The U.S. FDA Approval of Librela™ (bedinvetmab injection) to Control Osteoarthritis (OA) Pain in Dogs. A similar biological Solensia TM has already been approved in cats in the United States.
Librela has been approved in Canada and Europe since 2021 and has been very helpful for many dogs with osteoarthritis pain. The feedback that I have been getting from my colleagues in Canada and Europe has been very good.
As a holistic and integrative practitioner, I must consider if a Western medicine treatment contributes to a pet's quality of life significantly. Pain is something to be taken very seriously if it compromises the quality of life significantly.
September is National Pain Awareness Month
Since this month is pain awareness month, I'm reviewing the latest treatment for pain in dogs and cats. This blog post will review how these drugs work, situations for their use in chronic pain, and precautions regarding their use.
When you have been doing everything for your Dog or Cat's arthritis pain, but their quality of life still suffers
When you have been doing absolutely everything for your dog's arthritis: acupuncture, veterinary chiropractic, rehabilitation, weight management, nonsteroidal anti-inflammatory drugs, other pain medications, and supplements, but your dog's quality of life still suffers, you might consider Librela or Solensia.
Because sixty percent of a dog's weight is born on its front end, dogs with elbow arthritis tend to experience great pain simply walking and especially going downstairs. The elbow joint is very unforgiving when it comes to a dog's mobility. It's a hinge joint with very little give that does not absorb weight well. It's very unforgiving, especially when it comes down to bone-on-bone arthritis.
Elbow and shoulder arthritis can be the most difficult areas of arthritis to treat in pets. That is why walking downstairs or walking on painful elbows can be a dealbreaker for the quality of life of these pets.
Traditional treatments often involve long-term use of anti-inflammatory drugs, which can have side effects and may not fully alleviate the pain. Pets may still struggle to get up and walk even with traditional drugs. They are more prone to urinary tract infections and muscle atrophy as they tend to lay down and go outside less. This leads to weight gain and less movement, which leads to more atrophy and pain. It's a vicious cycle.
Librela Is the First and Only Monthly Injectable Monoclonal Antibody Therapy for Dogs With OA Pain
Western medicines have evolved to use biologicals in the treatment of many conditions. Librela for dogs and Solensia for cats are two examples of such biologicals.
How do these drugs work?
Librela and Solensia Target OA Pain With a Unique Mode of Action. Solensia (Frunevetmab) for cats and Librela (Bedinvetmab) for dogs are anti-nerve growth factor injections that are both specific to their species. Nerve growth factor NGF is a protein that helps maintain neurons and is considered "neuroprotective." It plays an important role in the regeneration and repair of nerves.
After an injury or inflammation, nerve growth factor NGF is released, which calls on inflammatory cells to help repair the injury. This is a good thing in the case of injury. But this backfires in the case of chronic pain.
Librela and Solensia work by blocking the nerve growth factor and work on this aspect of maladaptive pain. Our pets' bodies naturally produce NGF. When an animal has arthritis, the increased NGF levels lead to pain and inflammation. This is the aspect of pain that is considered maladaptive, i.e., nerve growth factor has done its job of alerting the body to signs of a potential injury or problem.
Librela and Solensia use therapeutic monoclonal antibodies to bind to NGF, preventing it from attaching to nerve cells and triggering pain signals. It's like adding a lock to a door that unwanted guests frequently use. Once the lock is in place (the therapeutic monoclonal antibodies), the guests (NGF) can no longer enter, providing relief from pain and inflammation. One Monthly Injection of Librela Can Reduce Your Dog's OA Pain
Reducing pain helps improve the quality of life for your cats
Solensia is the feline version of Librela and works by the same mechanism.
Solensia has been demonstrated to effectively control OA pain in Cats with a monthly injection
Cats are masters at hiding pain, making it challenging to diagnose and treat arthritis in our feline friends. Solensia, the first cat-specific anti-NGF antibody, offers a solution. It provides longer-lasting pain relief and improved mobility, helping cats live more comfortable lives.
Owners experienced improvement with a monthly injection, and the feedback from pet owners has been very positive.
How effective is Solensia in cats?
Research has shown that Solensia is not only effective in managing pain and inflammation in cats with osteoarthritis but also well-tolerated with manageable side effects. The FDA has approved this groundbreaking treatment, marking it as the first monoclonal antibody for use in any animal species for pain control.
In a 3-month study, 77% of cat owners reported an improvement in signs of pain when their cats were treated monthly with Solensia. Many cats showed improvement after 1-2 doses.
The most common adverse events included dermatitis at the injection site.
How long does a Solensia injection last?
Each animal is different, but an injection may last 3-6 weeks.
Important Safety Information for Solensia
Do not use in animals under 12 months (their nervous system is developing) or in animals that are pregnant or lactating.
Safety and efficacy have not been established for cats with IRIS Stage III or IV renal failure (creatinine over 2.9). Therefore, caution should be used with Solensia for cats with advanced renal disease. Discuss the benefits/risks with your veterinarian.
Until we know more, there are other strategies, such as using a modified low dose of meloxicam to control arthritis which has not been shown to worsen renal failure in cats.
Librela Is Approved as a Safe and Effective
Librela bedinvetmab injection was approved in the UK in 2020, so we know it has been around for a while. Common adverse events reported include: Anaphylaxis or injection site irritation (dermatitis) could potentially occur.
How effective is Librela for dogs?
In clinical trials, 47.4% of Librela-treated dogs achieved treatment success, compared to 36.6% of dogs given a placebo.
Is there a catch with Librela? Is this too good to be true?
As someone whose practice saw many pets with osteoarthritis pain plateau even with acupuncture, veterinary chiropractic, and as many holistic modalities as we could employ, I'd heard about Librela and the success veterinary professionals were having in the UK, and my clients were keen on doing whatever they could for their beloved pets with osteoarthritis or pain.
The downside is that I can foresee that there will be a shortage of Librela bedinvetmab injections as so many dogs are living longer, and many of these dogs have osteoarthritis pain. So if you are interested in Librela for your dog, you should let your veterinarian know right away, and hopefully, they will have a list of pet owners interested in this for their dog.
Playing the devil's advocate, the nerve growth factor has an important role in nerve repair, so there could be a potential issue for pets with neurological issues. The drug was only tested on pets with osteoarthritis, not dogs with degenerative myelopathy or other neurological problems.
With strictly osteoarthritis pain, it makes sense that this would help.
What are the side effects of the Librela shot for dogs?
The most common side effects associated with Librela are mild injection site reactions, such as swelling and heat. These reactions are typically manageable.
Of course, with any medication, a contraindication is an allergy to it, but this is apparently very rare.
How much does Solensia cost?
And just like anything else, you can try it once or twice, and if your cat has improved significantly, it's completely worth the price, which can be $80-100 per month.
How much does Librela cost?
Since it is not yet released here, it's hard to say what the cost will be. I would anticipate it to be at least $150 for an injection. But hey, with the price of gas these days, it could be more in a few minutes!
Can Feline Urinary Tract Disease Benefit From Solensia?
Cats with feline lower urinary tract pain/cystitis, painful stomatitis, and pancreatitis may also benefit from Solensia.
Can Feline Stomatitis Benefit From Solensia?
This is considered an off-label use of the drug, so you would have to discuss this application with your veterinarian, but I have heard that it has been used off-label and has been beneficial for this very painful condition.
