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Call your vet the same day if a dog on Apoquel develops a fever, a cough or laboured breathing, sudden lethargy, a new lump that grows quickly, skin infection that is spreading despite treatment, or blood in vomit or stool. The FDA-approved label warns that Apoquel modulates the immune system, may increase susceptibility to infection including demodectic mange, and may worsen existing cancers. It is not for dogs under 12 months old, dogs with serious infections, or breeding, pregnant or nursing dogs. Never stop or change the dose without your veterinarian.
The short answer: Apoquel (oclacitinib) is an FDA-approved prescription pill that controls allergic itch in dogs at least 12 months old by blocking the JAK1 signalling that itch cytokines such as IL-31 depend on. It works fast: in the 299-dog placebo-controlled trial, owner-scored itch fell 29.5% after one day and 66.7% by day 14, versus 3.9–10.4% on placebo. Short-term side effects are mostly mild stomach upset (diarrhoea 4.6% vs 3.4% on placebo). Long-term, the picture is different: in dogs followed for months, urinary tract infection (11.3%), vomiting (10.1%), ear and skin infections (9.3% each) were common, and in 2018 the FDA told the manufacturer its "similar to placebo" safety claim was misleading. On cancer, the best matched study of 660 dogs found no meaningful difference. Below: the dosage chart by weight, how long dogs can stay on it, the monitoring that catches problems, the alternatives, and what the CBD research in itchy dogs actually shows.
By Marc Brannigan and Natalie Mondine, co-founders of HempMy Pet · Published November 6, 2026 · Last reviewed November 6, 2026. We have grown and bottled full-spectrum hemp for pets on our own Colorado farm since 2016. We are not veterinarians — everything below comes from the FDA label and the peer-reviewed studies listed at the end.
Apoquel at a Glance: The Numbers That Matter
| Figure | What it measures | Source |
|---|---|---|
| 0.4–0.6 mg/kg (0.18–0.27 mg/lb) | Label dose: twice daily for up to 14 days, then once daily | FDA label |
| 12 months | Minimum approved age | FDA label |
| 66% vs 4% | Dogs with atopic dermatitis reaching owner-rated itch success at day 28, Apoquel vs placebo | FDA label (299-dog trial) |
| 86.4% vs 42.5% | Allergic dogs with a meaningful itch drop after one week, Apoquel vs placebo | FDA label (436-dog trial) |
| ~4 hours | Half-life in the blood, which is why a daily dose is needed | FDA label |
| 11.3% | Dogs developing urinary tract infection or cystitis on long-term use | Cosgrove 2015, 247 dogs |
| 45% vs 15% | Itch "rebound" after dropping to once daily: Apoquel alone vs with 4 days of prednisolone at the start | Olivry 2023, 40 dogs |
| 16.5% vs 12.8% | Malignancies in dogs on long-term Apoquel vs matched dogs without it — not a meaningful difference | Lancellotti 2020, 660 dogs |
Sources: Apoquel FDA-approved label (Zoetis) · Cosgrove 2013 · Cosgrove 2015 · Olivry 2023 · Lancellotti 2020
What Apoquel Is — and Why It Isn't Benadryl or a Steroid
Apoquel's active ingredient, oclacitinib, is a Janus kinase (JAK) inhibitor. Many of the cytokines that drive allergic itch and inflammation, including IL-31 (the cytokine most directly tied to the sensation of itch), signal into cells through JAK1 or JAK3. Oclacitinib interrupts that signal inside the cell. The label is explicit: "Oclacitinib is not a corticosteroid or an antihistamine." It is labelled for two uses: control of itch from allergic dermatitis (flea, food, contact and environmental allergy), and control of atopic dermatitis.
That mechanism explains both its strengths and its warnings. Because it blocks the itch signal directly, it works within hours rather than weeks. Because JAK signalling is also part of normal immune defence, the label classes Apoquel as an immunomodulator and carries infection and cancer warnings that an antihistamine like Benadryl or Zyrtec does not. It is absorbed quickly (89% bioavailability, peak in under an hour) and cleared in about four hours, which is why the itch relief wears off within 12 to 24 hours of the last dose.
Does Apoquel Work? What the Placebo-Controlled Trials Found
Yes, and quickly. In the pivotal 112-day trial at 18 US specialty clinics, 299 dogs with chronic atopic dermatitis were randomised to Apoquel or an identical-looking placebo. Owner-scored itch fell by 29.5% on day 1, 61.5% by day 7 and 66.7% by day 14 on Apoquel, against single-digit changes on placebo. Vets recorded a 48.4% drop in skin-lesion scores by day 14 and 28.
Two details almost every page leaves out. First, notice the drop between day 14 (66.7%) and day 28 (47.4%). That is when dogs switch from twice-daily to once-daily dosing, and some of the itch comes back. A 2023 randomised trial of 40 dogs measured this "rebound": 9 of 20 dogs (45%) on Apoquel alone had a rebound a week after the dose reduction, versus 3 of 20 (15%) given a short 4-day course of prednisolone at the start. If your dog's itch creeps back in week three, that is a known pattern, not necessarily a failure. Second, Apoquel does not work for every dog. In the label trial, 15% of Apoquel dogs (23 of 152) still withdrew within a month for worsening signs, and Zoetis itself, as quoted by veterinary dermatologist Dr. Melissa Eisenschenk, reports that about 60% of moderate to severe atopic cases are controlled long-term on once-daily dosing. Ear inflammation in particular tends to respond less well than itch elsewhere on the body.
Apoquel Side Effects: Short-Term vs Long-Term
The side-effect story depends entirely on which study you read, and that is the source of most of the confusion online.
| Side effect | First 16 days: Apoquel | First 16 days: placebo | Long-term (months) |
|---|---|---|---|
| Diarrhoea | 4.6% | 3.4% | 6.0–6.1% |
| Vomiting | 3.9% | 4.1% | 9.2–10.1% |
| Loss of appetite | 2.6% | 0% | 3.2% |
| Lethargy | 2.0% | 1.4% | 2.8% |
| New skin lump | 2.6% | 2.7% | 12.0% (non-specified dermal lumps) |
| Skin infection (pyoderma) | — | — | 9.3–12.0% |
| Ear infection (otitis) | — | — | 9.3–9.9% |
| Urinary tract infection / cystitis | — | — | 3.5–11.3% |
| Histiocytoma (benign skin tumour) | — | — | 3.9% |
Short-term column: FDA label, 152 Apoquel vs 147 placebo dogs, days 0–16 (most placebo dogs left the trial by day 16). Long-term column: the label's 283 dogs given Apoquel across the masked and open studies, and Cosgrove 2015's 247-dog compassionate-use study of up to 630 days. Long-term figures have no placebo comparison.
On bloodwork, the label reports that dogs on Apoquel had lower white cell counts (neutrophils, eosinophils, monocytes) and serum globulin, and higher cholesterol and lipase than placebo dogs, though group averages stayed in the normal range. Cholesterol rose in 25% of dogs in the allergic-dermatitis trial. In the 247-dog long-term study, average bloodwork values also stayed within reference ranges. Dr. Eisenschenk, who reports starting more than 1,000 dogs on Apoquel, describes bone-marrow suppression showing up on bloodwork in about 1% of her patients, with no outward signs, recovering within weeks once the dose was reduced. Other reported effects after approval include raised liver enzymes, seizures, increased thirst, and rarely aggression.
In 2018 the FDA's Center for Veterinary Medicine told Zoetis that promoting Apoquel's side effects as "similar to placebo" was misleading, because the claim rested on a short-term study while a longer study found higher rates of infection, vomiting and diarrhoea.
That letter is the single most useful thing an owner can know about Apoquel safety, and none of the top-ranking pages mention it. The FDA pointed out that the manufacturer's own long-term study reported urinary tract infection or cystitis in 11.3% of dogs, vomiting in 10.1%, otitis and pyoderma in 9.3% each, and diarrhoea in 6.1% — findings it said were "consistent with" the label warning that Apoquel may increase susceptibility to infection. The practical takeaway is not that Apoquel is dangerous. It is that "almost no side effects" describes the first two weeks, and recurring ear, skin and bladder infections are the thing to watch for over months. Read the FDA letter.
Does Apoquel Cause Cancer?
This is the question behind the search "Apoquel killed my dog," and it deserves a straight answer from both sides of the evidence.
What the label says. The FDA label warns that Apoquel may exacerbate existing neoplastic conditions and that new benign and malignant tumours were seen during clinical studies. In the uncontrolled continuation study of 239 dogs (mean 372 days on Apoquel), six dogs were euthanised for suspected malignancies, two developed mast cell tumours, one a low-grade lymphoma, two apocrine gland adenocarcinomas and one an oral sarcoma. That sounds alarming, and the label lists it honestly. But there was no comparison group, and these were middle-aged and older allergic dogs, a population in which cancer is common regardless of treatment.
What the matched study found. The best answer to "compared with what?" is a 2020 study in the Journal of the American Veterinary Medical Association. Researchers compared 339 allergic dogs treated with Apoquel for at least six months against 321 age- and breed-matched allergic dogs treated before Apoquel existed, all with at least two years of follow-up.
The authors found no meaningful differences in malignancies (16.5% vs 12.8%), skin masses (56.6% vs 58.3%) or age at death (11.2 vs 11.8 years), and no link between the daily dose and the odds of cancer. They still told vets to follow the label warnings and screen allergic dogs for tumours whether or not they take Apoquel. It is one retrospective study from a single practice, so it is reassuring rather than final. Dr. Eisenschenk adds a clinical observation worth repeating: severe itchy skin can itself be a sign of an internal disease or cancer, so some dogs who "got cancer right after starting Apoquel" were likely already sick, and were given Apoquel for the itch before the cause was found.
Two cautions stand. Benign skin growths are a real effect: the label's safety study in healthy dogs found papillomas and a dose-related increase in interdigital cysts, histiocytomas appeared in 3.9% of treated dogs, and viral papillomas can be worse on Apoquel. Have any new lump checked. And if your dog has a history of cancer, that is exactly the case the label says to weigh carefully with your vet.
Why Apoquel Is Not for Puppies
The 12-month minimum age is not a formality. A safety study in 6-month-old dogs was stopped after four months because dogs given 3 and 5 times the dose developed bacterial pneumonia and generalised demodectic mange. In a vaccine study, puppies given a high dose still responded to rabies, distemper and parvovirus vaccines, but two puppies were euthanised, one with pneumonia and one with sepsis that the label attributes to immunosuppression. For itchy puppies, vets use other options.
Apoquel Dosage Chart by Weight
Apoquel comes in 3.6 mg, 5.4 mg and 16 mg scored tablets (a chewable version is also sold). The label dose is 0.4–0.6 mg/kg twice daily for up to 14 days, then once daily. It can be given with or without food; some dogs have less stomach upset with a meal. Your vet sets the dose, and this chart is what the label uses:
| Dog weight (lb) | Dog weight (kg) | 3.6 mg tablet | 5.4 mg tablet | 16 mg tablet |
|---|---|---|---|---|
| 6.6–9.9 | 3.0–4.4 | ½ | — | — |
| 10.0–14.9 | 4.5–5.9 | — | ½ | — |
| 15.0–19.9 | 6.0–8.9 | 1 | — | — |
| 20.0–29.9 | 9.0–13.4 | — | 1 | — |
| 30.0–44.9 | 13.5–19.9 | — | — | ½ |
| 45.0–59.9 | 20.0–26.9 | — | 2 | — |
| 60.0–89.9 | 27.0–39.9 | — | — | 1 |
| 90.0–129.9 | 40.0–54.9 | — | — | 1½ |
| 130.0–175.9 | 55.0–80.0 | — | — | 2 |
From the FDA-approved Apoquel label. The label approves twice-daily dosing for no more than 14 days; longer twice-daily use is off-label. Wash your hands after handling the tablets.
Price is a common reason owners look for alternatives: GoodRx lists Apoquel chewables at around $92 for 30 tablets, and there is no generic. Large dogs on 1½ to 2 of the largest tablets a day pay the most.
How Long Can a Dog Safely Stay on Apoquel?
Many dogs stay on it for years. In the manufacturer's long-term compassionate-use study, 247 dogs took Apoquel for up to 630 days; 63.9% kept their itch at least halved at day 90, and owners reported better quality of life in more than 91% of dogs. A 2025 safety review drawing on the post-approval reporting programme concluded that long-term use at the label dose carries no cumulative safety risk. What makes long-term use safer is monitoring, not luck. A practical protocol from a veterinary dermatology clinic that has used it in more than 1,000 dogs:
- Bloodwork before starting — a complete blood count (CBC) and chemistry panel, and a check that there is no liver disease or active infection.
- Recheck at about 3 months. The CBC is the most important test, because it is where bone-marrow effects show up first.
- Then at least once a year, and sooner in older dogs or any dog on other immune-affecting drugs.
- Use the lowest dose that controls the itch. The label does not approve long-term twice-daily dosing.
- Treat infections first. Yeast, bacterial or mite infections stop Apoquel working well, and the drug should not be used in a dog with a serious infection.
- Check new lumps and recurring ear, skin or bladder infections with your vet rather than waiting for the annual visit.
Apoquel works quickly and also stops working quickly, so a dog does not usually need to be weaned off it the way dogs on long-term prednisone do. Expect the itch to return within a day or two of stopping. The label notes it has not been evaluated in combination with steroids, cyclosporine or other systemic immunosuppressants.
When to Call Your Vet
- Same day: fever, coughing or fast breathing, marked lethargy, blood in vomit or stool, pale gums, a seizure.
- Within a few days: a new or changing lump, a skin or ear infection that keeps coming back, straining or frequent urination, vomiting or diarrhoea that lasts beyond the first week.
- At the next visit: itch that rebounds after the switch to once daily, weight gain, or the feeling that it "isn't working like it used to."
Suspected side effects can be reported to Zoetis at 1-888-963-8471 or to the FDA at 1-888-FDA-VETS.
Can You Give CBD With Apoquel? What the Studies in Itchy Dogs Show
We make a hemp product, so here is our honest summary, including the parts that don't flatter it. Hemp is not a replacement for Apoquel in a dog with moderate or severe allergic itch, and it does nothing about the underlying allergy. Four studies have looked at cannabinoids in dogs with atopic dermatitis:
| Study | Design | What it found |
|---|---|---|
| Loewinger 2022, Vet Dermatology | Randomised, double-blind, placebo-controlled; 32 dogs; 2 mg/kg CBD + CBDA for 4 weeks; existing treatments continued | Owner-scored itch significantly lower than placebo at day 14 (p=0.04) and day 28 (p=0.01). Skin lesions did not improve. Alkaline phosphatase rose in 4 of 17 treated dogs. |
| Mariga 2023, Front Vet Sci | 14 dogs, full-spectrum high-CBD oil 2.5 mg/kg vs olive oil | No significant difference in itch, lesion scores or skin biopsies. |
| Mariga 2026, Front Allergy | 16 dogs already on Apoquel with poor control; fixed sequence: placebo month, then cannabis oil 2 mg/kg CBD twice daily, then Apoquel cut by 50% | Itch was lower than baseline after adding the oil and stayed controlled after the 50% Apoquel cut. But the placebo month vs oil month was not significantly different, and lesion scores did not change. The oil contained some THC (2.11% of cannabinoids), so it was not a US hemp product. |
| Mogi 2022, Can Vet J | Retrospective review of 8 dogs on THC-free CBD alongside other drugs | Well tolerated; itch reduced. No control group. |
Read together: there is one properly controlled trial showing a modest effect on itch and none on the skin itself, one null trial, and two weaker studies pointing the same hopeful direction. A 2025 review in Veterinary Sciences reached the same conclusion — promising, but limited by few placebo-controlled trials and inconsistent products. That is a reason to discuss hemp with your vet as a possible add-on, not a reason to stop a drug that is working.
On combining them: no study has formally measured how CBD and oclacitinib affect each other's blood levels. What we do know: the Apoquel label says oclacitinib barely inhibits the dog's liver enzymes (at 50 times the normal blood level). CBD in dogs inhibits the CYP2B11 and CYP2D15 enzymes but not CYP3A12, the main canine counterpart of the human enzyme most interaction warnings are based on (Court 2024). Dogs in both the Loewinger and Mariga 2026 trials took CBD alongside their existing treatment, including Apoquel in the 2026 study, without serious adverse events. CBD itself can raise alkaline phosphatase, so tell your vet before adding it; they may want it on the recheck bloodwork. Our full rundown is in Hemp & CBD Side Effects in Dogs.
Our own university research is in joint discomfort, not skin, so we will not borrow it for an itch claim: in our 90-day Colorado State University study, 30 of the 32 dogs that completed it showed a benefit for mobility and comfort.
Grown and bottled on our own Colorado farm and given to the 37 dogs in our 90-day study. Not a replacement for Apoquel or any prescription; if your dog is on Apoquel, talk to your vet before adding anything. Third-party tested every batch. $99
Shop 1,000mg Hemp Seed Oil → See the StudyApoquel Alternatives: What Vets Actually Use
If Apoquel isn't controlling the itch, isn't affordable, or isn't appropriate for your dog, these are the options a vet or veterinary dermatologist will weigh:
| Option | How it works | Speed | Main trade-off |
|---|---|---|---|
| Cytopoint (lokivetmab) | Antibody injection that neutralises IL-31, the itch cytokine | Days; one shot lasts about 1–2 months | Cost rises with weight; targets itch rather than inflammation broadly; does not suppress bone marrow |
| Zenrelia (ilunocitinib) | Newer once-daily JAK inhibitor | Fast | Boxed warning on inadequate vaccine response: stop 28 days to 3 months before vaccines and 28 days after. A 2026 case report described pancytopenia in an MDR1-mutant dog. |
| Cyclosporine (Atopica) | Calcineurin inhibitor | Several weeks | More stomach upset — about three times as many GI adverse events as Apoquel in a 226-dog head-to-head trial; generics available |
| Steroids (prednisone, prednisolone) | Broad anti-inflammatory | 1–2 days | Thirst, urination, hunger and weight gain; longer use carries bigger risks |
| Antihistamines (Zyrtec, Benadryl) | Block histamine | Hours | Help a minority of allergic dogs — about 30%, according to a University of Arizona veterinary dermatologist quoted by the AKC |
| Allergy shots (immunotherapy) | Retrains the immune response to specific allergens | Months to a year | Upfront testing cost; the only option that addresses the allergy rather than the itch |
| Diet, omega-3s, skin care | Support the skin barrier | Weeks | Add-ons, not stand-alone fixes for moderate disease. One trial found a marine-oil supplement reduced the rebound after the Apoquel dose drop. |
Sources: Little 2015 (Apoquel vs cyclosporine) · FDA Dear Veterinarian letter on Zenrelia · Mealey 2026 · AKC · Nishiyama 2023
Before switching, ask whether the itch is coming from something Apoquel can't fix. Fleas, food allergy, and secondary yeast or bacterial infection all keep a dog itchy on any drug. Our guides to treating allergies in dogs, home remedies for dog itching, hot spots and paw licking walk through how to tell them apart.
Questions Worth Asking Your Vet
- Have we ruled out fleas, food allergy and skin infection as the cause of the itch?
- When do you want bloodwork — before starting, at 3 months, and how often after that?
- What should I do if the itch comes back after we drop to once a day?
- Given my dog's age and history, how do you weigh the lump and infection warnings?
- Would Cytopoint, allergy testing or a diet trial make sense instead of, or alongside, Apoquel?
- Is it safe to add a hemp supplement, and should we track liver enzymes if I do?
Apoquel for Dogs: Frequently Asked Questions
Is Apoquel just Benadryl?
No. Benadryl (diphenhydramine) is an antihistamine. Apoquel (oclacitinib) is a JAK inhibitor that blocks the signalling of itch and inflammation cytokines such as IL-31 inside cells; its FDA label states it is not a corticosteroid or an antihistamine. It works faster and for more dogs than antihistamines, but unlike Benadryl it is a prescription immunomodulator with infection and tumour warnings.
What are the negatives of Apoquel?
The label warns it may increase susceptibility to infection, including demodectic mange, and may worsen existing cancers. In the manufacturer's long-term study, urinary tract infection or cystitis occurred in 11.3% of dogs, vomiting in 10.1%, and ear and skin infections in 9.3% each. It is not for dogs under 12 months, it costs around $92 for 30 chewables with no generic, itch can rebound when the dose drops to once daily, and it does not work for every dog.
What problems can Apoquel cause in dogs?
Short term, mostly mild vomiting, diarrhoea, loss of appetite and lethargy, at rates close to placebo in the first 16 days. Over months, recurring skin, ear and bladder infections, benign skin growths such as histiocytomas and papillomas, lower white cell counts and higher cholesterol. After approval, raised liver enzymes, seizures, increased thirst and demodicosis have also been reported.
How long can a dog safely take Apoquel?
Many dogs take it for years. Dogs in the manufacturer's compassionate-use study took it for up to 630 days, and a 2025 safety review concluded that long-term use at the label dose carries no cumulative safety risk. Long-term use is safest with bloodwork before starting, at about 3 months and then at least yearly, at the lowest dose that controls the itch.
Does Apoquel cause cancer in dogs?
The best matched study, of 660 allergic dogs, found no meaningful difference: malignancies in 16.5% of dogs on long-term Apoquel versus 12.8% of age- and breed-matched dogs without it, with similar age at death (11.2 vs 11.8 years). The label still warns that Apoquel may worsen existing cancers, and new tumours were seen in clinical studies, so vets weigh it carefully in dogs with a cancer history and check new lumps.
What can I give my dog instead of Apoquel?
Prescription alternatives include Cytopoint injections, Zenrelia (another JAK inhibitor), cyclosporine and steroids. Allergy testing and immunotherapy are the only options that address the allergy itself. Antihistamines such as Zyrtec help only a minority of dogs. Omega-3s, prescription skin diets and medicated bathing are useful add-ons. Ruling out fleas, food allergy and skin infection comes first.
Can I give my dog Zyrtec instead of Apoquel?
For mild itch, some vets will try cetirizine first, but antihistamines help only about 30% of dogs with environmental allergies, according to a veterinary dermatologist quoted by the AKC. Dogs with moderate or severe atopic dermatitis usually need something stronger. Ask your vet for the right dose; our Zyrtec for dogs guide covers the weight chart.
Is Cytopoint better than Apoquel?
Neither is better for every dog. Cytopoint is an injection that neutralises IL-31 and lasts about one to two months, does not suppress bone marrow, and suits dogs who are hard to pill or cannot take Apoquel. Apoquel is a daily pill that also dampens broader inflammation and can be stopped quickly. Some dogs that do poorly on one do well on the other.
Can I get Apoquel without a vet prescription?
No. Federal law restricts Apoquel to use by or on the order of a licensed veterinarian, and the label requires that dogs be at least 12 months old and free of serious infection. Your vet will usually want bloodwork before starting.
Can you give CBD with Apoquel?
No study has formally measured the interaction. Oclacitinib barely inhibits canine liver enzymes, and CBD does not inhibit CYP3A12 in dogs. In a 2026 study, dogs on Apoquel took a CBD-rich oil alongside it without serious adverse events, and itch stayed controlled after the Apoquel dose was halved, though the oil did not beat placebo directly. CBD can raise alkaline phosphatase, so tell your vet before adding it.
What is the new alternative to Apoquel for dogs?
Zenrelia (ilunocitinib) is a newer once-daily JAK inhibitor. It carries a boxed warning on inadequate vaccine response: it should be stopped 28 days to 3 months before vaccination and withheld for at least 28 days after. Your vet can compare it with Apoquel and Cytopoint for your dog.
Full-spectrum hemp from our own Colorado farm — a possible add-on to discuss with your vet
250mg Hemp Seed Oil Dogs under 25 lb $49 1,000mg Hemp Seed Oil Medium and large dogs — the trial formula $99 
500mg Hemp-Infused Coconut Oil Our edible or rub-on format for dry spots $89
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Taking Apoquel or any other prescription? Check with your vet before adding hemp, and see what the studies found on side effects.
The Short Version
Apoquel is a fast, effective itch drug that most dogs tolerate well, and the best matched study found no meaningful increase in cancer. Its real long-term trade-off is a higher rate of ear, skin and bladder infections, which the FDA said the manufacturer's early marketing understated. Get bloodwork before starting and at three months, use the lowest dose that works, expect a possible itch rebound in week three, and have new lumps checked. If you want to try hemp, treat it as a vet-approved add-on with modest, early evidence for itch, not a swap.
Treating Allergies in Dogs · Zyrtec for Dogs · Benadryl for Dogs · Prednisone Side Effects · Home Remedies for Itching · CBD Side Effects
Marc co-founded HempMy Pet in 2016 with his business partner Natalie Mondine, the company's COO. HempMy Pet breeds its own hemp genetics, grows them on its own Colorado farm, and formulates every batch in-house under human-grade standards — seed to sale, nothing sourced overseas. Every batch is third-party tested and the certificates of analysis are published. More about us.
HempMy Pet ran its own 90-day study of 37 dogs with chronic joint discomfort. Of the 32 that completed it, 30 (93%) showed a benefit, and 94% of owners reported their dog's quality of life had improved. It was overseen by Dr. Robin Downing, DVM, MS of the Downing Center for Animal Pain Management, with Lori Kogan, Ph.D. and Peter W. Hellyer, DVM of Colorado State University's College of Veterinary Medicine & Biomedical Sciences, and published in the Journal of the American Holistic Veterinary Medical Association. Read the methodology.
Why Dr. Downing: in 2005 she became only the third veterinarian in the world credentialed as a Diplomate of the American Academy of Pain Management. She founded the International Veterinary Academy of Pain Management, is a Diplomate of the ACVSMR, a Certified Veterinary Pain Practitioner and a Certified Canine Rehabilitation Practitioner, and was the AVMA's 2020 Bustad Companion Animal Veterinarian of the Year. Read the published paper (PDF).
This article is general information for dog owners, not veterinary advice. It is reviewed and updated as new peer-reviewed evidence is published, and where the evidence is thin or negative we say so.
How We Sourced This Article
Every claim above traces to one of these.
- Zoetis / FDA — Apoquel (oclacitinib tablet) FDA-approved label, NADA 141-345, revised December 2020. Dose chart, warnings, field-study adverse reactions, continuation study, safety studies in 6- and 12-month-old dogs, vaccine study, pharmacokinetics.
- US FDA Center for Veterinary Medicine — 2018 letter to Zoetis regarding Apoquel risk presentation.
- Cosgrove SB, et al. A blinded, randomized, placebo-controlled trial of the efficacy and safety of oclacitinib in client-owned dogs with atopic dermatitis. Vet Dermatol. 2013. PubMed.
- Cosgrove SB, et al. Long-term compassionate use of oclacitinib in dogs with atopic and allergic skin disease. Vet Dermatol. 2015. PubMed.
- Lancellotti BA, et al. Age- and breed-matched retrospective cohort study of malignancies and benign skin masses in 660 dogs with allergic dermatitis treated long-term with versus without oclacitinib. J Am Vet Med Assoc. 2020. PubMed.
- Olivry T, et al. Rebound-preventing benefit of four days of prednisolone during oclacitinib induction. Vet Dermatol. 2023. PubMed. Nishiyama, oclacitinib with marine oil extract, 2023. PubMed.
- Little PR, et al. Oclacitinib vs ciclosporin, 226 dogs. Vet Dermatol. 2015. PubMed. Nederveld, safety of oclacitinib in dogs (review), J Vet Pharmacol Ther. 2025. PubMed.
- Cannabinoid studies in canine atopic dermatitis: Loewinger 2022 · Mariga 2023 · Mariga 2026 · Mogi 2022 · review Bizarro 2025. CBD and canine liver enzymes: Court 2024.
- Zenrelia: FDA Dear Veterinarian letter · AAHA · Mealey 2026.
- Clinical experience and owner guides: Dr. Melissa Eisenschenk, DVM, DACVD · AKC · GoodRx.
- Kogan L, Hellyer P, Downing R. The Use of Cannabidiol-Rich Hemp Oil Extract to Treat Canine Osteoarthritis-Related Pain: A Pilot Study. J Am Holist Vet Med Assoc. 2020;58:35–45. Our disclosure: HempMy Pet supplied the hemp extract and reimbursed clinic costs; we had no involvement in any other study cited here.
Spot something that conflicts with your veterinarian's advice? Email support@hempmypet.com and we will correct it.
These statements have not been evaluated by the Food and Drug Administration. Our products are not intended to diagnose, treat, cure, or prevent any disease. This article is general information, not veterinary advice. Apoquel is a prescription medication — never start, stop or change your dog's dose without your veterinarian.
