Key Highlights

• This blog post provides an update on Librela, an injection in veterinary medicine used to alleviate pain associated with osteoarthritis in dogs.
• Studies have shown that Librela can significantly improve pain scores and quality of life in dogs with osteoarthritis pain.
• The most common side effects of Librela include mild injection site reactions, but more serious side effects such as renal and urinary tract disorders and neurological disorders have also been reported mostly in dogs with other chronic diseases.
• Many of the dogs with adverse side effects had concurrent issues such as kidney disease, neurological issues, or cancer.

Introduction

I was excited to see a new option for dogs suffering from osteoarthritis. The drug had been approved in Europe before its approval for dogs here in the United States. I had not heard any adverse effects, only that it benefited dogs in cases where they were doing everything they could to manage pain. I had many of these patients that are doing acupuncture, physical therapy, and medications to manage their dog's painful arthritis, but they still suffered. It's important to remember that not every pain protocol works for every dog or person, and having options when nothing seems to be working is a good thing.

Librela was granted marketing authorization by the European Medicines Agency (EMA) in 2020 and has been used by veterinarians in Europe for over two years as a treatment option for OA pain in dogs. In two field studies, dogs administered Librela as a monthly injection demonstrated a reduction in OA pain compared to dogs that received the placebo. Librela was shown to improve mobility and overall quality of life. Understanding the results of these field studies is essential in considering the use of Librela for dogs with osteoarthritis.

A recent Wall Street Journal article covered concerns that dogs were possibly deteriorating rapidly or declining after receiving Librela (1). Zoetis, a company specializing in osteoarthritis (OA) therapies for dogs and cats, is defending the safety and efficacy of its bedinvetmab injection (Librela) and frunevetmab injection (Solensia) products following concerns raised by the Wall Street Journal article. Pet owners reported instances where their animals experienced adverse reactions to these drugs, including cases where animals became sick rather than showing improvement in their conditions. Despite these reports, Zoetis representatives, including Richard Goldstein, the company's global chief medical officer, emphasized that the majority of patients using these drugs have benefited from them, attributing adverse events to rare occurrences, as seen with any medication.

What is Librela?

Librela contains the active substance bedinvetmab, which is a monoclonal antibody. Monoclonal antibodies are artificially created antibodies that are designed to bind to a specific protein in the body. In the case of Librela, bedinvetmab is designed to bind to nerve growth factor (NGF), a protein involved in pain signaling.

Addressing Safety Concerns and Adverse Events

Librela offers a promising solution for dogs suffering from arthritis. As a monthly injection, it provides long-lasting pain relief and improved overall quality of life for dogs with canine osteoarthritis. By targeting nerve growth factor (NGF) and interrupting the transmission of pain signals, Librela helps to alleviate pain and improve mobility.

Studies have shown that Librela significantly improves pain scores and weight-bearing ability in dogs with canine osteoarthritis. While it is an effective treatment option for dogs with arthritis, it's important to note that the dogs actually have osteoarthritis and not kidney or neurological disease, as these dogs could potentially have complications. The drug has not been studied in these dogs, only in dogs with osteoarthritis.

Real Life Side Effects

While Librela can provide effective pain relief for dogs with arthritis, it is important to be aware of the potential side effects. While not all dogs will experience side effects, some common side effects of Librela include mild injection site reactions, such as swelling and heat.

More serious side effects have also been reported, including renal and urinary tract disorders, neurological disorders, and gastrointestinal issues. An article in the Wall Street Journal tells the story of several dogs that had a precipitous decline after receiving Librela injections. Pet owners are blaming the drug for causing a rapid decline in their dogs, including weight loss, urinary tract infection, and other related issues.

Safety Information: Unpacking the Reported Side Effects

Reported side effects of Librela can vary in severity and may include injection site reactions, renal and urinary tract disorders, neurological disorders, and gastrointestinal issues.

Some dogs may experience mild injection site reactions, such as swelling and heat, while others may exhibit more severe symptoms. While the reported side effects are relatively rare (less than 1%), it is important to be aware that they can occur.

Adverse Effects: Neurological and Kidney Concerns in Dogs

Librela, like any medication, carries the potential for adverse effects, including neurological and kidney concerns. While rare, these side effects should be considered when deciding to use Librela for your dog. Neurological side effects may include ataxia (loss of coordination) and seizures, while kidney concerns may involve changes in kidney function.

Monitor your dog closely after receiving a Librela and report any concerns to your veterinarian. Your veterinarian can help assess the risks and benefits of using Librela for your dog, taking into account their individual health status and any pre-existing conditions.

Librela Can Reduce Chronic Pain In Dogs – But At What Cost?

Librela offers significant pain relief for dogs with arthritis, improving their quality of life and overall well-being. However, it is important to consider the cost-benefit analysis when using Librela. While it provides pain relief, it also carries the potential for side effects and risks, especially in older dogs with more than just osteoarthritis.

The monthly injection schedule and the potential for adverse effects should be carefully considered when deciding if Librela is the right treatment for your dog.

When Do Vets Recommend Librela?

Veterinarians may recommend Librela for dogs with arthritis when they determine that the potential benefits outweigh the potential risks in dogs with osteoarthritis.

Veterinarians may recommend Librela when other treatment options have been unsuccessful.

What Can You Try for Chronic OA Pain Before Using Librela?

• Acupuncture
• Cold Laser Therapy
• Pulse Magnetic Therapy
• Physical Therapy, Massage/Manual therapy
• Traditional Western Nonsteroidal Anti-inflammatories
• Other pain medications in combination, such as gabapentin, amantadine, and Adequan
• Adequan
• Herbal medicines prescribed by a veterinarian experienced in their use

It's about quality of life, and pain is a deal breaker. After consideration of all these factors, veterinarians and pet owners can make an informed decision about the use of Librela and provide the best possible care for their patients.

Cases Where Caution is Advised

While Librela can be an effective treatment for dogs with arthritis, there are cases where caution is advised. Veterinarians will carefully evaluate each dog's individual health status and consider any pre-existing conditions before recommending Librela.

Dogs with underlying kidney or neurological issues may be at a higher risk of experiencing adverse effects from Librela. It is important for pet owners to discuss their dog's medical history and any concerns with their veterinarian before starting treatment. By taking these precautions, veterinarians can ensure the safety and well-being of their patients and provide the most appropriate treatment plan for each individual dog.

Comparative Analysis: Librela vs. Veterinary Arthritis Treatments

Librela offers a unique approach to managing arthritis pain in dogs. It targets nerve growth factor (NGF) to interrupt pain signals and provide relief as the active ingredient in the medication. In comparison, traditional arthritis treatments often focus on reducing inflammation and providing pain relief through nonsteroidal anti-inflammatory drugs (NSAIDs) and other medications. While traditional treatments have been effective for many dogs, Librela offers a new option for dogs that do not respond well to these medications or have adverse reactions to them. The choice between Librela and traditional treatments should be based on the individual dog's needs, health status, and response to different treatment options.

Pros and Cons of Librela Over Conventional Methods

Librela offers several advantages over conventional methods of managing arthritis pain in dogs. Some of the pros include:

• Targeted pain relief: Librela specifically targets nerve growth factor (NGF) to interrupt pain signals and provide relief, offering a more targeted approach to pain management.
• Improved quality of life: Studies have shown that Librela can significantly improve pain scores and overall quality of life in dogs with osteoarthritis.
• Monthly dosing: Librela is administered as a monthly injection, providing long-lasting pain relief and convenience for pet owners.

However, it is important to consider the potential risks and side effects of Librela when compared to conventional treatments. Consulting with a veterinarian can help weigh the pros and cons and determine the best treatment approach for each individual dog.

Conclusion

In conclusion, it's essential to weigh the benefits against the potential drawbacks. Veterinary insights play a crucial role in recommending Librela, highlighting cases where caution is advised.

What Are Monoclonal Antibodies?

Monoclonal antibodies are lab-created molecules designed to target specific proteins in the body. They can be used in various medical treatments, including cancer therapy and autoimmune diseases. These antibodies are precise and effective in binding to their intended targets.

What Are Monoclonal Antibodies?

Monoclonal antibodies are laboratory-made proteins that can bind to specific substances in the body. They are designed to target and neutralize harmful cells or proteins, helping the immune system fight diseases like cancer and autoimmune disorders.

My Recommendation: Monoclonal Antibody Medicines Should Be Unless Your Final Option …

As a veterinarian, I advise caution when considering the use of monoclonal antibody (mAb) medicines, including Librela, for dogs with arthritis. While these medicines can provide effective pain relief, they also carry potential risks and side effects. It's also important to note, and the Wall Street Journal article indicated, that these medications are developed but not put on the market due to "safety issues."

It concerns me when I see obese dogs taking these drugs when weight management should be the first course of action. Yes, it's important to get these dogs moving again, and part of that is pain management, but there are plenty of other ways to address pain, and pet owners should seek the help of a physical therapist or animal rehabilitation specialist to helps facilitate healthy, and pain free activities to help lose weight.

It is essential to consider alternative treatment options and exhaust all other options before turning to these medicines. The potential harm that can be caused by blocking essential proteins and disrupting vital processes in the body should not be underestimated. It is crucial to discuss the potential risks and benefits with your veterinarian and explore other treatment modalities first.

Frequently Asked Questions

How Often Are Librela Injections Needed?

Librela injections are administered once a month to provide continuous pain relief for dogs with arthritis. The recommended dosing schedule is based on the dog's weight and should be followed as prescribed by the veterinarian. Monthly injections ensure that the active substance bedinvetmab remains effective in managing arthritis pain.

Can Any Dog Receive Librela Injection?

Not every dog is eligible for Librela injections. The use of Librela should be determined by a veterinarian based on the dog's individual health status and the presence of any pre-existing conditions. It is important to consult with a veterinarian to determine if Librela is a suitable treatment option for your dog.

What Should I Do if My Dog Experiences Side Effects? Report them to Zoetis Services

If your dog experiences side effects after receiving Librela injections, it is important to contact your veterinarian immediately so they may evaluate the complications and report them. They can assess the severity of the side effects and provide guidance on the appropriate course of action.

Are There Alternative Treatments to Consider?

Yes, there are alternative treatments available for managing arthritis pain in dogs. These may include nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, weight management, and supplements such as glucosamine and chondroitin. It is important to consult with a veterinarian to determine the most appropriate treatment plan for your dog based on their individual needs and health status.

It's also important to control your pet's weight to prevent the progression of arthritis. Given the statistic that over 50% of pets are reportedly overweight, it's easy to assume that the same number, and likely even more of arthritic pets that tend to be less active, have added weight contributing to their arthritis. A minimally processed homemade diet, such as Holistic Vet Blend, would be less likely to cause inflammation and contribute to a healthy weight for your pet. Check out our recipes here.

How Can I Discuss Librela with My Vet?

Schedule a consultation or appointment specifically to address your concerns about arthritis pain management for your pet. Your veterinarian can provide guidance and help you make an informed decision about using Librela for your dog.

It is important to report any adverse effects of Librela to your veterinarian.

References

(1)Caflas, J April 10, 2024 What Killed Their Pets? Owners Blame Meds, But Vets Aren't Sure

 https://www.wsj.com/health/pharma/dog-cat-arthritis-drugs-bcdddea6?