Rise in Apoquel ingestion calls puts focus on feline risk

Calls to Pet Poison Helpline about accidental Apoquel ingestions are climbing, and the trend is drawing wider attention because the most severe cases appear to involve cats exposed to the flavored chewable product intended for dogs. In the latest warning, the service described a cat that became seriously ill after consuming a dog’s recently refilled Apoquel supply, underscoring how quickly a routine dermatology prescription can turn into an emergency in a multi-pet home. (prnewswire.com)

The backdrop is the June 2023 FDA approval of Apoquel Chewable, a pork-liver-flavored oclacitinib formulation for control of pruritus associated with allergic dermatitis and atopic dermatitis in dogs at least 12 months old. The flavor may improve administration and adherence, but it also appears to increase the chance that dogs, and especially cats, will seek out the medication if it’s left within reach. FDA consumer guidance published in 2026 says overdose reports involving the chewable formulation have been increasing since launch. (news.zoetis.com)

Pet Poison Helpline’s account adds clinical detail to that broader signal. In the case it publicized, a cat named Tangerine was the only one of five cats in the home showing early signs after a bottle was found empty, but toxicologists warned that the threshold for concern in cats can be low and advised close monitoring of all exposed pets. The organization said it has seen an increasing number of Apoquel-related calls over the last few years and used the case to remind pet parents that large overdoses and exposure in unprescribed animals can be dangerous. (prnewswire.com)

Independent reporting and case literature suggest the problem is not isolated. The FDA says that, as of April 2, 2026, it had received 259 reports of overdose in dogs and 64 in cats involving Apoquel Chewable since approval in June 2023. It also states that cats are more likely than dogs to experience serious side effects, with signs typically appearing within 24 hours and including GI upset, lethargy, ocular changes, and effects on the heart, brain, kidneys, and liver. A 2026 feline case series in the Journal of Veterinary Emergency and Critical Care described three cats with severe acute kidney injury and systemic complications after accidental ingestion of large overdoses; two died or were euthanized, and one recovered after intensive supportive care. (fda.gov)

Clinicians at NC State have also reported seeing cats become severely ill after ingesting chewable Apoquel from dogs in the same household. In an August 5, 2025, university alert, emergency and nephrology specialists said two cats required hemodialysis but recovered, while noting that earlier reports of very high ingestions had resulted in death. One expert quoted in that report said the hospital’s incidence of Apoquel ingestion-related toxicity had increased since the chewable formulation was released, and another said veterinarians should consider whether cats are present in the home before prescribing the chewable version. (cvm.ncsu.edu)

Why it matters: For veterinary professionals, this is a reminder that formulation changes can reshape risk even when the active ingredient is familiar. Apoquel has long been a mainstay in canine allergy management, but the chewable’s palatability changes the exposure profile in ways that matter for triage, dispensing, and client education. Practices may want to build mixed-pet household screening into prescribing workflows, reinforce safe-storage counseling at every refill, and make sure teams are ready to escalate suspected feline exposures quickly because serious renal and hepatic injury can follow. That’s an inference based on the FDA’s overdose data, poison-control reporting, and the emerging feline case literature. (fda.gov)

There’s also a pharmacovigilance angle. The FDA is explicitly encouraging reporting of Apoquel Chewable overdose incidents to Zoetis and through FDA adverse-event channels, which suggests regulators are still building the post-approval safety picture. For practices, that means every exposure case may carry value beyond the individual patient, especially as the profession works to define what dose ranges are most dangerous in cats and whether additional risk-mitigation steps will be needed. (fda.gov)

What to watch: Watch for more case reports, updated manufacturer or FDA safety communications, and possibly stronger prescribing guidance for households with both dogs and cats as post-market data continue to accumulate. (fda.gov)