Rolling the Dice on Librela?
The latest product on the market to treat arthritis pain in dogs is called Librela. Technically speaking, it is an anti – Nerve Growth Factor monoclonal antibody. More simply put, it is a monthly injection for osteoarthritis pain, which inhibits nerve growth factor (NGF), to decrease the brain’s perception of pain and possibly the sensitivity of peripheral nerves.
Sounds great, right? Convenient, available in sizes suitable for varying body weights, and given as an injection so no pills to force down your dog’s throat or hide in messy treats.
The trouble is, adverse reaction reports have skyrocketed in the just over 12 months since Librela’s release. So many, in fact, that the FDA sent a “Dear Veterinarian” warning letter to veterinarians about these adverse events. You can read the summary and get further details at the FDA website. The letter describes what is happening as: “The adverse events identified and analyzed include: ataxia, seizures, other neurologic signs, including but not limited to, paresis, recumbency, urinary incontinence; polyuria, and polydipsia. In some cases, death (including euthanasia) was reported as an outcome of these adverse events.”
Nerve Growth Factor is essential for the development and survival of nerve cells (neurons). It is critical for the survival and maintenance of sympathetic and sensory neurons, which undergo apoptosis (death) when NGF levels are too low. So if Librela inhibits NGF too much for a dog, we may see neurological problems so severe that the dog cannot recover.
Veterinarians, including boarded neurologists and others with both general and advanced credentials are also sounding the alarm. Some point out the adverse outcomes, while others bring forward the 40 – 50% efficacy rate of Librela. Other practitioners point out the many options we have for a multimodal approach to arthritis cases, which can be tailored to the individual dog. These range from physical therapy to dietary management, pain medications, supportive supplements, and special techniques like laser therapy (photobiomodulation), chiropractic, and acupuncture. There is simply no reason to rely on a single product with both a mediocre efficacy rate and a serious adverse reaction rate high enough to initiate an FDA warning in its first year on the market.
Some owners will likely tell you that Librela was a miracle for their dog. And I am extremely happy for their good results. However, if this drug is used more widely, I believe we will see that more dogs are negatively impacted than we are comfortable with, and the success stories represent outliers. Should your veterinarian recommend Librela for your dog, I suggest you discuss it at length, as well as research the opinions of veterinary neurologists such as retired Cornell Veterinary College professor Dr. Curtis Dewey before you make a final decision.