Apoquel for Dogs: A Vet's Guide to Relieving Allergic Itch in dogs

Many dogs live with allergies, so it's understandable to assume scratching, licking, chewing, rubbing or recurrent ear infections are habits. As a veterinarian, I often hear that a dog simply enjoys cleaning their feet by nibbling, or their face by rubbing it on the carpet after dinner. Apoquel for dogs is one of the most common treatments I prescribe for exactly these signs.

Most of the time, those behaviours mean itch. Paws are a classic itch-site in canine allergies, and face rubbing after meals can point to excessive sensitivity to a protein in their food.

What causes allergies in dogs?

Allergies happen when the immune system overreacts to molecules that should usually be harmless. Estimates vary, but allergies to environmental triggers alone are thought to affect up to around 15% of dogs. Genes play a strong role in whether allergies develop.

Common triggers include fleas, food proteins, pollens, grasses, moulds and dust mites. The result is itching, a weaker skin barrier, and a higher risk of yeast or bacterial overgrowth or infection. Paws, face, ears, armpits, belly and skin folds are commonly affected. With food allergies, diarrhoea, weight loss, and itch around the muzzle or anus are also common.

What is Apoquel and how does it work?

Apoquel for dogs is the brand name for oclacitinib, a tablet which targets allergy symptoms. It's not a good choice for food allergies — for these, finding and removing the offending protein is the key.

Apoquel as a remedy for dog itching is not a 'cure', but it can make life much easier. It targets 'Janus kinase' pathways, often shortened to "JAK" pathways, which are part of the body's itch and inflammation signalling system. By reducing these signals, Apoquel helps break the itch–scratch cycle and can start relieving allergic itch in as little as four hours.

Typical cases I see are young adult dogs, often breeds such as French Bulldogs or Labrador Retrievers, with red paws, recurrent ear irritation and itchy bellies. Once we rule out other causes, Apoquel may be prescribed as part of a wider plan. That plan usually also includes parasite control, a recommended shampoo, and regular ear cleaning with a suitable product. Your vet will advise what's best for your dog.

Apoquel requires a veterinary prescription. Itch has many causes, and the wrong remedy for dog itching can delay proper treatment. Your vet will want to be reasonably confident allergies are the cause before prescribing.

The most commonly seen side effects of Apoquel are gastrointestinal upset (vomiting or diarrhoea); reduced appetite, and being sleepier than usual - these are usually temporary. Your dog may also be more prone to getting a type of bacterial skin infection called pyoderma. If pyoderma occurs it typically has to be treated with a special shampoo, prescribed ointment or antibiotics. Apoquel doesn't cause skin lumps, but it may increase the growth speed of lumps already present or which would have occurred anyway, so it's avoided in dogs with (or prone to) lumps.

Uncommonly Apoquel can cause decreased white blood cell (infection fighting cell) numbers, although when this happens the number does not usually fall low enough to be dangerous. If it is practically and financially possible then it’s ideal to have your dog’s blood tested a couple of weeks after they start Apoquel and then every 3-6 months after that, just to make sure. Again this is an uncommon side effect and in my experience it is rarely dangerous.

Apoquel is only available as an oral (taken by mouth daily) treatment. Both standard film-coated tablets as well as palatable tablets are available. It is usual for your vet to prescribe twice daily dosing for the first two weeks, and then once daily dosing ongoing after that. If your dog isn’t good at taking tablets, then you may want to consider Cytopoint injection instead - take a look below to learn more.

Apoquel alternatives: Cytopoint and Zenrelia

Apoquel is not the only modern option.  Cytopoint injection may be an alternative. This medicine contains lokivetmab, which targets a  interleukin-31, another important itch signal. It's given under the skin every 4–8 weeks, either year-round or seasonally, depending on what triggers your dog and whether their allergies come and go.

Zenrelia for dogs, containing ilunocitinib, is another JAK inhibitor, and like apoquel it is only available in tablet form. It's a very new drug, which may give

some owners pause, but it has undergone rigorous safety testing and is a promising option.

Personally, I feel comfortable prescribing Zenrelia where appropriate, and I always aim to offer the same standard of care to your pet that I would want for my own family's dogs.

Frequently Asked Questions

1) Is Apoquel safe for dogs? 

Apoquel is widely used, but it does have potential side effects and isn't suitable for every dog. It shouldn’t be used in dogs under 12 months old or under 3kg (6.6lb), in dogs with low white blood cell numbers, or in dogs with cancer. It is also not recommended in pregnant, lactating or breeding dogs. Your vet will decide based on medical history, test results and examination.

2) Which is better: Apoquel, Zenrelia or a Cytopoint injection?

Nothing is automatically 'better'. Your vet will match the treatment to your dog, and sometimes this involves trial and error.

3) Can I give Apoquel without seeing a vet?

No. Apoquel requires a vet prescription. Speak with your vet, who can prescribe the right treatment for your dog's needs.