a brewing ear infection . ..redness, and slight inflammation. Since this problem is chronic, I have decided to treat her ears prophylactically with an otic solution. I don't like what I have read about long term use side affects of apoquel, and, since is so new on the market with small population studies, I have decided that the benefit does not outweigh the cost of harmful affects on her overall health.

M.J.
Edgewood, KY

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February 14, 2016

Dear Dr. Hines - In 2011 I lost my entire family [ ]- I only have my female Cocker and she takes 8 mg. Apoquel sometimes up to one every 12 hours (BID) - I really don't want to lose her prematurely - she is the last vestige I have of any family. I read where you said that Apoquel shortens a dog's life span. Are we talking months or years - She is 9 1/2 years old and 24 pounds - She has been on Apoquel for nearly 2 years and it has solved her constant scratching problem. I also read that the dosage for her weight should be 5-6 mg. Please let me know what you think with regard to life span and dosage.
Thank You, P.D. Wilmington, NC

Dear Dr. D.,
I can not tell you that taking Apoquel will shorten your dog's life. What I was attempting to say was that the long-term side effects and consequences of tinkering with the immune system in that way are unknown. Apoquel turns down the volume of the immune system regarding many things. One of them is a positive thing, it turns down the volume or intensity of immune systems that have mistakenly identify harmless things in your dog's environment as potential threats. However, the drug affects other positive aspects of the pet's immune system as well. It comes down to this. You love your dog. Is it more important that its days be happy or that its life might be longer (perhaps but uncertainly so) if it was not taking this medication ? Compare it to people who have had a kidney transplant. Other than the very rare "perfect" match, that person must take drugs that also turn down the volume and intensity of their immune system in order to prevent organ rejection. The drugs that person must take also turn down the intensity of the entire immune system. But people generally make the decision that that risk is worth taking because they want to live a more pleasant life - whatever length God grants them. Every year the enormous complexity of the immune system becomes more apparent to us. I pin my hopes on the Broad Institute and their pioneering work on gene editing. It is in its infancy, but I have faith that some day we will be able to edit out immune system errors with something similar. Broad has a particular interest in the genomes of dogs and cats and their health problems since they are so similar to ours.

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February 23, 2016

My [12 year old male Shiba Inu, Fox] started off on a pretty high dose of 16mg [Apoquel], and then we tapered down to 8mg, and finally 4mg as a maintenance dose. Occasionally, when his allergies start to act up a bit we might bump up his dose to 8mg for a couple days, but then taper back to the 4mg.[] Fox did develop a small tumor in the brisket area under his right front leg that had to be removed. [] I can't help but wonder if maybe the Apoquel was the cause. Another thing that has happened much more frequently on Apoquel is ear infections. (one of the most common side effects of Pfizer's "sister" human medication, Xeljanz is nasal and sinus infections) Fox has never had an ear infection in his entire life, but the past year we've had two pretty bad ear infections, all while on Apoquel. The last thing that I have noticed with Fox is that his personality has really perked up. He's always been a bouncy happy guy, but this past year he's just had a renewed spirit and has really returned to his younger days. I love him so much and I want to make sure that his final years are spent enjoying his couch potato status and not spent chewing the fur off of his paws. His fur is so full, soft, and fluffy, something that has been missing for years. Even though he's an old man he looks and acts so much younger. For anyone who may be on the fence with this medication, please let them know to give it a try and do please share our success story with others.

C.C.

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March 15, 2016

We have a 4 yr old shiba inu who has been on apoquel for 2 years. He constantly chewed on his feet and up his legs. Our vet recommended Apoquel, and it has completely stopped the chewing. His fur grew back, and he looks great. We have noticed no side effects at all. He is on 5.4 mg a day. We tried cutting the dosage in half, but within 48 hrs, he was back to the chewing. He is a very happy and active pup.
L.H.
Laguna Niguel, CA
Sent from my iPad

Thank you for that information. I will post it without your name on my website. As with all things, people tend to respond online when things do not go as they anticipated. So I am sure my comments page has more negative responses than positive ones. That is why I value your information on the success of Apoquel in your pet so much. RSH

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March 24, 2016

I have a 5 year old American bull dogX. She weighs 38# []. She has been on Apoquel since June 2015 - 5.4mg - 1 1/2 pills [] per day. Within the last 6mths we have cut her back to 1 pill daily and we split it morning and night. [] Although we have cut her back [] she still itches, but I believe at a level that acceptable. Just within the last week I noticed some warts around her eyes. I seen where you had posted something about warts and infections being a problem. She also has severe problems with infections between your toes constant[ly] reoccurring not so much within the last three months but up until then quite frequently.
Also most recently she seems to be very fearful of things and more insecure, she's been laying in places in the house that she never has before? I don't know if any of these are due to this medication or not.

Sincerely,K.B.
Sent from my iPad

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April 18, 2016

I [] have a six year old terrier/lab mix — about 50 pounds. He [has] suffered from allergies since we adopted him at 8 months. We’ve done the usual [ things]: limited ingredient foods, bath once a week with medicated shampoo, he had allergy testing and shots a few years ago. We try to keep him out of dog parks with grass and away from what really bothers him. We dip his feet in water EVERY time we come in from outside. [] He has been on alternating rounds of antibiotics,steroids and benadryl. Then we tried Apoquel — we noticed a change in the first week. He no longer fussed over his feet []. His hair stopped falling out and his coat grew thicker. His usual issue [before Apoquel] was infection — lots of round, red, hivey looking spots, which would then turn flaky, and lead to hair loss. No more infections since he’s been on [Apoquel]. [] He has been on it about 3 months now. 2x/day at first, now 1x/day.
He had a small growth on his leg long before the apoquel — the vet said it was a wart and not a cause for concern. But since putting him on this medicine, it has grown pretty fast - from the size of a nailhead to the size of a dime. We’ve had it tested, It’s benign, but the vet thought it was infected (the dog licks at it constantly). He’s on antibiotics to see if that helps, but we will probably have to have it removed. He also has a small growth on the outside of his upper lip that’s new. [It came up] within the last couple of weeks. I’m thinking it’s Apoquel related. Behavior-wise, we’ve noticed him be a little more ‘amped up’ … he’s barkier toward other dogs (which he wasn’t when he was on steroids). Maybe related, maybe not. Hard to know or prove. Overall, I believe the quality of his life is better due to the reduction in itchiness. But I am concerned about the growths on his leg and lip and how that will ultimately affect [him].

P.D. , San Francisco

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May 10, 2016

I wanted to share our story with Apoquel use in our dog, a 6 year old, male, bull terrier mix. He has been on Apoquel for approximately 3 months due to chronic atopic dermatitis, yeast infections and secondary skin infections from scratching his skin open. We had tried many, many different options - multiple protein changes with his food, gluten free, potato free, etc..., different shampoos specifically for atopic dermatitis, yogurt, vinegar and peroxide mixes on the feet, fragrance and dye-free detergents, [cortico]steroids, antibiotics, Benadryl, Zyrtec, nothing worked. The [cortico]steroids helped, but each time he was on them, he had an injury to his CCL [knee cruciate ligament], and as soon as he stopped, the itching returned. And he scratched constantly, everywhere, and his skin pigment was darkening. So we tried Apoquel on recommendation from our vet. The itching stopped the first day on it. He took 2 pills a day for 14 days, then a 16 mg pill once a day. Fur grew back, his skin looked healthier, but I noticed he had a growth in the muscle of his front leg after 2 months on it. It hasn't gotten any bigger and is about the size of a pea. And then a toe swelled on his front paw. I initially thought he injured it somehow. After a week and a half, the swelling went away and he seemed fine. Then just a few days ago, a toe on one of his hind legs swelled so large that the skin broke open and bled. The entire foot swelled. I immediately suspected the Apoquel and stopped giving it to him. I called the vet and scheduled an appt. She fully agreed that it was due to the Apoquel. His foot has multiple cysts. He is now on antibiotics [] He is finally starting to put weight on it after being off the Apoquel for almost 3 days. I would rather have him scratch and keep looking for something that will help him than have him ever on this drug again. He was in terrible pain and couldn't even stand. What seemed like a miracle at first surely was not. I think this drug is good for very short term use, no longer than a month, but is definitely no cure for allergies. Our vet has shared this side effect with Zoetis and the FDA. []

H.S.
Palmerton, PA Sent from my iPad

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May 16, 2016

I came across your page back in July, 2015 to review Apoquel]. My dog Boo had really bad allergies and would get yeast infections. So we placed her on [it]. She was on Apoquel for 5 months. Everyday she would take one. But her yeast infection would always come back. Towards the end of her 5th month, she started to get sick. She wouldn't eat and she would throw up bile. I noticed when I took her off the meds she got better. We decided to see a allergy specialist [] because I couldn't see her taken a pill everyday and becoming sick. I also didn't want to risk her getting a cyst even thought her vet said it's rare. In the 6th month, the allergy Dr. placed her back on Apoquel for a couple of weeks. She started to get sick again, so we stopped the medicine and started giving her allergy shots. This time she didn't get better when we removed the Apoquel. We did several test to figure out why she was sick. [] We visited 3 vets and finally the last one decided to do an endoscopy. She had a tumor in her belly and would have needed surgery to remove part of her stomach. We put her down [] because even with surgery she only had a couple months to live. The surgeon said it was most likely because of the Apoquel since she was on that when she first started getting sick but he had no proof. [] She was a 5 year old dachshund-yorkie mix.

Amanda L.B., Plano, TX

I reviewed Boo' s records. As is often the case, it can be very difficult to know if a medication causes a disease, compounds a pre-existing disease or just happens to be given when an unrelated problem occurs. It is only over time that trends and links become apparent. Apoquel is oclacitinib. Xeljanz, a similar human medication, is tofacitinib. Through 2015, there is no evidence that Xeljanz increases the risk of cancer. (ref)

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May 24, 2016

I just read your article on line about apoquel. My dog has been through everything including environmental changes, skin and blood tests, diet restriction and reintroduction. She has tried Atopica tabs, steroid creams, sprays and potions. After a particularly nasty flare up recently, the vet recommended Apoquel - 14 days at half tab twice daily and then 14 days half tab daily. It made her better! She finished the tabs about 2 days ago and the telltale itching is already [reduced to] a bearable level, sore toes and itchy eyes have [stopped]. [] I'd prefer my dog to live a shorter happier life than an uncomfortable longer one with suffering. I'll be calling the vets tomorrow for some more tabs!

E.J.

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May 31, 2016

I meant to update you at the end of last year. We used Apoquel again, starting when our dog's itchiness started (end of July) and ending at the beginning of December (after hard frosts). We only did a 7-day loading dose instead of 14 days.[] Again the effect was quick and amazing with no side effects. His itchiness wasn't eliminated completely, but he was overall pretty normal and happy. He still got weekly baths and we wiped him down after he went outside, but he didn't chew/rub any skin raw or need his comfy cone. He stayed fluffy all season (his tummy was almost bare when we adopted him due to his scratching and rubbing). Our veterinarian is thrilled with how well he's doing.

Sarah, ....Madison, WI

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May 31, 2016

We had an adopted beagle, Cooper,[about 6 years old]. We had him for 4 years. He had allergy problems for much of his life. We took him to 4 vets with four different treatments. The last sent him home with Apoquel. That was May 9, 2016. His raw skin calmed down [] and his itched [got better]. We thought we were on the road to [recovery]v. Then around May 27th 2016 he wasn’t as hungry as he normally was, he would drink water [] but his appetite diminished drastically. Late on Day 2 he was drinking water and then vomiting, his nose was running. He still seemed alert and content. We just thought it was [the weather] change we were experiencing. Later that night he got sluggish and tired and he went to bed. He had been outside earlier in the day doing his normal howling and Beagle barking in the yard. By day 3 he looked as if he had aged 10 years overnight. He was able to walk, but wobbled. He tried to drink a little water, but couldn’t really manage. He had bright green loose stool. My wife got him [to the vet] at 10am on May 30th, By 12pm [we agreed to have him] put down. His liver [had failed] and his spleen was enlarged and his bloodwork wasn’t good.
S.C., Egg Harbor Township, NJ

I try to publish all emails that pet owners send to me regarding Apoquel without putting a spin on them. This last email was upsetting to me because of the owner's obvious grief. So I exchanged a series of emails with him and explained that with the information at hand, there was really no way of knowing if Apoquel played a part in this dog's crisis. The human 'sister' medication to Apoquel, Xeljanz, has an FDA warning that it can cause or exacerbate liver disease. But this dog had also been given cefpodoxime, a cephalosporin antibiotic. On extremely rare occasions, that group of antibiotics have also caused liver failure. However, Cooper had received another cephalosporin on a prior occasion without problems. We also can not know what other undiagnosed health issues this dog might have faced.

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September 3, 2016

My dog, Moby, is a 2 year old cross-breed rescue dog []. He showed inflammation and increased itchiness, especially in summer. Our local vet gave him steroids and that calmed it down, but I was concerned about long term usage. She switched to Apoquel and claimed it was a wonder drug vets couldn't keep in stock as it was so successful. Moby began his course and it worked a treat. No redness. No itching. A happy dog. Then he started showing signs of discomfort walking. I checked his paws and they were riddled with warts. At least ten on each paw. They bled when he walked and he became unwilling to walk. His toes also flared up red. [] I turned to the vet to help and she didn't agree that they were warts as "he was too old". She gave me Imaverol [enilconazole] to treat a "fungal infection" on his toes and "ringworm" that appeared on his leg. She also prescribed antibiotics and wants to treat him for parasites (scabies). He had no signs of fungus or parasites previously. I took him back to the vet and insisted she look at the warts. She did and agreed with a glance that they definitely WERE warts. He tries, every day, to walk but can only manage 200 metres or so. I carry him home. I stopped the Apoquel at the first signs of problems.The itch is the least of his problems now. My vet claims he is "unlucky" to have reacted so badly and that the fungal infections are coincidental. I don't buy this.

D.S., Dublin, Ireland

Six days after sending me the above email, the owner reported that since discontinuing the Apoquel, the warts were shrinking, the possible "ringworm" was gone and the dog was walking normally. Two weeks after that, he informed me that veterinarians at the vet school in Dublin had decided that the problem was demodectic mange which, they believed, was activated by the Apoquel. After two Bravecto (fluralaner) treatments, the mange problem was on the way to resolution and Moby's feet had returned to normal..

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September 16, 2016

You asked for positive or negative feedback from users and I have some positive comments. We have an aged [] Cavalier King Charles Spaniel.[] Recently, after trying antihistamines, corticosteroids, Temaril-P, and various medicated shampoos, all to no avail, our vet has put him on Apoquel. He has been taking one to two 5 mg. pills most days for several months with no side effects whatsoever so far. Perhaps the most amazing thing is -- that much of his itching/scratching seem[ed] to be neurological rather than allergy and yet Apoquel works, it works fast, and it keeps him comfortable. It has been a miracle drug for him and us.[] Whatever we can do for this little guy who has been through so much to make his life more comfortable is worth the risk of side-effects, of lowered immune system and so forth at this late stage in his life. He is a happy, loved dog, and every day is precious for him. [] Sincerely,

Judge A.G., Ft. Worth, Texas

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October 21, 2016

My six yr old mix breed took Apoquel for six months this summer. I didn't want to give it to him as the prednisone worked very well last yr and he didn't have to take very much. We had to use the Apoquel because he was scratching a lot and was about to have ACL surgery and couldn't take the pred. He now has a tumor (just removed and sent for histopathology) on his neck that looked cancerous under my Vets microscope when she aspirated it. We will know more next week when the pathology report comes back. It was attached to the muscle so she couldn't get margins in that area. I am very upset. I am not convinced that the Apoquel caused this tumor but am quite certain that it exacerbated it. My husband found it three months ago and thought it was nothing and said nothing to me. He said it was about the size that it was when we had it removed. I found it three days before she took it off so I don't know how much it grew or if it was there before we started the Apoquel. It was under the skin [] and kind of flat and wide so it didn't show to the naked eye, only when felt. Chauncey has had no other side affects from the Apoquel and it worked very well. I will never use it again.

10/24/16
We received VERY GOOD news this morning from our Vet. Chauncey's mass was a benign basal cell tumor which was completely removed. We are thrilled !

A.S., Marquette, Michigan