APOQUEL: RISKS AND ALTERNATIVES FOR DOGS WITH “ATOPIC” DERMATITIS

APOQUEL: RISKS AND ALTERNATIVES FOR DOGS WITH “ATOPIC” DERMATITIS By Dr. Michael W. Fox

So many veterinarians here and in Europe are prescribing APOQUEL® (oclacitinib tablet) to dogs with itchy skin, diagnosed as atopic dermatitis. Regrettably this drug is the new steroid quick fix that many veterinarians, including dermatology specialists, swear by and prescribe widely. This drug is also widely advertised on television.

A quick on-line search on the Internet will, however, reveal a very different picture including a letter from the U.S. Food and Drug Administration to the manufacturers, Zoetis essentially confronting their inadequate labelling of this immune system suppressing drug and potentially harmful, even fatal consequences.
N141345 Apoquel untitled letter - FDAPDF —higher frequency of adverse reactions in Apoquel treated dogs was seen—. I have received several letters from other readers of my Animal Doctor syndicated newspaper column whose dogs have developed adverse reactions to this drug. The crusty sores that developed on some dogs’ back are probably due to this drug.

I am disgusted that veterinarians attending to itchy dogs rarely address diet and possible food intolerance or allergy, also potential allergens in the dog’s environment. I highly recommend my home prepared dog food diet, ( posted on my website www.drfoxonehealth.com) with half the grain content for small dogs, and go to www.ahvma.org to find the nearest holistic veterinary practitioner. Dietary supplements are very helpful for this dermatological problem, notably good quality fish oil (not krill) and Vitamin D3. German veterinarians have reported that giving dogs cholecalciferol (vitamin D) an initial 300 international units per 1 kg gradually increasing to 1400 IU/kg by 4 weeks and after a total of 8 weeks and then repeating the same regimen after an 8-week wash-out period. (See Christoph J Klinger et al Vitamin D shows in vivo efficacy in a placebo-controlled, double-blinded, randomized clinical trial on canine atopic dermatitis. Veterinary Record – BMJ, http://dx.doi.org/10.1136/vr.104492). In many instances this malady is resolved with a wholesome, whole-food diet and alternating the main animal protein ingredient every 5-7 days, i.e. a rotational diet. In some cases the dog will start itching when fed a meal containing beef, dairy or egg and that way one can determine what is best to avoid. A few drops of fish oil in the food daily to provide essential fatty acids may also help since these vital nutrients are generally lacking or oxidized in dry kibble or destroyed by heat processing of poor-quality canned dog foods. Dogs, especially with seasonal allergies, respond well with 1-teaspoon per 30 lb body weight of local honey in their food daily, or the same amount of bee pollen which is especially preferably with dogs who are diabetic.