New Medication For Arthritis In Dogs, Apoquel (Oclacitinib)

Apoquel is a new medication being used for arthritis in dogs. It is the same as the human medication used for arthritis called Xeljanz (Tofacitinib ).

Because Apoquel has not been on the market long, there is a lot we don’t know about it. Remember when heartworm medications were first introduced and caused death due to seizures? Literally hundreds of herding dogs died before we discovered the NMDR1 gene and the effect that high doses of heartworm ivermectins had on herding dogs, including Border Collies and Australian Shepherds who had inherited the NMDR1 gene. Within two years of having been introduced, heartworm ivermectins were dramatically altered to prevent seizures and death among these breeds.

Now, we’re in the same position with Apoquel because it hasn’t been tried on enough dogs that we can understand how it affects all the different breeds, or dogs of a single breed with a variety of health problems and taking a variety of medications. So, go slowly with Apoquel. Try acupuncture, chiropractic care, salt water swim therapy, therapeutic laser, Adequan, Ichon, tramadol, gabapentin, NSAIDS (Metacam, Etogesic, Piroxicam), and stem cell therapy first. Then, consider Apoquel if your dog still has painful arthritis.

Apoquel helps relieve arthritic pain in two ways,

• by allowing new cartilage to grow and
• by blocking pain mediators.

There are stem cells within the synovial lining of joints that can differentiate into cartilage but these stem cells are held in check by protein kinases. Apoquel blocks the Janus kinase (It is called a JAK inhibitor.). With JAK held in check, the stem cells are able to produce glycosaminoglycans (GAGs) from which cartilage is constructed. At the same time as Apoquel is increasing GAG within the joints, it is blocking the joint’s production of matrix metalloproteinases (MMP1, MMP3, MMP13), the enzymes which damage cartilage and promote pain and inflammation.

Apoquel was not introduced into the veterinary market as a medication for arthritis, but as a medication to control itching (pruritus) and allergy symptoms by blocking interleukins (IL-2, IL-4, IL-6, IL-13, IL-31). Families noticed that their itchy, arthritic pets were both less itchy and less lame, and Apoquel began being dispensed off-label to help with arthritis.

 Apoquel has some rather common side effects (vomiting, diarrhea, loss of appetite), but it may also have some serious, if less common, side effects, including cancer, increased susceptibility to infection (pneumonia, demodex), and skin disorders (furunculosis, cysts, pododermatitis).

 Apoquel has not been approved for pregnant or lactating females or for dogs less than one year of age. It has been safely given to dogs at the same time as they were vaccinated. It has been safely given to dogs receiving some common medications, including NSAIDs, antibiotics, dewormers, and anticonvulsants, but it has not been proven to be safe when given with steroids or with cyclosporine.

Apoquel  (oclacitinib) is a prescription drug and is available in 3.6 mg, 5.4 mg, and 16 mg tablets. The dose for pruritus in dogs is 0.4-0.6 mg/kg orally twice daily for two weeks, then daily. For example, a 33 lb (15 kg) dog could receive 6-9mg or ½ a 16 mg Apoquel tablet. Apoquel can be given with food. It should also be given with caution, and stopped if there is any sign of infection (demodex, pneumonia, pododermatitis) or cancer.
 

Apoquel   (oclacitinib) was not developed as a medication for pain, but dogs tdking it have been less painful. The following from Sharon Gwaltney-Brant DVM, PhD Diplomate, American Board of Veterinary Toxicology,explains how it might work:

“Oclacitinib inhibits pro-inflammatory cytokines as well as pruritogenic cytokines, so I guess it is possible that it might inhibit some of the inflammatory cytokines associated with osteoarthritis and thereby relieve some of the discomfort. "

 



 

Share this post