Freya, a 7-year-old Belgian Malinois, successfully recovered after a team at the Texas A&M Small Animal Teaching Hospital (SATH) used hemoperfusion to remove excess oclacitinib (Apoquel; Zoetis) from her bloodstream. The overdose resulted from her eating a significant amount of the medication, as she managed to shred containers left on a countertop and consumed around six months' worth of the drug.
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Freya's owner, Chris Baron, contacted the Pet Poison Helpline (PPH) for guidance, which led to her transfer to an emergency facility in Katy, Texas. After the staff there reached out to the helpline, a PPH veterinary toxicologist advised the transfer to Texas A&M for hemoperfusion, a procedure effective at clearing specific toxins from the bloodstream.
Upon arrival at Texas A&M, several hours had elapsed since Freya had taken the medication. The short half-life of oclacitinib made timely intervention critical to ensure effective removal of the drug before it was eliminated naturally. Dr. Lance Wheeler, a clinical assistant professor of emergency and critical care, noted that waiting until morning would render treatment ineffective.
The hemoperfusion began approximately three hours after Freya's arrival. Prior to the procedure, she underwent emergency evaluations and diagnostic testing, and the team ensured blood was available for possible transfusions. The hospital has a dedicated training program for veterinary technicians handling hemoperfusion cases, which was crucial for her care.
During treatment, Freya's condition changed; she initially appeared stable, but later became lethargic and experienced an increased heart rate. However, by the halfway mark of the procedure, her heart rate stabilized, her awareness improved, and she started to engage with her surroundings. The veterinary team monitored her clinical signs, opting to extend the procedure beyond a set duration, ultimately treating approximately 30 blood volumes over 3.5 hours.
Dr. Wheeler highlighted the collaborative effort with PPH to devise the treatment plan, reflecting a growing trust in Texas A&M's expertise in hemoperfusion. After several days in the hospital and additional treatment, Freya's follow-up blood work returned to normal, and she showed no lasting effects from the overdose.
The rise in calls to the PPH regarding oclacitinib amounts indicates a growing concern surrounding potential overdoses. The Pet Poison Helpline documented an upward trend in reported cases over the past years, noting that serious side effects are typically associated with significant ingestions or accidental consumption by cats. As of April 2, 2026, the FDA had received numerous overdose reports since the chewable form of the drug was approved in June 2023, underscoring the need for careful storage and handling in multi-pet households.