Apoquel?

[Mirardosa]

My dog has been on Apoquel for a week. She has suffered with itching since her puppy years and we are giving this drug a go.
So far, it's like having a new dog; she has stopped itching and chewing her feet.
I have a follow up with the vet tonight, but I've been reading horror stories online about Apoquel and now I'm not sure whether to carry on with it long term. I'll obviously ask her for reassurance before deciding, but has anyone had any experience with their pet and this drug?

[TopDogs2019]

Mind if I follow this thread? My dog has been on this for a few months now, and also with great results. I notice even if I miss one day, she starts to nibble at her paws again. I've heard some horror stories as well, and also have reservations about her being on any medication long term, so I am interested in any information your thread provides. Xx

[SerendipityFelix]

What horror stories have you heard?

As a vet I prescribe it a lot and have had my own dog on it long term too. Generally speaking it is a very effective drug with very few side effects. It is relatively new, although not that new now, but that does mean there’s not that much evidence about very long term use, yet. Having said that I have very few concerns about it on the whole. The relief it brings and the improvement in quality of life for itchy pets is immense.

[Mirardosa]

@SerendipityFelix my vet pretty much echoed what you said. We are keeping her on them for a month initially so see how it goes.
Some of the things I read were saying that it suppresses the immune system, causes lymphoma, awful things. I trust my vets opinion over google though and she says it's safe and you could expect vomiting and diarrhoea at most.
Thank you for sharing your professional opinion.

@TopDogs2019 hope your pup gets on well with the drug, keep me updated! It's so nice to see them get relief from the itching isn't it? Mines a french bulldog, so the constant paw chewing sounds like a pig in the room!

[florence11]

I don't like Apoquel and it didn't work well for my boy, he kept needing the loading dose.

Have you come across cytopoint? Biological enzyme therapy. Monthly injections and the itching is all gone. It's very new, only been in the UK about a year. I pay about £120 a go it's not cheap but has changed his life. He's 11 this year.

[ClarkGriswold]

I'm a vet too and find most dogs tolerate apoquel really well (and their skin is very well controlled on it). The way it works is to "dampen down" a dog's over-exaggerated immune response to an allergen, and the main side effect we can see is that some dogs immune systems will be dampened down a little too much and their white blood cells can go slightly low. Your vet will probably suggest a blood sample every six months or so to keep an eye on the white cells and make sure they are not dipping too low
If you're worried about side effects then something else you could try is cytopoint which is a monthly injection and works well for some dogs at controlling symptoms - it has very few reported side effects and shouldn't affect the immune system. It's probably worth sticking with the apoquel for a while though if your dog is doing well on it, it's horrible to see them itchy all the time!

[gambaspilpil]

My dog has suffered since a pup and ended up on steroids for years after we tried diet changes, creams, shampoos, turmeric paste you name it. Steroids made him fat and miserable. When we did manage to get apoquel it was like a wonder drug. My dog has been on it now for 3yrs and gets regular blood tests and is fine. He is on a slightly higher maintenance dose as we noticed itching coming back when we went from 16 to 5.4 so he is on 8. Wouldn’t change it now as my dogs quality of life is brilliant now compared to how he was before.

[Skandinaviem]

Another vet here- Apoquel has revolutionised how we treat our itchy dogs and has improved quality of life for so many of my patients, as well as sparing them steroid treatment (which has its place, but often comes with horrid side effects long term) Good luck with your little dog. So glad that you’ve found something to help.

[Wolfiefan]

Apoquel didn’t nothing for our itchy dog. Only put a bloody great dent in our bank balance.
I would be wary of long term use of something that affects the immune system.

[DramaAlpaca]

Apoquel has worked wonders for my very itchy Springer. She still has occasional trouble with her ears but on the whole she's a much happier dog. Our vet is happy for her to be on it long term.

[SerendipityFelix]

There’s no evidence so far that Apoquel has any links with lymphoma in dogs, I know there’s one study in humans on a similar drug that suggests a possible increased risk, but AFAIAA anything more than that is conjecture/extrapolation at this point. Lymphoma is sadly not an uncommon cancer in dogs anyway and can affect younger otherwise healthy pets.

A paper published in Veterinary Dermatology journal last month did find that apoquel could suppress the immune system, but only at doses higher than what we use normally to control itch.

Cytopoint is an exciting new option, my own experience with it so far has been mixed efficacy wise, but as it’s a very specific therapy (monoclonal antibody - not an enzyme) it is inherently going to have low risk of side effects. Worth discussing as an option with your vet if it seems your pet is going to need long term treatment.

[Lonecatwithkitten]

At a dermatology conference Apoquel and Cytopoint were discussed and it was felt that they will work for around 66% of dogs, but not necessarily the same 66%. Personally I am a fan of immunotherapy again it works for 66% of dogs, but I feel those it helps have a better overall improvement.
But I do have dogs who only partially respond to anything so have immunotherapy, take apoquel, have cytopoint monthly and sometimes also take steroids.