I recently read in the AVMA journal that Apoquel has become the top-selling product in the U.S. animal health industry, according to data from the Executive Animal Health Study Center based in Belgium. It has surpassed the flea and tick preventives at different points during the last couple of years, the first time that a therapeutic agent has surpassed the flea and tick preventives that had dominated forever.
I have been outspoken against the use of chemical flea and tick prevention products, as well as the use of immunosuppressive drugs such as Apoquel and steroids for many years. The reason these drugs are so popular is very clear once we realize the top reasons dogs and cats are presented to veterinarians for treatment are itching, ear infections, allergies, and skin disorders.
Side effects listed when using Apoquel include vomiting, diarrhea, lethargy, anorexia, increased thirst, and overwhelming bacterial and fungal infections, including pneumonia. From the package insert, we see approximately 6% of test dogs developed cancers:
After completing APOQUEL field studies, 239 dogs enrolled in an unmasked (no placebo control), continuation therapy study receiving APOQUEL for an unrestricted period of time. Mean time on this study was 372 days (range 1 to 610 days). Of these 239 dogs, one dog developed demodicosis (demodex mange) following 273 days of APOQUEL administration. One dog developed dermal pigmented viral plaques following 266 days of APOQUEL administration. One dog developed a moderately severe bronchopneumonia after 272 days of APOQUEL administration; this infection resolved with antimicrobial treatment and temporary discontinuation of APOQUEL. One dog was euthanized after developing abdominal ascites and pleural effusion of unknown etiology after 450 days of APOQUEL administration. Six dogs were euthanized because of suspected malignant neoplasms: including thoracic metastatic, abdominal metastatic, splenic, frontal sinus, and intracranial neoplasms, and transitional cell carcinoma after 17, 120, 175, 49, 141, and 286 days of APOQUEL administration, respectively. Two dogs each developed a Grade II mast cell tumor after 52 and 91 days of APOQUEL administration, respectively. One dog developed low grade B-cell lymphoma after 392 days of APOQUEL administration. Two dogs each developed an apocrine gland adenocarcinoma (one dermal, one anal sac) after approximately 210 and 320 days of APOQUEL administration, respectively. One dog developed a low grade oral spindle cell sarcoma after 320 days of APOQUEL administration.
Would you knowingly give your family member a drug to decrease itching if cancer was a possible (or probable) side effect? How many of you have used this drug without any warning from your veterinarian? While this drug has only been studied in dogs, it is now being used off-label for cats, as well.
Allergies, skin infections, and ear infections are related to immune system dysfunction, which commonly occurs secondary to gut dysbiosis (imbalance of good and bad bacteria within the bowel resulting in swelling of the cells lining the bowel and secondary leaky gut).
The basis of allergy treatment requires healing of the gut with an appropriate diet, repair of the immune system, and rebalancing bacterial growth within the body. Holistic veterinarians use herbs, diet, acupuncture, and chiropractic care to rebalance and repair the body.